How much will it cost?

Courtesy of Sxc.hu

In short, a lot.

In particular, the Congressional Budget Office estimates the medical device tax will bring in about $29 billion over 10 years, and Ernst & Young estimates that it will cost the industry $2.5 billion in 2013, raising devicemakers' existing federal tax burden by 29%.

Part of the government's case for the tax is the idea that the medical device industry will sell more products as more and more Americans get insured through the Affordable Care Act. Helpfully, the CBO has written those sales increases into its revenue projection, figuring that the industry's tax burden will tick upward each year, reaching $3.6 billion in fiscal 2022.

Furthermore, you can't calculate a company's tax burden simply by taking 2.3% off its annual domestic revenues. The IRS is more concerned with a device's monetary value, not so much the actual dollars changing hands. Considering most devicemakers have fairly complicated pricing structures and multivalent agreements with distributors, the net cost could far exceed 2.3% of sales.

That's led to widely diverging estimates from the industry's giants. Boston Scientific ($BSX) is preparing to pay $100 million in 2013, while Medtronic ($MDT) expects to cough up $175 million, and St. Jude Medical ($STJ) said it stands to lose about $60 million. Zimmer ($ZMH), on the other hand, scaled back the amount it expects to pay after taking a closer look at the numbers.

This is the first time the medical device industry has been subjected to an excise tax, so devicemakers' accounting practices might not be quite up to speed. In any case, we'll likely have a much better idea of how the tax affects revenues when first-quarter earnings sheets come out.

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