CMS Announces Final Valuations and Reimbursement Rates for New ESD CPT Codes
The U.S. Centers for Medicare & Medicaid Services (CMS) has published final valuations and CY2027 reimbursement rates for new Endoscopic Submucosal Dissection (ESD) Category I Current Procedural Terminology (CPT) codes. These new codes, which distinguish between upper [CPT 43498] and lower [CPT 45991] gastrointestinal tract procedures, are set to take effect on January 1, 2027. This regulatory development is expected to streamline reimbursement for physicians and outpatient facilities, facilitating easier billing and reporting. By providing standardized coding that reflects the clinical complexity of ESD, the move aims to increase patient access to this organ-sparing, minimally invasive alternative to traditional surgery for treating cancerous and pre-cancerous lesions.
Topics: Endoscopy Healthcare Policy Medical Technology Reimbursement Rates