Medicare Part B Premium 2027: Wound Care and the $9.10 Drop

The standard Medicare Part B premium for 2027 is projected at $209.50 a month, and the more telling number is the one that disappeared. A year ago Medicare's trustees expected $218.60. The 2026 Medicare Trustees Report attributes lower projected Part B spending mainly to one line item: wound care products called skin substitutes, whose Part B spending climbed from $0.8 billion in 2021 to $14.1 billion in 2025 before a federal pay overhaul. Because the premium is set to cover about 25 percent of expected Part B spending, a lower spending path pulls it down too. Company filings show that overhaul is already cutting sales, and a second change proposed for 2027 would close a gap it left open. The projection also shrinks the hold-harmless shield to checks under about $183 a month.

The trustees' report, dated June 9, 2026, puts the 2027 increase at $6.60, or 3.25%, from this year's $202.90. The annual Part B deductible would rise to $292 from $283. These are estimates. The Centers for Medicare & Medicaid Services sets the official figures and released the 2026 numbers on Nov. 14, 2025, in a CMS fact sheet. That release raised the premium by $17.90, or 9.68% by TradeFlock's math, pushing it past $200.

On Google Trends, U.S. searches for "medicare premium 2027" scored 17 or lower on Google's 100-point scale through Sept. 30, then jumped to 74 on Oct. 14 and hit 100 on Oct. 17. Oct. 14 was the day the Social Security Administration announced a 3.6% cost-of-living adjustment for 2027. The agency said the average retirement benefit will rise by $75 a month, and that 2027 premium amounts will appear in my Social Security accounts in late November.

How Wound Care Spending Fed Into the Premium Forecast

Part B premiums are built to cover about 25 percent of expected Part B spending, with the Treasury's general fund paying about 73 percent, according to an October 2026 MedPAC primer on the Part B premium. When projected spending moves, the premium follows.

Projected spending did move a lot. The 2025 trustees' report, issued June 18, 2025, projected Part B spending of $714.0 billion in 2027. This year's report cuts that to $679.8 billion, a drop of $34.2 billion, or 4.8%. "Compared with last year's report, income and expenditures are lower in the short range mainly because of the assumed impact of policy changes for skin substitute payments," the trustees wrote. That sentence is about Part B income and spending, not the premium line itself.

The premium fell 4.2% in the same comparison, from $218.60 to $209.50, a similar proportion to the 4.8% spending cut. The report does not break down the $9.10 by cause, so how much of it traces to skin substitutes is TradeFlock's inference, not a published figure.

The 2026 report puts 2025 skin substitute spending at $14.1 billion, a 17.6-fold rise from 2021, and projects a decline of more than 90 percent in 2026 because of the 2026 physician fee schedule rule.

That rule, published in the Federal Register on Nov. 5, 2025 (90 FR 49266), stopped paying for most of these products as if they were biologicals priced at average sales price plus 6 percent. CMS now pays for them as incident-to supplies at a single rate of $127.14 per square centimeter (the Nov. 5 rule text said $127.28; CMS corrected it Nov. 28, 2025). In an Oct. 31, 2025, release, the agency said prices could reach more than $2,000 per square centimeter and estimated the change would cut fee-for-service spending on skin substitute services by $19.6 billion in 2026. Its premium fact sheet added that without the change, the 2026 increase "would have been about $11 more a month."

Wound Care Companies Show the Cut Is Real

MiMedx Group reported in its quarterly 10-Q filed July 29, 2026 that wound net sales fell to $25.1 million in the three months ended June 30 from $64.5 million a year earlier, a 61.1% decline "primarily driven by the continued impact of Medicare reimbursement changes effective January 1, 2026."

Convatec told investors on Aug. 4, 2026, in its first half results that revenue from its InnovaMatrix product fell by more than 90% after the U.S. reimbursement changes. The company said the $127 rate was a price cut of more than 85% for skin substitutes, booked a $69 million non-cash impairment covering all InnovaMatrix assets and now expects $5 million to $10 million of InnovaMatrix revenue in 2026, down from about $20 million.

