IREDELL DAVIS BEHAVIORAL HEALTH HOSPITAL· STATESVILLE, NC

Hospital

557 Brookdale Drive, STATESVILLE, NC 28677

Procedures offered

939 total

ProcedureMinAvgMax
Preventive visit new patient age 1-4
CPT 99382 • Preventive Care
$4$86$136
Preventive visit new patient age 5-11
CPT 99383 • Preventive Care
$4$93$140
Preventive visit new patient age 12-17
CPT 99384 • Preventive Care
$4$99$150
Preventive visit new patient age 18-39
CPT 99385 • Preventive Care
$4$83$121
Preventive visit new patient age 40-64
CPT 99386 • Preventive Care
$5$136$235
Preventive visit new patient age 65+
CPT 99387 • Preventive Care
$5$104$163
Preventive visit established patient infant
CPT 99391 • Preventive Care
$67$90$113
Preventive visit established patient age 1-4
CPT 99392 • Preventive Care
$3$81$126
Preventive visit established patient age 5-11
CPT 99393 • Preventive Care
$3$76$125
Preventive visit established patient age 12-17
CPT 99394 • Preventive Care
$4$91$138
Preventive visit established patient age 18-39
CPT 99395 • Preventive Care
$4$99$141
Preventive visit established patient age 40-64
CPT 99396 • Preventive Care
$4$113$168
Preventive visit established patient age 65+
CPT 99397 • Preventive Care
$4$106$171
Cervical or vaginal cancer screening pelvic exam
HCPCS G0101 • Preventive Care
$22$42$56
Colorectal cancer screening flexible sigmoidoscopy
HCPCS G0104 • Preventive Care
$54$118$191
Colorectal cancer screening colonoscopy high risk
HCPCS G0105 • Preventive Care
$9$260$543
Colorectal cancer screening colonoscopy not high risk
HCPCS G0121 • Preventive Care
$9$228$450
Initial preventive physical exam (Welcome to Medicare)
HCPCS G0402 • Preventive Care
$5$97$165
Annual wellness visit initial
HCPCS G0438 • Preventive Care
$5$143$191
Annual wellness visit subsequent
HCPCS G0439 • Preventive Care
$4$102$146
Bronchoscopy diagnostic
CPT 31622 • Pulmonology
$8$247$550
Bronchoscopy with brushing
CPT 31623 • Pulmonology
$9$142$273
Bronchoscopy with bronchial alveolar lavage
CPT 31624 • Pulmonology
$8$152$252
Bronchoscopy with biopsy
CPT 31625 • Pulmonology
$9$193$349
Bronchoscopy with transbronchial lung biopsy
CPT 31628 • Pulmonology
$10$252$455
Bronchoscopy with endobronchial ultrasound biopsy
CPT 31652 • Pulmonology
$7$875$1,841
Ventilation assist and management initiation
CPT 94002 • Pulmonology
$3$86$148
Spirometry
CPT 94010 • Pulmonology
$11$24$39
Spirometry before and after bronchodilator
CPT 94060 • Pulmonology
$19$37$56
Bronchospasm provocation evaluation
CPT 94070 • Pulmonology
$31$57$88
Respiratory flow volume loop
CPT 94375 • Pulmonology
$19$35$55
Cardiopulmonary exercise test
CPT 94621 • Pulmonology
$94$122$169
Nebulizer inhalation treatment
CPT 94640 • Pulmonology
$7$19$30
Aerosol or vapor inhalation initial demonstration
CPT 94664 • Pulmonology
$14$19$25
Plethysmography lung volumes
CPT 94726 • Pulmonology
$12$53$79
Gas dilution lung volumes
CPT 94727 • Pulmonology
$12$42$63
Diffusing capacity (DLCO)
CPT 94729 • Pulmonology
$8$49$82
Pulse oximetry single measurement
CPT 94760 • Pulmonology
$1$3$5
Pulse oximetry continuous overnight
CPT 94762 • Pulmonology
$11$27$37
Radiation therapy planning simple
CPT 77261 • Radiation Therapy
$71$93$119
Radiation therapy planning intermediate
CPT 77262 • Radiation Therapy
$3$90$127
Radiation therapy planning complex
CPT 77263 • Radiation Therapy
$5$140$188
Radiation therapy simulation simple
CPT 77280 • Radiation Therapy
$9$106$257
Radiation therapy simulation complex
CPT 77290 • Radiation Therapy
$76$377$661
3-dimensional radiation therapy plan
CPT 77295 • Radiation Therapy
$212$612$1,445
Radiation therapy dose calculation
CPT 77300 • Radiation Therapy
$31$60$95
IMRT radiation therapy plan
CPT 77301 • Radiation Therapy
$60$1,160$1,773
Radiation treatment device design complex
CPT 77334 • Radiation Therapy
$57$121$317
Radiation physics consultation
CPT 77336 • Radiation Therapy
$3$95$191
Stereotactic radiosurgery (SRS) cranial
CPT 77371 • Radiation Therapy
$853$1,123$1,379