▸ Hospital · NC · CCN 340014

Novant Health Forsyth Medical Center

3333 SILAS CREEK PARKWAY, WINSTON SALEM, NC, 27103

917 bedsAcute Care Hospitals2

Compliance grade

100/100

Procedures tracked

194

of 209 target codes

Payers

with negotiated rates

Rates published

20,262

last crawl 2026-05-22

▸ Compare with other hospitals All NC hospitals JSON Full cost report on HCRIS.io →

Source MRF: https://www2.novanthealth.org/Public_Files/regulatory/560928089_forsyth-memorial-hospital-inc.-dba-novant-health-forsyth-medical-center_standardcharges.json · JSON

Procedures & rates

Procedure	Type	Code	Payers	Gross	Cash	Neg min	Neg median	Neg max
behavioral
Psychoses	MS-DRG	885	23	—	—	$34.92	$80	$33,525
Psychiatric diagnostic evaluation	CPT	90791	23	$402	$241.2	$74.65	$265.92	$389.94
Psychiatric eval with medical services	CPT	90792	23	—	—	$18.57	$71	$344.3
Psychotherapy 30 minutes	CPT	90832	23	$173	$103.8	$32.12	$122.83	$344.3
Psychotherapy 45 minutes	CPT	90834	23	$280	$168	$51.99	$185.22	$344.3
Psychotherapy 60 minutes	CPT	90837	23	$301	$180.6	$55.89	$199.11	$344.3
Crisis psychotherapy 60 minutes	CPT	90839	23	—	—	$18.57	$71	$344.3
emergency
ED visit level 1	CPT	99281	23	—	—	$18.57	$71	$163.56
ED visit level 2	CPT	99282	23	—	—	$18.57	$71	$297.84
ED visit level 3	CPT	99283	23	—	—	$18.57	$71	$529.5
ED visit level 4	CPT	99284	23	—	—	$18.57	$71	$809.38
ED visit level 5	CPT	99285	23	—	—	$18.57	$71	$1,155.16
Critical care, first hour	CPT	99291	23	—	—	$18.57	$71	$1,602.26
imaging
CT head without contrast	CPT	70450	23	$1,533	$919.8	$59.4	$290.35	$1,487.01
CT head with contrast	CPT	70460	23	$1,820	$1,092	$59.4	$344.7	$1,765.4
CT head with and without contrast	CPT	70470	23	$2,090	$1,254	$59.4	$395.84	$2,027.3
CT neck with contrast	CPT	70491	23	$2,125	$1,275	$59.4	$402.47	$2,061.25
MRI brain without contrast	CPT	70551	23	$2,529	$1,517.4	$59.4	$1,414.4	$2,453.13
MRI brain with contrast	CPT	70552	23	$2,965	$1,779	$59.4	$1,323.84	$2,876.05
MRI brain with and without contrast	CPT	70553	23	$3,928	$2,356.8	$59.4	$2,008.31	$3,810.16
Chest X-ray single view	CPT	71045	23	$283	$169.8	$52.55	$175.46	$274.51
Chest X-ray 2 views	CPT	71046	23	$2,616	$1,569.6	$59.4	$301.5	$2,537.52
Chest X-ray 3 views	CPT	71047	23	$403	$241.8	$59.4	$249.86	$390.91
CT chest without contrast	CPT	71250	23	$1,659	$995.4	$59.4	$765.07	$1,609.23
CT chest with contrast	CPT	71260	23	$2,115	$1,269	$59.4	$400.58	$2,051.55
CT chest with and without contrast	CPT	71270	23	$2,756	$1,653.6	$59.4	$521.98	$2,673.32
MRI chest without contrast	CPT	71550	23	$2,505	$1,503	$59.4	$1,118.43	$2,429.85
