Visit calculator: 2026 vs 2027

Build a visit: an office E/M and the procedures done that day. The calculator adds the modifiers, applies Medicare's multiple-procedure reduction, and shows what the visit pays in 2026, in 2027 at the new rates, and in 2027 with the new same-day E/M cut. CMS's final rule leaves open how that cut combines with the other reductions. The calculator starts on the reading closest to CMS's own worked example; pick another to see the worst and best cases.

• Modifier 25 goes on the E/M whenever a procedure is done the same day; modifier 51 marks each procedure paid at 50% under the multiple-procedure rule (highest-paid procedure 100%, the rest 50%; add-on codes are exempt).
• NCCI edits: when two codes in the visit have a CMS procedure-to-procedure edit, the second code is either never paid with the first (shown as $0, "included in") or paid only when it was done on a separate lesion or site, with modifier 59 or XS (added here, assuming that is true). CMS NCCI practitioner PTP edits. Repeat units of the same code are not checked (those fall under CMS's unit limits, not these edits).
• The 2027 cut, in CMS's words: "a 20 percent reduction in payment to all services except the highest value service when an O/O E/M visit is performed on the same day with the same practitioner (or a practitioner of the same specialty in the same group practice) as a service with a 0-day global period" (91 FR 70992, Federal Register, Nov. 9, 2026). It applies only to office/outpatient E/M codes 99202-99215 and only when a 0-day global procedure is billed; 10- and 90-day global procedures alone do not trigger it. The rule does not say whether the 20% stacks on the multiple-procedure cut or reaches 10/90-day and add-on codes billed the same day, so each reading is offered.
• Office (non-facility) amounts for your locality, before the patient's deductible and 20% coinsurance and before sequestration. 2026 = CMS RVU26D; 2027 = RVU27A. All 2027 amounts are for clinicians who are not in an Advanced Alternative Payment Model (APM), which is nearly every dermatologist.
• The 1.0 floor on the work geographic index (GPCI) expired for 2027. If your locality's work GPCI is below 1.0, an extra tile shows what this visit would have kept had the floor continued.
• Code descriptions are our own plain-English summaries, not official CPT descriptors.