Both the American Medical Association (AMA) and Centers for Medicare & Medicaid Services (CMS) issued new rules covering the surgery. AMA issued a new Current Procedural Terminology (CPT) code for LVB surgery, while CMS finalized and released a payment rate for the procedures in the outpatient setting for 2026.
Together, the new actions create initial reimbursement for a procedure that previously required billing under unlisted codes. The new code (CPT 1019T lymphovenous bypass, including robotic assistance) goes into effect in the U.S. on Jan. 1, 2026. U.S. hospitals can then submit claims directly related to LVB procedures, further supporting facility payment and expanded access to lymphedema treatment options.
Medical Microinstruments says the decisions reflect the growing recognition of its lymphatic surgery as an option for chronic lymphedema. The company’s Symani surgical robotic system — the only microsurgical robot approved for commercial use — allows surgeons to connect lymphatic vessels to nearby veins. By connecting the vessels, smaller than several strands of hair, the procedure helps reroute fluid and relieve swelling.
Symani provides advanced solutions for a range of open surgeries. That includes post-mastectomy breast cancer reconstruction, extremity reconstruction using free tissue transfer and lymphatic system repair. The company’s tiny NanoWrist instruments help to access and suture small, delicate anatomies.
Medical Microinstruments won FDA de novo clearance for Symani, covering soft tissue manipulation to perform microsurgery, in April 2024. The company has since reported a number of milestones for Symani, including the world’s first robotic microsurgical intracranial brain surgery. In October, the company enrolled the first patient in a study for free flap reconstruction and lymphatic repair procedures. Last month, it received FDA investigational device exemption (IDE) to study evaluate microsurgery intervention for Alzheimer’s disease.
“This development marks a major step forward in making surgical treatment for lymphedema more widely available,” said Mark Toland, CEO of MMI. “We appreciate CMS and AMA’s leadership in recognizing the clinical and economic significance of these procedures. This code not only validates the importance and complexity of lymphatic surgery but also lays the groundwork for expanding patient access, advancing reimbursement policy, and driving broader adoption of innovative surgical techniques across the U.S.”
