Table 3. The baseline costs of each radiotherapy treatment defined by the 2014 Medicare payment schedule for hospital-based practice.
| No. | Service description | CPT | MPFS (facility price) | OPPS (mean cost) | Total |
|---|---|---|---|---|---|
| 3DCRT followed by 5 HDR BT | |||||
| 1 | MD office visit | 99205 | 170.16 | 200.4 | 370.56 |
| 2 | Simulation | 77290 | 507.25 | 360.25 | 867.5 |
| 3 | CT RT guidance for field placement | 77014 | 123.95 | 0 | 123.95 |
| 4 | Simulation device | 77334 | 150.46 | 234.67 | 385.13 |
| 5 | Clinical treatment plan | 77263 | 166.58 | 0 | 166.58 |
| 6 | 3D-Planning | 77295 | 485.04 | 1007.15 | 1492.19 |
| 7 | Calculation | 77300 | 67.35 | 100.82 | 168.17 |
| 8 | Treatment device | 77338 | 501.88 | 340.91 | 842.79 |
| 9 | Weekly treatment Management [8] | 77427 | 1490.24 | 0 | 1490.24 |
| 10 | Weekly physics [8] | 77336 | 598.96 | 1013.76 | 1612.72 |
| 11 | Special physics consult | 77370 | 114.63 | 167.38 | 282.01 |
| 12 | Special procedure | 77470 | 155.11 | 419.15 | 574.26 |
| 13 | 3D Delivery [25] | 77412 | 0 | 4624.25 | 4624.25 |
| 14 | Brachytherapy dosimetric plan [5] | 77327 | 1019.15 | 1105.1 | 2124.25 |
| 15 | Brachytherapy CT planning [5] | 77290 | 2536.25 | 1801.25 | 4337.5 |
| 16 | Placement of tandem and ovoids [5] | 57155 | 1470.55 | 4096.05 | 5566.6 |
| 17 | Brachytherapy source application [5] | C1717 | 0 | 1396.25 | 1396.25 |
| 18 | HDR delivery [5] | 77786 | 2423.4 | 3961.85 | 6385.25 |
| Total | – | 11980.96 | 20829.24 | 32810.2 | |
| 3DCRT followed by 5 non-robotic SBRT | |||||
| 1 | MD office visit | 99205 | 170.16 | 200.4 | 370.56 |
| 2 | Simulation | 77290 | 507.25 | 360.25 | 867.5 |
| 3 | Simulation device | 77334 | 150.46 | 234.67 | 385.13 |
| 4 | Clinical treatment plan | 77263 | 166.58 | 0 | 166.58 |
| 5 | 3DPlanning | 77295 | 485.04 | 1,007.15 | 1492.19 |
| 6 | Calculation | 77300 | 67.35 | 100.82 | 168.17 |
| 7 | Treatment device | 77338 | 501.88 | 340.91 | 842.79 |
| 8 | Weekly treatment management [8] | 77427 | 1490.24 | 0 | 1490.24 |
| 9 | Weekly physics [8] | 77336 | 598.96 | 1013.76 | 1612.72 |
| 10 | Special physics consult | 77370 | 114.63 | 167.38 | 282.01 |
| 11 | Special procedure | 77470 | 155.11 | 419.15 | 574.26 |
| 12 | 3D Delivery [25] | 77412 | 0 | 4624.25 | 4624.25 |
| 13 | CT RT guidance for field placement [6] | 77014 | 743.7 | 0 | 743.7 |
| 14 | SRT treatment device [5] | 77334 | 752.3 | 1173.35 | 1925.65 |
| 15 | SRT treatment delivery [5] | 77373 | 0 | 13237.65 | 13237.65 |
| 16 | IGRT daily [5] | 77014 | 619.75 | 0 | 619.75 |
| Total | – | 6523.41 | 22879.74 | 29403.15 | |
| IMRT 25 fractions | |||||
| 1 | MD office visit | 99205 | 170.16 | 200.4 | 370.56 |
| 2 | Simulation | 77290 | 507.25 | 360.25 | 867.5 |
| 3 | CT RT guidance for field placement | 77014 | 123.95 | 0 | 123.95 |
| 4 | Simulation device | 77334 | 150.46 | 234.67 | 385.13 |
| 5 | Clinical treatment plan | 77263 | 166.58 | 0 | 166.58 |
| 6 | IMRT planning | 77301 | 1959.87 | 1094.91 | 3054.78 |
| 7 | Calculation | 77300 | 67.35 | 100.82 | 168.17 |
| 8 | Treatment device | 77338 | 501.88 | 340.91 | 842.79 |
| 9 | Weekly treatment management [5] | 77427 | 931.4 | 0 | 931.4 |
| 10 | Weekly physics [5] | 77336 | 374.35 | 633.6 | 1007.95 |
| 11 | Special physics consult | 77370 | 114.63 | 167.38 | 282.01 |
| 12 | Special procedure | 77470 | 155.11 | 419.15 | 574.26 |
| 13 | IMRT treatment delivery [25] | 77418 | 0 | 12819.75 | 12819.75 |
| 14 | IGRT daily [25] | 77014 | 3098.75 | 0 | 3098.75 |
| Total | – | 8321.74 | 16371.84 | 24693.58 | |
CPT, current procedural terminology; MD, medical doctor; HDR, high dose rate;3DCRT, 3 dimensional conformal radiotherapy; SBRT, stereotactic body radiotherapy; SRT, stereotactic radiotherapy; IGRT, image guidance radiotherapy; IMRT, intensity modulated radiation therapy; MPFS, medicare physician fee schedule; OPPS, outpatient prospective payment system.