Robotic surgery interventions

Series
Robotic surgery
Status
Published
Date
Number of report
015

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Report presents summary of reimbursement situation for procedures using robotic equipment in European countries.

Sample pages are provided for an older version of the report. Before delivery to the client, the report is updated to the current state (e.g., 2022 coding, tariffs, and policy considerations). 

Five the most common robotic surgical procedures are included into report:

  • Total prostatectomy for prostate cancer
  • Total nephrectomy for kidney cancer
  • Total hysterectomy for endometrial cancer
  • Anterior resection of rectum for rectal cancer
  • Nissen (total) fundoplication for gastro-esophageal reflux disease (GERD)

Three types of surgical access are considered in the report:

  • Open access
  • Laparoscopic access
  • Robot-assisted access

Report includes essential information about reimbursement and national funding, including:

  • Brief overview of reimbursement system for medical devices
  • Procedure coding for technology
  • Diagnosis coding
  • Payment mechanism for technology
  • Reimbursement tariffs for technology
  • Restrictions in indications or scenarios for use of technology
  • Policy considerations by payers and policy-makers about technology

Report focuses solely on reimbursement of robotic-assisted procedures and does not provide information about procurement of robotic equipment.

Reimbursement information is provided for the following geographies:

  • Austria
  • Belgium
  • Denmark
  • England (UK)
  • France
  • Germany
  • Italy
  • Netherlands
  • Norway
  • Sweden
  • Switzerland

It is also possible to add analysis in Czech Republic, Finland, Hungary, Romania, Russia and Turkey.

Manufacturers of robotic surgery systems include:

  • Auris Surgical Robotics 
  • Corindus Vascular Robotics (CorPath®)                     
  • Elmed medical systems (Avicenna Roboflex™)                
  • Hansen Medical (Magellan™)                                                             
  • Intuitive Surgical (da Vinci®)
  • KB Medical (AQrate™)                                     
  • Mazor Robotics (Renaissance®)                     
  • Medrobotics (Flex®)                               
  • OR Productivity (FreeHand)                                                          
  • Renishaw (neuromate®) 
  • Robocath                                        
  • Smith & Nephew (NAVIO)            
  • Stereotaxis (Epoch®)                                        
  • Stryker (Mako platform)
  • THINK Surgical (TSolution One®)                                  
  • Titan Medical (SPORT™)                                       
  • TransEnterix (SurgiBot™)                                  
  • Verb Surgical                                     
  • Virtual Incision

Table of content

1.    Introduction and summary
2.    Executive summary table
3.    Contents
4.    Methodology
5.    Reimbursement analysis in Austria

