How much does tonsillectomy & adenoidectomy, under 12 cost in San Francisco, CA?
CPT 42820 — the fair price, every hospital's price, and the Medicare benchmark for San Francisco, CA.
| Facility | Type | Price | vs Medicare | Quality |
|---|---|---|---|---|
| Good Samaritan Hospital (San Jose) lowest | Hospital | $7,000negotiated | 1.2× | — |
| Stanford Health Care Tri-Valley (Pleasanton) | Hospital | $7,312negotiated | 1.2× | — |
| Providence Santa Rosa Memorial Hospital (Santa Rosa) | Hospital | $8,405negotiated | 1.4× | — |
| Dignity Sequoia Hospital (Redwood City) | Hospital | $8,675negotiated | 1.5× | ★★★★★ |
| Sutter Mills-Peninsula Medical Center (Burlingame) | Hospital | $9,822negotiated | 1.7× | ★★★★★ |
| Dignity Dominican Hospital (Santa Cruz) | Hospital | $9,848negotiated | 1.7× | — |
| Sutter Alta Bates Summit Medical Center (Oakland) | Hospital | $9,871negotiated | 1.7× | — |
| Sutter Santa Rosa Regional Hospital (Santa Rosa) | Hospital | $10,472negotiated | 1.8× | — |
| Sutter Eden Medical Center (Castro Valley) | Hospital | $10,472negotiated | 1.8× | — |
| Kaiser Permanente San Francisco Medical Center (San Francisco) | Hospital | $10,634cash | 1.8× | ★★★★★ |
| Providence Queen of the Valley Medical Center (Napa) | Hospital | $10,846negotiated | 1.8× | — |
| UCSF Medical Center (San Francisco) | Hospital | $10,928negotiated | 1.8× | ★★★★★ |
| Sutter CPMC Van Ness Campus (San Francisco) | Hospital | $11,123negotiated | 1.9× | — |
| Stanford Health Care (Stanford) gross charge | Hospital | $24,307negotiated | 4.1× | ★★★★★ |
| John Muir Health Walnut Creek Medical Center (Walnut Creek) gross charge | Hospital | $41,747cash | 7.1× | ★★★★★ |
- For 42820 (Tonsillectomy & adenoidectomy, under 12), Medicare's benchmark rate is $5,915.66. A fair self-pay target for this line is $11,831.32. If I was charged more than that, please reduce it toward this benchmark.
- Your own published cash / self-pay price for 42820 is $26,190.88, and negotiated rates at nearby facilities run $8,675.32–$10,928.00. Please apply a rate in that range to my bill rather than the gross charge.
- Please send a fully itemized bill listing every CPT/HCPCS/DRG code and its individual charge, so I can review each line against published rates.
- Separately, what is your financial assistance / charity care policy, and am I eligible? Please send me the application and the income thresholds.
What should 42820 cost in San Francisco, CA?
For tonsillectomy & adenoidectomy, under 12 (CPT 42820) in San Francisco, CA, a fair self-pay price is around $9,871, with hospitals ranging from $8,675 to $10,928 across 15 facilities. Medicare's benchmark rate is $5,916, the floor to negotiate toward. The card above lists each hospital's price, cheapest first, with CMS quality stars.
Frequently asked questions
How much does tonsillectomy & adenoidectomy, under 12 cost in San Francisco, CA?
A fair self-pay price for tonsillectomy & adenoidectomy, under 12 (CPT 42820) in San Francisco, CA is around $9,871, with hospital prices ranging from $8,675 to $10,928 across 15 facilities. These are estimates from hospital-published prices, not a guarantee.
What is the Medicare rate for CPT 42820?
Medicare pays about $5,916 for tonsillectomy & adenoidectomy, under 12 (CPT 42820). That's the negotiation floor — a fair cash-pay target is roughly 1.5–2× it, well below typical gross charges.
Can I negotiate the price of tonsillectomy & adenoidectomy, under 12?
Yes. Under the federal Hospital Price Transparency rule hospitals must publish these rates, so you can ask to pay the cash or negotiated rate instead of the gross charge. Paste your bill on the home page for a ready-to-send appeal letter and the exact numbers to cite.
Got a bill for this?
If you were charged more than the fair price, you can usually negotiate it down. Paste your itemized bill to get a personalized appeal letter, the exact numbers to cite, an AI negotiation coach, and a charity-care eligibility check — free.
Compare other procedures in San Francisco, CA
Prices last refreshed September 2026 from each hospital's official CMS machine-readable file. Medicare rate: CY2025 OPPS/PFS/CLFS. Estimates only — not a guarantee.