SOUTHEASTERN REGIONAL MEDICAL CENTER· LUMBERTON, NC
HospitalCMS 2/5
300 W 27 ST PO BOX 1408, LUMBERTON, NC 28359
Procedures offered
923 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $4 | $87 | $171 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $56 | $58 | $60 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $78 | $78 | $78 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $9 | $256 | $504 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $9 | $257 | $505 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $5 | $130 | $256 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $5 | $134 | $262 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $4 | $90 | $177 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $8 | $195 | $383 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $9 | $216 | $424 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $8 | $33 | $58 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $9 | $9 | $9 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $10 | $293 | $575 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $7 | $7 | $7 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $3 | $3 | $3 |
| Spirometry CPT 94010 • Pulmonology | $39 | $48 | $58 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $56 | $72 | $88 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $88 | $89 | $90 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $55 | $56 | $58 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $94 | $94 | $94 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $13 | $35 | $58 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $25 | $41 | $58 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $79 | $79 | $80 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $63 | $63 | $63 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $14 | $48 | $82 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $3 | $3 | $3 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $37 | $37 | $37 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $99 | $106 | $112 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $3 | $3 | $3 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $5 | $211 | $416 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $9 | $211 | $414 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $661 | $702 | $744 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $690 | $716 | $742 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $95 | $98 | $101 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $60 | $1,461 | $2,862 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $95 | $145 | $194 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $3 | $60 | $117 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $853 | $853 | $853 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $32 | $32 | $32 |
| Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy | $6 | $253 | $500 |
| Radiation therapy management complete course CPT 77431 • Radiation Therapy | $3 | $85 | $166 |
| Proton beam treatment simple CPT 77520 • Radiation Therapy | $29 | $29 | $29 |
| Proton beam treatment complex CPT 77523 • Radiation Therapy | $33 | $33 | $33 |
| Polysomnography under age 6 CPT 95782 • Sleep Medicine | $32 | $32 | $32 |
| Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine | $33 | $33 | $33 |
| Sleep study unattended CPT 95800 • Sleep Medicine | $56 | $153 | $249 |
| Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine | $77 | $77 | $77 |
| Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine | $79 | $348 | $617 |
| Polysomnography age 6 or older CPT 95810 • Sleep Medicine | $883 | $897 | $912 |
| Polysomnography with CPAP titration CPT 95811 • Sleep Medicine | $924 | $938 | $952 |