Reimbursement
Access billing Information and reimbursement guides.
Billing information and reimbursement rates for placement of BioProtect Balloon Spacer varies by setting. Providers must verify information is appropriate with each patient’s healthcare plan.
Medicare National Payment Rates*
| CPT®/HCPCS | Description | Hospital Outpatient Department | Ambulatory Surgical Center (ASC) | Physician PRO (HOPD or ASC) | Physician Office / Freestanding Facility (Global fees) |
|
C1889†, ‡ |
Implantable/insertable device, not otherwise classified (reported for device intensive procedures such as 55874 as required by payers) | Packaged | Packaged | Not billable | Not billable |
| 55874** | Transperineal placement of biodegradable material, periprostatic, single or multiple injection(s), including image guidance, when performed | $5,114 | $4,248 | $144 | $3,767 |
| 55876† | Placement of fiducial marker into the prostate for radiation therapy guidance | Packaged*** If performed on a separate date of service, the rate is $1,428 | $998.68 | $92 | $154 |
| A4648** | Implanted fiducial marker (markers themselves, invoice must be provided) | Packaged | Packaged | Packaged | Invoice Cost |
| 77387 (formerly G6002) | Image guidance utilizing stereoscopic X-ray guidance for target localization performed for treatment delivery | Not billed in this setting | Not billed in this setting | $37 | $37 |
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Learn more about the benefits and performance of the BioProtect Balloon Spacer and access reimbursement support.