ONSLOW MEMORIAL HOSPITAL INC· JACKSONVILLE, NC

HospitalCMS 1/5

317 WESTERN BLVD, JACKSONVILLE, NC 28546

Procedures offered

954 total

Procedure	Min	Avg	Max
Cataract surgery with intraocular lens insertion CPT 66984 • Ophthalmology	$640	$752	$1,075
Intravitreal injection therapeutic agent CPT 67028 • Ophthalmology	$105	$126	$173
Retinal detachment repair with vitrectomy CPT 67108 • Ophthalmology	$259	$1,139	$1,516
Retinal photocoagulation treatment CPT 67210 • Ophthalmology	$528	$674	$980
Retinal treatment extensive photocoagulation CPT 67228 • Ophthalmology	$361	$805	$1,124
Strabismus surgery one horizontal muscle CPT 67311 • Ophthalmology	$458	$607	$782
Excision chalazion single CPT 67800 • Ophthalmology	$95	$139	$210
Blepharoptosis repair levator resection CPT 67901 • Ophthalmology	$483	$672	$809
Lacrimal punctum closure by plug CPT 68761 • Ophthalmology	$96	$129	$156
Eye exam new patient intermediate CPT 92002 • Ophthalmology	$38	$71	$88
Eye exam new patient comprehensive CPT 92004 • Ophthalmology	$72	$139	$159
Eye exam established patient intermediate CPT 92012 • Ophthalmology	$30	$61	$92
Eye exam established patient comprehensive CPT 92014 • Ophthalmology	$48	$91	$133
Visual field examination CPT 92083 • Ophthalmology	$37	$60	$95
Retinal imaging OCT posterior segment CPT 92134 • Ophthalmology	$15	$29	$48
Ophthalmic biometry IOL power calculation CPT 92136 • Ophthalmology	$30	$60	$93
Fundus photography CPT 92250 • Ophthalmology	$23	$50	$83
Arthrocentesis aspiration small joint CPT 20600 • Orthopedics	$34	$51	$74
Arthrocentesis aspiration intermediate joint CPT 20605 • Orthopedics	$35	$52	$77
Arthrocentesis aspiration major joint CPT 20610 • Orthopedics	$40	$67	$81
Cervical spine fusion anterior approach CPT 22551 • Orthopedics	$1,719	$1,874	$2,328
Lumbar spine fusion posterior approach CPT 22612 • Orthopedics	$1,404	$1,660	$2,040
Lumbar spine fusion combined approach CPT 22633 • Orthopedics	$358	$1,648	$2,050
Total shoulder replacement CPT 23472 • Orthopedics	$282	$1,236	$1,540
Reverse total shoulder replacement CPT 23473 • Orthopedics	$1,576	$1,952	$3,304
Lateral epicondylitis open treatment CPT 24357 • Orthopedics	$350	$427	$452
Closed treatment distal radial fracture CPT 25600 • Orthopedics	$45	$257	$344
Tendon sheath incision trigger finger CPT 26055 • Orthopedics	$296	$422	$597
Total hip replacement CPT 27130 • Orthopedics	$258	$1,213	$1,450
Hip replacement conversion to total CPT 27132 • Orthopedics	$1,436	$1,636	$1,774
Open treatment femoral fracture CPT 27236 • Orthopedics	$994	$1,266	$1,669
Treatment intertrochanteric femoral fracture CPT 27244 • Orthopedics	$275	$1,071	$1,302
Treatment intertrochanteric fracture with plate/screw CPT 27245 • Orthopedics	$274	$1,118	$1,327
Partial knee replacement medial or lateral CPT 27446 • Orthopedics	$220	$986	$1,227
Total knee replacement CPT 27447 • Orthopedics	$1,344	$1,522	$1,790
Open treatment tibial shaft fracture CPT 27756 • Orthopedics	$30	$551	$816
Closed treatment distal fibula fracture CPT 27786 • Orthopedics	$300	$328	$379
Bunionectomy with osteotomy CPT 28296 • Orthopedics	$553	$711	$969
Arthroscopy shoulder decompression CPT 29826 • Orthopedics	$149	$434	$734
Arthroscopy shoulder rotator cuff repair CPT 29827 • Orthopedics	$989	$1,274	$2,243
Arthroscopy knee with meniscectomy medial and lateral CPT 29880 • Orthopedics	$592	$736	$1,130
Arthroscopy knee with meniscectomy CPT 29881 • Orthopedics	$481	$605	$653
Arthroscopy knee with meniscus repair CPT 29882 • Orthopedics	$610	$698	$736
Arthroscopy knee ACL repair CPT 29888 • Orthopedics	$212	$874	$1,078
Discectomy lumbar single level CPT 63030 • Orthopedics	$208	$895	$1,204
Laminectomy lumbar single level CPT 63047 • Orthopedics	$1,091	$1,251	$1,568
Carpal tunnel release CPT 64721 • Orthopedics	$433	$484	$571
Sacroiliac joint injection CPT 27096 • Pain Management	$83	$143	$200
Epidural injection cervical or thoracic with imaging CPT 62321 • Pain Management	$115	$208	$266
Epidural injection lumbar or sacral without imaging CPT 62322 • Pain Management	$92	$108	$137