North Carolina / Atrium Health Pineville
CMS certification 340098 · Charlotte, NC · 3 entries in CMS's price-transparency list
Atrium Health Pineville: charges and Medicare payments
Atrium Health Pineville reported 4,265 Medicare inpatient stays across 122 DRGs in 2024. Across them it charged 5.65 times what it was paid — among the higher ratios in North Carolina, number 3 of 73 hospitals with at least 100 stays (state median 3.55×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 296 stays at an average charge of $75,650, 16% below the national average. It also billed 3,176 outpatient services, charging 10.28 times what Medicare paid.
- 1Medicare inpatient stays 4,265
- 2Charge ÷ paid, inpatient 5.65×
- 3Rank in NC (highest ratio = 1) 3 of 73
- 4CMS price-transparency actions 3
Inpatient stays
For the 122 DRGs that can be compared with the national average, Atrium Health Pineville charged more than the national average in 31 (25%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 296 | $75,650 | -16% | $14,271 |
| 291 Heart Failure and Shock with MCC | 246 | $45,540 | -19% | $9,775 |
| 193 Simple Pneumonia and Pleurisy with MCC | 126 | $53,033 | -11% | $9,867 |
| 177 Respiratory Infections and Inflammations with MCC | 121 | $70,810 | 0% | $12,748 |
| 690 Kidney and Urinary Tract Infections without MCC | 121 | $34,472 | -9% | $6,101 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 107 | $37,573 | -6% | $6,745 |
| 378 Gastrointestinal Hemorrhage with CC | 85 | $46,888 | -3% | $7,985 |
| 312 Syncope and Collapse | 84 | $44,071 | -3% | $7,284 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 83 | $55,053 | -3% | $9,614 |
| 683 Renal Failure with CC | 81 | $43,071 | +6% | $7,306 |
| 689 Kidney and Urinary Tract Infections with MCC | 74 | $46,198 | -10% | $8,515 |
| 194 Simple Pneumonia and Pleurisy with CC | 73 | $34,672 | -10% | $6,733 |
| 603 Cellulitis without MCC | 67 | $32,954 | -12% | $6,647 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 63 | $34,279 | -7% | $6,680 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 62 | $103,251 | +11% | $14,429 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 60 | $49,421 | -11% | $7,397 |
| 552 Medical Back Problems without MCC | 53 | $40,095 | -18% | $7,017 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 53 | $207,833 | -9% | $43,584 |
| 481 Hip and Femur Procedures except Major Joint with CC | 52 | $97,393 | -3% | $14,281 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 52 | $48,450 | -20% | $9,801 |
| 189 Pulmonary Edema and Respiratory Failure | 51 | $50,786 | -12% | $8,962 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 50 | $131,795 | +15% | $12,850 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 49 | $103,152 | +1% | $14,396 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 48 | $83,042 | -17% | $14,239 |
| 178 Respiratory Infections and Inflammations with CC | 48 | $43,034 | -5% | $7,664 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 45 | $53,065 | +5% | $8,068 |
| 682 Renal Failure with MCC | 45 | $51,710 | -22% | $10,865 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 45 | $47,214 | -36% | $11,907 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 43 | $35,181 | -3% | $5,725 |
| 305 Hypertension without MCC | 40 | $35,826 | -11% | $5,796 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 40 | $185,508 | +13% | $26,990 |
| 330 Major Small and Large Bowel Procedures with CC | 40 | $103,787 | -13% | $19,227 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 39 | $27,868 | -3% | $5,092 |
| 377 Gastrointestinal Hemorrhage with MCC | 38 | $88,353 | +3% | $12,301 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 38 | $40,469 | -17% | $8,046 |
| 812 Red Blood Cell Disorders without MCC | 35 | $39,257 | -12% | $6,787 |
| 057 Degenerative Nervous System Disorders without MCC | 34 | $52,724 | -7% | $9,508 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 31 | $72,022 | -5% | $11,523 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 31 | $50,438 | -17% | $10,588 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 29 | $67,879 | +4% | $11,003 |
| 314 Other Circulatory System Diagnoses with MCC | 29 | $76,985 | -19% | $14,736 |
| 811 Red Blood Cell Disorders with MCC | 29 | $53,028 | -22% | $10,085 |
| 445 Disorders of The Biliary Tract with CC | 28 | $42,934 | -26% | $7,986 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 28 | $37,386 | -21% | $7,454 |
| 219 Cardiac Valve and Other Major Cardiothoracic Procedures... | 27 | $325,616 | -18% | $58,245 |
| 329 Major Small and Large Bowel Procedures with MCC | 27 | $155,142 | -28% | $34,396 |
| 069 Transient Ischemia without Thrombolytic | 26 | $49,099 | -3% | $6,108 |
| 071 Other Cerebrovascular Disorders with CC | 26 | $49,927 | -1% | $8,503 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 26 | $107,032 | -21% | $25,607 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 25 | $103,314 | -8% | $18,327 |
| 389 Gastrointestinal Obstruction with CC | 25 | $31,760 | -18% | $6,413 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 24 | $32,216 | -19% | $6,440 |
| 390 Gastrointestinal Obstruction without CC/MCC | 24 | $21,076 | -25% | $4,736 |
| 394 Other Digestive System Diagnoses with CC | 24 | $38,995 | -17% | $7,496 |
| 101 Seizures without MCC | 23 | $55,144 | +13% | $6,979 |
| 176 Pulmonary Embolism without MCC | 23 | $36,611 | -12% | $7,511 |
| 233 Coronary Bypass with Cardiac Catheterization or Open... | 23 | $293,237 | -24% | $61,193 |
| 100 Seizures with MCC | 22 | $83,018 | -12% | $14,723 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 22 | $60,145 | +19% | $6,884 |
| 637 Diabetes with MCC | 22 | $65,926 | -1% | $9,799 |
Showing the 60 most frequent of 122 DRGs.
Outpatient services
Against the North Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Atrium Health Pineville charged $75,650 on average, 33% more than the North Carolina average of $56,936, and was paid $14,271 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Atrium Health Pineville charged $45,540 on average, 27% more than the North Carolina average of $35,799, and was paid $9,775 against a state average of $11,305. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Atrium Health Pineville charged $53,033 on average, 33% more than the North Carolina average of $39,905, and was paid $9,867 against a state average of $11,523. For Respiratory Infections and Inflammations with MCC (DRG 177), Atrium Health Pineville charged $70,810 on average, 49% more than the North Carolina average of $47,554, and was paid $12,748 against a state average of $14,260. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $23,485 was 25% above the state average of $18,779. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $93,352 was 53% above the state average of $61,166. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $24,184 was 103% above the state average of $11,910. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $38,609 was 58% above the state average of $24,380.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Atrium Health Pineville in Charlotte, NC, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-11-06 (CMS case 2884)
- Closure Notice — 2025-02-14 (CMS case 2884)
- Met Requirements — 2026-02-05 (CMS case 6962)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.