SENTARA ALBEMARLE MEDICAL CENTER· ELIZABETH CITY, NC
HospitalCMS 3/5
1144 N ROAD ST, ELIZABETH CITY, NC 27909
Procedures offered
936 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $83 | $143 | $181 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $100 | $179 | $215 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $111 | $170 | $228 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $61 | $114 | $161 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $55 | $102 | $147 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $64 | $104 | $147 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $63 | $120 | $160 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $65 | $126 | $164 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $82 | $146 | $174 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $75 | $152 | $187 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $27 | $55 | $97 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $150 | $207 | $267 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $243 | $394 | $580 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $244 | $422 | $573 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $150 | $178 | $232 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $150 | $181 | $231 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $121 | $148 | $183 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $137 | $300 | $377 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $159 | $327 | $391 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $138 | $240 | $362 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $187 | $390 | $502 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $210 | $480 | $683 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $265 | $1,297 | $1,911 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $92 | $112 | $130 |
| Spirometry CPT 94010 • Pulmonology | $8 | $17 | $40 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $26 | $51 | $93 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $47 | $97 | $183 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $26 | $41 | $55 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $74 | $120 | $183 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $7 | $14 | $20 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $19 | $24 | $32 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $48 | $59 | $77 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $12 | $33 | $61 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $47 | $65 | $76 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $3 | $5 | $9 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $27 | $33 | $38 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $68 | $118 | $186 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $106 | $179 | $282 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $192 | $245 | $279 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $323 | $389 | $462 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $436 | $676 | $866 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $267 | $810 | $1,791 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $47 | $78 | $111 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $405 | $1,861 | $3,272 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $80 | $124 | $214 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $111 | $161 | $287 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $1,007 | $1,334 | $1,633 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $1,018 | $1,958 | $2,927 |
| IMRT delivery simple CPT 77385 • Radiation Therapy | $364 | $445 | $525 |
| IMRT delivery complex CPT 77386 • Radiation Therapy | $471 | $499 | $527 |