MAC Implementation File 8 - FY 2027 New Technology Add-on Payment (NTAP) - Technologies Continuing to Receive NTAP in FY 2027				
Technology	Maximum Add-on Payment	ICD-10-CM/PCS Coding Used to Identify Cases Eligible for NTAP	Alternative Pathways Status	
Annalise Enterprise CTB Triage - OH	$241.39	XXE0X1A 	Breakthrough Device	
ASTar System 	$97.50	XXE5X2A 	Breakthrough Device	
Edwards EVOQUE Tricuspid Valve Replacement System	"$31,850.00"	X2RJ3RA 	Breakthrough Device	
GORE EXCLUDER Thoracoabdominal Branch Endoprosthesis (TAMBE Device)	"$47,238.75"	X2VE3SA 	Breakthrough Device	
LimFlow System	"$16,250.00"	"041M3JS, 041N3JS, 041P3JS, 041Q3JS, 041R3JS, 041S3JS, 041T3JS, or 041U3JS"	Breakthrough Device	
Paradise Ultrasound Renal Denervation System	"$14,950.00"	X051329 	Breakthrough Device	
PulseSelect Pulsed Field Ablation (PFA) Loop Catheter	"$6,337.50"	02583ZF 	Breakthrough Device	
Symplicity Spyral Multi-Electrode Renal Denervation Catheter	"$10,400.00"	X05133A 	Breakthrough Device	
TriClip G4	"$26,000.00"	02UJ3JZ 	Breakthrough Device	
VADER Pedicle System	"$28,242.50"	"XRH60FA, XRH63FA, XRH64FA, XRH70FA, XRH73FA, XRH74FA, XRH80FA, XRH83FA, XRH84FA, XRHA0FA, XRHA3FA, XRHA4FA, XRHB0FA, XRHB3FA, XRHB4FA, XRHC0FA, XRHC3FA, XRHC4FA, XRHD0FA, XRHD3FA, or XRHD4FA in combination with one of the following: M46.20, M46.22, M46.23, M46.24, M46.25, M46.26, M46.27, M46.30, M46.32, M46.33, M46.34, M46.35, M46.36, M46.37, M46.39, M46.40, M46.42, M46.43, M46.44, M46.45, M46.46, M46.47, M46.49, M46.50, M46.51, M46.52, M46.53, M46.54, M46.55, M46.56, M46.57, M46.59, M46.80, M46.82, M46.83, M46.84, M46.85, M46.86, M46.87, M46.89, M46.90, M46.92, M46.93, M46.94, M46.95, M46.96, M46.97, or M46.99"	Breakthrough Device	
ZEVTERA (ceftobiprole medocaril); ABSSSI and CABP indications	"$5,287.50"	XW0335A or XW0435A 	QIDP	
ZEVTERA (ceftobiprole medocaril); SAB indication	"$16,215.00"	XW0335A or XW0435A in combination with R78.81 (in combination with B95.61 or B95.62)	QIDP	
CASGEVY (exagamglogene autotemcel); Sickle Cell Disease indication	"$1,650,000.00"	"XW133J8 or XW143J8 in combination with one of the following: D57.1, D57.20, D57.40, D57.42, D57.44, or D57.80"		
HEPZATO KIT (melphalan for injection/hepatic delivery system)	"$118,625.00"	XW053T9 in combination with 5A1C00Z		
LYFGENIA (lovotibeglogene autotemcel))	"$2,325,000.00"	XW133H9 or XW143H9 		
4WEB Medical Ankle Truss System	"$15,275.00"	"XRGJ0B9, XRGK0B9, XRGL0B9, or XRGM0B9"	Breakthrough Device	
AeroPace System	"$23,650.90"	X2H13XB	Breakthrough Device	
AGENT Paclitaxel-Coated Balloon Catheter	"$4,776.36"	"XW0J3HA, XW0J3JA, XW0J3KA, XW0J3LA, XW0K3HA, XW0K3JA, XW0K3KA, XW0K3LA, XW0L3HA, XW0L3JA, XW0L3KA, XW0L3LA, XW0M3HA, XW0M3JA, XW0M3KA, or XW0M3LA"	Breakthrough Device	
