FIRSTHEALTH MOORE REGIONAL HOSPITAL· PINEHURST, NC

HospitalCMS 4/5

155 MEMORIAL DRIVE, PINEHURST, NC 28374

Procedures offered

936 total

ProcedureMinAvgMax
Tonsillectomy and adenoidectomy age 12 or older
CPT 42821 • ENT
$289$471$671
Tonsillectomy primary under age 12
CPT 42826 • ENT
$245$396$567
Adenoidectomy primary under age 12
CPT 42830 • ENT
$163$284$475
Removal impacted cerumen unilateral
CPT 69210 • ENT
$26$45$69
Tympanostomy tube insertion
CPT 69436 • ENT
$30$184$352
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$685$1,182$1,939
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$644$1,402$2,294
Comprehensive audiometry evaluation
CPT 92557 • ENT
$32$51$79
Incision and drainage abscess simple
CPT 10060 • Emergency
$98$162$282
Incision and drainage abscess complicated
CPT 10061 • Emergency
$100$266$470
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$35$99$131
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$47$148$250
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$44$128$246
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$117$330$576
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$134$314$620
Initial treatment first degree burn
CPT 16000 • Emergency
$35$89$104
Emergency department visit self-limited problem
CPT 99281 • Emergency
$11$32$76
Emergency department visit low severity
CPT 99282 • Emergency
$42$64$89
Emergency department visit moderate severity
CPT 99283 • Emergency
$71$101$150
Emergency department visit high severity
CPT 99284 • Emergency
$120$180$256
Emergency department visit highest severity
CPT 99285 • Emergency
$174$281$371
Critical care first 30-74 minutes
CPT 99291 • Emergency
$223$391$594
Critical care each additional 30 minutes
CPT 99292 • Emergency
$118$181$257
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$114$207$338
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$118$451$704
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$127$423$815
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$169$483$833
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$147$941$1,642
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$187$598$869
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$221$351$493
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$215$349$481
ERCP diagnostic
CPT 43260 • Gastroenterology
$306$478$683
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$293$470$755
ERCP with removal of stones
CPT 43264 • Gastroenterology
$345$500$771
ERCP with stent placement
CPT 43274 • Gastroenterology
$438$589$977
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$150$443$942
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$164$531$894
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$177$370$742
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$192$545$942
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$192$526$960
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$170$376$707
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$242$562$985
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$203$554$904
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$257$1,914$4,358
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$299$441$704
Esophageal motility study
CPT 91010 • Gastroenterology
$61$230$480
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$91$584$975
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$363$538$864
Auto-added
CPT 00102 • General
$4$162$403
Auto-added
CPT 00104 • General
$4$38$79