North Carolina / Lexington Memorial Hospital Inc
CMS certification 340096 · Lexington, NC
Lexington Memorial Hospital Inc: charges and Medicare payments
Lexington Memorial Hospital Inc reported 304 Medicare inpatient stays across 12 DRGs in 2024. Across them it charged 2.79 times what it was paid — among the lower ratios in North Carolina, number 56 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: 94 stays at an average charge of $40,248, 55% below the national average. It also billed 615 outpatient services, charging 7.42 times what Medicare paid.
- 1Medicare inpatient stays 304
- 2Charge ÷ paid, inpatient 2.79×
- 3Rank in NC (highest ratio = 1) 56 of 73
- 4CMS price-transparency actions 0
Inpatient stays
For the 12 DRGs that can be compared with the national average, Lexington Memorial Hospital Inc 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 | 94 | $40,248 | -55% | $14,298 |
| 291 Heart Failure and Shock with MCC | 62 | $25,231 | -55% | $10,286 |
| 177 Respiratory Infections and Inflammations with MCC | 21 | $37,852 | -46% | $12,134 |
| 193 Simple Pneumonia and Pleurisy with MCC | 18 | $24,689 | -59% | $10,491 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 16 | $18,858 | -49% | $7,281 |
| 683 Renal Failure with CC | 16 | $15,106 | -63% | $7,961 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 15 | $28,002 | -45% | $9,391 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 14 | $68,230 | -27% | $14,472 |
| 189 Pulmonary Edema and Respiratory Failure | 13 | $26,320 | -54% | $10,313 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 13 | $19,216 | -52% | $7,367 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $27,946 | -54% | $10,259 |
| 690 Kidney and Urinary Tract Infections without MCC | 11 | $17,221 | -54% | $7,219 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 110 | $12,316 | $2,477 |
| Level 5 Musculoskeletal Procedures | 88 | $69,593 | $11,980 |
| Level 4 Urology and Related Services | 59 | $25,572 | $3,092 |
| Level 1 Nerve Procedures | 53 | $9,491 | $1,760 |
| Level 5 Urology and Related Services | 44 | $35,014 | $4,716 |
| Level 3 Urology and Related Services | 43 | $18,829 | $1,790 |
| Level 4 Musculoskeletal Procedures | 25 | $48,418 | $6,313 |
| Level 8 Urology and Related Services | 25 | $106,302 | $18,345 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 24 | $5,934 | $1,392 |
| Level 3 Musculoskeletal Procedures | 23 | $21,536 | $2,655 |
| Level 2 Laparoscopy and Related Services | 22 | $71,025 | $9,025 |
| Level 6 Musculoskeletal Procedures | 19 | $86,200 | $16,144 |
| Level 1 Laparoscopy and Related Services | 19 | $44,680 | $5,259 |
| Level 2 Upper GI Procedures | 17 | $14,062 | $1,734 |
| Level 6 Gynecologic Procedures | 17 | $37,759 | $6,888 |
| Level 4 Neurostimulator and Related Procedures | 14 | $105,370 | $19,891 |
| Level 5 Gynecologic Procedures | 13 | $32,675 | $4,534 |
Against the North Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Lexington Memorial Hospital Inc charged $40,248 on average, 29% less than the North Carolina average of $56,936, and was paid $14,298 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Lexington Memorial Hospital Inc charged $25,231 on average, 30% less than the North Carolina average of $35,799, and was paid $10,286 against a state average of $11,305. For Respiratory Infections and Inflammations with MCC (DRG 177), Lexington Memorial Hospital Inc charged $37,852 on average, 20% less than the North Carolina average of $47,554, and was paid $12,134 against a state average of $14,260. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Lexington Memorial Hospital Inc charged $24,689 on average, 38% less than the North Carolina average of $39,905, and was paid $10,491 against a state average of $11,523. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $12,316 was 34% below the state average of $18,779. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $69,593 was 14% above the state average of $61,166. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $25,572 was 34% above the state average of $19,065. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $9,491 was 20% below the state average of $11,910.
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.