CMS certification 340091 · Greensboro, NC

Cone Health: charges and Medicare payments

Cone Health reported 4,952 Medicare inpatient stays across 129 DRGs in 2024. Across them it charged 2.93 times what it was paid — among the lower ratios in North Carolina, number 51 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: 506 stays at an average charge of $45,838, 49% below the national average. It also billed 4,229 outpatient services, charging 5.67 times what Medicare paid.

1Medicare inpatient stays 4,952
2Charge ÷ paid, inpatient 2.93×
3Rank in NC (highest ratio = 1) 51 of 73
4CMS price-transparency actions 0

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

Inpatient stays

For the 129 DRGs that can be compared with the national average, Cone Health charged more than the national average in 0 (0%). 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	506	$45,838	-49%	$16,850
291 Heart Failure and Shock with MCC	373	$29,637	-47%	$11,923
193 Simple Pneumonia and Pleurisy with MCC	162	$31,651	-47%	$11,753
177 Respiratory Infections and Inflammations with MCC	138	$37,264	-47%	$14,313
378 Gastrointestinal Hemorrhage with CC	110	$29,056	-40%	$9,817
682 Renal Failure with MCC	92	$34,150	-48%	$13,078
683 Renal Failure with CC	92	$20,655	-49%	$9,173
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	91	$21,562	-46%	$8,373
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	80	$43,430	-57%	$16,623
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	77	$23,318	-37%	$8,164
190 Chronic Obstructive Pulmonary Disease with MCC	76	$29,792	-41%	$10,446
481 Hip and Femur Procedures except Major Joint with CC	76	$54,651	-46%	$17,405
689 Kidney and Urinary Tract Infections with MCC	74	$27,306	-47%	$10,907
189 Pulmonary Edema and Respiratory Failure	71	$34,563	-40%	$11,929
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	70	$30,089	-46%	$9,586
274 Percutaneous and Other Intracardiac Procedures without MCC	70	$73,693	-53%	$25,578
470 Major Hip and Knee Joint Replacement or Reattachment of...	70	$52,370	-44%	$16,083
309 Cardiac Arrhythmia and Conduction Disorders with CC	68	$17,526	-51%	$8,065
377 Gastrointestinal Hemorrhage with MCC	67	$48,229	-44%	$15,032
690 Kidney and Urinary Tract Infections without MCC	67	$21,203	-44%	$8,150
698 Other Kidney and Urinary Tract Diagnoses with MCC	67	$32,967	-55%	$14,040
853 Infectious and Parasitic Diseases with O.R. Procedures with...	67	$105,064	-54%	$38,558
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	67	$27,357	-44%	$10,623
812 Red Blood Cell Disorders without MCC	65	$21,102	-52%	$9,609
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	62	$28,698	-52%	$11,677
280 Acute Myocardial Infarction, Discharged Alive with MCC	54	$41,557	-45%	$14,686
194 Simple Pneumonia and Pleurisy with CC	53	$20,539	-46%	$8,631
308 Cardiac Arrhythmia and Conduction Disorders with MCC	53	$33,509	-41%	$12,037
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	52	$62,399	-39%	$17,229
286 Circulatory Disorders except AMI, with Cardiac...	51	$71,453	-36%	$18,923
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	50	$37,863	-42%	$13,006
312 Syncope and Collapse	47	$24,561	-46%	$8,828
322 Percutaneous Cardiovascular Procedures with Intraluminal...	44	$75,361	-34%	$22,610
603 Cellulitis without MCC	44	$18,134	-51%	$8,997
389 Gastrointestinal Obstruction with CC	35	$21,720	-44%	$8,199
100 Seizures with MCC	34	$56,138	-41%	$16,559
330 Major Small and Large Bowel Procedures with CC	34	$66,758	-44%	$19,951
394 Other Digestive System Diagnoses with CC	34	$26,152	-44%	$9,590
951 Other Factors Influencing Health Status	34	$14,342	-44%	$6,398
178 Respiratory Infections and Inflammations with CC	33	$23,555	-48%	$9,364
329 Major Small and Large Bowel Procedures with MCC	33	$121,956	-43%	$39,330
870 Septicemia or Severe Sepsis with MV >96 Hours	33	$123,213	-62%	$46,999
552 Medical Back Problems without MCC	31	$28,448	-42%	$9,432
638 Diabetes with CC	30	$21,072	-49%	$9,033
101 Seizures without MCC	29	$29,935	-39%	$8,915
314 Other Circulatory System Diagnoses with MCC	29	$56,600	-40%	$16,669
267 Endovascular Cardiac Valve Replacement and Supplement...	28	$177,994	-20%	$40,961
699 Other Kidney and Urinary Tract Diagnoses with CC	28	$24,712	-48%	$10,845
023 Craniotomy with Major Device Implant or Acute Complex Cns...	27	$124,910	-56%	$42,391
321 Percutaneous Cardiovascular Procedures with Intraluminal...	27	$95,636	-42%	$27,379
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	27	$32,593	-47%	$12,912
287 Circulatory Disorders except AMI, with Cardiac...	25	$40,384	-37%	$11,063
445 Disorders of The Biliary Tract with CC	25	$34,927	-40%	$11,177
480 Hip and Femur Procedures except Major Joint with MCC	25	$63,964	-54%	$23,655
202 Bronchitis and Asthma with CC/MCC	24	$27,212	-41%	$10,088
266 Endovascular Cardiac Valve Replacement and Supplement...	24	$214,440	-25%	$59,171
070 Other Cerebrovascular Disorders with MCC	23	$43,959	-42%	$14,007
468 Revision of Hip or Knee Replacement without CC/MCC	23	$80,843	-35%	$25,291
208 Respiratory System Diagnosis with Ventilator Support <=96...	22	$75,115	-45%	$19,449
252 Other Vascular Procedures with MCC	22	$96,640	-43%	$27,418

