Carlsmed’s aprevo Lumbar Procedures Earn CMS Reimbursement

The Centers for Medicare & Medicaid Services (CMS) has finalized a reimbursement policy for spinal fusion procedures using Carlsmed Inc.’s aprevo platform that will take effect on Oct. 1.

In the fiscal year 2027 Hospital Inpatient Prospective Payment System (IPPS) Final Rule, CMS addressed Carlsmed’s request and reassigned aprevo lumbar fusion procedures to three newly created MS-DRGs 523, 524, and 525 (Extensive or Complex Spinal Fusion Procedures Except Cervical with Major Complication or Comorbidity (MCC), with Complication or Comorbidity (CC), and without CC/MCC, respectively). Under the final rule, all inpatient aprevo lumbar fusion procedures are eligible for reimbursement under one of these three new MS-DRG codes.

“This reimbursement decision represents a significant step forward in expanding hospital, surgeon and patient access to the aprevo procedure,” Carlsmed Chairman/CEO Mike Cordonnier said. “We appreciate CMS’ continued partnership to implement this policy, and we remain focused on patient-centric innovation and our medical education to achieve our mission of improving outcomes and reducing the cost of healthcare for spine surgery and beyond.”

Carlsmed anticipates this policy to advance hospital access, driving the acceleration of patient access to aprevo lumbar with the MS-DRG assignment clarity and enhanced reimbursement for hospitals.

Carlsmed is a Carlsbad, Calif.-based medical technology company pioneering artificial intelligence-enabled personalized spine surgery solutions with a mission to improve outcomes and decrease healthcare costs for spine surgery and beyond.