Outpatient procedure · APC 5164 · Surgery or procedure

Level 4 ENT Procedures

In 2024, Medicare and patients paid an average of $2,798 per procedure at 378 hospitals. Half of hospitals averaged between $2,736 and $3,140.

Also known as: Ear, nose and throat surgery, sinus surgery

National figures, 2024

Average payment per case: $2,798
Typical range (middle half of hospitals): $2,736–$3,140
Medicare’s share: $2,21779% of the payment
Average billed charge: $20,680
Hospitals reporting: 37810,268 procedures

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Year of care

370 hospitals reported at least 11 Medicare procedures for this in 2024; showing 301–350. Download as CSV

Medicare payments per case for Level 4 ENT Procedures by hospital, 2024
Hospital	Cases	Average payment	vs national average	Medicare paid	Billed charge
Rhode Island HospitalProvidence, RI · CCN 410007	12	$3,267	17% above the national average	$2,603	$10,637
JFK University Medical CenterEdison, NJ · CCN 310108	13	$3,284	17% above the national average	$2,610	$16,898
Confluence Health HospitalWenatchee, WA · CCN 500016	14	$3,288	17% above the national average	$2,579	$7,571
The Queens Medical CenterHonolulu, HI · CCN 120001	14	$3,296	18% above the national average	$2,529	$14,422
Mayo Clinic Hospital RochesterRochester, MN · CCN 240010	123	$3,297	18% above the national average	$2,619	$21,178
Capital Medical CenterOlympia, WA · CCN 500139	11	$3,317	19% above the national average	$2,643	$29,482
Erie County Medical CenterBuffalo, NY · CCN 330219	117	$3,334	19% above the national average	$2,635	$9,771
Lahey Hospital & Medical Center, BurlingtonBurlington, MA · CCN 220171	16	$3,350	20% above the national average	$2,669	$7,042
Flagstaff Medical CenterFlagstaff, AZ · CCN 030023	11	$3,362	20% above the national average	$2,679	$10,621
Cooper University HospitalCamden, NJ · CCN 310014	35	$3,371	20% above the national average	$2,679	$19,136
OHSU Hospital And ClinicsPortland, OR · CCN 380009	41	$3,378	21% above the national average	$2,684	$19,311
Legacy Good Samaritan Medical CenterPortland, OR · CCN 380017	23	$3,378	21% above the national average	$2,682	$16,372
Mount Sinai South NassauOceanside, NY · CCN 330198	12	$3,387	21% above the national average	$2,650	$25,007
Glens Falls HospitalGlens Falls, NY · CCN 330191	12	$3,414	22% above the national average	$2,720	$7,619
Samaritan Hospital Of Troy, New YorkTroy, NY · CCN 330180	12	$3,414	22% above the national average	$2,720	$14,377
St Joseph's Hospital Health CenterSyracuse, NY · CCN 330140	15	$3,414	22% above the national average	$2,720	$14,711
United Health Services Hospitals, IncBinghamton, NY · CCN 330394	14	$3,414	22% above the national average	$2,720	$18,869
Wynn HospitalUtica, NY · CCN 330044	11	$3,414	22% above the national average	$2,720	$9,809
University Medical Center Of Princeton At PlainsboroPlainsboro, NJ · CCN 310010	11	$3,416	22% above the national average	$2,721	$23,652
Massachusetts Eye And Ear Infirmary -Boston, MA · CCN 220075	105	$3,432	23% above the national average	$2,728	$8,920
Swedish Medical CenterSeattle, WA · CCN 500027	16	$3,450	23% above the national average	$2,749	$32,158
