How much does a tonsils and adenoids procedure cost?

Surgical removal of the tonsils and lymph nodes at the back of the throat (adenoids).

How much does a tonsils and adenoids procedure cost?

Hospital cover

1

Procedure costs

2

Specialists & hospitals

3

 Preparing for hospital

4

Planning your recovery

5

A tonsils and adenoids removal costs approximately: $3,708 - $4,761

These are approximate costs~ based on claims data by Medibank members with eligible+ hospital cover for a hospital admission at a Medibank Members' Choice Hospitals. They don’t include doctors’ fees and outpatient appointments where you aren’t admitted into hospital.

Out-of-pocket costs vary based on your cover, your specialists' fees and the hospital.

The chart below shows how costs are typically split between Medibank, Medicare and your out-of-pocket costs:

~ This graph was compiled using the median figure for Medibank cost, Medicare cost, Excess, and out-of-pocket costs based on data for eligible+ members.

+ The above costs for tonsils and adenoids reflect MBS item numbers 41793, 41789. Medibank pays benefits towards in-hospital medical services based on the MBS. 

For Medibank to pay benefits towards this procedure, your hospital cover must include Tonsils, Adenoids and Grommets as an Included or Restricted service. For Included services, we pay benefits towards the treatment, but you may still have some out-of-pocket costs. For Restricted services, we pay the minimum amount set by the government, which can mean higher out-of-pocket costs. You must also have served the relevant waiting period(s). Ask your specialist for the MBS item numbers that apply for your treatment. 

Important information

This is not a quote and should be used as a guide only. The graph above shows a median view of costs for procedures (according to Medicare Benefits Schedule (MBS) item numbers, Adjacent Diagnostic Related Groups (DRGs) or International Classification of Diseases (ICD)) undertaken by Medibank members with eligible hospital cover for a hospital admission at a Medibank Members’ Choice hospital, who have served the relevant waiting period claims, data received electronically (between 1/07/2023 and 30/6/2024) for Australian residents. 

Typical procedure cost is based on the middle half of claims data.

Out-of-pocket costs and how to reduce them

Whether you’ll pay any out-of-pocket costs depends on whether your treatment is Included, Restricted, or Excluded under your hospital cover.  

Ask your specialist/s if they’ll participate in GapCover for your procedure

The GapCover scheme is designed to help reduce or eliminate gap payments. Each specialist involved in your care (for example, your surgeon and your anaesthetist) can choose whether to use GapCover for your procedure, so ask your specialist/s about GapCover before you book your procedure.

Consider if a Members’ Choice hospital is right for you

You can generally get better value at a Members’ Choice hospital than a non-Members’ Choice hospital. We have arrangements with most private hospitals and day surgeries in Australia.

Check your cover

Get a personalised assessment on your upcoming hospital visit based on your admission details and what’s included in your cover by completing a hospital eligbility check. You’ll need the Medicare Benefits Schedule (MBS) item codes from your specialist. 

Don't have your codes? You can still check which procedures we pay benefits towards by viewing your cover summary in My Medibank.

Check my hospital eligibility
View my cover summary

Frequently asked questions

Questions to ask your specialist

Your specialist can answer questions based on your individual health needs, including what to expect before, during and after the procedure. 

Health Concierge

Health Concierge provides personalised, phone-based health support to help eligible Medibank members with hospital cover prepare for or recover from a hospital stay or treatment.1

Contact Health Concierge Monday to Friday 9am to 5pm AEST/AEDT, or schedule a call. 

Call 1800 789 414
Schedule a call

Now that you’ve covered

☑ Understanding hospital cover

☑ Out-of-pocket costs

☑ Procedure costs

 

You might like to explore

☐ Choosing specialists and hospitals

☐ Preparing for hospital

☐ Planning your recovery

 

Looking for something else?

Find more tools and information to support your hospital stay, from planning through to recovery.

Back to Going to hospital
Things you need to know

1 Excludes Overseas Visitor Health Cover, Working Visa Health Cover and Overseas Student Health Cover (OSHC).

While we hope you find this information helpful, please note that it is general in nature. It is not health advice, and is not tailored to meet your individual health needs. You should always consult a trusted health professional before making decisions about your health care. While we have prepared the information carefully, we can’t guarantee that it is accurate, complete or up-to-date. And while we may mention goods or services provided by others, we aren’t specifically endorsing them and can’t accept responsibility for them. For these reasons we are unable to accept responsibility for any loss that may be sustained from acting on this information (subject to applicable consumer guarantees).