OBJECTIVES: Turkish medical device sector has its own unique reimbursement and pricing setting. Pricing of medical devices is statutorily not regulated and freely set by manufacturers. However, Social Security Institution (SSI), the only competent authority for reimbursement, has been monitoring which devices to reimburse and regulate reimbursement prices through official SSI generic positive lists (since 2011). Objective of this study is to describe the system used to define ceiling prices for reimbursement, concurrently assessing its alteration. METHODS: Health Implementation Communiqué (SUT) and public procurement law history regarding medical device pricing are analyzed. RESULTS: Our study shows that government’s impact has increased on reimbursement prices as a result of increasing budgetary concerns. After Public Procurement Law initiated in 2008, medical devices were sold at manufacturer defined prices and Public Procurement System (PPS) sales records were used to find average procurement price, which was then determined as reimbursement price. After SSI’s first implementation of positive lists in 2011, “average or lowest price in PPS” is used again to define ceiling prices, yet there were still items without a price. Since October 2014, the control over the reimbursement prices has increased as all items on SUT positive lists were assigned a price and no more “average price rule” of past procurement records exists. However, it is not clear how these reimbursement prices are defined and transparently conducted currently. CONCLUSIONS: Reimbursement prices are determined according to a merely retrospective and detection of lowest or average price practice. Effectiveness of this practice is the main concern since the data on PPS by hospitals may be misrecorded by hospitals. It has been quite challenging to develop clear and fair criteria for reimbursement pricing. There remains an urgent need for productive discussion and collaboration between government and industry regarding reasonable funding, transparency, and clarity in the Turkish reimbursement pricing process