NOVANT HEALTH NEW HANOVER REGIONAL MEDICAL CENTER LLC· WILMINGTON, NC

ProviderCMS 2/5

2131 S 17TH ST, WILMINGTON, NC 28401

Procedures offered

715 total

Procedure	Min	Avg	Max
Preventive visit established patient age 40-64 CPT 99396 • Preventive Care	$113	$160	$184
Preventive visit established patient age 65+ CPT 99397 • Preventive Care	$131	$175	$198
Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care	$37	$37	$37
Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care	$903	$3,092	$5,281
Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care	$903	$3,092	$5,281
Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care	$338	$2,174	$5,281
Annual wellness visit subsequent HCPCS G0439 • Preventive Care	$118	$118	$118
Bronchoscopy diagnostic CPT 31622 • Pulmonology	$113	$646	$1,725
Bronchoscopy with brushing CPT 31623 • Pulmonology	$74	$659	$1,725
Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology	$149	$665	$1,725
Bronchoscopy with biopsy CPT 31625 • Pulmonology	$67	$705	$1,725
Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology	$75	$723	$1,725
Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology	$1,268	$2,152	$3,920
Spirometry CPT 94010 • Pulmonology	$24	$27	$30
Spirometry before and after bronchodilator CPT 94060 • Pulmonology	$27	$33	$37
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	$16	$30
Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology	$16	$21	$30
Plethysmography lung volumes CPT 94726 • Pulmonology	$12	$41	$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	$2	$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	$220	$262
Radiation therapy simulation simple CPT 77280 • Radiation Therapy	$30	$288	$418
Radiation therapy simulation complex CPT 77290 • Radiation Therapy	$65	$547	$788
3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy	$184	$567	$759
Radiation therapy dose calculation CPT 77300 • Radiation Therapy	$51	$86	$103
IMRT radiation therapy plan CPT 77301 • Radiation Therapy	$340	$2,106	$2,989
Radiation treatment device design complex CPT 77334 • Radiation Therapy	$49	$151	$202
Radiation physics consultation CPT 77336 • Radiation Therapy	$67	$102	$119
Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy	$2,064	$2,064	$2,064
Radiation treatment delivery superficial CPT 77407 • Radiation Therapy	$172	$172	$172
Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy	$229	$229	$229
Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy	$150	$245	$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
Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine	$339	$339	$339
Polysomnography age 6 or older CPT 95810 • Sleep Medicine	$108	$366	$495
Polysomnography with CPAP titration CPT 95811 • Sleep Medicine	$113	$382	$517
Laparoscopic partial nephrectomy CPT 50543 • Urology	$1,883	$3,413	$7,025
Laparoscopic radical nephrectomy CPT 50545 • Urology	$1,170	$1,723	$2,138
Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology	$675	$2,490	$7,025
Complex uroflowmetry CPT 51741 • Urology	$9	$105	$360
Post-void residual urine measurement CPT 51798 • Urology	$12	$108	$360