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Table 3 Variables used in the model

From: The value of using a brain laser interstitial thermal therapy (LITT) system in patients presenting with high grade gliomas where maximal safe resection may not be feasible

Name Description Comment Root definition Low High
Percent_GTR_Neuroblate Percent of patients with a GTR deemed to be favorable for survival Data derived from Mohammadi et al. [24] 0.37 0 1
Percent_open_resection Percent of patients where open cranitomy was performed for a subtotal resection Data derived from Laws RE et al. [48] 0.78 0 1
Cost_blended_DRG25_26 Cost of craniotomy procedure for a patient with a high grade glioma—weighted average for DRGs 25–26 CRANIOTOMY and ENDOVASCULAR INTRACRANIAL PROCEDURES W CC or MCC (Nat Aver)—weighted average based on frequency of procedurs in Medicare patients for the 2012 calendar year. HCUPNet source $22,291 0 25,000
Cost_CPT_00210 National average payment amount Medicare for anesthesia Assumes surgical procedure to last at least 8 h, 30 min $1012.50 0 1012.5
Cost_CPT_61799 Stereotactic cranial lesion—complex Cost of creation of an additional stereotactic lesion (each complex lesion) above and beyond that created by CPT 61798 (assume 3 additional lesions)—each lesion @ $325/lesion (Medicare national average payment rate for 2015 $975 0 1406.76
Cost_CPT_61510 National average payment Medicare for a craniotomy to remove a brain tumor Craniotomy, trephination, for excision of a brain tumor $2225 0 2225
Cost_CPT_99144 Cost moederate sedation first 30 min Cost for moderate sedation of patient first 30 min $19.30 0 19.3
Cost_CPT_99145 Cost moderate sedation each additional 15 min at a cost of $9.40 for each 15 time increment   $9.40s 0 9.4
Cost_CPT_61798 National average payment amount Medicare for stereotactic radiosurgery Paid as part of the LITT procedure along with CPT 61510 and CPT 61781 $1408 0 1408
Cost_CPT_61800 National average payment Medicare for headframe placement 2015 national average payment rate for head frame placement used in stereotactic radiosurgery $165 0 235
Cost_CPT_99233 National average Medicare payment for E&M inpatient—subsequent patient visits   $105 0 105
Cost_CPT_99222 National average payment Medicare E&M care first patient visit   $138 0 138
Average_LOS_surgery Average length of hospital stay in days for patient having surgery in an eloquent area of the brain to remove a brain neoplasm   LOS_surgery_GBM 0 6
Average_LOS_LITT Average length of hospital stay for patient having LITT surgery for brain tumor   3 0 3
Average_LOS_brain_biopsy Average lengthe of hospital days for a brain biopsy—subtotal resection Derived from 2012 HCUPNet inpatient data on ICD9CM 01.13 (closed biopsy brain) 6 0 6
Local_recurrence_GBM Recurrence GBM that progresses locally Data derived from Pope WB et al. [49] 0.77 0 1
Cost_Routine_Home_Hospice Cost for routine home hospice care per day Medicare FY 2015   $159 0 300
Percent_palliative_care Percent of patients eligible for palliative care based on surviving <6 months Data derived from Park JK et al. [50] 0.44 0 0.44
Cost_CMG_302 Case mix group 302 for non-traumatic brain injury incurred during neurosurgery procedure. Surgery results in significant motor and cognitive deficits Assumes patient has “severe” comorbidities and inpatient rehabilitation facility (IRF) is paid at national weighted average of $23,310 for CMG 302 Tier 1 and Tier 2 at the mix of DRG 25 (59 %) and DRG 26 (41 %) (FY 2015 rate for Medicare). Derived from Federal Register, Vol. 79; No. 151, August 6, 2014, page 45888 $23,310 0 20,000
Cost_CPT_99220 Observation care facility setting—initial visit; 2015 Medicare national average payment Dervied from Medicare PPS FY 2015 $188 0 188
Cost_CPT_99226 Observation care facility setting—subsequent visit; 2015 Medicare national average payment Dervied from Medicare PPS FY 2015 $106 0 106
Cost_CPT_97001 National average payment Medicare for physical therapy initial evaluation Medicare PPS FY2015 $75.44 0 75.44
Cost_CPT_97112 National average payment rate for neuromuscular rehabilitation per day Medicare PFS FY 2015 $33.61 0 33.61
Average_LOS_IRF Length of stay inpatient rehabilitation facility post complication resulting for neurosurgery in an eloquent area of the brain Assumes and average LOS of 10 days—derived from Case Mix Group 301 for nontraumatic brain injury from surgery 10 0 10
