Medicaid Provider SpendingClaims paid 2018–2024 · HHS public file
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42820

Tonsillectomy and adenoidectomy; younger than age 12

Medicaid paid $500.23M on code 42820 from 2018 through 2024, to 1,327 providers — the #283 code in the file by dollars.

28Total paid$500.23M
24GClaims494,505
Paid per claim line$1K
33Providers billing it1,327
Box 32 · Location

Where 42820 is billed

  1. $46M
  2. $44M
  3. $43M
  4. $31M
  5. $28M
  6. $27M
  7. $27M
  8. $26M
  9. $22M
  10. $21M
  11. $17M
  12. $17M

The largest of 52 states and territories, by the billing provider's address. States cover different services and set their own rates, so the same code can mean different things in different programs.

Ranked

Top providers billing 42820

#ProviderLocationClaimsPaid on 42820
1 Phoenix Children's Hospital Phoenix, AZ 5,736 $20.14M
2 Yale New Haven Hospital New Haven, CT 3,124 $15.57M
3 Connecticut Children's Medical Center Hartford, CT 2,838 $14.46M
4 State of Mississippi - University of Mississippi Medical Center Jackson, MS 6,393 $14.18M
5 Vanderbilt University Medical Center Nashville, TN 4,255 $12.78M
6 VHS Childrens Hospital of Michigan INC Detroit, MI 4,376 $11.61M
7 Spectrum Health Hospitals Grand Rapids, MI 3,216 $8.44M
8 Texas Children's Hospital Houston, TX 3,241 $7.95M
9 Children's Hospital Corporation Boston, MA 3,109 $6.79M
10 Children's Hospital Washington, DC 2,399 $6.47M
11 Regents of the University of Michigan Ann Arbor, MI 2,371 $6.13M
12 Mcbride Clinic Orthopedic Hospital, LLC Oklahoma City, OK 1,513 $5.95M
13 Scottish Rite Children's Medical Center Atlanta, GA 4,947 $5.81M
14 Driscoll Childrens Hospital Corpus Christi, TX 1,234 $5.70M
15 Children's Hospital Medical Center Cincinnati, OH 5,082 $5.69M
16 Nationwide Children's Hospital Columbus, OH 4,572 $5.33M
17 Children's Hospital Medical Center of Akron Akron, OH 3,361 $5.20M
18 Multicare Health System Tacoma, WA 2,896 $4.93M
19 Seattle Children's Hospital Seattle, WA 2,890 $4.90M
20 Indiana University Health INC Indianapolis, IN 2,417 $4.88M
21 Ou Medicine INC. Oklahoma City, OK 1,260 $4.66M
22 Dayton Children's Hospital Dayton, OH 3,188 $4.62M
23 ST. Joseph's Outpatient Surgery Center, LLC Phoenix, AZ 2,677 $4.44M
24 Children's Health System of Texas Dallas, TX 1,438 $4.40M
25 Childrens Hospital of the Kings Daughters INC Norfolk, VA 2,191 $4.33M
26 North Mississippi Ambulatory Surgery Center LLC Tupelo, MS 2,560 $4.03M
27 Surgery Center of Peoria, LLC Peoria, AZ 2,334 $3.76M
28 Bronson Methodist Hospital Kalamazoo, MI 1,424 $3.69M
29 Carondelet ST. Mary's Northwest, LLC Tucson, AZ 2,270 $3.64M
30 University of Kentucky Lexington, KY 2,812 $3.45M
31 Lowery A. Woodall Outpatient Surgery Facility, LLC Hattiesburg, MS 2,316 $3.41M
32 Yuma Regional Medical Center Yuma, AZ 877 $3.33M
33 Outpatient Surgery Center of Jonesboro LLC Jonesboro, AR 1,959 $3.28M
34 STC Opco LLC Philadelphia, PA 1,097 $3.19M
35 Children's Hospital of Wisconsin, INC. Milwaukee, WI 4,113 $3.08M
36 Hurley Medical Center Flint, MI 1,202 $3.08M
37 Pediatric Surgery Centers, LLC Tampa, FL 2,758 $2.89M
38 Miami Children's Hospital Ambulatory Surgery Center, LLC Miami, FL 3,011 $2.79M
39 Children's West Surgery Center Knoxville, TN 3,305 $2.76M
40 Virginia Commonwealth University Health System Authority Richmond, VA 1,123 $2.75M
41 Montefiore Medical Center Bronx, NY 1,863 $2.73M
42 Mercy Hospital Springfield Springfield, MO 950 $2.71M
43 Children's Hospital Colorado Colorado Springs, CO 988 $2.65M
