OBJECTIVES: Growing interest in the use of Drug Eluting Stents (DES) in coronary angioplasty has prompted the Health Care Agency of the Emilia Romagna Region to draw up recommendations for their appropriate clinical use. Since the adoption of any new technology necessitates economic appraisal, we have analyzed the resource consumption by type of angioplasty procedure as well as the impact on the budget of a cardiology department. METHODS: A retrospective economic evaluation has been carried out on the angioplasty procedures performed in 2004 in the Cardiology Department of Reggio Emilia hospital. Using the Activity Based Costing method, detailed hospital costs have been estimated for each procedure and compared with the pertinent Italian DRG fees. RESULTS: In 2004, the Interventional Cardiology Department of Santa Maria Nuova Hospital in Reggio Emilia performed 806 angioplasty procedures for a total expenditure of €5,176,268. These were: 93 Plain Old Balloon Angioplasties (POBA) (€487,329), 401 procedures using Bare Metal Stents (BMS) (€2,380,071), 249 procedures using Drug Eluting Stents (DES) (€1,827,386) and 63 MIXED procedures(€481,480). Reimbursement via DRG funding amounted for €5,816,748 (11% for POBA, 50% for BMS, 31% for DES and 8% for MIXED procedures). The overall case-mix of the performed angioplasty procedures generated a positive margin of about €680,480 between the costs incurred and the reimbursement obtained. CONCLUSION: Analysis of the case-mix of procedures revealed that, although the adoption of innovative technologies increases costs, an overall positive margin between costs and DRG reimbursements can be achieved. It therefore emerges that, adherence in clinical practice to the guidelines designed by the Health Care Agency of the Emilia Romagna Region is economically sustainable from the point of view of the hospital-enterprise.