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CMS Increases Medicare Physician Payment for Minimally Invasive SI Joint Fusion

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In the U.S., the Centers for Medicare and Medicaid Services has increased the Medicare Physician Fee Schedule for CPT® Code 27279, Arthrodesis Sacroiliac Joint, under which minimally invasive sacroiliac (SI) joint fusion procedures are reported.

Effective in 2020, Work Relative Value Units associated with the code will increase by 27%, from 9.03 to 12.13. Medicare national average payments will increase from $720 to $914.52. The action follows a review of surgeon commentary, revealing that Work Relative Value Units associated with the procedure had understated the physician time and complexity required.

Companies affected by this change include RTI Surgical, marketer of the SImmetry® system, and SI-BONE, manufacturer of the iFuse Implant System®.

Other companies marketing devices for SI joint fusion include:

  • Biofusion Medical, SI-Restore Sacroiliac Joint Fixation System
  • Camber Spine, Siconus™ SI Joint Fixation System
  • CoreLink, Entasis® Sacroiliac Joint Fusion system
  • Cutting Edge Spine, EVOL®-SI Joint Fusion
  • Globus Medical, SI-LOK® Sacroiliac Joint Fusion System
  • joimax, MultiZYTE® SI 
  • Life Spine, SIMPACT® Sacroiliac Joint Fixation
  • Medacta, Medacta Unconstrained Screw Technology Sacro-Iliac Joint Screw System (MUST SI)