Other circulatory system operating room procedures in North Carolina
What 6 hospitals in North Carolina charged and were paid for a Medicare hospital stay for other circulatory system operating room procedures (DRG 264), from 2024 Medicare claims.
Average charge
$107,506
Hospital list price billed
Average payment
$35,831
Medicare + patient + other payers
Medicare paid
$25,626
Average per stay
State rank
#15 of 21
1 = lowest average payment
Hospitals in North Carolina billed an average of $107,506 for other circulatory system operating room procedures, about 3.0 times the average total payment of $35,831. That payment is about the same as the U.S. average of $35,518.
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 $35,831Billed $107,506
About 33¢ was paid for every $1 hospitals in North Carolina billed for this stay.
North Carolina hospitals: other circulatory system operating room procedures
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 | 28 | $138,422 | $49,673 | $34,426 |
| ECU Health Medical CenterGreenville | 22 | $77,617 | $27,068 | $21,478 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville | 15 | $91,074 | $26,106 | $20,329 |
| Wakemed, Raleigh CampusRaleigh | 14 | $96,326 | $26,400 | $23,953 |
| North Carolina Baptist HospitalWinston-Salem | 13 | $114,824 | $42,250 | $23,494 |
| Carolinas Medical Center/Behav HealthCharlotte | 12 | $115,823 | $35,804 | $23,582 |
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
| Memorial Mission Hospital and Asheville Surgery CeAsheville, NC | $26,106 |
|---|---|
| Wakemed, Raleigh CampusRaleigh, NC | $26,400 |
| ECU Health Medical CenterGreenville, NC | $27,068 |
| Carolinas Medical Center/Behav HealthCharlotte, NC | $35,804 |
| North Carolina Baptist HospitalWinston-Salem, NC | $42,250 |
Highest
| Duke University Medical CenterDurham, NC | $49,673 |
|---|---|
| North Carolina Baptist HospitalWinston-Salem, NC | $42,250 |
| Carolinas Medical Center/Behav HealthCharlotte, NC | $35,804 |
| ECU Health Medical CenterGreenville, NC | $27,068 |
| Wakemed, Raleigh CampusRaleigh, NC | $26,400 |
Other circulatory system operating room procedures in other states
Questions
How much does other circulatory system operating room procedures cost in North Carolina?
In 2024 Medicare data, a hospital stay for other circulatory system operating room procedures (DRG 264) at 6 hospitals in North Carolina was billed at $107,506 on average, while the average total payment was $35,831, of which Medicare paid $25,626. 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 3.0 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.