MRI chest with contrast	CPT	71551	23	$2,627	$1,576.2	$59.4	$1,356.6	$2,548.19
MRI chest with and without contrast	CPT	71552	23	$3,541	$2,124.6	$59.4	$1,809.91	$3,434.77
Lumbosacral spine X-ray	CPT	72100	23	$403	$241.8	$34.12	$104.43	$390.91
CT cervical spine without contrast	CPT	72125	23	$1,905	$1,143	$59.4	$360.8	$1,847.85
CT thoracic spine without contrast	CPT	72128	23	$1,905	$1,143	$59.4	$360.8	$1,847.85
CT lumbar spine without contrast	CPT	72131	23	$1,976	$1,185.6	$59.4	$374.25	$1,916.72
MRI cervical spine without contrast	CPT	72141	23	$3,059	$1,835.4	$59.4	$1,365.75	$2,967.23
MRI thoracic spine without contrast	CPT	72146	23	$3,059	$1,835.4	$59.4	$1,365.75	$2,967.23
MRI lumbar spine without contrast	CPT	72148	23	$3,059	$1,835.4	$59.4	$1,365.75	$2,967.23
MRI lumbar spine with and without contrast	CPT	72149	23	$3,333	$1,999.8	$59.4	$1,488.04	$3,233.01
MRI cervical spine with and without contrast	CPT	72156	23	$4,032	$2,419.2	$59.4	$1,734.67	$3,911.04
MRI lumbar spine with contrast	CPT	72158	23	$4,032	$2,419.2	$59.4	$1,734.67	$3,911.04
CT pelvis without contrast	CPT	72192	23	$1,697	$1,018.2	$59.4	$916.38	$1,646.09
CT pelvis with contrast	CPT	72193	23	$2,050	$1,230	$59.4	$388.27	$1,988.5
Shoulder X-ray	CPT	73030	23	$335	$201	$26.41	$86.93	$324.95
Humerus X-ray	CPT	73060	23	$335	$201	$25.81	$118.3	$324.95
Hand X-ray 3 views	CPT	73130	23	$403	$241.8	$27.07	$86.93	$390.91
MRI upper extremity joint without contrast	CPT	73221	23	$2,643	$1,585.8	$59.4	$1,180.26	$2,563.71
MRI upper extremity joint with and without contrast	CPT	73223	23	$3,811	$2,286.6	$59.4	$1,947.72	$3,696.67
Knee X-ray 1-2 views	CPT	73560	23	$335	$201	$25.81	$168.6	$324.95
Ankle X-ray 3 views	CPT	73610	23	$403	$241.8	$27.07	$86.93	$390.91
MRI lower extremity joint without contrast	CPT	73721	23	$2,617	$1,570.2	$59.4	$1,272.38	$2,538.49
MRI lower extremity joint with and without contrast	CPT	73723	23	$3,218	$1,930.8	$59.4	$1,776.65	$3,121.46
CT abdomen without contrast	CPT	74150	23	$1,776	$1,065.6	$59.4	$336.37	$1,722.72
CT abdomen with contrast	CPT	74160	23	$2,295	$1,377	$59.4	$434.67	$2,226.15
CT abdomen with and without contrast	CPT	74170	23	$2,643	$1,585.8	$59.4	$1,427.22	$2,563.71
CT abdomen and pelvis without contrast	CPT	74176	23	$3,273	$1,963.8	$59.4	$619.9	$3,174.81
CT abdomen and pelvis with contrast	CPT	74177	23	$4,024	$2,414.4	$59.4	$762.14	$3,903.28
CT abdomen and pelvis with and without contrast	CPT	74178	23	$4,637	$2,782.2	$59.4	$878.24	$4,497.89
MRI abdomen without contrast	CPT	74181	23	$2,759	$1,655.4	$59.4	$1,231.79	$2,676.23
