Methodology — $/Procedure Build

What is a procedure?

A procedure in this calculator represents one primary truncal ablation plus its allocated share of the patient's diagnostic and follow-up care. Every dollar in the per-procedure number traces to a billable CPT we actually deliver — there is no goodwill, no projected uplift, and no unattributed revenue.

Build:
  1. Pick the primary CPT — 36475 RFA · 36482 VenaSeal · 36465 / 36466 Varithena foam. Apply payer mix × commercial multiplier × net realization to get the actual collected rate.
  2. Weight by procedure mix (VenaSeal 65% / Varithena 25% / RFA 10%) to get the blended Primary $/procedure.
  3. Add the per-procedure share of bundled per-patient lines: ultrasound (93970 / 93971) and liquid sclerotherapy (36470 / 36471). Allocation divisor = average primary procedures per patient.
  4. Apply a 10% conservatism buffer to the final number for investor presentation. E&M revenue (99203 / 99204 / 99213 / 99214) is excluded entirely as an additional buffer.

Active scenario: Base. Toggle scenarios on the Dashboard to see this page update live.

Scenario Multiplier (Base)

(25.0% govt + 75.0% comm × 1.496) × 0.94 realization = 1.290

Applied to every primary CPT's Medicare rate to get the actual collected rate. Commercial multiplier 1.496 = BCBS 30% × 1.30 + other commercial 70% × 1.58. Net realization = collections net of denials & write-offs.

Primary CPT Mix

Each procedure encounter bills one of these four codes. Weighted by volume share.

CPTDescriptionMixMedicare× Scenario MultContribution
36482VenaSeal — Cyanoacrylate Closure65.0%$1,453$1,874$1,218
36465Varithena foam — single segment15.0%$1,122$1,447$217
36466Varithena foam — multiple segments10.0%$1,254$1,617$162
36475RFA — Endovenous Radiofrequency10.0%$1,700$2,192$219
Weighted Primary $/procedure$1,816
Engine value (calcOverallBlendedRate) for reconciliation$1,816

Bundle Per Patient

Per-patient revenue lines allocated across the patient's primary procedures (divisor: 3.08 procs/patient, active scenario).

LineCPTsPer Patient÷ 3.08$/procedure
Ultrasound93970 · 93971$1,295$1,295 ÷ 3.08$420
Liquid sclerotherapy36470 · 36471$596$596 ÷ 3.08$193
E&M (excluded as buffer)99203 · 99204 · 99213 · 99214~$654 real-worldheld out$0
Bundle subtotal$614

Final $/procedure (Base)

Weighted Primary CPT$1,816
+ Bundle allocation (US + sclero)$614
Raw modeled $/procedure$2,430
× 10% conservatism buffer (0.90)× 0.90
Dashboard $/procedure (buffered)$2,187
Reconciliation: The engine reconciles every month to grossRevenue = medicareRevenue + commercialRevenue + usRevenue + scleroRevenue with zero rounding delta. The Y1 dashboard average is slightly lower than the mature rate shown above because months 1–5 use a credentialing-ramped blended rate (commercial credentialing builds gradually). Full per-month detail is at /api/audit.