North Carolina / Duke Health Raleigh Hospital
CMS certification 340073 · Raleigh, NC · 2 entries in CMS's price-transparency list
Duke Health Raleigh Hospital: charges and Medicare payments
Duke Health Raleigh Hospital reported 530 Medicare inpatient stays across 23 DRGs in 2024. Across them it charged 3.58 times what it was paid — mid-range in North Carolina, number 36 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: 73 stays at an average charge of $43,009, 52% below the national average. It also billed 2,107 outpatient services, charging 6.29 times what Medicare paid.
- 1Medicare inpatient stays 530
- 2Charge ÷ paid, inpatient 3.58×
- 3Rank in NC (highest ratio = 1) 36 of 73
- 4CMS price-transparency actions 2
Inpatient stays
For the 23 DRGs that can be compared with the national average, Duke Health Raleigh Hospital 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 | 73 | $43,009 | -52% | $14,278 |
| 291 Heart Failure and Shock with MCC | 52 | $29,056 | -48% | $10,395 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 42 | $155,700 | -23% | $36,720 |
| 460 Spinal Fusion except Cervical without MCC | 31 | $97,328 | -43% | $26,597 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 27 | $224,269 | -20% | $50,976 |
| 378 Gastrointestinal Hemorrhage with CC | 25 | $22,638 | -53% | $8,119 |
| 473 Cervical Spinal Fusion without CC/MCC | 24 | $51,893 | -55% | $18,253 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 24 | $32,670 | -33% | $8,657 |
| 193 Simple Pneumonia and Pleurisy with MCC | 22 | $34,357 | -43% | $10,889 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 22 | $23,586 | -41% | $6,969 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 20 | $58,644 | -37% | $14,527 |
| 177 Respiratory Infections and Inflammations with MCC | 19 | $36,068 | -49% | $12,802 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 17 | $49,387 | -56% | $15,626 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 17 | $78,333 | -38% | $18,577 |
| 812 Red Blood Cell Disorders without MCC | 16 | $21,362 | -52% | $7,746 |
| 472 Cervical Spinal Fusion with CC | 15 | $73,644 | -49% | $21,535 |
| 690 Kidney and Urinary Tract Infections without MCC | 14 | $22,465 | -41% | $7,029 |
| 603 Cellulitis without MCC | 13 | $16,455 | -56% | $7,548 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 12 | $17,974 | -50% | $6,582 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 12 | $32,296 | -56% | $12,269 |
| 312 Syncope and Collapse | 11 | $18,364 | -60% | $7,713 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 11 | $48,749 | -43% | $12,441 |
| 682 Renal Failure with MCC | 11 | $35,627 | -46% | $11,739 |
Outpatient services
Against the North Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Duke Health Raleigh Hospital charged $43,009 on average, 24% less than the North Carolina average of $56,936, and was paid $14,278 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Duke Health Raleigh Hospital charged $29,056 on average, 19% less than the North Carolina average of $35,799, and was paid $10,395 against a state average of $11,305. For Combined Anterior and Posterior Spinal Fusion without CC/MCC (DRG 455), Duke Health Raleigh Hospital charged $155,700 on average, 10% less than the North Carolina average of $172,728, and was paid $36,720 against a state average of $39,556. For Spinal Fusion except Cervical without MCC (DRG 460), Duke Health Raleigh Hospital charged $97,328 on average, 33% less than the North Carolina average of $145,961, and was paid $26,597 against a state average of $30,322. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $11,670 was 15% above the state average of $10,153. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $7,795 was 17% below the state average of $9,423. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $2,325 was 8% below the state average of $2,536. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $60,571 was 1% below the state average of $61,166.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Duke Health Raleigh Hospital in Raleigh, NC, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2025-02-27 (CMS case 3149)
- Closure Notice — 2025-06-02 (CMS case 3149)
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.