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US MedTech: CMS Finalized FY27 IPPS: Broadly Supportive of Volumes in 2027
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US MedTech: CMS Finalized FY27 IPPS: Broadly Supportive of Volumes in 2027
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02 Aug 2026 20:32:48 ET │ 9 pages
US MedTech
CMS Finalized FY27 IPPS: Broadly Supportive of Volumes in 2027
CITI'S TAKE
The Centers for Medicare and Medicaid Services (CMS) has issued its
finalized rule for the Inpatient Prospective Payment System (IPPS),
including a 2.3% y/y increase in payment rates versus FY26, down
modestly from the proposed 2.3% increase (link) and FY26’s 2.6% – this Joanne WuenschAC
translates to $2.9B in incremental payments. On average, finalized rates +1-212-816-9606
for percutaneous coronary procedures and leadless pacemakers received joanne.wuensch@citi.com
the highest annual increases at ~6% while spine procedures are lowest at
Anthony Occhiogrosso ~flat (although with high variability amongst the codes). Additionally,
CMS is expanding its Comprehensive Care for Joint Replacement Model +1-212-816-7579
anthony.occhiogrosso@citi.com (CJR-X), intended to reduce “avoidable hospitalizations, complications,
and unnecessary costs for Medicare and taxpayers,” with most hospitals Jane-Marie Lai
required to participate beginning January 2028. We view these finalized +1-212-816-3628
rates as supportive of procedure volumes particularly for orthopedic (JNJ, janemarie.lai@citi.com
SYK, ZBH) and cardiovascular procedures (ABT, BSX, JNJ, MDT); these new Nikhil Guddeti
rates will take effect January 1, 2027. +1-212-816-2606
nikhiltej.guddeti@citi.com
Finalized rates for orthopedic procedures up low-single-digits. On average,
finalized payments for orthopedic codes we track are up 3.5% y/y, including hip or
knee replacement with MCC up 4.1% and without MCC up 3.0%. Additionally, CMS
has consolidated DRG codes 466-468 into code 499 with a finalized payment of
$16,009.
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