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