Average Medicaid Tonsillectomy Payments in Dallas, TX: $1,258
Avg. Paid
$1,258
Range
$519.21 – $3,383
Total Claims
5,098
Providers
13
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 Dallas, TX
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Seckin Omer Ulualp
1935 Medical District Dr |
$1,587 | 1,303 | 1,277 |
|
Kenneth H Lee
5323 Harry Hines Blvd. |
$1,351 | 852 | 847 |
|
Debra Gail Weinberger
5323 Harry Hines Blvd |
$1,418 | 823 | 812 |
|
Stephen Reed Chorney
5323 Harry Hines Blvd |
$1,224 | 528 | 526 |
|
Christopher Liu
5323 Harry Hines Blvd |
$519.21 | 455 | 454 |
|
Romaine Fitzgerald Johnson
5323 Harry Hines Blvd |
$795.51 | 395 | 392 |
|
Felicity Lenes-Voit
5201 Harry Hines Blvd |
$959.19 | 297 | 297 |
|
Ron Benson Mitchell
1935 Medical District Dr |
$788.86 | 250 | 248 |
|
Maria Clemencia Veling
5323 Harry Hines Blvd |
$1,321 | 53 | 52 |
|
Cynthia Sanhwa Wang
5323 Harry Hines Blvd |
$2,962 | 46 | 46 |
|
Amy Rasco Coffey
5323 Harry Hines Blvd |
$1,241 | 45 | 44 |
|
Helene Dabbous
1935 Medical District Dr |
$1,039 | 36 | 29 |
|
Children'S Health System Of Texas
1935 Medical District Dr |
$3,383 | 15 | 15 |
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 Dallas, TX?
Based on public Medicaid payment data, the average Medicaid reimbursement for Tonsillectomy in Dallas, TX is $1,258 per claim, based on 5,098 claims from 13 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 Dallas, TX?
There are 13 Medicaid providers offering Tonsillectomy related services in Dallas, TX according to public payment data.
What is the price range for Tonsillectomy in Dallas, TX?
Medicaid reimbursement for Tonsillectomy in Dallas, TX ranges from $519.21 to $3,383 per claim, with an average of $1,258. 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
Columbus, OH
Avg $798.70
10,468 claims · 17 providers
Atlanta, GA
Avg $1,186
9,625 claims · 4 providers
Other Procedures in Dallas, TX
Office Visit
Avg $47.45
3,693,999 claims
Blood Work & Lab Tests
Avg $8.85
3,062,549 claims
Dental Cleaning & Exam
Avg $40.86
1,984,728 claims
Emergency Room Visit
Avg $145.88
1,942,869 claims
Vaccines & Immunizations
Avg $6.15
1,940,547 claims
X-Ray
Avg $12.45
1,048,753 claims
Urinalysis & Urine Tests
Avg $7.08
949,406 claims
Dental Filling
Avg $87.64
876,814 claims