How much does tonsillectomy & adenoidectomy, under 12 cost in California?
CPT 42820 — the fair price, every hospital's price, and the Medicare benchmark for California.
Estimates only. Educational estimates from public Medicare
benchmarks and hospital-published prices — not a guarantee, and not legal, medical, or financial advice.
42820 Tonsillectomy & adenoidectomy, under 12
Ask to pay
$5,813
This is the local cash / self-pay price — usually the best rate you can ask for.
Typical
$8,376
Medicare $5,916
Ask $5,813
$154 lowboxed = typical rangehigh $41,747
What Medicare paysⓘ
$5,916
Typical price near you
$8,376
Cash / self-pay price
$5,813
Prices near you — 68 facilities, lowest first
| Facility | Type | Price | vs Medicare | Quality |
|---|---|---|---|---|
| Adventist Health Bakersfield (Bakersfield) lowest ⚠ likely error | Hospital | $154cash | 0.0× | — |
| Community Regional Medical Center (Fresno) ⚠ likely error | Hospital | $264negotiated | 0.0× | — |
| Clovis Community Medical Center (Clovis) ⚠ likely error | Hospital | $264negotiated | 0.0× | — |
| Los Angeles General Medical Center (Los Angeles) ⚠ likely error | Hospital | $360negotiated | 0.1× | ★★★★★ |
| Harbor-UCLA Medical Center (Torrance) ⚠ likely error | Hospital | $360negotiated | 0.1× | — |
| JFK Memorial Hospital (Indio) | Hospital | $2,664negotiated | 0.5× | — |
| Desert Regional Medical Center (Palm Springs) | Hospital | $2,730negotiated | 0.5× | — |
| Kaiser Permanente San Diego Zion Medical Center (San Diego) | Hospital | $4,321cash | 0.7× | ★★★★★ |
| Kaiser Permanente Fontana Medical Center (Fontana) | Hospital | $4,321cash | 0.7× | — |
| Kaiser Permanente Los Angeles Medical Center (Los Angeles) | Hospital | $4,321cash | 0.7× | ★★★★★ |
| Cedars-Sinai Medical Center (Los Angeles) | Hospital | $4,878cash | 0.8× | ★★★★★ |
| Pomona Valley Hospital Medical Center (Pomona) | Hospital | $5,041negotiated | 0.9× | ★★★★★ |
| Riverside Community Hospital (Riverside) | Hospital | $5,071negotiated | 0.9× | — |
| Dignity Glendale Memorial Hospital (Glendale) | Hospital | $6,292negotiated | 1.1× | — |
| Dignity St. Bernardine Medical Center (San Bernardino) | Hospital | $6,464negotiated | 1.1× | — |
| Riverside University Health System Medical Center (Moreno Valley) | Hospital | $6,749cash | 1.1× | — |
| Good Samaritan Hospital (San Jose) | Hospital | $7,000negotiated | 1.2× | — |
| Stanford Health Care Tri-Valley (Pleasanton) | Hospital | $7,312negotiated | 1.2× | — |
| Providence Holy Cross Medical Center (Mission Hills) | Hospital | $7,461negotiated | 1.3× | — |
| Dignity St. John's Regional Medical Center (Oxnard) | Hospital | $7,516negotiated | 1.3× | — |
| Dignity St. Mary Medical Center (Long Beach) | Hospital | $7,516negotiated | 1.3× | — |
| Dignity Bakersfield Memorial Hospital (Bakersfield) | Hospital | $7,516negotiated | 1.3× | — |
| Dignity Mercy Medical Center Redding (Redding) | Hospital | $7,516negotiated | 1.3× | — |
| Dignity Northridge Hospital Medical Center (Northridge) | Hospital | $7,516negotiated | 1.3× | ★★★★★ |
| Dignity California Hospital Medical Center (Los Angeles) | Hospital | $7,516negotiated | 1.3× | — |
| UCLA Santa Monica Medical Center (Santa Monica) | Hospital | $7,565negotiated | 1.3× | ★★★★★ |
| Ronald Reagan UCLA Medical Center (Los Angeles) | Hospital | $7,614negotiated | 1.3× | ★★★★★ |
| Providence Saint Joseph Medical Center (Burbank) | Hospital | $7,765negotiated | 1.3× | — |
| Providence Cedars-Sinai Tarzana Medical Center (Tarzana) | Hospital | $7,766negotiated | 1.3× | ★★★★★ |
| Dignity Mercy San Juan Medical Center (Carmichael) | Hospital | $7,774negotiated | 1.3× | — |
| Dignity Mercy General Hospital (Sacramento) | Hospital | $7,774negotiated | 1.3× | ★★★★★ |
| Providence Little Company of Mary Torrance (Torrance) | Hospital | $7,791negotiated | 1.3× | ★★★★★ |
| MemorialCare Saddleback Medical Center (Laguna Hills) | Hospital | $8,096negotiated | 1.4× | ★★★★★ |
| MemorialCare Orange Coast Medical Center (Fountain Valley) | Hospital | $8,259negotiated | 1.4× | — |
