North Carolina / Duke University Hospital
CMS certification 340030 · Durham, NC · 4 entries in CMS's price-transparency list
Duke University Hospital: charges and Medicare payments
Duke University Hospital reported 9,300 Medicare inpatient stays across 251 DRGs in 2024. Across them it charged 3.07 times what it was paid — mid-range in North Carolina, number 48 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: 347 stays at an average charge of $67,361, 25% below the national average. It also billed 14,568 outpatient services, charging 6.96 times what Medicare paid.
- 1Medicare inpatient stays 9,300
- 2Charge ÷ paid, inpatient 3.07×
- 3Rank in NC (highest ratio = 1) 48 of 73
- 4CMS price-transparency actions 4
Inpatient stays
For the 251 DRGs that can be compared with the national average, Duke University Hospital charged more than the national average in 25 (10%). 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 | 347 | $67,361 | -25% | $25,363 |
| 291 Heart Failure and Shock with MCC | 316 | $42,399 | -25% | $17,678 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 165 | $262,179 | +19% | $48,140 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 134 | $98,496 | -12% | $34,104 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 128 | $55,756 | -40% | $20,913 |
| 177 Respiratory Infections and Inflammations with MCC | 126 | $58,620 | -17% | $23,014 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 123 | $27,522 | -31% | $11,914 |
| 690 Kidney and Urinary Tract Infections without MCC | 109 | $24,489 | -35% | $11,765 |
| 378 Gastrointestinal Hemorrhage with CC | 108 | $32,842 | -32% | $12,928 |
| 847 Chemotherapy without Acute Leukemia As Secondary Diagnosis... | 106 | $58,061 | -14% | $18,964 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 98 | $44,424 | -20% | $13,784 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 98 | $32,831 | -31% | $13,920 |
| 027 Craniotomy and Endovascular Intracranial Procedures without... | 95 | $67,991 | -51% | $24,241 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 91 | $45,551 | -38% | $20,539 |
| 189 Pulmonary Edema and Respiratory Failure | 90 | $49,346 | -14% | $17,418 |
| 193 Simple Pneumonia and Pleurisy with MCC | 90 | $42,747 | -28% | $17,521 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 88 | $114,445 | -51% | $45,701 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 87 | $25,277 | -30% | $10,734 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 87 | $36,578 | -25% | $14,504 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 83 | $85,069 | -15% | $27,987 |
| 164 Major Chest Procedures with CC | 83 | $79,012 | -38% | $28,143 |
| 236 Coronary Bypass without Cardiac Catheterization without MCC | 82 | $124,474 | -41% | $42,976 |
| 481 Hip and Femur Procedures except Major Joint with CC | 82 | $79,111 | -21% | $23,824 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 76 | $190,929 | -17% | $59,702 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 75 | $26,461 | -29% | $11,699 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 74 | $47,223 | -26% | $13,831 |
| 314 Other Circulatory System Diagnoses with MCC | 73 | $67,410 | -29% | $26,485 |
| 683 Renal Failure with CC | 73 | $25,943 | -36% | $12,417 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 72 | $51,382 | -15% | $19,437 |
| 057 Degenerative Nervous System Disorders without MCC | 69 | $29,855 | -47% | $17,853 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 69 | $42,724 | -30% | $17,340 |
| 205 Other Respiratory System Diagnoses with MCC | 68 | $67,623 | -23% | $24,885 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 68 | $90,947 | -21% | $20,209 |
| 682 Renal Failure with MCC | 68 | $45,962 | -30% | $20,978 |
| 812 Red Blood Cell Disorders without MCC | 68 | $30,919 | -30% | $13,123 |
| 603 Cellulitis without MCC | 67 | $21,443 | -42% | $12,322 |
| 270 Other Major Cardiovascular Procedures with MCC | 66 | $228,126 | -12% | $65,353 |
| 460 Spinal Fusion except Cervical without MCC | 66 | $129,935 | -24% | $38,625 |
| 312 Syncope and Collapse | 65 | $29,573 | -35% | $11,669 |
| 220 Cardiac Valve and Other Major Cardiothoracic Procedures... | 62 | $246,148 | -11% | $66,027 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 61 | $34,143 | -40% | $15,409 |
| 330 Major Small and Large Bowel Procedures with CC | 60 | $65,945 | -45% | $27,091 |
| 194 Simple Pneumonia and Pleurisy with CC | 59 | $34,829 | -9% | $11,659 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 59 | $133,132 | -19% | $32,236 |
| 377 Gastrointestinal Hemorrhage with MCC | 56 | $78,224 | -8% | $24,973 |
| 689 Kidney and Urinary Tract Infections with MCC | 54 | $33,533 | -35% | $16,180 |
| 165 Major Chest Procedures without CC/MCC | 53 | $60,770 | -41% | $20,083 |
| 178 Respiratory Infections and Inflammations with CC | 52 | $45,219 | 0% | $14,147 |
| 393 Other Digestive System Diagnoses with MCC | 52 | $66,607 | -13% | $23,687 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 52 | $202,129 | 0% | $51,637 |
| 660 Kidney and Ureter Procedures for Non-Neoplasm with CC | 52 | $48,696 | -28% | $16,407 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 51 | $159,639 | +2% | $32,592 |
| 442 Disorders of Liver except Malignancy, Cirrhosis or Alcoholic... | 50 | $35,148 | -26% | $14,797 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 49 | $90,725 | -27% | $27,445 |
| 809 Major Hematological and Immunological Diagnoses except... | 49 | $69,057 | +10% | $19,045 |
| 811 Red Blood Cell Disorders with MCC | 49 | $49,844 | -27% | $18,593 |
| 219 Cardiac Valve and Other Major Cardiothoracic Procedures... | 48 | $281,421 | -29% | $88,938 |
| 467 Revision of Hip or Knee Replacement with CC | 48 | $113,017 | -28% | $36,719 |
| 026 Craniotomy and Endovascular Intracranial Procedures with CC | 47 | $67,246 | -59% | $31,251 |
| 329 Major Small and Large Bowel Procedures with MCC | 47 | $165,782 | -23% | $55,033 |
Showing the 60 most frequent of 251 DRGs.
Outpatient services
Against the North Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Duke University Hospital charged $67,361 on average, 18% more than the North Carolina average of $56,936, and was paid $25,363 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Duke University Hospital charged $42,399 on average, 18% more than the North Carolina average of $35,799, and was paid $17,678 against a state average of $11,305. For Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC (DRG 267), Duke University Hospital charged $262,179 on average, 35% more than the North Carolina average of $193,639, and was paid $48,140 against a state average of $40,640. For Circulatory Disorders except AMI, with Cardiac Catheterization with MCC (DRG 286), Duke University Hospital charged $98,496 on average, 31% more than the North Carolina average of $75,394, and was paid $34,104 against a state average of $20,567. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $3,222 was 27% above the state average of $2,536. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $14,837 was 46% above the state average of $10,153. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,020 was 15% below the state average of $9,423. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $16,085 was 14% below the state average of $18,779.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Duke University Hospital in Durham, NC, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-03-16 (CMS case 1086)
- Closure Notice — 2023-09-19 (CMS case 1086)
- Warning Notice — 2025-03-17 (CMS case 3262)
- Closure Notice — 2025-06-17 (CMS case 3262)
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.