facebook tracking Level 4 ENT Procedures cost in California: 149 hospitals compared (APC 5164)

Level 4 ENT Procedures in California

What 149 hospitals in California charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.

APC 5164 Outpatient 2024 Medicare data
Average charge $32,769 Hospital list price billed
Average allowed $3,847 Medicare's payment + patient's share
Medicare paid $3,060 Average per service
State rank #48 of 48 1 = lowest average payment

Hospitals in California billed an average of $32,769 for level 4 ent procedures, about 8.5 times the average medicare-allowed amount of $3,847. That payment is 37% above the U.S. average of $2,798.

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 $3,847Billed $32,769

About 12¢ was paid for every $1 hospitals in California billed for this service.

California hospitals: level 4 ent procedures

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

Hospital Services Avg charge Avg allowed Medicare paid
Santa Monica - UCLA Med Ctr & Orthopaedic HospitalSanta Monica 129 $13,576 $3,958 $3,153
Stanford HospitalPalo Alto 118 $63,271 $3,573 $2,847
USC University HospitalLos Angeles 72 $21,442 $3,915 $3,110
UCSF Medical CenterSan Francisco 66 $37,316 $4,479 $3,555
UCI Health-OrangeOrange 53 $19,406 $3,831 $3,053
University of California Davis Medical CenterSacramento 47 $44,368 $4,013 $3,197
UCLA Medical CenterLos Angeles 39 $26,672 $3,958 $3,149
Santa Barbara Cottage HospitalSanta Barbara 34 $18,714 $4,240 $3,371
Sonora Community HospitalSonora 31 $21,323 $4,239 $3,378
University of California San Diego Medical CenterSan Diego 30 $30,138 $3,892 $3,098
Community Regional Medical CenterFresno 29 $15,401 $1,501 $1,196
Highland HospitalOakland 26 $20,721 $2,923 $2,322
Orange County Global Medical CenterSanta Ana 24 $29,052 $3,958 $3,153
Sharp Memorial HospitalSan Diego 21 $38,559 $3,958 $3,154
Enloe Medical CenterChico 19 $32,303 $3,799 $2,988
Loma Linda University Medical CenterLoma Linda 18 $58,168 $3,959 $3,144
Scripps Green HospitalLa Jolla 15 $47,455 $3,958 $3,154
Cedars-Sinai Medical CenterLos Angeles 14 $105,388 $3,958 $3,149
San Francisco General HospitalSan Francisco 13 $36,449 $4,248 $3,385
Saint John's Health CenterSanta Monica 12 $16,008 $3,958 $3,154
Kern Medical CenterBakersfield 12 $16,922 $3,882 $3,088
Oroville HospitalOroville 11 $11,467 $3,958 $3,154
City of Hope Natl Medical CtrDuarte 11 $39,951 $3,958 $3,145
Santa Rosa Memorial HospitalSanta Rosa 11 $54,317 $4,509 $3,593
Memorial Medical CenterModesto 11 $18,796 $3,672 $2,867
Shasta Regional Medical CenterRedding 11 $52,670 $3,958 $3,154
St Joseph HospitalEureka – – – –
Peninsula Medical CenterBurlingame – – – –
Queen of the Valley Medical CenterNapa – – – –
Mercy General HospitalSacramento – – – –
Riverside Community HospitalRiverside – – – –
Grossmont HospitalLa Mesa – – – –
Bakersfield Memorial HospitalBakersfield – – – –
Santa Clara Valley Medical CenterSan Jose – – – –
Lac/Olive View-UCLA Medical CenterSylmar – – – –
California Pacific Medical Ctr-Pacific Campus HospSan Francisco – – – –
California Pacific Medical Ctr - St. Luke's CampusSan Francisco – – – –
Antelope Valley Hospital Med CenterLancaster – – – –
Kaweah Delta Medical CenterVisalia – – – –
Hollywood Presbyterian Medical CenterLos Angeles – – – –
Kaiser Foundation Hospital - San FranciscoSan Francisco – – – –