| Providence St. Jude Medical Center (Fullerton) | Hospital | $8,359negotiated | 1.4× | ★★★★★ |
| Dignity St. Joseph's Medical Center (Stockton) | Hospital | $8,393negotiated | 1.4× | — |
| Providence Santa Rosa Memorial Hospital (Santa Rosa) | Hospital | $8,405negotiated | 1.4× | — |
| MemorialCare Long Beach Medical Center (Long Beach) | Hospital | $8,477negotiated | 1.4× | ★★★★★ |
| Providence St. Mary Medical Center (Apple Valley) | Hospital | $8,567negotiated | 1.4× | — |
| Dignity Sequoia Hospital (Redwood City) | Hospital | $8,675negotiated | 1.5× | ★★★★★ |
| Providence St. Joseph Hospital (Orange) | Hospital | $8,863negotiated | 1.5× | ★★★★★ |
| Providence Mission Hospital (Mission Viejo) | Hospital | $8,948negotiated | 1.5× | ★★★★★ |
| Hoag Memorial Hospital Presbyterian (Newport Beach) | Hospital | $9,018negotiated | 1.5× | ★★★★★ |
| Keck Hospital of USC (Los Angeles) | Hospital | $9,517negotiated | 1.6× | ★★★★★ |
| Rady Children's Hospital (San Diego) | Hospital | $9,694negotiated | 1.6× | — |
| 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 Roseville Medical Center (Roseville) | Hospital | $9,974negotiated | 1.7× | ★★★★★ |
| Sutter Memorial Medical Center (Modesto) | Hospital | $9,974negotiated | 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× | — |
| Sutter Medical Center Sacramento (Sacramento) | Hospital | $10,472negotiated | 1.8× | ★★★★★ |
| Kaiser Permanente Fresno Medical Center (Fresno) | Hospital | $10,634cash | 1.8× | — |
| Kaiser Permanente San Francisco Medical Center (San Francisco) | Hospital | $10,634cash | 1.8× | ★★★★★ |
| Kaiser Permanente Sacramento Medical Center (Sacramento) | 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× | ★★★★★ |
| UCI Health – Lakewood (Lakewood) | Hospital | $11,040negotiated | 1.9× | — |
| UCI Health – Placentia Linda (Placentia) | Hospital | $11,040negotiated | 1.9× | — |
| UCI Health – Los Alamitos (Los Alamitos) | Hospital | $11,040negotiated | 1.9× | — |
| UCI Health – Fountain Valley (Fountain Valley) | Hospital | $11,040negotiated | 1.9× | — |
| UCI Medical Center (Orange) | Hospital | $11,040negotiated | 1.9× | ★★★★★ |
| Sutter CPMC Van Ness Campus (San Francisco) | Hospital | $11,123negotiated | 1.9× | — |
| Los Robles Health System (Thousand Oaks) | Hospital | $11,855negotiated | 2.0× | — |
| UC Davis Medical Center (Sacramento) gross charge | Hospital | $17,663negotiated | 3.0× | ★★★★★ |
| 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× | ★★★★★ |
Prices from each hospital's public machine-readable file; imaging & surgery-center prices are published self-pay rates (often the cheapest option). vs Medicare is how many times the Medicare rate each facility charges. 8 unusually low/high prices excluded from the typical price as likely data errors.
💬 What to say — negotiation scripts
- For 42820 (Tonsillectomy & adenoidectomy, under 12), Medicare's benchmark rate is $5,915.66. A fair self-pay target for this line is $5,813.31. If I was charged more than that, please reduce it toward this benchmark.
- Your own published cash / self-pay price for 42820 is $5,813.31, and negotiated rates at nearby facilities run $7,077.88–$10,472.50. 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.
See tonsillectomy & adenoidectomy, under 12 prices in another area
What should 42820 cost in California?
For tonsillectomy & adenoidectomy, under 12 (CPT 42820) in California, a fair self-pay price is around $8,376, with hospitals ranging from $7,078 to $10,472 across 68 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 California?
A fair self-pay price for tonsillectomy & adenoidectomy, under 12 (CPT 42820) in California is around $8,376, with hospital prices ranging from $7,078 to $10,472 across 68 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 California
Screening mammogram, bilateralDiagnostic mammogram, unilateralDiagnostic mammogram, bilateralDEXA bone density scanColonoscopy, diagnosticScreening colonoscopy (average risk)Chest X-ray, 2 viewsChest X-ray, 1 view
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.