Pancreas, liver and shunt procedures with major complications in North Carolina
What 2 hospitals in North Carolina charged and were paid for a Medicare hospital stay for pancreas, liver and shunt procedures with major complications (DRG 405), from 2024 Medicare claims.
Average charge
$172,431
Hospital list price billed
Average payment
$56,932
Medicare + patient + other payers
Medicare paid
$43,721
Average per stay
Volume
35
Medicare hospital stays
Hospitals in North Carolina billed an average of $172,431 for pancreas, liver and shunt procedures with major complications, about 3.0 times the average total payment of $56,932. That payment is 17% below the U.S. average of $68,850.
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 $56,932Billed $172,431
About 33¢ 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: pancreas, liver and shunt procedures 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 |
|---|---|---|---|---|
| Carolinas Medical Center/Behav HealthCharlotte | 18 | $183,432 | $53,118 | $36,960 |
| Duke University Medical CenterDurham | 17 | $160,783 | $60,970 | $50,880 |
Pancreas, liver and shunt procedures with major complications in other states
Questions
How much does pancreas, liver and shunt procedures with major complications cost in North Carolina?
In 2024 Medicare data, a hospital stay for pancreas, liver and shunt procedures with major complications (DRG 405) at 2 hospitals in North Carolina was billed at $172,431 on average, while the average total payment was $56,932, of which Medicare paid $43,721. 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.