Skip to main content
SpringerLink
Log in

Implementation of a hybrid angiography–CT system: increased short-term revenue at an academic radiology department

  • Practice
  • Published:
Abdominal Radiology Aims and scope Submit manuscript

Abstract

Purpose

To analyze the financial impact following implementation of a hybrid Angio–CT system at a tertiary care academic medical center.

Methods

Aggregate case types and volumes were compared 24 months before and 12 months after a hybrid Angio–CT system replaced a traditional interventional C-arm angiography suite at an academic medical center. Procedure revenues from this 36-month study period were derived from five payors mixes (Medicare, Medicaid, commercial insurance, out-of-pocket and managed care program) and Medicare-rate adjusted to each individual payor types.

Results

Average case volume per month increased 12% in the hybrid Angio–CT suite when compared to the previous traditional angiography suite (P < 0.05). The variety of IR procedures in the hybrid Angio–CT suite also expanded to include more complex interventional radiology and interventional oncology procedures; the breadth of cases performed in the hybrid Angio–CT suite were associated with CPT codes of higher rates (average CPT value/case increased from $2,334.61 to $2,567.25). The estimated average annual revenue of the hybrid Angio–CT suite increased 23% as compared to previous traditional angiography suite.

Conclusion

A hybrid Angio–CT system is a financially feasible endeavor at a tertiary care academic medical center that facilitated higher complexity procedure codes and increased procedure-related revenue.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

Availability of data and materials

The authors declare that they had full access to all of the data in this study and the authors take complete responsibility for the integrity of the data and the accuracy of the data analysis.

References

  1. Tanaka T, Arai Y, Inaba Y, et al. Current role of hybrid CT/angiography system compared with C-arm cone beam CT for interventional oncology. Br J Radiol. 2014;87(1041). https://doi.org/10.1259/bjr.20140126

  2. Piron L, Le Roy J, Cassinotto C, et al. Radiation Exposure During Transarterial Chemoembolization: Angio-CT Versus Cone-Beam CT. Cardiovasc Intervent Radiol. 2019;42(11):1609-1618. https://doi.org/10.1007/s00270-019-02269-8

    Article  PubMed  Google Scholar 

  3. Toyoda H, Kumada T, Sone Y. Impact of a unified CT angiography system on outcome of patients with hepatocellular carcinoma. Am J Roentgenol. 2009;192(3):766-774. https://doi.org/10.2214/AJR.08.1368

    Article  Google Scholar 

  4. Feinberg N, Funaki B, Hieromnimon M, et al. Improved Utilization Following Conversion of a Fluoroscopy Suite to Hybrid CT/Angiography System. J Vasc Interv Radiol. October 2020. https://doi.org/10.1016/j.jvir.2020.05.028

  5. NHE Fact Sheet | CMS. https://www.cms.gov/Research-Statistics-Data-and-Systems/Statistics-Trends-and-Reports/NationalHealthExpendData/NHE-Fact-Sheet. Accessed July 28, 2020.

  6. Medicaid-to-Medicare Fee Index | KFF. https://www.kff.org/medicaid/state-indicator/medicaid-to-medicare-fee-index/?currentTimeframe=0&sortModel=%7B%22colId%22:%22Location%22,%22sort%22:%22asc%22%7D. Accessed July 28, 2020.

  7. Chernew ME, Hicks AL, Shah SA. Wide State-Level Variation In Commercial Health Care Prices Suggests Uneven Impact Of Price Regulation. Health Aff (Millwood). 2020;39(5):791-799. https://doi.org/10.1377/hlthaff.2019.01377

    Article  PubMed  Google Scholar 

  8. Kutsenko O, Liu R, Borror W, et al. 4:03 PM Abstract No. 124 Stop the bleeding: What interventional radiologists need to know about the Medicare physician fee schedule cut. J Vasc Interv Radiol. 2020;31(3):S58. https://doi.org/10.1016/j.jvir.2019.12.155

