facebook tracking Cardiac valve and other major cardiothoracic procedures without cardiac catheterization cost in North Carolina: 13 hospitals compared (DRG 220)

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

What 13 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 220), from 2024 Medicare claims.

DRG 220 Inpatient 2024 Medicare data
Average charge $243,586 Hospital list price billed
Average payment $51,475 Medicare + patient + other payers
Medicare paid $42,006 Average per stay
State rank #18 of 33 1 = lowest average payment

Hospitals in North Carolina billed an average of $243,586 for cardiac valve and other major cardiothoracic procedures without cardiac catheterization, about 4.7 times the average total payment of $51,475. That payment is 7% below the U.S. average of $55,508.

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 $51,475Billed $243,586

About 21¢ 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 62 $246,148 $66,027 $51,132
Memorial Mission Hospital and Asheville Surgery CeAsheville 45 $259,131 $39,940 $35,679
Wakemed, Raleigh CampusRaleigh 34 $278,228 $49,407 $37,153
Carolinas Medical Center/Behav HealthCharlotte 34 $349,171 $59,876 $49,978
North Carolina Baptist HospitalWinston-Salem 31 $268,947 $58,372 $43,422
UNC HospitalsChapel Hill 20 $159,721 $60,446 $47,412
Rex HospitalRaleigh 20 $132,956 $38,930 $32,515
Presbyterian HospitalCharlotte 18 $259,967 $40,414 $39,166
New Hanover Regional Medical CenterWilmington 18 $224,493 $43,645 $41,843
Forsyth Memorial HospitalWinston-Salem 14 $159,893 $42,573 $33,131
Atrium Health PinevilleCharlotte 14 $276,362 $41,680 $32,900
Moses H Cone Memorial Hospital, theGreensboro 13 $201,189 $46,926 $38,037
Carolina East Medical CenterNew Bern 11 $133,620 $44,210 $42,727
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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$38,930
Memorial Mission Hospital and Asheville Surgery CeAsheville, NC$39,940
Presbyterian HospitalCharlotte, NC$40,414
Atrium Health PinevilleCharlotte, NC$41,680
Forsyth Memorial HospitalWinston-Salem, NC$42,573

Highest

Duke University Medical CenterDurham, NC$66,027
UNC HospitalsChapel Hill, NC$60,446
Carolinas Medical Center/Behav HealthCharlotte, NC$59,876
North Carolina Baptist HospitalWinston-Salem, NC$58,372
Wakemed, Raleigh CampusRaleigh, NC$49,407

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 220) at 13 hospitals in North Carolina was billed at $243,586 on average, while the average total payment was $51,475, of which Medicare paid $42,006. 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 4.7 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.