TABLE 2

Key Micro Costs: 2015 CMS and Hospital Cost Data

Hospital Costs (2015 PHIS)Median Length of StayMedian Cost, US $Range, US $
0222 (APR DRG for ventricular shunt surgery)0–2 d10 231.826115–58 404
CT brain2024516–5257
MRI32391008–8641
Facility charge (2015 Medicare payment)
 Level 5 ED visit (APC 0616)493394–592
 Ocular ultrasound (limited); CPT 7651293.6874.94–112.42
Description of serviceCPT codeTotal RVUsProfessional feea (range ± 20%), US $
 Level 5 ED visit (high complexity)99 2854.93176
 Observation/hospitalization (same date)99 2366.12219
 Initial hospital care99 2235.7204
 Subsequent hospital care99 2332.91104
 Discharge from hospital care99 2393107
 Replace and/or revise brain shunt62 23024.09861
 Replace and/or irrigate catheter62 22514.93534
 CSF shunt reprogram62 2522.4186
 CT brain without contrast70 4503.49125
 MRI brain without contrast70 5574.97178
 Anesthesia surgery on brain (base)6 U136
 Anesthesia (15–60 min)4 U90
 Total anesthesia billing10 U226
Total cost of management of future radiation-induced cancer21,2749 242b
  • APC, ambulatory payment classification; APR DRG, All Patients Refined Diagnosis Related Groups; CMS, Centers for Medicare & Medicaid Services; RVU, relative value units; U, units; —, not applicable.

  • a On the basis of the 2015 Medicare conversion factor of 35.7547 and anesthesia conversion factor of 22.6093.

  • b Includes hospital costs.