LAKE NORMAN REGIONAL MEDICAL CENTER· MOORESVILLE, NC

HospitalCMS 2/5

171 FAIRVIEW ROAD, MOORESVILLE, NC 28117

Procedures offered

935 total

ProcedureMinAvgMax
Radiation treatment delivery 3 or more MeV
CPT 77412 • Radiation Therapy
$98$260$454
Radiation treatment management 5 treatments
CPT 77427 • Radiation Therapy
$186$256$389
Radiation therapy management complete course
CPT 77431 • Radiation Therapy
$104$145$220
Proton beam treatment simple
CPT 77520 • Radiation Therapy
$831$886$920
Proton beam treatment complex
CPT 77523 • Radiation Therapy
$968$1,449$2,405
Polysomnography under age 6
CPT 95782 • Sleep Medicine
$1,174$1,402$1,759
Polysomnography under age 6 with CPAP
CPT 95783 • Sleep Medicine
$158$588$1,335
Sleep study unattended
CPT 95800 • Sleep Medicine
$40$102$223
Sleep study unattended minimum 3 channels
CPT 95801 • Sleep Medicine
$58$85$114
Multiple sleep latency test (MSLT)
CPT 95805 • Sleep Medicine
$530$662$885
Polysomnography age 6 or older
CPT 95810 • Sleep Medicine
$237$538$776
Polysomnography with CPAP titration
CPT 95811 • Sleep Medicine
$474$757$1,090
CPAP combination oral/nasal mask
HCPCS A7027 • Sleep Medicine
$122$165$207
Respiratory assist device BiPAP without backup
HCPCS E0470 • Sleep Medicine
$227$883$1,829
CPAP device continuous positive airway pressure
HCPCS E0601 • Sleep Medicine
$70$191$498
Laparoscopic partial nephrectomy
CPT 50543 • Urology
$1,310$6,220$16,631
Laparoscopic radical nephrectomy
CPT 50545 • Urology
$1,576$3,092$5,919
Lithotripsy extracorporeal shock wave (ESWL)
CPT 50590 • Urology
$662$5,179$16,631
Complex uroflowmetry
CPT 51741 • Urology
$23$166$682
Post-void residual urine measurement
CPT 51798 • Urology
$18$157$682
Cystourethroscopy diagnostic
CPT 52000 • Urology
$85$579$2,195
Cystourethroscopy with tumor fulguration small
CPT 52234 • Urology
$299$2,234$7,926
Cystourethroscopy with tumor fulguration medium
CPT 52235 • Urology
$352$2,332$7,926
Cystourethroscopy with dilation of ureteral stricture
CPT 52260 • Urology
$255$1,788$5,919
Cystourethroscopy with ureteral stent insertion
CPT 52332 • Urology
$148$1,898$7,926
Cystourethroscopy with lithotripsy
CPT 52353 • Urology
$497$4,116$14,813
TURP transurethral resection of prostate
CPT 52601 • Urology
$834$4,624$14,813
Laser vaporization of prostate
CPT 52648 • Urology
$595$5,083$14,813
Circumcision
CPT 54150 • Urology
$104$1,748$7,926
Orchiectomy simple
CPT 54520 • Urology
$399$2,617$11,257
Orchiectomy radical inguinal
CPT 54530 • Urology
$167$3,218$11,257
Vasectomy
CPT 55250 • Urology
$208$1,892$7,926
Prostate biopsy needle or punch
CPT 55700 • Urology
$109$226$344
Radical prostatectomy retropubic
CPT 55840 • Urology
$1,606$2,949$5,919
Laparoscopic radical prostatectomy
CPT 55866 • Urology
$388$5,038$19,963