ONSLOW MEMORIAL HOSPITAL· JACKSONVILLE, NC

HospitalCMS 1/5

317 WESTERN BOULEVARD, JACKSONVILLE, NC 28546

Procedures offered

935 total

ProcedureMinAvgMax
Radiation treatment delivery 3 or more MeV
CPT 77412 • Radiation Therapy
$98$203$270
Radiation treatment management 5 treatments
CPT 77427 • Radiation Therapy
$193$233$304
Radiation therapy management complete course
CPT 77431 • Radiation Therapy
$110$131$172
Proton beam treatment simple
CPT 77520 • Radiation Therapy
$858$1,173$1,414
Proton beam treatment complex
CPT 77523 • Radiation Therapy
$923$953$974
Polysomnography under age 6
CPT 95782 • Sleep Medicine
$798$1,003$1,174
Polysomnography under age 6 with CPAP
CPT 95783 • Sleep Medicine
$158$610$847
Sleep study unattended
CPT 95800 • Sleep Medicine
$45$94$160
Sleep study unattended minimum 3 channels
CPT 95801 • Sleep Medicine
$40$59$91
Multiple sleep latency test (MSLT)
CPT 95805 • Sleep Medicine
$356$453$572
Polysomnography age 6 or older
CPT 95810 • Sleep Medicine
$123$295$630
Polysomnography with CPAP titration
CPT 95811 • Sleep Medicine
$136$406$650
CPAP combination oral/nasal mask
HCPCS A7027 • Sleep Medicine
$78$115$179
Respiratory assist device BiPAP without backup
HCPCS E0470 • Sleep Medicine
$111$527$903
CPAP device continuous positive airway pressure
HCPCS E0601 • Sleep Medicine
$35$134$351
Laparoscopic partial nephrectomy
CPT 50543 • Urology
$286$1,067$1,606
Laparoscopic radical nephrectomy
CPT 50545 • Urology
$257$1,093$1,576
Lithotripsy extracorporeal shock wave (ESWL)
CPT 50590 • Urology
$662$867$1,163
Complex uroflowmetry
CPT 51741 • Urology
$9$36$72
Post-void residual urine measurement
CPT 51798 • Urology
$13$15$18
Cystourethroscopy diagnostic
CPT 52000 • Urology
$132$166$198
Cystourethroscopy with tumor fulguration small
CPT 52234 • Urology
$266$301$337
Cystourethroscopy with tumor fulguration medium
CPT 52235 • Urology
$311$418$591
Cystourethroscopy with dilation of ureteral stricture
CPT 52260 • Urology
$227$305$433
Cystourethroscopy with ureteral stent insertion
CPT 52332 • Urology
$185$333$495
Cystourethroscopy with lithotripsy
CPT 52353 • Urology
$424$581$801
TURP transurethral resection of prostate
CPT 52601 • Urology
$628$750$834
Laser vaporization of prostate
CPT 52648 • Urology
$595$1,253$1,750
Circumcision
CPT 54150 • Urology
$163$180$204
Orchiectomy simple
CPT 54520 • Urology
$351$402$457
Orchiectomy radical inguinal
CPT 54530 • Urology
$434$538$634
Vasectomy
CPT 55250 • Urology
$291$382$464
Prostate biopsy needle or punch
CPT 55700 • Urology
$109$214$391
Radical prostatectomy retropubic
CPT 55840 • Urology
$1,264$1,759$2,405
Laparoscopic radical prostatectomy
CPT 55866 • Urology
$277$1,137$1,576