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CCN 340014

Novant Health Forsyth Medical Center

WINSTON SALEM, NC · 917 beds

A100/100194 codes · 23 payers

Negotiated median rates by procedure

Showing 194 procedures any of these hospitals has published. Best (lowest) negotiated median in each row is highlighted in green.

Procedure	Code	Novant Health Forsyth …
Psychoses	MS-DRG 885	$80
Psychiatric diagnostic evaluation	CPT 90791	$265.92
Psychiatric eval with medical services	CPT 90792	$71
Psychotherapy 30 minutes	CPT 90832	$122.83
Psychotherapy 45 minutes	CPT 90834	$185.22
Psychotherapy 60 minutes	CPT 90837	$199.11
Crisis psychotherapy 60 minutes	CPT 90839	$71
ED visit level 1	CPT 99281	$71
ED visit level 2	CPT 99282	$71
ED visit level 3	CPT 99283	$71
ED visit level 4	CPT 99284	$71
ED visit level 5	CPT 99285	$71
Critical care, first hour	CPT 99291	$71
CT head without contrast	CPT 70450	$59.4
CT head with contrast	CPT 70460	$59.4
CT head with and without contrast	CPT 70470	$59.4
CT neck with contrast	CPT 70491	$59.4
MRI brain without contrast	CPT 70551	$1,529.96
MRI brain with contrast	CPT 70552	$1,260.64
MRI brain with and without contrast	CPT 70553	$2,018.46
Chest X-ray single view	CPT 71045	$59.4
Chest X-ray 2 views	CPT 71046	$59.4
Chest X-ray 3 views	CPT 71047	$59.4
CT chest without contrast	CPT 71250	$59.4
CT chest with contrast	CPT 71260	$59.4
CT chest with and without contrast	CPT 71270	$59.4
MRI chest without contrast	CPT 71550	$1,066.91
MRI chest with contrast	CPT 71551	$59.4
MRI chest with and without contrast	CPT 71552	$1,819.06
Lumbosacral spine X-ray	CPT 72100	$59.4
CT cervical spine without contrast	CPT 72125	$59.4
CT thoracic spine without contrast	CPT 72128	$360.8
CT lumbar spine without contrast	CPT 72131	$374.25
MRI cervical spine without contrast	CPT 72141	$59.4
MRI thoracic spine without contrast	CPT 72146	$1,936.35
MRI lumbar spine without contrast	CPT 72148	$1,936.35
MRI lumbar spine with and without contrast	CPT 72149	$59.4
MRI cervical spine with and without contrast	CPT 72156	$59.4
MRI lumbar spine with contrast	CPT 72158	$2,552.26
CT pelvis without contrast	CPT 72192	$1,103.64
CT pelvis with contrast	CPT 72193	$59.4
Shoulder X-ray	CPT 73030	$59.4
Humerus X-ray	CPT 73060	$59.4
Hand X-ray 3 views	CPT 73130	$59.4
MRI upper extremity joint without contrast	CPT 73221	$1,673.02
MRI upper extremity joint with and without contrast	CPT 73223	$1,957.56
Knee X-ray 1-2 views	CPT 73560	$59.4
Ankle X-ray 3 views	CPT 73610	$59.4
MRI lower extremity joint without contrast	CPT 73721	$1,535.66
MRI lower extremity joint with and without contrast	CPT 73723	$2,033.88
CT abdomen without contrast	CPT 74150	$336.37
CT abdomen with contrast	CPT 74160	$59.4
CT abdomen with and without contrast	CPT 74170	$1,791.12
CT abdomen and pelvis without contrast	CPT 74176	$619.9
CT abdomen and pelvis with contrast	CPT 74177	$762.14
CT abdomen and pelvis with and without contrast	CPT 74178	$878.24
MRI abdomen without contrast	CPT 74181	$1,134.97
MRI abdomen with and without contrast	CPT 74183	$2,153.38
Abdominal ultrasound complete	CPT 76700	$180.87
Abdominal ultrasound limited	CPT 76705	$652.12