  9. Heidrich J, Nguyen J, Florescu C, Steward A. Carbon dioxide CT angiography during endovascular treatment of bilateral common iliac disease with angio-CT utilisation. J Med Imaging Radiat Oncol. 2018;62(6):798-802. https://doi.org/10.1111/1754-9485.12799

    Article  PubMed  Google Scholar 

  10. Fu J, Liu F, Yuan K, et al. The Value of Hybrid Angio-CT in Preoperative Detection and Localization of Insulinomas: A Single-Center Retrospective Study. Cardiovasc Intervent Radiol. 2018;41(4):633-638. https://doi.org/10.1007/s00270-017-1847-2

    Article  PubMed  Google Scholar 

  11. Sone M, Arai Y, Sugawara S, et al. Angio-CT–Assisted Balloon Dissection: Protection of the Adjacent Intestine during Cryoablation for Patients with Renal Cancer. J Vasc Interv Radiol. 2016;27(9):1414-1419. https://doi.org/10.1016/j.jvir.2016.02.028

    Article  PubMed  Google Scholar 

  12. Kariya S, Nakatani M, Maruyama T, et al. Central venous access port placement by translumbar approach using angio-CT unit in patients with superior vena cava syndrome. Jpn J Radiol. 2018;36(7):450-455. https://doi.org/10.1007/s11604-018-0742-3

    Article  CAS  PubMed  Google Scholar 

  13. Crotty J, Horrocks I. Managing legacy system costs: A case study of a meta-assessment model to identify solutions in a large financial services company. Appl Comput Informatics. 2017;13(2):175-183. https://doi.org/10.1016/j.aci.2016.12.001

    Article  Google Scholar 

  14. Rawson J V., Kannan A, Furman M. Use of Process Improvement Tools in Radiology. Curr Probl Diagn Radiol. 2016;45(2):94-100. https://doi.org/10.1067/j.cpradiol.2015.09.004

    Article  PubMed  Google Scholar 

  15. Bruno MA. Advanced practice quality improvement: Beyond the radiology department. J Am Coll Radiol. 2014;11(12):1150-1154. https://doi.org/10.1016/j.jacr.2014.08.035

    Article  PubMed  Google Scholar 

  16. Dowell JD, Makary MS, Brocone M, Sarbinoff JG, Vargas IG, Gadkari M. Lean Six Sigma Approach to Improving Interventional Radiology Scheduling. J Am Coll Radiol. 2017;14(10):1316-1321. https://doi.org/10.1016/j.jacr.2017.02.017

    Article  PubMed  Google Scholar 

  17. Misono AS, Mueller PR, Hirsch JA, Sheridan RM, Siddiqi AU, Liu RW. Revenue Potential for Inpatient IR Consultation Services: A Financial Model. J Vasc Interv Radiol. 2016;27(5):658-664.e1. https://doi.org/10.1016/j.jvir.2016.01.144

    Article  PubMed  Google Scholar 

  18. Patel M V., Ahmed O, Hennemeyer C, Hatchett S, Sacramento M, Funaki B. IR is an Operational and Financial Hedge for Hospitals during COVID-19. J Vasc Interv Radiol. 2020;31(10):1724-1726. https://doi.org/10.1016/j.jvir.2020.07.019

    Article  PubMed  PubMed Central  Google Scholar 

  19. Lionberg A, Nijhawan K, Navuluri R, et al. Hybrid angiography-CT for transarterial radioembolization: a pictorial essay. Abdom Radiol. 2021;46(6):2850-2854. https://doi.org/10.1007/s00261-020-02914-8

    Article  Google Scholar 

  20. Yevich S, Odisio BC, Sheth R, Tselikas L, De Baère T, Deschamps F. Integrated CT-Fluoroscopy Equipment: Improving the Interventional Radiology Approach and Patient Experience for Treatment of Musculoskeletal Malignancies. Semin Intervent Radiol. 2018;35(4):229-237. https://doi.org/10.1055/s-0038-1669962

