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APC CASE-42999

Unlisted Procedure Pharynx Adenoids/Tonsils

Reported by 2 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

$1.7k

Average

$2.6k

Median

$2.6k

High

$3.5k

Hospitals reporting this code

#HospitalLocation
1Mercy Health Youngstown LlcWarren, OH$3.5k$3.5k$3.5k$3.6k$25
2Mercy Health Youngstown LlcYoungstown, OH$1.7k$1.7k$1.7k$1.7k$15

Look up this code directly

Ask Claude or any MCP client for APC CASE-42999 pricing at a specific hospital — see how to connect.

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