DLP PERSON MEMORIAL HOSPITAL LLC· ROXBORO, NC

Hospital

615 RIDGE RD, ROXBORO, NC 27573

Procedures offered

964 total

ProcedureMinAvgMax
Tonsillectomy and adenoidectomy under age 12
CPT 42820 • ENT
$272$448$754
Tonsillectomy and adenoidectomy age 12 or older
CPT 42821 • ENT
$241$411$787
Tonsillectomy primary under age 12
CPT 42826 • ENT
$218$481$749
Adenoidectomy primary under age 12
CPT 42830 • ENT
$182$376$547
Removal impacted cerumen unilateral
CPT 69210 • ENT
$59$82$128
Tympanostomy tube insertion
CPT 69436 • ENT
$135$306$477
Tympanoplasty without mastoidectomy
CPT 69631 • ENT
$841$1,268$2,332
Tympanoplasty with mastoidectomy
CPT 69633 • ENT
$842$1,585$2,748
Comprehensive audiometry evaluation
CPT 92557 • ENT
$31$63$92
Incision and drainage abscess simple
CPT 10060 • Emergency
$77$120$154
Incision and drainage abscess complicated
CPT 10061 • Emergency
$206$261$369
Simple wound repair up to 2.5cm
CPT 12001 • Emergency
$50$146$264
Simple wound repair 2.6-7.5cm
CPT 12002 • Emergency
$48$106$197
Simple wound repair face 2.5cm or less
CPT 12011 • Emergency
$79$158$289
Intermediate wound repair 2.5cm or less
CPT 12031 • Emergency
$126$352$632
Intermediate wound repair face 2.5cm or less
CPT 12051 • Emergency
$150$444$685
Initial treatment first degree burn
CPT 16000 • Emergency
$67$109$180
Emergency department visit self-limited problem
CPT 99281 • Emergency
$18$36$54
Emergency department visit low severity
CPT 99282 • Emergency
$40$62$98
Emergency department visit moderate severity
CPT 99283 • Emergency
$67$90$145
Emergency department visit high severity
CPT 99284 • Emergency
$113$179$326
Emergency department visit highest severity
CPT 99285 • Emergency
$145$258$479
Critical care first 30-74 minutes
CPT 99291 • Emergency
$228$272$322
Critical care each additional 30 minutes
CPT 99292 • Emergency
$113$173$294
Esophagoscopy rigid diagnostic
CPT 43191 • Gastroenterology
$145$223$401
Upper GI endoscopy diagnostic
CPT 43235 • Gastroenterology
$173$372$685
Upper GI endoscopy with biopsy
CPT 43239 • Gastroenterology
$110$402$923
Upper GI endoscopy with foreign body removal
CPT 43247 • Gastroenterology
$233$677$1,220
Upper GI endoscopy with balloon dilation
CPT 43249 • Gastroenterology
$202$1,698$3,224
Upper GI endoscopy with polypectomy by snare
CPT 43251 • Gastroenterology
$254$552$1,180
Upper GI endoscopy with stent placement
CPT 43257 • Gastroenterology
$139$393$697
Upper GI endoscopy with endoscopic ultrasound
CPT 43259 • Gastroenterology
$117$319$594
ERCP diagnostic
CPT 43260 • Gastroenterology
$303$636$991
ERCP with sphincterotomy
CPT 43262 • Gastroenterology
$334$526$937
ERCP with removal of stones
CPT 43264 • Gastroenterology
$189$714$1,118
ERCP with stent placement
CPT 43274 • Gastroenterology
$381$892$1,400
Colonoscopy through stoma diagnostic
CPT 44388 • Gastroenterology
$194$606$1,051
Colonoscopy through stoma with biopsy
CPT 44389 • Gastroenterology
$213$430$563
Colonoscopy diagnostic
CPT 45378 • Gastroenterology
$96$519$981
Colonoscopy with biopsy
CPT 45380 • Gastroenterology
$283$770$1,168
Colonoscopy with submucosal injection
CPT 45381 • Gastroenterology
$248$751$1,176
Colonoscopy with lesion removal by hot biopsy
CPT 45384 • Gastroenterology
$119$518$1,193
Colonoscopy with polypectomy by snare
CPT 45385 • Gastroenterology
$132$855$1,546
Colonoscopy with balloon dilation
CPT 45386 • Gastroenterology
$262$1,158$2,001
Colonoscopy with ablation of tumor or polyp
CPT 45388 • Gastroenterology
$223$3,195$8,902
Colonoscopy with endoscopic mucosal resection
CPT 45390 • Gastroenterology
$264$500$870
Esophageal motility study
CPT 91010 • Gastroenterology
$61$285$527
Esophageal motility study with acid reflux
CPT 91035 • Gastroenterology
$382$872$1,467
Esophageal pH monitoring 24 hours
CPT 91038 • Gastroenterology
$68$468$1,085
Auto-added
CPT 00102 • General
$64$407$713