5.1.    Overview of the reimbursement system
5.2.    Reimbursement for robotic surgery interventions
5.2.1.    Procedure coding
5.2.1.1.    Procedure coding for total prostatectomy
5.2.1.2.    Procedure coding for total nephrectomy
5.2.1.3.    Procedure coding for total hysterectomy
5.2.1.4.    Procedure coding for resection of rectum
5.2.1.5.    Procedure coding for total fundoplication
5.2.2.    Diagnosis coding
5.2.3.    Payment mechanism and reimbursement tariffs
5.2.3.1.    Reimbursement for total prostatectomy in prostate cancer
5.2.3.2.    Reimbursement for total nephrectomy in kidney cancer
5.2.3.3.    Reimbursement for total hysterectomy in endometrial cancer
5.2.3.4.    Reimbursement for resection of rectum in rectal cancer
5.2.3.5.    Reimbursement for total fundoplication in gastro-oesophageal reflux disease
5.2.4.    Health technology assessment by LBI-HTA
6.    Reimbursement analysis in Belgium
6.1.    Overview of the reimbursement system
6.2.    Reimbursement for robotic surgery interventions
6.2.1.    Procedure coding 
6.2.1.1.    Coding for total prostatectomy
6.2.1.2.    Coding for total nephrectomy
6.2.1.3.    Coding for total hysterectomy
6.2.1.4.    Coding for resection of rectum
6.2.2.    Payment mechanism and reimbursement tariffs
6.2.2.1.    Reimbursement for total prostatectomy in prostate cancer
6.2.2.2.    Reimbursement for total nephrectomy in kidney cancer
6.2.2.3.    Reimbursement for total hysterectomy in endometrial cancer
6.2.2.4.    Reimbursement for resection of rectum in rectal cancer
6.2.3.    Policy considerations for robotic-assisted total prostatectomy
6.2.3.1.    Health technology assessment by KCE
7.    Reimbursement analysis in Denmark
7.1.    Overview of the reimbursement system
7.2.    Reimbursement for robotic surgery interventions
7.2.1.    Procedure coding 
7.2.1.1.    Procedure coding for total prostatectomy
7.2.1.2.    Procedure coding for total nephrectomy
7.2.1.3.    Procedure coding for total hysterectomy
7.2.1.4.    Procedure coding for resection of rectum
7.2.1.5.    Procedure coding for total fundoplication
7.2.2.    Diagnosis coding
7.2.3.    Payment mechanism and reimbursement tariffs
7.2.3.1.    Reimbursement for total prostatectomy in prostate cancer
7.2.3.2.    Reimbursement for total nephrectomy in kidney cancer
7.2.3.3.    Reimbursement for total hysterectomy in endometrial cancer
7.2.3.4.    Reimbursement for resection of rectum in rectal cancer
7.2.3.5.    Reimbursement for total fundoplication in gastro-oesophageal reflux disease
8.    Reimbursement analysis in England
8.1.    Overview of the reimbursement system
8.2.    Reimbursement for robotic surgery interventions
8.2.1.    Procedure coding 
8.2.1.1.    Procedure coding for total prostatectomy
8.2.1.2.    Procedure coding for total nephrectomy
8.2.1.3.    Procedure coding for total hysterectomy
8.2.1.4.    Procedure coding for resection of rectum
8.2.1.5.    Procedure coding for total fundoplication
8.2.2.    Diagnosis coding
8.2.3.    Payment mechanism and reimbursement tariffs
8.2.3.1.    Reimbursement for total prostatectomy in prostate cancer
8.2.3.2.    Reimbursement for total nephrectomy in kidney cancer
8.2.3.3.    Reimbursement for total hysterectomy in endometrial cancer
8.2.3.4.    Reimbursement for resection of rectum in rectal cancer
8.2.4.    Reimbursement for total fundoplication in gastro-oesophageal reflux disease
8.2.5.    Policy considerations 
8.2.5.1.    National commissioning by NHS England
8.2.5.1.1.    Commissioning of robotic-assisted prostatectomy
8.2.5.1.2.    Commissioning of robotic-assisted total nephrectomy
8.2.5.1.3.    Commissioning of robotic-assisted total hysterectomy
8.2.5.1.4.    Commissioning of robotic-assisted resection of rectum with anastomosis
8.2.5.2.    Health technology assessment by NICE
9.    Reimbursement analysis in France
9.1.    Overview of the reimbursement system
9.2.    Reimbursement for robotic surgery interventions
9.2.1.    Procedure coding 
9.2.1.1.    Procedure coding for total prostatectomy
9.2.1.2.    Procedure coding for total nephrectomy
9.2.1.3.    Procedure coding for total hysterectomy
9.2.1.4.    Procedure coding for resection of rectum
9.2.2.    Diagnosis coding
9.2.3.    Payment mechanism and reimbursement tariffs
9.2.3.1.    Reimbursement for total prostatectomy in prostate cancer
9.2.3.2.    Reimbursement for total nephrectomy in kidney cancer
9.2.3.3.    Reimbursement for total hysterectomy in endometrial cancer
9.2.3.4.    Reimbursement for resection of rectum in rectal cancer
9.2.4.    Policy considerations
9.2.4.1.    Health technology assessment of total robot-assisted prostatectomy by HAS
9.2.4.2.    Coverage with evidence development
10.    Reimbursement analysis in Germany
10.1.    Overview of the reimbursement system
10.2.    Reimbursement for robotic surgery interventions
10.2.1.    Procedure coding 
10.2.1.1.    Procedure coding for total prostatectomy
10.2.1.2.    Procedure coding for total nephrectomy
10.2.1.3.    Procedure coding for total hysterectomy
10.2.1.4.    Procedure coding for resection of rectum
10.2.2.    Procedure coding for total fundoplication
10.2.3.    Diagnosis coding
10.2.4.    Payment mechanism and reimbursement tariffs
10.2.4.1.    Reimbursement for total prostatectomy in prostate cancer
