CMS FINALIZES HIGHER PAYMENT FOR CERAMENT® G IN THE US
CMS FINALIZES HIGHER PAYMENT FOR CERAMENT® G IN THE US
BONESUPPORT™, a leading company in orthobiologics for the management of bone injuries, today announces that the U.S. Centers for Medicare & Medicaid Services (CMS) has confirmed the proposed DRG reassignment for CERAMENT® G in the pre-published final Medicare Inpatient Prospective Payment System (IPPS) rule for fiscal year 2027. The decision means that qualifying CERAMENT G cases will be assigned to the highest reimbursing Diagnosis-Related Groups (DRGs) within their respective clinical categories.
The DRG reassignment will apply to gentamicin-eluting bone void fillers, a category in which CERAMENT G is currently the only product. The change is expected to improve hospital reimbursement for the use of CERAMENT G in the treatment of complex orthopedic infections - including periprosthetic joint infection (PJI), fracture-related infection (FRI), and diabetes-related bone infection.
The final rule also confirms the establishment of a new procedure code for vancomycin-eluting bone void fillers. If the FDA grants De Novo classification for CERAMENT® V, the product is expected to be the first and only therapy eligible under this code and to qualify for the same DRG reassignment as CERAMENT G. As a result, BONESUPPORT expects that a future New Technology Add-on Payment (NTAP) application for CERAMENT V will no longer be necessary.
The final rule takes effect on October 1, 2026.