NC CMS Medicare PUF 2023 Avg payment #21 of 56

North Carolina procedure costs

120 hospitals · 5,181 Medicare providers · 5,022 procedure codes with North Carolina locality adjustments.

The short answer

North Carolina has 120 hospitals and 5,181 Medicare-billing providers across 5,022 procedure codes. The average Medicare payment per procedure is $246.82; the average submitted (billed) charge is $1,368.65.

Procedure codes
5,022
Providers per hospital
43.2
Billed-to-Medicare ratio
5.5x
Markup rank
#28 of 56

Source: CMS Medicare Physician & Other Practitioners, 2023.

About this dataset, nationwide

According to the Centers for Medicare & Medicaid Services (CMS), the 2023 Medicare Physician & Other Practitioners dataset records payments for 9,297 procedure codes billed across 5,426 hospitals in 56 states and territories; see our methodology for how each figure is sourced and computed.

120
Hospitals
5,181
Providers
$246.82
Avg Medicare Payment
$1,368.65
Avg Billed Charge

North Carolina against every US state

Where the state's average Medicare payment per procedure falls, all 56 tracked jurisdictions

$247 higher than 63% of 56 states

$75–$100: 3 states (5%). Below this entry. $100–$125: 1 states (2%). Below this entry. $125–$150: 2 states (4%). Below this entry. $150–$175: 5 states (9%). Below this entry. $175–$200: 7 states (13%). Below this entry. $200–$225: 9 states (16%). Below this entry. $225–$250: 9 states (16%). This entry sits in this band. $250–$275: 11 states (20%). Above this entry. $275–$300: 4 states (7%). Above this entry. $300–$325: 4 states (7%). Above this entry. $325–$350: 1 states (2%). Above this entry. This state $75 $350 every US state, bucketed by value

Each bar is a $25-wide band; taller bars hold more states. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.

Source CMS Medicare Physician & Other Practitioners, 2023

The priciest procedures in North Carolina

Highest average Medicare payment per procedure billed in North Carolina. Hover any bar for the exact figure; even these top procedures are billed well above what Medicare reimburses.

Top procedures by Medicare payment - North Carolina

Sipuleucel-T, Minimum Of 50 …42073Generator, Neurostimulator (…10765Fusion Of Sacroiliac Joint B…9465Removal Of Plaque And Insert…8509Cochlear Implant, External S…7357Injection Of Cell Or Tissue-…6690Cystourethroscopy, With Inse…5094Removal Of Plaque And Insert…4943
Top procedures by Medicare payment - North Carolina-Average Medicare payment per procedure (CMS 2023)

The cost spread in North Carolina

The highest- and lowest-paying procedures Medicare reimbursed in North Carolina, side by side.

