# CPT 42830: Adenoidectomy alone, under age 12

Medicare 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.

Web page: https://www.med-reveal.com/rates/42830-cpt-fee-schedule
Section: Surgery and Procedures
Billed by: Otolaryngology

## Medicare rates

| | Amount |
| --- | --- |
| National non-facility | $195.40 |
| National facility | $195.40 |
| Conversion factor | 33.4009 |
| Release | 2026 Q4 (effective 2026-10-01) |

## By state

| State | Non-facility | Facility |
| --- | --- | --- |
| 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 | $187.60 | $187.60 |
| 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 |

## Related codes

- 40490: Biopsy of lip — https://www.med-reveal.com/rates/40490-cpt-fee-schedule
- 40650: Repair lip, vermilion only — https://www.med-reveal.com/rates/40650-cpt-fee-schedule
- 41010: Frenotomy, lingual — https://www.med-reveal.com/rates/41010-cpt-fee-schedule
- 41112: Excision of lesion of tongue — https://www.med-reveal.com/rates/41112-cpt-fee-schedule
- 41599: Unlisted procedure, tongue/floor of mouth — https://www.med-reveal.com/rates/41599-cpt-fee-schedule
- 42700: Incision and drainage of peritonsillar abscess — https://www.med-reveal.com/rates/42700-cpt-fee-schedule
- 42820: Tonsillectomy and adenoidectomy, under age 12 — https://www.med-reveal.com/rates/42820-cpt-fee-schedule
- 42821: Tonsillectomy and adenoidectomy, age 12 or over — https://www.med-reveal.com/rates/42821-cpt-fee-schedule

Commercial negotiated rates for 42830 by payer and state: https://www.med-reveal.com/solutions/rate-benchmarking

## Sources

- CMS Medicare fee schedules (2026 Q4): https://www.cms.gov/medicare/payment/fee-schedules