NOVANT HEALTH MINT HILL MEDICAL CENTER· CHARLOTTE, NC

HospitalCMS 4/5

8201 HEALTHCARE LOOP, CHARLOTTE, NC 28215

Procedures offered

932 total

ProcedureMinAvgMax
Preventive visit established patient age 1-4
CPT 99392 • Preventive Care
$78$111$140
Preventive visit established patient age 5-11
CPT 99393 • Preventive Care
$76$98$140
Preventive visit established patient age 12-17
CPT 99394 • Preventive Care
$89$140$214
Preventive visit established patient age 18-39
CPT 99395 • Preventive Care
$89$126$156
Preventive visit established patient age 40-64
CPT 99396 • Preventive Care
$100$153$192
Preventive visit established patient age 65+
CPT 99397 • Preventive Care
$112$190$250
Cervical or vaginal cancer screening pelvic exam
HCPCS G0101 • Preventive Care
$0$37$89
Colorectal cancer screening flexible sigmoidoscopy
HCPCS G0104 • Preventive Care
$54$90$128
Colorectal cancer screening colonoscopy high risk
HCPCS G0105 • Preventive Care
$295$366$449
Colorectal cancer screening colonoscopy not high risk
HCPCS G0121 • Preventive Care
$197$334$449
Initial preventive physical exam (Welcome to Medicare)
HCPCS G0402 • Preventive Care
$89$206$305
Annual wellness visit initial
HCPCS G0438 • Preventive Care
$158$214$260
Annual wellness visit subsequent
HCPCS G0439 • Preventive Care
$106$196$306
Bronchoscopy diagnostic
CPT 31622 • Pulmonology
$186$367$585
Bronchoscopy with brushing
CPT 31623 • Pulmonology
$190$327$429
Bronchoscopy with bronchial alveolar lavage
CPT 31624 • Pulmonology
$190$260$338
Bronchoscopy with biopsy
CPT 31625 • Pulmonology
$195$338$460
Bronchoscopy with transbronchial lung biopsy
CPT 31628 • Pulmonology
$245$439$579
Bronchoscopy with endobronchial ultrasound biopsy
CPT 31652 • Pulmonology
$1,247$1,581$2,205
Ventilation assist and management initiation
CPT 94002 • Pulmonology
$93$110$141
Spirometry
CPT 94010 • Pulmonology
$8$18$36
Spirometry before and after bronchodilator
CPT 94060 • Pulmonology
$19$44$61
Bronchospasm provocation evaluation
CPT 94070 • Pulmonology
$42$64$84
Respiratory flow volume loop
CPT 94375 • Pulmonology
$15$23$32
Cardiopulmonary exercise test
CPT 94621 • Pulmonology
$108$208$355
Nebulizer inhalation treatment
CPT 94640 • Pulmonology
$8$23$30
Aerosol or vapor inhalation initial demonstration
CPT 94664 • Pulmonology
$22$27$30
Plethysmography lung volumes
CPT 94726 • Pulmonology
$58$64$74
Gas dilution lung volumes
CPT 94727 • Pulmonology
$18$41$58
Diffusing capacity (DLCO)
CPT 94729 • Pulmonology
$9$53$74
Pulse oximetry single measurement
CPT 94760 • Pulmonology
$0$1$2
Pulse oximetry continuous overnight
CPT 94762 • Pulmonology
$11$29$40
Radiation therapy planning simple
CPT 77261 • Radiation Therapy
$84$120$165
Radiation therapy planning intermediate
CPT 77262 • Radiation Therapy
$102$132$168
Radiation therapy planning complex
CPT 77263 • Radiation Therapy
$188$313$392
Radiation therapy simulation simple
CPT 77280 • Radiation Therapy
$43$272$421
Radiation therapy simulation complex
CPT 77290 • Radiation Therapy
$366$509$588
3-dimensional radiation therapy plan
CPT 77295 • Radiation Therapy
$639$1,070$1,445
Radiation therapy dose calculation
CPT 77300 • Radiation Therapy
$37$65$88
IMRT radiation therapy plan
CPT 77301 • Radiation Therapy
$498$2,075$4,236
Radiation treatment device design complex
CPT 77334 • Radiation Therapy
$75$115$167
Radiation physics consultation
CPT 77336 • Radiation Therapy
$115$150$209
Stereotactic radiosurgery (SRS) cranial
CPT 77371 • Radiation Therapy
$1,083$1,367$1,639
Stereotactic body radiation therapy (SBRT)
CPT 77373 • Radiation Therapy
$1,294$1,721$2,334
IMRT delivery simple
CPT 77385 • Radiation Therapy
$392$392$392
IMRT delivery complex
CPT 77386 • Radiation Therapy
$393$616$839
Radiation treatment delivery superficial
CPT 77407 • Radiation Therapy
$88$203$293
Radiation treatment delivery 3 or more MeV
CPT 77412 • Radiation Therapy
$30$216$520
Radiation treatment management 5 treatments
CPT 77427 • Radiation Therapy
$193$265$404
Radiation therapy management complete course
CPT 77431 • Radiation Therapy
$110$148$222