Atrium Health Union: charges and Medicare payments

Atrium Health Union reported 1,897 Medicare inpatient stays across 59 DRGs in 2024. Across them it charged 4.93 times what it was paid — among the higher ratios in North Carolina, number 12 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: 179 stays at an average charge of $78,511, 13% below the national average. It also billed 1,572 outpatient services, charging 10.02 times what Medicare paid.

1Medicare inpatient stays 1,897
2Charge ÷ paid, inpatient 4.93×
3Rank in NC (highest ratio = 1) 12 of 73
4CMS price-transparency actions 0

Average charge per stay at Atrium Health Union, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 59 DRGs that can be compared with the national average, Atrium Health Union charged more than the national average in 7 (12%). 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	179	$78,511	-13%	$16,582
291 Heart Failure and Shock with MCC	163	$43,479	-23%	$10,735
177 Respiratory Infections and Inflammations with MCC	87	$64,013	-9%	$12,280
193 Simple Pneumonia and Pleurisy with MCC	78	$43,889	-27%	$10,318
689 Kidney and Urinary Tract Infections with MCC	61	$51,019	-1%	$9,880
690 Kidney and Urinary Tract Infections without MCC	61	$33,442	-12%	$7,059
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	54	$31,789	-21%	$6,785
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	51	$47,532	-15%	$8,202
194 Simple Pneumonia and Pleurisy with CC	50	$36,619	-5%	$6,879
280 Acute Myocardial Infarction, Discharged Alive with MCC	45	$67,311	-11%	$12,943
683 Renal Failure with CC	44	$36,342	-11%	$7,652
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	41	$52,389	-13%	$10,231
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	40	$31,004	-16%	$6,829
308 Cardiac Arrhythmia and Conduction Disorders with MCC	38	$41,218	-27%	$9,444
603 Cellulitis without MCC	38	$27,576	-26%	$7,485
190 Chronic Obstructive Pulmonary Disease with MCC	37	$46,016	-9%	$8,993
682 Renal Failure with MCC	37	$58,284	-12%	$11,530
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	36	$63,385	-37%	$14,173
309 Cardiac Arrhythmia and Conduction Disorders with CC	35	$31,508	-13%	$6,790
189 Pulmonary Edema and Respiratory Failure	31	$46,367	-19%	$9,776
312 Syncope and Collapse	31	$45,317	0%	$7,563
378 Gastrointestinal Hemorrhage with CC	31	$41,369	-15%	$8,229
481 Hip and Femur Procedures except Major Joint with CC	30	$86,538	-14%	$15,351
698 Other Kidney and Urinary Tract Diagnoses with MCC	27	$79,781	+9%	$10,455
637 Diabetes with MCC	25	$52,868	-21%	$10,860
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	25	$41,293	-16%	$8,340
069 Transient Ischemia without Thrombolytic	24	$41,582	-18%	$7,152
305 Hypertension without MCC	23	$38,537	-4%	$6,041
389 Gastrointestinal Obstruction with CC	22	$29,182	-25%	$6,757
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	22	$93,747	-8%	$15,716
178 Respiratory Infections and Inflammations with CC	21	$41,207	-9%	$8,745
812 Red Blood Cell Disorders without MCC	21	$37,525	-15%	$7,505
470 Major Hip and Knee Joint Replacement or Reattachment of...	20	$102,545	+10%	$17,699
100 Seizures with MCC	19	$64,548	-32%	$12,676
377 Gastrointestinal Hemorrhage with MCC	18	$59,587	-30%	$13,375
699 Other Kidney and Urinary Tract Diagnoses with CC	18	$29,865	-37%	$8,323
948 Signs and Symptoms without MCC	18	$35,180	-8%	$6,714
638 Diabetes with CC	17	$44,476	+7%	$7,589
811 Red Blood Cell Disorders with MCC	17	$40,340	-41%	$10,841
329 Major Small and Large Bowel Procedures with MCC	16	$170,011	-21%	$35,295
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	15	$56,014	-14%	$9,930
191 Chronic Obstructive Pulmonary Disease with CC	15	$36,679	-7%	$7,221
281 Acute Myocardial Infarction, Discharged Alive with CC	15	$35,380	-30%	$7,771
390 Gastrointestinal Obstruction without CC/MCC	15	$25,556	-9%	$5,492
066 Intracranial Hemorrhage or Cerebral Infarction without...	14	$37,906	-10%	$6,060
149 Dysequilibrium	14	$40,558	-9%	$6,796
394 Other Digestive System Diagnoses with CC	14	$39,463	-16%	$7,814
536 Fractures of Hip and Pelvis without MCC	14	$34,763	-8%	$6,741
057 Degenerative Nervous System Disorders without MCC	13	$42,591	-25%	$10,535
071 Other Cerebrovascular Disorders with CC	13	$56,735	+12%	$7,708
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	13	$33,491	+17%	$5,383
092 Other Disorders of Nervous System with CC	12	$42,623	-17%	$7,963
552 Medical Back Problems without MCC	12	$38,656	-21%	$8,524
853 Infectious and Parasitic Diseases with O.R. Procedures with...	12	$130,574	-43%	$31,186
056 Degenerative Nervous System Disorders with MCC	11	$89,001	-7%	$13,907
286 Circulatory Disorders except AMI, with Cardiac...	11	$86,926	-23%	$17,885
330 Major Small and Large Bowel Procedures with CC	11	$121,045	+2%	$17,592
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	11	$73,933	+21%	$11,594
602 Cellulitis with MCC	11	$43,339	-28%	$11,423

