1.     Primary lesion Tx (biopsy, WLE, pathology, dermatology, surgery, oncology visits)

(15% closure, 60% flaps, 25% grafts)

$2,685.20

+$534.36 +$311.70

2.     Initial systemic workup

$15,336.00

3.     Workup and treatment for SLN: $3,521.80 x 40% =

LN recurrence (systemic recurrence included in rate of distant metastases): does not matter
RT adjunctive chemotherapy to SLN – does not matter

$1,408.70

4.     Workup and Tx for palpable LN: $4,039.75 x 40%
LN recurrence (systemic recurrence included in rate of distant metastases)
RT adjunctive chemotherapy to TLND

$1,615.90

5.     Workup and treatment for LR (like treatment for primary lesion; no other visits)

NA

6.     Workup and Tx for in-transit metastases like treatment for primary lesion; 0 other visits)
+ 2 medium excisions
+ 2 surgical visits
+ SLN or TLND

NA

7.     Workup and treatment for metastatic disease: $116,294.18

$116,294.18

8.     Surveillance (5 y)

NA

9.     Patient time costs: 445.1hr x $16.00/hr (including time during palliative care)

$7,122.13

10.   Terminal care costs 100% x $14,500.00

$14,500.00

Total

$159,808.17