Showing the 60 most frequent of 129 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	666	$14,564	$2,396
Level 5 Musculoskeletal Procedures	389	$44,297	$11,739
Level 1 Endovascular Procedures	219	$21,150	$2,875
Level 3 Vascular Procedures	211	$14,967	$2,800
Level 4 Urology and Related Services	206	$13,405	$3,079
Level 6 Musculoskeletal Procedures	181	$80,595	$16,682
Level 5 Urology and Related Services	168	$22,853	$4,576
Level 3 Electrophysiologic Procedures	144	$109,715	$20,482
Level 2 Upper GI Procedures	143	$7,936	$1,650
Level 4 Musculoskeletal Procedures	136	$26,523	$6,342
Level 2 Excision/ Biopsy/ Incision and Drainage	128	$9,084	$1,427
Level 1 Laparoscopy and Related Services	117	$28,927	$5,070
Level 1 Breast/Lymphatic Surgery and Related Procedures	110	$14,744	$3,322
Level 3 Endovascular Procedures	91	$47,906	$9,481
Level 3 Excision/ Biopsy/ Incision and Drainage	84	$14,077	$2,501
Level 1 Intraocular Procedures	84	$11,076	$2,090
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	82	$13,758	$3,104
Level 3 Musculoskeletal Procedures	80	$17,182	$2,875
Level 3 Urology and Related Services	80	$8,942	$1,809
Level 2 Vascular Procedures	73	$6,356	$1,424
Level 4 Vascular Procedures	70	$20,344	$3,747
Level 3 Pacemaker and Similar Procedures	63	$36,396	$9,573
Level 2 Laparoscopy and Related Services	60	$56,076	$9,229
Level 5 Airway Endoscopy	58	$21,846	$6,055
Level 2 Endovascular Procedures	58	$25,208	$5,057

Against the North Carolina average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Cone Health charged $45,838 on average, 19% less than the North Carolina average of $56,936, and was paid $16,850 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Cone Health charged $29,637 on average, 17% less than the North Carolina average of $35,799, and was paid $11,923 against a state average of $11,305. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Cone Health charged $31,651 on average, 21% less than the North Carolina average of $39,905, and was paid $11,753 against a state average of $11,523. For Respiratory Infections and Inflammations with MCC (DRG 177), Cone Health charged $37,264 on average, 22% less than the North Carolina average of $47,554, and was paid $14,313 against a state average of $14,260. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $14,564 was 22% below the state average of $18,779. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $44,297 was 28% below the state average of $61,166. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $21,150 was 13% below the state average of $24,380. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $14,967 was 13% below the state average of $17,111.

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.