MRI abdomen with and without contrast	CPT	74183	23	$4,192	$2,515.2	$59.4	$2,142.55	$4,066.24
Abdominal ultrasound complete	CPT	76700	23	$955	$573	$101.39	$180.87	$926.35
Abdominal ultrasound limited	CPT	76705	23	$959	$575.4	$87.62	$413.72	$930.23
Retroperitoneal ultrasound complete	CPT	76770	23	$816	$489.6	$101.39	$154.55	$791.52
Obstetric ultrasound first trimester	CPT	76801	23	$660	$396	$101.39	$126.14	$640.2
Obstetric ultrasound after first trimester	CPT	76805	23	$573	$343.8	$101.39	$141.36	$555.81
Obstetric ultrasound with fetal anatomy	CPT	76811	23	$812	$487.2	$150.78	$240.67	$787.64
Transvaginal ultrasound	CPT	76830	23	$742	$445.2	$101.39	$140.53	$719.74
Pelvic ultrasound complete	CPT	76856	23	$936	$561.6	$101.39	$177.27	$907.92
Scrotal ultrasound	CPT	76870	23	$749	$449.4	$101.39	$141.86	$726.53
Diagnostic mammography unilateral	CPT	77065	21	$360	$216	$59.4	$247.32	$349.2
Diagnostic mammography bilateral	CPT	77066	21	$457	$274.2	$59.4	$313.95	$443.29
Screening mammography bilateral	CPT	77067	21	$325	$195	$59.4	$223.27	$315.25
EKG complete	CPT	93000	21	—	—	$18.02	$50	$97
EKG tracing only	CPT	93005	23	$233	$139.8	$9.96	$117.01	$226.01
EKG interpretation only	CPT	93010	21	$44	$26.4	$8.17	$30.22	$42.68
Transthoracic echocardiogram complete	CPT	93306	23	$2,606	$1,563.6	$206.8	$1,260.44	$2,527.82
Transthoracic echocardiogram	CPT	93307	23	$1,482	$889.2	$133.09	$806.66	$1,437.54
Stress echocardiogram	CPT	93350	23	$2,926	$1,755.6	$176.25	$1,656	$2,838.22
inpatient
Respiratory infections & inflammations w MCC	MS-DRG	177	23	—	—	$56.5	$90	$37,506
COPD w MCC	MS-DRG	190	23	—	—	$56.5	$90	$26,586
COPD w CC	MS-DRG	191	23	—	—	$56.5	$90	$20,233
COPD w/o CC/MCC	MS-DRG	192	23	—	—	$56.5	$90	$15,409
Simple pneumonia & pleurisy w CC	MS-DRG	194	23	—	—	$56.5	$90	$19,342
Simple pneumonia & pleurisy w/o CC/MCC	MS-DRG	195	23	—	—	$56.5	$90	$15,085
AMI discharged alive w MCC	MS-DRG	280	23	—	—	$56.5	$90	$38,500
AMI discharged alive w CC	MS-DRG	281	23	—	—	$56.5	$90	$22,059
AMI discharged alive w/o CC/MCC	MS-DRG	282	23	—	—	$56.5	$90	$17,355
Heart failure & shock w MCC	MS-DRG	291	23	—	—	$56.5	$90	$30,812
Heart failure & shock w CC	MS-DRG	292	23	—	—	$56.5	$90	$20,377
Heart failure & shock w/o CC/MCC	MS-DRG	293	23	—	—	$56.5	$90	$13,585
Cardiac arrhythmia w MCC	MS-DRG	308	23	—	—	$56.5	$90	$28,897
Cardiac arrhythmia w CC	MS-DRG	309	23	—	—	$56.5	$90	$17,658
Cardiac arrhythmia w/o CC/MCC	MS-DRG	310	23	—	—	$56.5	$90	$13,587
GI hemorrhage w CC	MS-DRG	378	23	—	—	$56.5	$90	$23,538
GI hemorrhage w/o CC/MCC	MS-DRG	379	23	—	—	$56.5	$90	$15,130
Esophagitis/gastroenteritis w/o MCC	MS-DRG	392	23	—	—	$56.5	$90	$18,711
