THE OUTER BANKS HOSPITAL, INC· NAGS HEAD, NC
HospitalCMS 4/5
4800 SOUTH CROATAN HIGHWAY, NAGS HEAD, NC 27959
Procedures offered
966 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Group therapeutic procedures CPT 97150 • Physical Therapy | $12 | $17 | $25 |
| Physical therapy evaluation low complexity CPT 97161 • Physical Therapy | $58 | $125 | $235 |
| Physical therapy evaluation moderate complexity CPT 97162 • Physical Therapy | $58 | $125 | $235 |
| Physical therapy evaluation high complexity CPT 97163 • Physical Therapy | $69 | $129 | $235 |
| Physical therapy re-evaluation CPT 97164 • Physical Therapy | $47 | $62 | $95 |
| Therapeutic activities each 15 minutes CPT 97530 • Physical Therapy | $18 | $32 | $54 |
| Self-care/home management training each 15 min CPT 97535 • Physical Therapy | $22 | $31 | $46 |
| Wheelchair management training each 15 minutes CPT 97542 • Physical Therapy | $22 | $29 | $45 |
| Physical performance test each 15 minutes CPT 97750 • Physical Therapy | $23 | $32 | $47 |
| Orthotic management and training each 15 min CPT 97760 • Physical Therapy | $26 | $41 | $69 |
| Prosthetic training each 15 minutes CPT 97761 • Physical Therapy | $23 | $36 | $58 |
| Immunization admin first vaccine component CPT 90460 • Preventive Care | $10 | $14 | $19 |
| Immunization admin each additional component CPT 90461 • Preventive Care | $5 | $7 | $10 |
| Immunization admin injection single CPT 90471 • Preventive Care | $10 | $18 | $23 |
| Immunization admin injection each additional CPT 90472 • Preventive Care | $10 | $12 | $18 |
| HPV vaccine 9-valent CPT 90651 • Preventive Care | $314 | $340 | $378 |
| Pneumococcal conjugate vaccine 13-valent CPT 90670 • Preventive Care | $232 | $248 | $260 |
| Rotavirus vaccine pentavalent CPT 90680 • Preventive Care | $101 | $107 | $118 |
| Influenza vaccine quadrivalent preservative free CPT 90686 • Preventive Care | $20 | $21 | $23 |
| MMR vaccine CPT 90707 • Preventive Care | $97 | $102 | $109 |
| Tdap vaccine age 7 years or older CPT 90715 • Preventive Care | $39 | $46 | $56 |
| Varicella vaccine CPT 90716 • Preventive Care | $187 | $200 | $221 |
| Pneumococcal vaccine adult CPT 90732 • Preventive Care | $120 | $129 | $135 |
| Zoster vaccine recombinant adjuvanted CPT 90750 • Preventive Care | $219 | $230 | $248 |
| Genetic counseling 30 minutes CPT 96040 • Preventive Care | $143 | $143 | $143 |
| Preventive visit new patient infant CPT 99381 • Preventive Care | $96 | $115 | $153 |
| Preventive visit new patient age 1-4 CPT 99382 • Preventive Care | $85 | $157 | $282 |
| Preventive visit new patient age 5-11 CPT 99383 • Preventive Care | $85 | $162 | $294 |
| Preventive visit new patient age 12-17 CPT 99384 • Preventive Care | $112 | $135 | $187 |
| Preventive visit new patient age 18-39 CPT 99385 • Preventive Care | $115 | $185 | $322 |
| Preventive visit new patient age 40-64 CPT 99386 • Preventive Care | $105 | $205 | $371 |
| Preventive visit new patient age 65+ CPT 99387 • Preventive Care | $114 | $166 | $228 |
| Preventive visit established patient infant CPT 99391 • Preventive Care | $64 | $93 | $138 |
| Preventive visit established patient age 1-4 CPT 99392 • Preventive Care | $75 | $143 | $260 |
| Preventive visit established patient age 5-11 CPT 99393 • Preventive Care | $91 | $108 | $147 |
| Preventive visit established patient age 12-17 CPT 99394 • Preventive Care | $101 | $162 | $283 |
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $84 | $160 | $289 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $111 | $192 | $362 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $119 | $145 | $187 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $35 | $41 | $54 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $111 | $189 | $267 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $214 | $270 | $314 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $244 | $327 | $384 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $100 | $160 | $232 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $134 | $174 | $231 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $104 | $130 | $183 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $101 | $214 | $348 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $78 | $214 | $391 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $195 | $397 | $784 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $92 | $481 | $988 |