GOSHEN MEDICAL CENTER INCORPORATED· WHITEVILLE, NC

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

5 WHITEVILLE TOWNE CTR, WHITEVILLE, NC 28472

Procedures offered

952 total

Procedure	Min	Avg	Max
Pulse oximetry single measurement CPT 94760 • Pulmonology	$2	$2	$2
Pulse oximetry continuous overnight CPT 94762 • Pulmonology	$21	$21	$21
Radiation therapy planning simple CPT 77261 • Radiation Therapy	$54	$56	$61
Radiation therapy planning intermediate CPT 77262 • Radiation Therapy	$82	$87	$92
Radiation therapy planning complex CPT 77263 • Radiation Therapy	$127	$132	$143
Radiation therapy simulation simple CPT 77280 • Radiation Therapy	$28	$149	$225
Radiation therapy simulation complex CPT 77290 • Radiation Therapy	$63	$177	$405
3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy	$170	$181	$192
Radiation therapy dose calculation CPT 77300 • Radiation Therapy	$25	$35	$55
IMRT radiation therapy plan CPT 77301 • Radiation Therapy	$318	$730	$1,555
Radiation treatment device design complex CPT 77334 • Radiation Therapy	$46	$66	$105
Radiation physics consultation CPT 77336 • Radiation Therapy	$64	$67	$68
Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy	$1,990	$1,990	$1,990
Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy	$972	$972	$972
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	$156	$156	$156
Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy	$209	$209	$209
Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy	$144	$150	$161
Radiation therapy management complete course CPT 77431 • Radiation Therapy	$89	$89	$89
Proton beam treatment simple CPT 77520 • Radiation Therapy	$675	$675	$675
Proton beam treatment complex CPT 77523 • Radiation Therapy	$726	$726	$726
Polysomnography under age 6 CPT 95782 • Sleep Medicine	$108	$108	$108
Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine	$778	$778	$778
Sleep study unattended CPT 95800 • Sleep Medicine	$27	$90	$135
Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine	$74	$74	$74
Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine	$336	$489	$641
Polysomnography age 6 or older CPT 95810 • Sleep Medicine	$392	$667	$942
Polysomnography with CPAP titration CPT 95811 • Sleep Medicine	$107	$447	$617
CPAP combination oral/nasal mask HCPCS A7027 • Sleep Medicine	$87	$87	$87
Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine	$87	$157	$227
CPAP device continuous positive airway pressure HCPCS E0601 • Sleep Medicine	$50	$263	$397
Laparoscopic partial nephrectomy CPT 50543 • Urology	$1,269	$1,269	$1,269
Laparoscopic radical nephrectomy CPT 50545 • Urology	$1,141	$1,141	$1,141
Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology	$483	$992	$1,500
Complex uroflowmetry CPT 51741 • Urology	$6	$9	$14
Post-void residual urine measurement CPT 51798 • Urology	$8	$9	$9
Cystourethroscopy diagnostic CPT 52000 • Urology	$70	$145	$193
Cystourethroscopy with tumor fulguration small CPT 52234 • Urology	$209	$209	$209
Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology	$245	$249	$250
Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology	$179	$385	$591
Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology	$132	$134	$136
Cystourethroscopy with lithotripsy CPT 52353 • Urology	$334	$337	$340
TURP transurethral resection of prostate CPT 52601 • Urology	$621	$633	$639
Laser vaporization of prostate CPT 52648 • Urology	$588	$588	$588
Circumcision CPT 54150 • Urology	$76	$79	$84
Orchiectomy simple CPT 54520 • Urology	$276	$276	$276
Orchiectomy radical inguinal CPT 54530 • Urology	$430	$430	$430
Vasectomy CPT 55250 • Urology	$289	$293	$300
Prostate biopsy needle or punch CPT 55700 • Urology	$146	$425	$704