10.2.4.2.    Reimbursement for total nephrectomy in kidney cancer
10.2.4.3.    Reimbursement for total hysterectomy in endometrial cancer
10.2.4.4.    Reimbursement for resection of rectum in rectal cancer
10.2.4.5.    Reimbursement for total fundoplication in gastro-oesophageal reflux disease
11.    Reimbursement analysis in Italy
11.1.    Overview of the reimbursement system
11.2.    Reimbursement for robotic surgery interventions
11.2.1.    Procedure coding 
11.2.1.1.    Procedure coding for total prostatectomy
11.2.1.2.    Procedure coding for total nephrectomy
11.2.1.3.    Procedure coding for total hysterectomy
11.2.1.4.    Procedure coding for resection of rectum
11.2.1.5.    Procedure coding for total fundoplication
11.2.2.    Diagnosis coding
11.2.3.    Payment mechanism and reimbursement tariffs at national level
11.2.3.1.    Reimbursement for total prostatectomy in prostate cancer
11.2.3.2.    Reimbursement for total nephrectomy in kidney cancer
11.2.3.3.    Reimbursement for total hysterectomy in endometrial cancer
11.2.3.4.    Reimbursement for resection of rectum in rectal cancer
11.2.3.5.    Reimbursement for total fundoplication in gastro-oesophageal reflux disease
12.    Reimbursement analysis in the Netherlands
12.1.    Overview of the reimbursement system
12.2.    Reimbursement for robotic surgery interventions
12.2.1.    Procedure coding 
12.2.1.1.    Procedure coding for total prostatectomy
12.2.1.2.    Procedure coding for total nephrectomy
12.2.1.3.    Procedure coding for total hysterectomy
12.2.1.4.    Procedure coding for resection of rectum
12.2.1.5.    Procedure coding for total fundoplication
12.2.2.    Diagnosis coding
12.2.3.    Payment mechanism and reimbursement tariffs
12.2.3.1.    Reimbursement for total prostatectomy in prostate cancer
12.2.3.2.    Reimbursement for total nephrectomy in kidney cancer
12.2.3.3.    Reimbursement for total hysterectomy in endometrial cancer
12.2.3.4.    Reimbursement for resection of rectum in rectal cancer
12.2.3.5.    Reimbursement for total fundoplication in gastro-oesophageal reflux disease
12.2.4.    Policy considerations
12.2.5.    Health technology assessment by National Healthcare Institute
13.    Reimbursement analysis in Norway
13.1.    Overview of the reimbursement system
13.2.    Reimbursement for mitral robotic surgery interventions
13.2.1.    Procedure coding
13.2.1.1.    Procedure coding for total prostatectomy
13.2.1.2.    Procedure coding for total nephrectomy
13.2.1.3.    Procedure coding for total hysterectomy
13.2.1.4.    Procedure coding for resection of rectum
13.2.1.5.    Procedure coding for total fundoplication 
13.2.2.    Diagnosis coding
13.2.3.    Payment mechanism and reimbursement tariffs
13.2.3.1.    Reimbursement for total prostatectomy in prostate cancer
13.2.3.2.    Reimbursement for total nephrectomy in kidney cancer
13.2.3.3.    Reimbursement for total hysterectomy in endometrial cancer
13.2.3.4.    Reimbursement for resection of rectum in rectal cancer
13.2.3.5.    Reimbursement for total fundoplication in gastro-oesophageal reflux disease
13.2.4.    Policy considerations 
13.2.4.1.    Review of evidence for robot-assisted prostatectomy by NOKC
14.    Reimbursement analysis in Sweden
14.1.    Overview of the reimbursement system
14.2.    Reimbursement for robotic surgery interventions
14.2.1.    Procedure coding 
14.2.1.1.    Procedure coding for total prostatectomy
14.2.1.2.    Procedure coding for total nephrectomy
14.2.1.3.    Procedure coding for total hysterectomy
14.2.1.4.    Procedure coding for resection of rectum
14.2.1.5.    Procedure coding for total fundoplication
14.2.2.    Diagnosis coding
14.2.3.    Payment mechanism and reimbursement tariffs
14.2.3.1.    Reimbursement for total prostatectomy in prostate cancer
14.2.3.2.    Reimbursement for total nephrectomy in kidney cancer
14.2.3.3.    Reimbursement for total hysterectomy in endometrial cancer
14.2.3.4.    Reimbursement for resection of rectum in rectal cancer
14.2.3.5.    Reimbursement for total fundoplication in gastro-oesophageal reflux disease
14.2.4.    Policy considerations 
14.2.4.1.    Recommendations for radical prostatectomy in the national clinical guidelines
14.2.4.2.    Recommendations for resection of rectum in the national clinical guidelines
15.    Reimbursement analysis in Switzerland
15.1.    Overview of the reimbursement system
15.2.    Reimbursement for robotic surgery interventions
15.2.1.    Procedure coding 
15.2.1.1.    Procedure coding for total prostatectomy
15.2.1.2.    Procedure coding for total nephrectomy
15.2.1.3.    Procedure coding for total hysterectomy
15.2.1.4.    Procedure coding for resection of rectum
15.2.1.5.    Procedure coding for total fundoplication
15.2.2.    Diagnosis coding
15.2.3.    Payment mechanism and reimbursement tariffs
15.2.3.1.    Reimbursement for total prostatectomy in prostate cancer
15.2.3.2.    Reimbursement for total nephrectomy in kidney cancer
15.2.3.3.    Reimbursement for total hysterectomy in endometrial cancer
15.2.3.4.    Reimbursement for resection of rectum in rectal cancer
15.2.3.5.    Reimbursement for total fundoplication in gastro-oesophageal reflux disease
15.2.4.    Policy considerations 
16.    Disclaimer

