SAMPSON REGIONAL MEDICAL CENTER· CLINTON, NC
HospitalCMS 3/5
607 BEAMAN ST, CLINTON, NC 28328
Procedures offered
933 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Preventive visit established patient infant CPT 99391 • Preventive Care | $67 | $85 | $119 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $64 | $89 | $127 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $78 | $94 | $127 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $87 | $105 | $139 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $71 | $101 | $143 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $100 | $126 | $152 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $81 | $119 | $163 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $22 | $31 | $37 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $82 | $111 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $214 | $320 | $449 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $197 | $286 | $449 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $89 | $162 | $202 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $150 | $179 | $231 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $96 | $120 | $158 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $105 | $197 | $301 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $190 | $250 | $327 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $190 | $238 | $306 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $124 | $244 | $412 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $204 | $296 | $439 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $274 | $661 | $1,406 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $63 | $84 | $97 |
| Spirometry CPT 94010 • Pulmonology | $8 | $17 | $32 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $19 | $38 | $47 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $26 | $48 | $76 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $13 | $23 | $32 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $108 | $159 | $243 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $10 | $17 | $29 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $12 | $21 | $30 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $31 | $53 | $67 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $32 | $49 | $67 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $33 | $53 | $66 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $1 | $2 | $2 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $11 | $23 | $41 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $84 | $99 | $119 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $120 | $131 | $146 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $178 | $198 | $228 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $39 | $142 | $345 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $366 | $456 | $568 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $636 | $934 | $1,445 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $35 | $53 | $88 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $498 | $1,555 | $2,393 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $75 | $160 | $239 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $68 | $103 | $126 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $1,058 | $1,266 | $1,658 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $1,250 | $1,364 | $1,533 |
| 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 | $130 | $172 |
| Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy | $30 | $134 | $275 |
| Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy | $193 | $216 | $259 |