LAKE NORMAN REGIONAL MEDICAL CENTER· MOORESVILLE, NC

HospitalCMS 2/5

171 FAIRVIEW ROAD, MOORESVILLE, NC 28117

Procedures offered

935 total

ProcedureMinAvgMax
Tonsillectomy primary under age 12
CPT 42826 • ENT
$294$2,265$7,926
Adenoidectomy primary under age 12
CPT 42830 • ENT
$207$2,248$7,926
Removal impacted cerumen unilateral
CPT 69210 • ENT
$40$198$682
Tympanostomy tube insertion
CPT 69436 • ENT
$144$1,398$5,919
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$687$4,917$14,813
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$840$4,673$14,813
Comprehensive audiometry evaluation
CPT 92557 • ENT
$34$47$64
Incision and drainage abscess simple
CPT 10060 • Emergency
$87$268$682
Incision and drainage abscess complicated
CPT 10061 • Emergency
$180$368$682
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$57$207$682
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$56$223$682
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$62$231$682
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$91$371$682
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$120$356$682
Initial treatment first degree burn
CPT 16000 • Emergency
$55$273$682
Emergency department visit self-limited problem
CPT 99281 • Emergency
$22$31$44
Emergency department visit low severity
CPT 99282 • Emergency
$37$59$85
Emergency department visit moderate severity
CPT 99283 • Emergency
$77$100$144
Emergency department visit high severity
CPT 99284 • Emergency
$93$150$243
Emergency department visit highest severity
CPT 99285 • Emergency
$157$228$353
Critical care first 30-74 minutes
CPT 99291 • Emergency
$223$328$432
Critical care each additional 30 minutes
CPT 99292 • Emergency
$94$149$243
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$147$1,713$5,919
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$159$1,629$5,919
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$105$1,512$5,919
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$142$1,539$5,919
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$116$1,484$5,919
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$219$1,802$5,919
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$324$2,361$7,926
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$30$1,321$5,919
ERCP diagnostic
CPT 43260 • Gastroenterology
$351$2,339$7,926
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$30$1,797$7,926
ERCP with removal of stones
CPT 43264 • Gastroenterology
$30$1,973$7,926
ERCP with stent placement
CPT 43274 • Gastroenterology
$342$2,235$7,926
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$125$1,486$5,919
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$253$2,074$5,919
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$183$1,617$5,919
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$161$1,643$5,919
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$30$1,396$5,919
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$221$1,706$5,919
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$204$1,642$5,919
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$269$1,939$5,919
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$377$3,345$6,268
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$266$1,588$5,919
Esophageal motility study
CPT 91010 • Gastroenterology
$30$247$682
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$82$537$932
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$52$276$682
Auto-added
CPT 00102 • General
$40$403$713
Auto-added
CPT 00104 • General
$40$235$340
Auto-added
CPT 00120 • General
$40$273$441