DLP PERSON MEMORIAL HOSPITAL LLC· ROXBORO, NC
Hospital
615 RIDGE RD, ROXBORO, NC 27573
Procedures offered
980 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Preventive visit established patient age 18-39 CPT 99395 • Preventive Care | $71 | $154 | $310 |
| Preventive visit established patient age 40-64 CPT 99396 • Preventive Care | $118 | $238 | $362 |
| Preventive visit established patient age 65+ CPT 99397 • Preventive Care | $83 | $138 | $168 |
| Cervical or vaginal cancer screening pelvic exam HCPCS G0101 • Preventive Care | $0 | $42 | $94 |
| Colorectal cancer screening flexible sigmoidoscopy HCPCS G0104 • Preventive Care | $54 | $3,058 | $6,954 |
| Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care | $153 | $2,600 | $6,953 |
| Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care | $164 | $2,575 | $6,953 |
| Initial preventive physical exam (Welcome to Medicare) HCPCS G0402 • Preventive Care | $159 | $232 | $402 |
| Annual wellness visit initial HCPCS G0438 • Preventive Care | $182 | $250 | $414 |
| Annual wellness visit subsequent HCPCS G0439 • Preventive Care | $104 | $160 | $282 |
| Bronchoscopy diagnostic CPT 31622 • Pulmonology | $78 | $3,248 | $6,954 |
| Bronchoscopy with brushing CPT 31623 • Pulmonology | $262 | $2,599 | $6,953 |
| Bronchoscopy with bronchial alveolar lavage CPT 31624 • Pulmonology | $106 | $2,594 | $6,953 |
| Bronchoscopy with biopsy CPT 31625 • Pulmonology | $146 | $3,325 | $6,954 |
| Bronchoscopy with transbronchial lung biopsy CPT 31628 • Pulmonology | $311 | $2,985 | $6,954 |
| Bronchoscopy with endobronchial ultrasound biopsy CPT 31652 • Pulmonology | $181 | $3,778 | $6,954 |
| Ventilation assist and management initiation CPT 94002 • Pulmonology | $71 | $114 | $204 |
| Spirometry CPT 94010 • Pulmonology | $8 | $37 | $85 |
| Spirometry before and after bronchodilator CPT 94060 • Pulmonology | $10 | $46 | $146 |
| Bronchospasm provocation evaluation CPT 94070 • Pulmonology | $37 | $74 | $140 |
| Respiratory flow volume loop CPT 94375 • Pulmonology | $12 | $37 | $94 |
| Pulmonary stress test simple CPT 94620 • Pulmonology | $139 | $139 | $139 |
| Cardiopulmonary exercise test CPT 94621 • Pulmonology | $148 | $244 | $383 |
| Nebulizer inhalation treatment CPT 94640 • Pulmonology | $8 | $30 | $47 |
| Aerosol or vapor inhalation initial demonstration CPT 94664 • Pulmonology | $15 | $23 | $42 |
| Plethysmography lung volumes CPT 94726 • Pulmonology | $53 | $74 | $126 |
| Gas dilution lung volumes CPT 94727 • Pulmonology | $32 | $64 | $100 |
| Diffusing capacity (DLCO) CPT 94729 • Pulmonology | $46 | $74 | $131 |
| Pulse oximetry single measurement CPT 94760 • Pulmonology | $0 | $3 | $7 |
| Pulse oximetry continuous overnight CPT 94762 • Pulmonology | $18 | $41 | $64 |
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $59 | $166 | $263 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $90 | $223 | $389 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $140 | $345 | $569 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $31 | $452 | $1,021 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $307 | $1,042 | $1,921 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $188 | $664 | $1,778 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $30 | $88 | $240 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $398 | $3,061 | $7,229 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $101 | $201 | $474 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $54 | $186 | $296 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $1,058 | $2,188 | $3,216 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $951 | $2,811 | $5,131 |
| IMRT delivery simple CPT 77385 • Radiation Therapy | $373 | $595 | $950 |
| IMRT delivery complex CPT 77386 • Radiation Therapy | $325 | $581 | $953 |
| Radiation treatment delivery superficial CPT 77407 • Radiation Therapy | $172 | $293 | $472 |
| Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy | $186 | $363 | $626 |
| Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy | $158 | $385 | $640 |
| Radiation therapy management complete course CPT 77431 • Radiation Therapy | $90 | $207 | $286 |
| Proton beam treatment simple CPT 77520 • Radiation Therapy | $286 | $1,205 | $2,278 |
| Proton beam treatment complex CPT 77523 • Radiation Therapy | $657 | $1,869 | $2,653 |