Simple pneumonia and pleurisy with major complications in North Carolina
What 72 hospitals in North Carolina charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with major complications (DRG 193), from 2024 Medicare claims.
Average charge
$40,007
Hospital list price billed
Average payment
$11,518
Medicare + patient + other payers
Medicare paid
$9,259
Average per stay
State rank
#29 of 50
1 = lowest average payment
Hospitals in North Carolina billed an average of $40,007 for simple pneumonia and pleurisy with major complications, about 3.5 times the average total payment of $11,518. That payment is 4% below the U.S. average of $12,020.
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 $11,518Billed $40,007
About 29¢ 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: simple pneumonia and pleurisy 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 | 211 | $35,254 | $11,331 | $9,410 |
| Forsyth Memorial HospitalWinston-Salem | 201 | $37,780 | $10,434 | $8,760 |
| Moses H Cone Memorial Hospital, theGreensboro | 162 | $31,651 | $11,753 | $9,167 |
| Memorial Mission Hospital and Asheville Surgery CeAsheville | 158 | $43,138 | $10,732 | $8,531 |
| Atrium Health PinevilleCharlotte | 126 | $53,033 | $9,867 | $7,945 |
| Carolinas Medical Center-NortheastConcord | 123 | $50,068 | $10,902 | $8,670 |
| Wakemed, Raleigh CampusRaleigh | 119 | $40,349 | $11,728 | $9,804 |
| Carolina East Medical CenterNew Bern | 116 | $28,650 | $11,164 | $9,940 |
| Carolinas Medical Center/Behav HealthCharlotte | 106 | $57,839 | $17,765 | $10,682 |
| Onslow Memorial HospitalJacksonville | 92 | $35,910 | $11,117 | $9,680 |
| Firsthealth Moore Regional HospitalPinehurst | 92 | $46,730 | $9,692 | $7,922 |
| Rex HospitalRaleigh | 91 | $28,781 | $9,314 | $8,086 |
| Duke University Medical CenterDurham | 90 | $42,747 | $17,521 | $11,388 |
| Cape Fear Valley Medical CenterFayetteville | 89 | $28,541 | $11,186 | $9,760 |
| Iredell Memorial Hospital INCStatesville | 87 | $58,186 | $9,689 | $8,078 |
| Northern Hospital of Surry CountyMt Airy | 78 | $16,120 | $9,507 | $7,915 |
| Carolinas Medical Center-UnionMonroe | 78 | $43,889 | $10,318 | $8,715 |
| Cleveland Regional Medical CenterShelby | 75 | $54,447 | $10,638 | $8,712 |
| Wakemed, Cary HospitalCary | 69 | $47,516 | $8,983 | $7,488 |
| UNC HospitalsChapel Hill | 66 | $41,951 | $19,683 | $12,969 |
| ECU Health Medical CenterGreenville | 64 | $29,972 | $12,766 | $9,363 |
| Carolinas Medical Center-LincolnLincolnton | 61 | $40,552 | $12,203 | $10,920 |
| Haywood Regional Medical CenterClyde | 60 | $51,065 | $9,513 | $7,973 |
| Frye Regional Medical CenterHickory | 59 | $64,485 | $9,070 | $7,378 |
| Southeastern Regional Medical CenterLumberton | 58 | $32,771 | $14,438 | $10,415 |
| Presbyterian Hospital HuntersvilleHuntersville | 58 | $31,977 | $10,411 | $8,024 |
| Wayne Memorial HospitalGoldsboro | 57 | $31,930 | $11,148 | $9,656 |
| North Carolina Baptist HospitalWinston-Salem | 57 | $91,652 | $32,122 | $19,328 |
| Presbyterian HospitalCharlotte | 56 | $43,576 | $10,777 | $9,075 |
| Rowan Regional Medical CenterSalisbury | 54 | $39,884 | $10,323 | $8,205 |
| Catawba Valley Medical CenterHickory | 53 | $33,963 | $10,724 | $9,195 |
| Stanly Regional Medical CenterAlbemarle | 51 | $46,526 | $10,734 | $8,930 |
| Johnston Memorial HospitalSmithfield | 50 | $37,230 | $9,818 | $8,408 |
| Duke Regional HospitalDurham | 50 | $30,633 | $11,564 | $9,686 |
| Albemarle Hospital AuthorityElizabeth City | 49 | $33,465 | $11,548 | $10,065 |
| Nash General HospitalRocky Mount | 48 | $36,851 | $9,541 | $7,750 |
