Data Platform
Sign InTry for Free

CPT 42844 Fee Schedule

Last Verified: January 2026

Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.

Resect Tonsil Radical W Local Flap
Key FactDetail
Service Type

Surgery

Surgical Procedures on the Digestive System

Common Place of Service

21 - Inpatient Hospital

22 - On Campus Outpatient Hospital

Common Modifiers

None

51 - Multiple procedures

58 - Staged or related procedure during postoperative period

Complexity LevelHigh
Medicare Fee ScheduleView Medicare rates for 42844

National average reimbursement for CPT 42844 by major payers:

bcbs

$1,841.25

uhc

$1,820.60

aetna

$1,965.31

cigna

$2,272.09

Preview provider-level rates for...
For billing codeCPT 42844
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 42844

United
42844$3160.001235466863 - AESTHETIC ASSOCIATES INC., P.S, SEATTLE FACIAL PLASTIC SURGERY CENTER911650765 - (WA) AESTHETIC ASSOCIATES INC PSWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$642.001396192241 - ANDERSON ENDOSCOPY CENTER LLC811947476 - (OH) ANDERSON ENDOSCOPY CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$3085.001730463753 - PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETER201285759 - (GA) PEACHTREE ORTHOPAEDIC SURGERY CENTER AT PERIMETERGAAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$1167.001801457478 - DIALYSIS ACCESS CENTER, LLC834488032 - (OH) DIALYSIS ACCESS CENTER LLCOHAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$3001.001497746747 - PHYSICIANS' SURGERY CENTER OF VICTORVILLE LLC260057464 - (CA) PHYSICIANS SURGERY CENTER OF VICTORVILLE, LLCCAAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$1974.001093214819 - PREMIER SURGICAL CENTER, LLC823438730 - (MS) PREMIER SURGICAL CENTER LLCMSAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$2400.001437120953 - MONTGOMERY SURGERY CENTER LIMITED PARTNERSHIP521401868 - (MD) MONTGOMERY SURGERY CENTER LIMITED PARTNERSHIPMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$3646.001942231493 - TAYLOR STATION SURGICAL CENTER LTD311459910 - (OH) TAYLOR STATION SURGICAL CENTEROHAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$2734.001467783233 - SOUTH SOUND SURGERY, PLLC, AUBURN SURGICAL CENTER204413058 - (WA) SOUTH SOUND SURGERY PLLCWAAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$3600.001003870825 - PINELLAS SURGERY CENTER, LLC, CENTER FOR SPECIAL SURGERY752563226 - (FL) PINELLAS SURGERY CENTER LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$3027.001225091630 - GRAMERCY SURGERY CENTER, LTD752399524TXAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$2964.001467195057 - BONE AND JOINT SURGICAL SUITES, LLC872413013 - (FL) BONE AND JOINT SURGICAL SUITES LLCFLAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$5810.001154369114 - CHRISTUS SANTA ROSA PASC-SAN ANTONIO LLC, CHRISTUS SURGERY CENTER - ALAMO HEIGHTS412092141 - (TX) CHRISTUS SRPASC - SAN ANTONIO, LLCTXAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$6286.001659772648 - SURGICAL SPECIALTY CENTER OF MID ATLANTIC, LLC465727021 - (MD) SURGICAL SPECIALTY CENTER OF MID-ATLANTIC, LLCMDAmbulatory Surgical Clinic/Center (261QA1903X)
United
42844$1126.931265160881 - LISA KOOP350593390 - DEACONESS HOSPITAL INCINCertified Registered Nurse Anesthetist (367500000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

Want to see your competitors' rates?

Start your trial today to unlock complete access to provider rates and fee schedules in your area.

Here's what you can do with PayerPrice

Renegotiate your managed care contracts

Benchmark your current rates against market averages to identify opportunities for rate optimization.

Prospect for new business using fee schedules

Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.

Integrate real-time payer data into your workflows

Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.

PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.

CPT 42844 vs. Other Surgical Procedures on the Digestive System Codes

The CPT 42844 code is part of the Surgery services used for Surgical Procedures on the Digestive System. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.

The CPT 42844 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.

CodeComplexityDescription
42842-CPTHighRadical Resec Tonsil/Pillars/Trigone;Wo
42844-CPTHighResect Tonsil Radical W Local Flap
42845-CPTHighRadical Resec Tonsil,Etc;Closure W Other
42900-CPTModerateSuture Pharynx Wound/Injury

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 42844. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 42844 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.

Factors that affect fee schedules


Medicare & Medicaid Rates

Government-set reimbursement amounts


Private Insurance Rates

Negotiated rates between providers and insurance companies


Geographic Location

Costs may be higher in urban areas.


Provider Type

Hospital providers may have different rates than private practice.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 42844) and we'll show you how you compare in 15 minutes or less.