Level 5 ENT Procedures in Virginia
What 47 hospitals in Virginia charged and were paid for level 5 ent procedures (APC 5165), from 2024 Medicare claims.
Average charge
$42,500
Hospital list price billed
Average allowed
$5,180
Medicare's payment + patient's share
Medicare paid
$4,113
Average per service
State rank
#19 of 49
1 = lowest average payment
Hospitals in Virginia billed an average of $42,500 for level 5 ent procedures, about 8.2 times the average medicare-allowed amount of $5,180. That payment is 7% below the U.S. average 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.
Paid $5,180Billed $42,500
About 12¢ was paid for every $1 hospitals in Virginia billed for this service.
Virginia hospitals: level 5 ent procedures
Every Virginia hospital that billed Medicare for this service at least 11 times. Click a column to sort.
Lowest and highest allowed amounts in Virginia
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
| Montgomery Regional HospitalBlacksburg, VA | $4,739 |
|---|---|
| Henrico Doctors' HospitalRichmond, VA | $4,775 |
| Sentara Norfolk General HospitalNorfolk, VA | $4,856 |
| Carilion Medical CenterRoanoke, VA | $4,973 |
| Medical College of Virginia HospitalsRichmond, VA | $5,006 |
Highest
| Winchester Medical Center INCWinchester, VA | $5,759 |
|---|---|
| Mary Washington Hospital, INCFredericksburg, VA | $5,491 |
| Inova Fairfax HospitalFalls Church, VA | $5,407 |
| Inova Fair Oaks HospitalFairfax, VA | $5,402 |
| Centra Health - Lynchburg Gen HospitalLynchburg, VA | $5,400 |
Level 5 ENT Procedures in other states
Questions
How much does level 5 ent procedures cost in Virginia?
In 2024 Medicare data, level 5 ent procedures (APC 5165) at 47 hospitals in Virginia was billed at $42,500 on average, while the average medicare-allowed amount was $5,180, of which Medicare paid $4,113. 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 Virginia, average charges were 8.2 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.