미국에서 하지정맥류, 레이져 수술의 비용은?

Endovenous Laser Ablation Therapy

Facility coding and payment (hospital outpatient, ambulatory surgery center)

The following are possible coding options when coding and billing for the CoolTouch CTEV procedure. Other coding options may apply based on the patient's diagnosis.Coding of additional diagnoses and procedure codes, just as for principal diagnosis and procedure coding, is dependent on the documentation in the patient's medical record. Medical necessity must be established before coverage will be considered by any payer.

Table 3   -- 

Code	Description	Medicare 2010 Natl Avg Payment Rates*
		Hospital Outpatient	Amb Surg Center
CoolTouch CTEV Endovenous Laser Ablation Procedure
36478	Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated	$1,786.68	$1,117.30
36479	Second and subsequent veins treated in a single extremity, each through separate access sites. (List separately in addition to code for primary procedure.) Note: This is an add-on code and cannot be used without CPT 36478	$1,786.68	$1,117.30
Extremity Venous Studies
93965	Non-invasive physiologic studies of extremity veins, complete bilateral study	$108.09	Not payable in the ASC setting
93970	Duplex scan of extremity veins … complete bilateral study	$154.69
93971	Duplex scan of extremity veins … unilateral or limited study	$97.06
Sclerotherapy/Echosclerotherapy/Ultrasound-Guided Sclerotherapy
36468	Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); limb or trunk	$59.10	$35.17
36470	Injection of sclerosing solution; single vein	$59.10	$35.17
36471	Injection of sclerosing solution; multiple veins, same leg	$59.10	$35.17
76942	Ultrasonic guidance for needle placement … imaging supervision & interpretation	$00 – packaged	$00 - packaged
ligation
37700	Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions	$1,786.68	$903.96
37718	Ligation, division, and stripping, short saphenous vein	$1,786.68	$903.96
37722	Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below	$3,027.81	$1,473.18
37735	Ligation and division and complete stripping of long and short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia	$3,027.81	$1,473.18
37760	Ligation of perforator veins, subfascial, radical (Linton type), with or without skin graft, open	$1,786.68	$919.25
37780	Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)	$1,786.68	$919.25
37785	Ligation, division, and/or excision of varicose vein cluster(s), one leg	$1,786.68	$919.25
Phlebectomy
37765	Stab phlebectomy of varicose veins, one extremity; 10-20 stab incisions	$1,786.68	$1,063.22
ENDOVENOUS LASER ABLATION THERAPY Physician Payment – Facility and Non Facility Setting
Code	Description	Medicare 2010 Nat’l Avg Phys Payment*
		Non-Facility	Facility
CoolTouch CTEV Endovenous Laser Ablation Procedure
36478	Endovenous ablation therapy of incompetent vein, extremity, inclusive of all imaging guidance and monitoring, percutaneous, laser; first vein treated	$1,426.98	$369.84
36479	Second and subsequent veins treated in a single extremity, each through separate access sites. (List separately in addition to code for primary procedure.) Note: This is an add-on code and cannot be used without CPT 36478.	$403.02	$181.05
Extremity Venous Studies
93965	Non-invasive physiologic studies of extremity veins, complete bilateral study	$120.94	$18.07
93970	Duplex scan of extremity veins … complete bilateral study	$244.84	$35.40
93971	Duplex scan of extremity veins … unilateral or limited study	$161.50	$23.60
Sclerotherapy/Echosclerotherapy/Ultrasound-Guided Sclerotherapy
36468	Single or multiple injections of sclerosing solutions, spider veins (telangiectasia); limb or trunk	$00.00	$00.00
36470	Injection of sclerosing solution; single vein	$139.01	$72.64
36471	Injection of sclerosing solution; multiple veins, same leg	$171.83	$102.57
76942	Ultrasonic guidance for needle placement … imaging supervision & interpretation	$185.47	$34.66
ligation
37700	Ligation and division of long saphenous vein at saphenofemoral junction, or distal interruptions	$259.95	$259.95
37718	Ligation, division, and stripping, short saphenous vein	$450.22	$450.22
37722	Ligation, division, and stripping, long (greater) saphenous veins from saphenofemoral junction to knee or below	$502.95	$502.95
37735	Ligation and division and complete stripping of long and short saphenous veins with radical excision of ulcer and skin graft and/or interruption of communicating veins of lower leg, with excision of deep fascia	$655.97	$655.97
37760	Ligation of perforator veins, subfascial, radical (Linton type), with or without skin graft, open	$655.60	$655.60
37780	Ligation and division of short saphenous vein at saphenopopliteal junction (separate procedure)	$268.43	$268.43
37785	Ligation, division, and/or excision of varicose vein cluster(s), one leg	$356.56	$268.80
Phlebectomy
37765	Stab phlebectomy of varicose veins, one extremity; 10-20 stab incisions	$475.29	$475.29

*	All Medicare payment rates are current as of the time of printing.