Retroperitoneal ultrasound complete	CPT 76770	$154.55
Obstetric ultrasound first trimester	CPT 76801	$126.14
Obstetric ultrasound after first trimester	CPT 76805	$141.36
Obstetric ultrasound with fetal anatomy	CPT 76811	$240.67
Transvaginal ultrasound	CPT 76830	$140.53
Pelvic ultrasound complete	CPT 76856	$177.27
Scrotal ultrasound	CPT 76870	$141.86
Diagnostic mammography unilateral	CPT 77065	$247.32
Diagnostic mammography bilateral	CPT 77066	$313.95
Screening mammography bilateral	CPT 77067	$223.27
EKG complete	CPT 93000	$50
EKG tracing only	CPT 93005	$133.28
EKG interpretation only	CPT 93010	$30.22
Transthoracic echocardiogram complete	CPT 93306	$1,772.08
Transthoracic echocardiogram	CPT 93307	$1,007.76
Stress echocardiogram	CPT 93350	$1,757.36
Respiratory infections & inflammations w MCC	MS-DRG 177	$90
COPD w MCC	MS-DRG 190	$90
COPD w CC	MS-DRG 191	$90
COPD w/o CC/MCC	MS-DRG 192	$90
Simple pneumonia & pleurisy w CC	MS-DRG 194	$90
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG 195	$90
AMI discharged alive w MCC	MS-DRG 280	$90
AMI discharged alive w CC	MS-DRG 281	$90
AMI discharged alive w/o CC/MCC	MS-DRG 282	$90
Heart failure & shock w MCC	MS-DRG 291	$90
Heart failure & shock w CC	MS-DRG 292	$90
Heart failure & shock w/o CC/MCC	MS-DRG 293	$90
Cardiac arrhythmia w MCC	MS-DRG 308	$90
Cardiac arrhythmia w CC	MS-DRG 309	$90
Cardiac arrhythmia w/o CC/MCC	MS-DRG 310	$90
GI hemorrhage w CC	MS-DRG 378	$90
GI hemorrhage w/o CC/MCC	MS-DRG 379	$90
Esophagitis/gastroenteritis w/o MCC	MS-DRG 392	$90
Fractures of femur w/o MCC	MS-DRG 533	$90
Kidney/UTI w MCC	MS-DRG 689	$90
Kidney/UTI w/o MCC	MS-DRG 690	$90
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG 871	$90
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG 872	$90
Initial hospital care, low complexity	CPT 99221	$68.7
Initial hospital care, moderate complexity	CPT 99222	$68.7
Initial hospital care, high complexity	CPT 99223	$68.7
Hospital discharge, <30 min	CPT 99238	$68.7
Hospital discharge, >30 min	CPT 99239	$68.7
Basic metabolic panel (BMP)	CPT 80048	$59.4
General health panel	CPT 80050	$205.8
Electrolyte panel	CPT 80051	$64.48
Comprehensive metabolic panel	CPT 80053	$156.8
Lipid panel	CPT 80061	$76.38
Renal function panel	CPT 80069	$79.98
Hepatic function panel	CPT 80076	$71.87
Urinalysis non-automated	CPT 81002	$33.02
Urinalysis automated	CPT 81003	$59.4
Glucose quantitative	CPT 82947	$25.66
Hemoglobin A1c	CPT 83036	$59.4
Thyroid stimulating hormone (TSH)	CPT 84443	$103.88
Complete blood count with automated differential	CPT 85025	$2,261
Complete blood count without differential	CPT 85027	$59.4
Urine culture bacterial	CPT 87086	$59.4
Urine culture identification	CPT 87088	$59.4
Tissue exam by pathologist level IV	CPT 88305	$59.4
Fetal non-stress test	CPT 59025	$432.05
Routine obstetric care including vaginal delivery	CPT 59400	$68.7
Vaginal delivery only	CPT 59409	$71
Vaginal delivery with postpartum	CPT 59410	$68.7
Routine obstetric care with C-section	CPT 59510	$68.7
C-section delivery only	CPT 59514	$68.7
C-section with postpartum	CPT 59515	$68.7
Office visit, new patient, 15-29 min	CPT 99202	$196.48
