facebook tracking Level 3 ENT Procedures cost in Vermont: 5 hospitals compared (APC 5163)

Level 3 ENT Procedures in Vermont

What 5 hospitals in Vermont charged and were paid for level 3 ent procedures (APC 5163), from 2024 Medicare claims.

APC 5163 Outpatient 2024 Medicare data
Average charge $3,508 Hospital list price billed
Average allowed $723 Medicare's payment + patient's share
Medicare paid $418 Average per service
State rank #1 of 44 1 = lowest average payment

Hospitals in Vermont billed an average of $3,508 for level 3 ent procedures, about 4.9 times the average medicare-allowed amount of $723. That payment is 48% 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 $723Billed $3,508

About 21¢ was paid for every $1 hospitals in Vermont billed for this service.

Vermont hospitals: level 3 ent procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Fletcher Allen Hospital of VermontBurlington 59 $3,653 $749 $444
Rutland Regional Medical CenterRutland 12 $2,795 $596 $288
Central Vermont Medical CenterGraniteville-East Barre – – – –
Brattleboro Memorial HospitalBrattleboro – – – –
Northwestern Medical CenterSt Albans – – – –
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Level 3 ENT Procedures in other states

Questions

How much does level 3 ent procedures cost in Vermont?

In 2024 Medicare data, level 3 ent procedures (APC 5163) at 5 hospitals in Vermont was billed at $3,508 on average, while the average medicare-allowed amount was $723, of which Medicare paid $418. 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 Vermont, average charges were 4.9 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.