NOVANT HEALTH NEW HANOVER REGIONAL MEDICAL CENTER· WILMINGTON, NC

HospitalCMS 2/5

2131 S 17TH ST, WILMINGTON, NC 28402

Procedures offered

710 total

Procedure	Min	Avg	Max
Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care	$903	$903	$903
Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care	$903	$903	$903
Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care	$338	$621	$903
Annual wellness visit subsequent HCPCS G0439 • Preventive Care	$118	$118	$118
Bronchoscopy diagnostic CPT 31622 • Pulmonology	$113	$737	$1,725
Bronchoscopy with brushing CPT 31623 • Pulmonology	$74	$739	$1,725
Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology	$149	$756	$1,725
Bronchoscopy with biopsy CPT 31625 • Pulmonology	$67	$768	$1,725
Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology	$75	$782	$1,725
Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology	$1,268	$2,594	$3,920
Spirometry CPT 94010 • Pulmonology	$24	$25	$26
Spirometry before and after bronchodilator CPT 94060 • Pulmonology	$27	$31	$34
Bronchospasm provocation evaluation CPT 94070 • Pulmonology	$60	$60	$60
Respiratory flow volume loop CPT 94375 • Pulmonology	$35	$36	$37
Cardiopulmonary exercise test CPT 94621 • Pulmonology	$150	$150	$150
Nebulizer inhalation treatment CPT 94640 • Pulmonology	$8	$9	$11
Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology	$16	$17	$18
Plethysmography lung volumes CPT 94726 • Pulmonology	$52	$55	$58
Gas dilution lung volumes CPT 94727 • Pulmonology	$40	$40	$40
Diffusing capacity (DLCO) CPT 94729 • Pulmonology	$56	$57	$58
Pulse oximetry single measurement CPT 94760 • Pulmonology	$2	$3	$3
Pulse oximetry continuous overnight CPT 94762 • Pulmonology	$25	$25	$25
Radiation therapy planning simple CPT 77261 • Radiation Therapy	$120	$120	$120
Radiation therapy planning intermediate CPT 77262 • Radiation Therapy	$178	$178	$178
Radiation therapy planning complex CPT 77263 • Radiation Therapy	$136	$199	$262
Radiation therapy simulation simple CPT 77280 • Radiation Therapy	$30	$224	$418
Radiation therapy simulation complex CPT 77290 • Radiation Therapy	$65	$426	$788
3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy	$184	$471	$759
Radiation therapy dose calculation CPT 77300 • Radiation Therapy	$51	$77	$103
IMRT radiation therapy plan CPT 77301 • Radiation Therapy	$340	$1,665	$2,989
Radiation treatment device design complex CPT 77334 • Radiation Therapy	$49	$126	$202
Radiation physics consultation CPT 77336 • Radiation Therapy	$67	$93	$119
Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy	$2,064	$2,064	$2,064
Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy	$229	$229	$229
Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy	$150	$221	$292
Radiation therapy management complete course CPT 77431 • Radiation Therapy	$161	$161	$161
Polysomnography under age 6 CPT 95782 • Sleep Medicine	$768	$768	$768
Sleep study unattended CPT 95800 • Sleep Medicine	$114	$114	$114
Polysomnography age 6 or older CPT 95810 • Sleep Medicine	$108	$302	$495
Polysomnography with CPAP titration CPT 95811 • Sleep Medicine	$113	$315	$517
Laparoscopic partial nephrectomy CPT 50543 • Urology	$1,883	$3,760	$7,025
Laparoscopic radical nephrectomy CPT 50545 • Urology	$1,170	$1,585	$2,138
Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology	$675	$2,944	$7,025
Complex uroflowmetry CPT 51741 • Urology	$9	$131	$360
Post-void residual urine measurement CPT 51798 • Urology	$12	$134	$360
Cystourethroscopy diagnostic CPT 52000 • Urology	$93	$417	$903
Cystourethroscopy with tumor fulguration small CPT 52234 • Urology	$394	$2,157	$3,920
Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology	$335	$1,572	$3,920
Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology	$336	$1,031	$1,725
Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology	$196	$1,623	$3,920