Price Checker / CPT 42800
How much does Biopsy Of Throat cost?
CPT 42800 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 14x the fair price — among the most extreme markups. Dispute this.
Fair price
$240–$480
What this should cost
With insurance
~$2,600
Typical out-of-pocket
Overcharged if over
$600
Push back above this
The average hospital charge of $4,962 is $4,602 over the fair price (about 14x the fair rate).
What hospitals charge for Biopsy Of Throat
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| UPMC Chautauqua , NY | — | — | 3297% |
| Troy Regional Medical Center TROY, AL | $4,500 | — | 2718% |
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 Biopsy Of Throat
CPT code 42800 refers to biopsy of throat (billing description: "Biopsy of throat"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $106 in a facility (hospital or surgery center) and $160 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.