RegulatoryAug 3, 2026, 08:03 AM
Carlsmed Secures Favorable CMS Reimbursement for aprevo® Lumbar
AI Summary
Carlsmed, Inc. announced that the Centers for Medicare & Medicaid Services (CMS) has finalized a favorable reimbursement policy for its aprevo® Lumbar spinal fusion procedures. Effective October 1, 2026, these procedures will be assigned to three newly created MS-DRGs (523, 524, and 525), ensuring eligibility for reimbursement. The company anticipates this decision will significantly expand hospital, surgeon, and patient access to the aprevo® procedure, accelerating its adoption and contributing to improved patient outcomes and reduced healthcare costs.
Key Highlights
- CMS finalized favorable reimbursement for aprevo® Lumbar spinal fusion procedures.
- New MS-DRG assignments and payment rates become effective on October 1, 2026.
- aprevo® Lumbar procedures reassigned to three new MS-DRGs: 523, 524, and 525.
- MS-DRG 523 covers procedures with Major Complication or Comorbidity (MCC).
- MS-DRG 524 covers procedures with Complication or Comorbidity (CC).
- MS-DRG 525 covers procedures without CC/MCC.
- Policy is expected to advance hospital access and accelerate patient access to aprevo® Lumbar.
Price Impact
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