facebook tracking Pleural effusion with major complications cost in North Carolina: 4 hospitals compared (DRG 186)

Pleural effusion with major complications in North Carolina

What 4 hospitals in North Carolina charged and were paid for a Medicare hospital stay for pleural effusion with major complications (DRG 186), from 2024 Medicare claims.

DRG 186 Inpatient 2024 Medicare data
Average charge $46,713 Hospital list price billed
Average payment $13,454 Medicare + patient + other payers
Medicare paid $11,586 Average per stay
State rank #6 of 16 1 = lowest average payment

Hospitals in North Carolina billed an average of $46,713 for pleural effusion with major complications, about 3.5 times the average total payment of $13,454. That payment is 9% below the U.S. average of $14,801.

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 $13,454Billed $46,713

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: pleural effusion 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
New Hanover Regional Medical CenterWilmington 24 $42,301 $13,252 $11,886
ECU Health Medical CenterGreenville 15 $44,729 $16,361 $11,748
Forsyth Memorial HospitalWinston-Salem 14 $49,803 $12,110 $11,316
Memorial Mission Hospital and Asheville Surgery CeAsheville 11 $55,110 $11,646 $11,054
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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

Highest

Pleural effusion with major complications in other states

Questions

How much does pleural effusion with major complications cost in North Carolina?

In 2024 Medicare data, a hospital stay for pleural effusion with major complications (DRG 186) at 4 hospitals in North Carolina was billed at $46,713 on average, while the average total payment was $13,454, of which Medicare paid $11,586. 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.