Gastroenterology reimbursement continues to erode under Medicare and commercial payment models, even as operating costs, staffing pressures and inflation rise.
From steep long-term inflation-adjusted cuts to new 2026 ASC reductions, here are 10 data points illustrating how reimbursement trends are reshaping GI practice economics:
1. Beginning Jan. 1, 2026, Medicare will reduce payments for GI endoscopy services performed in ASCs by an average of 8%, while increasing reimbursement for office-based E/M visits.
2. Between 2018 and 2023, inflation-adjusted Medicare payments to physicians for colonoscopies declined by more than 22%, according to The American Journal of Gastroenterology.
3. Over the same five-year period, inflation-adjusted Medicare payments for esophagogastroduodenoscopies also fell by more than 22%.
4. From 2007 to 2022, unadjusted GI reimbursement declined 7%, highlighting long-term downward pressure even before inflation is considered.
5. When adjusted for inflation, GI reimbursement dropped 33% over that same 2007–2022 period, widening the gap between payments and practice expenses.
6. Colonoscopy reimbursement has fallen more than 40% since 2001, even as ASC revenue growth has shifted the balance between professional and facility fees, according to a Nov. 21 Medscape report.
7. CMS implemented a 2.5% reduction to work RVUs for endoscopy and other non-time-based codes, arguing efficiency gains. GI societies counter that the policy undermines congressional conversion factor increases and risks further devaluation, especially since the adjustment is recalculated every three years with no floor.
8. Average gastroenterologist compensation dropped from $512,000 in 2023 to $495,000 in 2024, a 3% nominal decrease.
9. Adjusted for inflation, $370,000 in 2015 equates to roughly $502,930 today, meaning the 2024 average salary represents a real-term pay cut despite rising practice costs.10. Only 37% of gastroenterologists say they feel fairly compensated, and 32% report taking on additional work to supplement income — intensifying concerns around burnout, retention and the shift toward hospital employment.
