ONSLOW MEMORIAL HOSPITAL· JACKSONVILLE, NC
HospitalCMS 1/5
317 WESTERN BOULEVARD, JACKSONVILLE, NC 28546
Procedures offered
935 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $123 | $145 | $162 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $134 | $156 | $175 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $67 | $80 | $105 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $78 | $88 | $106 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $78 | $87 | $100 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $85 | $99 | $123 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $89 | $99 | $113 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $100 | $109 | $125 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $112 | $130 | $144 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $22 | $26 | $29 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $156 | $236 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $295 | $367 | $469 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $197 | $217 | $253 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $89 | $142 | $175 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $149 | $185 | $252 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $106 | $113 | $122 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $114 | $184 | $252 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $190 | $344 | $565 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $190 | $315 | $492 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $133 | $166 | $195 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $245 | $462 | $765 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $274 | $1,275 | $2,548 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $87 | $100 | $118 |
| Spirometry CPT 94010 • Pulmonology | $9 | $9 | $11 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $14 | $21 | $31 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $38 | $47 | $62 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $19 | $28 | $41 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $71 | $91 | $108 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $18 | $23 | $29 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $17 | $20 | $22 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $47 | $54 | $60 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $16 | $32 | $47 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $9 | $39 | $60 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $1 | $2 | $3 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $11 | $21 | $27 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $75 | $78 | $84 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $115 | $135 | $165 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $178 | $182 | $188 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $43 | $252 | $428 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $88 | $280 | $387 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $273 | $663 | $1,445 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $37 | $59 | $70 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $450 | $775 | $1,376 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $69 | $93 | $133 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $81 | $106 | $126 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $900 | $1,455 | $2,192 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $819 | $1,314 | $1,580 |
| IMRT delivery simple CPT 77385 • Radiation Therapy | $363 | $378 | $392 |
| IMRT delivery complex CPT 77386 • Radiation Therapy | $364 | $379 | $393 |
| Radiation treatment delivery superficial CPT 77407 • Radiation Therapy | $88 | $165 | $206 |