facebook tracking Cardiac valve and other major cardiothoracic procedures without cardiac catheterization cost in North Carolina: 12 hospitals compared (DRG 219)

Cardiac valve and other major cardiothoracic procedures without cardiac catheterization in North Carolina

What 12 hospitals in North Carolina charged and were paid for a Medicare hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 219), from 2024 Medicare claims.

DRG 219 Inpatient 2024 Medicare data
Average charge $285,620 Hospital list price billed
Average payment $74,303 Medicare + patient + other payers
Medicare paid $58,433 Average per stay
State rank #15 of 37 1 = lowest average payment

Hospitals in North Carolina billed an average of $285,620 for cardiac valve and other major cardiothoracic procedures without cardiac catheterization, about 3.8 times the average total payment of $74,303. That payment is 11% below the U.S. average of $83,705.

These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.

Paid $74,303Billed $285,620

About 26¢ was paid for every $1 hospitals in North Carolina billed for this stay.

Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in North Carolina:

North Carolina hospitals: cardiac valve and other major cardiothoracic procedures without cardiac catheterization

Every North Carolina hospital that billed Medicare for this stay at least 11 times. Click a column to sort.

Hospital Stays Avg charge Avg payment Medicare paid
Duke University Medical CenterDurham 48 $281,421 $88,938 $75,058
Carolinas Medical Center/Behav HealthCharlotte 43 $340,427 $72,543 $50,401
ECU Health Medical CenterGreenville 30 $204,496 $73,387 $51,009
North Carolina Baptist HospitalWinston-Salem 28 $360,111 $86,352 $64,249
Atrium Health PinevilleCharlotte 27 $325,616 $58,245 $44,782
Rex HospitalRaleigh 27 $138,745 $55,502 $46,602
Wakemed, Raleigh CampusRaleigh 24 $240,395 $63,521 $52,176
UNC HospitalsChapel Hill 14 $291,053 $105,264 $85,814
Forsyth Memorial HospitalWinston-Salem 12 $293,360 $82,554 $62,537
Moses H Cone Memorial Hospital, theGreensboro 12 $253,308 $64,103 $61,189
Memorial Mission Hospital and Asheville Surgery CeAsheville 11 $420,492 $61,238 $59,973
Presbyterian HospitalCharlotte 11 $367,363 $74,020 $55,041
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Lowest and highest payments in North Carolina

Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.

Lowest

Rex HospitalRaleigh, NC$55,502
Atrium Health PinevilleCharlotte, NC$58,245
Memorial Mission Hospital and Asheville Surgery CeAsheville, NC$61,238
Wakemed, Raleigh CampusRaleigh, NC$63,521
Moses H Cone Memorial Hospital, theGreensboro, NC$64,103

Highest

UNC HospitalsChapel Hill, NC$105,264
Duke University Medical CenterDurham, NC$88,938
North Carolina Baptist HospitalWinston-Salem, NC$86,352
Forsyth Memorial HospitalWinston-Salem, NC$82,554
Presbyterian HospitalCharlotte, NC$74,020

Cardiac valve and other major cardiothoracic procedures without cardiac catheterization in other states

Questions

How much does cardiac valve and other major cardiothoracic procedures without cardiac catheterization cost in North Carolina?

In 2024 Medicare data, a hospital stay for cardiac valve and other major cardiothoracic procedures without cardiac catheterization (DRG 219) at 12 hospitals in North Carolina was billed at $285,620 on average, while the average total payment was $74,303, of which Medicare paid $58,433. Your own cost depends on your insurance, deductible and the hospital.

Why are hospital charges so much higher than payments?

Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in North Carolina, average charges were 3.8 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.

Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.