ONSLOW MEMORIAL HOSPITAL INC· JACKSONVILLE, NC

HospitalCMS 1/5

317 WESTERN BLVD, JACKSONVILLE, NC 28546

Procedures offered

937 total

ProcedureMinAvgMax
Tonsillectomy primary under age 12
CPT 42826 • ENT
$266$341$534
Adenoidectomy primary under age 12
CPT 42830 • ENT
$185$208$223
Removal impacted cerumen unilateral
CPT 69210 • ENT
$35$49$67
Tympanostomy tube insertion
CPT 69436 • ENT
$144$176$223
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$687$1,099$1,859
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$840$1,305$2,197
Comprehensive audiometry evaluation
CPT 92557 • ENT
$33$39$43
Incision and drainage abscess simple
CPT 10060 • Emergency
$87$99$112
Incision and drainage abscess complicated
CPT 10061 • Emergency
$180$216$284
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$47$72$99
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$62$87$116
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$69$93$119
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$91$159$249
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$120$315$588
Initial treatment first degree burn
CPT 16000 • Emergency
$55$78$113
Emergency department visit self-limited problem
CPT 99281 • Emergency
$22$35$73
Emergency department visit low severity
CPT 99282 • Emergency
$37$49$73
Emergency department visit moderate severity
CPT 99283 • Emergency
$64$71$77
Emergency department visit high severity
CPT 99284 • Emergency
$117$127$145
Emergency department visit highest severity
CPT 99285 • Emergency
$177$188$203
Critical care first 30-74 minutes
CPT 99291 • Emergency
$223$237$264
Critical care each additional 30 minutes
CPT 99292 • Emergency
$111$118$130
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$132$166$222
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$188$346$594
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$150$314$508
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$201$324$510
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$167$183$210
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$219$475$977
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$227$321$480
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$246$294$328
ERCP diagnostic
CPT 43260 • Gastroenterology
$277$335$360
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$389$446$519
ERCP with removal of stones
CPT 43264 • Gastroenterology
$333$445$533
ERCP with stent placement
CPT 43274 • Gastroenterology
$497$642$1,010
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$230$387$631
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$253$411$550
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$269$332$426
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$172$366$509
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$172$343$497
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$312$416$501
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$416$499$572
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$289$485$725
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$377$1,169$3,155
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$362$433$520
Esophageal motility study
CPT 91010 • Gastroenterology
$93$143$210
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$82$419$626
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$62$255$426
Auto-added
CPT 00102 • General
$30$170$490
Auto-added
CPT 00104 • General
$30$145$350
Auto-added
CPT 00120 • General
$30$164$420