Price Checker / CPT 42120
How much does Remove Palate/lesion cost?
CPT 42120 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is roughly 4.1x the fair price. This is well above fair — push back or dispute it.
Fair price
$1,350–$2,750
What this should cost
With insurance
~$3,700
Typical out-of-pocket
Overcharged if over
$3,450
Push back above this
The average hospital charge of $8,496 is $6,446 over the fair price (about 4.1x the fair rate).
What hospitals charge for Remove Palate/lesion
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Carlinville Area Hospital Carlinville, IL | $8,496 | — | 831% |
Were you billed for this procedure?
Send us your bill and we'll compare every line item against Medicare rates and your hospital's published prices. Free review, no obligation.
About Remove Palate/lesion
CPT code 42120 refers to remove palate/lesion (billing description: "Remove palate/lesion"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $912 in a facility (hospital or surgery center) and $912 in a doctor's office.
The Medicare rate is the closest thing to an objective "what this work is actually worth." A fair cash price for the uninsured is generally 1.5–3x that rate. Hospital sticker (gross) charges are often far higher — but almost nobody actually pays them.
What to do if you were overcharged
- 1Send us your bill — we'll identify this code and compare it against the rates shown above.
- 2Get a dispute letter — citing the Medicare rate and your hospital's own published pricing data.
- 3We negotiate for you — 25% of savings, no savings = no fee.