NOVANT HEALTH ROWAN MEDICAL CENTER· SALISBURY, NC

HospitalCMS 2/5

612 MOCKSVILLE AVE, SALISBURY, NC 28144

Procedures offered

962 total

ProcedureMinAvgMax
Tonsillectomy and adenoidectomy under age 12
CPT 42820 • ENT
$302$385$527
Tonsillectomy and adenoidectomy age 12 or older
CPT 42821 • ENT
$353$547$895
Tonsillectomy primary under age 12
CPT 42826 • ENT
$294$457$749
Adenoidectomy primary under age 12
CPT 42830 • ENT
$207$340$529
Removal impacted cerumen unilateral
CPT 69210 • ENT
$40$70$112
Tympanostomy tube insertion
CPT 69436 • ENT
$144$330$477
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$687$1,379$2,250
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$840$1,270$1,867
Comprehensive audiometry evaluation
CPT 92557 • ENT
$32$65$136
Incision and drainage abscess simple
CPT 10060 • Emergency
$49$127$243
Incision and drainage abscess complicated
CPT 10061 • Emergency
$129$323$598
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$67$215$361
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$49$89$117
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$69$123$203
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$91$308$464
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$120$452$642
Initial treatment first degree burn
CPT 16000 • Emergency
$43$86$133
Emergency department visit self-limited problem
CPT 99281 • Emergency
$17$51$126
Emergency department visit low severity
CPT 99282 • Emergency
$37$79$126
Emergency department visit moderate severity
CPT 99283 • Emergency
$58$74$84
Emergency department visit high severity
CPT 99284 • Emergency
$111$173$248
Emergency department visit highest severity
CPT 99285 • Emergency
$188$312$479
Critical care first 30-74 minutes
CPT 99291 • Emergency
$49$395$661
Critical care each additional 30 minutes
CPT 99292 • Emergency
$111$228$294
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$153$193$279
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$49$300$799
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$49$203$365
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$201$650$1,220
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$174$1,403$3,224
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$219$522$923
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$299$406$697
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$286$491$678
ERCP diagnostic
CPT 43260 • Gastroenterology
$337$419$583
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$317$481$646
ERCP with removal of stones
CPT 43264 • Gastroenterology
$518$723$1,118
ERCP with stent placement
CPT 43274 • Gastroenterology
$438$839$1,400
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$146$287$581
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$209$358$537
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$49$429$840
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$49$472$1,102
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$49$654$1,176
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$208$664$1,174
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$49$244$416
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$274$929$2,001
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$778$2,352$4,629
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$299$536$846
Esophageal motility study
CPT 91010 • Gastroenterology
$119$185$330
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$82$542$1,467
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$77$304$616
Auto-added
CPT 00102 • General
$6$107$329