US CMS to provide increased 2017 reimbursement for minimally invasive sacroiliac joint fusion

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Some sacroiliac joint fusion devices on the market from left to right: SI-Bone iFuse, Globus Medical SI-Lok, NuTech SI-Fix, Zyga SImmetry
Some sacroiliac joint fusion devices on the market from left to right: SI-Bone iFuse, Globus Medical SI-Lok, NuTech SI-Fix, Zyga SImmetry

The US Centers for Medicare & Medicaid Services (CMS) has issued its 2017 Final Hospital Outpatient Prospective Payment System (HOPPS) and Ambulatory Surgical Center (ASC) payment rule for minimally invasive sacroiliac joint fusion.

The final payment rule shows American Medical Association Current Procedural Terminology code 27279 (for minimally invasive sacroiliac joint fusion) has been assigned to Ambulatory Payment Classification 5116. An increased Medicare national average hospital outpatient payment is to be been provided, from US$10,538 to US$14,698, representing an increase of US$4,160 or 40% over the current payment amount.  In the ASC, the new Medicare national average payment will increase from US$7,887 to US$12,553, representing an increase of US$4,666 or 59% over the current payment amount. The new payments will become effective January 1, 2017.

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