Level 5 ENT Procedures
What 1,882 hospitals in the U.S. charged and were paid for level 5 ent procedures (APC 5165), from 2024 Medicare claims.
Average charge
$41,129
Hospital list price billed
Average allowed
$5,586
Medicare's payment + patient's share
Medicare paid
$4,436
Average per service
Volume
33,150
Medicare services
Hospitals in the U.S. billed an average of $41,129 for level 5 ent procedures, about 7.4 times the average medicare-allowed amount of $5,586.
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.
Lowest and highest allowed amounts
Among hospitals with at least 20 Medicare services. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Memorial Hospital at GulfportGulfport, MS | $2,011 |
|---|---|
| Metrohealth SystemCleveland, OH | $2,428 |
| Barnes-Jewish West County HospitalSt Louis, MO | $2,500 |
| Fletcher Allen Hospital of VermontBurlington, VT | $3,566 |
| Shands Hospital at the University of FloridaGainesville, FL | $3,747 |
| Piedmont HospitalAtlanta, GA | $4,391 |
| Ochsner Foundation HospitalNew Orleans, LA | $4,529 |
| LSU Medical Center-Univ HospShreveport, LA | $4,540 |
| Upper Valley Medical CenterTroy, OH | $4,548 |
| St Vincent's BirminghamBirmingham, AL | $4,640 |
Highest
| San Francisco General HospitalSan Francisco, CA | $8,370 |
|---|---|
| El Camino HospitalMountain View, CA | $8,246 |
| Santa Rosa Memorial HospitalSanta Rosa, CA | $8,201 |
| Sutter General HospitalSacramento, CA | $8,201 |
| UCSF Medical CenterSan Francisco, CA | $8,184 |
| Stanford Health Care Tri-ValleyPleasanton, CA | $8,074 |
| John Muir Medical Center - Walnut Creek CampusWalnut Creek, CA | $8,051 |
| Stanford HospitalPalo Alto, CA | $7,946 |
| Santa Barbara Cottage HospitalSanta Barbara, CA | $7,711 |
| Sonora Community HospitalSonora, CA | $7,580 |
Level 5 ENT Procedures cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg allowed | Range |
|---|---|---|---|---|
| Alabama | 40 | $43,081 | $4,776 | $4,416 – $4,939 |
| Alaska | 6 | $47,447 | $6,045 | $6,045 – $6,045 |
| Arizona | 33 | $41,665 | $5,714 | $5,331 – $6,339 |
| Arkansas | 19 | $23,033 | $5,032 | $4,879 – $5,379 |
| California | 170 | $62,428 | $7,426 | $6,073 – $8,370 |
| Colorado | 37 | $50,847 | $5,588 | $5,379 – $5,971 |
| Connecticut | 19 | $30,643 | $6,479 | $6,164 – $6,596 |
| Delaware | 6 | $22,535 | $5,780 | $5,762 – $5,783 |
| Florida | 110 | $60,712 | $5,168 | $3,747 – $5,305 |
| Georgia | 59 | $41,955 | $5,122 | $4,391 – $5,435 |
| Hawaii | 9 | $29,103 | $6,579 | $6,476 – $6,854 |
| Idaho | 10 | $26,402 | $5,315 | $5,011 – $5,644 |
| Illinois | 71 | $43,421 | $5,491 | $5,125 – $5,796 |
| Indiana | 49 | $42,662 | $5,285 | $4,943 – $5,591 |
| Iowa | 18 | $29,660 | $5,117 | $4,875 – $5,409 |
| Kansas | 22 | $32,853 | $5,053 | $4,751 – $5,477 |
| Kentucky | 31 | $35,012 | $4,967 | $4,673 – $5,358 |
| Louisiana | 41 | $36,683 | $4,780 | $4,446 – $5,070 |
| Maine | 13 | $28,094 | $5,319 | $5,025 – $5,502 |
| Massachusetts | 45 | $26,572 | $6,255 | $5,995 – $6,385 |
| Michigan | 58 | $30,120 | $5,177 | $4,651 – $5,506 |
| Minnesota | 33 | $27,760 | $5,738 | $5,265 – $5,950 |
| Mississippi | 23 | $25,169 | $4,527 | $2,011 – $5,112 |
| Missouri | 50 | $28,936 | $4,657 | $2,500 – $5,509 |
| Montana | 10 | $22,610 | $5,509 | $5,223 – $5,880 |
