CAPE FEAR VALLEY HOKE HOSPITAL· RAEFORD, NC

HospitalCMS 4/5

210 MEDICAL PAVILION DRIVE, RAEFORD, NC 28376

Procedures offered

936 total

ProcedureMinAvgMax
Blood typing Rh
CPT 86901 • Laboratory
$1$3$6
Urine culture bacterial colony count
CPT 87086 • Laboratory
$4$8$15
Chlamydia nucleic acid amplification
CPT 87491 • Laboratory
$20$37$65
Gonorrhea nucleic acid amplification
CPT 87591 • Laboratory
$20$55$138
SARS-CoV-2 COVID-19 amplified probe
CPT 87635 • Laboratory
$21$55$95
Influenza virus assay with direct optical
CPT 87804 • Laboratory
$12$19$32
Amniocentesis diagnostic
CPT 59000 • Maternity
$85$180$356
Cordocentesis fetal blood sampling
CPT 59012 • Maternity
$165$307$569
Chorionic villus sampling
CPT 59015 • Maternity
$138$261$438
Fetal non-stress test
CPT 59025 • Maternity
$24$47$86
Insertion cervical dilator
CPT 59200 • Maternity
$58$144$230
Vaginal delivery including prenatal and postpartum care
CPT 59400 • Maternity
$2,446$3,431$4,343
Vaginal delivery only
CPT 59409 • Maternity
$1,181$1,388$1,564
Vaginal delivery including postpartum care
CPT 59410 • Maternity
$1,563$1,781$2,111
External cephalic version
CPT 59412 • Maternity
$103$159$200
Antepartum care 7 or more visits
CPT 59426 • Maternity
$159$1,148$1,838
Postpartum care only
CPT 59430 • Maternity
$178$330$463
Cesarean delivery including prenatal and postpartum care
CPT 59510 • Maternity
$2,716$4,160$5,222
Cesarean delivery only
CPT 59514 • Maternity
$1,182$1,416$1,651
Cesarean delivery including postpartum care
CPT 59515 • Maternity
$1,622$2,130$2,618
Vaginal delivery after prior cesarean (VBAC) including prenatal
CPT 59610 • Maternity
$2,561$3,927$4,923
Obstetric ultrasound first trimester
CPT 76801 • Maternity
$61$118$197
Obstetric ultrasound complete
CPT 76805 • Maternity
$93$138$226
Obstetric ultrasound detailed fetal anatomy
CPT 76811 • Maternity
$126$231$362
Obstetric ultrasound limited
CPT 76815 • Maternity
$30$58$121
Ultrasound transvaginal obstetric
CPT 76817 • Maternity
$46$87$155
Interactive complexity add-on
CPT 90785 • Mental Health
$14$20$26
Psychiatric diagnostic evaluation
CPT 90791 • Mental Health
$163$236$305
Psychiatric diagnostic evaluation with medical services
CPT 90792 • Mental Health
$188$273$343
Psychotherapy 30 minutes
CPT 90832 • Mental Health
$76$111$144
Psychotherapy 30 min add-on to E/M
CPT 90833 • Mental Health
$77$102$133
Psychotherapy 45 minutes
CPT 90834 • Mental Health
$101$147$190
Psychotherapy 45 min add-on to E/M
CPT 90836 • Mental Health
$99$132$169
Psychotherapy 60 minutes
CPT 90837 • Mental Health
$141$226$357
Psychotherapy 60 min add-on to E/M
CPT 90838 • Mental Health
$130$171$225
Psychotherapy crisis first 60 minutes
CPT 90839 • Mental Health
$148$209$293
Psychotherapy crisis each additional 30 minutes
CPT 90840 • Mental Health
$72$105$140
Family psychotherapy without patient
CPT 90846 • Mental Health
$114$143$182
Family psychotherapy with patient
CPT 90847 • Mental Health
$119$150$190
Group psychotherapy
CPT 90853 • Mental Health
$29$39$51
Brief emotional/behavioral assessment
CPT 96127 • Mental Health
$5$6$8
Lumbar puncture diagnostic
CPT 62270 • Neurology
$52$155$250
Chemodenervation of muscle cervical dystonia
CPT 64612 • Neurology
$126$227$370
Chemodenervation of muscle neck
CPT 64616 • Neurology
$109$184$246
Electroencephalogram (EEG) awake and asleep
CPT 95816 • Neurology
$73$440$642
Electroencephalogram (EEG) awake and asleep with activation
CPT 95819 • Neurology
$55$509$747
Electromyography (EMG) 1 extremity
CPT 95860 • Neurology
$65$99$187
Electromyography (EMG) 2 extremities
CPT 95861 • Neurology
$103$220$480
EMG needle each extremity complete
CPT 95886 • Neurology
$52$111$158
Nerve conduction study 1-2 nerves
CPT 95907 • Neurology
$46$118$269