NORTHERN REGIONAL HOSPITAL· MOUNT AIRY, NC

HospitalCMS 4/5

830 ROCKFORD ST, MOUNT AIRY, NC 27030

Procedures offered

936 total

ProcedureMinAvgMax
Tonsillectomy and adenoidectomy age 12 or older
CPT 42821 • ENT
$189$350$503
Tonsillectomy primary under age 12
CPT 42826 • ENT
$156$292$425
Adenoidectomy primary under age 12
CPT 42830 • ENT
$126$232$356
Removal impacted cerumen unilateral
CPT 69210 • ENT
$29$51$79
Tympanostomy tube insertion
CPT 69436 • ENT
$144$189$264
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$687$992$1,454
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$626$1,091$1,721
Comprehensive audiometry evaluation
CPT 92557 • ENT
$35$48$60
Incision and drainage abscess simple
CPT 10060 • Emergency
$46$116$211
Incision and drainage abscess complicated
CPT 10061 • Emergency
$155$224$352
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$34$84$163
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$44$100$174
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$69$107$173
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$85$217$432
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$120$269$465
Initial treatment first degree burn
CPT 16000 • Emergency
$42$62$78
Emergency department visit self-limited problem
CPT 99281 • Emergency
$18$22$27
Emergency department visit low severity
CPT 99282 • Emergency
$31$50$67
Emergency department visit moderate severity
CPT 99283 • Emergency
$65$78$95
Emergency department visit high severity
CPT 99284 • Emergency
$103$140$192
Emergency department visit highest severity
CPT 99285 • Emergency
$160$210$279
Critical care first 30-74 minutes
CPT 99291 • Emergency
$223$303$445
Critical care each additional 30 minutes
CPT 99292 • Emergency
$111$141$193
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$147$186$253
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$143$286$472
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$107$334$611
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$125$299$624
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$174$262$416
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$136$356$800
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$192$318$386
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$286$330$375
ERCP diagnostic
CPT 43260 • Gastroenterology
$351$535$848
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$268$449$566
ERCP with removal of stones
CPT 43264 • Gastroenterology
$510$561$637
ERCP with stent placement
CPT 43274 • Gastroenterology
$438$576$733
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$201$334$519
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$253$430$671
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$126$357$556
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$151$438$706
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$243$443$720
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$262$491$794
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$299$517$739
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$263$573$982
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$325$1,197$3,657
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$400$447$528
Esophageal motility study
CPT 91010 • Gastroenterology
$98$158$223
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$82$452$731
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$88$175$322
Auto-added
CPT 00102 • General
$40$412$693
Auto-added
CPT 00104 • General
$40$298$495