DLP FRYE REGIONAL MEDICAL CENTER LLC· HICKORY, NC
ProviderCMS 2/5
420 N CENTER ST, HICKORY, NC 28601
Procedures offered
940 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Preventive visit new patient infant CPT 99381 • Preventive Care | $161 | $170 | $179 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $117 | $125 | $133 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $176 | $185 | $195 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $198 | $209 | $220 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $192 | $202 | $213 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $222 | $234 | $247 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $241 | $254 | $267 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $145 | $153 | $161 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $154 | $163 | $172 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $154 | $163 | $171 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $188 | $230 | $271 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $174 | $183 | $192 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $185 | $195 | $205 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $220 | $269 | $318 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $40 | $51 | $63 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $278 | $1,567 | $2,712 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $261 | $1,282 | $2,712 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $261 | $1,271 | $2,712 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $246 | $257 | $268 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $245 | $261 | $276 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $187 | $190 | $193 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $295 | $1,926 | $5,358 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $406 | $1,964 | $5,358 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $372 | $1,949 | $5,358 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $497 | $2,016 | $5,358 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $533 | $2,034 | $5,358 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $1,561 | $2,819 | $6,142 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $91 | $132 | $153 |
| Spirometry CPT 94010 • Pulmonology | $14 | $35 | $51 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $56 | $73 | $90 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $41 | $64 | $101 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $24 | $31 | $37 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $37 | $92 | $147 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $11 | $30 | $50 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $25 | $26 | $27 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $66 | $79 | $88 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $50 | $57 | $65 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $74 | $83 | $94 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $2 | $3 | $4 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $25 | $37 | $44 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $69 | $148 | $268 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $105 | $222 | $402 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $148 | $332 | $599 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $61 | $275 | $532 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $371 | $806 | $1,528 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $198 | $943 | $1,804 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $54 | $87 | $139 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $1,484 | $13,185 | $42,301 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $103 | $195 | $328 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $77 | $151 | $202 |