Price Checker / CPT 42826
How much does Removal Of Tonsils cost?
CPT 42826 · Based on 2026 Medicare rates and hospital-published pricing
The average hospital charge is around 28x the fair price — among the most extreme markups. Dispute this.
Fair price
$350–$690
What this should cost
With insurance
~$3,050
Typical out-of-pocket
Overcharged if over
$860
Push back above this
The average hospital charge of $14,301 is $13,781 over the fair price (about 28x 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 |
|---|---|---|---|
| Starr Regional Medical Center , TN | $41,248 | — | 17720% |
| Lake Cumberland Regional Hospital SOMERSET, CO | $28,594 | — | 12253% |
| Los Alamos Medical Center LOS ALAMOS, NY | $23,920 | — | 10234% |
| "St. Mary's General Hospital" PASSAIC, NJ | $21,638 | $4,840 | 9248% |
| Georgetown Community Hospital GEORGETOWN, KY | $18,865 | — | 8050% |
| Bourbon Community Hospital PARIS, KY | $17,831 | — | 7603% |
| Meadowview Regional Medical Center MAYSVILLE, KY | $17,645 | — | 7523% |
| Castleview Hospital PRICE, UT | $15,263 | — | 6494% |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham, TX | — | — | 4307% |
| Troy Regional Medical Center TROY, AL | $6,600 | $3,300 | 2751% |
| UPMC Green , PA | — | — | 2614% |
| Dallas County Hospital PERRY, IA | $6,195 | $4,027 | 2576% |
| Jennie M Melham Memorial Medical Center BROKEN BOW, NE | $4,866 | — | 2002% |
| Northern Itasca Hospital District , MN | $3,987 | $2,830 | 1622% |
| Crane Memorial Hospital Crane, TX | $4,280 | — | 1564% |
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 42826 refers to removal of tonsils (billing description: "Removal of tonsils"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $231 in a facility (hospital or surgery center) and $231 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.