Average Medicaid Tonsillectomy Payments in Columbus, OH: $798.70
Avg. Paid
$798.70
Range
$170.47 – $1,241
Total Claims
10,468
Providers
17
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 Columbus, OH
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Nationwide Children'S Hospital
700 Childrens Dr |
$1,241 | 4,973 | 4,021 |
|
Spencer Eugene Lindsey
555 S 18Th St |
$371.04 | 759 | 727 |
|
Charles Albert Elmaraghy
555 S 18Th St |
$430.56 | 691 | 665 |
|
Kris R Jatana
555 S 18Th St |
$423.43 | 600 | 585 |
|
Meredith N. Lind
555 S 18Th St |
$445.25 | 555 | 539 |
|
James Michael Ruda
555 S 18Th St |
$407.01 | 541 | 524 |
|
Ethan Christopher Bassett
555 S 18Th St |
$440.05 | 514 | 489 |
|
Patrick Collins Walz
555 S 18Th St |
$332.70 | 472 | 447 |
|
Ohio Surgery Center Llc
930 Bethel Rd |
$533.64 | 435 | 409 |
|
Jonathan Marc Grischkan
555 S 18Th St |
$482.97 | 325 | 312 |
|
Aaron Lee Thatcher
700 Childrens Dr |
$176.14 | 314 | 298 |
|
Amy M Manning
555 S 18Th St |
$242.43 | 122 | 119 |
|
Gregory J Wiet
555 S 18Th St |
$179.98 | 101 | 100 |
|
Tendy Chiang
555 S 18Th St |
$181.07 | 27 | 27 |
|
Prasanth Pattisapu
555 S 18Th St |
$173.95 | 14 | 13 |
|
Prashant Solanki Malhotra
555 S 18Th St |
$186.62 | 13 | 13 |
|
Ashley Lorraine Miller
700 Childrens Dr |
$170.47 | 12 | 12 |
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 Columbus, OH?
Based on public Medicaid payment data, the average Medicaid reimbursement for Tonsillectomy in Columbus, OH is $798.70 per claim, based on 10,468 claims from 17 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 Columbus, OH?
There are 17 Medicaid providers offering Tonsillectomy related services in Columbus, OH according to public payment data.
What is the price range for Tonsillectomy in Columbus, OH?
Medicaid reimbursement for Tonsillectomy in Columbus, OH ranges from $170.47 to $1,241 per claim, with an average of $798.70. Private insurance and self-pay costs are typically higher than these Medicaid rates.
Tonsillectomy in Other Cities
Knoxville, TN
Avg $425.33
14,943 claims · 6 providers
Phoenix, AZ
Avg $1,967
14,090 claims · 25 providers
St Petersburg, FL
Avg $144.73
13,997 claims · 6 providers
Nashville, TN
Avg $1,316
11,572 claims · 12 providers
Cincinnati, OH
Avg $805.15
10,929 claims · 18 providers
Birmingham, AL
Avg $378.75
10,761 claims · 6 providers
Atlanta, GA
Avg $1,186
9,625 claims · 4 providers
Alexandria, LA
Avg $282.37
8,774 claims · 5 providers
Other Procedures in Columbus, OH
Home Health Visit
Avg $45.80
26,745,681 claims
Office Visit
Avg $62.00
8,388,006 claims
Blood Work & Lab Tests
Avg $8.64
6,317,089 claims
Emergency Room Visit
Avg $98.63
3,813,295 claims
X-Ray
Avg $8.91
2,932,314 claims
Behavioral & Mental Health Therapy
Avg $86.62
2,709,784 claims
Substance Abuse Treatment
Avg $101.75
2,434,686 claims
Psychiatric Evaluation
Avg $92.89
2,227,259 claims