{"procedure":{"code_type":"CPT","code":"42975","lay_name":"Sleep endoscopy of the airway under sedation","blurb":"A flexible scope exam of the soft palate, throat, tongue base, and voice box while the patient is in medication-induced sleep, to find where the airway collapses during breathing.","slug":"cpt-42975-sleep-endoscopy-of-the-airway-under-sedation","description":"Dise Dyn Eval Sleep Disordered Breathing Flx Dx","name_source":"llm:claude-opus-5","name_reviewed":false,"ccs":{"code":"31","label":"Diagnostic procedures on nose, mouth and pharynx","surgery_flag":"neither"}},"settings":{"outpatient":{"setting":"outpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-25T01:10:45.071082Z","filing_date_min":"2023-03-09","filing_date_max":"2026-09-18","checked_from":"2026-09-05T02:07:09.005325Z","checked_through":"2026-09-25T01:13:17.894638Z","n_priced_setters":3956,"n_filed":612,"n_usable":562,"n_not_usable":1,"n_labelled":33,"n_no_cash":12,"n_estimated":4,"n_states":48,"cash_p10":177.45,"cash_p20":215.0,"cash_p25":252.06,"cash_p50":1120.0,"cash_p75":2883.9,"cash_p80":3721.39,"cash_p90":5419.0,"cash_mean_trimmed":1364.49,"gross_p50":1324.0,"cash_to_gross_p50":0.6,"medicare_rate":1818.45,"medicare_schedule":"opps","medicare_year":2026,"cash_to_medicare_p50":0.6159,"by_state":[{"state":"AK","n":2,"p20":null,"p50":null,"p80":null},{"state":"AL","n":5,"p20":null,"p50":null,"p80":null},{"state":"AR","n":8,"p20":null,"p50":null,"p80":null},{"state":"AZ","n":3,"p20":null,"p50":null,"p80":null},{"state":"CA","n":44,"p20":733.2,"p50":1120.0,"p80":1120.0},{"state":"CO","n":5,"p20":null,"p50":null,"p80":null},{"state":"CT","n":3,"p20":null,"p50":null,"p80":null},{"state":"DE","n":1,"p20":null,"p50":null,"p80":null},{"state":"FL","n":26,"p20":451.75,"p50":1156.8,"p80":3131.21},{"state":"GA","n":8,"p20":null,"p50":null,"p80":null},{"state":"HI","n":4,"p20":null,"p50":null,"p80":null},{"state":"IA","n":22,"p20":273.3,"p50":288.8,"p80":289.8},{"state":"ID","n":9,"p20":null,"p50":null,"p80":null},{"state":"IL","n":14,"p20":194.4,"p50":198.45,"p80":7427.35},{"state":"IN","n":7,"p20":null,"p50":null,"p80":null},{"state":"KS","n":6,"p20":null,"p50":null,"p80":null},{"state":"KY","n":4,"p20":null,"p50":null,"p80":null},{"state":"LA","n":7,"p20":null,"p50":null,"p80":null},{"state":"MA","n":4,"p20":null,"p50":null,"p80":null},{"state":"MD","n":1,"p20":null,"p50":null,"p80":null},{"state":"MI","n":31,"p20":119.3,"p50":187.2,"p80":2447.43},{"state":"MN","n":10,"p20":234.5,"p50":291.0,"p80":662.22},{"state":"MO","n":8,"p20":null,"p50":null,"p80":null},{"state":"MS","n":3,"p20":null,"p50":null,"p80":null},{"state":"MT","n":3,"p20":null,"p50":null,"p80":null},{"state":"NC","n":17,"p20":252.0,"p50":759.62,"p80":4224.25},{"state":"ND","n":2,"p20":null,"p50":null,"p80":null},{"state":"NE","n":17,"p20":348.0,"p50":1086.54,"p80":3100.5},{"state":"NH","n":5,"p20":null,"p50":null,"p80":null},{"state":"NJ","n":33,"p20":1910.4,"p50":2302.88,"p80":5419.0},{"state":"NM","n":1,"p20":null,"p50":null,"p80":null},{"state":"NV","n":3,"p20":null,"p50":null,"p80":null},{"state":"NY","n":39,"p20":1000.0,"p50":2040.67,"p80":4595.0},{"state":"OH","n":21,"p20":1869.12,"p50":4385.8,"p80":6120.96},{"state":"OK","n":15,"p20":202.07,"p50":202.07,"p80":2787.13},{"state":"OR","n":6,"p20":null,"p50":null,"p80":null},{"state":"PA","n":25,"p20":65.28,"p50":2102.88,"p80":3249.49},{"state":"SC","n":21,"p20":1600.5,"p50":2802.15,"p80":5387.48},{"state":"SD","n":1,"p20":null,"p50":null,"p80":null},{"state":"TN","n":10,"p20":61.48,"p50":114.48,"p80":1900.8},{"state":"TX","n":43,