COVENANT EYE CARE, PA· GASTONIA, NC

Physician group

2555 COURT DRIVE, SUITE 150, GASTONIA, NC 28054

Procedures offered

953 total

Procedure	Min	Avg	Max
Diffusing capacity (DLCO) CPT 94729 • Pulmonology	$9	$33	$58
Pulse oximetry single measurement CPT 94760 • Pulmonology	$2	$4	$5
Pulse oximetry continuous overnight CPT 94762 • Pulmonology	$5	$16	$25
Radiation therapy planning simple CPT 77261 • Radiation Therapy	$70	$70	$70
Radiation therapy planning intermediate CPT 77262 • Radiation Therapy	$106	$106	$106
Radiation therapy planning complex CPT 77263 • Radiation Therapy	$157	$157	$157
Radiation therapy simulation simple CPT 77280 • Radiation Therapy	$37	$116	$173
Radiation therapy simulation complex CPT 77290 • Radiation Therapy	$383	$402	$439
3-dimensional radiation therapy plan CPT 77295 • Radiation Therapy	$223	$653	$1,084
Radiation therapy dose calculation CPT 77300 • Radiation Therapy	$30	$39	$48
IMRT radiation therapy plan CPT 77301 • Radiation Therapy	$391	$1,062	$1,747
Radiation treatment device design complex CPT 77334 • Radiation Therapy	$115	$146	$176
Radiation physics consultation CPT 77336 • Radiation Therapy	$78	$90	$96
Stereotactic radiosurgery (SRS) cranial CPT 77371 • Radiation Therapy	$1,058	$1,080	$1,113
Stereotactic body radiation therapy (SBRT) CPT 77373 • Radiation Therapy	$5	$877	$1,576
IMRT delivery simple CPT 77385 • Radiation Therapy	$409	$409	$409
IMRT delivery complex CPT 77386 • Radiation Therapy	$410	$410	$410
Radiation treatment delivery superficial CPT 77407 • Radiation Therapy	$5	$58	$111
Radiation treatment delivery 3 or more MeV CPT 77412 • Radiation Therapy	$5	$68	$130
Radiation treatment management 5 treatments CPT 77427 • Radiation Therapy	$179	$181	$186
Radiation therapy management complete course CPT 77431 • Radiation Therapy	$93	$97	$104
Proton beam treatment simple CPT 77520 • Radiation Therapy	$5	$308	$831
Proton beam treatment complex CPT 77523 • Radiation Therapy	$98	$711	$1,067
Polysomnography under age 6 CPT 95782 • Sleep Medicine	$133	$629	$987
Polysomnography under age 6 with CPAP CPT 95783 • Sleep Medicine	$970	$1,089	$1,208
Sleep study unattended CPT 95800 • Sleep Medicine	$61	$120	$159
Sleep study unattended minimum 3 channels CPT 95801 • Sleep Medicine	$40	$56	$74
Multiple sleep latency test (MSLT) CPT 95805 • Sleep Medicine	$85	$202	$339
Polysomnography age 6 or older CPT 95810 • Sleep Medicine	$395	$517	$613
Polysomnography with CPAP titration CPT 95811 • Sleep Medicine	$676	$735	$794
CPAP combination oral/nasal mask HCPCS A7027 • Sleep Medicine	$102	$136	$153
Respiratory assist device BiPAP without backup HCPCS E0470 • Sleep Medicine	$121	$707	$1,219
CPAP device continuous positive airway pressure HCPCS E0601 • Sleep Medicine	$339	$459	$499
Laparoscopic partial nephrectomy CPT 50543 • Urology	$1,621	$1,662	$1,703
Laparoscopic radical nephrectomy CPT 50545 • Urology	$1,476	$1,513	$1,550
Lithotripsy extracorporeal shock wave (ESWL) CPT 50590 • Urology	$633	$778	$975
Complex uroflowmetry CPT 51741 • Urology	$13	$57	$92
Post-void residual urine measurement CPT 51798 • Urology	$19	$19	$20
Cystourethroscopy diagnostic CPT 52000 • Urology	$139	$204	$237
Cystourethroscopy with tumor fulguration small CPT 52234 • Urology	$273	$280	$287
Cystourethroscopy with tumor fulguration medium CPT 52235 • Urology	$320	$328	$336
Cystourethroscopy with dilation of ureteral stricture CPT 52260 • Urology	$232	$238	$244
Cystourethroscopy with ureteral stent insertion CPT 52332 • Urology	$170	$354	$451
Cystourethroscopy with lithotripsy CPT 52353 • Urology	$470	$482	$493
TURP transurethral resection of prostate CPT 52601 • Urology	$888	$910	$932
Laser vaporization of prostate CPT 52648 • Urology	$3,258	$3,340	$3,422
Circumcision CPT 54150 • Urology	$133	$155	$187
Orchiectomy simple CPT 54520 • Urology	$297	$334	$371
Orchiectomy radical inguinal CPT 54530 • Urology	$498	$560	$622
Vasectomy CPT 55250 • Urology	$155	$235	$328