DLP PERSON MEMORIAL HOSPITAL LLC· ROXBORO, NC

Hospital

615 RIDGE RD, ROXBORO, NC 27573

Procedures offered

964 total

Procedure	Min	Avg	Max
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	$154	$263
Radiation therapy planning intermediate CPT 77262 • Radiation Therapy	$90	$189	$389
Radiation therapy planning complex CPT 77263 • Radiation Therapy	$140	$264	$569
Radiation therapy simulation simple CPT 77280 • Radiation Therapy	$31	$369	$1,021
Radiation therapy simulation complex CPT 77290 • Radiation Therapy	$307	$1,072	$1,921
3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy	$188	$672	$1,778
Radiation therapy dose calculation CPT 77300 • Radiation Therapy	$30	$91	$240
IMRT radiation therapy plan CPT 77301 • Radiation Therapy	$398	$2,611	$7,229
Radiation treatment device design complex CPT 77334 • Radiation Therapy	$101	$228	$474
Radiation physics consultation CPT 77336 • Radiation Therapy	$54	$166	$296
Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy	$1,058	$1,799	$3,216
Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy	$951	$2,938	$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	$204	$291
Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy	$186	$232	$280
Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy	$158	$291	$640
Radiation therapy management complete course CPT 77431 • Radiation Therapy	$90	$148	$286
Proton beam treatment simple CPT 77520 • Radiation Therapy	$286	$855	$1,414
Proton beam treatment complex CPT 77523 • Radiation Therapy	$657	$1,280	$2,522
Polysomnography under age 6 CPT 95782 • Sleep Medicine	$821	$1,704	$2,469
Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine	$107	$1,267	$2,809
Sleep study unattended CPT 95800 • Sleep Medicine	$59	$232	$425
Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine	$44	$119	$212
Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine	$168	$507	$1,033
Polysomnography age 6 or older CPT 95810 • Sleep Medicine	$95	$581	$1,496
Polysomnography with CPAP titration CPT 95811 • Sleep Medicine	$115	$928	$1,571
CPAP combination oral/nasal mask HCPCS A7027 • Sleep Medicine	$110	$173	$234
Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine	$280	$793	$1,057
CPAP device continuous positive airway pressure HCPCS E0601 • Sleep Medicine	$44	$215	$401
Laparoscopic partial nephrectomy CPT 50543 • Urology	$1,211	$2,159	$3,836
Laparoscopic radical nephrectomy CPT 50545 • Urology	$202	$1,622	$3,450
Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology	$947	$1,418	$1,893
Complex uroflowmetry CPT 51741 • Urology	$8	$22	$42
Post-void residual urine measurement CPT 51798 • Urology	$10	$24	$54
Cystourethroscopy diagnostic CPT 52000 • Urology	$144	$330	$590