Scripps Mercy HospitalSan Diego – – – –
Providence Little Co of Mary Med Ctr San PedroLos Angeles – – – –
St Johns Regional Medical CenterOxnard – – – –
St Josephs Med Center of StocktonStockton – – – –
Saint Agnes Medical CenterFresno – – – –
San Antonio Community HospitalUpland – – – –
White Memorial Medical CenterLos Angeles – – – –
Marian Medical CenterSanta Maria – – – –
Sutter General HospitalSacramento – – – –
San Mateo Medical CenterSan Mateo – – – –
Doctors Hospital of MantecaManteca – – – –
Hanford Community Medical CenterHanford – – – –
Verdugo Hills HospitalGlendale – – – –
Regional Medical Center of San JoseSan Jose – – – –
Woodland Memorial HospitalWoodland – – – –
Tri-City Medical CenterOceanside – – – –
San Gabriel Valley Medical CenterSan Gabriel – – – –
Rideout Memorial HospitalMarysville – – – –
Kaiser Foundation Hospital - Panorama CityPanorama City – – – –
Kaiser Foundation HospitalBellflower – – – –
Kaiser Foundation Hospital FontanaFontana – – – –
Community Hospital of the Monterey PeninsulaMonterey – – – –
California Hospital Medical Center laLos Angeles – – – –
Saint Francis Memorial HospitalSan Francisco – – – –
Ventura County Medical CenterVentura – – – –
St Jude Medical CenterFullerton – – – –
PIH Health Hospital-WhittierWhittier – – – –
Emanuel Medical Center INCTurlock – – – –
John Muir Medical Center - Walnut Creek CampusWalnut Creek – – – –
St Mary Medical CenterLong Beach – – – –
Washington HospitalFremont – – – –
Sequoia HospitalRedwood City – – – –
Palmdale Regional Medical CenterLancaster – – – –
Hoag Memorial Hospital PresbyterianNewport Beach – – – –
Pomona Valley Hospital Medical CenterPomona – – – –
French Hospital Medical CenterSan Luis Obispo – – – –
Sharp Coronado Hospital and Hlthcr CtrCoronado – – – –
Providence Saint Joseph Medical CtrBurbank – – – –
Simi Valley Hospital & Health Care ServicesSimi Valley – – – –
USC Arcadia HospitalArcadia – – – –
Glendale Adventist Medical CtrGlendale – – – –
Arrowhead Regional Medical CenterColton – – – –
Marshall Medical Center (1-Rh)Placerville – – – –
Sierra View District HospitalPorterville – – – –
Contra Costa Regional Medical CenterMartinez – – – –
Providence Holy Cross Medical CenterMission Hills – – – –
Mercy Medical Center ReddingRedding – – – –
Stanford Health Care Tri-ValleyPleasanton – – – –
Sutter Medical Center of Santa RosaSanta Rosa – – – –
Riverside County Regional Medical CenterMoreno Valley – – – –
Mercy HospitalBakersfield – – – –
Alta Bates Summit Medical Center - Alta Bates CampBerkeley – – – –
El Camino HospitalMountain View – – – –
Sutter Roseville Medical CenterRoseville – – – –
Scripps Memorial Hospital la JollaLa Jolla – – – –
Salinas Valley Memorial HospitalSalinas – – – –
Lodi Memorial HospitalLodi – – – –
Torrance Memorial Medical CenterTorrance – – – –
Barton Memorial HospitalSouth Lake Tahoe – – – –
Providence Little Company of Mary Med Ctr TorranceTorrance – – – –
Marinhealth Medical CenterGreenbrae – – – –
Northbay Medical CenterFairfield – – – –
Los Angeles General Medical CenterLos Angeles – – – –
Lac/Harbor-UCLA Med CenterTorrance – – – –
Good Samaritan HospitalSan Jose – – – –
Emanate Health Inter-Community HospitalCovina – – – –
Downey Regional Medical CenterDowney – – – –
Community Memorial Hospital - VenturaVentura – – – –
