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Outpatient procedure · APC 5165 · Surgery or procedure

Level 5 ENT Procedures

In 2024, Medicare and patients paid an average of $5,586 per procedure at 744 hospitals. Half of hospitals averaged between $5,081 and $5,904.

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

National figures, 2024

Average payment per case
$5,586
Typical range (middle half of hospitals)
$5,081–$5,904
Medicare’s share
$4,43679% of the payment
Average billed charge
$41,129
Hospitals reporting
74433,150 procedures

Hospitals in Pennsylvania

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.

Location
Pennsylvania
Specific hospitals up to 10
Average payment across these 34 hospitals
$5,287National $5,586 · Pennsylvania $5,290
Median hospital
$5,287
Lowest to highest
$4,598–$6,172
Medicare procedures
1,589

34 hospitals reported at least 11 Medicare procedures for this in 2024. Download as CSV

Medicare payments per case for Level 5 ENT Procedures by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
UPMC MemorialYork, PA · CCN 39010112$4,59818% below the national average$3,664$24,920
Hospital Of University Of PennsylvaniaPhiladelphia, PA · CCN 390111376$4,81114% below the national average$3,833$56,268
UPMC St MargaretPittsburgh, PA · CCN 39010212$4,91812% below the national average$3,854$49,706
Robert Packer HospitalSayre, PA · CCN 39007911$4,99011% below the national average$3,894$34,576
Geisinger Medical CenterDanville, PA · CCN 390006 · +$791 outlier payments per case96$5,119About average$4,056$96,470
Geisinger Wyoming Valley Medical CenterWilkes Barre, PA · CCN 39027024$5,122About average$4,076$91,839
Lancaster General HospitalLancaster, PA · CCN 39010014$5,137About average$4,030$25,349
UPMC Presbyterian ShadysidePittsburgh, PA · CCN 39016492$5,157About average$4,099$53,260
Allegheny General HospitalPittsburgh, PA · CCN 39005053$5,231About average$4,167$43,940
Jefferson HospitalJefferson Hills, PA · CCN 39026512$5,231About average$4,167$32,348
Geisinger-Community Medical CenterScranton, PA · CCN 39000118$5,231About average$4,167$76,411
UPMC WilliamsportWilliamsport, PA · CCN 39004515$5,231About average$4,167$31,058
Wilkes-Barre General HospitalWilkes-Barre, PA · CCN 39013717$5,231About average$4,167$53,079
UPMC MercyPittsburgh, PA · CCN 39002812$5,231About average$4,165$47,937
Lehigh Valley Hospital - Dickson CityDickson City, PA · CCN 39033833$5,231About average$4,164$34,401
UPMC Pinnacle HospitalsHarrisburg, PA · CCN 39006756$5,248About average$4,181$32,799
Surgical Institute Of ReadingWyomissing, PA · CCN 39031617$5,271About average$4,195$19,756
Penn State Health Holy Spirit Medical CenterCamp Hill, PA · CCN 39000412$5,302About average$4,224$83,103
Milton S Hershey Medical CenterHershey, PA · CCN 390256 · +$2,097 outlier payments per case98$5,411About average$4,299$57,486
Jefferson Abington HospitalAbington, PA · CCN 39023138$5,494About average$4,377$25,837
Wellspan York HospitalYork, PA · CCN 39004631$5,512About average$4,389$54,709
Lehigh Valley HospitalAllentown, PA · CCN 390133104$5,537About average$4,373$43,182
Thomas Jefferson University HospitalPhiladelphia, PA · CCN 390174 · +$896 outlier payments per case140$5,553About average$4,417$41,088
Penn Highlands DuboisDubois, PA · CCN 39008620$5,602About average$4,463$13,561
Bryn Mawr HospitalBryn Mawr, PA · CCN 39013916$5,650About average$4,501$26,584
Doylestown HospitalDoylestown, PA · CCN 39020337$5,650About average$4,495$30,592
Main Line Hospital LankenauWynnewood, PA · CCN 39019514$5,650About average$4,488$29,168
Jefferson Health- NortheastPhiladelphia, PA · CCN 39011518$5,689About average$4,533$30,968
St Lukes HospitalBethlehem, PA · CCN 39004959$5,712About average$4,548$71,739
Pennsylvania HospitalPhiladelphia, PA · CCN 39022657$5,900About average$4,701$37,272
Penn Presbyterian Medical CenterPhiladelphia, PA · CCN 39022332$5,900About average$4,701$61,843
Temple University HospitalPhiladelphia, PA · CCN 39002715$5,900About average$4,701$85,466
UPMC HamotErie, PA · CCN 39006313$6,020About average$4,766$47,971
Saint Vincent HospitalErie, PA · CCN 39000915$6,17210% above the national average$4,918$43,966

