Table 1

Outpatient costs of conventional testing

Diagnostic testReimbursement codeUnit payment*Average number of tests during the year pre-ICM (baseline period)Average number of tests per syncope event†
Emergency department visitCPT 99284+APC 5024US$515N/A1
Speciality physician consultationCPT 99205US$229N/A2
Holter monitor (24–48 hour)CPT 93224US$1010.260.11
External loop recorderCPT 93268US$2270.150.07
Mobile cardiovascular telemetryCPT 93229US$8050.170.07
Extended Holter (up to 21 days)CPT 0295TUS$1450.010.00
ECGCPT 93000US$275.032.19
CT (brain)CPT 70460+APC 5571US$4551.560.68
CT (cardiac)CPT 75574+APC 5571US$6780.010.00
MRI (brain)CPT 70552+APC 5571US$6280.550.24
MRI (cardiac)CPT 75559+APC 5523US$4090.020.01
Exercise test (cardiac stress test)CPT 93015US$790.820.36
ElectroencephalogramCPT 95812+APC 5722US$6270.110.05
Tilt testCPT 93660+APC 5723US$6590.160.07
Electrophysiology studyCPT 93620+APC 0085US$64680.120.05
Coronary angiogramCPT 93454+APC 0080US$39790.200.09
Carotid DopplerCPT 93880+APC 5522US$4250.720.31
Basic laboratory testingCPT 80053US$174.401.91
Total weighted average costUS$14 724US$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.