DLP HARRIS REGIONAL HOSPITAL LLC· SYLVA, NC
HospitalCMS 3/5
68 HOSPITAL RD, SYLVA, NC 28779
Procedures offered
965 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Group therapeutic procedures CPT 97150 • Physical Therapy | $16 | $21 | $35 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $76 | $158 | $500 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $76 | $90 | $100 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $76 | $89 | $100 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $52 | $70 | $112 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $27 | $37 | $48 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $29 | $35 | $48 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $26 | $33 | $43 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $27 | $43 | $66 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $24 | $52 | $94 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $23 | $44 | $80 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $7 | $20 | $34 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $10 | $18 |
| Immunization admin injection single CPT 90471 • Preventive Care | $7 | $17 | $34 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $5 | $12 | $18 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $277 | $339 | $413 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $232 | $250 | $272 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $89 | $110 | $129 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $22 | $26 |
| MMR vaccine CPT 90707 • Preventive Care | $86 | $106 | $123 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $44 | $47 | $55 |
| Varicella vaccine CPT 90716 • Preventive Care | $165 | $200 | $241 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $105 | $120 | $133 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $194 | $234 | $270 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $58 | $58 | $58 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $78 | $122 | $159 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $85 | $136 | $167 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $63 | $135 | $174 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $100 | $157 | $197 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $100 | $153 | $191 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $123 | $219 | $380 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $134 | $204 | $240 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $52 | $112 | $152 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $55 | $127 | $166 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $55 | $118 | $153 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $83 | $114 | $165 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $89 | $170 | $271 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $70 | $138 | $184 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $112 | $142 | $194 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $22 | $33 | $52 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $1,163 | $2,788 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $214 | $951 | $2,788 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $197 | $1,011 | $2,788 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $89 | $164 | $227 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $158 | $263 | $585 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $106 | $148 | $174 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $137 | $1,444 | $4,940 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $190 | $1,699 | $4,940 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $138 | $1,361 | $4,940 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $160 | $1,369 | $4,940 |