The Centers for Medicare & Medicaid Services (CMS) just released the details of its proposed payment rule for 2027, and gastroenterology practices have good reason to pay attention.
While ambulatory surgery centers (ASCs) that meet quality reporting requirements would receive an overall payment update, CMS is also proposing across-the-board reimbursement reductions for the common GI endoscopy procedures that most practices rely on for financial stability.
According to the American Gastroenterological Association (AGA), aggregate ASC payments for many GI procedures would decrease by approximately 2%, with some high-volume endoscopy codes seeing cuts of up to 8%.
You can read the AGA’s summary of the proposal here:
Proposed Cuts to GI ASC Payments in Store for 2027.
Why This Matters
For GI practices, even modest reimbursement changes can have a big impact over the course of a year, especially when those changes hit high-volume procedures like colonoscopies and EGD with biopsy and lesion removal. As margins tighten, operational efficiency becomes more important. Practices that reduce overhead, improve procedural workflows, and optimize staffing will find themselves better positioned to navigate reimbursement changes without compromising patient care.
The proposed rule also reinforces a trend many physicians have been experiencing for years: annual reimbursement updates are becoming less predictable, making long-term operational planning just as important as the payment rates themselves.
Looking Beyond Reimbursement
While fee schedules usually dominate the conversation, reimbursement is only one part of the picture. The proposed payment changes also continue a broader shift toward performing appropriate lower-acuity procedures in office-based settings.
For some GI practices, that may create an opportunity to re-evaluate site-of-care strategies and determine whether certain procedures can be delivered more efficiently outside the ASC while maintaining high standards for patient safety and clinical outcomes.
Every practice has different operational and financial considerations, and there is no one-size-fits-all approach. However, as reimbursement models continue to evolve, practices that periodically assess the economics of ASC versus office-based care will be better positioned to make informed decisions and adapt to future changes.
The Rule Isn’t Final Yet
It’s important to remember that these are proposed payment changes. CMS is accepting public comments before publishing the final rule later this year, and some provisions may change before taking effect on January 1, 2027.
If you’d like to review the proposal directly, CMS has published an overview of the proposed rule here:
CY 2027 Hospital Outpatient Prospective Payment System and ASC Proposed Rule.
See the Financial Impact on Your Practice
Wondering how different anesthesia and procedural models could affect your bottom line? AAC’s GI Reimbursement Calculator helps practices estimate the financial impact of different anesthesia delivery models using real-world assumptions.