Two sellers are not the whole market, but both filings point the same way as the trustees' assumption of sharply lower skin substitute spending.

The Loophole CMS Wants Closed in 2027

The 2026 rule did not cover everything. It left skin substitutes that do not come in sheet form to be priced by Medicare's regional contractors. CMS had said their billing units were hard to standardize, the Medicare Payment Advisory Commission noted in a Sept. 9, 2026, comment letter.

The 2027 physician fee schedule proposal, published July 16, 2026, would pay for those non-sheet products at the same national rate per square centimeter starting Jan. 1, 2027, and would measure the wound surface treated rather than the size of the product. MedPAC backed the idea, saying it would "protect beneficiaries and ensure good value for the Medicare program." As of Oct. 18, the final rule had not appeared in the Federal Register.

Our reading: if finalized, it closes the most obvious route for wound care billing to drift back up, which matters more for 2028 and later premiums than for 2027. The trustees' report predates the proposal.

Why Hold-Harmless Protects Far Fewer People in 2027

Federal law, at 42 U.S.C. 1395r(f), limits the dollar increase in a person's Part B premium to the dollar increase in their Social Security check, if the premium is deducted from that check. The trustees say this covers roughly 70 percent of Part B enrollees. New enrollees, people without Social Security checks, higher earners paying surcharges and dual Medicare and Medicaid enrollees are excluded.

The protection only kicks in when the raise is smaller than the premium increase. With a 3.6% COLA and a $6.60 increase, that happens only for benefits below about $183.33 a month, by TradeFlock's calculation. For 2026, with a 2.8% COLA listed in the SSA's COLA history and a $17.90 premium increase, the break-even benefit was about $639.29. Nearly everyone whose premium comes out of Social Security would pay the full 2027 increase if the projection holds.

For the average retiree, a $75 raise would shrink to $68.40 after a $6.60 premium increase, with the premium taking 8.8% of the raise. TradeFlock looked at the COLA estimate earlier in our story on the 2027 Social Security raise.

Higher Earners and the Bigger 2028 Step

About 8% of Part B enrollees pay an income-related surcharge, according to CMS. For 2026 the surcharges run from $81.20 to $487.00 a month. The trustees project 2027 surcharges of $83.70 to $502.60, which by TradeFlock's math would make total premiums about $293.20 to $712.10 on top of the $209.50 standard premium. The report's income-related table implies a $209.40 standard premium, $0.10 below the $209.50 used elsewhere, so treat those totals as approximate. The trustees expect 6.6 million people to pay them, up from 6.1 million. The top bracket, at $500,000 for individuals and $750,000 for couples, will not be indexed until 2028.

The slower 2027 increase also looks like a pause. The same report projects $224.50 for 2028, a $15.00 jump or 7.16%, and $360.60 by 2035. That works out to about 7.02% a year from 2027 to 2035, by TradeFlock's math.

A calendar quirk shows up in the trust fund numbers. Benefits normally due Sunday, Jan. 3, 2027, will be paid Thursday, Dec. 31, 2026, so about $5.8 billion of Part B premiums and matching money lands in 2026. That helps explain why the trustees show the Part B account taking in $36.6 billion more than it spends in 2026, then spending $7.6 billion more in 2027.

What Retirees Can Check Before the Official Number

Forecasts miss: last year's report projected a 2026 premium of $206.50, and the actual figure came in $3.60 lower. The official 2027 amounts will be posted on Medicare.gov's costs page.

Medicare Advantage members may pay less. MedPAC estimates that in 2026, 29 percent of enrollees in conventional Medicare Advantage plans are in plans that reduce the Part B premium, with a median cut of $61 a month. Plan details for next year are rolling out, as in Aetna's 2027 Medicare plans.

The number to watch when CMS publishes is whether it lands near $209.50. If it does, lower wound care spending will be one visible reason the increase is just over a third of last year's $17.90, though the trustees do not say how much.

Illustration: TradeFlock USA