CMS Chooses to Not Provide Office Practice Expense Inputs for Minimally Invasive Sacroiliac Fusion

In response to comments made to the July 2023 Medicare Physician Fee Schedule, CMS announced they will not create Relative Value Units (RVUs) 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.” This CMS statement came in the Physician Fee Schedule Final Rule published on November 2, 2023.

ISASS submitted comments on the Proposed Rule on September 11, 2023, urging CMS to take this action in the 2024 Final Rule. In both the proposed and final rule, CMS stated they are concerned about potential safety risks for patients if this procedure is performed in the office setting. ISASS agrees with this concern and cited this and other clinical reasons to not allow payment in the non-facility setting in their letter.

As a result, 27279 will remain priced and paid for physicians in the outpatient and ambulatory surgical center settings but without practice expense RVUs again for 2024. ISASS believes this is best for patients and the safest way to ensure that the procedure is performed by trained, expert spine surgeons.

To read the ISASS Proposed Rule comment letter, see here.




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