| Nebraska | 19 | $25,593 | $5,115 | $4,877 – $5,404 |
| Nevada | 11 | $69,234 | $6,154 | $5,867 – $6,288 |
| New Hampshire | 12 | $38,231 | $5,891 | $5,586 – $5,944 |
| New Jersey | 47 | $32,193 | $6,327 | $6,001 – $6,664 |
| New Mexico | 11 | $34,998 | $5,277 | $4,518 – $5,930 |
| New York | 88 | $36,773 | $6,432 | $5,520 – $6,664 |
| North Carolina | 49 | $29,801 | $5,212 | $4,942 – $5,458 |
| North Dakota | 6 | $21,453 | $5,523 | $5,490 – $5,880 |
| Ohio | 82 | $37,251 | $4,897 | $2,428 – $5,490 |
| Oklahoma | 30 | $40,430 | $4,956 | $4,817 – $5,046 |
| Oregon | 25 | $32,347 | $6,213 | $5,778 – $7,110 |
| Pennsylvania | 91 | $51,537 | $5,290 | $4,598 – $6,172 |
| Rhode Island | 4 | $15,158 | $5,943 | $5,943 – $5,943 |
| South Carolina | 29 | $51,114 | $4,978 | $4,683 – $5,418 |
| South Dakota | 12 | $33,404 | $5,560 | $5,178 – $5,880 |
| Tennessee | 41 | $33,364 | $4,845 | $4,691 – $5,252 |
| Texas | 156 | $41,938 | $5,188 | $4,423 – $5,497 |
| Utah | 26 | $22,917 | $5,312 | $4,883 – $5,618 |
| Vermont | 5 | $22,474 | $3,566 | $3,566 – $3,566 |
| Virginia | 47 | $42,500 | $5,180 | $4,739 – $5,759 |
| Washington | 39 | $36,580 | $5,934 | $5,700 – $6,295 |
| West Virginia | 15 | $32,262 | $4,942 | $4,673 – $5,594 |
| Wisconsin | 45 | $32,266 | $5,396 | $4,978 – $5,696 |
| Wyoming | 6 | $24,266 | $5,880 | $5,880 – $5,880 |
Hospitals that treat the most Medicare patients for this
| Hospital | Services | Avg charge | Avg allowed |
|---|---|---|---|
| Memorial Hospital of TampaTampa, FL | 840 | $65,648 | $5,285 |
| Hospital of the Univ of PaPhiladelphia, PA | 376 | $56,268 | $4,811 |
| Mayo Clinic - Saint Marys HospitalRochester, MN | 356 | $31,010 | $5,938 |
| New York-Presbyterian HospitalNew York, NY | 323 | $39,378 | $6,631 |
| Stanford HospitalPalo Alto, CA | 319 | $121,432 | $7,946 |
| Massachusetts Eye and Ear InfirmaryBoston, MA | 291 | $19,112 | $6,289 |
| MUSC Medical CenterCharleston, SC | 275 | $57,316 | $4,983 |
| NYU Hospitals CenterNew York, NY | 259 | $65,316 | $6,541 |
| Vanderbilt University HospitalNashville, TN | 253 | $47,150 | $4,766 |
| University of California Davis Medical CenterSacramento, CA | 249 | $64,745 | $7,285 |
| Univ of Michigan HospitalsAnn Arbor, MI | 242 | $38,174 | $5,314 |
| University of Alabama HospitalBirmingham, AL | 225 | $43,052 | $4,760 |
| UCLA Medical CenterLos Angeles, CA | 222 | $33,132 | $7,057 |
| Mary Hitchcock Mem HospitalLebanon, NH | 220 | $38,789 | $5,944 |
| UCSF Medical CenterSan Francisco, CA | 214 | $57,722 | $8,184 |
Questions
How much does level 5 ent procedures cost in the U.S.?
In 2024 Medicare data, level 5 ent procedures (APC 5165) at 1,882 hospitals in the U.S. was billed at $41,129 on average, while the average medicare-allowed amount was $5,586, of which Medicare paid $4,436. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for level 5 ent procedures?
Among states with at least three hospitals reporting, the average medicare-allowed amount was highest in California ($7,426), Hawaii ($6,579), Connecticut ($6,479) and lowest in Vermont ($3,566), Mississippi ($4,527), Missouri ($4,657).
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 the U.S., average charges were 7.4 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.