OBJECTIVES: There are no published “real world” data for costs of drug-eluting stenting procedures with the TAXUS Paclitaxel-Eluting Stent System. Whether Medicare payments sufficiently cover costs of cases with comorbidities has not been investigated. METHODS: We analyzed resource utilization data from ARRIVE, a prospective, multicenter, community-hospital-based single arm US registry capturing 2,590 consecutive patients treated with the TAXUS stents at 50 sites. Procedural costs were calculated for subgroups with comorbidities of diabetes, renal disease, multivessel disease, congestive heart failure, left main disease, acute myocardial infarction (MI), and combinations of above conditions. Medical devices were priced using 2004 national average prices, and procedural medications using 2004 average wholesale prices. Hospitalization costs were calculated using the 2003 MedPAR files, adjusted to 2004 costs. RESULTS: As shown in the table below, patients with one or more comorbid conditions on average had higher resource utilization and costs, ranging from $16,077 for left main disease to $27,116 for renal disease (largely driven by the length of stay). CONCLUSIONS: Stenting cases with severe comorbidities incur higher costs than overall average. Average Medicare payments in 2003 were $17,441 for patients with MI (DRG 526) and $13,999 without MI (DRG 527). Clearly MI is not the only comorbid condition that drives high inpatient costs. The current DRG structure is not giving fair payments for patients with certain high-cost comorbidities.