Fractures of femur w/o MCC	MS-DRG	533	23	—	—	$56.5	$90	$37,626
Kidney/UTI w MCC	MS-DRG	689	23	—	—	$56.5	$90	$27,848
Kidney/UTI w/o MCC	MS-DRG	690	23	—	—	$56.5	$90	$19,429
Septicemia or severe sepsis w MV 96+ hrs	MS-DRG	871	23	—	—	$56.5	$90	$46,622
Septicemia or severe sepsis w/o MV 96+ hrs	MS-DRG	872	23	—	—	$56.5	$90	$24,560
Initial hospital care, low complexity	CPT	99221	21	—	—	$18.57	$68.7	$97
Initial hospital care, moderate complexity	CPT	99222	21	—	—	$18.57	$68.7	$97
Initial hospital care, high complexity	CPT	99223	21	—	—	$18.57	$68.7	$97
Hospital discharge, <30 min	CPT	99238	21	—	—	$18.57	$68.7	$97
Hospital discharge, >30 min	CPT	99239	21	—	—	$18.57	$68.7	$97
lab
Basic metabolic panel (BMP)	CPT	80048	23	$140	$84	$5.75	$73.08	$135.8
General health panel	CPT	80050	21	$331	$198.6	$54.59	$205.8	$321.07
Electrolyte panel	CPT	80051	23	$104	$62.4	$7.01	$64.48	$100.88
Comprehensive metabolic panel	CPT	80053	23	$224	$134.4	$6.49	$52.56	$217.28
Lipid panel	CPT	80061	23	$200	$120	$9.47	$76.38	$194
Renal function panel	CPT	80069	23	$129	$77.4	$8.68	$79.98	$125.13
Hepatic function panel	CPT	80076	23	$140	$84	$5.75	$71.87	$135.8
Urinalysis non-automated	CPT	81002	23	$58	$34.8	$1.67	$23.2	$59.4
Urinalysis automated	CPT	81003	23	$73	$43.8	$2.25	$21.45	$70.81
Glucose quantitative	CPT	82947	23	$66	$39.6	$2.97	$29.6	$64.02
Hemoglobin A1c	CPT	83036	23	$145	$87	$7.05	$56.67	$140.65
Thyroid stimulating hormone (TSH)	CPT	84443	23	$240	$144	$13.18	$103.35	$232.8
Complete blood count with automated differential	CPT	85025	23	$3,230	$1,938	$5.38	$78.89	$3,133.1
Complete blood count without differential	CPT	85027	23	$103	$61.8	$4.45	$55.62	$99.91
Urine culture bacterial	CPT	87086	23	$120	$72	$8.07	$51.6	$116.4
Urine culture identification	CPT	87088	23	$136	$81.6	$8.09	$78.4	$131.92
Tissue exam by pathologist level IV	CPT	88305	23	$864	$518.4	$35.65	$450	$838.08
maternity
Fetal non-stress test	CPT	59025	23	$679	$407.4	$93.4	$402.4	$658.63
Routine obstetric care including vaginal delivery	CPT	59400	21	—	—	$18.57	$68.7	$97
Vaginal delivery only	CPT	59409	23	—	—	$18.57	$71	$6,279.12
Vaginal delivery with postpartum	CPT	59410	21	—	—	$18.57	$68.7	$97
Routine obstetric care with C-section	CPT	59510	21	—	—	$18.57	$68.7	$97
C-section delivery only	CPT	59514	21	—	—	$18.57	$68.7	$97
C-section with postpartum	CPT	59515	21	—	—	$18.57	$68.7	$97
office
Office visit, new patient, 15-29 min	CPT	99202	21	$286	$171.6	$53.11	$196.48	$277.42
Office visit, new patient, 30-44 minutes	CPT	99203	21	$317	$190.2	$58.86	$217.77	$307.49
Office visit, new patient, 45-59 min	CPT	99204	21	—	—	$18.57	$68.7	$97
