ONSLOW MEMORIAL HOSPITAL· JACKSONVILLE, NC

HospitalCMS 1/5

317 WESTERN BOULEVARD, JACKSONVILLE, NC 28546

Procedures offered

935 total

ProcedureMinAvgMax
Tonsillectomy primary under age 12
CPT 42826 • ENT
$266$365$534
Adenoidectomy primary under age 12
CPT 42830 • ENT
$185$204$219
Removal impacted cerumen unilateral
CPT 69210 • ENT
$35$48$67
Tympanostomy tube insertion
CPT 69436 • ENT
$144$178$223
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$687$1,157$1,859
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$840$1,377$2,197
Comprehensive audiometry evaluation
CPT 92557 • ENT
$33$37$43
Incision and drainage abscess simple
CPT 10060 • Emergency
$87$95$104
Incision and drainage abscess complicated
CPT 10061 • Emergency
$180$227$284
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$47$62$73
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$62$77$87
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$69$85$114
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$91$128$162
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$120$328$588
Initial treatment first degree burn
CPT 16000 • Emergency
$55$81$113
Emergency department visit self-limited problem
CPT 99281 • Emergency
$22$22$23
Emergency department visit low severity
CPT 99282 • Emergency
$37$41$44
Emergency department visit moderate severity
CPT 99283 • Emergency
$64$69$77
Emergency department visit high severity
CPT 99284 • Emergency
$117$121$125
Emergency department visit highest severity
CPT 99285 • Emergency
$177$183$188
Critical care first 30-74 minutes
CPT 99291 • Emergency
$223$228$236
Critical care each additional 30 minutes
CPT 99292 • Emergency
$111$118$130
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$147$178$222
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$188$354$594
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$150$294$508
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$201$362$510
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$167$183$210
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$219$558$977
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$252$352$480
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$246$287$328
ERCP diagnostic
CPT 43260 • Gastroenterology
$277$326$351
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$389$447$519
ERCP with removal of stones
CPT 43264 • Gastroenterology
$333$416$518
ERCP with stent placement
CPT 43274 • Gastroenterology
$504$691$1,010
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$230$390$631
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$253$403$550
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$269$301$337
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$172$318$432
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$172$291$423
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$312$388$481
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$416$475$555
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$289$405$621
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$377$1,361$3,155
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$362$405$453
Esophageal motility study
CPT 91010 • Gastroenterology
$93$120$142
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$82$372$626
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$62$204$426
Auto-added
CPT 00102 • General
$40$205$490
Auto-added
CPT 00104 • General
$40$174$350
Auto-added
CPT 00120 • General
$40$198$420