CAPE FEAR VALLEY HOKE HOSPITAL· RAEFORD, NC

HospitalCMS 4/5

210 MEDICAL PAVILION DRIVE, RAEFORD, NC 28376

Procedures offered

936 total

ProcedureMinAvgMax
Tonsillectomy and adenoidectomy age 12 or older
CPT 42821 • ENT
$248$400$541
Tonsillectomy primary under age 12
CPT 42826 • ENT
$252$351$454
Adenoidectomy primary under age 12
CPT 42830 • ENT
$211$301$378
Removal impacted cerumen unilateral
CPT 69210 • ENT
$32$64$91
Tympanostomy tube insertion
CPT 69436 • ENT
$129$209$281
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$711$1,355$2,524
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$1,023$1,701$2,980
Comprehensive audiometry evaluation
CPT 92557 • ENT
$33$57$104
Incision and drainage abscess simple
CPT 10060 • Emergency
$45$137$192
Incision and drainage abscess complicated
CPT 10061 • Emergency
$171$273$370
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$37$131$177
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$48$127$197
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$46$158$211
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$121$297$442
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$138$364$478
Initial treatment first degree burn
CPT 16000 • Emergency
$36$106$196
Emergency department visit self-limited problem
CPT 99281 • Emergency
$12$26$55
Emergency department visit low severity
CPT 99282 • Emergency
$43$59$73
Emergency department visit moderate severity
CPT 99283 • Emergency
$73$100$127
Emergency department visit high severity
CPT 99284 • Emergency
$124$171$216
Emergency department visit highest severity
CPT 99285 • Emergency
$180$248$314
Critical care first 30-74 minutes
CPT 99291 • Emergency
$242$378$480
Critical care each additional 30 minutes
CPT 99292 • Emergency
$121$169$211
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$157$253$442
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$122$274$482
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$136$518$694
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$174$455$643
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$151$1,409$1,937
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$192$551$817
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$189$440$1,098
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$181$292$395
ERCP diagnostic
CPT 43260 • Gastroenterology
$315$522$939
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$287$461$623
ERCP with removal of stones
CPT 43264 • Gastroenterology
$356$505$636
ERCP with stent placement
CPT 43274 • Gastroenterology
$451$700$886
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$155$324$595
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$45$336$635
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$118$278$578
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$198$499$728
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$198$532$741
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$224$592$821
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$205$519$770
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$209$800$1,677
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$265$2,828$6,136
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$308$500$637
Esophageal motility study
CPT 91010 • Gastroenterology
$93$246$485
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$83$549$966
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$56$364$640
Auto-added
CPT 00102 • General
$3$352$760
Auto-added
CPT 00104 • General
$3$256$543