Capsule endoscopy in suspected small bowel Crohn’s disease: Economic impact of disease diagnosis and treatment

Table 2 Procedure charges used for the model according to the 2007 medicare fee schedule

HCPCS code	Procedure	Reimbursement	Colonoscopy w/SBFT	Capsule endoscopy
45380	Colonoscopy, flexible, proximal to splenic flexure; with biopsy, single or multiple	$491.15	x	x
74249	Radiological examination, gastrointestinal tract, upper, air contrast, with specific high density barium, effervescent agent, with or without glucagon; with small intestine follow-through	$177.87	x
88305	Level IV-surgical pathology, gross and microscopic examination	$115.38	x
88323	Consultation and report on referred material requiring preparation of slides	$150.09	x
91110	Gastrointestinal tract imaging, intraluminal (e.g. capsule endoscopy), esophagus through ileum, with physician interpretation and report	$950.00		x
99242	Office (gastroenterologist) consultation (Level 2)	$97.37	x	x
		Additional Medications1	$50
		Total	$1179.00	$1538.00

¹Additional medications: Sedatives, anxiolytics, and anti-emetics administered during a routine procedure.