Carolinas Medical Center/Behav Health: charges and Medicare payments

Carolinas Medical Center/Behav Health reported 6,585 Medicare inpatient stays across 206 DRGs in 2024. Across them it charged 4.28 times what it was paid — among the higher ratios in North Carolina, number 24 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: 260 stays at an average charge of $94,586, 5% above the national average. It also billed 8,133 outpatient services, charging 10.41 times what Medicare paid.

1Medicare inpatient stays 6,585
2Charge ÷ paid, inpatient 4.28×
3Rank in NC (highest ratio = 1) 24 of 73
4CMS price-transparency actions 0

Average charge per stay at Carolinas Medical Center/Behav Health, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 206 DRGs that can be compared with the national average, Carolinas Medical Center/Behav Health charged more than the national average in 102 (50%). 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	260	$94,586	+5%	$24,644
291 Heart Failure and Shock with MCC	155	$49,953	-11%	$15,709
267 Endovascular Cardiac Valve Replacement and Supplement...	138	$196,776	-11%	$40,376
193 Simple Pneumonia and Pleurisy with MCC	106	$57,839	-3%	$17,765
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	105	$99,498	0%	$25,066
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	99	$37,077	-8%	$11,532
177 Respiratory Infections and Inflammations with MCC	93	$86,654	+23%	$23,508
025 Craniotomy and Endovascular Intracranial Procedures with MCC	90	$162,088	-30%	$41,732
454 Combined Anterior and Posterior Spinal Fusion with CC	89	$272,176	-3%	$57,121
274 Percutaneous and Other Intracardiac Procedures without MCC	87	$138,689	-12%	$28,757
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	84	$63,201	+5%	$16,652
481 Hip and Femur Procedures except Major Joint with CC	80	$136,913	+36%	$23,563
885 Psychoses	80	$44,769	+2%	$19,557
690 Kidney and Urinary Tract Infections without MCC	78	$37,089	-2%	$12,608
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	76	$213,570	+5%	$42,301
699 Other Kidney and Urinary Tract Diagnoses with CC	75	$46,959	-1%	$14,296
312 Syncope and Collapse	71	$48,294	+6%	$12,684
023 Craniotomy with Major Device Implant or Acute Complex Cns...	67	$211,439	-25%	$54,158
460 Spinal Fusion except Cervical without MCC	66	$186,350	+9%	$34,596
698 Other Kidney and Urinary Tract Diagnoses with MCC	66	$77,250	+5%	$20,667
194 Simple Pneumonia and Pleurisy with CC	65	$43,645	+14%	$12,976
266 Endovascular Cardiac Valve Replacement and Supplement...	64	$231,886	-19%	$54,730
330 Major Small and Large Bowel Procedures with CC	62	$115,434	-3%	$25,610
689 Kidney and Urinary Tract Infections with MCC	61	$59,494	+16%	$17,518
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	57	$54,023	-3%	$13,256
472 Cervical Spinal Fusion with CC	57	$139,547	-2%	$28,715
468 Revision of Hip or Knee Replacement without CC/MCC	56	$129,455	+5%	$24,708
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	56	$37,251	+1%	$11,185
603 Cellulitis without MCC	55	$38,517	+3%	$13,177
308 Cardiac Arrhythmia and Conduction Disorders with MCC	54	$47,402	-16%	$15,626
853 Infectious and Parasitic Diseases with O.R. Procedures with...	53	$317,084	+38%	$73,556
683 Renal Failure with CC	50	$37,166	-9%	$12,666
286 Circulatory Disorders except AMI, with Cardiac...	49	$124,152	+11%	$27,759
682 Renal Failure with MCC	49	$66,853	+1%	$18,401
467 Revision of Hip or Knee Replacement with CC	47	$184,780	+17%	$32,819
552 Medical Back Problems without MCC	47	$44,554	-9%	$13,723
189 Pulmonary Edema and Respiratory Failure	45	$52,021	-10%	$16,359
309 Cardiac Arrhythmia and Conduction Disorders with CC	44	$47,426	+31%	$13,724
470 Major Hip and Knee Joint Replacement or Reattachment of...	44	$115,832	+24%	$21,264
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	43	$340,427	-15%	$72,543
314 Other Circulatory System Diagnoses with MCC	42	$114,943	+21%	$31,861
377 Gastrointestinal Hemorrhage with MCC	42	$65,885	-23%	$20,437
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	42	$247,219	+14%	$54,076
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	41	$834,180	-21%	$189,440
269 Aortic and Heart Assist Procedures except Pulsation Balloon...	40	$232,924	+21%	$40,402
378 Gastrointestinal Hemorrhage with CC	40	$53,500	+10%	$12,897
271 Other Major Cardiovascular Procedures with CC	39	$213,832	+23%	$37,192
329 Major Small and Large Bowel Procedures with MCC	39	$184,059	-14%	$46,121
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	39	$56,279	-8%	$17,002
812 Red Blood Cell Disorders without MCC	39	$42,460	-4%	$13,588
027 Craniotomy and Endovascular Intracranial Procedures without...	38	$129,195	-8%	$23,630
057 Degenerative Nervous System Disorders without MCC	38	$58,272	+3%	$20,838
322 Percutaneous Cardiovascular Procedures with Intraluminal...	38	$132,671	+16%	$18,458
652 Kidney Transplant	38	$286,403	-15%	$64,149
637 Diabetes with MCC	36	$57,432	-14%	$17,733
897 Alcohol, Drug Abuse or Dependence without Rehabilitation...	36	$21,947	-41%	$12,010
252 Other Vascular Procedures with MCC	35	$180,419	+6%	$37,495
393 Other Digestive System Diagnoses with MCC	35	$62,082	-19%	$20,893
483 Major Joint or Limb Reattachment Procedures of Upper...	35	$143,469	+14%	$23,741
100 Seizures with MCC	34	$103,460	+10%	$24,439

