METROLINA VASCULAR ACCESS CARE LLC· CHARLOTTE, NC

Ambulatory surgery center

3158 FREEDOM DR., CHARLOTTE, NC 28208

Procedures offered

953 total

Procedure	Min	Avg	Max
Tonsillectomy and adenoidectomy age 12 or older CPT 42821 • ENT	$955	$1,225	$1,620
Tonsillectomy primary under age 12 CPT 42826 • ENT	$439	$1,025	$1,620
Adenoidectomy primary under age 12 CPT 42830 • ENT	$778	$1,203	$1,620
Removal impacted cerumen unilateral CPT 69210 • ENT	$26	$242	$955
Tympanostomy tube insertion CPT 69436 • ENT	$296	$791	$985
Tympanoplasty without mastoidectomy CPT 69631 • ENT	$955	$2,093	$3,390
Tympanoplasty with mastoidectomy CPT 69633 • ENT	$955	$1,817	$3,390
Comprehensive audiometry evaluation CPT 92557 • ENT	$36	$58	$94
Incision and drainage abscess simple CPT 10060 • Emergency	$61	$414	$955
Incision and drainage abscess complicated CPT 10061 • Emergency	$139	$412	$955
Simple wound repair up to 2.5cm CPT 12001 • Emergency	$55	$246	$955
Simple wound repair 2.6-7.5cm CPT 12002 • Emergency	$60	$261	$955
Simple wound repair face 2.5cm or less CPT 12011 • Emergency	$77	$547	$955
Intermediate wound repair 2.5cm or less CPT 12031 • Emergency	$210	$525	$955
Intermediate wound repair face 2.5cm or less CPT 12051 • Emergency	$152	$541	$955
Initial treatment first degree burn CPT 16000 • Emergency	$31	$66	$132
Emergency department visit self-limited problem CPT 99281 • Emergency	$26	$45	$56
Emergency department visit low severity CPT 99282 • Emergency	$56	$63	$82
Emergency department visit moderate severity CPT 99283 • Emergency	$90	$105	$117
Emergency department visit high severity CPT 99284 • Emergency	$104	$160	$223
Emergency department visit highest severity CPT 99285 • Emergency	$239	$273	$328
Critical care first 30-74 minutes CPT 99291 • Emergency	$228	$361	$520
Critical care each additional 30 minutes CPT 99292 • Emergency	$101	$166	$211
Esophagoscopy rigid diagnostic CPT 43191 • Gastroenterology	$475	$847	$1,004
Upper GI endoscopy diagnostic CPT 43235 • Gastroenterology	$167	$695	$1,132
Upper GI endoscopy with biopsy CPT 43239 • Gastroenterology	$192	$643	$955
Upper GI endoscopy with foreign body removal CPT 43247 • Gastroenterology	$246	$678	$955
Upper GI endoscopy with balloon dilation CPT 43249 • Gastroenterology	$267	$1,391	$3,776
Upper GI endoscopy with polypectomy by snare CPT 43251 • Gastroenterology	$341	$728	$1,004
Upper GI endoscopy with stent placement CPT 43257 • Gastroenterology	$326	$1,207	$2,767
Upper GI endoscopy with endoscopic ultrasound CPT 43259 • Gastroenterology	$106	$712	$1,004
ERCP diagnostic CPT 43260 • Gastroenterology	$902	$1,254	$2,180
ERCP with sphincterotomy CPT 43262 • Gastroenterology	$489	$1,060	$2,180
ERCP with removal of stones CPT 43264 • Gastroenterology	$249	$950	$2,180
ERCP with stent placement CPT 43274 • Gastroenterology	$824	$1,685	$4,131
Colonoscopy through stoma diagnostic CPT 44388 • Gastroenterology	$262	$634	$1,274
Colonoscopy through stoma with biopsy CPT 44389 • Gastroenterology	$669	$948	$1,433
Flexible sigmoidoscopy diagnostic CPT 45330 • Gastroenterology	$38	$265	$493
Colonoscopy diagnostic CPT 45378 • Gastroenterology	$64	$562	$955
Colonoscopy with biopsy CPT 45380 • Gastroenterology	$198	$721	$1,683
Colonoscopy with submucosal injection CPT 45381 • Gastroenterology	$140	$614	$955
Colonoscopy with lesion removal by hot biopsy CPT 45384 • Gastroenterology	$397	$729	$955
Colonoscopy with polypectomy by snare CPT 45385 • Gastroenterology	$354	$796	$1,139
Colonoscopy with balloon dilation CPT 45386 • Gastroenterology	$410	$706	$955
Colonoscopy with ablation of tumor or polyp CPT 45388 • Gastroenterology	$377	$789	$1,248
Colonoscopy with endoscopic mucosal resection CPT 45390 • Gastroenterology	$463	$1,012	$1,625
Esophageal motility study CPT 91010 • Gastroenterology	$90	$608	$955
Esophageal motility study with acid reflux CPT 91035 • Gastroenterology	$211	$510	$955
Esophageal pH monitoring 24 hours CPT 91038 • Gastroenterology	$147	$686	$955
Auto-added CPT 00102 • General	$50	$60	$79