Average Medicaid Tonsillectomy Payments in Akron, OH: $896.44
Avg. Paid
$896.44
Range
$177.85 – $2,074
Total Claims
8,609
Providers
8
Typical Payment Range
Typical Medicaid Tonsillectomy payments fall between $206.59 and $1,054 per claim (median: $326.29). The top 10% of payments exceed $1,741.
Based on per-provider averages across all Medicaid claims in this category.
Surgical removal of the tonsils, commonly performed for recurrent tonsillitis or obstructive sleep apnea in children and adults.
Understanding these costs
The amounts shown are Medicaid reimbursement rates — what state Medicaid programs paid providers per claim. Medicaid typically pays well below private insurance rates and out-of-pocket prices. Use this data to compare relative costs between providers, not as a price estimate for privately insured or self-pay patients.
Providers Offering Tonsillectomy in Akron, OH
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Katie Mingo English
55 Arch St Ste 2A |
$2,074 | 25 | 24 |
|
Andrew Marc Shapiro
1 Perkins Sq Ste 320 |
$181.53 | 29 | 28 |
|
Marc Erik Nelson
1 Perkins Sq |
$457.41 | 529 | 515 |
|
Terry L Good
1 Perkins Sq |
$474.21 | 539 | 528 |
|
Anton Gc Milo
1 Perkins Sq |
$459.08 | 628 | 603 |
|
Samuel Albert
1 Perkins Sq |
$489.18 | 1,650 | 1,598 |
|
Vincent P Callanan
214 W Bowery St |
$177.85 | 1,714 | 1,712 |
|
Children'S Hospital Medical Center Of Akron
1 Perkins Sq |
$1,649 | 3,495 | 2,682 |
What to Expect: Tonsillectomy
A tonsillectomy takes about 30-45 minutes under general anesthesia. It's usually an outpatient procedure. Recovery takes 10-14 days. Throat pain is the most common complaint and can be managed with pain medication. A soft diet and plenty of fluids are recommended. Watch for signs of bleeding, which can occur up to 2 weeks after surgery.
Cost Components
National average Medicaid payment per billing code. Individual rates vary by provider and state.
| Code | Description | Avg. Paid | Claims | Providers |
|---|---|---|---|---|
| 42820 | Tonsillectomy & adenoidectomy <12 | $1,012 | 494,505 | 1,624 |
| 42830 | Adenoidectomy primary <12 | $707.06 | 97,633 | 368 |
| 42821 | Tonsillectomy & adenoidect >12 | $1,047 | 2,603 | 42 |
| 42826 | Tonsillectomy primary >12 | $686.37 | 314 | 9 |
| 42825 | Tonsillectomy primary <12 | $426.12 | 147 | 4 |
| 42831 | Adenoidectomy primary >12 | — | — | — |
| 42835 | Adenoidectomy secondary <12 | — | — | — |
| 42836 | Adenoidectomy secondary >12 | — | — | — |
These are national Medicaid averages for each billing code. Actual amounts vary by state, provider, and complexity.
Frequently Asked Questions
How much does a Tonsillectomy cost in Akron, OH?
Based on public Medicaid payment data, the average Medicaid reimbursement for Tonsillectomy in Akron, OH is $896.44 per claim, based on 8,609 claims from 8 providers. Typical payments fall between $206.59 and $1,054. Note: Medicaid rates are typically much lower than private insurance or self-pay prices.
How many providers offer Tonsillectomy in Akron, OH?
There are 8 Medicaid providers offering Tonsillectomy related services in Akron, OH according to public payment data.
What is the price range for Tonsillectomy in Akron, OH?
Medicaid reimbursement for Tonsillectomy in Akron, OH ranges from $177.85 to $2,074 per claim, with an average of $896.44. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Tonsillectomy in Other Cities
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Avg $1,186
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Other Procedures in Akron, OH
Office Visit
Avg $82.36
2,903,849 claims
Blood Work & Lab Tests
Avg $6.59
1,893,555 claims
Emergency Room Visit
Avg $101.47
1,830,030 claims
Behavioral & Mental Health Therapy
Avg $78.20
1,149,768 claims
Substance Abuse Treatment
Avg $74.21
890,491 claims
Psychiatric Evaluation
Avg $80.57
885,433 claims
Vaccines & Immunizations
Avg $7.34
873,645 claims
X-Ray
Avg $10.18
642,936 claims