Table 6: Diagnosis-related group (DRG) codes are listed for all study-relevant inpatient discharge diagnoses; Healthcare Common Procedure Coding System (HCPCS) codes are listed for all relevant outpatient cardiac stress testing. Data is based on 2012 reimbursement figures. All values are listed in US dollars.
Inpatient service | DRG code | Reimbursement |
CABG | 238 - Major cardiovasc proc w/o MCC | $20,224.94 |
Inpatient ICA (with DES) | 247 - Percutaneous cardiovascular proc w/ | $12,016.59 |
Inpatient ICA (with BMS) | Drug eluting stent w/o MCC | $11,000.00 |
Inpatient ICA (diagnostic) | 287 - Circulatory disorders except AMI w/ card cath w/o MCC | $6,292.35 |
Medically managed MI | 282 - AMI discharged alive w/o CC/MCC | $4,344.40 |
Chest pain rule out | 313 - Chest pain | $2,951.06 |
Outpatient service | HCPCS code | Reimbursement |
SPECT MPI | 78452 - Ht muscle image spectmult | $549.98 |
Stress echo | 93351 - Stress TTE complete | $265.14 |
Exercise EKG | 93014 - Cardiovascular stress test | $96.68 |
CABG: coronary artery bypass graft; ICA: invasive coronary angiography; DES: drug-eluting stent; BMS: bare-metal stent; MI: myocardial infarction; MPI: myocardial perfusion imaging; MCC: major cardiac complications; TTE transthoracic echocardiogram.