idea-008 · business case

Who pays, from which budget, how much, and 2-4 commercial routes to first revenue — every figure below traces to a copied claim or a declared assumption, and the routes are laid out unranked. Choosing a commercial strategy is a Tier 3 act, so this page presents options and stops.

Single-use office radiofrequency applicator with integrated dosimetry and disposable anoscope for grade II-III internal hemorrhoids, sized to the CPT 46930 non-facility payment — business case

Intended use: For use by a physician in an office setting to coagulate and devascularise symptomatic grade II and grade III internal hemorrhoids in adults, delivered transanally through an anoscope without sedation, in patients who have failed conservative medical management.

Who pays

The chain's weakest link is the same one the candidate's own scope note names as the whole premise. The budget line for a grade I-II sale is well understood and crowded. The budget line for a grade III sale — the one that would make this device more than a fourth entrant in an already-occupied category — depends on a clinical and regulatory claim [claim 33: unconfirmed], [claim 51: unconfirmed] that is, on the file's own reading, its central unproven premise.

The money model

Decomposed, not asserted. Every line resolves to a copied claim or a declared assumption.

LineFigureBacking
Addressable Medicare-claims procedure volume (46930 + 46945 + 46946)not established — Generator states no number, and the check is blocked only by a missing data/ cache[claim 7: unconfirmed]
Non-facility payment for 46930, aggregator-sourced reading~$158 non-facility / ~$248 facility[claim 5: unconfirmed]
Non-facility payment for 46930, CMS-primary-file-sourced reading — the reverse pairingnon-facility total RVU 7.42 is higher than facility total RVU 4.72, i.e. non-facility is the higher-paying setting (~$248), not the lower one (~$158)[claim 58: unconfirmed]
90-day global surgical period on 46930/46945/46946confirmed to exist as a CMS administrative field, independent of the AMA-licensed descriptor[claim 57: unconfirmed]
Realistic net selling price per disposable kit to the practice, constrained by the payment figure aboveroughly $40-60[claim 8: unconfirmed]
Landed manufacturing cost of the kit at that pricenot established[assumption A1]
Console placement cost to the manufacturer, recovered through the consumable marginnot established[assumption A2]
Procedures per practice per year, which decides whether a placed console pays backnot established[assumption A3]
Addressable share of qualifying procedures within five years15-25%[claim 9: unconfirmed]
Pace of practice adoption needed to reach that share inside the stated windownot established[assumption A4]
Gross margin on the disposable kitnot established — depends on [assumption A1] against [claim 8: unconfirmed][assumption A1]

Read the largest number first, and note it does not exist. No claim in the file, and no connector run for this case, produces a national revenue figure — the one genuinely checkable component (procedure volume, [claim 7: unconfirmed]) is unresolved for lack of a cached CMS file, and the two components that would turn a volume into a dollar figure — price [claim 8: unconfirmed] and share [claim 9: unconfirmed] — are Generator assumptions the file itself already records as such, not market data.

The two payment readings in the table above disagree about which site of service pays more, and that disagreement runs through every dollar figure downstream of it. The candidate's own $40-60 disposable-price ceiling was derived from the aggregator reading, ~$158 non-facility [claim 5: unconfirmed], not the CMS-primary-file reading, which puts non-facility at ~$248 and facility at ~$158 instead [claim 58: unconfirmed]. This case reports the discrepancy; the file itself records it as unresolved rather than as evidence either way.

The two connectors that would ordinarily carry a business case both refuse, and the verdicts go on the page rather than being routed around:

The connector's own suggested proxies were both attempted by the candidate's own Verifier passes and both remain blocked: coverage 46930 → unconfirmed, no local cache, the companion check behind [claim 5: unconfirmed]; procedures 46930 → unconfirmed, same missing-cache reason [claim 7: unconfirmed].

Path to first revenue

Routes

Four, laid out and not ranked. Choosing a commercial strategy is a Tier 3 act — the same class of decision as choosing what to shortlist — so this section presents options and stops.

Route A — Narrow to grade I-II and compete head-on with the entrenched bipolar RF incumbent

Match the intended use to the nearest predicate exactly — the HET Bipolar family's cleared scope [claim 52: verified] — trading away the candidate's own stated premise (durability at grade III) for the fastest, least contested clearance path.

