GASTON FAMILY HEALTH SERVICES, INC.· BELMONT, NC
ProviderClinic/Center, Federally Qualified Health Center (FQHC)
210 SCHOOL ST, BELMONT, NC 28012
Procedures offered
947 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Radiation therapy planning simple CPT 77261 • Radiation Therapy | $63 | $63 | $63 |
| Radiation therapy planning intermediate CPT 77262 • Radiation Therapy | $112 | $112 | $112 |
| Radiation therapy planning complex CPT 77263 • Radiation Therapy | $150 | $157 | $165 |
| Radiation therapy simulation simple CPT 77280 • Radiation Therapy | $37 | $128 | $218 |
| Radiation therapy simulation complex CPT 77290 • Radiation Therapy | $73 | $73 | $73 |
| 3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy | $434 | $434 | $434 |
| Radiation therapy dose calculation CPT 77300 • Radiation Therapy | $26 | $45 | $63 |
| IMRT radiation therapy plan CPT 77301 • Radiation Therapy | $1,424 | $1,586 | $1,747 |
| Radiation treatment device design complex CPT 77334 • Radiation Therapy | $24 | $62 | $100 |
| Radiation physics consultation CPT 77336 • Radiation Therapy | $78 | $83 | $88 |
| Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy | $6,471 | $6,471 | $6,471 |
| Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy | $964 | $966 | $968 |
| Radiation treatment delivery superficial CPT 77407 • Radiation Therapy | $167 | $167 | $167 |
| Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy | $203 | $203 | $203 |
| Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy | $186 | $191 | $196 |
| Radiation therapy management complete course CPT 77431 • Radiation Therapy | $93 | $99 | $104 |
| Proton beam treatment simple CPT 77520 • Radiation Therapy | $166 | $427 | $688 |
| Proton beam treatment complex CPT 77523 • Radiation Therapy | $955 | $962 | $968 |
| Polysomnography under age 6 CPT 95782 • Sleep Medicine | $105 | $122 | $140 |
| Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine | $407 | $526 | $645 |
| Sleep study unattended CPT 95800 • Sleep Medicine | $106 | $106 | $106 |
| Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine | $40 | $51 | $62 |
| Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine | $231 | $231 | $231 |
| Polysomnography age 6 or older CPT 95810 • Sleep Medicine | $134 | $315 | $495 |
| Polysomnography with CPAP titration CPT 95811 • Sleep Medicine | $508 | $508 | $508 |
| CPAP combination oral/nasal mask HCPCS A7027 • Sleep Medicine | $87 | $121 | $154 |
| Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine | $462 | $462 | $462 |
| CPAP device continuous positive airway pressure HCPCS E0601 • Sleep Medicine | $355 | $427 | $499 |
| Laparoscopic partial nephrectomy CPT 50543 • Urology | $1,528 | $1,528 | $1,528 |
| Laparoscopic radical nephrectomy CPT 50545 • Urology | $1,074 | $1,074 | $1,074 |
| Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology | $30 | $548 | $1,065 |
| Complex uroflowmetry CPT 51741 • Urology | $11 | $21 | $30 |
| Post-void residual urine measurement CPT 51798 • Urology | $8 | $8 | $8 |
| Cystourethroscopy diagnostic CPT 52000 • Urology | $264 | $264 | $264 |
| Cystourethroscopy with tumor fulguration small CPT 52234 • Urology | $197 | $197 | $197 |
| Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology | $231 | $231 | $231 |
| Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology | $169 | $169 | $169 |
| Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology | $113 | $372 | $631 |
| Cystourethroscopy with lithotripsy CPT 52353 • Urology | $403 | $403 | $403 |
| TURP transurethral resection of prostate CPT 52601 • Urology | $1,082 | $1,082 | $1,082 |
| Laser vaporization of prostate CPT 52648 • Urology | $774 | $1,187 | $1,600 |
| Circumcision CPT 54150 • Urology | $30 | $71 | $113 |
| Orchiectomy simple CPT 54520 • Urology | $261 | $261 | $261 |
| Orchiectomy radical inguinal CPT 54530 • Urology | $380 | $380 | $380 |
| Vasectomy CPT 55250 • Urology | $373 | $373 | $373 |
| Radical prostatectomy retropubic CPT 55840 • Urology | $30 | $485 | $940 |
| Laparoscopic radical prostatectomy CPT 55866 • Urology | $30 | $680 | $1,330 |