Price Checker / CPT 42831

How much does Removal Of Adenoids cost?

CPT 42831 · Based on 2026 Medicare rates and hospital-published pricing

Severe overcharge

The average hospital charge is around 52x the fair price — among the most extreme markups. Dispute this.

Fair price

$320–$640

What this should cost

With insurance

~$2,950

Typical out-of-pocket

Overcharged if over

$800

Push back above this

The average hospital charge of $24,902 is $24,422 over the fair price (about 52x 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.

HospitalGross ChargeCash Ratevs Medicare
The Christ Hospital Inpatient Psychiatry

, OH

$45,701$12,62921380%
The Christ Hospital Inpatient Rehab

, OH

$45,701$12,62921380%
The Christ Hospital Liberty

, OH

$45,701$12,62921380%
The Christ Hospital

, OH

$45,701$12,62921380%
Centrastate Medical Center

FREEHOLD, NJ

$25,929$4,23512087%
Mather Hospital

, NY

$4,5959742%
Georgetown Community Hospital

GEORGETOWN, KY

$16,5097660%
Animas Surgical Hospital

, CO

$4,7755082%
BAYLOR SCOTT & WHITE MEDICAL CENTER - BRENHAM

Brenham, TX

4694%
Troy Regional Medical Center

TROY, AL

$6,573$3,3002989%
Dallas County Hospital

PERRY, IA

$6,195$4,0272812%

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About Removal Of Adenoids

CPT code 42831 refers to removal of adenoids (billing description: "Removal of adenoids"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $213 in a facility (hospital or surgery center) and $213 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

  1. 1Send us your billwe'll identify this code and compare it against the rates shown above.
  2. 2Get a dispute letterciting the Medicare rate and your hospital's own published pricing data.
  3. 3We negotiate for you25% of savings, no savings = no fee.

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