Tonsillectomies are common, fast, and highly shoppable. Most adults and older children have this procedure done at an ambulatory surgery center. Facility fees in Tampa range from $1,500 to $9,000 depending on where you go.
Adults vs. children have different risk profiles
Adult tonsillectomies carry a higher risk of post-operative bleeding than pediatric procedures. Some surgeons prefer to perform adult tonsillectomies in a hospital outpatient setting where overnight observation is available if needed.
For children under 3 or with sleep apnea, a hospital setting may be appropriate. For otherwise healthy older children and adults, ask your ENT whether an ASC is an option and what their specific reasoning is.
Adenoid removal is often billed as an add-on
If your child needs both tonsils and adenoids removed, the adenoidectomy is billed as a separate CPT code (42820 vs. 42821 for tonsils-only).
Confirm with your ENT exactly what codes they expect to use. The facility fee is higher when both procedures are performed.
The anesthesiologist bills separately
Anesthesia for tonsillectomy is billed based on base units plus time units, not as a flat fee. The anesthesiologist is a separate provider from the facility and surgeon.
Verify the anesthesiology group's network status before the procedure. For a common elective surgery like tonsillectomy, there is no reason to accept an out-of-network anesthesiologist if an in-network option is available at the same facility.