The Centers for Medicare and Medicaid Services (CMS) has created a new Healthcare Common Procedure Coding System (HCPCS) code for the Surfacer® Inside-Out® Access Catheter System (Surfacer System) procedure which was effective October 1, 2021.


Click here to download the Surfacer® System Reimbursement Guide

Case Studies

Inside-Out® Upper Body Venous Access: First-in-Human Experience with a Novel Approach using the Surfacer®Inside-Out® Access Catheter System
Dr. Adrian Ebner, Dr. Santiago Gallo, Carlos Cetraro, RT, Dr. John Gurley, Laura Minarsch, RT (R), CVT, RCIS

A 30-year-old woman with renal failure required central venous access for hemodialysis. Angiography demonstrated chronic total occlusion of the internal jugular and subclavian veins, as well as total occlusion of the superior vena cava at the level of the right atrium. Attempts to obtain access by conventional methods failed, and the patient was referred for inside-out access using the Surfacer® Inside-Out® Access Catheter System.
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Novel “Inside Out” Approach to Central Venous Access in Patients with Occlusive Disease Requiring Hemodialysis
Gurley J, Minarsch L, Gallo S, Alvarez E, Silva E, Cetraro C, Ebner A
Presented at ISET 2013.

Inside Out Central Venous Access – Presentation (University of Kentucky May 9, 2012)
Gurley, JC
Heart Rhythm Society 2012, May 9-12, Boston MA.

Maintaining Patency in the Haemodialysis Circuit
Gilbert, J. and Sengölge, G.
Vascular Access Society of Britain and Ireland (VASBI), 2020 Annual Society Meeting, Oct 1-2, 2020, virtual meeting
VIEW PRESENTATION   (presentation on the Surfacer System starts at timecode 37:37)

Hemodialysis Access, Challenges and Solutions – Presentation at Stanford Surgery Grand Rounds
Sorial, E., February 23, 2021