NOVANT HEALTH FORSYTH MEDICAL CENTER· WINSTON-SALEM, NC

HospitalCMS 4/5

3333 SILAS CREEK PARKWAY, WINSTON-SALEM, NC 27103

Procedures offered

942 total

ProcedureMinAvgMax
Electroencephalogram (EEG) awake and asleep
CPT 95816 • Neurology
$56$376$585
Electroencephalogram (EEG) awake and asleep with activation
CPT 95819 • Neurology
$52$337$583
Electromyography (EMG) 1 extremity
CPT 95860 • Neurology
$49$114$275
Electromyography (EMG) 2 extremities
CPT 95861 • Neurology
$74$163$262
EMG needle each extremity complete
CPT 95886 • Neurology
$41$120$242
Nerve conduction study 1-2 nerves
CPT 95907 • Neurology
$44$105$220
Nerve conduction study 3-4 nerves
CPT 95908 • Neurology
$48$129$274
Nerve conduction study 5-6 nerves
CPT 95909 • Neurology
$61$157$329
Nerve conduction study 7-8 nerves
CPT 95910 • Neurology
$96$226$430
Nerve conduction study 13 or more nerves
CPT 95913 • Neurology
$105$324$695
Office visit new patient straightforward
CPT 99202 • Office Visits
$53$87$165
Office visit new patient low complexity
CPT 99203 • Office Visits
$76$118$255
Office visit new patient moderate complexity
CPT 99204 • Office Visits
$85$199$381
Office visit new patient high complexity
CPT 99205 • Office Visits
$183$273$508
Office visit established patient minimal
CPT 99211 • Office Visits
$8$29$67
Office visit established patient straightforward
CPT 99212 • Office Visits
$35$58$128
Office visit established patient low complexity
CPT 99213 • Office Visits
$45$96$207
Office visit established patient moderate complexity
CPT 99214 • Office Visits
$85$138$292
Office visit established patient high complexity
CPT 99215 • Office Visits
$128$229$412
Initial hospital care low complexity
CPT 99221 • Office Visits
$82$121$228
Initial hospital care moderate complexity
CPT 99222 • Office Visits
$98$151$307
Initial hospital care high complexity
CPT 99223 • Office Visits
$172$230$451
Subsequent hospital care low complexity
CPT 99231 • Office Visits
$38$57$88
Subsequent hospital care moderate complexity
CPT 99232 • Office Visits
$66$93$162
Subsequent hospital care high complexity
CPT 99233 • Office Visits
$92$126$233
Hospital discharge day management 30 minutes or less
CPT 99238 • Office Visits
$65$94$163
Hospital discharge day management more than 30 min
CPT 99239 • Office Visits
$95$127$238
Consultation office straightforward
CPT 99241 • Office Visits
$80$80$80
Consultation office low complexity
CPT 99243 • Office Visits
$0$135$273
Consultation office high complexity
CPT 99245 • Office Visits
$0$288$546
Blepharoplasty upper eyelid
CPT 15823 • Ophthalmology
$590$792$1,223
Foreign body removal external eye corneal
CPT 65210 • Ophthalmology
$42$56$68
Corneal transplant endothelial
CPT 65756 • Ophthalmology
$726$1,293$2,036
Trabeculoplasty laser surgery
CPT 65855 • Ophthalmology
$250$337$449
Trabeculectomy glaucoma filtering surgery
CPT 66170 • Ophthalmology
$171$1,135$1,886
Endoscopic cyclophotocoagulation
CPT 66711 • Ophthalmology
$539$644$869
Iridotomy laser surgery
CPT 66761 • Ophthalmology
$219$390$519
Cataract surgery complex with intraocular lens
CPT 66982 • Ophthalmology
$435$890$1,287
Cataract surgery with intraocular lens insertion
CPT 66984 • Ophthalmology
$603$743$939
Intravitreal injection therapeutic agent
CPT 67028 • Ophthalmology
$116$164$200
Retinal detachment repair with vitrectomy
CPT 67108 • Ophthalmology
$154$1,313$2,055
Retinal photocoagulation treatment
CPT 67210 • Ophthalmology
$462$627$892
Retinal treatment extensive photocoagulation
CPT 67228 • Ophthalmology
$346$639$1,097
Strabismus surgery one horizontal muscle
CPT 67311 • Ophthalmology
$508$628$832
Excision chalazion single
CPT 67800 • Ophthalmology
$68$141$223
Blepharoptosis repair levator resection
CPT 67901 • Ophthalmology
$543$931$1,389
Lacrimal punctum closure by plug
CPT 68761 • Ophthalmology
$111$168$257
Eye exam new patient intermediate
CPT 92002 • Ophthalmology
$34$91$136
Eye exam new patient comprehensive
CPT 92004 • Ophthalmology
$63$165$245
Eye exam established patient intermediate
CPT 92012 • Ophthalmology
$35$86$143