Table 1.
Inputs and Calculations for Initial Therapy Costs
| Cost | Polidocanol injectable foam | Endovenous laser ablation | Radiofrequency ablation | Surgery | ||||
|---|---|---|---|---|---|---|---|---|
| Wholesale acquisition cost, $ | 710 | — | — | — | ||||
| Administration pack, $ | 40 | — | — | — | ||||
| Professional feesa, $19,20 | Office | Facility | Office | Facility | Office | Facility | Office | Facility |
| 1000 | 200 | 1354 | 367 | 1699 | 371 | — | 422 | |
| Facility feesb, $21 | — | 2139 | — | 2139 | — | 2139 | — | 2139 |
| Weights applied, % | 89 | 11 | 95 | 5 | 89 | 11 | — | 100 |
| Weighted average initial treatment costs (<20% coinsurance), $ | 1550 | 1130 | 1430 | 2049 | ||||
CPT codes used in calculations include: polidocanol injectable foam, CPT code 37799 (unlisted); assumed crosswalk to CPT 36475 (radiofrequency ablation) after removing the cost of the disposable catheter kit (the primary supply component of the professional fee); EVLA, CPT code 36478; RFA, CPT code 36475; surgery, weighted average of CPT codes 37765 (25.0%), 37766 (19.3%), 37722 (16.7%), 37785 (9.6%), 37799 (9.4%; also required ICD-9-CM code 454.xx), 37700 (9.3%), 37760 (4.0%), 37718 (3.3%), 37780 (1.8%), 37735 (0.7%), 37500 (0.5%), and 37761 (0.5%).
Facility fees were based on APC 0219.
APC indicates ambulatory payment classification; CPT, Current Procedural Terminology; ICD-9-CM, International Classification of Diseases, Ninth Revision, Clinical Modification; EVLA, endovenous laser ablation; RFA, radiofrequency ablation.