DLP PERSON MEMORIAL HOSPITAL LLC· ROXBORO, NC
Hospital
615 RIDGE RD, ROXBORO, NC 27573
Procedures offered
663 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $230 | $230 | $230 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $158 | $158 | $158 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $85 | $85 | $85 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $75 | $75 | $75 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $73 | $73 | $73 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $110 | $110 | $110 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $95 | $95 | $95 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $1,755 | $5,257 | $6,954 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $1,755 | $5,507 | $6,954 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $1,755 | $5,146 | $6,953 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $3,287 | $6,220 | $6,954 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $3,287 | $6,037 | $6,953 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $3,287 | $5,814 | $6,954 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $3,287 | $6,220 | $6,954 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $3,287 | $6,220 | $6,954 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $6,575 | $6,878 | $6,954 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $191 | $191 | $191 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $290 | $290 | $290 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $452 | $452 | $452 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $603 | $603 | $603 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $981 | $981 | $981 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $648 | $648 | $648 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $84 | $84 | $84 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $3,660 | $3,660 | $3,660 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $165 | $165 | $165 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $213 | $213 | $213 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $2,900 | $2,900 | $2,900 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $2,642 | $2,642 | $2,642 |
| IMRT delivery simple CPT 77385 • Radiation Therapy | $950 | $950 | $950 |
| IMRT delivery complex CPT 77386 • Radiation Therapy | $953 | $953 | $953 |
| Radiation treatment delivery superficial CPT 77407 • Radiation Therapy | $472 | $472 | $472 |
| Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy | $626 | $626 | $626 |
| Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy | $511 | $511 | $511 |
| Radiation therapy management complete course CPT 77431 • Radiation Therapy | $286 | $286 | $286 |
| Proton beam treatment simple CPT 77520 • Radiation Therapy | $456 | $1,822 | $2,278 |
| Proton beam treatment complex CPT 77523 • Radiation Therapy | $2,653 | $2,653 | $2,653 |
| Polysomnography under age 6 CPT 95782 • Sleep Medicine | $1,816 | $1,816 | $1,816 |
| Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine | $1,916 | $1,916 | $1,916 |
| Sleep study unattended CPT 95800 • Sleep Medicine | $265 | $265 | $265 |
| Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine | $111 | $111 | $111 |
| Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine | $796 | $796 | $796 |
| Polysomnography age 6 or older CPT 95810 • Sleep Medicine | $1,083 | $1,083 | $1,083 |
| Polysomnography with CPAP titration CPT 95811 • Sleep Medicine | $1,132 | $1,132 | $1,132 |
| Laparoscopic partial nephrectomy CPT 50543 • Urology | $6,953 | $10,591 | $13,479 |
| Laparoscopic radical nephrectomy CPT 50545 • Urology | $3,287 | $6,037 | $6,953 |
| Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology | $6,953 | $12,947 | $14,767 |
| Complex uroflowmetry CPT 51741 • Urology | $1,085 | $1,085 | $1,085 |
| Post-void residual urine measurement CPT 51798 • Urology | $1,085 | $1,085 | $1,085 |
| Cystourethroscopy diagnostic CPT 52000 • Urology | $1,755 | $4,833 | $6,953 |
| Cystourethroscopy with tumor fulguration small CPT 52234 • Urology | $6,575 | $6,859 | $6,953 |