Outpatient costs of conventional testing
| Diagnostic test | Reimbursement code | Unit payment* | Average number of tests during the year pre-ICM (baseline period) | Average number of tests per syncope event† |
| Emergency department visit | CPT 99284+APC 5024 | US$515 | N/A | 1 |
| Speciality physician consultation | CPT 99205 | US$229 | N/A | 2 |
| Holter monitor (24–48 hour) | CPT 93224 | US$101 | 0.26 | 0.11 |
| External loop recorder | CPT 93268 | US$227 | 0.15 | 0.07 |
| Mobile cardiovascular telemetry | CPT 93229 | US$805 | 0.17 | 0.07 |
| Extended Holter (up to 21 days) | CPT 0295T | US$145 | 0.01 | 0.00 |
| ECG | CPT 93000 | US$27 | 5.03 | 2.19 |
| CT (brain) | CPT 70460+APC 5571 | US$455 | 1.56 | 0.68 |
| CT (cardiac) | CPT 75574+APC 5571 | US$678 | 0.01 | 0.00 |
| MRI (brain) | CPT 70552+APC 5571 | US$628 | 0.55 | 0.24 |
| MRI (cardiac) | CPT 75559+APC 5523 | US$409 | 0.02 | 0.01 |
| Exercise test (cardiac stress test) | CPT 93015 | US$79 | 0.82 | 0.36 |
| Electroencephalogram | CPT 95812+APC 5722 | US$627 | 0.11 | 0.05 |
| Tilt test | CPT 93660+APC 5723 | US$659 | 0.16 | 0.07 |
| Electrophysiology study | CPT 93620+APC 0085 | US$6468 | 0.12 | 0.05 |
| Coronary angiogram | CPT 93454+APC 0080 | US$3979 | 0.20 | 0.09 |
| Carotid Doppler | CPT 93880+APC 5522 | US$425 | 0.72 | 0.31 |
| Basic laboratory testing | CPT 80053 | US$17 | 4.40 | 1.91 |
| Total weighted average cost | US$14 724 | US$2536 | ||
*Payments are based on national average payments, and represent a weighted average between Medicare and commercial paid amounts based on the proportion of patients with syncope covered by Medicare (66%).
†Calculated by dividing the average number of tests in the baseline year by the average number of syncope events (2.3) over the same period.
APC, ambulatory payment classification; CPT, current procedural terminology; CT, computed tomography; ECG, electrocardiogram; ICM, insertable cardiac monitor; MRI, magnetic resonance imaging.