Amendment to Purchasing Agreement Agreement No. 4037 Vendor: Cardiovascular Systems, Inc Agreement Date: August 1, 2014 Amendment Date: December 1, 2017

Exhibit 10.57

Amendment to Purchasing Agreement

Agreement No. 4037

Vendor: Cardiovascular Systems, Inc

Agreement Date: August 1, 2014

Amendment Date: December 1, 2017

Effective as of the Amendment Date above, HealthTrust Purchasing Group, L.P., a Delaware Limited Partnership having its principal place of business at, 0000 Xxxxxxxxx Xxxxxx, Xxxxx 0000, Xxxxxxxxx, XX 00000, (hereinafter referred to as "HPG"), and Cardiovascular Systems Inc. (hereinafter referred to as “Vendor”), having its principal place of business at, 000 Xxxxxx Xxxxx, Xxxxx Xxxx, Xxxxxxxxx 00000-0000, hereby agree to amend their Purchasing Agreement dated, August 1, 2014, for ATHERECTOMY – MECHANICAL (the “Agreement”), as follows:

1.Definitions. The capitalized terms in this Amendment shall have the meaning designated in the Agreement unless otherwise expressly provided herein.

2.Term. The term of the Agreement shall be extended, with the Expiration Date listed in Exhibit B being amended to be, January 31, 2018.

3.Except as expressly amended by this Amendment, the terms and conditions of the Agreement shall remain in full force and effect.

Signatures Follow on Next Page

Exhibit 10.57

IN WITNESS WHEREOF, the parties hereby indicate their agreement to the terms of this Amendment by the signatures of their authorized representatives.

HealthTrust Purchasing Group, L.P.,        VENDOR: Cardiovascular Systems, Inc.

a Delaware limited partnership by

HPG Enterprises, LLC, a Delaware,

limited liability company, its general partner

HealthTrust Signee: /s/ Xxxx Xxxxxxx        Vendor Signee: /s/ Xxxxx Xxxxx

HealthTrust Signee Name: Xxxx Xxxxxxx        Vendor Signee Name: Xxxxx Xxxxx

HealthTrust Signee Title: AVP        Vendor Signee Title: VP, Market Development

HealthTrust Signature Date: 4/7/2017        Vendor Signature Date: 4/7/2017