How much does tonsillectomy & adenoidectomy, under 12 cost in Texas?

CPT 42820 — the fair price, every hospital's price, and the Medicare benchmark for Texas.

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
$4,670
This is the local cash / self-pay price — usually the best rate you can ask for.
What Medicare paysⓘ
$5,916
Typical price near you
$5,989
Cash / self-pay price
$4,670
Prices near you — 69 facilities, lowest first
FacilityTypePricevs MedicareQuality
Methodist Hospital (San Antonio) lowest ⚠ likely error Hospital $106cash 0.0× ★★★★★
Valley Baptist Medical Center – Brownsville ⚠ likely error Hospital $184negotiated 0.0× ★★★★★
UT Southwestern William P. Clements Jr. University Hospital (Dallas) ⚠ likely error Hospital $779cash 0.1× ★★★★★
The Hospitals of Providence Memorial Campus (El Paso) ⚠ likely error Hospital $812negotiated 0.1× ★★★★★
UT MD Anderson Cancer Center (Houston) ⚠ likely error Hospital $828negotiated 0.1× —
The Hospitals of Providence Sierra Campus (El Paso) ⚠ likely error Hospital $1,331negotiated 0.2× —
University Medical Center of El Paso Hospital $1,954negotiated 0.3× ★★★★★
Dell Seton Medical Center at UT (Austin) Hospital $1,954negotiated 0.3× ★★★★★
Ascension Seton Medical Center Austin Hospital $1,954negotiated 0.3× ★★★★★
Harris Health Lyndon B. Johnson Hospital (Houston) Hospital $2,041negotiated 0.3× —
Harris Health Ben Taub Hospital (Houston) Hospital $2,041negotiated 0.3× —
Cook Children's Medical Center (Fort Worth) Hospital $2,052negotiated 0.3× —
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 $4,669.62. If I was charged more than that, please reduce it toward this benchmark.
  • Your own published cash / self-pay price for 42820 is $4,669.62, and negotiated rates at nearby facilities run $3,695.00–$6,097.12. 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.
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What should 42820 cost in Texas?

For tonsillectomy & adenoidectomy, under 12 (CPT 42820) in Texas, a fair self-pay price is around $5,989, with hospitals ranging from $3,695 to $6,097 across 69 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 Texas?

A fair self-pay price for tonsillectomy & adenoidectomy, under 12 (CPT 42820) in Texas is around $5,989, with hospital prices ranging from $3,695 to $6,097 across 69 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.

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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.