Treace Comments on CMS’ 2025 Final Rule for Hospital Outpatient and ASC Settings
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.
Treace Medical Concepts ha annunciato significativi aumenti delle tariffe di rimborso per la sua procedura Lapiplasty® a seguito della Regola Finale CMS del 2025. Il codice CPT 28297, utilizzato per le procedure di fusione di Lapidus e Lapiplasty®, sarà riassociato al codice APC 5115, comportando un aumento dell'89% delle tariffe di pagamento per le strutture ospedaliere ambulatoriali, che passeranno così a $12,867 (un aumento di $6,050 rispetto al 2024). Nell'ambito dell'ASC, il pagamento aumenterà del 100%, raggiungendo $9,820, rispetto ai $4,900 nel 2024. Queste modifiche entreranno in vigore il 1° gennaio 2025.
Treace Medical Concepts ha anunciado aumentos significativos en las tarifas de reembolso para su procedimiento Lapiplasty® tras la Regla Final CMS de 2025. El código CPT 28297, utilizado para los procedimientos de fusión de Lapidus y Lapiplasty®, será reasignado al código APC 5115, lo que resultará en un aumento del 89% en las tarifas de pago de pacientes ambulatorios a $12,867 (un aumento de $6,050 respecto a 2024). En el entorno de ASC, el pago aumentará un 100%, llegando a $9,820, en comparación con los $4,900 de 2024. Estos cambios entrarán en efecto el 1 de enero de 2025.
Treace Medical Concepts는 CMS의 2025년 최종 규칙에 따라 라피플라스티® 시술에 대한 상당한 환급률 증가를 발표했습니다. Lapidus 융합 및 Lapiplasty® 시술에 사용되는 CPT 코드 28297은 APC 코드 5115로 재배정되어 병원 외래 진료소의 지급률이 89% 증가하여 $12,867(2024년 대비 $6,050 증가)로 조정됩니다. ASC 환경에서 지급률은 100% 증가하여 $9,820가 되며, 이는 2024년의 $4,900에 비해 상승한 수치입니다. 이러한 변경 사항은 2025년 1월 1일부터 시행됩니다.
Treace Medical Concepts a annoncé des augmentations significatives des tarifs de remboursement pour sa procédure Lapiplasty® suite à la Règle Finale CMS de 2025. Le code CPT 28297, utilisé pour les procédures de fusion de Lapidus et Lapiplasty®, sera réaffecté au code APC 5115, entraînant une augmentation de 89% des tarifs de paiement pour les hôpitaux ambulatoires, qui s'élèveront à 12 867 $ (soit une augmentation de 6 050 $ par rapport à 2024). Dans le cadre de l'ASC, le paiement augmentera de 100% pour atteindre 9 820 $, contre 4 900 $ en 2024. Ces changements entreront en vigueur le 1er janvier 2025.
Treace Medical Concepts hat bedeutende Erhöhungen der Erstattungsbeträge für sein Lapiplasty®-Verfahren nach der endgültigen Regel des CMS von 2025 angekündigt. Der CPT-Code 28297, der für Lapidus-Fusion und Lapiplasty®-Verfahren verwendet wird, wird dem APC-Code 5115 zugewiesen, was zu einer 89%-igen Erhöhung der Zahlungssätze für ambulante Krankenhausleistungen auf $12,867 (ein Anstieg von $6,050 im Vergleich zu 2024) führen wird. Im ASC-Bereich wird die Zahlung um 100% auf $9,820 ansteigen, verglichen mit $4,900 im Jahr 2024. Diese Änderungen treten am 1. Januar 2025 in Kraft.
- 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
- 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
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