Route B — Hold the grade II-III indication and argue the cross-code predicate story

Keep the candidate's own stated premise — durability at grade III — and pursue clearance on a mixed predicate argument: grade I-II bipolar RF applicators for modality and delivery route, plus the Ultroid grade I-IV predicate [claim 53: verified] for indication scope, even though it sits in a different product code and panel.

Route C — License the dosimetry-and-cutoff module into an already-cleared applicator

Ship the differentiator, not the whole device: an OEM impedance-dosimetry module into an existing bipolar RF or anorectal RFA platform — the HET Bipolar family [claim 40: verified] or the Barrx Anorectal RFA Wand [claim 43: unconfirmed] — neither of which claims dosimetry today.

Route D — Position against the surgical budget line, not the office one

Sell the grade III half of the indication as a substitute for escalation to hemorrhoidectomy rather than as a substitute for RBL or IRC, moving the comparator, and the budget, from the office consumable line to the facility/surgical-avoidance line the candidate's own scope note gestures at [claim 24: unconfirmed].

Assumption register

Every assumption cited above, with what would settle it and who could run it. These are written back to the candidate as unverified claims 65-72 — an assumption that lives only in a business case is invisible to the Verifier.

#AssumptionFalsifierOwner
A1A contract-manufacturing quote for the single-use bipolar RF applicator with integrated impedance-dosimetry electronics, at commercial launch volumes, yields a landed cost that leaves margin under the price ceiling the candidate's own economic claim implies [claim 65: unverified]A bill-of-materials cost roll-up / contract-manufacturing quote from an electrosurgical-device CM at stated launch volumes (e.g. 1,000 / 10,000 / 50,000 units/yr)Engineering + operations
A2The RF console can be placed into a purchasing practice at little or no upfront capital cost, recovered through the disposable-applicator margin on a razor-and-blade model [claim 66: unverified]Comparable console-placement terms for the incumbent HET Bipolar or Barrx Anorectal RFA lines — list price, lease terms, or placement agreements — from a distributor price list or a competitor quoteCommercial / business development
A3A colorectal surgery, gastroenterology, or proctology practice performs enough qualifying grade II-III procedures per year that one placed console reaches consumable-margin payback within a normal capital-equipment payback window [claim 67: unverified]Office procedure-volume-per-practice data — the same CMS Part B utilisation file that would resolve claim 7, cut by billing NPI or practice — benchmarked against the disposable margin from A1Commercial / business development
A4The number of practices adopting the device by year three to five is large enough, at the pace of a comparable single-specialty office-device launch, to reach the 15-25% addressable-share figure [claim 9: unconfirmed] inside the candidate's own five-year window [claim 68: unverified]Revealed-behaviour twin: practice/console adoption curves in the twelve to twenty-four months following the last two comparable clearances in this exact modality — K200146 (2020) and K250645 (2025) — from distributor sell-through data or the device makers directlyCommercial / business development
A5The lag between 510(k) clearance and the first paid consumable order — sales cycle, distributor onboarding, any GPO or health-system contracting — is short enough to finance inside a normal launch runway [claim 69: unverified]Time-to-first-order data from a comparable single-specialty office capital-equipment launch (e.g. the HET Bipolar or SleeveLUX launch), from a distributor or the device maker directlyCommercial / business development
A6The cost and calendar to build a sales and distribution channel into colorectal surgery, gastroenterology, and proctology practices, separate from the clearance spend, is affordable within a launch budget [claim 70: unverified]A signed or quoted distribution agreement in a comparable single-specialty office-device category, or headcount/cost data from a comparable launchCommercial / business development
A7The impedance-dosimetry control module can be qualified for integration into an already-cleared bipolar RF or anorectal applicator, as a licensing or OEM route, without triggering a new full 510(k) for the host device [claim 71: unverified]A regulatory consultant's written scoping opinion on whether adding the module to a cleared host device is a letter-to-file, a special 510(k), or a new submission, plus a bench-validation quote for the standalone moduleRegulatory consultant + engineering
A8A US comparative study large enough to demonstrate that a single office RF session at grade III reduces escalation to surgical hemorrhoidectomy, relative to rubber band ligation, is affordable and can be run in a useful calendar [claim 72: unverified]A CRO protocol scoping and quote against that endpoint, benchmarked to the design of the one relevant registered trial in this space, NCT04621695, the RBL-vs-hemorrhoidectomy noninferiority trial underlying [claim 59: unconfirmed]Clinical

Where this case outruns the file

Every figure with no claim behind it, gathered as work items.