Medicare Conversion Factor 2026 (QP and Non-QP) and 2027
The Medicare conversion factor for 2026 is 33.4009 for most clinicians and 33.5675 for qualifying APM participants. How it works, its history and the 2027 proposal.
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The 2026 Medicare Physician Fee Schedule conversion factor is 33.4009 dollars per RVU for most clinicians (the non-qualifying APM conversion factor) and 33.5675 for qualifying APM participants (QPs), effective January 1, 2026. Both are up from the single 2025 conversion factor of 32.3465, by 3.26% and 3.77%, mostly because of a one-year 2.5% increase set by statute that expires at the end of 2026.
Key takeaways
- 2026 is the first year with two conversion factors: 33.4009 (non-QP) and 33.5675 (QP).
- The anesthesia conversion factors are 20.4976 (non-QP) and 20.5998 (QP), before locality adjustment.
- The conversion factor turns geographically adjusted RVUs into the allowed amount. It's the same in every locality and both settings.
- It doesn't change in the quarterly RVU updates; it changes each January with the final rule (and in 2024, mid-year by law).
- CMS's CY 2027 proposed rule would lower it to about 32.84 (non-QP) and 33.17 (QP) when the 2.5% increase lapses.
The 2026 conversion factors
| Non-qualifying APM (most clinicians) | Qualifying APM participant (QP) | |
|---|---|---|
| PFS conversion factor | 33.4009 | 33.5675 |
| Change from 2025 (32.3465) | +3.26% | +3.77% |
| Statutory update | +0.25% | +0.75% |
| Anesthesia conversion factor | 20.4976 | 20.5998 |
CMS built both from the 2025 conversion factor in the same order: a +0.49% budget neutrality adjustment for RVU changes, the APM-specific statutory update under section 1848(d)(20) of the Social Security Act, then the one-year 2.50% increase for 2026 (CY 2026 PFS final rule, 90 FR 49960–49961). CMS identifies the 2.5% as coming from Public Law 119-21.
Who is a QP? A clinician who meets CMS's participation thresholds in an Advanced Alternative Payment Model for the performance period, as determined under the Quality Payment Program. If you don't know that you're a QP, you're paid with the non-QP conversion factor. FeeBase shows non-QP rates by default.
Sources: CY 2026 PFS final rule (CMS-1832-F), 90 FR 49266, Nov. 5, 2025, conversion factor calculation at 90 FR 49960–49961; CMS fact sheet, CY 2026 PFS final rule (Oct. 31, 2025); CY 2025 PFS final rule, 89 FR 97710, 98499–98500. Verified October 6, 2026.
How the conversion factor turns RVUs into dollars
Every code on the fee schedule has three relative value units: work, practice expense (PE) and malpractice (MP). Each is multiplied by its geographic practice cost index (GPCI) for the locality, the three are added, and the sum is multiplied by the conversion factor:
- Work: work RVU × work GPCI
- Practice expense: PE RVU (office or facility) × PE GPCI
- Malpractice: MP RVU × MP GPCI
- Allowed amount: (work + PE + MP) × conversion factor
The conversion factor is the only national number in the formula. A 1% change to it moves every code's payment by 1% in every locality. Here's the arithmetic for 99213, with sliders for the GPCIs:
How the rate is built · 99213
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.30Practice expense 1.46Malpractice 0.09
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
For a deeper look at RVUs and GPCIs, see what an RVU is, or run any code at your ZIP in the RVU calculator. Where the facility and office PE values come from is covered in facility vs non-facility.
Why your 2026 rates didn't all rise 3.26%
The conversion factor rose, but RVUs changed too. Three 2026 policies pulled individual codes in different directions:
- The efficiency adjustment. CMS finalized a −2.5% adjustment to work RVUs for non-time-based services. E/M visits, care management and telehealth services were excluded (CMS fact sheet, Oct. 31, 2025). Many procedures gained less than the conversion factor.
- The site-of-service change to practice expense. CMS cut the indirect PE allocated to facility services, so facility rates fell relative to office rates (90 FR 49296).
- Ordinary revaluations of individual codes and the budget neutrality adjustment that offsets them.
Compare two visit levels and a therapy code at the current release:
Compare codes
99213 vs 99214 vs 97110: national Medicare rates
Swap in your local Medicare rate.
