CMS facility RVU proposal for 26 common spine surgeries

CMS released the 2021 Proposed Medicare Physician Fee Schedule in August, which would reduce relative value unit conversion factor from $36.09 to $32.26.

 

The International Society for the Advancement of Spine Surgery compiled a list of spine procedures and how the RVU adjustment would affect payment rates. The RVU reduction along with code-specific adjustments reduced Medicare payment for spine procedures between 5 percent and 12 percent when compared with 2020 rates.

Here is a list of 26 spine procedures and the proposed 2021 total facility RVU. Note: all procedure codes would have reduced payment; this list includes the rate for 26 common codes.

Click here to see the proposed pay rates for these procedures in 2021.

1. Remove part of neck vertebra (22100): 25.61

2. Remove part lumbar vertebra (22102): 24.59

3. Remove extra spine segment (22103): 4.14

4. Treat spine fracture (22325): 43.45

5. Treat neck spine fracture (22326): 44.56

6. Lat lumbar spine fusion (22533): 48.9

7. Neck spine fusion (22548): 58.17

8. Neck spine fusion (22554): 37.3

9. Thorax spine fusion (22556): 49.26

10. Lumbar spine fusion (22558): 45.26

11. Neck spinal fusion (22595): 44.79

12. Neck spine fusion (22600): 38.45

13. Thorax spine fusion (22610): 37.81

14. Lumbar spine fusion (22612): 46.93

15. Insert spine fixation device (22843): 23.98

16. Insert spine fixation device (22844): 29.01

17. Insert spine fixation device (22845): 21.4

18. Insert spine fixation device (22846): 22.25

19. Insert spine fixation device (22847): 23.54

20. Remove spine fixation device (22850): 21.78

21. Remove spine fixation device (22852): 20.92

22. Cervical artificial discectomy (22856): 48.28

23. Lumbar artificial discectomy (22857): 52.07

24. Revise cervical artificial disc (22861): 68.66

25. Revise lumbar artificial disc (22862): 68.61

26. Fusion of sacroiliac joint (27280): 40.2

More articles on surgery centers:
The 3 things facilities should do now to prepare for the 2021 CMS Physician Fee Schedule
6 must-know coding updates in 2020
Blue Cross North Carolina, Wake Forest collaborate on new insurance network

© Copyright ASC COMMUNICATIONS 2020. Interested in LINKING to or REPRINTING this content? View our policies by clicking here.

 

Featured Webinars

Featured Whitepapers