MOORESVILLE HOSPITAL MANAGEMENT ASSOCIATES LLC· MOORESVILLE, NC
ProviderCMS 2/5
171 FAIRVIEW RD, MOORESVILLE, NC 28117
Procedures offered
948 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $257 | $307 | $404 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $92 | $138 | $175 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $21 | $26 | $37 |
| MMR vaccine CPT 90707 • Preventive Care | $91 | $116 | $169 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $34 | $53 | $86 |
| Varicella vaccine CPT 90716 • Preventive Care | $163 | $223 | $324 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $133 | $152 | $209 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $176 | $248 | $382 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $78 | $136 | $219 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $89 | $146 | $190 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $89 | $147 | $238 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $100 | $151 | $202 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $100 | $157 | $262 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $116 | $167 | $234 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $134 | $209 | $328 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $67 | $105 | $137 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $78 | $127 | $150 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $78 | $142 | $210 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $88 | $138 | $230 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $89 | $144 | $174 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $100 | $144 | $191 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $112 | $173 | $208 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $0 | $24 | $48 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $980 | $2,329 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $295 | $1,134 | $2,329 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $197 | $969 | $2,329 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $89 | $217 | $400 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $158 | $277 | $509 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $106 | $211 | $401 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $186 | $2,637 | $6,280 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $190 | $2,653 | $6,280 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $190 | $2,630 | $6,280 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $195 | $2,697 | $6,280 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $245 | $2,772 | $6,280 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $274 | $4,364 | $8,409 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $97 | $134 | $184 |
| Spirometry CPT 94010 • Pulmonology | $11 | $31 | $56 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $10 | $41 | $76 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $42 | $57 | $75 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $29 | $36 | $49 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $108 | $150 | $206 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $10 | $20 | $29 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $21 | $26 | $37 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $17 | $42 | $66 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $12 | $51 | $92 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $9 | $59 | $98 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $0 | $2 | $4 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $11 | $31 | $52 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $69 | $99 | $144 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $105 | $188 | $331 |