Baystate Medical CenterSpringfield, MA · CCN 220077	14	$3,458	24% above the national average	$2,755	$7,765
Lowell General HospitalLowell, MA · CCN 220063	11	$3,458	24% above the national average	$2,755	$12,454
South Shore HospitalSouth Weymouth, MA · CCN 220100	17	$3,458	24% above the national average	$2,755	$6,979
Beth Israel Deaconess Medical CenterBoston, MA · CCN 220086	23	$3,458	24% above the national average	$2,755	$9,729
Massachusetts General HospitalBoston, MA · CCN 220071	22	$3,458	24% above the national average	$2,755	$24,359
Heywood Hospital -Gardner, MA · CCN 220095	25	$3,458	24% above the national average	$2,754	$7,168
UMass Memorial Medical Center/University CampusWorcester, MA · CCN 220163	29	$3,458	24% above the national average	$2,752	$13,251
St Vincent HospitalWorcester, MA · CCN 220176	14	$3,458	24% above the national average	$2,729	$39,047
Newark Beth Israel Medical CenterNewark, NJ · CCN 310002	12	$3,458	24% above the national average	$2,749	$20,408
Providence St Mary Medical CenterWalla Walla, WA · CCN 500002	11	$3,461	24% above the national average	$2,757	$25,387
Bay Area HospitalCoos Bay, OR · CCN 380090	12	$3,518	26% above the national average	$2,803	$22,577
Mercy Medical CenterRoseburg, OR · CCN 380027	11	$3,518	26% above the national average	$2,799	$16,199
Yale-New Haven HospitalNew Haven, CT · CCN 070022	73	$3,544	27% above the national average	$2,805	$18,168
Mat-Su Regional Medical CenterPalmer, AK · CCN 020006	11	$3,559	27% above the national average	$2,836	$29,060
Stanford Health CareStanford, CA · CCN 050441 · +$878 outlier payments per case	118	$3,573	28% above the national average	$2,847	$63,271
St Francis Hospital & Medical CenterHartford, CT · CCN 070002	54	$3,592	28% above the national average	$2,856	$26,615
SUNY/Stony Brook University HospitalStony Brook, NY · CCN 330393	29	$3,596	29% above the national average	$2,859	$24,869
Montefiore Medical CenterBronx, NY · CCN 330059	15	$3,615	29% above the national average	$2,878	$36,223
Morristown Medical CenterMorristown, NJ · CCN 310015	18	$3,623	29% above the national average	$2,887	$21,817
North Shore University HospitalManhasset, NY · CCN 330106	13	$3,623	29% above the national average	$2,887	$22,108
Nyu Langone HospitalsNew York, NY · CCN 330214	47	$3,626	30% above the national average	$2,889	$37,841
Lenox Hill HospitalNew York, NY · CCN 330119	16	$3,627	30% above the national average	$2,889	$24,595
Mount Sinai WestNew York, NY · CCN 330046	14	$3,627	30% above the national average	$2,889	$24,230
Mount Sinai Beth IsraelNew York, NY · CCN 330169	14	$3,627	30% above the national average	$2,889	$10,875
Hackensack University Medical CenterHackensack, NJ · CCN 310001	18	$3,664	31% above the national average	$2,919	$24,469
Mount Sinai HospitalNew York, NY · CCN 330024	27	$3,664	31% above the national average	$2,919	$20,310
New York-Presbyterian HospitalNew York, NY · CCN 330101	43	$3,664	31% above the national average	$2,919	$28,402
Memorial Medical CenterModesto, CA · CCN 050557	11	$3,672	31% above the national average	$2,867	$18,796
Enloe HealthChico, CA · CCN 050039	19	$3,799	36% above the national average	$2,988	$32,303

