Price Checker / CPT 42820
How much does Remove Tonsils And Adenoids cost?
CPT 42820 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 21x the fair price — among the most extreme markups. Dispute this.
Fair price
$390–$780
What this should cost
With insurance
~$3,500
Typical out-of-pocket
Overcharged if over
$980
Push back above this
The average hospital charge of $12,149 is $11,559 over the fair price (about 21x the fair rate).
What hospitals charge for Remove Tonsils And Adenoids
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Franciscan Health Lafayette LAFAYETTE, IN | $37,875 | $9,734 | 14419% |
| Los Alamos Medical Center LOS ALAMOS, NY | $24,031 | — | 9112% |
| Lake Cumberland Regional Hospital SOMERSET, CO | $20,812 | — | 7878% |
| LifeBrite Community Hospital of Stokes DANBURY, NC | $19,909 | — | 6286% |
| Georgetown Community Hospital GEORGETOWN, KY | $16,209 | — | 6114% |
| Meadowview Regional Medical Center MAYSVILLE, KY | $15,768 | — | 5945% |
| Castleview Hospital PRICE, UT | $15,380 | — | 5796% |
| Bourbon Community Hospital PARIS, KY | $14,946 | — | 5629% |
| Down East Community Hospital Machias, ME | $14,927 | — | 5136% |
| Spring View Hospital LEBANON, KY | $12,776 | — | 4798% |
| Brown County Hospital Ainsworth, NE | $6,073 | — | 4556% |
| Syracuse Area Health Syracuse, NE | $12,000 | — | 4408% |
| Brodstone Memorial Hospital Superior, NE | $11,837 | — | 4347% |
| Butler County Health David City, NE | $11,698 | — | 4295% |
| UPMC Green , PA | — | — | 4281% |
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 Tonsils And Adenoids
CPT code 42820 refers to remove tonsils and adenoids (billing description: "Remove tonsils and adenoids"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $261 in a facility (hospital or surgery center) and $261 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.