CMS releases 2027 HOPPS and MPFS final rules
November 9, 2026
Numerous major policy changes in the 2027 Medicare Physician Fee Schedule (MPFS) and Hospital Outpatient Prospective Payment System (HOPPS) final rules from the Centers for Medicare and Medicaid Services (CMS) will have divergent impacts on radiation oncologists, hospitals and freestanding centers when implemented on January 1, 2027.
ASTRO’s MPFS and HOPPS summaries provide details on the policies, but here’s a snapshot of how different segments of the radiation oncology community will fare:
Radiation oncologists: High-volume radiation therapy professional service codes are scheduled for some of the biggest cuts in years, ranging from 4% to 6% and largely driven by reductions to the conversion factor, including the expiration of a 2.5% statutory fix. ASTRO and other physician groups are urging Congress to address the conversion factor before year-end.
Hospitals: Hospital technical payments for radiation therapy codes will see significant increases in 2027, thanks to changes to 340B drug payment policy that bump up reimbursement for nondrug services. Hospitals also get a big boost from CMS agreeing to ASTRO’s recommendation to reassign CPT® code 77407 to a more appropriately reimbursed payment group.
Freestanding centers: Freestanding center technical reimbursement will benefit from increases to treatment delivery codes due to increases on hospital technical payments that inform these rates. Increases reach as high as 21% for code 77412, an important boost for freestanding centers digging out of a massive hole from 2026. However, CMS failed to crosswalk the reassignment of code 77407 to freestanding payments, leaving centers well underwater for that high-volume code and widening the gap between hospital and freestanding payment.
While there are some positives in the final rules, ASTRO will continue advocating with CMS for regulatory changes to address significant problems, particularly the failure to crosswalk code 77407, which risks further closures and consolidations. At the same time, ASTRO will lobby Congress to provide an immediate fix to professional code cuts from the conversion factor and comprehensive payment reform via the Radiation Oncology Case Rate (ROCR).
