ASHE MEMORIAL HOSPITAL· JEFFERSON, NC
HospitalCMS 3/5
200 HOSPITAL AVE, JEFFERSON, NC 28640
Procedures offered
935 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Tonsillectomy primary under age 12 CPT 42826 • ENT | $258 | $384 | $570 |
| Adenoidectomy primary under age 12 CPT 42830 • ENT | $213 | $317 | $477 |
| Removal impacted cerumen unilateral CPT 69210 • ENT | $33 | $61 | $104 |
| Tympanostomy tube insertion CPT 69436 • ENT | $95 | $205 | $354 |
| Tympanoplasty without mastoidectomy CPT 69631 • ENT | $839 | $1,178 | $1,944 |
| Tympanoplasty with mastoidectomy CPT 69633 • ENT | $1,061 | $1,521 | $2,308 |
| Comprehensive audiometry evaluation CPT 92557 • ENT | $29 | $50 | $76 |
| Incision and drainage abscess simple CPT 10060 • Emergency | $112 | $123 | $134 |
| Incision and drainage abscess complicated CPT 10061 • Emergency | $127 | $244 | $468 |
| Simple wound repair up to 2.5cm CPT 12001 • Emergency | $63 | $136 | $208 |
| Simple wound repair 2.6-7.5cm CPT 12002 • Emergency | $110 | $179 | $253 |
| Simple wound repair face 2.5cm or less CPT 12011 • Emergency | $84 | $143 | $249 |
| Intermediate wound repair 2.5cm or less CPT 12031 • Emergency | $217 | $316 | $571 |
| Intermediate wound repair face 2.5cm or less CPT 12051 • Emergency | $159 | $327 | $615 |
| Initial treatment first degree burn CPT 16000 • Emergency | $51 | $66 | $86 |
| Emergency department visit self-limited problem CPT 99281 • Emergency | $20 | $42 | $106 |
| Emergency department visit low severity CPT 99282 • Emergency | $35 | $55 | $106 |
| Emergency department visit moderate severity CPT 99283 • Emergency | $61 | $89 | $149 |
| Emergency department visit high severity CPT 99284 • Emergency | $117 | $153 | $255 |
| Emergency department visit highest severity CPT 99285 • Emergency | $161 | $223 | $371 |
| Critical care first 30-74 minutes CPT 99291 • Emergency | $198 | $344 | $587 |
| Critical care each additional 30 minutes CPT 99292 • Emergency | $111 | $157 | $254 |
| Esophagoscopy rigid diagnostic CPT 43191 • Gastroenterology | $124 | $181 | $229 |
| Upper GI endoscopy diagnostic CPT 43235 • Gastroenterology | $147 | $326 | $624 |
| Upper GI endoscopy with biopsy CPT 43239 • Gastroenterology | $346 | $487 | $807 |
| Upper GI endoscopy with foreign body removal CPT 43247 • Gastroenterology | $203 | $378 | $827 |
| Upper GI endoscopy with balloon dilation CPT 43249 • Gastroenterology | $89 | $681 | $2,252 |
| Upper GI endoscopy with polypectomy by snare CPT 43251 • Gastroenterology | $221 | $463 | $1,057 |
| Upper GI endoscopy with stent placement CPT 43257 • Gastroenterology | $323 | $373 | $460 |
| Upper GI endoscopy with endoscopic ultrasound CPT 43259 • Gastroenterology | $307 | $364 | $481 |
| ERCP diagnostic CPT 43260 • Gastroenterology | $351 | $397 | $445 |
| ERCP with sphincterotomy CPT 43262 • Gastroenterology | $223 | $480 | $755 |
| ERCP with removal of stones CPT 43264 • Gastroenterology | $361 | $566 | $772 |
| ERCP with stent placement CPT 43274 • Gastroenterology | $473 | $693 | $978 |
| Colonoscopy through stoma diagnostic CPT 44388 • Gastroenterology | $296 | $431 | $692 |
| Colonoscopy through stoma with biopsy CPT 44389 • Gastroenterology | $158 | $395 | $549 |
| Colonoscopy diagnostic CPT 45378 • Gastroenterology | $170 | $445 | $739 |
| Colonoscopy with biopsy CPT 45380 • Gastroenterology | $126 | $472 | $936 |
| Colonoscopy with submucosal injection CPT 45381 • Gastroenterology | $249 | $447 | $695 |
| Colonoscopy with lesion removal by hot biopsy CPT 45384 • Gastroenterology | $227 | $461 | $587 |
| Colonoscopy with polypectomy by snare CPT 45385 • Gastroenterology | $379 | $632 | $979 |
| Colonoscopy with balloon dilation CPT 45386 • Gastroenterology | $195 | $644 | $1,300 |
| Colonoscopy with ablation of tumor or polyp CPT 45388 • Gastroenterology | $249 | $1,886 | $6,236 |
| Colonoscopy with endoscopic mucosal resection CPT 45390 • Gastroenterology | $337 | $499 | $704 |
| Esophageal motility study CPT 91010 • Gastroenterology | $59 | $196 | $470 |
| Esophageal motility study with acid reflux CPT 91035 • Gastroenterology | $460 | $598 | $960 |
| Esophageal pH monitoring 24 hours CPT 91038 • Gastroenterology | $51 | $258 | $848 |
| Auto-added CPT 00102 • General | $48 | $476 | $1,092 |
| Auto-added CPT 00104 • General | $48 | $305 | $780 |
| Auto-added CPT 00120 • General | $48 | $290 | $654 |