Average Medicaid Tonsillectomy Payments in El Paso, TX: $707.25
Avg. Paid
$707.25
Range
$203.29 – $1,228
Total Claims
1,683
Providers
10
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 El Paso, TX
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Tyler Swiss
5005 N Piedras St |
$210.08 | 41 | 40 |
|
Benjamin James Westbrook
1500 N Mesa St |
$203.29 | 44 | 42 |
|
Rodney Keith Jamison
1600 Medical Ctr |
$243.84 | 85 | 84 |
|
Kevin Edward Bright
1600 Medical Ctr |
$226.44 | 87 | 85 |
|
Jonathan Chiao
4845 Alameda Ave |
$1,128 | 127 | 104 |
|
Jorge Ivan Contreras
5959 Gateway Blvd W |
$243.96 | 131 | 129 |
|
Surgery Affiliate Of El Paso, Llc
125 W. Castellano Drive |
$1,165 | 214 | 213 |
|
David A Reiersen
1600 Medical Center Dr |
$226.41 | 215 | 209 |
|
Gary Nanez
5959 Gateway West |
$234.56 | 250 | 247 |
|
El Paso Day Surgery Llc
1300 Murchison |
$1,228 | 489 | 485 |
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 El Paso, TX?
Based on public Medicaid payment data, the average Medicaid reimbursement for Tonsillectomy in El Paso, TX is $707.25 per claim, based on 1,683 claims from 10 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 El Paso, TX?
There are 10 Medicaid providers offering Tonsillectomy related services in El Paso, TX according to public payment data.
What is the price range for Tonsillectomy in El Paso, TX?
Medicaid reimbursement for Tonsillectomy in El Paso, TX ranges from $203.29 to $1,228 per claim, with an average of $707.25. 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 El Paso, TX
Office Visit
Avg $46.37
2,780,417 claims
Vaccines & Immunizations
Avg $7.78
1,519,516 claims
Emergency Room Visit
Avg $138.81
968,153 claims
Dental Cleaning & Exam
Avg $38.29
959,310 claims
Personal Care Services
Avg $63.88
821,382 claims
Blood Work & Lab Tests
Avg $14.36
702,778 claims
Physical Therapy
Avg $54.21
597,599 claims
Speech Therapy
Avg $67.05
530,977 claims