Price AtlasInteractive atlas · All states · techysurgeon.comTonsils and adenoids removal (child under 12): what insurers pay
Removal of the tonsils and adenoids in a child younger than 12. Commercial negotiated rates by hospital and market, next to Medicare for the same code.
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CPT 42820: Remove Tonsils and Adenoids
91 hospitals in 32 markets. National Medicare rate $6,048, surgery center $3,026.
| Market | Hospitals | 25th pct | Median | 75th pct | Low–high |
|---|---|---|---|---|---|
| Atlanta GA | 1 | — | — | — | $5,886–$5,886 |
| Austin TX | 2 | — | — | — | $4,657–$5,926 |
| Boston MA | 7 | $7,478 | $8,485 | $9,479 | $5,704–$10,604 |
| California (statewide) | 1 | — | — | — | $11,855–$11,855 |
| Chicago IL | 6 | $6,093 | $6,770 | $7,437 | $5,908–$9,148 |
| Cleveland OH | 5 | $6,238 | $10,614 | $12,125 | $3,256–$13,731 |
| Dallas-Fort Worth TX | 4 | — | — | — | $6,093–$15,810 |
| Denver CO | 7 | $4,938 | $5,303 | $5,500 | $4,712–$6,866 |
| Detroit MI | 5 | $3,067 | $3,067 | $4,722 | $3,067–$6,842 |
| Georgia (statewide) | 1 | — | — | — | $5,495–$5,495 |
| Houston TX | 1 | — | — | — | $4,958–$4,958 |
| Kansas (statewide) | 1 | — | — | — | $6,182–$6,182 |
| Las Vegas NV | 2 | — | — | — | $4,679–$7,622 |
| Los Angeles CA | 2 | — | — | — | $8,014–$20,636 |
| Minneapolis-St. Paul MN | 1 | — | — | — | $6,994–$6,994 |
| Nashville TN | 3 | — | — | — | $3,411–$5,857 |
| New York (statewide) | 1 | — | — | — | $5,783–$5,783 |
| New York City | 2 | — | — | — | $9,011–$9,887 |
| Ohio (statewide) | 1 | — | — | — | $9,823–$9,823 |
| Pennsylvania (statewide) | 1 | — | — | — | $12,530–$12,530 |
| Philadelphia PA | 5 | $5,480 | $7,409 | $9,172 | $5,156–$11,208 |
| Phoenix AZ | 3 | — | — | — | $4,000–$4,231 |
| Portland OR | 6 | $13,160 | $13,160 | $16,185 | $13,160–$17,193 |
| Richmond VA | 2 | — | — | — | $7,016–$7,138 |
| Salt Lake City UT | 3 | — | — | — | $4,385–$4,523 |
| San Antonio TX | 1 | — | — | — | $5,500–$5,500 |
| San Francisco Bay Area CA | 2 | — | — | — | $20,650–$24,307 |
| Seattle-Tacoma WA | 6 | $18,176 | $19,670 | $23,773 | $16,107–$26,160 |
| St. Louis MO | 2 | — | — | — | $4,953–$4,953 |
| Tampa FL | 2 | — | — | — | $5,195–$7,430 |
| Washington DC | 4 | — | — | — | $4,250–$7,242 |
| Wisconsin (statewide) | 1 | — | — | — | $4,812–$4,812 |
| Hospital | Market | Median across insurers | × Medicare | Insurers | File date |
|---|---|---|---|---|---|
| Corewell Health Beaumont Grosse Pointe Hospital | Detroit MI | $3,067 | 0.5× | 1 | 2026-05-01 |
| Corewell Health William Beaumont University Hospit | Detroit MI | $3,067 | 0.5× | 1 | 2026-05-01 |
| Corewell Health Beaumont Troy Hospital | Detroit MI | $3,067 | 0.5× | 1 | 2026-05-01 |
| University Hospitals - Elyria Medical Center | Cleveland OH | $3,256 | 0.6× | 3 | 2026-07-14 |
