CPT 42280

Other Organ Systems

Current code35 hospitals with prices

This name is the CMS category the code belongs to (CMS's Restructured BETOS Classification System), shared with similar codes. The official CPT description belongs to the American Medical Association and isn't shown.

What Washington hospitals publish for this code

Medicaid managed care: Rate for an Apple Health managed-care plan. Applies only to members of that plan.

Prices for CPT 42280 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
Virginia Mason Medical CenterSeattle	—	$900	$1,764

Lowest and highest amounts each hospital lists for this code during a hospital stay, including lines it lists for both settings or without saying which. A doctor’s fee is shown separately when the hospital lists one with the code. “At least” means plans were counted in more than one group and some may be the same plan. This is one line of a bill; most care brings several.

Medicare (traditional) reference

Only for people on original Medicare. These are CMS’s 2026 amounts. They aren’t what private insurance or cash patients pay.

Doctor's fee, Seattle (King County): $215 in an office; $108 in a hospital or surgery center
Doctor's fee, rest of Washington: $191 in an office; $99.19 in a hospital or surgery center
Hospital outpatient payment (national): $551 (APC 5162)
Surgery center payment (national): $127