44 The Children's Hospital of Alabama Birmingham, AL 6,670 $2.62M
45 ST Lukes Regional Medical Center Boise, ID 979 $2.51M
46 Tulsa Spine & Specialty Hospital Tulsa, OK 651 $2.48M
47 Methodist Healthcare - Memphis Hospitals Memphis, TN 1,050 $2.37M
48 Kaleida Health Buffalo, NY 1,704 $2.31M
49 Physicians Surgical Center LLC Moore, OK 1,192 $2.24M
50 Egleston Children's Hospital at Emory University, INC. Atlanta, GA 1,386 $2.22M
51 Massachusetts Eye and Ear Infirmary Boston, MA 1,445 $2.22M
52 The Nemours Foundation Orlando, FL 1,431 $2.22M
53 Christus Santa Rosa Health Care Corporation San Antonio, TX 664 $2.17M
54 Childrens Hospital of Philadelphia Philadelphia, PA 989 $2.15M
55 Great Lakes Surgical Center LLC Southfield, MI 1,763 $2.11M
56 University of Texas Medical Branch at Galveston Galveston, TX 451 $2.09M
57 Robert Wood Johnson University Hospital, INC New Brunswick, NJ 1,165 $2.06M
58 Camp Lowell Surgery Center,llc Tucson, AZ 1,218 $2.03M
59 Pediatric Surgery Center -Odessa, LLC Odessa, FL 2,064 $2.01M
60 Arkansas Otolaryngology Center, P.A. Little Rock, AR 1,394 $1.92M
61 William Beaumont Hospital Royal Oak, MI 709 $1.88M
62 Longview Medical Center LP Longview, TX 607 $1.85M
63 University of Rochester Rochester, NY 1,270 $1.83M
64 Southern Baptist Hospital of Florida, INC Jacksonville, FL 636 $1.80M
65 Rector & Visitors of the University of Virginia Charlottesville, VA 622 $1.79M
66 Vanderbilt University Medical Center Nashville, TN 6,088 $1.78M
67 Norton Hospitals INC Louisville, KY 1,235 $1.75M
68 Westchester County Health Care Corporation Valhalla, NY 1,007 $1.75M
69 Unm Hospital Albuquerque, NM 1,154 $1.73M
70 Children's Health System of Texas Plano, TX 543 $1.71M
71 Surgical Elite of Avondale, LLC Avondale, AZ 1,086 $1.71M
72 The New York and Presbyterian Hospital New York, NY 916 $1.67M
73 Arkansas Childrens Hospital Little Rock, AR 4,295 $1.66M
74 Mymichigan Medical Center Midland Midland, MI 608 $1.65M
75 Yakima Valley Memorial Hospital Association Yakima, WA 948 $1.61M
76 Southern Baptist Hospital of Florida INC Jacksonville, FL 1,959 $1.61M
77 Summit Medical Center Edmond, OK 514 $1.60M
78 The Children's Hospital of Alabama Birmingham, AL 3,897 $1.55M
79 Shands Teaching Hospital and Clinics INC Gainesville, FL 1,454 $1.49M
80 Valley Children's Hospital Madera, CA 3,478 $1.44M
81 River Road Surgery Center LLC Salem, OR 916 $1.43M
82 Tennessee Ear, Nose & Throat Consultants, PC Knoxville, TN 5,934 $1.43M
83 Saint Francis Hospital Muskogee INC Muskogee, OK 398 $1.42M
84 Yellowstone Surgery Center, LLC Billings, MT 637 $1.42M
85 Texas Health Huguley, INC. Burleson, TX 421 $1.41M
86 ST. Vincent Hospital & Health Care Center, INC. Indianapolis, IN 614 $1.41M
87 Banner Mesa Surgery Center LLC Mesa, AZ 839 $1.41M
88 Multicare Health System Tacoma, WA 762 $1.39M
89 Albany Medical Center Hospital Albany, NY 715 $1.37M
90 Stillwater Medical Center Authority Stillwater, OK 392 $1.36M
91 Newark Beth Israel Medical Center INC Newark, NJ 843 $1.35M
92 HMH Hospitals Corporation Hackensack, NJ 501 $1.33M
93 The Milton S Hershey Medical Center Hershey, PA 173 $1.29M
94 The Children's Mercy Hospital Kansas City, MO 256 $1.27M
95 Texas Children's Physician Group Houston, TX 4,175 $1.26M
96 The Cleveland Clinic Foundation Cleveland, OH 996 $1.25M
97 Phoebe Putney Memorial Hospital INC Albany, GA 1,027 $1.25M
98 Floyd Healthcare Management INC Rome, GA 665 $1.23M
99 Pediatric Otolaryngology Head and Neck Surgeyr Assoc. PA St Petersburg, FL 6,808 $1.20M
100 Umass Memorial Medical Center, INC. Worcester, MA 654 $1.20M