What would you do differently this December if you knew that, starting January 1, roughly $100,000 a year of your collections was simply going to stop showing up? Run through one reasonable set of assumptions, that's close to what the proposed 2027 Medicare fee schedule could mean for a surgeon collecting $1.5 million a year, and most year-end reviews are built to answer a completely different question than the one that actually matters right now.

In this episode, Jared flips the year-end practice review around to face forward instead of backward, with five questions built around CMS's proposed CY 2027 Physician Fee Schedule: what the proposal actually does to your top ten billing codes, how much of your commercial revenue is priced off Medicare's current fee schedule (and what that means at contract renewal), where each procedure is actually most profitable by site, whether the cash sitting in your practice is doing a job before December 31 (payroll deferrals, the pass-through entity tax election, and bonus depreciation all have year-end deadlines), and whether next year's budget is quietly built on this year's rates.

He walks through a worked example on the proposed cuts (roughly $110,000 a year in collections for a hypothetical $1.5 million-collections surgeon, split between Medicare and Medicare-pegged commercial contracts) and a separate one on the pass-through entity tax election (turning $36,000 of otherwise-nondeductible state tax into roughly $13,000 of federal tax value).