NOVANT HEALTH ROWAN MEDICAL CENTER LLC· SALISBURY, NC

HospitalCMS 2/5

612 MOCKSVILLE AVE, SALISBURY, NC 28144

Procedures offered

984 total

ProcedureMinAvgMax
Preventive visit established patient infant
CPT 99391 • Preventive Care
$67$135$203
Preventive visit established patient age 1-4
CPT 99392 • Preventive Care
$74$152$260
Preventive visit established patient age 5-11
CPT 99393 • Preventive Care
$78$141$240
Preventive visit established patient age 12-17
CPT 99394 • Preventive Care
$89$177$283
Preventive visit established patient age 18-39
CPT 99395 • Preventive Care
$89$185$289
Preventive visit established patient age 40-64
CPT 99396 • Preventive Care
$100$217$362
Preventive visit established patient age 65+
CPT 99397 • Preventive Care
$99$180$291
Cervical or vaginal cancer screening pelvic exam
HCPCS G0101 • Preventive Care
$22$45$89
Colorectal cancer screening flexible sigmoidoscopy
HCPCS G0104 • Preventive Care
$54$225$394
Colorectal cancer screening colonoscopy high risk
HCPCS G0105 • Preventive Care
$236$376$647
Colorectal cancer screening colonoscopy not high risk
HCPCS G0121 • Preventive Care
$197$375$647
Initial preventive physical exam (Welcome to Medicare)
HCPCS G0402 • Preventive Care
$89$218$375
Annual wellness visit initial
HCPCS G0438 • Preventive Care
$130$206$384
Annual wellness visit subsequent
HCPCS G0439 • Preventive Care
$87$144$244
Bronchoscopy diagnostic
CPT 31622 • Pulmonology
$101$241$438
Bronchoscopy with brushing
CPT 31623 • Pulmonology
$49$230$610
Bronchoscopy with bronchial alveolar lavage
CPT 31624 • Pulmonology
$49$324$784
Bronchoscopy with biopsy
CPT 31625 • Pulmonology
$195$559$988
Bronchoscopy with transbronchial lung biopsy
CPT 31628 • Pulmonology
$49$484$1,113
Bronchoscopy with endobronchial ultrasound biopsy
CPT 31652 • Pulmonology
$226$1,296$2,474
Ventilation assist and management initiation
CPT 94002 • Pulmonology
$75$118$223
Spirometry
CPT 94010 • Pulmonology
$8$31$62
Spirometry before and after bronchodilator
CPT 94060 • Pulmonology
$14$64$137
Bronchospasm provocation evaluation
CPT 94070 • Pulmonology
$27$49$83
Respiratory flow volume loop
CPT 94375 • Pulmonology
$23$74$116
Pulmonary stress test simple
CPT 94620 • Pulmonology
$139$139$139
Cardiopulmonary exercise test
CPT 94621 • Pulmonology
$30$134$372
Nebulizer inhalation treatment
CPT 94640 • Pulmonology
$17$34$49
Aerosol or vapor inhalation initial demonstration
CPT 94664 • Pulmonology
$15$26$49
Plethysmography lung volumes
CPT 94726 • Pulmonology
$10$35$60
Gas dilution lung volumes
CPT 94727 • Pulmonology
$10$49$98
Diffusing capacity (DLCO)
CPT 94729 • Pulmonology
$12$69$126
Pulse oximetry single measurement
CPT 94760 • Pulmonology
$1$6$15
Pulse oximetry continuous overnight
CPT 94762 • Pulmonology
$5$28$58
Radiation therapy planning simple
CPT 77261 • Radiation Therapy
$84$132$211
Radiation therapy planning intermediate
CPT 77262 • Radiation Therapy
$95$154$249
Radiation therapy planning complex
CPT 77263 • Radiation Therapy
$188$281$466
Radiation therapy simulation simple
CPT 77280 • Radiation Therapy
$34$220$621
Radiation therapy simulation complex
CPT 77290 • Radiation Therapy
$103$717$1,531
3-dimensional radiation therapy plan
CPT 77295 • Radiation Therapy
$253$1,113$3,542
Radiation therapy dose calculation
CPT 77300 • Radiation Therapy
$37$71$96
IMRT radiation therapy plan
CPT 77301 • Radiation Therapy
$498$1,315$2,408
Radiation treatment device design complex
CPT 77334 • Radiation Therapy
$62$171$499
Radiation physics consultation
CPT 77336 • Radiation Therapy
$78$167$280
Stereotactic radiosurgery (SRS) cranial
CPT 77371 • Radiation Therapy
$890$1,637$4,476
Stereotactic body radiation therapy (SBRT)
CPT 77373 • Radiation Therapy
$1,289$1,545$2,186
IMRT delivery simple
CPT 77385 • Radiation Therapy
$392$1,060$1,564
IMRT delivery complex
CPT 77386 • Radiation Therapy
$393$1,006$1,564
Radiation treatment delivery superficial
CPT 77407 • Radiation Therapy
$88$304$661
Radiation treatment delivery 3 or more MeV
CPT 77412 • Radiation Therapy
$98$266$576