CY 2027 proposed rule
What the Medicare PFS changes, specialty by specialty.
Fulcrum reconstructs the payment build-up behind the national estimates, then traces the proposed policies to the services and codes that move.
CMS-1848-P was released July 14, 2026. The comment period closed September 14, 2026. Figures remain subject to the final rule.
View the CMS rulePublished analysis
Begin with the evidence behind the specialty estimate.
The full dermatology analysis traces the national headline through the proposed policies, service categories, and code-level changes. Browse all 14 specialty summaries below.
Why the proposed impact is not evenly distributed.
CMS estimate -9.4% · Fulcrum reconstruction -9.9%
Read the full analysis →Browse by specialty
Find the services that matter to your practice.
These 14 summaries show proposed changes in RVU-based allowed charges, before the separate conversion-factor adjustment. Each includes service-category charts and practitioner impact.
Dermatology
Specialty summary · charts and practitioner distribution
Otolaryngology (ENT)
Specialty summary · charts and practitioner distribution
Orthopedic Surgery
Specialty summary · charts and practitioner distribution
Podiatry
Specialty summary · charts and practitioner distribution
Ophthalmology
Specialty summary · charts and practitioner distribution
Optometry
Specialty summary · charts and practitioner distribution
Interventional Pain Management
Specialty summary · charts and practitioner distribution
Cardiology
Specialty summary · charts and practitioner distribution
Nurse Practitioner Practices
Specialty summary · charts and practitioner distribution
Psychiatry
Specialty summary · charts and practitioner distribution
Internal Medicine
Specialty summary · charts and practitioner distribution
Physical & Occupational Therapy
Specialty summary · charts and practitioner distribution
Family Practice
Specialty summary · charts and practitioner distribution
Clinical Social Work
Specialty summary · charts and practitioner distribution
Methodology
Specialty estimates are context. Utilization creates the forecast.
Fulcrum holds CMS's 2025 utilization basis constant, reconstructs the proposed Medicare payment build-up, and isolates the policies and codes driving each specialty result. A practice forecast goes further by applying those changes to the organization's actual CPT mix, locality, sites of service, and Medicare-linked contracts.
Read the full methodology →Your practice
See where your own service mix lands.
Start with your claims export and contract set, shared through the agreed secure transfer process. Fulcrum models the Medicare and commercial impact on your practice.