Average Medicaid Tonsillectomy Payments in Clinton Township, MI: $1,082
Avg. Paid
$1,082
Range
$217.29 – $4,009
Total Claims
57
Providers
2
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 Clinton Township, MI
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Kathleen Elizabeth Mcclain
15855 19 Mile Rd |
$4,009 | 13 | 13 |
|
Drue A Manning
15855 19 Mile Rd |
$217.29 | 44 | 42 |
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 Clinton Township, MI?
Based on public Medicaid payment data, the average Medicaid reimbursement for Tonsillectomy in Clinton Township, MI is $1,082 per claim, based on 57 claims from 2 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 Clinton Township, MI?
There are 2 Medicaid providers offering Tonsillectomy related services in Clinton Township, MI according to public payment data.
What is the price range for Tonsillectomy in Clinton Township, MI?
Medicaid reimbursement for Tonsillectomy in Clinton Township, MI ranges from $217.29 to $4,009 per claim, with an average of $1,082. Private insurance and self-pay costs are typically higher than these Medicaid rates.
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Other Procedures in Clinton Township, MI
Ambulance Transport
Avg $114.59
438,803 claims
Office Visit
Avg $59.84
398,073 claims
Psychiatric Evaluation
Avg $68.08
341,463 claims
Behavioral & Mental Health Therapy
Avg $36.37
221,902 claims
Emergency Room Visit
Avg $75.94
186,506 claims
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Avg $6.86
106,495 claims
Eye Exam
Avg $42.47
40,069 claims
Blood Work & Lab Tests
Avg $8.68
36,445 claims