NOVANT HEALTH MIDTOWN OUTPATIENT SURGERY, LLC· CHARLOTTE, NC
Ambulatory surgery center
1918 RANDOLPH RD STE 740, CHARLOTTE, NC 28207
Procedures offered
947 total
| Procedure | Min | Avg | Max |
|---|---|---|---|
| Tonsillectomy primary under age 12 CPT 42826 • ENT | $518 | $518 | $518 |
| Adenoidectomy primary under age 12 CPT 42830 • ENT | $222 | $222 | $222 |
| Removal impacted cerumen unilateral CPT 69210 • ENT | $46 | $51 | $56 |
| Tympanostomy tube insertion CPT 69436 • ENT | $155 | $167 | $191 |
| Tympanoplasty without mastoidectomy CPT 69631 • ENT | $1,797 | $1,797 | $1,797 |
| Tympanoplasty with mastoidectomy CPT 69633 • ENT | $1,037 | $1,580 | $2,123 |
| Comprehensive audiometry evaluation CPT 92557 • ENT | $67 | $67 | $67 |
| Incision and drainage abscess simple CPT 10060 • Emergency | $88 | $110 | $121 |
| Incision and drainage abscess complicated CPT 10061 • Emergency | $142 | $174 | $207 |
| Simple wound repair up to 2.5cm CPT 12001 • Emergency | $91 | $137 | $184 |
| Simple wound repair 2.6-7.5cm CPT 12002 • Emergency | $110 | $168 | $225 |
| Simple wound repair face 2.5cm or less CPT 12011 • Emergency | $109 | $118 | $137 |
| Intermediate wound repair 2.5cm or less CPT 12031 • Emergency | $257 | $342 | $511 |
| Intermediate wound repair face 2.5cm or less CPT 12051 • Emergency | $145 | $233 | $278 |
| Initial treatment first degree burn CPT 16000 • Emergency | $44 | $89 | $150 |
| Emergency department visit self-limited problem CPT 99281 • Emergency | $18 | $18 | $18 |
| Emergency department visit low severity CPT 99282 • Emergency | $34 | $59 | $78 |
| Emergency department visit moderate severity CPT 99283 • Emergency | $104 | $109 | $119 |
| Emergency department visit high severity CPT 99284 • Emergency | $102 | $133 | $156 |
| Emergency department visit highest severity CPT 99285 • Emergency | $195 | $236 | $318 |
| Critical care first 30-74 minutes CPT 99291 • Emergency | $234 | $259 | $271 |
| Critical care each additional 30 minutes CPT 99292 • Emergency | $105 | $112 | $119 |
| Esophagoscopy rigid diagnostic CPT 43191 • Gastroenterology | $161 | $161 | $161 |
| Upper GI endoscopy diagnostic CPT 43235 • Gastroenterology | $296 | $364 | $568 |
| Upper GI endoscopy with biopsy CPT 43239 • Gastroenterology | $376 | $378 | $378 |
| Upper GI endoscopy with foreign body removal CPT 43247 • Gastroenterology | $384 | $507 | $754 |
| Upper GI endoscopy with balloon dilation CPT 43249 • Gastroenterology | $1,100 | $1,645 | $2,190 |
| Upper GI endoscopy with polypectomy by snare CPT 43251 • Gastroenterology | $232 | $232 | $232 |
| Upper GI endoscopy with stent placement CPT 43257 • Gastroenterology | $228 | $358 | $488 |
| Upper GI endoscopy with endoscopic ultrasound CPT 43259 • Gastroenterology | $220 | $347 | $474 |
| ERCP diagnostic CPT 43260 • Gastroenterology | $30 | $341 | $677 |
| ERCP with sphincterotomy CPT 43262 • Gastroenterology | $349 | $549 | $749 |
| ERCP with removal of stones CPT 43264 • Gastroenterology | $30 | $396 | $763 |
| ERCP with stent placement CPT 43274 • Gastroenterology | $971 | $971 | $971 |
| Colonoscopy through stoma diagnostic CPT 44388 • Gastroenterology | $76 | $201 | $327 |
| Colonoscopy through stoma with biopsy CPT 44389 • Gastroenterology | $814 | $814 | $814 |
| Flexible sigmoidoscopy diagnostic CPT 45330 • Gastroenterology | $65 | $65 | $65 |
| Colonoscopy diagnostic CPT 45378 • Gastroenterology | $338 | $355 | $388 |
| Colonoscopy with biopsy CPT 45380 • Gastroenterology | $195 | $498 | $865 |
| Colonoscopy with submucosal injection CPT 45381 • Gastroenterology | $420 | $435 | $443 |
| Colonoscopy with lesion removal by hot biopsy CPT 45384 • Gastroenterology | $504 | $504 | $504 |
| Colonoscopy with polypectomy by snare CPT 45385 • Gastroenterology | $453 | $514 | $576 |
| Colonoscopy with balloon dilation CPT 45386 • Gastroenterology | $735 | $735 | $735 |
| Colonoscopy with ablation of tumor or polyp CPT 45388 • Gastroenterology | $607 | $607 | $607 |
| Colonoscopy with endoscopic mucosal resection CPT 45390 • Gastroenterology | $324 | $511 | $697 |
| Esophageal motility study CPT 91010 • Gastroenterology | $262 | $262 | $262 |
| Esophageal motility study with acid reflux CPT 91035 • Gastroenterology | $782 | $782 | $782 |
| Esophageal pH monitoring 24 hours CPT 91038 • Gastroenterology | $410 | $578 | $746 |
| Auto-added CPT 00102 • General | $30 | $41 | $62 |
| Auto-added CPT 00104 • General | $30 | $41 | $62 |