FY 2027 IPPS Updates
Instructor
Cari Greenwood, RHIA, CCS, CPC, CICADescription
Prepare for the FY 2027 Inpatient Prospective Payment System changes with HIAlearn’s self-paced course. This course reviews the IPPS updates affecting inpatient coding, including MS-DRG changes, Non-OR to OR DRG changes, Medicare Code Editor updates, ICD-10-CM and ICD-10-PCS updates, and New Technology Add-on Payments.
Payment changes will also be briefly discussed to provide context for their coding and reimbursement impact. Designed for inpatient coders and coding leaders, this approximately 90-minute course provides the information needed to apply the FY 2027 changes beginning October 1, 2026.
Key Takeaways
- Payment Rate Changes: Eligible acute care hospitals that report quality data and are meaningful users of electronic health records will receive an approximately 2.3% increase in Medicare operating rates.
- MS-DRG Updates: CMS deleted 18 MS-DRGs, created 14 new MS-DRGs and revised the titles of 23 MS-DRGs for FY 2027.
- Major Areas of Change: Many of the MS-DRG changes affect MDC 05, Diseases and Disorders of the Circulatory System, and MDC 08, Diseases and Disorders of the Musculoskeletal System and Connective Tissue.
- Procedure Reassignments: Review changes affecting cardiac pacemaker procedures, antibiotic-eluting bone void filler, spinal fusion, hip and knee procedures, and procedures involving uterine and adnexa malignancies.
- NTAP Updates: Learn about the services and technologies approved for FY 2027 New Technology Add-on Payments and why accurate documentation and coding are essential for capturing available reimbursement.
- CJR-X Model: Explore the new Comprehensive Care for Joint Replacement–Expanded Model, including its focus on spending and quality during the procedure and the 90 days following discharge.
- Code Update Connection: Understand how FY 2027 ICD-10-CM and ICD-10-PCS changes interact with MS-DRG assignment, Medicare Code Editor logic and inpatient reimbursement.
- Implementation Date: Apply the FY 2027 IPPS updates to discharges beginning October 1, 2026.
- Non-OR to OR Changes: Review procedures that have changed from Non-OR to OR status and how those updates affect MS-DRG assignment.
- Medicare Code Editor Updates: Examine FY 2027 Medicare Code Editor changes affecting edits, code assignment and inpatient claim reporting.
FAQs
What are the major MS-DRG changes for FY 2027?
CMS deleted 18 MS-DRGs, created 14 new MS-DRGs and revised the titles of 23 MS-DRGs. Many of the changes affect circulatory and musculoskeletal conditions and procedures, including cardiac pacemaker procedures, spinal fusion, joint procedures and antibiotic-eluting bone void filler.
How are hospital payment rates changing for FY 2027?
Acute care hospitals that report required quality data and are meaningful users of electronic health records will receive an approximately 2.3% increase in Medicare operating rates. Hospitals that do not meet quality-reporting or electronic health record requirements may receive a reduced or negative update.
What is changing with New Technology Add-on Payments for FY 2027?
FY 2027 includes technologies continuing from the previous year as well as newly approved technologies under the traditional and alternative pathways. Because some technologies qualify for significant additional reimbursement, organizations must accurately identify, document and code their use.
When do the FY 2027 IPPS updates take effect?
The FY 2027 IPPS updates take effect October 1, 2026. Inpatient coding and revenue cycle teams should review the MS-DRG, Medicare Code Editor, ICD-10-CM, ICD-10-PCS, NTAP and payment policy changes before implementation.
About Our Medical Coding Courses
HIAlearn, powered by Health Information Associates (HIA)—a leader in medical coding and auditing for more than three decades—offers a flexible, online education platform designed for today’s coders. With a growing catalog of AHIMA and AAPC-approved coding courses, HIAlearn supports both beginners and experienced coders looking to build confidence, accuracy, and CEU credits.
Courses are available across various coding types including CPT, E/M, ICD-10-CM, and ICD-10-PCS, and are designed for multiple specialties including inpatient, outpatient, profee, and CDI.
To stay up to date, coders can explore our Coding Updates hub for the latest ICD-10-CM, ICD-10-PCS, CPT, and IPPS changes. HIAlearn also supports organizations with group discounts and scalable team access, promoting accuracy, compliance, and continuous professional development across departments.
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