ONSLOW MEMORIAL HOSPITAL INC· JACKSONVILLE, NC

HospitalCMS 1/5

317 WESTERN BLVD, JACKSONVILLE, NC 28546

Procedures offered

954 total

ProcedureMinAvgMax
Gas dilution lung volumes
CPT 94727 • Pulmonology
$16$38$47
Diffusing capacity (DLCO)
CPT 94729 • Pulmonology
$9$40$60
Pulse oximetry single measurement
CPT 94760 • Pulmonology
$1$3$3
Pulse oximetry continuous overnight
CPT 94762 • Pulmonology
$11$23$27
Radiation therapy planning simple
CPT 77261 • Radiation Therapy
$73$76$84
Radiation therapy planning intermediate
CPT 77262 • Radiation Therapy
$105$125$165
Radiation therapy planning complex
CPT 77263 • Radiation Therapy
$162$175$188
Radiation therapy simulation simple
CPT 77280 • Radiation Therapy
$43$233$428
Radiation therapy simulation complex
CPT 77290 • Radiation Therapy
$88$305$594
3-dimensional radiation therapy plan
CPT 77295 • Radiation Therapy
$242$576$1,445
Radiation therapy dose calculation
CPT 77300 • Radiation Therapy
$31$59$76
IMRT radiation therapy plan
CPT 77301 • Radiation Therapy
$411$1,343$2,326
Radiation treatment device design complex
CPT 77334 • Radiation Therapy
$65$105$167
Radiation physics consultation
CPT 77336 • Radiation Therapy
$60$83$126
Stereotactic radiosurgery (SRS) cranial
CPT 77371 • Radiation Therapy
$900$1,398$2,192
Stereotactic body radiation therapy (SBRT)
CPT 77373 • Radiation Therapy
$819$1,458$1,813
IMRT delivery simple
CPT 77385 • Radiation Therapy
$363$373$392
IMRT delivery complex
CPT 77386 • Radiation Therapy
$364$374$393
Radiation treatment delivery superficial
CPT 77407 • Radiation Therapy
$88$213$291
Radiation treatment delivery 3 or more MeV
CPT 77412 • Radiation Therapy
$98$235$270
Radiation treatment management 5 treatments
CPT 77427 • Radiation Therapy
$182$211$304
Radiation therapy management complete course
CPT 77431 • Radiation Therapy
$100$117$172
Proton beam treatment simple
CPT 77520 • Radiation Therapy
$831$981$1,414
Proton beam treatment complex
CPT 77523 • Radiation Therapy
$923$1,502$2,616
Polysomnography under age 6
CPT 95782 • Sleep Medicine
$136$825$1,174
Polysomnography under age 6 with CPAP
CPT 95783 • Sleep Medicine
$114$531$847
Sleep study unattended
CPT 95800 • Sleep Medicine
$34$117$233
Sleep study unattended minimum 3 channels
CPT 95801 • Sleep Medicine
$34$67$106
Multiple sleep latency test (MSLT)
CPT 95805 • Sleep Medicine
$64$386$572
Polysomnography age 6 or older
CPT 95810 • Sleep Medicine
$123$428$792
Polysomnography with CPAP titration
CPT 95811 • Sleep Medicine
$136$479$856
CPAP combination oral/nasal mask
HCPCS A7027 • Sleep Medicine
$78$124$179
Respiratory assist device BiPAP without backup
HCPCS E0470 • Sleep Medicine
$111$621$1,219
CPAP device continuous positive airway pressure
HCPCS E0601 • Sleep Medicine
$35$288$498
Laparoscopic partial nephrectomy
CPT 50543 • Urology
$30$1,100$1,759
Laparoscopic radical nephrectomy
CPT 50545 • Urology
$257$1,315$1,584
Lithotripsy extracorporeal shock wave (ESWL)
CPT 50590 • Urology
$662$916$1,163
Complex uroflowmetry
CPT 51741 • Urology
$9$35$72
Post-void residual urine measurement
CPT 51798 • Urology
$13$18$25
Cystourethroscopy diagnostic
CPT 52000 • Urology
$132$201$257
Cystourethroscopy with tumor fulguration small
CPT 52234 • Urology
$266$292$337
Cystourethroscopy with tumor fulguration medium
CPT 52235 • Urology
$311$375$591
Cystourethroscopy with dilation of ureteral stricture
CPT 52260 • Urology
$45$239$433
Cystourethroscopy with ureteral stent insertion
CPT 52332 • Urology
$174$382$624
Cystourethroscopy with lithotripsy
CPT 52353 • Urology
$424$528$801
TURP transurethral resection of prostate
CPT 52601 • Urology
$628$835$988
Laser vaporization of prostate
CPT 52648 • Urology
$595$1,798$2,638
Circumcision
CPT 54150 • Urology
$163$181$204
Orchiectomy simple
CPT 54520 • Urology
$351$385$457
Orchiectomy radical inguinal
CPT 54530 • Urology
$434$550$634