| Ascension Saint Thomas Hospital (Midtown + West) | Nashville TN | $3,411 | 0.6× | 1 | 2026-01-01 |
| HonorHealth Scottsdale Thompson Peak Medical Center | Phoenix AZ | $4,000 | 0.6× | 2 | 2026-04-01 |
| HonorHealth Scottsdale Osborn Medical Center | Phoenix AZ | $4,231 | 0.7× | 3 | 2026-04-01 |
| HonorHealth Scottsdale Shea Medical Center | Phoenix AZ | $4,231 | 0.7× | 3 | 2026-04-01 |
| George Washington Univ Hospital | Washington DC | $4,250 | 0.6× | 3 | 2026-09-01 |
| Mckay-Dee Hospital | Salt Lake City UT | $4,385 | 0.7× | 2 | 2026-08-05 |
| Intermountain Health Utah Valley Hospital | Salt Lake City UT | $4,523 | 0.8× | 2 | 2026-08-05 |
| Lds Hospital | Salt Lake City UT | $4,523 | 0.8× | 2 | 2026-08-05 |
| Ascension Seton Medical Center Austin | Austin TX | $4,657 | 0.8× | 1 | 2026-01-01 |
| Henderson Hospital | Las Vegas NV | $4,679 | 0.8× | 1 | 2026-09-01 |
| TriStar StoneCrest Medical Center | Nashville TN | $4,682 | 0.8× | 4 | 2026-09-01 |
| Adventhealth Porter | Denver CO | $4,712 | 0.8× | 2 | 2026-04-01 |
| Adventhealth Parker | Denver CO | $4,712 | 0.8× | 2 | 2026-04-01 |
| Henry Ford Health Rochester Hospital | Detroit MI | $4,722 | 0.8× | 1 | 2026-01-01 |
| Orthopaedic Hospital Of Wisconsin | Wisconsin (statewide) | $4,812 | 0.8× | 3 | 2026-01-01 |
| Mercy Hospital St Louis | St. Louis MO | $4,953 | 0.8× | 1 | 2026-06-04 |
| Mercy Hospital South | St. Louis MO | $4,953 | 0.8× | 1 | 2026-06-10 |
| Houston Methodist Hospital | Houston TX | $4,958 | 0.8× | 5 | 2026-04-01 |
| Riddle Memorial Hospital | Philadelphia PA | $5,156 | 0.8× | 2 | 2026-04-01 |
| HCA HealthONE Swedish | Denver CO | $5,164 | 0.8× | 4 | 2026-09-01 |
| Tampa General Hospital | Tampa FL | $5,195 | 0.8× | 1 | 2026-04-01 |
| HCA HealthONE Presbyterian/St. Luke's | Denver CO | $5,303 | 0.8× | 4 | 2026-09-01 |
| HCA HealthONE Sky Ridge | Denver CO | $5,447 | 0.9× | 4 | 2026-09-01 |
| Bryn Mawr Hospital | Philadelphia PA | $5,480 | 0.9× | 2 | 2026-04-01 |
| Emory Houston Hospital Warner Robins | Georgia (statewide) | $5,495 | 1.1× | 3 | 2026-04-01 |
| Methodist Hospital | San Antonio TX | $5,500 | 0.9× | 5 | 2026-09-01 |
| Hca Healthone Rose | Denver CO | $5,552 | 0.9× | 4 | 2026-09-01 |
| Beverly Hospital Corporation | Boston MA | $5,704 | 0.8× | 2 | 2026-04-01 |
| Stony Brook University Hospital | New York (statewide) | $5,783 | 0.8× | 5 | 2026-06-10 |
| Vanderbilt University Medical Center | Nashville TN | $5,857 | 1.0× | 7 | 2025-10-01 |
| Emory University Hospital | Atlanta GA | $5,886 | 1.0× | 6 | 2026-04-01 |
| Endeavor Health Evanston Hospital | Chicago IL | $5,908 | 0.9× | 2 | 2026-04-01 |
| Endeavor Health Northwest Community Hospital | Chicago IL | $5,916 | 0.9× | 2 | 2026-04-01 |
| St David's Medical Center | Austin TX | $5,926 | 1.0× | 5 | 2026-09-01 |
