ASHE MEMORIAL HOSPITAL· JEFFERSON, NC

HospitalCMS 3/5

200 HOSPITAL AVE, JEFFERSON, NC 28640

Procedures offered

935 total

ProcedureMinAvgMax
Radiation treatment delivery 3 or more MeV
CPT 77412 • Radiation Therapy
$112$234$361
Radiation treatment management 5 treatments
CPT 77427 • Radiation Therapy
$179$250$412
Radiation therapy management complete course
CPT 77431 • Radiation Therapy
$98$114$127
Proton beam treatment simple
CPT 77520 • Radiation Therapy
$455$1,129$1,956
Proton beam treatment complex
CPT 77523 • Radiation Therapy
$792$1,282$1,963
Polysomnography under age 6
CPT 95782 • Sleep Medicine
$130$1,184$2,451
Polysomnography under age 6 with CPAP
CPT 95783 • Sleep Medicine
$918$1,052$1,237
Sleep study unattended
CPT 95800 • Sleep Medicine
$74$163$318
Sleep study unattended minimum 3 channels
CPT 95801 • Sleep Medicine
$37$59$79
Multiple sleep latency test (MSLT)
CPT 95805 • Sleep Medicine
$60$562$968
Polysomnography age 6 or older
CPT 95810 • Sleep Medicine
$515$828$1,377
Polysomnography with CPAP titration
CPT 95811 • Sleep Medicine
$129$757$1,443
CPAP combination oral/nasal mask
HCPCS A7027 • Sleep Medicine
$88$127$182
Respiratory assist device BiPAP without backup
HCPCS E0470 • Sleep Medicine
$105$667$1,337
CPAP device continuous positive airway pressure
HCPCS E0601 • Sleep Medicine
$104$373$568
Laparoscopic partial nephrectomy
CPT 50543 • Urology
$1,381$1,968$3,201
Laparoscopic radical nephrectomy
CPT 50545 • Urology
$173$1,514$2,866
Lithotripsy extracorporeal shock wave (ESWL)
CPT 50590 • Urology
$438$793$1,042
Complex uroflowmetry
CPT 51741 • Urology
$6$27$70
Post-void residual urine measurement
CPT 51798 • Urology
$11$22$40
Cystourethroscopy diagnostic
CPT 52000 • Urology
$120$266$481
Cystourethroscopy with tumor fulguration small
CPT 52234 • Urology
$226$329$525
Cystourethroscopy with tumor fulguration medium
CPT 52235 • Urology
$293$427$614
Cystourethroscopy with dilation of ureteral stricture
CPT 52260 • Urology
$122$215$266
Cystourethroscopy with ureteral stent insertion
CPT 52332 • Urology
$158$483$989
Cystourethroscopy with lithotripsy
CPT 52353 • Urology
$360$541$832
TURP transurethral resection of prostate
CPT 52601 • Urology
$427$965$1,709
Laser vaporization of prostate
CPT 52648 • Urology
$699$2,345$4,008
Circumcision
CPT 54150 • Urology
$139$230$323
Orchiectomy simple
CPT 54520 • Urology
$194$328$401
Orchiectomy radical inguinal
CPT 54530 • Urology
$512$565$637
Vasectomy
CPT 55250 • Urology
$234$521$751
Prostate biopsy needle or punch
CPT 55700 • Urology
$223$280$342
Radical prostatectomy retropubic
CPT 55840 • Urology
$1,087$1,640$2,523
Laparoscopic radical prostatectomy
CPT 55866 • Urology
$698$1,813$2,677