Contract intelligence
Structure payer products, fee schedules, Medicare tiebacks, and effective dates in one usable model.
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Practice financial intelligence
See how every contract, payment, and service line performs. Model visits, injections, ablations, implants, and facility-sensitive procedures against every payer contract.

Financial visibility for Interventional Pain Management
Fulcrum connects contract logic, CPT utilization, and payment data across office and facility settings so pain practices can see expected reimbursement and precise service economics.
One connected intelligence layer
Structure payer products, fee schedules, Medicare tiebacks, and effective dates in one usable model.
Detect and investigate potential underpayments in an automated, accurate way.
Test proposed rates against actual volume and bring clear evidence into payer conversations.
Integrate encounter and cost data to see precise unit economics for specific CPT codes.
What becomes answerable
CY 2027 proposed PFS
A national specialty average is useful context, not a practice forecast. Your result depends on your codes, volume, locality, sites of service, and Medicare-linked contracts.
CMS's own reconciliation table (Table D-B5) puts interventional pain management at -1.2% for 2027. That figure is the specialty-wide, volume-weighted change in total RVU-based allowed charges: the aggregate gain or loss across every code the specialty bills, before the separate conversion-factor cut. Our reconstruction agrees closely at -1.3%, a net reduction of $11 million in national allowed charges.
Interventional Pain Management bills about 81% of its Medicare dollars in the office (non-facility) setting, where nearly all of the change lands.
All figures are national, hold 2025 utilization fixed, and exclude the separate 1.68% conversion-factor cut that lands on every specialty on top of this.


The specialty average hides a wide spread, and CMS's own practitioner-level file proves it. 48% of interventional pain management practitioners land in the -1 to +1% band, and about 16% see a cut deeper than 2%. Where a practice lands is a question of service mix: the interventional pain management practices hit hardest are those with the most image-guided injection and radiofrequency-ablation volume.
Practice-specific analysis
Start with one contract, one fee-schedule question, or an ongoing view across the practice.