CMS sets reimbursement rates for prostate, renal cryoablation

November 15, 2007

The Centers for Medicare & Medicaid Services has increased hospital outpatient and ambulatory surgical center reimbursement rates for cryoablation treatments for prostate cancer, and has created a reimbursement code and rate for percutaneous renal cryoablation. The new rates will go into effect in 2008.

The Centers for Medicare & Medicaid Services has increased hospital outpatient and ambulatory surgical center reimbursement rates for cryoablation treatments for prostate cancer, and has created a reimbursement code and rate for percutaneous renal cryoablation. The new rates will go into effect in 2008.

Under the new rates, reimbursement for prostate cryoablation performed in an outpatient hospital setting (APC code 674) for patients who do not stay overnight was raised from $6,685.05 to $7,816.10, a 16.9% increase. For procedures performed at ambulatory surgical centers (ASC code 55873), the reimbursement rate was raised from $1,339.00 to $6,219.63, an increase of 364%.

CMS also has accepted the recommendation from AMA’s Specialty Society Relative Value Update Committee and has created a specific clinical reimbursement code and rate for percutaneous renal cryoablation. The new code (CPT 50593) will be paid as an adjusted average in the $440 range.