Vertos Medical Gains ASC Reimbursement Increase for mild Procedure

By Julie A. Vetalice

Vertos Medical Gains ASC Reimbursement Increase for mild Procedure

Vertos Medical noted that the Centers for Medicare and Medicaid Services (CMS) has increased Ambulatory Surgery Center (ASC) reimbursement for the mild® Procedure, an outpatient lumbar spinal stenosis (LSS) treatment that removes a major root cause of stenosis through a portal the size of a baby aspirin tablet.

Effective January 1, 2021, the national average ASC reimbursement for CPT 0275T will increase by 41%, from $2,803.35 to $3,941.14, in recognition of the device cost associated with the procedure.

The mild Procedure requires no implants, no general anesthesia, no stitches, no steroids or opioids and no overnight hospital stay.

The mild Procedure is approved in the U.S. for Medicare and Medicare Advantage patients and various regional private insurers. Coverage stands at over 80 million lives. Since FDA clearance in 2006, the mild Procedure has been performed on more than 30,000 patients and its safety and efficacy have been analyzed in 13 clinical studies and over 25 publications. The procedure has also received approval under the CE Mark.

"The mild® Procedure is ideally suited for an ASC setting and we are pleased that CMS has improved the reimbursement for these facilities. We believe this will significantly increase patient access to the mild® Procedure across the country," said Philip Macdonald, Vice President, Market Access & Reimbursement for Vertos Medical.

Product Labels: Lumbar Spine