| Baylor University Medical Center | Dallas-Fort Worth TX | $6,093 | 1.0× | 3 | 2026-06-29 |
| Inova Alexandria Hospital | Washington DC | $6,158 | 1.0× | 5 | 2026-04-01 |
| Menorah Medical Center | Kansas (statewide) | $6,182 | 1.1× | 5 | 2026-09-01 |
| Cleveland Clinic (main campus) | Cleveland OH | $6,238 | 1.1× | 3 | 2026-06-16 |
| Loyola University Medical Center | Chicago IL | $6,625 | 1.0× | 1 | 2026-03-31 |
| Harper University Hospital | Detroit MI | $6,842 | 1.2× | 2 | 2026-09-02 |
| UCHealth University of Colorado Hospital | Denver CO | $6,866 | 1.1× | 3 | 2025-11-01 |
| New England Baptist Hospital | Boston MA | $6,891 | 1.0× | 3 | 2026-04-01 |
| Endeavor Health Edward Hospital | Chicago IL | $6,914 | 1.1× | 2 | 2026-04-01 |
| Park Nicollet Methodist Hospital | Minneapolis-St. Paul MN | $6,994 | 1.1× | 2 | 2026-03-31 |
| CJW Medical Center (Chippenham + Johnston-Willis) | Richmond VA | $7,016 | 1.2× | 4 | 2026-09-01 |
| Henrico Doctors' Hospital | Richmond VA | $7,138 | 1.2× | 4 | 2026-09-01 |
| Reston Hospital Center | Washington DC | $7,242 | 1.2× | 4 | 2026-09-01 |
| Stonesprings Hospital Center | Washington DC | $7,242 | 1.2× | 4 | 2026-09-01 |
| Jefferson Stratford Hospital | Philadelphia PA | $7,409 | 1.1× | 3 | 2026-09-15 |
| Morton Plant Hospital | Tampa FL | $7,430 | 1.2× | 2 | 2026-01-01 |
| Endeavor Health Elmhurst Hospital | Chicago IL | $7,611 | 1.2× | 2 | 2026-04-01 |
| University Medical Center of Southern Nevada | Las Vegas NV | $7,622 | 1.2× | 7 | 2026-07-01 |
| Keck Hospital Of Usc | Los Angeles CA | $8,014 | 1.1× | 5 | 2026-04-01 |
| Winchester Hospital | Boston MA | $8,066 | 1.1× | 2 | 2026-04-01 |
| Medical City Plano | Dallas-Fort Worth TX | $8,375 | 1.4× | 5 | 2026-09-01 |
| Beth Israel Deaconess Hospital - Plymouth | Boston MA | $8,485 | 1.2× | 1 | 2026-04-01 |
| Medical City Mckinney | Dallas-Fort Worth TX | $8,580 | 1.4× | 5 | 2026-09-01 |
| Montefiore Medical Center | New York City | $9,011 | 1.2× | 8 | 2026-04-01 |
| University of Chicago Medical Center | Chicago IL | $9,148 | 1.4× | 2 | 2026-04-01 |
| Thomas Jefferson University Hospital | Philadelphia PA | $9,172 | 1.5× | 3 | 2026-09-15 |
| Anna Jaques Hospital | Boston MA | $9,188 | 1.3× | 2 | 2026-04-01 |
| Lahey Hospital & Medical Center, Burlington | Boston MA | $9,770 | 1.4× | 1 | 2026-04-01 |
| Bethesda North | Ohio (statewide) | $9,823 | 1.7× | 4 | 2026-04-01 |
| NYU Langone Hospitals (Orthopedic Hospital + Tisch files) | New York City | $9,887 | 1.3× | 7 | 2026-01-01 |
| Beth Israel Deaconess Medical Center | Boston MA | $10,604 | 1.5× | 2 | 2026-04-01 |
| Medina Hospital | Cleveland OH | $10,614 | 1.9× | 1 | 2026-06-15 |
| Inspira Medical Center Mullica Hill | Philadelphia PA | $11,208 | 1.7× | 1 | 2026-03-24 |
| Los Robles Hospital & Medical Center | California (statewide) | $11,855 | 1.6× | 5 | 2026-09-01 |