National trend

Average payment and billed charge per procedure, and how many Medicare procedures were reported each year.

Average payment
Average billed charge

2020: 6,896 procedures at 325 hospitals · 2021: 8,068 procedures at 365 hospitals · 2022: 8,371 procedures at 382 hospitals · 2023: 8,001 procedures at 353 hospitals · 2024: 10,268 procedures at 378 hospitals

View data as a table

National average payment and billed charge for Level 4 ENT Procedures
Year of care	Average payment	Average billed charge
2020	$2,527	$17K
2021	$2,646	$17K
2022	$2,678	$19K
2023	$2,719	$21K
2024	$2,798	$21K

By state, 2024

Case-weighted average payment across each state’s reporting hospitals, lowest first.

Show all 49 states

Average payment by state for Level 4 ENT Procedures, 2024
State	Hospitals	Cases	Average payment	Typical range
New Hampshire	2	471	$820	$1,342–$2,505
Mississippi	2	129	$878	$1,111–$2,167
Vermont	3	39	$1,800	$1,545–$1,913
Illinois	14	423	$2,389	$2,974–$3,068
Kentucky	5	129	$2,468	$2,566–$2,750
Virginia	8	221	$2,527	$2,749–$2,840
Ohio	19	561	$2,540	$2,348–$2,726
North Carolina	9	242	$2,589	$2,802–$2,925
Tennessee	8	218	$2,594	$2,583–$2,726
Kansas	6	132	$2,598	$2,733–$2,803
Missouri	14	283	$2,633	$2,707–$2,838
Louisiana	7	182	$2,647	$2,636–$2,757
Idaho	6	120	$2,653	$2,552–$2,884
South Carolina	8	164	$2,663	$2,630–$2,777
Alabama	3	95	$2,668	$2,615–$2,684
West Virginia	2	67	$2,682	$2,678–$2,688
Oklahoma	7	196	$2,708	$2,670–$2,774
Georgia	12	206	$2,756	$2,675–$2,865
Iowa	8	204	$2,761	$2,754–$2,826
Nebraska	3	93	$2,773	$2,804–$2,901
Arkansas	6	83	$2,803	$2,744–$2,926
Florida	21	491	$2,835	$2,814–$2,916
Maine	4	84	$2,846	$2,772–$3,025
Texas	24	587	$2,859	$2,783–$2,907
Michigan	10	308	$2,863	$2,765–$2,874
Indiana	10	243	$2,875	$2,809–$2,899
Utah	5	99	$2,875	$2,884–$2,884
Minnesota	7	240	$2,893	$2,426–$2,916
District of Columbia	1	12	$2,943	$2,943–$2,943
Wisconsin	7	178	$2,972	$2,908–$3,031
Pennsylvania	13	358	$2,973	$2,876–$3,097
South Dakota	8	222	$2,990	$2,950–$3,019
Nevada	1	23	$2,998	$2,998–$2,998
Massachusetts	15	632	$3,020	$3,298–$3,458
New York	23	660	$3,023	$3,298–$3,626
New Mexico	3	52	$3,029	$2,827–$3,055
Colorado	4	53	$3,065	$3,065–$3,065
Arizona	6	140	$3,081	$3,105–$3,140
Montana	2	42	$3,090	$3,048–$3,105
North Dakota	3	50	$3,091	$3,019–$3,126
Washington	13	220	$3,182	$3,231–$3,288
Delaware	1	14	$3,230	$3,230–$3,230
Rhode Island	1	12	$3,267	$3,267–$3,267
Hawaii	1	14	$3,296	$3,296–$3,296
Oregon	6	126	$3,354	$3,275–$3,483
New Jersey	8	135	$3,415	$3,270–$3,500
Alaska	1	11	$3,559	$3,559–$3,559
Connecticut	2	127	$3,564	$3,556–$3,580
California	26	877	$3,847	$3,884–$3,959

About these numbers

Average payment is what Medicare paid plus the patient’s deductible and coinsurance (and any other insurer), averaged over the hospital’s Medicare cases. It covers the hospital’s part of the care; doctors bill separately. For outpatient procedures it is Medicare’s allowed amount, which leaves out extra “outlier” payments for unusually costly cases; those are shown under the hospital name where CMS reported any, and included in the CSV. Billed charges are the hospital’s list prices, which few patients pay.

Medicare sets its payments by formula, adjusting for local wages, teaching programs, the share of low-income patients and unusually costly cases. Those adjustments drive most differences between hospitals, so a lower payment doesn’t mean better or worse care, and Medicare patients’ own costs usually vary much less than the totals. Private insurance pays different, usually higher, prices.

Source: CMS Medicare Outpatient Hospitals by Provider and Service (Medicare fee-for-service claims). CMS omits hospitals with fewer than 11 procedures. More in the glossary.