alfapump system	"$21,450.00"	0W1G3J6 in combination with 0JH80YZ	Breakthrough Device	
aprevo-C cervical interbody fusion device	"$21,125.00"	"XRG10RB, XRG13RB, XRG14RB, XRG20RB, XRG23RB, XRG24RB, XRG40RB, XRG43RB, or XRG44RB"	Breakthrough Device	
CERAMENT G (open fracture indication)	"$5,687.50"	XW0V0P7 without any of the ICD-10-CM diagnosis codes in category M86 (see additional sheet for CERAMENT G for list of diagnosis codes)	Breakthrough Device	
Emily's Care Nourish Test System (Model 1)	"$3,347.50"	"XXEZXAB in combination with one of the following: P05.01, P05.02, P05.03, P05.04, P05.05, P05.11, P05.12, P05.13, P05.14, P05.15, P07.00, P07.01, P07.02, P07.03, P07.14, or P07.15"	Breakthrough Device	
Esprit BTK Everolimus Eluting Resorbable Scaffold System	"$6,922.50"	"X27P3TA, X27Q3TA, X27R3TA, X27S3TA, X27T3TA, or X27U3TA"	Breakthrough Device	
EUROPA Posterior Cervical Fusion System	"$80,548.00"	"XRH10GB, XRH13GB, XRH14GB, XRH20GB, XRH23GB, XRH24GB, XRH40GB, XRH43GB, XRH44GB, XRH60GB, XRH63GB, or XRH64GB"	Breakthrough Device	
iFuse TORQ TNT Implant System	"$4,135.95"	"XRGE0HB, XRGE3HB, XRGF0HB, XRGF3HB, XNSN0HB, XNSN3HB, XNSP0HB, XNSP3HB, XNH60HB, XNH63HB, XNH70HB, or XNH73HB"	Breakthrough Device	
Merit Wrapsody Cell Impermeable Endoprosthesis (CIE)	"$3,770.00"	"X27535B, X27635B, X27735B, X27835B, X27935B, X27A35B, X27B35B, X27C35B, X27D35B, or X27E35B"	Breakthrough Device	
Minima Stent System	"$22,685.00"	"X27339B, X27439B, X27W39B, or X27X39B"	Breakthrough Device	
MY01 Continuous Compartmental Pressure Monitor	"$2,112.50"	XX2F3W9	Breakthrough Device	
PBC Separator with Selux AST System	$87.78	XXE5XY9	Breakthrough Device	
restor3d TIDAL Fusion Cage	"$18,196.75"	"XRGK0CA, XRGM0CA, XRGJ0CA, or XRGL0CA"	Breakthrough Device	
ShortCut	"$9,750.00"	X28F3VA	Breakthrough Device	
The WiSE CRT System	"$41,145.00"	X2HN37B in combination with XHH80HB	Breakthrough Device	
TriVerity Test	$243.75	XXE5XBB	Breakthrough Device	
VITEK REVEAL AST System	$81.25 	XXE5X4A	Breakthrough Device	
EMBLAVEO (aztreonam-avibactam)	"$9,000.68"	XW033PB or XW043PB	QIDP	
CONTEPO (fosfomycin)*	"$4,111.65"	XW033WB or XW043WB	QIDP	
AURLUMYN (iloprost injection)	"$28,600.00"	XW033QB or XW043QB		
BREYANZI (lisocabtagene maraleucel)	"$316,860.05"	"XW033N7 or XW043N7 in combination with one of the following: C83.00, C83.01, C83.02, C83.03, C83.04, C83.05, C83.06, C83.07, C83.08, C83.09, C91.10, or C91.12"		
GRAFAPEX (treosulfan)	"$21,411.00"	XW03388 or XW04388		
IMDELLTRA (tarlatamab-dlle)	"$7,117.50"	XW033NA or XW043NA		
TECELRA (afamitresgene autoleucel)	"$472,550.00"	XW03368 or XW04368		
				
*These two technologies were determined to be substantially similar to each other and were therefore evaluated as one application for new technology add-on payments under the IPPS.				
