CPT 42830

Adenoidectomy Primary <Age 12

CPT 42830 pays $195.40 in a non-facility setting and $195.40 in a facility setting under the 2026 Medicare Physician Fee Schedule, before geographic adjustment. After geographic adjustment, state amounts run from $175.63 in Arkansas to $239.06 in Alaska, a 36% spread.

National non-facility rate

$195.40

Office and other outpatient settings

Facility rate
$195.40

Hospital and ASC settings

Highest state
$239.06

Alaska

Lowest state
$175.63

Arkansas · 36% spread

Medicare rate by state

53 Medicare jurisdictions, highest to lowest. State values average every locality in the jurisdiction at a 33.4009 conversion factor.

Non-facilityFacilityNational $195.40
CPT 42830 Medicare reimbursement rate by state, 33.4009 conversion factor, 2026 Physician Fee Schedule. National non-facility $195.40, national facility $195.40.
StateRate compared visuallyNon-facilityFacility
Alaska
$239.06$239.06
District of Columbia
$218.67$218.67
New York
$215.20$215.20
New Jersey
$213.04$213.04
California
$210.37$210.37
Washington
$208.95$208.95
Massachusetts
$207.79$207.79
Florida
$207.73$207.73
Connecticut
$207.22$207.22
Illinois
$204.00$204.00
Hawaii
$203.28$203.28
Maryland
$201.60$201.60
Colorado
$199.83$199.83
Rhode Island
$198.85$198.85
New Hampshire
$197.77$197.77
Oregon
$197.74$197.74
Puerto Rico
$196.27$196.27
Virgin Islands
$196.27$196.27
Montana
$195.37$195.37
Pennsylvania
$195.07$195.07
Michigan
$194.68$194.68
Georgia
$193.58$193.58
Texas
$193.47$193.47
Delaware
$193.39$193.39
Nevada
$193.37$193.37
Wyoming
$192.10$192.10
Arizona
$190.58$190.58
Virginia
$190.02$190.02
New Mexico
$189.93$189.93
Minnesota
$189.26$189.26
Utah
$188.31$188.31
West Virginia
$188.22$188.22
Vermont
$188.16$188.16
North Dakota
$187.86$187.86
Louisiana
$187.59$187.59
Missouri
$187.25$187.25
Ohio
$187.10$187.10
South Dakota
$186.97$186.97
Maine
$186.36$186.36
South Carolina
$186.16$186.16
North Carolina
$184.35$184.35
Kentucky
$183.60$183.60
Wisconsin
$182.56$182.56
Oklahoma
$182.24$182.24
Indiana
$181.82$181.82
Idaho
$180.98$180.98
Tennessee
$180.73$180.73
Nebraska
$180.07$180.07
Kansas
$179.83$179.83
Iowa
$179.54$179.54
Mississippi
$178.67$178.67
Alabama
$177.82$177.82
Arkansas
$175.63$175.63

Billed by 1 specialties

Commercial rates for 42830

Medicare is the floor, not the market. See what UHC, Aetna, Cigna and BCBS actually pay — down to the TIN.

See negotiated rates