Showing the 60 most frequent of 206 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Urology and Related Services	1,020	$3,112	$584
Level 2 Upper GI Procedures	465	$14,963	$1,675
Comprehensive Observation Services	462	$20,743	$2,434
Level 3 Excision/ Biopsy/ Incision and Drainage	428	$24,943	$2,443
Level 5 Musculoskeletal Procedures	427	$87,927	$11,505
Level 5 Urology and Related Services	367	$45,451	$4,589
Level 2 Excision/ Biopsy/ Incision and Drainage	342	$14,072	$1,416
Level 4 Urology and Related Services	314	$28,439	$3,087
Level 3 Vascular Procedures	293	$24,126	$2,756
Level 3 Urology and Related Services	293	$12,575	$1,767
Level 3 Electrophysiologic Procedures	273	$238,806	$21,143
Level 1 Endovascular Procedures	267	$37,851	$2,901
Level 1 Laparoscopy and Related Services	252	$50,392	$4,995
Level 2 Laparoscopy and Related Services	213	$82,979	$8,973
Level 4 Musculoskeletal Procedures	212	$62,768	$6,339
Level 6 Musculoskeletal Procedures	176	$117,791	$16,540
Level 3 Endovascular Procedures	176	$76,913	$9,739
Level 5 Airway Endoscopy	164	$31,980	$6,031
Level 4 Airway Endoscopy	124	$23,842	$3,343
Level 3 Musculoskeletal Procedures	120	$37,559	$2,793
Level 2 Vascular Procedures	109	$9,328	$1,394
Level 4 Vascular Procedures	102	$38,356	$4,543
Level 3 Upper GI Procedures	102	$18,239	$3,387
Level 2 Endovascular Procedures	98	$50,412	$4,946
Level 4 Endovascular Procedures	93	$111,781	$13,900

Against the North Carolina average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Carolinas Medical Center/Behav Health charged $94,586 on average, 66% more than the North Carolina average of $56,936, and was paid $24,644 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Carolinas Medical Center/Behav Health charged $49,953 on average, 40% more than the North Carolina average of $35,799, and was paid $15,709 against a state average of $11,305. For Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC (DRG 267), Carolinas Medical Center/Behav Health charged $196,776 on average, 2% more than the North Carolina average of $193,639, and was paid $40,376 against a state average of $40,640. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Carolinas Medical Center/Behav Health charged $57,839 on average, 45% more than the North Carolina average of $39,905, and was paid $17,765 against a state average of $11,523. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $3,112 was 23% above the state average of $2,536. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $14,963 was 33% above the state average of $11,289. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $20,743 was 10% above the state average of $18,779. For Level 3 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5073), its average charge of $24,943 was 41% above the state average of $17,735.

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.