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10035850Primary tonsillectomy, patient 12 years of age or older

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--Select Hospitals-- Advanced Spine Center of Wisconsin, LLC AdventHealth Durand Alexander Eye Surgery Center, LLC Ambulatory Surgery Center LLC Ambulatory Surgical Center of Stevens Point Amery Regional Medical Center Arthroscopic Surgery Center, LLC Ascension All Saints Hospital Ascension Calumet Hospital Ascension Columbia St. Mary's Hospital Milwaukee Ascension Columbia St. Mary's Hospital Ozaukee Ascension NE Wisconsin - Mercy Campus Ascension NE Wisconsin - St. Elizabeth Campus Ascension Sacred Heart Rehabilitation Hospital Ascension SE Wisconsin - Elmbook Campus Ascension SE Wisconsin Hospital - Franklin Campus Ascension SE Wisconsin Hospital - St. Joseph Campus Ascension St. Francis Hospital Ascension Wisconsin Hospital - Greenfield Ascension Wisconsin Hospital - Menomonee Falls Ascension Wisconsin Hospital - Waukesha Ascension Wisconsin Surgery Center - Mount Pleasant LLC Aspirus Divine Savior Hospital & Clinics Aspirus Eagle River Hospital Aspirus Langlade Hospital Aspirus Medford Hospital & Clinics, Inc Aspirus Merrill Hospital Aspirus Plover Hospital Aspirus Rhinelander Hospital Aspirus Riverview Hospital and Clinics, Inc Aspirus Stanley Hospital Aspirus Stevens Point Hospital Aspirus Tomahawk Hospital Aspirus Wausau Hospital Aurora Baycare Medical Center Aurora Lakeland Medical Center Aurora Medical Center - Bay Area Aurora Medical Center - Grafton Aurora Medical Center - Kenosha Aurora Medical Center - Mount Pleasant Aurora Medical Center - Oshkosh Aurora Medical Center - Sheboygan County Aurora Medical Center - Summit Aurora Medical Center - Washington County Aurora Medical Center Burlington Aurora Medical Center Manitowoc County Aurora Pleasant Prairie Ambulatory Surgery Center Aurora Psychiatric Hospital Aurora Sinai Medical Center Aurora St Luke's Medical Center Aurora St. Luke's South Shore Aurora Surgery Center, LLC Aurora Surgery Center, LLC - Germantown Aurora West Allis Medical Center BayCare Aurora Kaukauna Surgery Center Bellin Health Marinette Surgery Center Bellin Health Oconto Hospital Bellin Hospital Bellin Psychiatric Center Beloit Health System BJOSC at Plover BJOSC LLC Westwood BJOSC, LLC Black River Memorial Hospital Bluemound Surgery Center Burnett Medical Center Center for Aesthetic and Plastic Surgery Center for Digestive Health Children's Wisconsin-Fox Valley Hospital Children's Wisconsin-Milwaukee Hospital Clement J. Zablocki VA Medical Center Crossing Rivers Health Cumberland Healthcare Door County Medical Center Drexel Town Square Surgery Center LLC East Mequon Surgery Center, LLC EC Laser and Surgery Institute of WI, LLC Edgerton Hospital and Health Services Eye Surgery Center of Wisconsin, LLC Fort HealthCare Froedtert Bluemound Rehabilitation Hospital Froedtert Community Hospital - Mequon Froedtert Community Hospital - New Berlin Froedtert Community Hospital - Oak Creek Froedtert Community Hospital - Pewaukee Froedtert Holy Family Memorial Froedtert Hospital Froedtert Menomonee Falls Hospital Froedtert South – Froedtert Pleasant Prairie Froedtert Surgery Center, LLC Froedtert West Bend Hospital Gastrointestinal Associates Endoscopy Center LLC GastroIntestinal Associates Endoscopy Center LLC Geneva Surgical Suites, LLC GI Specialists, LLC d/b/a Moreland Endoscopy Center GLSD Medical LLC Granite Hills Hospital Grant Regional Health Center Gundersen Boscobel Area Hospital and Clinics Gundersen Lutheran Medical Center Gundersen Moundview Hospital and Clinics Gundersen St Joseph's Hospital and Clinics Gundersen Tri-County Hospital and Clinics Heart & Vascular Institute, LLC Howard Young Medical Center Hudson Hospital & Clinics Independent Surgery Center, LLC Indianhead Medical Center/Shell Lake Kenosha Digestive Health Center Lake Country Endoscopy Center LLC Lakeview Specialty Hospital & Rehab Madison Surgery Center, Inc. Marshfield Clinic - Wausau Center ASC Marshfield Medical Center Marshfield Medical Center – Beaver Dam Marshfield