Table 3 Cost tables

DRG 482

Hip and femur procedures except major joint without CC/MCC

9,830

[41]

HCPCS 99,222

Initial hospital care

143

[40]

HCPCS 27,245

Treat thigh fracture

1,300

[40]

HCPCS 99,203

Office/outpatient visit new (3-month)

122

[40]

HCPCS 99,213

Office/outpatient visit new (6-month)

85

[40]

HCPCS 99,214

Office/outpatient visit new (12-month)

85

[40]

SNF

14-day stay

4,620

[42]

Total

16,185

Extra cost of fracture complications

Code

Description

Medicare payment ($)

Source

DRG 481

Hip and femur procedures except major joint with CC

12,340

[41]

DRG 482

Hip and femur procedures except major joint without CC/MCC

9,830

[41]

Difference

2,510

Cost of the contralateral side’s prophylaxis (model A)

Description

Cost ($)

Source

Equipment

1,200

Assumption

Surgeon

500

Expert approximation

Total

1,700

Cost of the primary preventive procedure (model B)

Code

Description

Medicare payment ($)

Source

Equipment

1,200

Assumption

Surgeon

500

Expert approximation

HCPCS 99,222

Initial hospital care

143

[40]

HCPCS 99,203

Office/outpatient visit new (3-month)

122

[40]

HCPCS 99,213

Office/outpatient visit new (6-month)

85

[40]

HCPCS 99,214

Office/outpatient visit new (12-month)

85

[40]

SNF

One-day stay

330

[42]

Total

2,465