Top Procedures by Volume

Procedure Medicare Services
Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml $0.11 3.6M
Established Patient Office Or Other Outpatient Visit, 30-39 Minutes $77.57 3.6M
Ground Mileage, Per Statute Mile $7.54 3.5M
Injection, Tocilizumab, 1 Mg $4.61 2.9M
Insertion Of Needle Into Vein For Collection Of Blood Sample $8.32 2.7M
Injection, Certolizumab Pegol, 1 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) $3.88 2.5M
Blood Test, Comprehensive Group Of Blood Chemicals $10.33 2.2M
Established Patient Office Or Other Outpatient Visit, 20-29 Minutes $54.43 2.2M
Injection, Testosterone Cypionate, 1 Mg $0.02 1.9M
Complete Blood Cell Count (red Cells, White Blood Cell, Platelets), Automated Test And Automated Differential White Blood Cell Count $7.60 1.9M
Injection, Denosumab, 1 Mg $18.19 1.9M
Therapy Procedure Using Exercise To Develop Strength, Endurance, Range Of Motion, And Flexibility, Each 15 Minutes $17.12 1.6M
Injection, Onabotulinumtoxina, 1 Unit $4.86 1.6M
Blood Test, Lipids (cholesterol And Triglycerides) $13.09 1.6M
Travel Allowance One Way In Connection With Medically Necessary Laboratory Specimen Collection Drawn From Home Bound Or Nursing Home Bound Patient; Prorated Miles Actually Travelled $1.06 1.3M
Injection, Golimumab, 1 Mg, For Intravenous Use $10.45 1.3M
Injection, Ferric Carboxymaltose, 1 Mg $0.87 1.3M
Injection, Faricimab-Svoa, 0.1 Mg $28.87 1.2M
Blood Test, Thyroid Stimulating Hormone (tsh) $16.45 1.2M
Hemoglobin A1c Level $9.49 1.2M
Injection, Romosozumab-Aqqg, 1 Mg $7.91 1.1M
Injection, Gadobutrol, 0.1 Ml $0.26 1.0M
Therapy Procedure Using Functional Activities $23.58 975.2K
Injection, Vedolizumab, 1 Mg $17.08 965.1K
Injection, Abatacept, 10 Mg (code May Be Used For Medicare When Drug Administered Under The Direct Supervision Of A Physician, Not For Use When Drug Is Self Administered) $33.36 942.6K
Hyaluronan Or Derivative, Gelsyn-3, For Intra-Articular Injection, 0.1 Mg $0.55 939.4K
Injection, Triamcinolone Acetonide, Not Otherwise Specified, 10 Mg $0.79 896.5K
Subsequent Hospital Care With Moderate Levelof Medical Decision Making, If Using Time, At Least 35 Minutes $58.59 812.9K
Provision Of Covid-19 Test, Nonprescription Self-Administered And Self-Collected Use, Fda Approved, Authorized Or Cleared, One Test Count $11.06 769.2K
Removal Of Cataract With Insertion Of Prosthetic Lens $57.71 751.2K

North Carolina Healthcare Cost Landscape

CMS lists 120 hospitals in North Carolina across 95 cities. CHARLOTTE holds 6 (5%). The three densest cities together hold 12% of the state roster. Statewide that is 5,181 Medicare-billing providers, 43.2 per listed hospital.

86 hospitals carry a CMS overall star rating (7 five-star, 22 four-star, 30 three-star, 19 two-star, 8 one-star) ; five-star share among rated facilities is 8%. 34 hospitals in this extract have no published overall rating.

Facility-type mix: Acute Care Hospitals 80 (67%); Critical Access Hospitals 20 (17%); Psychiatric 14 (12%); Acute Care - Veterans Administration 4 (3%).

Among the 30 highest-volume procedure codes billed in North Carolina, Drugs (Administered) leads with 19.4M services (39% of this top-volume slice) across 13 codes. Next is Blood Test at 16%.

Submitted charges average $1,368.65 against $246.82 Medicare payment (5.5x billed-to-Medicare). That ratio ranks #28 of 56 jurisdictions with both figures in this extract. Average Medicare payment itself is #21 of 56.

Volume leaders are not the high-payment codes. Low Osmolar Contrast Material, 300-399 Mg/ml Iodine Concentration, Per Ml is in the top volume slice but not the highest Medicare payments; Sipuleucel-T, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-Gm-Csf, Including Leukapheresis And All Other Preparatory Procedures, Per Infusion is in the high-payment set without matching volume rank.

These are CMS roster and claims aggregates for North Carolina, not a quote for any patient, plan, or visit. See the methodology and CMS Medicare Provider Charge Data.

Where North Carolina hospitals sit

City of the CMS hospital roster, not a travel or care recommendation. 95 distinct cities appear on 120 listed facilities.

City Hospitals Share of state roster
CHARLOTTE 6 5%
DURHAM 4 3%
RALEIGH 4 3%
WINSTON-SALEM 3 3%
ASHEVILLE 2 2%
FAYETTEVILLE 2 2%
GOLDSBORO 2 2%
GREENVILLE 2 2%

Nationwide states with similar hospital scale or Medicare payment

Two CMS-extract-derived peer sets for North Carolina: nearest hospital inventory and nearest statewide average Medicare payment. Not clinical substitutes: registry-scale and payment neighborhoods only.

Similar CMS hospital count

Nearest states with ≥5 hospitals (120 here).

