Lung Volume Reduction Surgery (Reduction Pneumoplasty)

Medicare covers bilateral lung volume reduction surgery only for patients with documented severe emphysema who meet specific clinical, physiologic, imaging, smoking-abstinence, and rehabilitation criteria (including FEV1, TLC, RV, ABG thresholds, HRCT distribution, exercise testing, and specialist approvals). Surgery must be performed at an approved/certified facility and be preceded and followed by a NETT-consistent preoperative (16–20 sessions over 6–10 weeks) and postoperative (6–10 sessions within 8–9 weeks) program; several high-risk clinical scenarios (e.g., FEV1 ≤20% with homogeneous disease or DLCO ≤20%, inability to complete the program, or high perioperative risk) are explicitly non-covered.

"History and physical examination consistent with emphysema."

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