Tonsil and/or Adenoid Removal
NYC Health and Hospitals - Bellevue
What goes into a price?
Prices across providers
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 42820 | Base Code | Tonsil and/or Adenoid Removal |
| HCPCS 42820 | Professional Fee | Tonsil and/or Adenoid Removal |
| RC 0710 | Facility Fee | Recovery Room - General |
| RC 0710 | Facility Fee | Recovery Room - General |
| RC 0710 | Facility Fee | Recovery Room - General |
| RC 0710 | Facility Fee | Recovery Room - General |
| RC 0710 | Facility Fee | Recovery Room - General |
| RC 0710 | Facility Fee | Recovery Room - General |
| RC 0710 | Facility Fee | Recovery Room - General |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| HCPCS J1100 | Facility Fee | Intramuscular injection of 1mg dexamethasone sodium phosphate |
| RC 0370 | Facility Fee | Anesthesia - General |
| RC 0370 | Facility Fee | Anesthesia - General |
| RC 0370 | Facility Fee | Anesthesia - General |
| RC 0370 | Facility Fee | Anesthesia - General |
| RC 0370 | Facility Fee | Anesthesia - General |
| RC 0370 | Facility Fee | Anesthesia - General |
| RC 0370 | Facility Fee | Anesthesia - General |
| RC 0360 | Facility Fee | Operating Room Services - General |
| RC 0360 | Facility Fee | Operating Room Services - General |
| RC 0360 | Facility Fee | Operating Room Services - General |
| RC 0360 | Facility Fee | Operating Room Services - General |
| RC 0360 | Facility Fee | Operating Room Services - General |
| RC 0360 | Facility Fee | Operating Room Services - General |
| RC 0360 | Facility Fee | Operating Room Services - General |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| HCPCS J2405 | Facility Fee | Intramuscular injection of ondansetron hydrochloride, 1mg |
| RC 0250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |
| RC 0250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |
| RC 0250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |
| RC 0250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |
| RC 0250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |
| RC 0250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |
| RC 0250 | Facility Fee | Pharmacy (Also see 063X, an extension of 250X) - General |
| RC 0636 | Facility Fee | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| RC 0636 | Facility Fee | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| RC 0636 | Facility Fee | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| RC 0636 | Facility Fee | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| RC 0636 | Facility Fee | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| RC 0636 | Facility Fee | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| RC 0636 | Facility Fee | Pharmacy - Extension of 025X - Drugs requiring detailed coding |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS J2704 | Facility Fee | Intramuscular injection of 10mg propofol |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS J3010 | Facility Fee | Intramuscular injection of fentanyl citrate, 0.1mg |
| HCPCS 00170 | Professional Fee | Intraoral Anesthesia for Biopsy, Unspecified |
| HCPCS 00170 | Professional Fee | Intraoral Anesthesia for Biopsy, Unspecified |
| HCPCS 00170 | Professional Fee | Intraoral Anesthesia for Biopsy, Unspecified |
| HCPCS 00170 | Professional Fee | Intraoral Anesthesia for Biopsy, Unspecified |
| 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 |
| RC 0272 | Facility Fee | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile |
| RC 0272 | Facility Fee | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile |
| RC 0272 | Facility Fee | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile |
| RC 0272 | Facility Fee | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile |
| RC 0272 | Facility Fee | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile |
| RC 0272 | Facility Fee | Medical/Surgical Supplies and Devices (Also see 062X, an extension of 027X) - Sterile |
| HCPCS 69436 | Professional Fee | Ventilating Tube Insertion via Tympanostomy Under General Anesthesia |
| HCPCS J7120 | Optional Fee | Intravenous infusion of 1000cc of ringer's lactate solution |
| HCPCS J7120 | Optional Fee | Intravenous infusion of 1000cc of ringer's lactate solution |