Medicare Cuts General Surgeon Reimbursements by 6% Effective Jan 1, 2021

On Tuesday, December 1, 2020, the Centers for Medicare and Medicaid Services (CMS) released the calendar year (CY) 2021 Medicare Physician Fee Schedule (MPFS) final rule. As is customary, the final rule lays out the payment rates for physician services for the following calendar year. However, in 2020 rulemaking, CMS finalized increases in the payment levels for standalone office and outpatient E/M codes slated to take effect on January 1, 2021. Because the increases to these codes are so significant, they have caused a significant redistribution of Medicare dollars such that CMS proposed to cut the CY 2021 Medicare Physician Fee Schedule conversion factor by ‑10.6%, which would result in a net reduction of reimbursements to general surgeons of -7.0% in 2021. The final rule has codified these policies for CY 2021, resulting in a CY 2021 conversion factor of $32.4085 (a -10.2% reduction over 2020), with an estimated reduction in reimbursements to general surgeons of -6.0%.

While the policies are effective January 1, 2021, ASBrS will continue its advocacy efforts at the federal legislative level to seek a remedy to avoid these devastating cuts. As a result of the surgical community’s efforts, bipartisan legislation has already been introduced to avert these cuts. We appreciate the outreach that ASBrS members have conducted already to engage their members of Congress on this issue. We will continue to provide updates as we increase our outreach efforts in the wake of the finale rule given that Congress must act to avoid these devastating cuts in the middle of the COVID-19 public health emergency from going into effect before the end of the year.

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