Medicare Officially Cuts Payments for Outpatient Surgeries and Procedures

Tara Bannow covers hospitals, providers and insurers. You can reach Tara on Signal at tarabannow.70.

Medicare on Friday followed through on its earlier proposal to reduce payment for surgeries, outpatient procedures and other services that it says can be made more efficient starting in 2026.

This controversial decision represents a significant change in the pricing of thousands of medical services under Medicare. It’s a blow to the powerful doctors’ lobby that has long controlled procedure pricing and could help ensure more equitable pay between specialists and primary care doctors.

So-called efficiency adjustment assumes that technological advances and standardized workflows have reduced the time and expense required to perform certain procedures – changes that reimbursement had not accounted for. These services will see their reimbursement reduced by 2.5% starting January 1, 2026, unlike time-based services, such as office visits or behavioral health therapy. Telehealth and some maternity services will also not be affected.