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	386	$23,424	$2,440
Level 5 Musculoskeletal Procedures	106	$84,366	$11,235
Level 3 Vascular Procedures	99	$16,254	$2,558
Level 2 Upper GI Procedures	98	$12,503	$1,631
Level 1 Nerve Procedures	82	$22,676	$1,704
Level 5 Urology and Related Services	78	$39,491	$4,602
Level 4 Urology and Related Services	76	$19,280	$3,100
Level 1 Endovascular Procedures	72	$32,988	$2,903
Level 1 Laparoscopy and Related Services	55	$51,276	$5,038
Level 2 Excision/ Biopsy/ Incision and Drainage	39	$14,959	$1,368
Level 1 Breast/Lymphatic Surgery and Related Procedures	39	$26,642	$3,285
Level 4 Musculoskeletal Procedures	37	$59,449	$6,428
Level 2 Breast/Lymphatic Surgery and Related Procedures	31	$55,832	$5,709
Level 2 Neurostimulator and Related Procedures	31	$45,920	$5,947
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	30	$24,467	$3,026
Level 3 Excision/ Biopsy/ Incision and Drainage	29	$21,840	$2,483
Level 3 Musculoskeletal Procedures	29	$27,120	$2,829
Level 1 Intraocular Procedures	28	$20,304	$2,034
Level 4 Airway Endoscopy	27	$24,373	$3,166
Level 2 Musculoskeletal Procedures	26	$12,854	$1,444
Level 3 Urology and Related Services	25	$13,307	$1,757
Level 3 Pacemaker and Similar Procedures	23	$40,048	$9,467
Level 3 Extraocular, Repair, and Plastic Eye Procedures	22	$20,686	$2,100
Level 3 Endovascular Procedures	20	$89,085	$9,465
Level 2 Vascular Procedures	19	$6,316	$1,152

Against the North Carolina average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Atrium Health Union charged $78,511 on average, 38% more than the North Carolina average of $56,936, and was paid $16,582 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Atrium Health Union charged $43,479 on average, 21% more than the North Carolina average of $35,799, and was paid $10,735 against a state average of $11,305. For Respiratory Infections and Inflammations with MCC (DRG 177), Atrium Health Union charged $64,013 on average, 35% more than the North Carolina average of $47,554, and was paid $12,280 against a state average of $14,260. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Atrium Health Union charged $43,889 on average, 10% more than the North Carolina average of $39,905, and was paid $10,318 against a state average of $11,523. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $23,424 was 25% above the state average of $18,779. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $84,366 was 38% above the state average of $61,166. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $16,254 was 5% below the state average of $17,111. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $12,503 was 11% above the state average of $11,289.

Price-transparency record

No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.

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.