Table 3.
Total annual medical costs by health state and for a one-time nephrology evaluation
| Description | Cost ($)
|
Source | ||
|---|---|---|---|---|
| Base Case | Range
|
|||
| Lower | Upper | |||
| Single nephrology evaluation for CKDa | 266 | 133 | 399 | Based on CMS laboratory fee schedule (33) |
| Annual medical costs for patients with CKD (FN-CKD or TP-CKD), ages 65+ | 20,784 | 15,588 | 25,980 | USRDS ADR, 2007 (24) |
| Annual medical costs for patients without CKD stages 3-4 (TN-CKD), ages 65+ | 11,760 | 8,820 | 14,700 | Smith, USRDS ADR, 2007 (32, 24) |
| Annual medical costs for patients with ESRD, ages 65+ | 68,808 | 51,606 | 86,010 | USRDS ADR, 2007 (24) |
| One-time death cost | 37,611 | 28,208 | 47,014 | Hoover (34) |
Evaluation consists of new patient visit (CPT code 99203, outpatient visit of new patient with presenting problem of moderate severity), renal metabolic panel (CPT 80069), complete blood count (CPT 85025), urinalysis (CPT 81001), limited retroperitoneal ultrasound with image documentation (CPT 76775), urine protein (CPT 84156), urine creatinine (CPT 82570), and repeat patient visit (CPT 99213). CKD, chronic kidney disease, stages 3 to 4 (glomerular filtration rate 15 to 59 ml/min/1.73 m2); FN-CKD, false negative state for patient with chronic kidney disease, stages 3 to 4; TP-CKD, true positive state for patient with chronic kidney disease, stages 3 to 4; USRDS ADR, United States Renal Data System, Annual Data Report; TN-CKD, true negative state for patient without chronic kidney disease (glomerular filtration rate ≥ 60 ml/min/1.73 m2); ESRD, end stage renal disease (glomerular filtration rate < 15 ml/min/1.73 m2); CMS; Center for Medicare and Medicaid Services.