Office visit, new patient, 30-44 minutes	CPT 99203	$217.77
Office visit, new patient, 45-59 min	CPT 99204	$68.7
Office visit, new patient, 60-74 min	CPT 99205	$441.05
Office visit, established patient, 5 min	CPT 99211	$164.88
Office visit, established patient, 10-19 min	CPT 99212	$154.57
Office visit, established patient, 20-29 minutes	CPT 99213	$193.73
Office visit, established patient, 30-39 minutes	CPT 99214	$243.19
Office visit, established patient, 40-54 min	CPT 99215	$272.73
Upper GI endoscopy diagnostic	CPT 43235	$71
Upper GI endoscopy with biopsy	CPT 43239	$71
Sigmoidoscopy diagnostic	CPT 45330	$71
Sigmoidoscopy with biopsy	CPT 45331	$71
Colonoscopy diagnostic	CPT 45378	$71
Colonoscopy with biopsy	CPT 45380	$71
Colonoscopy with polyp removal	CPT 45385	$71
Total shoulder arthroplasty	CPT 23472	$71
Hip hemiarthroplasty	CPT 27125	$71
Total hip replacement	CPT 27130	$71
Total knee replacement	CPT 27447	$71
Knee revision arthroplasty single component	CPT 27486	$71
Knee revision arthroplasty all components	CPT 27487	$71
Shoulder arthroscopy with decompression	CPT 29826	$68.7
Shoulder arthroscopy with rotator cuff repair	CPT 29827	$71
Knee arthroscopy with meniscectomy	CPT 29881	$71
ACL reconstruction	CPT 29888	$71
Major small/large bowel procedures w MCC	MS-DRG 329	$90
Major small/large bowel procedures w CC	MS-DRG 330	$90
Major small/large bowel procedures w/o CC/MCC	MS-DRG 331	$90
CABG single arterial graft	CPT 33533	$68.7
CABG 2 arterial grafts	CPT 33534	$68.7
CABG 3 arterial grafts	CPT 33535	$68.7
CABG 4+ arterial grafts	CPT 33536	$68.7
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG 418	$90
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG 419	$90
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG 420	$90
Open appendectomy	CPT 44950	$71
Laparoscopic appendectomy	CPT 44970	$71
Major joint replacement w MCC	MS-DRG 469	$90
Major joint replacement w/o MCC	MS-DRG 470	$89
Laparoscopic cholecystectomy	CPT 47562	$71
Lap cholecystectomy with cholangiography	CPT 47563	$71
Hip & femur procedures except major joint w MCC	MS-DRG 480	$90
Hip & femur procedures except major joint w CC	MS-DRG 481	$90
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG 482	$90
Lap inguinal hernia repair	CPT 49650	$71
Total abdominal hysterectomy	CPT 58150	$68.7
Vaginal hysterectomy	CPT 58260	$71
Lap-assisted vaginal hysterectomy	CPT 58550	$71
Lap-assisted vaginal hysterectomy >250g	CPT 58552	$71
Lap salpingo-oophorectomy	CPT 58661	$71
OR procedure for obesity w MCC	MS-DRG 619	$90
OR procedure for obesity w CC	MS-DRG 620	$90
OR procedure for obesity w/o CC/MCC	MS-DRG 621	$90
Complex cataract surgery	CPT 66982	$71
Cataract surgery with lens implant	CPT 66984	$71
Intravitreal injection	CPT 67028	$169.92
Vitrectomy mechanical	CPT 67042	$71
Uterine & adnexa procedures w CC/MCC	MS-DRG 743	$90
Uterine & adnexa procedures w/o CC/MCC	MS-DRG 744	$90
PCI single major coronary artery	CPT 92920	$71
PCI with drug-eluting stent	CPT 92928	$71
PCI bypass graft	CPT 92937	$71
Left heart catheterization	CPT 93452	$71
Coronary angiography with cath	CPT 93455	$71
Coronary angiography with bypass cath	CPT 93458	$71