Similar average Medicare payment

Nearest states with published averages ($246.82 here).

Hospitals in North Carolina

ADVENTHEALTH HENDERSONVILLE
HENDERSONVILLE · ★★★★☆
ALAMANCE REGIONAL MEDICAL CENTER
BURLINGTON · ★★☆☆☆
ALLEGHANY MEMORIAL HOSPITAL
SPARTA · -
ANGEL MEDICAL CENTER
FRANKLIN · ★★☆☆☆
APPALACHIAN REGIONAL BEHAVIORAL HEALTHCARE
LINVILLE · -
ASHE MEMORIAL HOSPITAL
JEFFERSON · ★★★☆☆
ASHEVILLE-OTEEN VA MEDICAL CENTER
ASHEVILLE · ★★★★★
ATRIUM HEALTH ANSON
WADESBORO · -
ATRIUM HEALTH CLEVELAND
SHELBY · ★★☆☆☆
ATRIUM HEALTH LINCOLN
LINCOLNTON · ★★★★☆
ATRIUM HEALTH PINEVILLE
CHARLOTTE · ★★★☆☆
ATRIUM HEALTH UNION
MONROE · ★★★☆☆
ATRIUM HEALTH UNIVERSITY CITY
CHARLOTTE · ★★★☆☆
BETSY JOHNSON REGIONAL HOSPITAL
DUNN · ★★★☆☆
BLUE RIDGE HEALTHCARE HOSPITALS, INC
MORGANTON · ★★☆☆☆
BLUE RIDGE REGIONAL HOSPITAL
SPRUCE PINE · ★★★☆☆
BROUGHTON HOSPITAL
MORGANTON · -
BRYNN MARR HOSP
JACKSONVILLE · -
CALDWELL MEMORIAL HOSPITAL
LENOIR · ★☆☆☆☆
CAPE FEAR VALLEY HOKE HOSPITAL
RAEFORD · ★★★★☆
CAPE FEAR VALLEY MEDICAL CENTER
FAYETTEVILLE · ★☆☆☆☆
CAPE FEAR VALLEY-BLADEN COUNTY HOSPITAL
ELIZABETHTOWN · -
CAROLINA EAST MEDICAL CENTER
NEW BERN · ★★★☆☆
CAROLINAS MEDICAL CENTER-NORTHEAST
CONCORD · ★★★☆☆
CAROLINAS MEDICAL CENTER/BEHAV HEALTH
CHARLOTTE · ★★★☆☆
CAROMONT REGIONAL MEDICAL CENTER
GASTONIA · ★★★★☆
CARTERET GENERAL HOSPITAL
MOREHEAD CITY · ★☆☆☆☆
CATAWBA VALLEY MEDICAL CENTER
HICKORY · ★★★☆☆
CENTRAL CAROLINA HOSPITAL
SANFORD · ★☆☆☆☆
CENTRAL REGIONAL HOSPITAL
BUTNER · -

View all 120 hospitals in North Carolina →

How North Carolina Compares Nationally

North Carolina's average Medicare payment is #21 of 56 in this extract. Submitted-over-Medicare markup ranks #28 of 56 (5.5x). Hospital-count peers (nearest CMS roster size to 120): Missouri 121, Iowa 118, Tennessee 122, Arizona 106. Payment peers (nearest average Medicare payment to $246.82): South Carolina $244.35, Indiana $250.97, Massachusetts $252.82, Washington $254.32.

Those peer sets are registry neighborhoods, not clinical substitutes. Markup rank and payment rank can diverge: a jurisdiction can sit high on billed-to-Medicare while sitting mid-pack on payment, or the reverse. Figures remain CMS averages for North Carolina, not an out-of-pocket quote.

Related registry pages

North Carolina averages sit on two maps: Medicare payment and submitted-over-Medicare markup.

Figures here are North Carolina CMS averages, not a quote for any patient, plan, or visit.

Data sourced from the CMS Medicare Physician and Other Practitioners dataset. See our methodology for details. Retrieved and formatted by PlainProcedure  · Verify with CMS →

Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, the data changelog, or report a data error.