CATAWBA VALLEY MEDICAL CENTER· HICKORY, NC

HospitalCMS 3/5

810 FAIRGROVE CHURCH RD, HICKORY, NC 28602

Procedures offered

944 total

ProcedureMinAvgMax
Varicella vaccine
CPT 90716 • Preventive Care
$187$208$230
Pneumococcal vaccine adult
CPT 90732 • Preventive Care
$119$147$248
Zoster vaccine recombinant adjuvanted
CPT 90750 • Preventive Care
$220$233$248
Genetic counseling 30 minutes
CPT 96040 • Preventive Care
$52$52$52
Preventive visit new patient infant
CPT 99381 • Preventive Care
$57$101$189
Preventive visit new patient age 1-4
CPT 99382 • Preventive Care
$60$116$198
Preventive visit new patient age 5-11
CPT 99383 • Preventive Care
$63$111$206
Preventive visit new patient age 12-17
CPT 99384 • Preventive Care
$74$144$232
Preventive visit new patient age 18-39
CPT 99385 • Preventive Care
$71$122$226
Preventive visit new patient age 40-64
CPT 99386 • Preventive Care
$86$162$261
Preventive visit new patient age 65+
CPT 99387 • Preventive Care
$95$171$283
Preventive visit established patient infant
CPT 99391 • Preventive Care
$52$87$169
Preventive visit established patient age 1-4
CPT 99392 • Preventive Care
$55$105$181
Preventive visit established patient age 5-11
CPT 99393 • Preventive Care
$55$101$181
Preventive visit established patient age 12-17
CPT 99394 • Preventive Care
$63$119$198
Preventive visit established patient age 18-39
CPT 99395 • Preventive Care
$65$115$204
Preventive visit established patient age 40-64
CPT 99396 • Preventive Care
$70$129$217
Preventive visit established patient age 65+
CPT 99397 • Preventive Care
$75$143$233
Cervical or vaginal cancer screening pelvic exam
HCPCS G0101 • Preventive Care
$22$36$67
Colorectal cancer screening flexible sigmoidoscopy
HCPCS G0104 • Preventive Care
$54$798$3,348
Colorectal cancer screening colonoscopy high risk
HCPCS G0105 • Preventive Care
$126$932$3,348
Colorectal cancer screening colonoscopy not high risk
HCPCS G0121 • Preventive Care
$197$946$3,348
Initial preventive physical exam (Welcome to Medicare)
HCPCS G0402 • Preventive Care
$89$173$288
Annual wellness visit initial
HCPCS G0438 • Preventive Care
$150$206$288
Annual wellness visit subsequent
HCPCS G0439 • Preventive Care
$104$149$226
Bronchoscopy diagnostic
CPT 31622 • Pulmonology
$101$844$4,058
Bronchoscopy with brushing
CPT 31623 • Pulmonology
$120$887$4,058
Bronchoscopy with bronchial alveolar lavage
CPT 31624 • Pulmonology
$114$843$4,058
Bronchoscopy with biopsy
CPT 31625 • Pulmonology
$160$1,020$4,058
Bronchoscopy with transbronchial lung biopsy
CPT 31628 • Pulmonology
$180$935$4,058
Bronchoscopy with endobronchial ultrasound biopsy
CPT 31652 • Pulmonology
$226$2,227$9,194
Ventilation assist and management initiation
CPT 94002 • Pulmonology
$76$104$154
Spirometry
CPT 94010 • Pulmonology
$8$25$48
Spirometry before and after bronchodilator
CPT 94060 • Pulmonology
$10$35$65
Bronchospasm provocation evaluation
CPT 94070 • Pulmonology
$38$54$108
Respiratory flow volume loop
CPT 94375 • Pulmonology
$13$26$64
Cardiopulmonary exercise test
CPT 94621 • Pulmonology
$92$162$259
Nebulizer inhalation treatment
CPT 94640 • Pulmonology
$9$23$48
Aerosol or vapor inhalation initial demonstration
CPT 94664 • Pulmonology
$19$22$27
Plethysmography lung volumes
CPT 94726 • Pulmonology
$10$33$60
Gas dilution lung volumes
CPT 94727 • Pulmonology
$10$33$53
Diffusing capacity (DLCO)
CPT 94729 • Pulmonology
$51$65$93
Pulse oximetry single measurement
CPT 94760 • Pulmonology
$1$3$4
Pulse oximetry continuous overnight
CPT 94762 • Pulmonology
$11$27$40
Radiation therapy planning simple
CPT 77261 • Radiation Therapy
$68$99$184
Radiation therapy planning intermediate
CPT 77262 • Radiation Therapy
$95$110$127
Radiation therapy planning complex
CPT 77263 • Radiation Therapy
$149$196$300
Radiation therapy simulation simple
CPT 77280 • Radiation Therapy
$40$192$378
Radiation therapy simulation complex
CPT 77290 • Radiation Therapy
$80$354$732
3-dimensional radiation therapy plan
CPT 77295 • Radiation Therapy
$270$765$1,445