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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 West Virginia

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
West Virginia
Specific hospitals up to 10
Average payment across these 6 hospitals
$4,942National $5,586 · West Virginia $4,942
Median hospital
$4,976
Lowest to highest
$4,673–$5,594
Medicare procedures
184

6 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
Charleston Area Medical CenterCharleston, WV · CCN 51002234$4,67316% below the national average$3,710$33,203
West Virginia University Hospitals, IncMorgantown, WV · CCN 510001 · +$976 outlier payments per case92$4,85713% below the national average$3,859$39,121
Camc Charleston Surgical HospitalCharleston, WV · CCN 51009111$4,96411% below the national average$3,955$5,493
St Marys Medical CenterHuntington, WV · CCN 51000719$4,98811% below the national average$3,974$22,400
Berkeley Medical CenterMartinsburg, WV · CCN 51000811$5,377About average$4,284$30,457
United Hospital Center, IncBridgeport, WV · CCN 51000617$5,594About average$4,457$22,768

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.