"p20":212.03,"p50":244.89,"p80":2348.04},{"state":"UT","n":3,"p20":null,"p50":null,"p80":null},{"state":"VA","n":11,"p20":1039.5,"p50":1247.4,"p80":7075.15},{"state":"VT","n":2,"p20":null,"p50":null,"p80":null},{"state":"WA","n":11,"p20":347.75,"p50":2727.4,"p80":3678.64},{"state":"WI","n":29,"p20":323.12,"p50":627.25,"p80":1329.3},{"state":"WV","n":6,"p20":null,"p50":null,"p80":null},{"state":"WY","n":3,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":486,"p20":244.89,"p50":1247.4,"p80":3986.0},{"key":"childrens","n":10,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":65,"p20":198.45,"p50":323.12,"p80":1850.0}],"ownership":[{"key":"for_profit","n":64,"p20":202.07,"p50":1335.47,"p80":5135.55},{"key":"government","n":67,"p20":224.0,"p50":1324.4,"p80":2831.5},{"key":"nonprofit","n":430,"p20":212.03,"p50":1120.0,"p80":3868.59}],"affiliation":[{"key":"affiliated","n":485,"p20":212.03,"p50":1120.0,"p80":3786.0},{"key":"independent","n":77,"p20":252.0,"p50":1445.4,"p80":3033.22}]},"histogram":[{"lo":119.3,"hi":180.39,"n":37},{"lo":180.39,"hi":272.76,"n":83},{"lo":272.76,"hi":412.43,"n":52},{"lo":412.43,"hi":623.61,"n":11},{"lo":623.61,"hi":942.94,"n":48},{"lo":942.94,"hi":1425.78,"n":56},{"lo":1425.78,"hi":2155.86,"n":61},{"lo":2155.86,"hi":3259.78,"n":63},{"lo":3259.78,"hi":4928.98,"n":55},{"lo":4928.98,"hi":7452.9,"n":43}],"previous":null},"inpatient":{"setting":"inpatient","computed_at":"2026-09-25T11:55:12.319193Z","corpus_loaded_through":"2026-09-23T22:20:23.317834Z","filing_date_min":"2024-11-12","filing_date_max":"2026-09-15","checked_from":"2026-09-05T02:07:09.005325Z","checked_through":"2026-09-25T01:13:17.894638Z","n_priced_setters":3956,"n_filed":343,"n_usable":326,"n_not_usable":0,"n_labelled":7,"n_no_cash":10,"n_estimated":0,"n_states":42,"cash_p10":148.32,"cash_p20":198.45,"cash_p25":209.5,"cash_p50":627.25,"cash_p75":1156.8,"cash_p80":1900.8,"cash_p90":2849.02,"cash_mean_trimmed":626.99,"gross_p50":965.0,"cash_to_gross_p50":0.6,"medicare_rate":null,"medicare_schedule":null,"medicare_year":null,"cash_to_medicare_p50":null,"by_state":[{"state":"AL","n":2,"p20":null,"p50":null,"p80":null},{"state":"CA","n":39,"p20":733.2,"p50":1120.0,"p80":1120.0},{"state":"CO","n":3,"p20":null,"p50":null,"p80":null},{"state":"CT","n":1,"p20":null,"p50":null,"p80":null},{"state":"DE","n":1,"p20":null,"p50":null,"p80":null},{"state":"FL","n":14,"p20":432.25,"p50":1156.8,"p80":1156.8},{"state":"GA","n":6,"p20":null,"p50":null,"p80":null},{"state":"HI","n":3,"p20":null,"p50":null,"p80":null},{"state":"IA","n":14,"p20":288.8,"p50":288.8,"p80":289.8},{"state":"ID","n":6,"p20":null,"p50":null,"p80":null},{"state":"IL","n":10,"p20":163.1,"p50":198.45,"p80":231.2},{"state":"IN","n":5,"p20":null,"p50":null,"p80":null},{"state":"KS","n":4,"p20":null,"p50":null,"p80":null},{"state":"KY","n":5,"p20":null,"p50":null,"p80":null},{"state":"LA","n":2,"p20":null,"p50":null,"p80":null},{"state":"MA","n":3,"p20":null,"p50":null,"p80":null},{"state":"MI","n":11,"p20":187.2,"p50":627.25,"p80":1662.06},{"state":"MN","n":8,"p20":null,"p50":null,"p80":null},{"state":"MO","n":2,"p20":null,"p50":null,"p80":null},{"state":"MS","n":1,"p20":null,"p50":null,"p80":null},{"state":"MT","n":2,"p20":null,"p50":null,"p80":null},{"state":"NC","n":11,"p20":252.0,"p50":759.62,"p80":4224.25},{"state":"ND","n":2,"p20":null,"p50":null,"p80":null},{"state":"NE","n":10,"p20":1007.95,"p50":1086.54,"p80":3035.5},{"state":"NH","n":5,"p20":null,"p50":null,"p80":null},{"state":"NJ","n":4,"p20":null,"p50":null,"p80":null},{"state":"NV","n":2,"p20":null,"p50":null,"p80