SENTARA ALBEMARLE REGIONAL MEDICAL CENTER· ELIZABETH CITY, NC

HospitalCMS 3/5

3050 HALSTEAD BLVD, ELIZABETH CITY, NC 27909

Procedures offered

938 total

ProcedureMinAvgMax
IMRT delivery simple
CPT 77385 • Radiation Therapy
$364$445$525
IMRT delivery complex
CPT 77386 • Radiation Therapy
$471$499$527
Radiation treatment delivery superficial
CPT 77407 • Radiation Therapy
$135$224$280
Radiation treatment delivery 3 or more MeV
CPT 77412 • Radiation Therapy
$150$256$363
Radiation treatment management 5 treatments
CPT 77427 • Radiation Therapy
$188$287$424
Radiation therapy management complete course
CPT 77431 • Radiation Therapy
$107$134$162
Proton beam treatment simple
CPT 77520 • Radiation Therapy
$129$804$1,296
Proton beam treatment complex
CPT 77523 • Radiation Therapy
$228$952$1,501
Polysomnography under age 6
CPT 95782 • Sleep Medicine
$122$901$1,274
Polysomnography under age 6 with CPAP
CPT 95783 • Sleep Medicine
$133$956$1,359
Sleep study unattended
CPT 95800 • Sleep Medicine
$0$100$179
Sleep study unattended minimum 3 channels
CPT 95801 • Sleep Medicine
$0$59$126
Multiple sleep latency test (MSLT)
CPT 95805 • Sleep Medicine
$144$417$600
Polysomnography age 6 or older
CPT 95810 • Sleep Medicine
$116$694$1,095
Polysomnography with CPAP titration
CPT 95811 • Sleep Medicine
$586$839$1,131
CPAP combination oral/nasal mask
HCPCS A7027 • Sleep Medicine
$129$156$198
Respiratory assist device BiPAP without backup
HCPCS E0470 • Sleep Medicine
$115$544$1,549
CPAP device continuous positive airway pressure
HCPCS E0601 • Sleep Medicine
$133$533$782
Laparoscopic partial nephrectomy
CPT 50543 • Urology
$1,507$2,025$2,287
Laparoscopic radical nephrectomy
CPT 50545 • Urology
$1,346$1,865$2,156
Lithotripsy extracorporeal shock wave (ESWL)
CPT 50590 • Urology
$558$1,045$1,380
Complex uroflowmetry
CPT 51741 • Urology
$8$80$247
Post-void residual urine measurement
CPT 51798 • Urology
$14$31$78
Cystourethroscopy diagnostic
CPT 52000 • Urology
$77$310$602
Cystourethroscopy with tumor fulguration small
CPT 52234 • Urology
$274$406$686
Cystourethroscopy with tumor fulguration medium
CPT 52235 • Urology
$321$413$488
Cystourethroscopy with dilation of ureteral stricture
CPT 52260 • Urology
$201$267$323
Cystourethroscopy with ureteral stent insertion
CPT 52332 • Urology
$175$634$963
Cystourethroscopy with lithotripsy
CPT 52353 • Urology
$435$672$1,175
TURP transurethral resection of prostate
CPT 52601 • Urology
$824$1,099$1,350
Laser vaporization of prostate
CPT 52648 • Urology
$673$2,013$3,147
Circumcision
CPT 54150 • Urology
$112$309$718
Orchiectomy simple
CPT 54520 • Urology
$323$465$590
Orchiectomy radical inguinal
CPT 54530 • Urology
$576$672$772
Vasectomy
CPT 55250 • Urology
$228$593$1,070
Prostate biopsy needle or punch
CPT 55700 • Urology
$145$282$350
Radical prostatectomy retropubic
CPT 55840 • Urology
$365$1,420$2,056
Laparoscopic radical prostatectomy
CPT 55866 • Urology
$312$1,773$2,677