Price Checker / CPT 42825
How much does Removal Of Tonsils cost?
CPT 42825 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 24x the fair price — among the most extreme markups. Dispute this.
Fair price
$370–$730
What this should cost
With insurance
~$3,550
Typical out-of-pocket
Overcharged if over
$910
Push back above this
The average hospital charge of $12,968 is $12,418 over the fair price (about 24x the fair rate).
What hospitals charge for Removal Of Tonsils
From hospital-published transparency (MRF) files. These are the hospitals in our database that list this procedure.
| Hospital | Gross Charge | Cash Rate | vs Medicare |
|---|---|---|---|
| Stony Brook Southampton Hospital , NY | $3,368 | — | 31128% |
| St. Anne Hospital , WA | — | — | 10987% |
| Los Alamos Medical Center LOS ALAMOS, NY | $19,933 | — | 8086% |
| Lake Cumberland Regional Hospital SOMERSET, CO | $18,335 | — | 7430% |
| Bourbon Community Hospital PARIS, KY | $16,430 | — | 6648% |
| Georgetown Community Hospital GEORGETOWN, KY | $16,418 | — | 6643% |
| Meadowview Regional Medical Center MAYSVILLE, KY | $15,399 | — | 6224% |
| Troy Regional Medical Center TROY, AL | $12,601 | — | 5075% |
| LifeBrite Community Hospital of Stokes DANBURY, NC | $13,273 | — | 4806% |
| Animas Surgical Hospital , CO | $10,528 | — | 4428% |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham, TX | — | — | 4089% |
| Lamb Healthcare Center Littlefield, TX | $8,912 | — | 3966% |
| Pecos County Memorial Hospital Fort Stockton, TX | $10,722 | — | 3863% |
| UPMC Bedford , PA | — | — | 2258% |
| Jennie M Melham Memorial Medical Center BROKEN BOW, NE | $5,663 | — | 2226% |
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 Removal Of Tonsils
CPT code 42825 refers to removal of tonsils (billing description: "Removal of tonsils"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $243 in a facility (hospital or surgery center) and $243 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.