NORTHERN HOSPITAL DISTRICT OF SURRY COUNTY· MOUNT AIRY, NC
ProviderCMS 4/5
830 ROCKFORD ST, MOUNT AIRY, NC 27030
Procedures offered
941 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT | $194 | $351 | $503 |
| Tonsillectomy primary under age 12 CPT 42826 • ENT | $260 | $318 | $425 |
| Adenoidectomy primary under age 12 CPT 42830 • ENT | $207 | $281 | $356 |
| Removal impacted cerumen unilateral CPT 69210 • ENT | $40 | $62 | $79 |
| Tympanostomy tube insertion CPT 69436 • ENT | $144 | $189 | $264 |
| Tympanoplasty without mastoidectomy CPT 69631 • ENT | $687 | $1,008 | $1,454 |
| Tympanoplasty with mastoidectomy CPT 69633 • ENT | $840 | $1,333 | $1,721 |
| Comprehensive audiometry evaluation CPT 92557 • ENT | $31 | $47 | $60 |
| Incision and drainage abscess simple CPT 10060 • Emergency | $68 | $122 | $211 |
| Incision and drainage abscess complicated CPT 10061 • Emergency | $180 | $267 | $352 |
| Simple wound repair up to 2.5cm CPT 12001 • Emergency | $28 | $83 | $163 |
| Simple wound repair 2.6-7.5cm CPT 12002 • Emergency | $87 | $111 | $174 |
| Simple wound repair face 2.5cm or less CPT 12011 • Emergency | $69 | $101 | $173 |
| Intermediate wound repair 2.5cm or less CPT 12031 • Emergency | $91 | $261 | $432 |
| Intermediate wound repair face 2.5cm or less CPT 12051 • Emergency | $120 | $261 | $465 |
| Initial treatment first degree burn CPT 16000 • Emergency | $55 | $82 | $120 |
| Emergency department visit self-limited problem CPT 99281 • Emergency | $18 | $22 | $27 |
| Emergency department visit low severity CPT 99282 • Emergency | $37 | $52 | $67 |
| Emergency department visit moderate severity CPT 99283 • Emergency | $70 | $80 | $95 |
| Emergency department visit high severity CPT 99284 • Emergency | $119 | $144 | $192 |
| Emergency department visit highest severity CPT 99285 • Emergency | $173 | $213 | $279 |
| Critical care first 30-74 minutes CPT 99291 • Emergency | $211 | $300 | $445 |
| Critical care each additional 30 minutes CPT 99292 • Emergency | $106 | $139 | $193 |
| Esophagoscopy rigid diagnostic CPT 43191 • Gastroenterology | $147 | $182 | $253 |
| Upper GI endoscopy diagnostic CPT 43235 • Gastroenterology | $188 | $322 | $472 |
| Upper GI endoscopy with biopsy CPT 43239 • Gastroenterology | $223 | $401 | $611 |
| Upper GI endoscopy with foreign body removal CPT 43247 • Gastroenterology | $201 | $364 | $624 |
| Upper GI endoscopy with balloon dilation CPT 43249 • Gastroenterology | $96 | $182 | $245 |
| Upper GI endoscopy with polypectomy by snare CPT 43251 • Gastroenterology | $219 | $445 | $800 |
| Upper GI endoscopy with stent placement CPT 43257 • Gastroenterology | $145 | $307 | $386 |
| Upper GI endoscopy with endoscopic ultrasound CPT 43259 • Gastroenterology | $222 | $311 | $375 |
| ERCP diagnostic CPT 43260 • Gastroenterology | $317 | $402 | $512 |
| ERCP with sphincterotomy CPT 43262 • Gastroenterology | $221 | $437 | $566 |
| ERCP with removal of stones CPT 43264 • Gastroenterology | $358 | $523 | $637 |
| ERCP with stent placement CPT 43274 • Gastroenterology | $455 | $580 | $733 |
| Colonoscopy through stoma diagnostic CPT 44388 • Gastroenterology | $230 | $403 | $519 |
| Colonoscopy through stoma with biopsy CPT 44389 • Gastroenterology | $253 | $407 | $671 |
| Colonoscopy diagnostic CPT 45378 • Gastroenterology | $115 | $354 | $556 |
| Colonoscopy with biopsy CPT 45380 • Gastroenterology | $198 | $449 | $706 |
| Colonoscopy with submucosal injection CPT 45381 • Gastroenterology | $279 | $456 | $720 |
| Colonoscopy with lesion removal by hot biopsy CPT 45384 • Gastroenterology | $225 | $481 | $794 |
| Colonoscopy with polypectomy by snare CPT 45385 • Gastroenterology | $250 | $505 | $739 |
| Colonoscopy with balloon dilation CPT 45386 • Gastroenterology | $209 | $560 | $982 |
| Colonoscopy with ablation of tumor or polyp CPT 45388 • Gastroenterology | $266 | $1,182 | $3,657 |
| Colonoscopy with endoscopic mucosal resection CPT 45390 • Gastroenterology | $400 | $458 | $528 |
| Esophageal motility study CPT 91010 • Gastroenterology | $63 | $132 | $223 |
| Esophageal motility study with acid reflux CPT 91035 • Gastroenterology | $82 | $452 | $731 |
| Esophageal pH monitoring 24 hours CPT 91038 • Gastroenterology | $88 | $195 | $404 |
| Auto-added CPT 00102 • General | $40 | $419 | $713 |
| Auto-added CPT 00104 • General | $40 | $247 | $360 |