CMS 2020 physician fee schedule proposal doesn’t include MIS SI joint fusion value increase

Medicare’s Physician Fee Schedule Proposed Rule would keep the current value for minimally invasive sacroiliac joint fusion after the American Medical Association’s RVS Update Committee conducted a review, according to the International Society for the Advancement of Spine Surgery.

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ISASS, along with other spine and orthopedic societies including the North American Spine Society and American Academy of Orthopaedic Surgeons, recommended increasing the relative value units for CPT code 27279, or minimally invasive SI joint fusion. The RUC did not agree that the code was misvalued, and CMS did not recommend updating the value in its 2020 proposal.

CMS will accept comments on whether the CPT code should be assigned a higher RVU. The agency is considering updating the work RVU of 9.03 to 20.0 to achieve parity with the work RVU for open SI joint fusion.

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