NOVANT HEALTH FORSYTH MEDICAL CENTER· WINSTON-SALEM, NC
HospitalCMS 4/5
3333 SILAS CREEK PARKWAY, WINSTON-SALEM, NC 27103
Procedures offered
942 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Tonsillectomy primary under age 12 CPT 42826 • ENT | $247 | $387 | $621 |
| Adenoidectomy primary under age 12 CPT 42830 • ENT | $128 | $289 | $515 |
| Removal impacted cerumen unilateral CPT 69210 • ENT | $45 | $68 | $115 |
| Tympanostomy tube insertion CPT 69436 • ENT | $95 | $221 | $387 |
| Tympanoplasty without mastoidectomy CPT 69631 • ENT | $825 | $1,331 | $2,185 |
| Tympanoplasty with mastoidectomy CPT 69633 • ENT | $982 | $1,536 | $2,583 |
| Comprehensive audiometry evaluation CPT 92557 • ENT | $29 | $56 | $92 |
| Incision and drainage abscess simple CPT 10060 • Emergency | $72 | $170 | $302 |
| Incision and drainage abscess complicated CPT 10061 • Emergency | $127 | $262 | $518 |
| Simple wound repair up to 2.5cm CPT 12001 • Emergency | $49 | $131 | $215 |
| Simple wound repair 2.6-7.5cm CPT 12002 • Emergency | $64 | $144 | $173 |
| Simple wound repair face 2.5cm or less CPT 12011 • Emergency | $60 | $128 | $170 |
| Intermediate wound repair 2.5cm or less CPT 12031 • Emergency | $191 | $270 | $347 |
| Intermediate wound repair face 2.5cm or less CPT 12051 • Emergency | $177 | $342 | $587 |
| Initial treatment first degree burn CPT 16000 • Emergency | $45 | $86 | $140 |
| Emergency department visit self-limited problem CPT 99281 • Emergency | $11 | $23 | $50 |
| Emergency department visit low severity CPT 99282 • Emergency | $39 | $52 | $98 |
| Emergency department visit moderate severity CPT 99283 • Emergency | $53 | $85 | $166 |
| Emergency department visit high severity CPT 99284 • Emergency | $113 | $176 | $289 |
| Emergency department visit highest severity CPT 99285 • Emergency | $161 | $254 | $425 |
| Critical care first 30-74 minutes CPT 99291 • Emergency | $219 | $327 | $636 |
| Critical care each additional 30 minutes CPT 99292 • Emergency | $89 | $141 | $279 |
| Esophagoscopy rigid diagnostic CPT 43191 • Gastroenterology | $150 | $187 | $250 |
| Upper GI endoscopy diagnostic CPT 43235 • Gastroenterology | $151 | $436 | $927 |
| Upper GI endoscopy with biopsy CPT 43239 • Gastroenterology | $180 | $505 | $933 |
| Upper GI endoscopy with foreign body removal CPT 43247 • Gastroenterology | $191 | $507 | $953 |
| Upper GI endoscopy with balloon dilation CPT 43249 • Gastroenterology | $89 | $1,011 | $2,744 |
| Upper GI endoscopy with polypectomy by snare CPT 43251 • Gastroenterology | $208 | $610 | $1,230 |
| Upper GI endoscopy with stent placement CPT 43257 • Gastroenterology | $252 | $389 | $777 |
| Upper GI endoscopy with endoscopic ultrasound CPT 43259 • Gastroenterology | $245 | $333 | $517 |
| ERCP diagnostic CPT 43260 • Gastroenterology | $326 | $429 | $740 |
| ERCP with sphincterotomy CPT 43262 • Gastroenterology | $385 | $552 | $821 |
| ERCP with removal of stones CPT 43264 • Gastroenterology | $368 | $502 | $835 |
| ERCP with stent placement CPT 43274 • Gastroenterology | $499 | $675 | $1,062 |
| Colonoscopy through stoma diagnostic CPT 44388 • Gastroenterology | $96 | $294 | $581 |
| Colonoscopy through stoma with biopsy CPT 44389 • Gastroenterology | $100 | $503 | $1,224 |
| Colonoscopy diagnostic CPT 45378 • Gastroenterology | $350 | $516 | $845 |
| Colonoscopy with biopsy CPT 45380 • Gastroenterology | $291 | $646 | $1,078 |
| Colonoscopy with submucosal injection CPT 45381 • Gastroenterology | $435 | $673 | $1,100 |
| Colonoscopy with lesion removal by hot biopsy CPT 45384 • Gastroenterology | $222 | $589 | $1,214 |
| Colonoscopy with polypectomy by snare CPT 45385 • Gastroenterology | $147 | $634 | $1,131 |
| Colonoscopy with balloon dilation CPT 45386 • Gastroenterology | $206 | $732 | $1,512 |
| Colonoscopy with ablation of tumor or polyp CPT 45388 • Gastroenterology | $293 | $2,425 | $6,637 |
| Colonoscopy with endoscopic mucosal resection CPT 45390 • Gastroenterology | $350 | $464 | $762 |
| Esophageal motility study CPT 91010 • Gastroenterology | $59 | $229 | $552 |
| Esophageal motility study with acid reflux CPT 91035 • Gastroenterology | $82 | $505 | $1,177 |
| Esophageal pH monitoring 24 hours CPT 91038 • Gastroenterology | $80 | $299 | $616 |
| Auto-added CPT 00102 • General | $42 | $260 | $713 |
| Auto-added CPT 00104 • General | $42 | $165 | $361 |
| Auto-added CPT 00120 • General | $57 | $338 | $611 |