facebook tracking Level 3 ENT Procedures cost in Tennessee: 27 hospitals compared (APC 5163)

Level 3 ENT Procedures in Tennessee

What 27 hospitals in Tennessee charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.

APC 5163 Outpatient 2024 Medicare data
Average charge $8,377 Hospital list price billed
Average allowed $1,203 Medicare's payment + patient's share
Medicare paid $950 Average per service
State rank #9 of 44 1 = lowest average payment

Hospitals in Tennessee billed an average of $8,377 for level 3 ent procedures, about 7.0 times the average medicare-allowed amount of $1,203. That payment is 14% below the U.S. average of $1,397.

These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.

Paid $1,203Billed $8,377

About 14¢ was paid for every $1 hospitals in Tennessee billed for this service.

Tennessee hospitals: level 3 ent procedures

Every Tennessee hospital that billed Medicare for this service at least 11 times. Click a column to sort.

Hospital Services Avg charge Avg allowed Medicare paid
Vanderbilt University HospitalNashville 89 $8,458 $1,175 $925
Memorial Healthcare System, INCChattanooga 14 $9,241 $1,300 $1,036
Methodist Healthcare-MemphisMemphis 13 $6,887 $1,288 $1,025
Jackson-Madison Cnty Gen HospJackson – – – –
Sumner Regional Medical CenterGallatin – – – –
Skyline Medical CenterNashville – – – –
Cumberland Medical CenterCrossville – – – –
Blount Memorial HospitalMaryville – – – –
Univ of Tn Mem HospitalKnoxville – – – –
Morristown-Hamblen HospitalMorristown – – – –
Baptist Memorial HospitalMemphis – – – –
Greeneville Community HospitalGreeneville – – – –
St Mary's Jefferson Memorial HospitalJefferson City – – – –
Cookeville Regional Med CenterCookeville – – – –
Tristar Northcrest Medical CenterSpringfield – – – –
Maury Regional HospitalColumbia – – – –
Leconte Medical CenterSevierville – – – –
Sweetwater Hospital AssociationSweetwater – – – –
Erlanger Medical CenterChattanooga – – – –
Physicians Regional Medical CenterKnoxville – – – –
Fort Sanders Reg Medical CtrKnoxville – – – –
Regional One HealthMemphis – – – –
Centennial Medical CenterNashville – – – –
Franklin Woods Community HospitalJohnson City – – – –
Vanderbilt Wilson County HospitalLebanon – – – –
Hendersonville Medical CenterHendersonville – – – –
Southern Hills Medical CtrNashville – – – –
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Lowest and highest allowed amounts in Tennessee

Among hospitals with at least 11 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Lowest

Highest

Level 3 ENT Procedures in other states

Questions

How much does level 3 ent procedures cost in Tennessee?

In 2024 Medicare data, level 3 ent procedures (APC 5163) at 27 hospitals in Tennessee was billed at $8,377 on average, while the average medicare-allowed amount was $1,203, of which Medicare paid $950. Your own cost depends on your insurance, deductible and the hospital.

Why are hospital charges so much higher than payments?

Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this service in Tennessee, average charges were 7.0 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.

Source: CMS, Medicare Outpatient Hospitals by Provider and Service, 2024. The allowed amount is Medicare's payment plus the patient's coinsurance. CMS omits hospitals with fewer than 11 services for privacy. About the data.