THE CHARLOTTE MECKLENBURG HOSPITAL AUTHORITY· CHARLOTTE, NC
ProviderCMS 3/5
8800 N TRYON ST, CHARLOTTE, NC 28262
Procedures offered
966 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Manual therapy one or more regions each 15 min CPT 97140 • Physical Therapy | $21 | $50 | $71 |
| Group therapeutic procedures CPT 97150 • Physical Therapy | $13 | $31 | $46 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $58 | $151 | $258 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $58 | $151 | $258 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $58 | $151 | $258 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $28 | $108 | $178 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $18 | $58 | $91 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $24 | $57 | $84 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $22 | $54 | $81 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $23 | $54 | $88 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $24 | $66 | $122 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $23 | $58 | $107 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $7 | $36 | $59 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $17 | $27 |
| Immunization admin injection single CPT 90471 • Preventive Care | $7 | $35 | $54 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $5 | $20 | $38 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $314 | $477 | $668 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $232 | $337 | $560 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $101 | $139 | $214 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $21 | $35 | $49 |
| MMR vaccine CPT 90707 • Preventive Care | $97 | $145 | $207 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $40 | $73 | $106 |
| Varicella vaccine CPT 90716 • Preventive Care | $187 | $282 | $397 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $120 | $173 | $254 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $220 | $328 | $468 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $77 | $77 | $77 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $75 | $163 | $279 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $89 | $178 | $292 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $89 | $173 | $303 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $100 | $207 | $340 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $100 | $202 | $330 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $123 | $214 | $380 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $114 | $237 | $413 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $67 | $140 | $250 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $78 | $152 | $266 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $78 | $142 | $266 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $85 | $168 | $290 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $89 | $180 | $298 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $100 | $196 | $317 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $96 | $198 | $342 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $22 | $65 | $99 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $307 | $493 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $295 | $694 | $1,413 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $197 | $750 | $1,413 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $89 | $234 | $421 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $158 | $278 | $420 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $106 | $196 | $331 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $186 | $482 | $999 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $190 | $620 | $1,059 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $163 | $400 | $653 |