ONSLOW MEMORIAL HOSPITAL INC· JACKSONVILLE, NC

HospitalCMS 1/5

317 WESTERN BLVD, JACKSONVILLE, NC 28546

Procedures offered

954 total

ProcedureMinAvgMax
Tonsillectomy primary under age 12
CPT 42826 • ENT
$266$316$534
Adenoidectomy primary under age 12
CPT 42830 • ENT
$185$213$223
Removal impacted cerumen unilateral
CPT 69210 • ENT
$35$48$67
Tympanostomy tube insertion
CPT 69436 • ENT
$144$173$223
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$30$892$1,859
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$840$1,213$2,197
Comprehensive audiometry evaluation
CPT 92557 • ENT
$33$40$43
Incision and drainage abscess simple
CPT 10060 • Emergency
$87$106$124
Incision and drainage abscess complicated
CPT 10061 • Emergency
$180$216$284
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$45$71$99
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$62$80$116
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$69$101$119
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$91$190$255
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$120$284$588
Initial treatment first degree burn
CPT 16000 • Emergency
$44$67$113
Emergency department visit self-limited problem
CPT 99281 • Emergency
$22$39$73
Emergency department visit low severity
CPT 99282 • Emergency
$37$52$73
Emergency department visit moderate severity
CPT 99283 • Emergency
$64$71$77
Emergency department visit high severity
CPT 99284 • Emergency
$117$128$145
Emergency department visit highest severity
CPT 99285 • Emergency
$177$190$203
Critical care first 30-74 minutes
CPT 99291 • Emergency
$223$251$292
Critical care each additional 30 minutes
CPT 99292 • Emergency
$111$118$130
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$132$161$222
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$188$330$594
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$150$308$508
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$201$298$510
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$167$334$1,091
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$213$390$977
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$227$294$480
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$246$293$328
ERCP diagnostic
CPT 43260 • Gastroenterology
$277$338$360
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$389$437$519
ERCP with removal of stones
CPT 43264 • Gastroenterology
$333$422$533
ERCP with stent placement
CPT 43274 • Gastroenterology
$497$615$1,010
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$230$371$631
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$191$373$550
Flexible sigmoidoscopy diagnostic
CPT 45330 • Gastroenterology
$178$178$178
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$269$333$426
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$45$288$509
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$172$348$497
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$247$402$501
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$277$432$572
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$289$547$725
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$263$872$3,155
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$362$448$520
Esophageal motility study
CPT 91010 • Gastroenterology
$93$151$210
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$82$440$626
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$62$296$458
Auto-added
CPT 00102 • General
$30$135$490
Auto-added
CPT 00104 • General
$30$117$350