Medical Center - Eau Claire Marshfield Medical Center - Ladysmith Marshfield Medical Center - Minocqua Marshfield Medical Center - Neilsville Marshfield Medical Center - Park Falls Marshfield Medical Center - Rice Lake Marshfield Medical Center - Weston Marshfield Medical Center-River Region at Stevens Point Mayfair Digestive Health Center LLC Mayo Clinic Health System – Chippewa Valley in Bloomer Mayo Clinic Health System - Eau Claire Mayo Clinic Health System - La Crosse Mayo Clinic Health System – Northland in Barron Mayo Clinic Health System – Oakridge in Osseo Mayo Clinic Health System - Red Cedar in Menomonie Mayo Clinic Health System - Sparta Memorial Hospital of Lafayette Co. Menomonee Falls ASC Mercyhealth Hospital and Medical Center - Walworth Mercyhealth Hospital and Trauma Center - Janesville Metropolitan Medical Center Midwest Nephrology Associates Surgery Center Midwest Orthopedic Specialty Hospital Mile Bluff Medical Center Milwaukee Rehabilitation Hospital at Greenfield Milwaukee Surgical Suites, LLC Miramont Behavioral Health Monroe Clinic Neurospine and Endovascular Center LLC New Berlin Medical Services, LLC Niagara Health Center North Central Health Care North Shore Surgical Suites, LLC Northwest Surgery Center Northwoods Surgery Center NovaMed Surgery Center of Madison LLP OakLeaf Surgical Hospital Orthopaedic Hospital of Wisconsin Orthopedic & Sports Surgery Center Orthopedic Surgery Center of Green Bay Orthopedic Surgery Center of the Fox Valley Osceola Medical Center Pain Centers of Wisconsin - Fort Atkinson Pine Ridge Surgery Center Pinnacle Cataract & Laser Institute LLC PMTC Surgery Center, Inc. Prairie Ridge Health ProHealth Care Moreland Surgery Center ProHealth Care Waukesha Memorial Hospital - Mukwonago ProHealth Oconomowoc Memorial Hospital ProHealth Rehabilitation Hospital of Wisconsin ProHealth Waukesha Memorial Hospital Racine Digestive Health Center Reedsburg Area Medical Center Ripon Medical Center River Falls Area Hospital Rogers Memorial Hospital - Oconomowoc Sacred Heart Hospital Sauk Prairie Healthcare Select Specialty Hospital Select Specialty Hospital - Milwaukee - St. Francis Select Specialty Hospital - West Allis Southern Lakes Endoscopy LLC Southwest Health Spine Solutions of Green Bay, LLC Spine Solutions of Sheboygan, LLC Spine Solutions of West Bend, LLC Spooner Health SSM Health Davis Duehr Surgery Center SSM Health Surgery and Care Center St Agnes Hospital - Fond du Lac St Clare Hospital & Health Services St Clare Memorial Hospital St Joseph's Hospital St Mary's Hospital St Mary's Hospital Medical Center St Mary's Hospital of Superior St Mary's Janesville Hospital St Nicholas Hospital St Vincent Hospital St. Croix Health Stoughton Hospital Association Surgery Center of Wisconsin Rapids SurgiCenter of Greater Milwaukee Tamarack Health Ashland Medical Center Tamarack Health Hayward Medical Center The Orthopaedic Surgery Center LLC The Richland Hospital Inc The Surgery Center, LLC ThedaCare Medical Center - Berlin, Inc. ThedaCare Medical Center - New London ThedaCare Medical Center - Shawano ThedaCare Medical Center - Waupaca ThedaCare Medical Center - Wild Rose ThedaCare Medical Center Orthopedics, Spine and Pain ThedaCare Regional Medical Center - Appleton, Inc. ThedaCare Regional Medical Center - Neenah Tomah Health Tomah VA Medical Center Tower Clock Surgery Center Transformations Surgery Center Inc UnityPoint Health - Meriter Upland Hills Health Inc UW Health Rehabilitation Hospital UW Hospitals and Clinics Authority Vascare Mayfair, LLC Vernon Memorial Hospital Watertown Regional Medical Center Waupun Memorial Hospital Wausau Surgery Center Wauwatosa Surgery Center West Bend Surgery Center Western Wisconsin Health Westfields Hospital & Clinic William S. Middleton Memorial Veterans Hospital Willow Creek Behavioral Health Wisconsin Digestive Health Center Wisconsin Institute of Surgical Excellence, LLC Wisconsin Laser and Surgery Center, LLC Wisconsin Specialty Surgery Center, LLC Wisconsin Surgery Center LLC Woodland Surgery Center

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