PainTEQ: CMS Sets Office-Based Payment Rate for CPT Code 27279 Starting 2027
The Centers for Medicare & Medicaid Services has introduced an office-based reimbursement pathway for CPT code 27279, effective January 1, 2027.
In its 2027 Physician Fee Schedule, the Centers for Medicare & Medicaid Services (CMS) finalized a non-facility payment rate for CPT code 27279. The policy, which takes effect on January 1, 2027, establishes a formal pathway for providers to be reimbursed for posterior sacroiliac (SI) joint procedures performed in office settings.
Previously, reimbursement for these procedures was primarily tied to hospital-based environments. This regulatory change permits physicians to perform and bill for these specific SI joint treatments in clinics, potentially shifting the site of care for patients suffering from SI joint dysfunction.
PainTEQ, a developer of SI joint intervention technologies, noted that the update provides a clearer economic framework for practitioners. By expanding the settings where these procedures are covered, the policy seeks to align Medicare reimbursement with the evolution of outpatient surgical care.