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APC CASE-42825

Tonsillectomy Primary/Secondary <Age 12

Reported by 10 hospitals in the network.

Filter by billing methodology

All methodologiesAggregated across all available billing methodologies for this code.Case rateCMS definition: a flat rate for a package of items and services triggered by a diagnosis, treatment, or condition for a designated length of time.Fee scheduleCMS definition: the payer-specific negotiated charge is based on a fee schedule — for example, a Medicare, Medicaid, commercial payer, or workers’ compensation fee schedule.Per diemCMS definition: the per day charge for providing hospital items and services.Percent of billed chargesCMS definition: the payer-specific negotiated charge is based on a percentage of the total billed charges for an item or service, which may vary depending on certain pre-determined criteria being met.OtherCMS definition: used when the standard charge methodology can’t be described by case rate, fee schedule, per diem, or percent of total billed charges.

National pricing summary

Low

$5.6k

Average

$5.7k

Median

$5.7k

High

$5.9k

Hospitals reporting this code

#HospitalLocation
1Mercy Health Youngstown LlcWarren, OH$5.6k$5.6k$5.6k$5.7k$39
2Mercy Health Youngstown LlcYoungstown, OH$5.6k$5.6k$5.6k$5.7k$49
3Mercy Health Lourdes Hospital LlcPaducah, KY$5.9k$5.9k$5.9k$6.0k$51
4Mercy Health Regional Medical Center LlcLorain, OH$5.6k$5.6k$5.6k$5.7k$39
5Mercy Health St Ritas Medical Center LlcLima, OH$5.9k$5.9k$5.9k$5.9k—
6Mercy Health Anderson Hospital LlcCincinnati, OH$5.8k$5.8k$5.8k$5.8k—
7Bon Secours St Francis Medical Center LlcMidlothian, VA$5.8k$5.8k$5.8k$5.8k—
8St Francis Hospital IncGreenville, SC$5.7k$5.7k$5.7k$5.7k$23
9St Francis Hospital IncGreenville, SC$5.7k$5.7k$5.7k$5.7k$26
10Mary Immaculate Hospital LlcNewport News, VA$5.8k$5.8k$5.8k$5.9k$54

Look up this code directly

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