NOVANT HEALTH FORSYTH MEDICAL CENTER· WINSTON-SALEM, NC
HospitalCMS 4/5
3333 SILAS CREEK PARKWAY, WINSTON-SALEM, NC 27103
Procedures offered
940 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Nuclear antigen antibody CPT 86235 • Laboratory | $9 | $20 | $30 |
| Heterophile antibodies screen CPT 86308 • Laboratory | $3 | $6 | $8 |
| TB skin test intradermal CPT 86580 • Laboratory | $3 | $11 | $22 |
| Blood typing ABO CPT 86900 • Laboratory | $1 | $4 | $6 |
| Blood typing Rh CPT 86901 • Laboratory | $2 | $4 | $6 |
| Urine culture bacterial colony count CPT 87086 • Laboratory | $4 | $9 | $12 |
| Chlamydia nucleic acid amplification CPT 87491 • Laboratory | $17 | $33 | $53 |
| Gonorrhea nucleic acid amplification CPT 87591 • Laboratory | $17 | $33 | $60 |
| SARS-CoV-2 COVID-19 amplified probe CPT 87635 • Laboratory | $36 | $57 | $77 |
| Influenza virus assay with direct optical CPT 87804 • Laboratory | $12 | $20 | $31 |
| Amniocentesis diagnostic CPT 59000 • Maternity | $87 | $140 | $233 |
| Cordocentesis fetal blood sampling CPT 59012 • Maternity | $189 | $237 | $384 |
| Chorionic villus sampling CPT 59015 • Maternity | $143 | $175 | $228 |
| Fetal non-stress test CPT 59025 • Maternity | $16 | $41 | $60 |
| Insertion cervical dilator CPT 59200 • Maternity | $26 | $93 | $202 |
| Vaginal delivery including prenatal and postpartum care CPT 59400 • Maternity | $1,727 | $2,370 | $3,000 |
| Vaginal delivery only CPT 59409 • Maternity | $749 | $1,005 | $1,531 |
| Vaginal delivery including postpartum care CPT 59410 • Maternity | $891 | $1,196 | $1,597 |
| External cephalic version CPT 59412 • Maternity | $104 | $137 | $194 |
| Antepartum care 7 or more visits CPT 59426 • Maternity | $633 | $1,232 | $2,291 |
| Postpartum care only CPT 59430 • Maternity | $135 | $246 | $400 |
| Cesarean delivery including prenatal and postpartum care CPT 59510 • Maternity | $1,684 | $2,716 | $4,111 |
| Cesarean delivery only CPT 59514 • Maternity | $850 | $1,052 | $1,383 |
| Cesarean delivery including postpartum care CPT 59515 • Maternity | $1,074 | $1,863 | $2,974 |
| Vaginal delivery after prior cesarean (VBAC) including prenatal CPT 59610 • Maternity | $1,806 | $2,797 | $4,889 |
| Obstetric ultrasound first trimester CPT 76801 • Maternity | $43 | $131 | $263 |
| Obstetric ultrasound complete CPT 76805 • Maternity | $48 | $139 | $303 |
| Obstetric ultrasound detailed fetal anatomy CPT 76811 • Maternity | $83 | $194 | $245 |
| Obstetric ultrasound limited CPT 76815 • Maternity | $31 | $76 | $182 |
| Ultrasound transvaginal obstetric CPT 76817 • Maternity | $59 | $120 | $208 |
| Interactive complexity add-on CPT 90785 • Mental Health | $6 | $17 | $21 |
| Psychiatric diagnostic evaluation CPT 90791 • Mental Health | $179 | $243 | $334 |
| Psychiatric diagnostic evaluation with medical services CPT 90792 • Mental Health | $149 | $244 | $286 |
| Psychotherapy 30 minutes CPT 90832 • Mental Health | $59 | $108 | $163 |
| Psychotherapy 30 min add-on to E/M CPT 90833 • Mental Health | $50 | $88 | $110 |
| Psychotherapy 45 minutes CPT 90834 • Mental Health | $89 | $146 | $217 |
| Psychotherapy 45 min add-on to E/M CPT 90836 • Mental Health | $81 | $113 | $140 |
| Psychotherapy 60 minutes CPT 90837 • Mental Health | $142 | $202 | $326 |
| Psychotherapy 60 min add-on to E/M CPT 90838 • Mental Health | $128 | $147 | $184 |
| Psychotherapy crisis first 60 minutes CPT 90839 • Mental Health | $168 | $225 | $340 |
| Psychotherapy crisis each additional 30 minutes CPT 90840 • Mental Health | $76 | $102 | $163 |
| Family psychotherapy without patient CPT 90846 • Mental Health | $89 | $146 | $263 |
| Family psychotherapy with patient CPT 90847 • Mental Health | $106 | $150 | $273 |
| Group psychotherapy CPT 90853 • Mental Health | $28 | $46 | $103 |
| Brief emotional/behavioral assessment CPT 96127 • Mental Health | $4 | $7 | $12 |
| Lumbar puncture diagnostic CPT 62270 • Neurology | $70 | $168 | $288 |
| Chemodenervation of muscle cervical dystonia CPT 64612 • Neurology | $155 | $197 | $308 |
| Chemodenervation of muscle neck CPT 64616 • Neurology | $146 | $178 | $315 |
| Electroencephalogram (EEG) awake and asleep CPT 95816 • Neurology | $56 | $355 | $585 |
| Electroencephalogram (EEG) awake and asleep with activation CPT 95819 • Neurology | $52 | $296 | $539 |