CMS' 2020 Medicare Physician Fee Schedule increased the payment rate for minimally invasive sacroiliac joint fusions by 27 percent.
The fee schedule, enacted Jan. 1, increased the payment rate for CPT 27279 by 27 percent and boosted the work relative value units associated with the CPT code from 9.03 to 12.13.
As a result, surgeon pay for the procedure rose from $720 to $915, with many payers and device manufacturers taking a closer look at the MIS SI joint space this year.
Here are six key developments from device companies and payers since the new rule:
1. Medica, a health insurer based in Minneapolis, in August revised its coverage policy to include MIS SI joint fusion with SI-Bone's iFuse Implant System. Launched in 2009, iFuse has been performed by more than 2,000 surgeons in over 45,000 procedures.
2. Aetna in May began covering minimally invasive arthrodesis of the sacroiliac joint under a new policy. The payer is now offering its 22 million medical plan members coverage for SI-Bone's iFuse.
3. Spine surgeons at Burnsville, Minn.-based Inspired Spine are developing the Trident Sacroiliac Joint Fusion System for the treatment of sacroiliac joint disease, which aims to improve surgical efficiency and shorten procedure time to under 15 minutes.
4. Aurora Spine completed designs for a posterior sacroiliac joint fusion product, as outlined in its second-quarter financial report. The implant will feature multiple retaining and bone locking mechanisms and offer minimal distraction of the SI joint through a posterior approach.
5. Genesys Spine launched its Sacroiliac Joint Fusion System for lateral and posterior approaches to sacroiliitis in February. The device features a rough surface area to promote osteoinduction and a cannulated design that facilitates minimally invasive placement.
6. In February, Tenon Medical completed the first phase of its clinical trial for the Catamaran sacroiliac joint fixation system, finding a greater than 85 percent reduction in sacroiliac joint pain at six weeks.