| Cleveland Clinic Lutheran Hospital | Cleveland OH | $12,125 | 2.2× | 1 | 2026-06-15 |
| Lehigh Valley Hospital | Pennsylvania (statewide) | $12,530 | 2.1× | 8 | 2026-07-01 |
| Legacy Emanuel Medical Center | Portland OR | $13,160 | 2.0× | 5 | 2026-04-01 |
| Legacy Good Samaritan Medical Center | Portland OR | $13,160 | 2.0× | 5 | 2026-04-01 |
| Legacy Mount Hood Medical Center | Portland OR | $13,160 | 2.0× | 5 | 2026-04-01 |
| Legacy Meridian Park Medical Center | Portland OR | $13,160 | 2.0× | 5 | 2026-04-01 |
| Cleveland Clinic Hillcrest Hospital | Cleveland OH | $13,731 | 2.5× | 1 | 2026-06-15 |
| Texas Health Presbyterian Hospital Dallas | Dallas-Fort Worth TX | $15,810 | 2.7× | 2 | 2026-04-21 |
| Overlake Hospital Medical Center | Seattle-Tacoma WA | $16,107 | 2.3× | 5 | 2026-04-01 |
| Providence St Vincent Medical Center | Portland OR | $17,193 | 2.6× | 3 | 2026-04-01 |
| Providence Portland Medical Center | Portland OR | $17,193 | 2.6× | 3 | 2026-04-01 |
| St Clare Hospital | Seattle-Tacoma WA | $18,096 | 2.6× | 6 | 2026-02-28 |
| St Anthony Hospital | Seattle-Tacoma WA | $18,416 | 2.7× | 6 | 2026-02-28 |
| Cedars-Sinai Medical Center | Los Angeles CA | $20,636 | 2.7× | 3 | 2025-11-26 |
| John Muir Medical Center - Walnut Creek Campus | San Francisco Bay Area CA | $20,650 | 2.5× | 6 | 2026-03-23 |
| Swedish Medical Center | Seattle-Tacoma WA | $20,924 | 3.0× | 5 | 2026-04-01 |
| Stanford Health Care | San Francisco Bay Area CA | $24,307 | 2.8× | 4 | 2026-04-01 |
| Tacoma General Allenmore Hospital | Seattle-Tacoma WA | $24,723 | 3.6× | 5 | 2026-08-27 |
| Multicare Good Samaritan Hospital | Seattle-Tacoma WA | $26,160 | 3.8× | 4 | 2026-08-27 |
Questions
How much do commercial insurers pay hospitals for tonsils and adenoids removal (child under 12)?
Across 91 hospitals in 32 metro areas that post a usable dollar rate, the median commercial rate for CPT 42820, hospital outpatient is $6,891, 1.1× the same hospital's local Medicare base rate. The middle half of hospitals runs $5,160 to $10,246. Figures are each hospital's median across insurers, from its federal price-transparency file.
What does Medicare pay for tonsils and adenoids removal (child under 12)?
Medicare's national hospital outpatient rate for CPT 42820 is $6,048 and its surgery-center rate is $3,026, before local wage adjustment.
Which hospitals post the lowest and highest commercial rates for tonsils and adenoids removal (child under 12)?
Lowest medians: Corewell Health Beaumont Grosse Pointe Hospital ($3,067), Corewell Health William Beaumont University Hospit ($3,067), Corewell Health Beaumont Troy Hospital ($3,067). Highest: Multicare Good Samaritan Hospital ($26,160), Tacoma General Allenmore Hospital ($24,723), Stanford Health Care ($24,307). Coverage is limited to the markets listed on this page.