2027 Gastroenterology Reimbursement and Coding Update (Virtual) | November 2026-Breaking News in GI: What’s Now and What’s Next for 2027

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The presentation reviews 2027 policy and coding changes affecting gastroenterology practices. It was delivered by Kathleen Mueller of AskMueller Consulting, who disclosed consulting fees from Boston Scientific. The material reflects information available when the course was given on November 14, 2026; practices are advised to verify current payer rules and regulations.

Key updates include:

- <strong>ASC payments:</strong> CMS finalized a 2.3% rate increase for ASCs meeting quality-reporting requirements and will remove a colonoscopy follow-up quality measure beginning with the 2027 reporting period.
- <strong>Physician payments:</strong> The 2027 Medicare conversion factors are $32.95 for Advanced APM participants and $32.63 for other clinicians. CMS also finalized payment changes for same-day E/M visits and procedures, plans to replace G2211 with modifiers B1 or B2 for documented longitudinal care, and delayed an RPM/RTM staffing requirement until 2029.
- <strong>New codes:</strong> CPT changes effective January 1, 2027 include upper- and lower-GI endoscopic submucosal dissection codes and revised biofeedback-training codes. The ICD-10-CM update effective October 1, 2026 adds 238 diagnoses, revises four codes, and deletes 21.
- <strong>Colorectal cancer screening:</strong> Medicare’s updated coverage includes qualifying noninvasive biomarker tests once every three years for eligible, asymptomatic, average-risk patients ages 45–85. From January 1, 2027, beneficiary coinsurance falls to 10% when a screening colonoscopy becomes therapeutic; it is scheduled to reach zero in 2030.
- <strong>Surveillance colonoscopy:</strong> Cost-sharing depends on the clinical indication, insurance type, federal and state requirements, and payer policy. Screening, follow-up after a positive noninvasive test, and surveillance for prior polyps or cancer are distinct categories and should not be treated interchangeably.

The presentation also flags broader practice concerns, including E/M coding, advanced endoscopy, pathology and ancillary services, audits, payer downcoding, AI, and revenue-cycle improvement.

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Kathleen A. Mueller, RN, CPC, QMC, QGMC, CCS-P, ICD-10 Proficient

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Keywords

gastroenterology

CMS

2027 policy changes

Medicare conversion factor

ASC payments

colonoscopy screening

ICD-10-CM updates

CPT codes

advanced endoscopy

revenue cycle

Ambulatory Surgical Center Fee Schedule

Physician Fee Schedule

Colorectal Cancer Screening

Screening Colonoscopy

Surgical Center