Price Checker / CPT 42955
How much does Surgical Opening Of Throat cost?
CPT 42955 · Based on 2026 Medicare rates and hospital-published pricing
A fair cash price for this is roughly $1,550–$1,850.
Fair price
$1,550–$1,850
What this should cost
With insurance
~$2,600
Typical out-of-pocket
Overcharged if over
$2,300
Push back above this
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 Surgical Opening Of Throat
CPT code 42955 refers to surgical opening of throat (billing description: "Surgical opening of throat"). Under the 2026 Medicare Physician Fee Schedule, it is reimbursed at $697 in a facility (hospital or surgery center) and $697 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.