Office visit, new patient, 60-74 min	CPT	99205	21	$642	$385.2	$119.21	$441.05	$622.74
Office visit, established patient, 5 min	CPT	99211	21	$240	$144	$28.22	$110.88	$232.8
Office visit, established patient, 10-19 min	CPT	99212	21	$225	$135	$40.11	$151.2	$218.25
Office visit, established patient, 20-29 minutes	CPT	99213	21	$282	$169.2	$50.32	$189.7	$273.54
Office visit, established patient, 30-39 minutes	CPT	99214	21	$354	$212.4	$64.99	$243.19	$343.38
Office visit, established patient, 40-54 min	CPT	99215	21	$397	$238.2	$72.98	$272.73	$385.09
preventive
Upper GI endoscopy diagnostic	CPT	43235	23	—	—	$18.57	$71	$1,759.3
Upper GI endoscopy with biopsy	CPT	43239	23	—	—	$18.57	$71	$1,759.3
Sigmoidoscopy diagnostic	CPT	45330	23	—	—	$18.57	$71	$1,803.86
Sigmoidoscopy with biopsy	CPT	45331	23	—	—	$18.57	$71	$1,803.86
Colonoscopy diagnostic	CPT	45378	23	—	—	$18.57	$71	$1,803.86
Colonoscopy with biopsy	CPT	45380	23	—	—	$18.57	$71	$2,321.16
Colonoscopy with polyp removal	CPT	45385	23	—	—	$18.57	$71	$2,321.16
surgery
Total shoulder arthroplasty	CPT	23472	23	—	—	$18.57	$71	$34,011
Hip hemiarthroplasty	CPT	27125	23	—	—	$18.57	$71	$24,903
Total hip replacement	CPT	27130	23	—	—	$18.57	$71	$24,903
Total knee replacement	CPT	27447	23	—	—	$18.57	$71	$24,903
Knee revision arthroplasty single component	CPT	27486	23	—	—	$18.57	$71	$24,903
Knee revision arthroplasty all components	CPT	27487	23	—	—	$18.57	$71	$34,011
Shoulder arthroscopy with decompression	CPT	29826	21	—	—	$18.57	$68.7	$97
Shoulder arthroscopy with rotator cuff repair	CPT	29827	23	—	—	$18.57	$71	$14,075
Knee arthroscopy with meniscectomy	CPT	29881	23	—	—	$18.57	$71	$6,346.78
ACL reconstruction	CPT	29888	23	—	—	$18.57	$71	$14,075
Major small/large bowel procedures w MCC	MS-DRG	329	23	—	—	$56.5	$90	$110,321
Major small/large bowel procedures w CC	MS-DRG	330	23	—	—	$56.5	$90	$57,535
Major small/large bowel procedures w/o CC/MCC	MS-DRG	331	23	—	—	$56.5	$90	$40,391
CABG single arterial graft	CPT	33533	21	—	—	$18.57	$68.7	$97
CABG 2 arterial grafts	CPT	33534	21	—	—	$18.57	$68.7	$97
CABG 3 arterial grafts	CPT	33535	21	—	—	$18.57	$68.7	$97
CABG 4+ arterial grafts	CPT	33536	21	—	—	$18.57	$68.7	$97
Laparoscopic cholecystectomy w/o CDE w MCC	MS-DRG	418	23	—	—	$56.5	$90	$40,600
Laparoscopic cholecystectomy w/o CDE w CC	MS-DRG	419	23	—	—	$56.5	$90	$32,781
Laparoscopic cholecystectomy w/o CDE w/o CC/MCC	MS-DRG	420	23	—	—	$56.5	$90	$81,774
Open appendectomy	CPT	44950	23	—	—	$18.57	$71	$12,557
Laparoscopic appendectomy	CPT	44970	23	—	—	$18.57	$71	$11,727
Major joint replacement w MCC	MS-DRG	469	23	—	—	$56.5	$90	$85,110