National trend

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

  • Average payment
  • Average billed charge
2020: 27,909 procedures at 711 hospitals · 2021: 31,678 procedures at 755 hospitals · 2022: 32,082 procedures at 738 hospitals · 2023: 32,671 procedures at 748 hospitals · 2024: 33,150 procedures at 744 hospitals
View data as a table
National average payment and billed charge for Level 5 ENT Procedures
Year of careAverage paymentAverage billed charge
2020$4,831$33K
2021$5,104$35K
2022$5,171$37K
2023$5,285$39K
2024$5,586$41K

By state, 2024

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

Show all 50 states
Average payment by state for Level 5 ENT Procedures, 2024
StateHospitalsCasesAverage paymentTypical range
Vermont142$3,566$3,566–$3,566
Mississippi7245$4,527$4,696–$4,902
Missouri15763$4,657$4,910–$5,119
Alabama9489$4,776$4,640–$4,873
Louisiana14413$4,780$4,693–$4,958
Tennessee12782$4,845$4,791–$5,016
Ohio341,454$4,897$4,818–$5,046
West Virginia6184$4,942$4,884–$5,280
Oklahoma12573$4,956$4,922–$5,045
Kentucky10479$4,967$4,904–$5,020
South Carolina14739$4,978$4,871–$5,047
Arkansas10335$5,032$4,940–$5,180
Kansas12429$5,053$4,944–$5,114
Nebraska9484$5,115$5,036–$5,229
Iowa9386$5,117$5,029–$5,201
Georgia24819$5,122$4,950–$5,346
Florida372,610$5,168$5,216–$5,305
Michigan241,016$5,177$5,050–$5,229
Virginia19764$5,180$5,024–$5,389
Texas562,076$5,188$5,096–$5,287
North Carolina18965$5,212$5,099–$5,282
New Mexico7210$5,277$5,048–$5,183
Indiana20604$5,285$5,220–$5,408
Pennsylvania351,604$5,290$5,231–$5,650
Utah7301$5,312$5,097–$5,246
Idaho8241$5,315$5,270–$5,585
Maine4156$5,319$5,083–$5,413
Wisconsin18741$5,396$5,287–$5,467
Illinois351,212$5,491$5,412–$5,560
Montana6203$5,509$5,290–$5,695
North Dakota5155$5,523$5,490–$5,490
South Dakota8340$5,560$5,437–$5,588
Colorado12528$5,588$5,568–$5,575
Arizona14826$5,714$5,685–$5,711
Minnesota14742$5,738$5,556–$5,598
Delaware2117$5,780$5,767–$5,778
Wyoming232$5,880$5,880–$5,880
New Hampshire4261$5,891$5,607–$5,697
District of Columbia3254$5,922$5,912–$5,962
Washington22778$5,934$5,844–$6,113
Rhode Island265$5,943$5,943–$5,943
Alaska126$6,045$6,045–$6,045
Nevada6143$6,154$5,994–$6,272
Oregon9334$6,213$6,145–$6,188
Massachusetts201,174$6,255$6,244–$6,289
New Jersey16608$6,327$6,203–$6,539
New York381,922$6,432$6,209–$6,541
Connecticut10315$6,479$6,457–$6,590
Hawaii391$6,579$6,606–$6,795
California613,120$7,426$7,200–$7,711

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.