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

Hospitals in California

Narrow by a state, city or ZIP code (optionally a distance around it), and/or pick specific hospitals. With both, your picks are added to the area’s hospitals.

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Year of care

Average payment across these 25 hospitals: $3,846National $2,798 · California $3,847
Median hospital: $3,958
Lowest to highest: $1,501–$4,509
Medicare procedures: 866

25 hospitals reported at least 11 Medicare procedures for this in 2024. 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
Community Regional Medical CenterFresno, CA · CCN 050060	29	$1,501	46% below the national average	$1,196	$15,401
Highland HospitalOakland, CA · CCN 050320	26	$2,923	About average	$2,322	$20,721
Stanford Health CareStanford, CA · CCN 050441 · +$878 outlier payments per case	118	$3,573	28% above the national average	$2,847	$63,271
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
Uci Health-OrangeOrange, CA · CCN 050348	53	$3,831	37% above the national average	$3,053	$19,406
Kern Medical CenterBakersfield, CA · CCN 050315	12	$3,882	39% above the national average	$3,088	$16,922
UCSan Diego Health Hillcrest - Hillcrest Medical CenterSan Diego, CA · CCN 050025	30	$3,892	39% above the national average	$3,098	$30,138
Keck Hospital Of USCLos Angeles, CA · CCN 050696	72	$3,915	40% above the national average	$3,110	$21,442
Oroville HospitalOroville, CA · CCN 050030	11	$3,958	41% above the national average	$3,154	$11,467
Saint John's Health CenterSanta Monica, CA · CCN 050290	12	$3,958	41% above the national average	$3,154	$16,008
Scripps Green HospitalLa Jolla, CA · CCN 050424	15	$3,958	41% above the national average	$3,154	$47,455
Sharp Memorial HospitalSan Diego, CA · CCN 050100	21	$3,958	41% above the national average	$3,154	$38,559
Shasta Regional Medical CenterRedding, CA · CCN 050764	11	$3,958	41% above the national average	$3,154	$52,670
Santa Monica - UCLA Medical Center & Orthopaedic HospitalSanta Monica, CA · CCN 050112	129	$3,958	41% above the national average	$3,153	$13,576
Orange County Global Medical CenterSanta Ana, CA · CCN 050746	24	$3,958	41% above the national average	$3,153	$29,052
Cedars-Sinai Medical CenterLos Angeles, CA · CCN 050625	14	$3,958	41% above the national average	$3,149	$105,388
Ronald Reagan UCLA Medical CenterLos Angeles, CA · CCN 050262	39	$3,958	41% above the national average	$3,149	$26,672
Loma Linda University Medical CenterLoma Linda, CA · CCN 050327	18	$3,959	41% above the national average	$3,144	$58,168
University Of California Davis Medical CenterSacramento, CA · CCN 050599 · +$1,320 outlier payments per case	47	$4,013	43% above the national average	$3,197	$44,368
Adventist Health SonoraSonora, CA · CCN 050335	31	$4,239	51% above the national average	$3,378	$21,323
Santa Barbara Cottage HospitalSanta Barbara, CA · CCN 050396	34	$4,239	52% above the national average	$3,371	$18,714
Zuckerberg San Francisco General Hospital & Trauma CenterSan Francisco, CA · CCN 050228	13	$4,248	52% above the national average	$3,385	$36,449
UCSF Medical CenterSan Francisco, CA · CCN 050454 · +$1,109 outlier payments per case	66	$4,479	60% above the national average	$3,555	$37,316
Providence Santa Rosa Memorial HospitalSanta Rosa, CA · CCN 050174	11	$4,509	61% above the national average	$3,593	$54,317

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.