The 2027 modifier 25 cut for dermatology procedures
Starting in 2027, when an office visit billed with modifier 25 is done the same day as a procedure with a 0-day global period, Medicare pays the highest-valued service in full and cuts every other service 20% (CMS final rule, Federal Register, Nov. 9, 2026). With one procedure and one visit, that means the lower-valued of the two is paid at 80%. Pick your locality and the visit level to see what each procedure-plus-visit pair pays in 2026 and 2027; for more than one procedure, use the visit calculator.
How to read each row: Procedure alone is what the procedure pays with no visit that day. Same day as a 99213 visit, 2027 splits the 2027 payment when both are billed together: whichever of the two is worth less is cut to 80% (highlighted), the other is paid in full. Visit + procedure total adds the two up: 2026 (no cut) vs 2027 (with the cut).
| Code | Description | Procedure alone | Same day as a 99213 visit, 2027 | Visit + procedure total | ||||
|---|---|---|---|---|---|---|---|---|
| 2026 | 2027 | Procedure paid | Visit paid | 2026 | 2027 | Change | ||
- The cut comes from CMS's CY 2027 physician fee schedule final rule (CMS-1848-F, 91 FR 70992, Federal Register text): "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." It is triggered only by procedures with a 0-day global period; 10- and 90-day global procedures (for example destruction codes 17000 and 17110) are not affected. Cut amounts are shown in red.
- The 2026 "Visit + procedure total" is the full visit plus the full procedure, with no same-day reduction. With more than one procedure the usual multiple-procedure reduction also applies; this table shows one procedure with one visit.
- Rates are office (non-facility) amounts for your locality, before the patient's deductible and 20% coinsurance and before sequestration. 2026 uses CMS's October 2026 release (RVU26D); 2027 uses the January 2027 release (RVU27A). All 2027 amounts are for clinicians who are not in an Advanced Alternative Payment Model (APM), which is nearly every dermatologist. In localities whose work GPCI is below 1.0, 2027 also reflects the expired 1.0 work floor; the rates page and visit calculator show what it costs.
- Code descriptions are our own plain-English summaries, not official CPT descriptors.