CPT 42809 at Cascade Medical Center

Other Organ Systems

Cascade Medical Center, Leavenworth

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 Cascade Medical Center publishes for this code: as an outpatient

Cascade Medical Center’s prices for CPT 42809, as an outpatient
Who pays	Hospital’s fee (lowest – highest)	Doctor’s fee the hospital lists
Commercial insuranceInsurer rates	$273 – $3562 plans	$273 – $436
Medicare AdvantageInsurer rates	$262 – $4757 plans	$133 – $582
Medicaid managed careInsurer rates	$261 – $4754 plans	$387 – $582
Medicaid (state program)Insurer rates	$251 – $3031 plan	$372
Medicare (traditional)Insurer rates	$271 – $3281 plan	$133
Other government programInsurer rates	$212 – $5072 plans	$212 – $621
UnknownInsurer rates	$273 – $5116 plans	$273 – $626
Cash pricePaying yourself, without insurance	$375 – $454	$557
List priceBefore any discount; few people pay it	$469 – $568	$696

Lowest and highest amounts Cascade Medical Center lists for this code as an outpatient, including lines it lists for both settings or without saying which. This is one line of a bill; most care brings several.

Bills to expect

The hospital’s fee is the price above. Doctors usually send their own bills. Their amounts here are what original Medicare allows in the rest of Washington for 2026, and a private-plan estimate of 118% to 179% of that (the range found across studies of what insurers pay doctors). Those are estimates, not quotes.

Bills to expect for CPT 42809 at Cascade Medical Center
Bill	What it’s for	Original Medicare allows	Private plan estimate
Hospital's feeThe hospital	The operating or procedure room, nursing, supplies and recovery	—	The price above
Surgeon or doctor doing itThe doctor's practice	The procedure, and routine follow-up visits for 10 days	$118	$139 – $211
AnesthesiaAn anesthesia group (only sometimes)	Anesthesia or deep sedation, if you need itOnly if an anesthesia team is part of your care. Its amount depends on how long it takes.	—	—

Original Medicare amounts are only for people on original Medicare. Your share depends on your plan’s deductible, copay and coinsurance.

Compare CPT 42809 at every Washington hospital, with Medicare’s reference amounts.