    Article  PubMed  PubMed Central  Google Scholar 

  21. Garnon J, Auloge P, Dalili D, Koch G, Cazzato RL, Gangi A. Combined Percutaneous Screw Fixation and Cementoplasty of the Odontoid Process. J Vasc Interv Radiol. 2019;30(10):1667-1669. https://doi.org/10.1016/j.jvir.2019.05.003

    Article  PubMed  Google Scholar 

  22. Matsumoto MM, Nijhawan K, Leef JA, Dorsey C, Ahmed O. Hybrid CT-angiography to facilitate lower extremity sharp venous recanalization: a novel approach to a common procedure. CVIR Endovasc. 2020;3(1):1-4. https://doi.org/10.1186/s42155-020-00145-y

    Article  Google Scholar 

  23. Sze DY, Strobel N, Fahrig R, Moore T, Busque S, Frisoli JK. Transjugular intrahepatic portosystemic shunt creation in a polycystic liver facilitated by hybrid cross-sectional/angiographic imaging. J Vasc Interv Radiol. 2006;17(4):711-715. https://doi.org/10.1097/01.RVI.0000208984.17697.58

    Article  PubMed  Google Scholar 

Download references

Acknowledgements

Canon Medical Systems USA, Inc.

Funding

Not applicable.

Author information

Authors and Affiliations

  1. Department of Radiology, University of Chicago, Chicago, IL, USA

    Jonathan Fergus, Karan Nijhawan, Nicholas Feinberg, Rakesh Navuluri, Steve Zangan, Brian S. Funaki & Osman Ahmed

  2. School of Medicine, University of Illinois at Chicago, Chicago, IL, USA

    Mark Hieromnimon

  3. Department of Radiology, University of Chicago Medical Center, 5841 South Maryland Avenue, MC2026, Chicago, IL, 60637, USA

    Karan Nijhawan

Authors
  1. Jonathan Fergus
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Karan Nijhawan
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Nicholas Feinberg
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Mark Hieromnimon
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. Rakesh Navuluri
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. Steve Zangan
    View author publications

    You can also search for this author in PubMed Google Scholar

  7. Brian S. Funaki
    View author publications

    You can also search for this author in PubMed Google Scholar

  8. Osman Ahmed
    View author publications

    You can also search for this author in PubMed Google Scholar

Contributions

JF: study design, data acquisition/analysis/interpretation, manuscript drafting/revisions. KN: manuscript drafting. NF: data acquisition/analysis. MH: manuscript drafting. RN: manuscript revisions. SZ: manuscript revisions. BSF: manuscript revisions, manuscript final approval. OA: study design, data acquisition/analysis/interpretation, manuscript drafting/revisions/final approval.

Corresponding author

Correspondence to Karan Nijhawan.

Ethics declarations

Conflict of interest

Dr. Funaki reports personal fees from Canon Medical Systems, during the conduct of the study. Dr. Ahmed reports personal fees from Canon Medical Systems, during the conduct of the study; personal fees from Argon, personal fees from Cardiva, personal fees from Phillips, personal fees from Medtronic, personal fees from Boston Scientific, personal fees from Johnson and Johnson, personal fees from Genentech, outside the submitted work. Dr. Fergus, Dr. Nijhawan, Dr. Feinberg, Dr. Hieromnimon, Dr. Navuluri, Dr. Zangan does not have any relevant financial or non-financial interests to disclose.

Additional information

Publisher's Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Fergus, J., Nijhawan, K., Feinberg, N. et al. Implementation of a hybrid angiography–CT system: increased short-term revenue at an academic radiology department. Abdom Radiol 46, 5428–5433 (2021). https://doi.org/10.1007/s00261-021-03204-7

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00261-021-03204-7

Keywords

Search

Navigation