":null},{"state":"NY","n":7,"p20":null,"p50":null,"p80":null},{"state":"OH","n":8,"p20":null,"p50":null,"p80":null},{"state":"OK","n":12,"p20":202.07,"p50":202.07,"p80":202.07},{"state":"OR","n":5,"p20":null,"p50":null,"p80":null},{"state":"PA","n":23,"p20":784.13,"p50":2052.32,"p80":2915.46},{"state":"SC","n":17,"p20":1600.5,"p50":2802.15,"p80":5387.48},{"state":"SD","n":1,"p20":null,"p50":null,"p80":null},{"state":"TN","n":9,"p20":null,"p50":null,"p80":null},{"state":"TX","n":36,"p20":212.03,"p50":244.89,"p80":275.5},{"state":"VA","n":5,"p20":null,"p50":null,"p80":null},{"state":"VT","n":3,"p20":null,"p50":null,"p80":null},{"state":"WA","n":7,"p20":null,"p50":null,"p80":null},{"state":"WI","n":12,"p20":627.25,"p50":627.25,"p80":627.25},{"state":"WV","n":3,"p20":null,"p50":null,"p80":null},{"state":"WY","n":2,"p20":null,"p50":null,"p80":null}],"by_segment":{"hospital_type":[{"key":"acute","n":281,"p20":198.45,"p50":627.25,"p80":1900.8},{"key":"childrens","n":5,"p20":null,"p50":null,"p80":null},{"key":"critical_access","n":39,"p20":198.45,"p50":627.25,"p80":2520.0}],"ownership":[{"key":"for_profit","n":33,"p20":198.45,"p50":244.89,"p80":1335.47},{"key":"government","n":34,"p20":187.2,"p50":404.0,"p80":1900.8},{"key":"nonprofit","n":258,"p20":202.07,"p50":627.25,"p80":1908.75}],"affiliation":[{"key":"affiliated","n":289,"p20":198.45,"p50":627.25,"p80":1827.0},{"key":"independent","n":37,"p20":163.1,"p50":333.0,"p80":2371.0}]},"histogram":[{"lo":108.15,"hi":156.03,"n":18},{"lo":156.03,"hi":225.1,"n":59},{"lo":225.1,"hi":324.75,"n":45},{"lo":324.75,"hi":468.51,"n":22},{"lo":468.51,"hi":675.91,"n":21},{"lo":675.91,"hi":975.13,"n":28},{"lo":975.13,"hi":1406.8,"n":42},{"lo":1406.8,"hi":2029.57,"n":16},{"lo":2029.57,"hi":2928.04,"n":31},{"lo":2928.04,"hi":4224.25,"n":13}],"previous":null}},"related":[{"code_type":"CPT","code":"92610","lay_name":"Bedside swallowing evaluation","slug":"cpt-92610-bedside-swallowing-evaluation"},{"code_type":"CPT","code":"92611","lay_name":"Swallowing study with moving X-ray recording","slug":"cpt-92611-swallowing-study-with-moving-x-ray-recording"},{"code_type":"CPT","code":"92612","lay_name":"Swallowing study with a flexible scope through the nose","slug":"cpt-92612-swallowing-study-with-a-flexible-scope-through-the-nose"},{"code_type":"CPT","code":"42400","lay_name":"Needle biopsy of a salivary gland","slug":"cpt-42400-needle-biopsy-of-a-salivary-gland"},{"code_type":"CPT","code":"92511","lay_name":"Scope exam of the nose and upper throat","slug":"cpt-92511-scope-exam-of-the-nose-and-upper-throat"},{"code_type":"CPT","code":"31231","lay_name":"Diagnostic nasal endoscopy, both sides","slug":"cpt-31231-diagnostic-nasal-endoscopy-both-sides"},{"code_type":"CPT","code":"31237","lay_name":"Nasal or sinus endoscopy with biopsy or tissue removal","slug":"cpt-31237-nasal-or-sinus-endoscopy-with-biopsy-or-tissue-removal"},{"code_type":"CPT","code":"40808","lay_name":"Biopsy of the lining inside the lip or cheek","slug":"cpt-40808-biopsy-of-the-lining-inside-the-lip-or-cheek"},{"code_type":"CPT","code":"41100","lay_name":"Biopsy of the front part of the tongue","slug":"cpt-41100-biopsy-of-the-front-part-of-the-tongue"},{"code_type":"CPT","code":"40490","lay_name":"Biopsy of the lip","slug":"cpt-40490-biopsy-of-the-lip"},{"code_type":"CPT","code":"42800","lay_name":"Biopsy of the back of the mouth and throat","slug":"cpt-42800-biopsy-of-the-back-of-the-mouth-and-throat"},{"code_type":"CPT","code":"30100","lay_name":"Biopsy of tissue inside the nose","slug":"cpt-30100-biopsy-of-tissue-inside-the-nose"}]}