DLP WILSON MEDICAL CENTER LLC· WILSON, NC
HospitalCMS 2/5
1705 TARBORO ST SW, WILSON, NC 27893
Procedures offered
967 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $24 | $27 | $31 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $14 | $17 | $24 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $66 | $95 | $113 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $66 | $95 | $113 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $66 | $95 | $113 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $54 | $71 | $93 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $26 | $32 | $44 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $28 | $33 | $43 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $25 | $30 | $36 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $27 | $29 | $32 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $30 | $38 | $48 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $27 | $29 | $33 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $14 | $22 | $33 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $6 | $10 | $16 |
| Immunization admin injection single CPT 90471 • Preventive Care | $19 | $23 | $33 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $13 | $16 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $285 | $327 | $378 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $232 | $275 | $364 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $96 | $105 | $118 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $21 | $25 | $37 |
| MMR vaccine CPT 90707 • Preventive Care | $97 | $102 | $109 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $50 | $56 |
| Varicella vaccine CPT 90716 • Preventive Care | $170 | $194 | $221 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $120 | $142 | $188 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $195 | $224 | $248 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $92 | $92 | $92 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $100 | $168 | $204 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $107 | $168 | $201 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $137 | $177 | $208 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $115 | $181 | $234 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $115 | $161 | $227 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $135 | $220 | $262 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $146 | $234 | $303 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $78 | $129 | $173 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $87 | $125 | $184 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $62 | $118 | $184 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $94 | $123 | $146 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $95 | $148 | $205 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $105 | $169 | $218 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $117 | $166 | $212 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $0 | $34 | $63 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $87 | $1,335 | $6,072 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $314 | $1,574 | $6,072 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $370 | $1,586 | $6,072 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $98 | $182 | $271 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $174 | $220 | $271 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $104 | $159 | $214 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $270 | $1,725 | $6,982 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $313 | $1,721 | $6,982 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $106 | $1,623 | $6,982 |