Malignancy of hepatobiliary system or pancreas with major complications in North Carolina
What 12 hospitals in North Carolina charged and were paid for a Medicare hospital stay for malignancy of hepatobiliary system or pancreas with major complications (DRG 435), from 2024 Medicare claims.
Average charge
$64,195
Hospital list price billed
Average payment
$18,482
Medicare + patient + other payers
Medicare paid
$13,637
Average per stay
State rank
#22 of 32
1 = lowest average payment
Hospitals in North Carolina billed an average of $64,195 for malignancy of hepatobiliary system or pancreas with major complications, about 3.5 times the average total payment of $18,482. That payment is 5% below the U.S. average of $19,425.
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 $18,482Billed $64,195
About 29¢ was paid for every $1 hospitals in North Carolina billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them in North Carolina:
North Carolina hospitals: malignancy of hepatobiliary system or pancreas with major complications
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 | 33 | $57,999 | $21,422 | $15,715 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville | 31 | $66,413 | $13,928 | $12,240 |
| North Carolina Baptist HospitalWinston-Salem | 27 | $74,450 | $26,029 | $15,860 |
| Rex HospitalRaleigh | 27 | $40,990 | $12,854 | $10,384 |
| Carolinas Medical Center/Behav HealthCharlotte | 22 | $102,900 | $25,046 | $17,655 |
| UNC HospitalsChapel Hill | 18 | $55,585 | $23,005 | $14,698 |
| Cape Fear Valley Medical CenterFayetteville | 17 | $56,220 | $15,223 | $13,639 |
| ECU Health Medical CenterGreenville | 17 | $47,152 | $18,373 | $12,440 |
| Forsyth Memorial HospitalWinston-Salem | 15 | $60,306 | $15,266 | $11,521 |
| Carolinas Medical Center-NortheastConcord | 12 | $72,924 | $16,187 | $11,292 |
| New Hanover Regional Medical CenterWilmington | 12 | $58,672 | $15,313 | $14,302 |
| Presbyterian HospitalCharlotte | 11 | $85,476 | $12,812 | $10,660 |
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
| Presbyterian HospitalCharlotte, NC | $12,812 |
|---|---|
| Rex HospitalRaleigh, NC | $12,854 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $13,928 |
| Cape Fear Valley Medical CenterFayetteville, NC | $15,223 |
| Forsyth Memorial HospitalWinston-Salem, NC | $15,266 |
Highest
| North Carolina Baptist HospitalWinston-Salem, NC | $26,029 |
|---|---|
| Carolinas Medical Center/Behav HealthCharlotte, NC | $25,046 |
| UNC HospitalsChapel Hill, NC | $23,005 |
| Duke University Medical CenterDurham, NC | $21,422 |
| ECU Health Medical CenterGreenville, NC | $18,373 |
Malignancy of hepatobiliary system or pancreas with major complications in other states
Questions
How much does malignancy of hepatobiliary system or pancreas with major complications cost in North Carolina?
In 2024 Medicare data, a hospital stay for malignancy of hepatobiliary system or pancreas with major complications (DRG 435) at 12 hospitals in North Carolina was billed at $64,195 on average, while the average total payment was $18,482, of which Medicare paid $13,637. 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 3.5 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.