Kaiser Foundation Hospital - Harbor CityHarbor City – – – –
Mercy Hospital of FolsomFolsom – – – –
Sutter Coast HospitalCrescent City – – – –
Kaiser Foundation Hospital - Sacramento/RosevilleSacramento – – – –
Huntington Memorial HospitalPasadena – – – –
Mercy Medical Ctr MercedMerced – – – –
Adventist Health BakersfieldBakersfield – – – –
Good Samaritan HospitalLos Angeles – – – –
Long Beach Memorial Medical CenterLong Beach – – – –
Clovis Community Medical CenterClovis – – – –
John Muir Medical Center - Concord CampusConcord – – – –
Sutter Auburn Faith HospitalAuburn – – – –
Sierra Vista Regional Medical CenterSan Luis Obispo – – – –
Kaiser Foundation Hospital - San DiegoSan Diego – – – –
Mercy San Juan Medical CenterCarmichael – – – –
Sutter Davis HospitalDavis – – – –
Los Robles Hospital & Medical CenterThousand Oaks – – – –
Mission Hospital Regional Med CenterMission Viejo – – – –
Fountain Valley Regional Hospital & Medical CenterFountain Valley – – – –
Eisenhower Memorial HospitalRancho Mirage – – – –
Methodist Hospital of SacramentoSacramento – – – –
Saddleback Memorial Medical CenterLaguna Hills – – – –
Henry Mayo Newhall Memorial HospitalValencia – – – –
Palomar Medical Center PowayPoway – – – –
USC Kenneth Norris Jr Cancer HospitalLos Angeles – – – –
Kaiser Foundation Hosp So SacramentoSacramento – – – –
Kaiser Foundation Hospital, RiversideRiverside – – – –
Southwest Healthcare SystemMurrieta – – – –
Sutter Maternity & Surgery Center of Santa CruzSanta Cruz – – – –
Lac/Rancho los Amigos National Rehabilitation CtrDowney – – – –
Monterey Park HospitalMonterey Park – – – –
Marina del Rey HospitalMarina del Rey – – – –
Coastal Communities HospitalSanta Ana – – – –
Sherman Oaks HospitalSherman Oaks – – – –
Providence Tarzana Medical CenterTarzana – – – –
Kaiser Foundation Hospital - RosevilleRoseville – – – –
Kaiser Foundation Hospital - San MarcosSan Marcos – – – –
Childrens Hosp of los AngelesLos Angeles – – – –
Lucile Salter Packard Children's Hsp at StanfordPalo Alto – – – –
Memorial Care Miller Children's & Women's Hosp LbLong Beach – – – –
Level 4 ENT Procedures: all states All California hospitals California hospital finances
Advertisement

Lowest and highest allowed amounts in California

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

Community Regional Medical CenterFresno, CA$1,501
Highland HospitalOakland, CA$2,923
Stanford HospitalPalo Alto, CA$3,573
Memorial Medical CenterModesto, CA$3,672
Enloe Medical CenterChico, CA$3,799

Highest

Santa Rosa Memorial HospitalSanta Rosa, CA$4,509
UCSF Medical CenterSan Francisco, CA$4,479
San Francisco General HospitalSan Francisco, CA$4,248
Santa Barbara Cottage HospitalSanta Barbara, CA$4,240
Sonora Community HospitalSonora, CA$4,239

Level 4 ENT Procedures in other states

Alaska · $3,559 Connecticut · $3,564 Delaware · $3,230 Hawaii · $3,296 New Jersey · $3,415 Oregon · $3,354 Rhode Island · $3,267 Washington · $3,182

Questions

How much does level 4 ent procedures cost in California?

In 2024 Medicare data, level 4 ent procedures (APC 5164) at 149 hospitals in California was billed at $32,769 on average, while the average medicare-allowed amount was $3,847, of which Medicare paid $3,060. 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 California, average charges were 8.5 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.