Average Medicaid Tonsillectomy Payments in Phoenix, AZ: $1,967
Avg. Paid
$1,967
Range
$178.61 – $3,309
Total Claims
14,090
Providers
25
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 Phoenix, AZ
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Peter C Kaiser
3805 E. Bell Road |
$234.12 | 14 | 13 |
|
Joseph Ahlstrom Chiara
3806 East Bell Road |
$297.61 | 15 | 15 |
|
Luis Vazquez
2340 E Beardsley Rd |
$297.12 | 43 | 43 |
|
Mark Evan Gerber
1920 E Cambridge Ave Ste 201 |
$220.83 | 46 | 45 |
|
Punam Patel
1919 E Thomas Rd |
$281.98 | 58 | 58 |
|
Clare M Richardson
1920 E Cambridge Ave Ste 201 |
$288.87 | 60 | 60 |
|
Richard P Pearlstein
1010 E Mcdowell Rd Ste 200 |
$269.45 | 83 | 83 |
|
Richard Law
1919 E Thomas Rd |
$278.94 | 101 | 101 |
|
Nathan Clarke Page
1920 E Cambridge Ave Ste 201 |
$257.50 | 101 | 101 |
|
Matthew Gropler
1919 E Thomas Rd |
$290.90 | 102 | 101 |
|
Stuart Hal Curtis
1920 E Cambridge Ave Ste 201 |
$291.14 | 102 | 102 |
|
Austin N Dehart
1920 E Cambridge Ave Ste 201 |
$271.51 | 163 | 158 |
|
Desert Ridge Outpatient Surgery Llc
20940 N Tatum Blvd |
$1,734 | 176 | 173 |
|
Patrick Scheffler
1920 E Cambridge Ave Ste 201 |
$275.14 | 189 | 187 |
|
Robert F Mancuso
1920 E Cambridge Ave Ste 201 |
$292.99 | 196 | 193 |
|
Christian Paquet
4400 N 32Nd St Ste 220 |
$223.72 | 242 | 217 |
|
Jeffrey M Taffet
4400 N 32Nd St |
$204.13 | 273 | 254 |
|
David J. Crockett
4545 E Chandler Blvd |
$290.14 | 296 | 291 |
|
Adrian Arya
4400 N 32Nd St |
$262.63 | 315 | 310 |
|
Sharon Hughes Gnagi
1920 E Cambridge Ave Ste 201 |
$269.69 | 321 | 310 |
|
David B Bowne
4400 N 32Nd St Ste 220 |
$207.98 | 324 | 291 |
|
John Tyler French
1010 E Mcdowell Rd Ste 200 |
$252.85 | 510 | 490 |
|
Brian Scott Rizzo
16841 N 31St Ave Bldg 2 |
$178.61 | 621 | 548 |
|
St. Joseph'S Outpatient Surgery Center, Llc
240 W Thomas Rd |
$1,476 | 3,184 | 3,062 |
|
Phoenix Children'S Hospital
1919 E Thomas Rd |
$3,309 | 6,555 | 6,459 |
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 Phoenix, AZ?
Based on public Medicaid payment data, the average Medicaid reimbursement for Tonsillectomy in Phoenix, AZ is $1,967 per claim, based on 14,090 claims from 25 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 Phoenix, AZ?
There are 25 Medicaid providers offering Tonsillectomy related services in Phoenix, AZ according to public payment data.
What is the price range for Tonsillectomy in Phoenix, AZ?
Medicaid reimbursement for Tonsillectomy in Phoenix, AZ ranges from $178.61 to $3,309 per claim, with an average of $1,967. 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
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
Alexandria, LA
Avg $282.37
8,774 claims · 5 providers
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Avg $10.65
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Avg $1.58
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Avg $123.66
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