Table I.

Medicare-Based Reimbursement Rates for Outpatient (Combined Professional and Facility Fees) and Inpatient (Diagnosis Related Group [DRG]) Hospital Procedures in US dollars^*

Procedure	CPT Code	Prof + Fac Fee ($)	DRG
Bronchoscopy w/o TBNA	31622	560
EUS FNA	43242	480
EBUS FNA	31620	1,711
TBNA	31629	1,430
MED (outpatient)**	39400	1,842
MED (outpatient) – professional fee (anesthesia)**		1,196
MED (inpatient)**			6,624
TRC			16,913
Cytology	88173	27
Hospitalization for FNA complication***			24,456
Hospital admission***	99222	290
Hospital care × 1 day***	99231	105
Hospital discharge***	99238	170

^*based on 2007 Medicare Fee Schedule

^**direct cost of mediastinoscopy was based on 50% inpatient plus 50% outpatient reimbursement rates assuming that half of patients undergoing mediastinoscopy do so as outpatients and half as inpatients

^***management of FNA complication was assumed to require hospital admission (day 1), observation for 1 day (day 2) and discharge (day 3), i.e. a 3-day hospitalization. When a procedure related complication occurs, the original facility fee is lost, i.e. only the original professional fee remains which is added to the cost of the hospitalization

EUS = endoscopic ultrasound; FNA = fine needle aspiration; MED = mediastinoscopy; TBNA = transbronchial needle aspiration; EBUS = endobronchial ultrasound; TRC = thoracotomy