DLP WILSON MEDICAL CENTER LLC· WILSON, NC

HospitalCMS 2/5

1705 TARBORO ST SW, WILSON, NC 27893

Procedures offered

967 total

ProcedureMinAvgMax
Tonsillectomy and adenoidectomy under age 12
CPT 42820 • ENT
$286$3,437$15,352
Tonsillectomy and adenoidectomy age 12 or older
CPT 42821 • ENT
$298$3,400$15,352
Tonsillectomy primary under age 12
CPT 42826 • ENT
$247$3,390$15,352
Adenoidectomy primary under age 12
CPT 42830 • ENT
$200$3,335$15,352
Removal impacted cerumen unilateral
CPT 69210 • ENT
$26$147$502
Tympanostomy tube insertion
CPT 69436 • ENT
$163$1,596$6,982
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$825$6,948$29,462
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$982$7,230$29,462
Comprehensive audiometry evaluation
CPT 92557 • ENT
$33$46$56
Incision and drainage abscess simple
CPT 10060 • Emergency
$98$205$502
Incision and drainage abscess complicated
CPT 10061 • Emergency
$171$384$502
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$36$178$502
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$48$198$502
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$53$216$502
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$126$304$502
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$235$367$505
Initial treatment first degree burn
CPT 16000 • Emergency
$45$181$502
Emergency department visit self-limited problem
CPT 99281 • Emergency
$11$44$94
Emergency department visit low severity
CPT 99282 • Emergency
$39$59$69
Emergency department visit moderate severity
CPT 99283 • Emergency
$66$92$117
Emergency department visit high severity
CPT 99284 • Emergency
$113$166$208
Emergency department visit highest severity
CPT 99285 • Emergency
$164$231$286
Critical care first 30-74 minutes
CPT 99291 • Emergency
$272$386$497
Critical care each additional 30 minutes
CPT 99292 • Emergency
$122$158$188
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$147$1,573$6,982
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$280$1,762$6,982
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$110$1,702$6,982
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$191$1,813$6,982
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$166$2,443$6,982
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$208$1,979$6,982
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$300$3,352$15,352
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$217$1,683$6,982
ERCP diagnostic
CPT 43260 • Gastroenterology
$306$3,423$15,352
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$409$3,565$15,352
ERCP with removal of stones
CPT 43264 • Gastroenterology
$346$3,530$15,352
ERCP with stent placement
CPT 43274 • Gastroenterology
$559$3,795$15,352
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$322$1,790$6,982
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$341$1,785$6,982
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$279$1,856$6,982
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$455$1,859$6,982
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$191$1,777$6,982
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$217$1,702$6,982
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$521$2,052$6,982
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$198$1,825$6,982
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$377$2,336$6,982
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$400$1,858$6,982
Esophageal motility study
CPT 91010 • Gastroenterology
$97$271$502
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$438$566$824
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$83$271$528
Auto-added
CPT 00102 • General
$68$528$1,079