| Adventhealth HendersonvilleFletcher | 47 | $30,532 | $10,034 | $8,406 |
| Lenoir Memorial HospitalKinston | 47 | $19,957 | $9,987 | $8,696 |
| Brunswick Community HospitalSupply | 47 | $31,685 | $10,069 | $8,784 |
| Carteret General HospitalMorehead City | 44 | $19,400 | $11,206 | $9,875 |
| High Point Regional Hlth SystHigh Point | 43 | $35,204 | $9,997 | $8,982 |
| Randolph HospitalAsheboro | 43 | $61,138 | $11,085 | $9,738 |
| Grace Hospital INCMorganton | 42 | $43,873 | $11,374 | $9,287 |
| Caromont Regional Medical CenterGastonia | 41 | $50,885 | $10,103 | $8,674 |
| Alamance Regional Medical CenterBurlington | 40 | $30,868 | $10,939 | $8,908 |
| C J Harris Community HospitalSylva | 38 | $40,360 | $10,494 | $9,059 |
| Betsy Johnson Regional HospitalDunn | 37 | $27,523 | $12,478 | $10,017 |
| McDowell HospitalMarion | 37 | $34,255 | $12,936 | $11,224 |
| Presbyterian Hospital-MatthewsMatthews | 37 | $36,557 | $9,538 | $8,172 |
| Hugh Chatham Memorial HospitalElkin | 36 | $38,191 | $10,866 | $8,498 |
| Watauga Medical CenterBoone | 35 | $27,936 | $12,112 | $10,062 |
| Thomasville Medical CenterThomasville | 34 | $33,498 | $12,320 | $11,122 |
| Caldwell Memorial HospitalLenoir | 32 | $28,678 | $9,705 | $8,193 |
| Wilson Medical CenterWilson | 32 | $47,222 | $10,782 | $9,125 |
| Lake Norman Regional Medical CenterMooresville | 32 | $57,740 | $9,347 | $7,849 |
| Sampson Regional Medical CenterClinton | 30 | $21,798 | $15,214 | $10,931 |
| Scotland Memorial HospitalLaurinburg | 28 | $40,113 | $10,579 | $9,704 |
| Carolinas Med Ctr-UniversityCharlotte | 26 | $56,075 | $11,866 | $10,781 |
| Rutherford Hospital INCRutherfordton | 23 | $50,386 | $10,274 | $8,928 |
| Novant Health Mint Hill Medical CenterCharlotte | 23 | $38,809 | $9,936 | $7,569 |
| Wilkes Regional Medical CenterNorth Wilkesboro | 22 | $36,911 | $10,099 | $9,283 |
| Duke Health Raleigh HospitalRaleigh | 22 | $34,357 | $10,889 | $8,673 |
| Novant Health Ballantyne Medical CenterCharlotte | 22 | $30,630 | $7,745 | $6,152 |
| Central Carolina HospitalSanford | 21 | $50,657 | $10,640 | $9,320 |
| Maria Parham HospitalHenderson | 21 | $52,254 | $10,495 | $8,686 |
| Lexington Memorial Hospital INCLexington | 18 | $24,689 | $10,491 | $9,040 |
| Margaret R Pardee Mem HospitalHendersonville | 16 | $36,394 | $9,765 | $8,388 |
| ECU Health North HospitalRoanoke Rapids | 16 | $30,428 | $11,763 | $8,172 |
| Columbus Regional Healthcare SystemWhiteville | 15 | $37,402 | $9,494 | $8,519 |
| Vidant Edgecombe HospitalTarboro | 15 | $30,168 | $11,838 | $10,752 |
| Granville Medical CenterOxford | 15 | $31,724 | $11,073 | $9,767 |
| Cape Fear Valley Hoke HospitalRaeford | 11 | $24,765 | $11,204 | $9,572 |
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
| Novant Health Ballantyne Medical CenterCharlotte, NC | $7,745 |
|---|---|
| Wakemed, Cary HospitalCary, NC | $8,983 |
| Frye Regional Medical CenterHickory, NC | $9,070 |
| Rex HospitalRaleigh, NC | $9,314 |
| Lake Norman Regional Medical CenterMooresville, NC | $9,347 |
Highest
| North Carolina Baptist HospitalWinston-Salem, NC | $32,122 |
|---|---|
| UNC HospitalsChapel Hill, NC | $19,683 |
| Carolinas Medical Center/Behav HealthCharlotte, NC | $17,765 |
| Duke University Medical CenterDurham, NC | $17,521 |
| Sampson Regional Medical CenterClinton, NC | $15,214 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in North Carolina?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 72 hospitals in North Carolina was billed at $40,007 on average, while the average total payment was $11,518, of which Medicare paid $9,259. 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.