Other respiratory system operating room procedures with complications in North Carolina
What 1 hospital in North Carolina charged and were paid for a Medicare hospital stay for other respiratory system operating room procedures with complications (DRG 167), from 2024 Medicare claims.
Average charge
$56,259
Hospital list price billed
Average payment
$20,837
Medicare + patient + other payers
Medicare paid
$15,504
Average per stay
Volume
23
Medicare hospital stays
Hospitals in North Carolina billed an average of $56,259 for other respiratory system operating room procedures with complications, about 2.7 times the average total payment of $20,837. That payment is 4% below the U.S. average of $21,619.
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 $20,837Billed $56,259
About 37¢ 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: other respiratory system operating room procedures with 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 | 23 | $56,259 | $20,837 | $15,504 |
Other respiratory system operating room procedures with complications in other states
Questions
How much does other respiratory system operating room procedures with complications cost in North Carolina?
In 2024 Medicare data, a hospital stay for other respiratory system operating room procedures with complications (DRG 167) at 1 hospital in North Carolina was billed at $56,259 on average, while the average total payment was $20,837, of which Medicare paid $15,504. 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 2.7 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.