Conversion factor history: 2024 to 2027
| Period | Conversion factor | What drove it |
|---|---|---|
| Jan 1 – Mar 8, 2024 | 32.7442 | CY 2024 final rule, including a temporary 1.25% increase from the Consolidated Appropriations Act, 2023 |
| Mar 9 – Dec 31, 2024 | 33.2875 | The Consolidated Appropriations Act, 2024 replaced the 1.25% with a 2.93% increase mid-year |
| 2025 | 32.3465 | 2.93% increase removed; 0.00% statutory update; +0.02% budget neutrality |
| 2026 non-QP | 33.4009 | +0.25% update, +0.49% budget neutrality, one-year +2.50% |
| 2026 QP | 33.5675 | +0.75% update, +0.49% budget neutrality, one-year +2.50% |
| 2027 proposed, non-QP | 32.84 | 2.50% increase lapses; +0.25% update; +0.53% adjustment |
| 2027 proposed, QP | 33.17 | 2.50% increase lapses; +0.75% update; +0.53% adjustment |
In 2024, services furnished on or after March 9 were priced at 33.2875 and earlier services at 32.7442, so the same code paid two amounts within the year. FeeBase keeps each quarterly CMS release from 2025 onward with its effective dates, so a rate matches its date of service.
What the CY 2027 proposed rule says
CMS released the CY 2027 PFS proposed rule on July 14, 2026. Its fact sheet proposes a qualifying APM conversion factor of 33.17, down 1.19% from 33.57, and a non-qualifying conversion factor of 32.84, down 1.68% from 33.40. The statutory updates are +0.75% (QP) and +0.25% (non-QP), with an estimated +0.53% adjustment for proposed work RVU changes. The main reason for the decline is that the one-year 2.50% increase for 2026 "will no longer be in effect for CY 2027." CMS states this "effectively means that current law requires -2.50% reduction in Medicare payment under the PFS compared to CY 2026."
These are proposed values, rounded to the cent in the fact sheet. The final 2027 conversion factors come with the CY 2027 final rule, and Congress can still change them by law, as it did in 2024 and 2026.
Sources: CY 2025 PFS final rule, 89 FR 98499–98500 (CY 2024 and 2025 conversion factors, Table 108); CY 2026 PFS final rule, 90 FR 49960–49961; CMS fact sheet, CY 2027 PFS proposed rule (CMS-1848-P), July 14, 2026. Verified October 6, 2026.
Get an email when CMS publishes the final 2027 conversion factor and your codes' new rates.
FAQ
What is the 2026 Medicare conversion factor?
33.4009 for clinicians who aren't qualifying APM participants (most practices) and 33.5675 for qualifying APM participants, effective January 1, 2026 (CY 2026 PFS final rule).
How is the Medicare conversion factor calculated?
CMS starts from the prior year's conversion factor, applies a budget neutrality adjustment so RVU changes don't raise total spending, then applies the update set by statute. For 2026 that meant the 2025 factor × 1.0049 budget neutrality × the 0.25% or 0.75% update × the one-year 2.5% increase.
What is the current Medicare anesthesia conversion factor?
For 2026 the national anesthesia conversion factor is 20.4976 for non-QPs and 20.5998 for QPs. Each MAC publishes locality-adjusted anesthesia conversion factors.
Why are there two conversion factors in 2026?
Section 1848(d)(20) of the Social Security Act sets separate annual updates, starting in 2026, for qualifying APM participants (+0.75% a year) and everyone else (+0.25% a year). Under current law the gap between the two grows each year.
Will the conversion factor go down in 2027?
CMS has proposed 32.84 (non-QP) and 33.17 (QP) for 2027, decreases of 1.68% and 1.19%, because the 2026 one-year 2.5% increase expires. The final values come with the CY 2027 final rule.
Related tools and guides
Payment basicsFacility vs Non-Facility Rates: How Medicare Pays by Setting
Facility vs non-facility: Medicare's two fee schedule rates per code. Only the practice expense RVU differs, and the place of service code decides which applies.
Payment basicsWhat Is an RVU? Relative Value Units Explained (2026)
What is an RVU? A relative value unit is Medicare's measure of the resources behind a service. Work vs total RVUs, GPCIs and how RVUs become payment.
Visits and programsG2211: Medicare Billing Guidelines, RVUs and Modifier 25
G2211 is Medicare's add-on for the ongoing relationship behind an office or home E/M visit. Who can bill it, the modifier 25 rule, RVUs and 2026 changes.
