VALLEYGATE DENTAL SURGERY CENTER OF CHARLOTTE LLC· CHARLOTTE, NC

Ambulatory surgery center

8415 MEDICAL PLAZA DR, CHARLOTTE, NC 28262

Procedures offered

219 total

Procedure	Min	Avg	Max
Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology	$1,655	$1,655	$1,655
Retinal photocoagulation treatment CPT 67210 • Ophthalmology	$200	$200	$200
Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology	$218	$218	$218
Lacrimal punctum closure by plug CPT 68761 • Ophthalmology	$66	$66	$66
Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics	$23	$23	$23
Arthrocentesis aspiration major joint CPT 20610 • Orthopedics	$112	$112	$112
Cervical spine fusion anterior approach CPT 22551 • Orthopedics	$3,560	$3,560	$3,560
Lumbar spine fusion combined approach CPT 22633 • Orthopedics	$7,662	$7,662	$7,662
Closed treatment distal radial fracture CPT 25600 • Orthopedics	$61	$61	$61
Tendon sheath incision trigger finger CPT 26055 • Orthopedics	$694	$694	$694
Hip replacement conversion to total CPT 27132 • Orthopedics	$7,350	$7,350	$7,350
Partial knee replacement medial or lateral CPT 27446 • Orthopedics	$3,028	$3,028	$3,028
Total knee replacement CPT 27447 • Orthopedics	$3,581	$3,581	$3,581
Arthroscopy shoulder decompression CPT 29826 • Orthopedics	$1,201	$1,201	$1,201
Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics	$2,303	$2,303	$2,303
Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics	$1,201	$1,201	$1,201
Arthroscopy knee ACL repair CPT 29888 • Orthopedics	$3,585	$3,585	$3,585
Carpal tunnel release CPT 64721 • Orthopedics	$762	$762	$762
Sacroiliac joint injection CPT 27096 • Pain Management	$2,727	$2,727	$2,727
Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management	$274	$274	$274
Plantar common digital nerve injection CPT 64455 • Pain Management	$15	$15	$15
Epidural injection lumbar each additional level CPT 64484 • Pain Management	$156	$156	$156
Facet joint nerve destruction lumbar first level CPT 64635 • Pain Management	$516	$516	$516
Unlisted nervous system procedure CPT 64999 • Pain Management	$182	$182	$182
Cytopathology cervical/vaginal automated thin layer CPT 88175 • Pathology	$43	$43	$43
Immunization admin first vaccine component CPT 90460 • Preventive Care	$35	$35	$35
Immunization admin each additional component CPT 90461 • Preventive Care	$14	$14	$14
Immunization admin injection single CPT 90471 • Preventive Care	$35	$35	$35
Immunization admin injection each additional CPT 90472 • Preventive Care	$24	$24	$24
HPV vaccine 9-valent CPT 90651 • Preventive Care	$209	$209	$209
MMR vaccine CPT 90707 • Preventive Care	$72	$72	$72
Tdap vaccine age 7 years or older CPT 90715 • Preventive Care	$34	$34	$34
Varicella vaccine CPT 90716 • Preventive Care	$124	$124	$124
Pneumococcal vaccine adult CPT 90732 • Preventive Care	$113	$113	$113
Preventive visit new patient infant CPT 99381 • Preventive Care	$189	$189	$189
Preventive visit new patient age 1-4 CPT 99382 • Preventive Care	$196	$196	$196
Preventive visit new patient age 5-11 CPT 99383 • Preventive Care	$205	$205	$205
Preventive visit new patient age 12-17 CPT 99384 • Preventive Care	$211	$211	$211
Preventive visit new patient age 18-39 CPT 99385 • Preventive Care	$204	$204	$204
Preventive visit new patient age 40-64 CPT 99386 • Preventive Care	$237	$237	$237
Preventive visit new patient age 65+ CPT 99387 • Preventive Care	$280	$280	$280
Preventive visit established patient infant CPT 99391 • Preventive Care	$155	$155	$155
Preventive visit established patient age 1-4 CPT 99392 • Preventive Care	$165	$165	$165
Preventive visit established patient age 5-11 CPT 99393 • Preventive Care	$154	$154	$154
Preventive visit established patient age 12-17 CPT 99394 • Preventive Care	$168	$168	$168
Preventive visit established patient age 18-39 CPT 99395 • Preventive Care	$185	$185	$185
Preventive visit established patient age 40-64 CPT 99396 • Preventive Care	$184	$184	$184
Colorectal cancer screening colonoscopy high risk HCPCS G0105 • Preventive Care	$336	$336	$336
Colorectal cancer screening colonoscopy not high risk HCPCS G0121 • Preventive Care	$336	$336	$336
Bronchoscopy with brushing CPT 31623 • Pulmonology	$422	$422	$422