NOVANT HEALTH THOMASVILLE MEDICAL CENTER· THOMASVILLE, NC

HospitalCMS 3/5

207 OLD LEXINGTON RD BOX 789, THOMASVILLE, NC 27360

Procedures offered

937 total

ProcedureMinAvgMax
Preventive visit new patient age 12-17
CPT 99384 • Preventive Care
$96$136$180
Preventive visit new patient age 18-39
CPT 99385 • Preventive Care
$100$245$628
Preventive visit new patient age 40-64
CPT 99386 • Preventive Care
$123$177$268
Preventive visit new patient age 65+
CPT 99387 • Preventive Care
$114$188$291
Preventive visit established patient infant
CPT 99391 • Preventive Care
$64$101$130
Preventive visit established patient age 1-4
CPT 99392 • Preventive Care
$75$119$188
Preventive visit established patient age 5-11
CPT 99393 • Preventive Care
$75$109$136
Preventive visit established patient age 12-17
CPT 99394 • Preventive Care
$85$121$154
Preventive visit established patient age 18-39
CPT 99395 • Preventive Care
$89$140$209
Preventive visit established patient age 40-64
CPT 99396 • Preventive Care
$100$151$223
Preventive visit established patient age 65+
CPT 99397 • Preventive Care
$112$165$239
Cervical or vaginal cancer screening pelvic exam
HCPCS G0101 • Preventive Care
$22$33$44
Colorectal cancer screening flexible sigmoidoscopy
HCPCS G0104 • Preventive Care
$54$89$111
Colorectal cancer screening colonoscopy high risk
HCPCS G0105 • Preventive Care
$295$340$388
Colorectal cancer screening colonoscopy not high risk
HCPCS G0121 • Preventive Care
$197$286$450
Initial preventive physical exam (Welcome to Medicare)
HCPCS G0402 • Preventive Care
$89$116$149
Annual wellness visit initial
HCPCS G0438 • Preventive Care
$158$202$231
Annual wellness visit subsequent
HCPCS G0439 • Preventive Care
$106$141$159
Bronchoscopy diagnostic
CPT 31622 • Pulmonology
$120$274$518
Bronchoscopy with brushing
CPT 31623 • Pulmonology
$124$250$406
Bronchoscopy with bronchial alveolar lavage
CPT 31624 • Pulmonology
$115$251$538
Bronchoscopy with biopsy
CPT 31625 • Pulmonology
$177$403$744
Bronchoscopy with transbronchial lung biopsy
CPT 31628 • Pulmonology
$240$430$792
Bronchoscopy with endobronchial ultrasound biopsy
CPT 31652 • Pulmonology
$260$858$1,432
Ventilation assist and management initiation
CPT 94002 • Pulmonology
$75$118$209
Spirometry
CPT 94010 • Pulmonology
$11$36$65
Spirometry before and after bronchodilator
CPT 94060 • Pulmonology
$19$36$56
Bronchospasm provocation evaluation
CPT 94070 • Pulmonology
$28$67$139
Respiratory flow volume loop
CPT 94375 • Pulmonology
$23$70$189
Cardiopulmonary exercise test
CPT 94621 • Pulmonology
$108$150$195
Nebulizer inhalation treatment
CPT 94640 • Pulmonology
$11$22$31
Aerosol or vapor inhalation initial demonstration
CPT 94664 • Pulmonology
$14$24$37
Plethysmography lung volumes
CPT 94726 • Pulmonology
$12$65$120
Gas dilution lung volumes
CPT 94727 • Pulmonology
$12$24$46
Diffusing capacity (DLCO)
CPT 94729 • Pulmonology
$39$74$130
Pulse oximetry single measurement
CPT 94760 • Pulmonology
$1$3$5
Pulse oximetry continuous overnight
CPT 94762 • Pulmonology
$11$27$59
Radiation therapy planning simple
CPT 77261 • Radiation Therapy
$69$104$146
Radiation therapy planning intermediate
CPT 77262 • Radiation Therapy
$105$143$221
Radiation therapy planning complex
CPT 77263 • Radiation Therapy
$164$219$344
Radiation therapy simulation simple
CPT 77280 • Radiation Therapy
$43$142$271
Radiation therapy simulation complex
CPT 77290 • Radiation Therapy
$347$491$813
3-dimensional radiation therapy plan
CPT 77295 • Radiation Therapy
$249$743$1,445
Radiation therapy dose calculation
CPT 77300 • Radiation Therapy
$37$76$134
IMRT radiation therapy plan
CPT 77301 • Radiation Therapy
$498$1,822$2,932
Radiation treatment device design complex
CPT 77334 • Radiation Therapy
$69$129$254
Radiation physics consultation
CPT 77336 • Radiation Therapy
$44$102$160
Stereotactic radiosurgery (SRS) cranial
CPT 77371 • Radiation Therapy
$733$1,309$2,317
Stereotactic body radiation therapy (SBRT)
CPT 77373 • Radiation Therapy
$717$1,685$2,272
IMRT delivery simple
CPT 77385 • Radiation Therapy
$392$392$392