11

Jul 2022

In June 2022, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0184 and 0081 with changes to be implemented no later than August 09, 2022. Two new procedure codes for robotic surgery and two new diagnostic codes were introduced.

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13

May 2022

In April 2022, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclatures for private payers in England, published Bulletins 0183 and 0080 with changes to be implemented no later than June 14, 2022. Eleven new procedure codes and nine new diagnostic codes were introduced.

Read more

14

Mar 2022

In February 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, published Bulletins 0182 and 0079 with changes to be implemented no later than April 10, 2022. Three new procedure codes concerned robotic surgery in orthopaedic area, spinal procedures, and ophthalmology, and five new diagnostic codes were introduced.

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18

Feb 2022

Dutch Organization for Health Research and Development, ZonMw awarded eight projects under the "Healthcare Evaluation and Appropriate Use" program, including two projects for geriatric care, two projects for cancer, per one project for cardiovascular, neurovascular, and dermatology care.

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08

Nov 2021

In late September 2021, the Clinical Coding and Schedule Development (CCSD) working group, which develops and maintains procedural and diagnostics nomenclature for private payers in England, has published Bulletins 0179 and 0076 with changes to be implemented no later than January 01, 2022. Four new procedure codes related to gynecology, robotic surgery in the pulmonology area, and orthopedics, and four new diagnostic codes were introduced.

Read more
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