ATRIUM HEALTH HOSPITALS INC· SHELBY, NC

HospitalCMS 2/5

201 E GROVER ST, SHELBY, NC 28150

Procedures offered

940 total

ProcedureMinAvgMax
CT chest with contrast
CPT 71260 • Imaging
$195$412$836
CT angiography chest
CPT 71275 • Imaging
$241$388$524
MRI cervical spine without contrast
CPT 72141 • Imaging
$272$436$646
MRI thoracic spine without contrast
CPT 72146 • Imaging
$182$353$433
MRI lumbar spine without contrast
CPT 72148 • Imaging
$163$592$1,340
X-ray shoulder complete
CPT 73030 • Imaging
$7$22$52
MRI joint upper extremity without contrast
CPT 73221 • Imaging
$261$353$456
X-ray knee 1-2 views
CPT 73560 • Imaging
$9$29$46
X-ray ankle complete
CPT 73610 • Imaging
$27$41$65
MRI lower extremity without contrast
CPT 73718 • Imaging
$58$250$456
MRI joint lower extremity without contrast
CPT 73721 • Imaging
$127$337$456
CT abdomen without contrast
CPT 74150 • Imaging
$97$153$257
CT abdomen and pelvis without contrast
CPT 74176 • Imaging
$96$214$340
CT abdomen and pelvis with contrast
CPT 74177 • Imaging
$64$253$333
CT abdomen and pelvis without then with contrast
CPT 74178 • Imaging
$324$402$629
Ultrasound abdominal complete
CPT 76700 • Imaging
$109$171$224
Ultrasound retroperitoneal complete
CPT 76770 • Imaging
$40$142$281
Ultrasound transvaginal
CPT 76830 • Imaging
$36$128$223
Ultrasound pelvic complete
CPT 76856 • Imaging
$42$92$188
Diagnostic mammography unilateral
CPT 77065 • Imaging
$68$138$223
Diagnostic mammography bilateral
CPT 77066 • Imaging
$39$162$280
Screening mammography bilateral
CPT 77067 • Imaging
$34$119$227
Nuclear myocardial perfusion study
CPT 78452 • Imaging
$96$524$1,324
Venipuncture (routine blood draw)
CPT 36415 • Lab
$5$5$5
Urinalysis non-automated without microscopy
CPT 81002 • Lab
$2$3$5
Basic metabolic panel
CPT 80048 • Laboratory
$5$7$9
Comprehensive metabolic panel
CPT 80053 • Laboratory
$5$6$8
Lipid panel
CPT 80061 • Laboratory
$8$10$14
Hepatic function panel
CPT 80076 • Laboratory
$4$6$8
Urinalysis with microscopy
CPT 81001 • Laboratory
$3$4$5
Urinalysis automated without microscopy
CPT 81003 • Laboratory
$2$2$2
Fecal hemoglobin immunoassay
CPT 82274 • Laboratory
$8$19$32
Vitamin D 25-hydroxy
CPT 82306 • Laboratory
$17$20$23
Creatine kinase (CK) total
CPT 82550 • Laboratory
$4$6$7
Creatinine urine
CPT 82570 • Laboratory
$3$5$8
Ferritin
CPT 82728 • Laboratory
$7$10$15
IgA IgD IgG IgM each
CPT 82784 • Laboratory
$5$7$10
Glucose quantitative blood
CPT 82947 • Laboratory
$3$4$6
Hemoglobin A1c
CPT 83036 • Laboratory
$7$11$15
Iron serum
CPT 83540 • Laboratory
$3$6$8
Iron binding capacity
CPT 83550 • Laboratory
$4$7$10
Prostate specific antigen (PSA)
CPT 84153 • Laboratory
$10$18$29
Free thyroxine (T4)
CPT 84439 • Laboratory
$5$9$14
Thyroid stimulating hormone (TSH)
CPT 84443 • Laboratory
$11$17$20
Complete blood count with differential
CPT 85025 • Laboratory
$4$6$9
Complete blood count automated
CPT 85027 • Laboratory
$4$6$7
Prothrombin time (PT)
CPT 85610 • Laboratory
$3$4$6
Sedimentation rate (ESR) automated
CPT 85652 • Laboratory
$2$3$3
Partial thromboplastin time (PTT)
CPT 85730 • Laboratory
$3$5$6
Cyclic citrullinated peptide antibody
CPT 86200 • Laboratory
$6$11$15