GOSHEN MEDICAL CENTER INCORPORATED· CLINTON, NC

ProviderClinic/Center, Federally Qualified Health Center (FQHC)Clinic/Center, Multi-Specialty

906 US HIGHWAY 421, CLINTON, NC 28328

Procedures offered

952 total

Procedure	Min	Avg	Max
Pulse oximetry single measurement CPT 94760 • Pulmonology	$3	$3	$3
Pulse oximetry continuous overnight CPT 94762 • Pulmonology	$29	$29	$29
Radiation therapy planning simple CPT 77261 • Radiation Therapy	$53	$60	$74
Radiation therapy planning intermediate CPT 77262 • Radiation Therapy	$82	$97	$112
Radiation therapy planning complex CPT 77263 • Radiation Therapy	$127	$143	$174
Radiation therapy simulation simple CPT 77280 • Radiation Therapy	$28	$156	$245
Radiation therapy simulation complex CPT 77290 • Radiation Therapy	$63	$71	$85
3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy	$170	$201	$232
Radiation therapy dose calculation CPT 77300 • Radiation Therapy	$25	$28	$34
IMRT radiation therapy plan CPT 77301 • Radiation Therapy	$318	$717	$1,516
Radiation treatment device design complex CPT 77334 • Radiation Therapy	$46	$53	$67
Radiation physics consultation CPT 77336 • Radiation Therapy	$68	$73	$81
Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy	$2,030	$2,030	$2,030
Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy	$1,231	$1,231	$1,231
IMRT delivery simple CPT 77385 • Radiation Therapy	$368	$368	$368
IMRT delivery complex CPT 77386 • Radiation Therapy	$370	$370	$370
Radiation treatment delivery superficial CPT 77407 • Radiation Therapy	$197	$197	$197
Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy	$264	$264	$264
Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy	$144	$161	$196
Radiation therapy management complete course CPT 77431 • Radiation Therapy	$109	$109	$109
Proton beam treatment simple CPT 77520 • Radiation Therapy	$893	$893	$893
Proton beam treatment complex CPT 77523 • Radiation Therapy	$1,033	$1,033	$1,033
Polysomnography under age 6 CPT 95782 • Sleep Medicine	$846	$846	$846
Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine	$896	$896	$896
Sleep study unattended CPT 95800 • Sleep Medicine	$109	$133	$181
Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine	$46	$46	$46
Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine	$387	$387	$387
Polysomnography age 6 or older CPT 95810 • Sleep Medicine	$133	$133	$133
Polysomnography with CPAP titration CPT 95811 • Sleep Medicine	$556	$597	$617
CPAP combination oral/nasal mask HCPCS A7027 • Sleep Medicine	$82	$82	$82
Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine	$968	$968	$968
CPAP device continuous positive airway pressure HCPCS E0601 • Sleep Medicine	$303	$344	$426
Laparoscopic partial nephrectomy CPT 50543 • Urology	$1,660	$1,660	$1,660
Laparoscopic radical nephrectomy CPT 50545 • Urology	$1,493	$1,493	$1,493
Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology	$818	$818	$818
Complex uroflowmetry CPT 51741 • Urology	$6	$7	$10
Post-void residual urine measurement CPT 51798 • Urology	$9	$10	$11
Cystourethroscopy diagnostic CPT 52000 • Urology	$193	$205	$231
Cystourethroscopy with tumor fulguration small CPT 52234 • Urology	$273	$273	$273
Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology	$250	$274	$321
Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology	$183	$209	$235
Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology	$136	$257	$500
Cystourethroscopy with lithotripsy CPT 52353 • Urology	$340	$388	$437
TURP transurethral resection of prostate CPT 52601 • Urology	$639	$697	$813
Laser vaporization of prostate CPT 52648 • Urology	$1,847	$1,847	$1,847
Circumcision CPT 54150 • Urology	$76	$87	$110
Orchiectomy simple CPT 54520 • Urology	$363	$363	$363
Orchiectomy radical inguinal CPT 54530 • Urology	$565	$565	$565
Vasectomy CPT 55250 • Urology	$253	$284	$309
Prostate biopsy needle or punch CPT 55700 • Urology	$146	$177	$209