Major joint replacement w/o MCC	MS-DRG	470	23	—	—	$56.5	$89	$51,634
Laparoscopic cholecystectomy	CPT	47562	23	—	—	$18.57	$71	$11,727
Lap cholecystectomy with cholangiography	CPT	47563	23	—	—	$18.57	$71	$11,727
Hip & femur procedures except major joint w MCC	MS-DRG	480	23	—	—	$56.5	$90	$69,898
Hip & femur procedures except major joint w CC	MS-DRG	481	23	—	—	$56.5	$90	$50,270
Hip & femur procedures except major joint w/o CC/MCC	MS-DRG	482	23	—	—	$56.5	$90	$39,146
Lap inguinal hernia repair	CPT	49650	23	—	—	$18.57	$71	$11,727
Total abdominal hysterectomy	CPT	58150	21	—	—	$18.57	$68.7	$97
Vaginal hysterectomy	CPT	58260	23	—	—	$18.57	$71	$9,703.36
Lap-assisted vaginal hysterectomy	CPT	58550	23	—	—	$18.57	$71	$11,727
Lap-assisted vaginal hysterectomy >250g	CPT	58552	23	—	—	$18.57	$71	$20,619
Lap salpingo-oophorectomy	CPT	58661	23	—	—	$18.57	$71	$11,727
OR procedure for obesity w MCC	MS-DRG	619	23	—	—	$56.5	$90	$69,300
OR procedure for obesity w CC	MS-DRG	620	23	—	—	$56.5	$90	$38,409
OR procedure for obesity w/o CC/MCC	MS-DRG	621	23	—	—	$56.5	$90	$36,203
Complex cataract surgery	CPT	66982	23	—	—	$18.57	$71	$4,476.54
Cataract surgery with lens implant	CPT	66984	23	—	—	$18.57	$71	$4,476.54
Intravitreal injection	CPT	67028	23	$236	$141.6	$43.82	$167.56	$640.7
Vitrectomy mechanical	CPT	67042	23	—	—	$18.57	$71	$8,017.7
Uterine & adnexa procedures w CC/MCC	MS-DRG	743	23	—	—	$56.5	$90	$29,778
Uterine & adnexa procedures w/o CC/MCC	MS-DRG	744	23	—	—	$56.5	$90	$49,180
PCI single major coronary artery	CPT	92920	23	—	—	$18.57	$71	$11,040
PCI with drug-eluting stent	CPT	92928	23	—	—	$18.57	$71	$22,393
PCI bypass graft	CPT	92937	23	—	—	$18.57	$71	$22,393
Left heart catheterization	CPT	93452	23	—	—	$18.57	$71	$6,288.44
Coronary angiography with cath	CPT	93455	23	—	—	$18.57	$71	$6,288.44
Coronary angiography with bypass cath	CPT	93458	23	—	—	$18.57	$71	$6,288.44

Payer mix (top 23)

Payer	Codes covered	Median rate
WellCare	194	$86.55
amerihealth	194	$86.55
amps	194	$118.3
atlantic corporation dba atlantic packaging	194	$102.83
bcbsfl	194	$72
beechstreet	194	$163.8
Blue Cross Blue Shield	194	$276.52
CareSource	194	$201.2
carolina complete	194	$84.86
Cigna	194	$209.09
employers choice network	194	$176.54
Humana	194	$231.41
UnitedHealthcare	194	$264.48
Aetna	194	$160
medcost	194	$163.56
Multiplan	194	$163.8
nc department of public safety	194	$335.47
phcs	194	$163.8
plotkin health	194	$109.2
primary physician care	194	$160.16
three rivers provider network	194	$176.54
liberty health	163	$355.28
pace of the southern piedmont	163	$338.36