ATRIUM HEALTH PINEVILLE· CHARLOTTE, NC

HospitalCMS 3/5

10628 PARK RD, CHARLOTTE, NC 28210

Procedures offered

966 total

ProcedureMinAvgMax
Group therapeutic procedures
CPT 97150 • Physical Therapy
$13$23$46
Physical therapy evaluation low complexity
CPT 97161 • Physical Therapy
$58$118$258
Physical therapy evaluation moderate complexity
CPT 97162 • Physical Therapy
$58$118$258
Physical therapy evaluation high complexity
CPT 97163 • Physical Therapy
$66$128$258
Physical therapy re-evaluation
CPT 97164 • Physical Therapy
$28$108$184
Therapeutic activities each 15 minutes
CPT 97530 • Physical Therapy
$18$44$91
Self-care/home management training each 15 min
CPT 97535 • Physical Therapy
$24$44$84
Wheelchair management training each 15 minutes
CPT 97542 • Physical Therapy
$21$37$81
Physical performance test each 15 minutes
CPT 97750 • Physical Therapy
$23$43$88
Orthotic management and training each 15 min
CPT 97760 • Physical Therapy
$24$53$122
Prosthetic training each 15 minutes
CPT 97761 • Physical Therapy
$23$44$107
Immunization admin first vaccine component
CPT 90460 • Preventive Care
$7$25$59
Immunization admin each additional component
CPT 90461 • Preventive Care
$5$12$22
Immunization admin injection single
CPT 90471 • Preventive Care
$7$25$53
Immunization admin injection each additional
CPT 90472 • Preventive Care
$5$16$38
HPV vaccine 9-valent
CPT 90651 • Preventive Care
$161$339$690
Pneumococcal conjugate vaccine 13-valent
CPT 90670 • Preventive Care
$18$208$260
Rotavirus vaccine pentavalent
CPT 90680 • Preventive Care
$101$135$215
Influenza vaccine quadrivalent preservative free
CPT 90686 • Preventive Care
$21$46$93
MMR vaccine
CPT 90707 • Preventive Care
$38$98$206
Tdap vaccine age 7 years or older
CPT 90715 • Preventive Care
$39$59$125
Varicella vaccine
CPT 90716 • Preventive Care
$90$198$403
Pneumococcal vaccine adult
CPT 90732 • Preventive Care
$92$140$274
Zoster vaccine recombinant adjuvanted
CPT 90750 • Preventive Care
$13$196$452
Genetic counseling 30 minutes
CPT 96040 • Preventive Care
$92$92$92
Preventive visit new patient infant
CPT 99381 • Preventive Care
$78$141$279
Preventive visit new patient age 1-4
CPT 99382 • Preventive Care
$85$148$292
Preventive visit new patient age 5-11
CPT 99383 • Preventive Care
$85$152$303
Preventive visit new patient age 12-17
CPT 99384 • Preventive Care
$100$192$340
Preventive visit new patient age 18-39
CPT 99385 • Preventive Care
$94$170$330
Preventive visit new patient age 40-64
CPT 99386 • Preventive Care
$123$226$380
Preventive visit new patient age 65+
CPT 99387 • Preventive Care
$134$245$413
Preventive visit established patient infant
CPT 99391 • Preventive Care
$64$120$250
Preventive visit established patient age 1-4
CPT 99392 • Preventive Care
$78$137$266
Preventive visit established patient age 5-11
CPT 99393 • Preventive Care
$78$137$266
Preventive visit established patient age 12-17
CPT 99394 • Preventive Care
$89$176$290
Preventive visit established patient age 18-39
CPT 99395 • Preventive Care
$84$140$298
Preventive visit established patient age 40-64
CPT 99396 • Preventive Care
$100$157$317
Preventive visit established patient age 65+
CPT 99397 • Preventive Care
$96$199$342
Cervical or vaginal cancer screening pelvic exam
HCPCS G0101 • Preventive Care
$22$49$99
Colorectal cancer screening flexible sigmoidoscopy
HCPCS G0104 • Preventive Care
$54$213$479
Colorectal cancer screening colonoscopy high risk
HCPCS G0105 • Preventive Care
$295$436$863
Colorectal cancer screening colonoscopy not high risk
HCPCS G0121 • Preventive Care
$197$453$864
Initial preventive physical exam (Welcome to Medicare)
HCPCS G0402 • Preventive Care
$89$199$421
Annual wellness visit initial
HCPCS G0438 • Preventive Care
$153$224$420
Annual wellness visit subsequent
HCPCS G0439 • Preventive Care
$106$180$331
Bronchoscopy diagnostic
CPT 31622 • Pulmonology
$104$397$665
Bronchoscopy with brushing
CPT 31623 • Pulmonology
$185$422$724
Bronchoscopy with bronchial alveolar lavage
CPT 31624 • Pulmonology
$78$252$653
Bronchoscopy with biopsy
CPT 31625 • Pulmonology
$92$432$884