NORTHERN HOSPITAL DISTRICT OF SURRY COUNTY· MOUNT AIRY, NC

ProviderCMS 4/5

830 ROCKFORD ST, MOUNT AIRY, NC 27030

Procedures offered

941 total

ProcedureMinAvgMax
Radiation physics consultation
CPT 77336 • Radiation Therapy
$70$121$153
Stereotactic radiosurgery (SRS) cranial
CPT 77371 • Radiation Therapy
$1,050$1,073$1,085
Stereotactic body radiation therapy (SBRT)
CPT 77373 • Radiation Therapy
$997$1,480$1,743
IMRT delivery simple
CPT 77385 • Radiation Therapy
$392$392$392
IMRT delivery complex
CPT 77386 • Radiation Therapy
$393$393$393
Radiation treatment delivery superficial
CPT 77407 • Radiation Therapy
$88$205$282
Radiation treatment delivery 3 or more MeV
CPT 77412 • Radiation Therapy
$98$186$237
Radiation treatment management 5 treatments
CPT 77427 • Radiation Therapy
$190$236$315
Radiation therapy management complete course
CPT 77431 • Radiation Therapy
$108$130$178
Proton beam treatment simple
CPT 77520 • Radiation Therapy
$300$833$1,481
Proton beam treatment complex
CPT 77523 • Radiation Therapy
$842$1,173$1,700
Polysomnography under age 6
CPT 95782 • Sleep Medicine
$196$936$1,513
Polysomnography under age 6 with CPAP
CPT 95783 • Sleep Medicine
$132$641$2,062
Sleep study unattended
CPT 95800 • Sleep Medicine
$62$132$301
Sleep study unattended minimum 3 channels
CPT 95801 • Sleep Medicine
$58$102$155
Multiple sleep latency test (MSLT)
CPT 95805 • Sleep Medicine
$56$304$572
Polysomnography age 6 or older
CPT 95810 • Sleep Medicine
$116$659$978
Polysomnography with CPAP titration
CPT 95811 • Sleep Medicine
$533$778$1,002
CPAP combination oral/nasal mask
HCPCS A7027 • Sleep Medicine
$90$159$245
Respiratory assist device BiPAP without backup
HCPCS E0470 • Sleep Medicine
$220$578$1,052
CPAP device continuous positive airway pressure
HCPCS E0601 • Sleep Medicine
$82$222$401
Laparoscopic partial nephrectomy
CPT 50543 • Urology
$207$1,471$2,396
Laparoscopic radical nephrectomy
CPT 50545 • Urology
$212$1,429$2,142
Lithotripsy extracorporeal shock wave (ESWL)
CPT 50590 • Urology
$662$876$1,165
Complex uroflowmetry
CPT 51741 • Urology
$9$50$108
Post-void residual urine measurement
CPT 51798 • Urology
$17$19$24
Cystourethroscopy diagnostic
CPT 52000 • Urology
$132$281$365
Cystourethroscopy with tumor fulguration small
CPT 52234 • Urology
$153$294$392
Cystourethroscopy with tumor fulguration medium
CPT 52235 • Urology
$179$345$460
Cystourethroscopy with dilation of ureteral stricture
CPT 52260 • Urology
$255$296$336
Cystourethroscopy with ureteral stent insertion
CPT 52332 • Urology
$154$388$619
Cystourethroscopy with lithotripsy
CPT 52353 • Urology
$385$524$623
TURP transurethral resection of prostate
CPT 52601 • Urology
$457$844$1,092
Laser vaporization of prostate
CPT 52648 • Urology
$436$1,175$2,722
Circumcision
CPT 54150 • Urology
$174$213$243
Orchiectomy simple
CPT 54520 • Urology
$399$464$538
Orchiectomy radical inguinal
CPT 54530 • Urology
$634$724$833
Vasectomy
CPT 55250 • Urology
$146$381$550
Prostate biopsy needle or punch
CPT 55700 • Urology
$109$266$396
Radical prostatectomy retropubic
CPT 55840 • Urology
$1,163$1,608$1,887
Laparoscopic radical prostatectomy
CPT 55866 • Urology
$190$1,500$2,314