BETSY JOHNSON REGIONAL HOSPITAL· DUNN, NC

HospitalCMS 3/5

800 TILGHMAN DR, DUNN, NC 28334

Procedures offered

975 total

Procedure	Min	Avg	Max
Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care	$243	$362	$449
Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care	$122	$321	$449
Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care	$89	$194	$223
Annual wellness visit initial HCPCS G0438 • Preventive Care	$158	$201	$233
Annual wellness visit subsequent HCPCS G0439 • Preventive Care	$104	$141	$175
Bronchoscopy diagnostic CPT 31622 • Pulmonology	$186	$378	$789
Bronchoscopy with brushing CPT 31623 • Pulmonology	$121	$293	$363
Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology	$30	$327	$784
Bronchoscopy with biopsy CPT 31625 • Pulmonology	$195	$441	$988
Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology	$170	$478	$1,113
Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology	$201	$1,336	$2,746
Ventilation assist and management initiation CPT 94002 • Pulmonology	$84	$155	$262
Spirometry CPT 94010 • Pulmonology	$11	$36	$92
Spirometry before and after bronchodilator CPT 94060 • Pulmonology	$9	$49	$124
Bronchospasm provocation evaluation CPT 94070 • Pulmonology	$36	$84	$176
Respiratory flow volume loop CPT 94375 • Pulmonology	$23	$46	$116
Pulmonary stress test simple CPT 94620 • Pulmonology	$139	$139	$139
Cardiopulmonary exercise test CPT 94621 • Pulmonology	$87	$207	$293
Nebulizer inhalation treatment CPT 94640 • Pulmonology	$8	$26	$47
Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology	$16	$25	$45
Plethysmography lung volumes CPT 94726 • Pulmonology	$12	$57	$74
Gas dilution lung volumes CPT 94727 • Pulmonology	$33	$71	$126
Diffusing capacity (DLCO) CPT 94729 • Pulmonology	$8	$51	$74
Pulse oximetry single measurement CPT 94760 • Pulmonology	$0	$3	$10
Pulse oximetry continuous overnight CPT 94762 • Pulmonology	$11	$37	$64
Radiation therapy planning simple CPT 77261 • Radiation Therapy	$69	$116	$211
Radiation therapy planning intermediate CPT 77262 • Radiation Therapy	$101	$150	$268
Radiation therapy planning complex CPT 77263 • Radiation Therapy	$165	$266	$466
Radiation therapy simulation simple CPT 77280 • Radiation Therapy	$37	$232	$399
Radiation therapy simulation complex CPT 77290 • Radiation Therapy	$111	$600	$1,531
3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy	$441	$752	$1,445
Radiation therapy dose calculation CPT 77300 • Radiation Therapy	$31	$57	$91
IMRT radiation therapy plan CPT 77301 • Radiation Therapy	$498	$1,155	$1,800
Radiation treatment device design complex CPT 77334 • Radiation Therapy	$56	$133	$179
Radiation physics consultation CPT 77336 • Radiation Therapy	$115	$134	$229
Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy	$1,083	$1,736	$3,216
Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy	$1,294	$1,705	$3,829
IMRT delivery simple CPT 77385 • Radiation Therapy	$392	$809	$1,225
IMRT delivery complex CPT 77386 • Radiation Therapy	$393	$810	$1,228
Radiation treatment delivery superficial CPT 77407 • Radiation Therapy	$88	$277	$661
Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy	$30	$275	$739
Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy	$185	$272	$523
Radiation therapy management complete course CPT 77431 • Radiation Therapy	$100	$140	$244
Proton beam treatment simple CPT 77520 • Radiation Therapy	$444	$1,078	$2,197
Proton beam treatment complex CPT 77523 • Radiation Therapy	$733	$1,295	$2,522
Polysomnography under age 6 CPT 95782 • Sleep Medicine	$120	$1,204	$2,323
Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine	$158	$1,541	$3,307
Sleep study unattended CPT 95800 • Sleep Medicine	$38	$218	$330
Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine	$54	$116	$168
Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine	$168	$433	$572