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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 Wisconsin

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
Wisconsin
Specific hospitals up to 10
Average payment across these 18 hospitals
$5,396National $5,586 · Wisconsin $5,396
Median hospital
$5,359
Lowest to highest
$4,978–$5,696
Medicare procedures
741

18 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
Thedacare Regional Medical Center - Appleton IncAppleton, WI · CCN 52016028$4,97811% below the national average$3,894$17,055
Bellin Memorial HospitalGreen Bay, WI · CCN 52004912$4,97811% below the national average$3,966$26,078
Aspirus Wausau HospitalWausau, WI · CCN 52003021$5,115About average$4,076$25,346
Aurora BayCare Medical CenterGreen Bay, WI · CCN 52019316$5,273About average$4,201$25,382
St Vincent HospitalGreen Bay, WI · CCN 52007513$5,273About average$4,201$35,065
Aurora Medical CenterGrafton, WI · CCN 52020731$5,328About average$4,244$27,259
SSM Health St Mary's Hospital - MadisonMadison, WI · CCN 52008331$5,332About average$4,215$27,585
Waukesha Memorial HospitalWaukesha, WI · CCN 52000824$5,335About average$4,251$51,974
West Allis Memorial HospitalWest Allis, WI · CCN 52013917$5,335About average$4,251$30,591
Aurora St Lukes Medical CenterMilwaukee, WI · CCN 52013838$5,383About average$4,262$38,161
University Of Wisconsin Hospitals & Clinics AuthorityMadison, WI · CCN 520098212$5,405About average$4,290$32,670
Mayo Clinic Health System-Franciscan Medical Center IncLa Crosse, WI · CCN 52000443$5,415About average$4,294$24,103
Froedtert Memorial Lutheran HospitalMilwaukee, WI · CCN 520177 · +$658 outlier payments per case99$5,466About average$4,346$48,676
UnityPoint Health - MeriterMadison, WI · CCN 52008932$5,467About average$4,355$30,730
Gundersen Lutheran Medical CenterLa Crosse, WI · CCN 520087 · +$2,702 outlier payments per case44$5,517About average$4,389$34,077
Mayo Clinic Health System Eau Claire HospitalEau Claire, WI · CCN 52007049$5,556About average$4,425$23,660
Marshfield Medical CenterMarshfield, WI · CCN 52003717$5,612About average$4,471$17,690
Beloit Health SystemBeloit, WI · CCN 52010014$5,696About average$4,532$5,884

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.