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Package

Tonsil and/or Adenoid Removal

Package

Tonsil and/or Adenoid Removal

Tonsil removal, also known as a tonsillectomy, is a surgical procedure to remove the tonsils. The tonsils are two small, oval-shaped tissues located at the back of the throat, one on each side. They are part of the body’s immune system and help fight infections by trapping bacteria and viruses. However, the tonsils can sometimes become problematic, leading to frequent infections, breathing difficulties, or other complications. Tonsillectomy is typically performed when these issues cause significant discomfort or health problems.


The most common reason for tonsil removal is recurrent tonsillitis, an inflammation of the tonsils often caused by infections. Tonsillitis can cause symptoms such as sore throat, difficulty swallowing, swollen tonsils, and fever. If someone experiences frequent bouts of tonsillitis—especially more than 5–7 episodes per year—doctors may recommend removing the tonsils to prevent future infections.


Tonsillectomy may also be performed for other reasons. Enlarged tonsils can obstruct the airway, causing sleep problems such as snoring or sleep apnea, a condition where breathing temporarily stops during sleep. Removing the tonsils can help open the airway and improve sleep quality. In rare cases, tonsil removal may be necessary if there is concern about abnormal growths or tumors in the tonsils.


There are several techniques for removing the tonsils, and the choice of method depends on the patient’s specific situation and the surgeon’s preference. The traditional method involves using a scalpel, while modern techniques may use heat (cauterization), radiofrequency, or a specialized tool called a microdebrider to remove the tissue. Regardless of the method, the goal is the same: to completely remove the tonsils.


After the procedure, patients may experience a sore throat for several days as the area heals. Discomfort with swallowing and eating is common during recovery, which typically takes 10–14 days. Patients are usually advised to eat soft foods and drink plenty of fluids. Ice chips, popsicles, and cold liquids are often recommended to soothe the throat.

Tonsillectomy is generally a safe procedure, but as with any surgery, it carries risks. The most common risks include bleeding, infection, and dehydration if throat pain makes drinking fluids difficult. Rarely, more serious complications, such as breathing difficulties, can occur. However, for most patients, the benefits of removing problematic tonsils far outweigh the risks. Many experience significant improvements in quality of life, particularly if they suffered from frequent infections or sleep issues before the procedure.


In some cases, the adenoids—another part of the immune system located higher in the throat—may also be removed in a procedure called an adenoidectomy. This is often done when the adenoids are enlarged or contributing to breathing problems. When both the tonsils and adenoids are removed, the procedure is called a tonsillectomy with adenoidectomy, a common approach for children with frequent infections or sleep apnea.


By removing the tonsils, patients can expect fewer throat infections, improved breathing during sleep, and relief from symptoms such as sore throats, fevers, and swollen glands.

Memorial Sloan Kettering Cancer Center

1275 York Avenue, New York, NY 10065
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Nearest station
72 St
7 minute walk
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Up to
$1,785 / Case Rate

A single, all-inclusive pricing methodology for a procedure in health care contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

Memorial Sloan Kettering Cancer Center
$1,785

Without insurance

What goes into a price?

Prices across providers

This provider
$1,785
Lowest
$896
Highest
$6,391

Self pay or cash prices vary by provider when paying out of pocket without insurance benefits. The chart shows you how the lowest and highest amounts providers charge for this service if you were paying without insurance benefits. If you're uninsured or not submitting a claim to insurance, you also have the right to a Good Faith Estimate under federal law. Contact the provider for a copy of your Good Faith Estimate or to better understand payment options available to you.

Procedures included in this package

This list includes the services and fees bundled into the Tonsil and/or Adenoid Removal Standard Service Package (SSP EN004). The final price for the procedure will depend on which services your provider ultimately performs, your insurance plan and your medical benefits.

Code Code Type Description
HCPCS 42830 Base Code Tonsil and/or Adenoid Removal
HCPCS 42830 Professional Fee Tonsil and/or Adenoid Removal
RC 0710 Facility Fee Recovery Room - General
RC 0370 Facility Fee Anesthesia - General
RC 0360 Facility Fee Operating Room Services - General
RC 0250 Facility Fee Pharmacy (Also see 063X, an extension of 250X) - General
HCPCS J1100 Facility Fee Intramuscular injection of 1mg dexamethasone sodium phosphate
HCPCS J2405 Facility Fee Intramuscular injection of ondansetron hydrochloride, 1mg
RC 0636 Facility Fee Pharmacy - Extension of 025X - Drugs requiring detailed coding
HCPCS J2704 Facility Fee Intramuscular injection of 10mg propofol
HCPCS J3010 Facility Fee Intramuscular injection of fentanyl citrate, 0.1mg
HCPCS 00170 Professional Fee Intraoral Anesthesia for Biopsy, Unspecified
RC 0272 Facility Fee Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile

Disclaimer

The NYC Health Department is committed to empowering New York City residents and employees to make informed health care decisions. This tool offers personalized estimates for common health services, providing a clearer picture of potential costs before your visit.

Your final out-of-pocket cost may vary based on your insurance coverage, any discounts, and the specific care you receive. Contact the provider directly to verify your estimate.

Up to
$1,785 / Case Rate

A single, all-inclusive pricing methodology for a procedure in health care contracts, instead of separate charges for each service.

The estimated total cost of care without any insurance coverage or discounts.

Memorial Sloan Kettering Cancer Center

Disclaimer

The NYC Health Department is committed to empowering New York City residents and employees to make informed health care decisions. This tool offers personalized estimates for common health services, providing a clearer picture of potential costs before your visit.

Your final out-of-pocket cost may vary based on your insurance coverage, any discounts, and the specific care you receive. Contact the provider directly to verify your estimate.

What’s the difference between an individual procedure and a Standard Service Package (SSP)?

Individual Procedure

Individual procedures, like blood tests, each have unique prices and billing codes (like a CPT or HCPCS code). While they can be billed alone, they're usually grouped with other procedures on a claim. This grouping is what determines the total cost of your care.

Standard Service Package (SSP)

Turquoise Health has developed SSPs which combine multiple medical services, materials, and fees associated with a health care visit or procedure into a single bundle to offer a more comprehensive estimate. SSPs are designed based on how health care procedures are commonly billed on claims. When discussing estimates with healthcare providers, you can refer to the individual codes listed in the 'Procedures included in this package' section of the tool.

Contact provider to verify your estimate

Have your service name, codes, and payment preference ready. If you’re using insurance, you may be asked for insurance details like your Member or Group ID.

Service Tonsil and/or Adenoid Removal
Service Codes HCPCS 42830, Revenue Code 0710, Revenue Code 0370, Revenue Code 0360, Revenue Code 0250
Insurance I'm not using insurance
Provider Memorial Sloan Kettering Cancer Center
When you contact them, you can say:
"Hi, I'm calling to verify a price for Tonsil and/or Adenoid Removal I found through NYC Health Department's price estimate tool. Here are the codes I’m looking at: HCPCS 42830, Revenue Code 0710, Revenue Code 0370, Revenue Code 0360, Revenue Code 0250. I'm not using insurance, can you confirm the cash pay estimate and help me schedule if needed?"