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  4. /97-4

APR-DRG 97-4

TONSIL AND ADENOID PROCEDURES

Reported by 3 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

$32.0k

Average

$43.4k

Median

$41.9k

High

$56.2k

Hospitals reporting this code

#HospitalLocation
1Sanford Medical Center BismarckBismarck, ND$56.2k$56.2k$56.2k$56.2k—
2Albert Einstein Medical CenterPhiladelphia, PA$27.7k$41.9k$41.9k$48.6k$6.7k
3Einstein Medical Center MontgomeryEast Norriton, PA$21.2k$32.0k$32.0k$39.8k$5.1k

Look up this code directly

Ask Claude or any MCP client for APR-DRG 97-4 pricing at a specific hospital — see how to connect.

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