CPT 42972

Other Organ Systems

Current code36 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 42972 by hospital
Hospital	Medicaid managed care rates (lowest – highest)	Cash price	List price (before discounts)
Coulee Medical CenterGrand Coulee	—	$4,819	$5,354
Legacy Salmon Creek Medical CenterVancouverFile dated 2026-04-01	—	$933	$1,436
Virginia Mason Medical CenterSeattle	—	$3,306	$6,483

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): $487 in a hospital or surgery center
Doctor's fee, rest of Washington: $448 in a hospital or surgery center
Hospital outpatient payment (national): $3,387 (APC 5164)
Surgery center payment (national): $1,481