Average Medicaid Tonsillectomy Payments in Tucson, AZ: $1,300
Avg. Paid
$1,300
Range
$264.51 – $3,765
Total Claims
5,213
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 Tucson, AZ
| Provider | Avg. Paid | Claims | Patients |
|---|---|---|---|
|
Carondelet St. Mary'S Northwest, Llc
2220 W Orange Grove Rd |
$1,589 | 2,301 | 2,217 |
|
David A Parry
1358 W. Orange Grove |
$271.07 | 1,322 | 1,295 |
|
Camp Lowell Surgery Center,Llc
4620 East Camp Lowell Drive |
$1,670 | 1,218 | 1,195 |
|
Banner - University Medical Center Tucson Campus Llc
1625 N Campbell Ave |
$3,765 | 167 | 163 |
|
Jonathan Skirko
1501 N Campbell Ave |
$282.57 | 113 | 112 |
|
Che Carrie Liu
3838 N Campbell Ave Bldg 2 |
$304.25 | 40 | 40 |
|
Tucson Medical Center
5301 E Grant Rd |
$3,079 | 15 | 14 |
|
Robert L. Dean
1358 W. Orange Grove |
$304.09 | 13 | 13 |
|
John B Chastain
2121 N Craycroft Rd Bldg 5 |
$301.15 | 12 | 12 |
|
Elias D. Stratigouleas
2121 N Craycroft Rd Bldg 5 |
$264.51 | 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 Tucson, AZ?
Based on public Medicaid payment data, the average Medicaid reimbursement for Tonsillectomy in Tucson, AZ is $1,300 per claim, based on 5,213 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 Tucson, AZ?
There are 10 Medicaid providers offering Tonsillectomy related services in Tucson, AZ according to public payment data.
What is the price range for Tonsillectomy in Tucson, AZ?
Medicaid reimbursement for Tonsillectomy in Tucson, AZ ranges from $264.51 to $3,765 per claim, with an average of $1,300. 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
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Avg $181.32
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Avg $16.59
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