CMS created three new Medicare Severity-Diagnosis Related Groups for extensive or complex spinal fusion procedures in its fiscal 2027 Hospital Inpatient Prospective Payment System final rule and reassigned Carlsmed’s aprevo lumbar procedures to the new payment categories.
CMS finalized the policy after proposing the new MS-DRGs earlier this year.
The three categories, MS-DRGs 523, 524 and 525, are for certain noncervical spinal fusion procedures. All of Carlsmed’s AI-enabled personalized lumbar fusion procedures are eligible for reimbursement under one of the new MS-DRG codes, according to an Aug. 3 news release from the company.
The new MS-DRG assignments and payment rates take effect Oct. 1.
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