Price Checker / CPT 42830
How much does Removal Of Adenoids cost?
CPT 42830 · 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
$290–$590
What this should cost
With insurance
~$3,000
Typical out-of-pocket
Overcharged if over
$740
Push back above this
The average hospital charge of $12,147 is $11,707 over the fair price (about 28x the fair rate).
What hospitals charge for Removal Of 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 | $41,867 | $10,760 | 21326% |
| Los Alamos Medical Center LOS ALAMOS, NY | $20,197 | — | 10236% |
| Lake Cumberland Regional Hospital SOMERSET, CO | $18,437 | — | 9336% |
| Georgetown Community Hospital GEORGETOWN, KY | $15,214 | — | 7686% |
| Meadowview Regional Medical Center MAYSVILLE, KY | $14,679 | — | 7412% |
| Troy Regional Medical Center TROY, AL | $14,259 | — | 7197% |
| Animas Surgical Hospital , CO | $5,014 | — | 5542% |
| Lamb Healthcare Center Littlefield, TX | $9,229 | — | 5147% |
| BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM Brenham, TX | — | — | 5120% |
| Wills Memorial Hospital WASHINGTON, GA | $7,273 | $5,091 | 3622% |
| Dallas County Hospital PERRY, IA | $6,568 | $4,269 | 3261% |
| UPMC Green , PA | — | — | 3116% |
| Jennie M Melham Memorial Medical Center BROKEN BOW, NE | $4,945 | — | 2431% |
| Pomerene Hospital MILLERSBURG, OH | $4,153 | $3,322 | 2025% |
| UPMC Bedford , PA | — | — | 1891% |
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 Adenoids
CPT code 42830 refers to removal of adenoids (billing description: "Removal of adenoids"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $195 in a facility (hospital or surgery center) and $195 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.