Treace Comments on CMS’ 2025 Final Rule for Hospital Outpatient and ASC Settings
Rhea-AI Summary
Treace Medical Concepts has announced significant reimbursement rate increases for its Lapiplasty® procedure following CMS' 2025 Final Rule. The CPT code 28297, used for Lapidus fusion and Lapiplasty® procedures, will be reassigned to APC code 5115, resulting in an 89% increase in hospital outpatient payment rates to $12,867 (up $6,050 from 2024). In the ASC setting, the payment will increase by 100% to $9,820, compared to $4,900 in 2024. These changes will take effect January 1, 2025.
Positive
- 89% increase in hospital outpatient reimbursement rate to $12,867
- 100% increase in ASC setting reimbursement to $9,820
- Significant payment improvement supports procedure adoption
Negative
- None.
Insights
The significant reimbursement increase for the Lapiplasty® procedure in both hospital outpatient and ASC settings represents a major positive development for Treace Medical. The
This reimbursement boost validates the clinical value of the procedure and could accelerate market penetration, particularly in Medicare-heavy facilities. Higher reimbursement rates typically lead to increased procedure volumes and better profit margins for facilities, which should drive stronger demand for Treace's technology. The timing of implementation starting January 2025 gives facilities adequate time to update their budgets and procedure planning.
PONTE VEDRA, Fla., Nov. 04, 2024 (GLOBE NEWSWIRE) -- Treace Medical Concepts, Inc. ("Treace" or the "Company") (NasdaqGS: TMCI), a medical technology company driving a fundamental shift in the surgical treatment of bunions and related midfoot deformities through its flagship Lapiplasty® and Adductoplasty® Procedures, today commented on the recently released Centers for Medicare & Medicaid Services (CMS) Calendar Year 2025 Hospital Outpatient Prospective Payment System (OPPS) and Ambulatory Surgical Center (ASC) Final Rule, effective January 1, 2025.
The Final Rule and accompanying Addenda include the reassignment of Current Procedural Terminology (CPT) code 28297 (a primary code used for Lapidus fusion and one typically used for Lapiplasty® procedure reimbursement) to Ambulatory Payment Classification (APC) code 5115 with a hospital outpatient payment rate of
“As the pioneer of the market leading Lapiplasty® 3D Bunion Correction® System, we are pleased that the final rule recognizes the value that Lapidus fusion offers patients suffering from painful, lifestyle-limiting bunion deformities,” said John T. Treace, CEO and Founder of Treace.
Internet Posting of Information
Treace routinely posts information that may be important to investors in the “Investor Relations” section of its website at www.treace.com. The Company encourages investors and potential investors to consult the Treace website regularly for important information about Treace.
About Treace Medical Concepts
Treace Medical Concepts, Inc. is a medical technology company with the goal of advancing the standard of care for the surgical management of bunion and related midfoot deformities. Bunions are complex 3-dimensional deformities that originate from an unstable joint in the middle of the foot and affect approximately 67 million Americans, of which Treace estimates 1.1 million are annual surgical candidates. Treace has pioneered and patented the Lapiplasty® 3D Bunion Correction® System – a combination of instruments, implants, and surgical methods designed to surgically correct all three planes of the bunion deformity and secure the unstable joint, addressing the root cause of the bunion and helping patients get back to their active lifestyles. To further support the needs of bunion patients, Treace has introduced its Adductoplasty® Midfoot Correction System, designed for reproducible surgical correction of midfoot deformities. The Company continues to expand its footprint in the foot and ankle market with the introduction of its SpeedPlate™ Rapid Compression Implants, an innovative fixation platform with broad versatility across Lapiplasty® and Adductoplasty® procedures, as well as other common bone fusion procedures of the foot. For more information, please visit www.treace.com.
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Contacts:
Treace Medical Concepts
Mark L. Hair
Chief Financial Officer
mhair@treace.net
(904) 373-5940
Investors:
Gilmartin Group
Vivian Cervantes
IR@treace.net
FAQ
What is the new CMS reimbursement rate for Lapiplasty (TMCI) in hospital outpatient settings for 2025?
How much will ASC centers be reimbursed for Lapiplasty procedures (TMCI) in 2025?
When will the new CMS reimbursement rates for Treace Medical (TMCI) take effect?
