November 30, 2019

CMS Medicare Physician Fee Schedule Final Rule Increases Value for Minimally Invasive SI Joint Spine Fusion

In the 2020 Medicare Physician Fee Schedule Final Rule, released on Nov. 1, CMS finalized a work RVU of 12.13 for CPT code 27279, Arthrodesis, sacroiliac joint, percutaneous or minimally invasive (indirect visualization), with image guidance, includes obtaining bone graft when performed, and placement of transfixing device. The current (2019) work RVU for 27279 is 9.03 so the increase is 3.10 or approximately 33%.  In addition, the Total RVUS for CPT 27279 changed from 2019 to 2020 from 19.99 to 25.34. These increases have long been advocated by ISASS and other stakeholders. ISASS had submitted comments to CMS on the 2020 Medicare Physician Fee Schedule Proposed Rule in September, where CMS indicated a proposed value of 9.03 work RVU. At […]
March 28, 2019

ISASS Meets with the Office of Management and Budget (OMB) Officials Regarding Reimbursement of Minimally Invasive Spine Surgery

ISASS Coding and Reimbursement Task Force Chair Dr. Morgan Lorio participated in a meeting with officials from the Office of Management and Budget (OMB) to discuss reimbursement of minimally invasive spine surgery procedures in the Medicare Physician Fee Schedule. The meeting occurred March 19, 2019, and was focused on the undervaluation of spine surgical procedures in the Medicare Physician Fee Schedule. Dr. Lorio described two clear examples of mis-valuation of minimally invasive spinal procedure in CPT code 27279, Minimally Invasive Sacroiliac Joint Fusion, and 22867, Interlaminar Spinal Stabilization. The Centers for Medicare and Medicaid Services (CMS) have already identified as potentially misvalued in previous Medicare Physician Fee Schedules but have not changed the Relative Value Units (RVUs) for 27279. OMB […]