Medigus Announces CMS’ Publication of Fee Schedules for Endoscopic Fundoplication Procedures Under CPT Code 43210 Effective January 2016
OMER, Israel, November 3, 2015 – Medigus Ltd. (NASDAQ: MDGS) (TASE: MDGS), a medical device company developing minimally invasive endosurgical tools and a leader in direct visualization technology, today announced that following the American Medical Association’s (AMA) decision earlier this year to create a new Category I Current Procedural Terminology (CPT®) code for esophagogastric fundoplasty (43210), the Centers for Medicare and Medicaid Services (CMS) has recently posted new payment information for endoscopic fundoplication procedures, such as the ones completed with MUSE™ (Medigus Ultrasonic Surgical Endostapler). The payment value assigned to physicians is 12.43 total relative value units (RVU), yielding a national unadjusted payment amount of $445.34. The payment value for outpatient hospitals has been grouped into Ambulatory Payment Classification (APC) 5331, which has a national unadjusted payment amount of $3,613.57. These values are expected to take effect on January 1st, 2016.
“The new reimbursement values reflect the medical community’s recognition of transoral procedures such as MUSE as valuable clinical options for physicians and patients,” said Chris Rowland, CEO of Medigus. “CMS’ decision could further support the growing availability of MUSE in the U.S. by providing physicians with appropriate reimbursement for procedures completed with MUSE.”
MUSE merges the latest advancements in microvisual, ultrasonic and surgical technologies into a comprehensive platform that allows a single physician or surgeon to perform fundoplication (stapling of the upper part of the stomach to the lower esophageal sphincter), a procedure intended to deliver long-term relief from GERD.
The AMA’s Specialty Society Relative Value Scale Update Committee (RUC), a panel of specialty medical experts, provides relative value recommendations to the Centers for Medicare & Medicaid Services (CMS). Each CPT code is assigned a RVU, which is based on three components: physician’s work, practice expenses, and malpractice insurance. Specialty gastroenterology and surgical societies AGA, ACG, ASGE, ASGS and SAGES were amongst the experts who reviewed and approved this recommendation.
For more information, please visit: https://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2015-Fact-sheets-items/2015-10-30-2.html.
About Current Procedural Terminology (CPT®)
Decided upon by the CPT Editorial Panel, CPT codes are nationally recognized codes that the healthcare community uses to report all treatment options being administered to patients. The purpose of CPT is to provide a uniform language that accurately describes medical, surgical, and diagnostic services, and thereby serves as an effective means for reliable nationwide communication among physicians and other healthcare providers, patients, and third parties. Proposals for new CPT codes undergo rigorous review by numerous specialty societies and others, including the Centers for Medicare and Medicaid Services (CMS), who ultimately make recommendations on reimbursement value. CPT® is registered trademark of the American Medical Association. For more information on CPT codes, visit the AMA website.