North Carolina / Caldwell Memorial Hospital
CMS certification 340041 · Lenoir, NC · 1 entry in CMS's price-transparency list
Caldwell Memorial Hospital: charges and Medicare payments
Caldwell Memorial Hospital reported 379 Medicare inpatient stays across 19 DRGs in 2024. Across them it charged 2.98 times what it was paid — among the lower ratios in North Carolina, number 50 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: 80 stays at an average charge of $33,104, 63% below the national average. It also billed 1,144 outpatient services, charging 5.34 times what Medicare paid.
- 1Medicare inpatient stays 379
- 2Charge ÷ paid, inpatient 2.98×
- 3Rank in NC (highest ratio = 1) 50 of 73
- 4CMS price-transparency actions 1
Inpatient stays
For the 19 DRGs that can be compared with the national average, Caldwell Memorial Hospital charged more than the national average in 1 (5%). 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 | 80 | $33,104 | -63% | $13,888 |
| 193 Simple Pneumonia and Pleurisy with MCC | 32 | $28,678 | -52% | $9,705 |
| 885 Psychoses | 29 | $46,922 | +7% | $10,421 |
| 291 Heart Failure and Shock with MCC | 26 | $27,931 | -50% | $9,291 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 22 | $25,671 | -57% | $9,273 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 16 | $47,970 | -49% | $13,300 |
| 177 Respiratory Infections and Inflammations with MCC | 15 | $26,528 | -62% | $11,485 |
| 189 Pulmonary Edema and Respiratory Failure | 15 | $28,921 | -50% | $9,190 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 15 | $49,433 | -52% | $14,831 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 15 | $21,031 | -43% | $6,193 |
| 690 Kidney and Urinary Tract Infections without MCC | 15 | $23,362 | -38% | $6,391 |
| 603 Cellulitis without MCC | 14 | $22,193 | -40% | $7,053 |
| 689 Kidney and Urinary Tract Infections with MCC | 14 | $30,452 | -41% | $8,636 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 13 | $22,512 | -54% | $7,918 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 12 | $29,513 | -61% | $9,742 |
| 682 Renal Failure with MCC | 12 | $28,741 | -56% | $10,772 |
| 683 Renal Failure with CC | 12 | $16,280 | -60% | $7,311 |
| 481 Hip and Femur Procedures except Major Joint with CC | 11 | $56,026 | -44% | $14,534 |
| 638 Diabetes with CC | 11 | $13,352 | -68% | $7,048 |
Outpatient services
Against the North Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Caldwell Memorial Hospital charged $33,104 on average, 42% less than the North Carolina average of $56,936, and was paid $13,888 against a state average of $16,444. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Caldwell Memorial Hospital charged $28,678 on average, 28% less than the North Carolina average of $39,905, and was paid $9,705 against a state average of $11,523. For Psychoses (DRG 885), Caldwell Memorial Hospital charged $46,922 on average, 31% more than the North Carolina average of $35,803, and was paid $10,421 against a state average of $12,625. For Heart Failure and Shock with MCC (DRG 291), Caldwell Memorial Hospital charged $27,931 on average, 22% less than the North Carolina average of $35,799, and was paid $9,291 against a state average of $11,305. For Level 2 Endovascular Procedures (outpatient APC 5192), its average charge of $15,271 was 51% below the state average of $30,961. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $16,010 was 6% below the state average of $17,111. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,225 was 52% below the state average of $2,536. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $40,330 was 33% below the state average of $59,943.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Caldwell Memorial Hospital in Lenoir, NC, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-08-06 (CMS case 6202)
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.