Cost_APC_0067 CMS payment for APC 0067—cranial SRS CMS FY 2015 payment rate for aPC 0067 @ $9765.40—for SRS brain $9765.40 0 20,000
Cost_CPT_77372 National average payment for Medicare for treatment of brain cancer using SRS linear accelerator Medicare FY 2015 payment rate for SRS linear based $1063 0 1063
OS_Survival_KPS_70_or_lower Overall median survival in months with a Karnofsky Performance Score of less than or equal to 70 Derived from Simpson JR et al. [51] 7.8 0 7.8
OS_Survival_KPS_80_or_greater Overall median survival in months with a Karnofsky Score of 80 or greater Derived from Lacroix et al. [13] 11.2 0 11.2
OS_survival_SRS Median survival time in months for patients with SRS after failed surgery Derived from Niranjan A, et al. [52] 9.03 0 9.03
Cost_CPT_77262 Therapeutic radiation treatment planning—intermediate Radiation treatment planning for SRS (EBRT)—Medicare reimbursement for CY 2015 $113 0 113
Cost_CPT_77285 Therapeutic radiology simulation—intermediate Cost for simulation treatment—therapeutic radiology—Medicare CY 2015 payment rate $428 0 428
Cost_CPT_77306 Cost EBRT isodose plans for radiation therapy Cost for EBRT isodose planning—Medicare CY 2015 $146 0 146
Cost_CPT_77300 Cost for dosimetry calculations Medicare reimbursement for dosimetry calculations—CY 2015 $63 0 63
Cost_CPT_77333 Cost for design and construction for treatment devices used to protect normal tissues Medicare reimbursement CY 2015 for design and construction of treatment devices used to protect normal tissues $53 0 53
Cost_CPT_77336 Cost for medical physicists time in treatment and planning Medicare reimbursement for medical physicist CY 2015 $77 0 77
Cost_CPT_77370 Cost medical physicist consultative report Medicare payment for medical physicist consultative report $117 0 117
Cost_CPT_77432 Cost reporting patient’s care—review films, review dosimetry and chart Medicare reimbursement for reporting patient’s care during EBRT—CY 2015 $419 0 419
Cost_CPT_61517 Medicare reimbursement for placement of carmustine wafer placement in patient with high grade glioma Medicare national average reimbursement amount for placement of carmustine wafer placement in patient with a high grade glioma—2015 $94 0 94
Cost_DRG_23 National average reimbursement amount for DRG 23—craniotomy with major device implantation National average payment amount for DRG 23—craniotomy with major device implantation—chemo implant (e.g. carmustine wafer. Based on level II evidence, carmustine wafers are recommended in patients for whom craniotomy is indicated. Fadul CE et al. [28] $31,090 0 31,090
Costs_Planning_EBRT Combined physician service costs for EBRT Medicare 2015 reimbursement for planning and reporting on EBRT Cost_CPT_77262 + Cost_CPT_77285 + Cost_CPT_77300 + Cost_CPT_77306 + Cost_CPT_77333 + Cost_CPT_77336 + Cost_CPT_77370 + Cost_CPT_77432 0 1416
Cost_TMZ_with_radiation Cost TMZ oral therapy during period of radiation—total of 6 weeks Cost of TMZ as per Medicare fee schedule J8700 = $9.75/pill. Obtained from 2013 Ingenix HCPCS level II code national average Medicare payment amount. Therefore $9.75 X 42 = $409.50 $410 0 410
Cost_TMZ_per_pill Cost of TMZ per pill—HCPCS code J8700 Cost of TMZ per pill based on 2013 HCPCS level II code book for J8700 @ $9.75/pill $9.75 0 9.75
Percent_Gliadel_wafer Percent of time gliadel wafer used as adjuncitve therapy in high grade glioma post craniotomy Derived from Price et al. [30] Percent_Gliadel_wafer_implantations 0 1
Percent_neuro_deficit_Gliadel Percent of patients experiencing neurological deficit with Gliadel wafer Derived from Bregy et al. [37] 0.153 0 0
Percent_major_comps_surg_plus_Gliadel Combination of major complications resulting from major surgery plus Gliadel usage   Percent_neuro_deficit_Gliadel + Percent_major_complications_surgery 0 0
Percent_biopsy_disch_SNF_IRF Percent of patients with biopsy procedure discharged to SNF or IRF post biopsy Derived from Malone et al. 2015 World Neursurg—24.4 % of all patients with a stereotactic biopsy discharged either to SNF or IRF 0.244 0 0
Cost_SNF Cost skilled nursing facility in caring for a patient post brain surgery Derived from 2015 Medicare rates in caring for a person post brain surgery in a skilled nursing facility $4930 0 0