Several Spine Surgery Procedure RVUs Reviewed With Medicare Physician Fee Schedule 2023 Proposed Rule
As part of the 2023 Medicare Physician Fee Schedule proposed rule, CMS reviewed new codes for arthrodesis decompression when performed with fusion, fusion with minimal decompression to prepare the interspace, and lumbar laminotomy codes.
The table below shows the CMS proposed work relative value units (RVUs) compared to the recommendations made to CMS by the American Medical Association/Multi-Specialty Society Relative Value Update Committee (RUC).
CPT CODE CPT Descriptor Current 2022 Work RVU Proposed RUC 2023 Work RVU Proposed CMS 2023 Work RVU 22630 PLIF w/minimal decompression first level 22.09 22.09 20.42 22632 PLIF w/minimal decompression additional level 5.22 5.22 5.22 22633 TLIF w/minimal decompression first level 27.75 26.80 24.83 22634 TLIF w/minimal decompression additional level 8.16 7.96 7.30 63052 Lumbar decompression w/arthrodesis first level N/A (new code) 5.70 4.25 63053 Lumbar decompression w/arthrodesis first level N/A (new code) 3.78 5.00 63020 Laminotomy Cervical first level 16.20 15.96 14.91 63030 Laminotomy Lumbar first level 13.18 13.18 12.00 63035 Laminotomy Cervical or Lumbar additional level 3.15 4.00 3.86
The RUC recommendations reflect those made by ISASS and other spine surgery societies to the RUC and are based on survey responses from members who perform the procedures. ISASS is extremely disappointed with the CMS proposed values and met in August with the Agency to discuss the proposed values and argue for accepting the RUC recommended values. In addition, ISASS has submitted extensive written comments to the agency on the proposed values.