GOOD HOPE HOSPITAL, INC· ERWIN, NC

Hospital

410 DENIM DRIVE, ERWIN, NC 28339

Procedures offered

923 total

Procedure	Min	Avg	Max
Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care	$34	$66	$99
Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care	$78	$125	$171
Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care	$252	$282	$312
Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care	$235	$273	$312
Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care	$132	$140	$148
Annual wellness visit initial HCPCS G0438 • Preventive Care	$148	$390	$632
Annual wellness visit subsequent HCPCS G0439 • Preventive Care	$117	$308	$499
Bronchoscopy diagnostic CPT 31622 • Pulmonology	$161	$217	$274
Bronchoscopy with brushing CPT 31623 • Pulmonology	$268	$287	$307
Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology	$284	$405	$526
Bronchoscopy with biopsy CPT 31625 • Pulmonology	$133	$264	$395
Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology	$357	$388	$419
Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology	$1,402	$1,550	$1,699
Ventilation assist and management initiation CPT 94002 • Pulmonology	$83	$90	$96
Spirometry CPT 94010 • Pulmonology	$15	$21	$27
Spirometry before and after bronchodilator CPT 94060 • Pulmonology	$31	$36	$42
Bronchospasm provocation evaluation CPT 94070 • Pulmonology	$51	$54	$57
Respiratory flow volume loop CPT 94375 • Pulmonology	$26	$31	$35
Cardiopulmonary exercise test CPT 94621 • Pulmonology	$145	$211	$278
Nebulizer inhalation treatment CPT 94640 • Pulmonology	$9	$10	$12
Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology	$15	$17	$19
Plethysmography lung volumes CPT 94726 • Pulmonology	$12	$31	$50
Gas dilution lung volumes CPT 94727 • Pulmonology	$21	$31	$40
Diffusing capacity (DLCO) CPT 94729 • Pulmonology	$9	$32	$54
Pulse oximetry single measurement CPT 94760 • Pulmonology	$2	$2	$3
Pulse oximetry continuous overnight CPT 94762 • Pulmonology	$25	$26	$27
Radiation therapy planning simple CPT 77261 • Radiation Therapy	$60	$86	$112
Radiation therapy planning intermediate CPT 77262 • Radiation Therapy	$91	$132	$172
Radiation therapy planning complex CPT 77263 • Radiation Therapy	$142	$160	$178
Radiation therapy simulation simple CPT 77280 • Radiation Therapy	$40	$141	$242
Radiation therapy simulation complex CPT 77290 • Radiation Therapy	$420	$447	$474
3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy	$238	$324	$411
Radiation therapy dose calculation CPT 77300 • Radiation Therapy	$34	$45	$56
IMRT radiation therapy plan CPT 77301 • Radiation Therapy	$680	$1,151	$1,621
Radiation treatment device design complex CPT 77334 • Radiation Therapy	$105	$106	$107
Radiation physics consultation CPT 77336 • Radiation Therapy	$69	$96	$122
Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy	$1,001	$1,118	$1,235
Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy	$981	$2,582	$4,182
Radiation treatment delivery superficial CPT 77407 • Radiation Therapy	$167	$238	$309
Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy	$222	$430	$638
Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy	$160	$309	$458
Radiation therapy management complete course CPT 77431 • Radiation Therapy	$90	$131	$172
Proton beam treatment simple CPT 77520 • Radiation Therapy	$529	$639	$748
Proton beam treatment complex CPT 77523 • Radiation Therapy	$872	$897	$923
Polysomnography under age 6 CPT 95782 • Sleep Medicine	$859	$884	$909
Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine	$140	$525	$910
Sleep study unattended CPT 95800 • Sleep Medicine	$144	$149	$154
Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine	$82	$93	$103
Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine	$389	$423	$458
Polysomnography age 6 or older CPT 95810 • Sleep Medicine	$570	$952	$1,334