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Medicare outpatient rule: 2.3% more, wider site-neutral pay
Published Nov 13, 2026 · Last checked Nov 13, 2026 · Last changed Nov 13, 2026Medicare's final outpatient rule for 2027 raises hospital outpatient rates by 2.3% and extends lower site-neutral payment to imaging at certain off-campus departments.
- For
- Hospitals. Operations, compliance, IT. Also medical practices owned by a hospital.
The facts
- CMS finalized the 2027 outpatient and surgery center rule on Nov 4, 2026.
- Outpatient rates rise 2.3% for hospitals that meet the quality reporting rules.
- CMS will pay the lower physician fee schedule rate for imaging without contrast at certain off-campus hospital departments. Rural sole community hospitals are exempt.
- CMS expects that change to save Medicare $260 million in 2027.
- Drugs bought under the 340B program will be paid at average sales price minus 28%.
- CMS is removing 637 services from the inpatient-only list in 2027.
What it means for you
In 2027, off-campus imaging and 340B drugs bring a hospital less from Medicare, while the base outpatient rate rises 2.3%.
Sources
- Becker's ASC Review, trade publication, Nov 2026.