facebook tracking Level 4 ENT Procedures cost in Tennessee: 38 hospitals compared (APC 5164)

Level 4 ENT Procedures in Tennessee

What 38 hospitals in Tennessee charged and were paid for level 4 ent procedures (APC 5164), from 2024 Medicare claims.

APC 5164 Outpatient 2024 Medicare data
Average charge $19,965 Hospital list price billed
Average allowed $2,594 Medicare's payment + patient's share
Medicare paid $2,059 Average per service
State rank #9 of 48 1 = lowest average payment

Hospitals in Tennessee billed an average of $19,965 for level 4 ent procedures, about 7.7 times the average medicare-allowed amount of $2,594. That payment is 7% below 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 $2,594Billed $19,965

About 13¢ was paid for every $1 hospitals in Tennessee billed for this service.

Tennessee hospitals: level 4 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 65 $27,640 $2,409 $1,913
Univ of Tn Mem HospitalKnoxville 35 $11,753 $2,595 $2,055
Memorial Healthcare System, INCChattanooga 29 $16,037 $2,744 $2,173
Parkwest Medical CenterKnoxville 25 $8,545 $2,655 $2,116
Baptist Memorial HospitalMemphis 19 $16,918 $2,720 $2,167
Methodist Healthcare-MemphisMemphis 17 $19,182 $2,709 $2,146
Centennial Medical CenterNashville 14 $35,395 $2,774 $2,210
Franklin Woods Community HospitalJohnson City 14 $23,051 $2,546 $2,004
Jackson-Madison Cnty Gen HospJackson – – – –
Cumberland Medical CenterCrossville – – – –
Blount Memorial HospitalMaryville – – – –
Wellmont Bristol Regional Medical CenterBristol – – – –
Baptist Memorial Hospital HuntingdonHuntingdon – – – –
Wellmont Holston Vly Med CtrKingsport – – – –
Williamson Medical CenterFranklin – – – –
Morristown-Hamblen HospitalMorristown – – – –
Horizon Medical CenterDickson – – – –
Greeneville Community HospitalGreeneville – – – –
St Mary's Jefferson Memorial HospitalJefferson City – – – –
Cookeville Regional Med CenterCookeville – – – –
Tristar Northcrest Medical CenterSpringfield – – – –
Athens Regional Medical CenterAthens – – – –
Maury Regional HospitalColumbia – – – –
St Thomas HospitalNashville – – – –
Sweetwater Hospital AssociationSweetwater – – – –
Erlanger Medical CenterChattanooga – – – –
Fort Sanders Loudon Med CenterLoudon – – – –
Metro Nashville General HospitalNashville – – – –
Physicians Regional Medical CenterKnoxville – – – –
Fort Sanders Reg Medical CtrKnoxville – – – –
Henry County Medical CenterParis – – – –
Regional One HealthMemphis – – – –
Crockett HospitalLeoma – – – –
Indian Path Medical CenterKingsport – – – –
Vanderbilt Wilson County HospitalLebanon – – – –
Southern Hills Medical CtrNashville – – – –
Stonecrest Medical CenterSmyrna – – – –
Saint Francis Bartlett Medical CenterBartlett – – – –
Advertisement

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

Vanderbilt University HospitalNashville, TN$2,409
Franklin Woods Community HospitalJohnson City, TN$2,546
Univ of Tn Mem HospitalKnoxville, TN$2,595
Parkwest Medical CenterKnoxville, TN$2,655
Methodist Healthcare-MemphisMemphis, TN$2,709

Highest

Centennial Medical CenterNashville, TN$2,774
Memorial Healthcare System, INCChattanooga, TN$2,744
Baptist Memorial HospitalMemphis, TN$2,720
Methodist Healthcare-MemphisMemphis, TN$2,709
Parkwest Medical CenterKnoxville, TN$2,655

Level 4 ENT Procedures in other states

Questions

How much does level 4 ent procedures cost in Tennessee?

In 2024 Medicare data, level 4 ent procedures (APC 5164) at 38 hospitals in Tennessee was billed at $19,965 on average, while the average medicare-allowed amount was $2,594, of which Medicare paid $2,059. 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 7.7 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.