EAST CAROLINA HEALTH-BERTIE· WINDSOR, NC

HospitalCMS 5/5

1403 S KING ST, WINDSOR, NC 27983

Procedures offered

971 total

Procedure	Min	Avg	Max
Annual wellness visit subsequent HCPCS G0439 • Preventive Care	$74	$126	$166
Bronchoscopy diagnostic CPT 31622 • Pulmonology	$42	$223	$453
Bronchoscopy with brushing CPT 31623 • Pulmonology	$105	$240	$480
Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology	$158	$389	$784
Bronchoscopy with biopsy CPT 31625 • Pulmonology	$195	$488	$988
Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology	$245	$549	$1,113
Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology	$274	$1,035	$1,312
Ventilation assist and management initiation CPT 94002 • Pulmonology	$63	$99	$138
Spirometry CPT 94010 • Pulmonology	$8	$26	$51
Spirometry before and after bronchodilator CPT 94060 • Pulmonology	$19	$45	$124
Bronchospasm provocation evaluation CPT 94070 • Pulmonology	$26	$45	$59
Respiratory flow volume loop CPT 94375 • Pulmonology	$13	$40	$116
Pulmonary stress test simple CPT 94620 • Pulmonology	$139	$139	$139
Cardiopulmonary exercise test CPT 94621 • Pulmonology	$78	$154	$236
Nebulizer inhalation treatment CPT 94640 • Pulmonology	$12	$30	$47
Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology	$12	$23	$42
Plethysmography lung volumes CPT 94726 • Pulmonology	$10	$34	$60
Gas dilution lung volumes CPT 94727 • Pulmonology	$10	$38	$60
Diffusing capacity (DLCO) CPT 94729 • Pulmonology	$7	$40	$63
Pulse oximetry single measurement CPT 94760 • Pulmonology	$1	$3	$4
Pulse oximetry continuous overnight CPT 94762 • Pulmonology	$11	$25	$35
Radiation therapy planning simple CPT 77261 • Radiation Therapy	$52	$108	$211
Radiation therapy planning intermediate CPT 77262 • Radiation Therapy	$79	$125	$164
Radiation therapy planning complex CPT 77263 • Radiation Therapy	$123	$255	$466
Radiation therapy simulation simple CPT 77280 • Radiation Therapy	$39	$102	$224
Radiation therapy simulation complex CPT 77290 • Radiation Therapy	$342	$644	$1,531
3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy	$352	$725	$1,445
Radiation therapy dose calculation CPT 77300 • Radiation Therapy	$35	$67	$96
IMRT radiation therapy plan CPT 77301 • Radiation Therapy	$498	$1,692	$2,769
Radiation treatment device design complex CPT 77334 • Radiation Therapy	$62	$84	$94
Radiation physics consultation CPT 77336 • Radiation Therapy	$61	$116	$229
Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy	$833	$1,310	$1,767
Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy	$759	$1,405	$1,752
IMRT delivery simple CPT 77385 • Radiation Therapy	$392	$684	$1,225
IMRT delivery complex CPT 77386 • Radiation Therapy	$393	$478	$561
Radiation treatment delivery superficial CPT 77407 • Radiation Therapy	$88	$295	$661
Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy	$98	$245	$338
Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy	$140	$266	$523
Radiation therapy management complete course CPT 77431 • Radiation Therapy	$108	$125	$149
Proton beam treatment simple CPT 77520 • Radiation Therapy	$89	$774	$1,171
Proton beam treatment complex CPT 77523 • Radiation Therapy	$157	$1,156	$2,522
Polysomnography under age 6 CPT 95782 • Sleep Medicine	$195	$1,117	$2,323
Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine	$113	$392	$937
Sleep study unattended CPT 95800 • Sleep Medicine	$66	$163	$330
Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine	$58	$111	$179
Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine	$49	$377	$596
Polysomnography age 6 or older CPT 95810 • Sleep Medicine	$118	$529	$695
Polysomnography with CPAP titration CPT 95811 • Sleep Medicine	$105	$561	$731
CPAP combination oral/nasal mask HCPCS A7027 • Sleep Medicine	$109	$154	$202
Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine	$128	$715	$1,695