North Carolina / Northern Regional Hospital
CMS certification 340003 · Mount Airy, NC · 2 entries in CMS's price-transparency list
Northern Regional Hospital: charges and Medicare payments
Northern Regional Hospital reported 472 Medicare inpatient stays across 14 DRGs in 2024. Across them it charged 1.66 times what it was paid — among the lower ratios in North Carolina, number 71 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: 92 stays at an average charge of $21,593, 76% below the national average. It also billed 1,208 outpatient services, charging 3.36 times what Medicare paid.
- 1Medicare inpatient stays 472
- 2Charge ÷ paid, inpatient 1.66×
- 3Rank in NC (highest ratio = 1) 71 of 73
- 4CMS price-transparency actions 2
Inpatient stays
For the 14 DRGs that can be compared with the national average, Northern Regional 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 | 92 | $21,593 | -76% | $13,847 |
| 193 Simple Pneumonia and Pleurisy with MCC | 78 | $16,120 | -73% | $9,507 |
| 291 Heart Failure and Shock with MCC | 65 | $14,196 | -75% | $9,460 |
| 177 Respiratory Infections and Inflammations with MCC | 52 | $18,965 | -73% | $11,724 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 28 | $17,255 | -65% | $7,728 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 20 | $20,279 | -72% | $12,076 |
| 189 Pulmonary Edema and Respiratory Failure | 19 | $12,253 | -79% | $9,103 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 19 | $14,166 | -61% | $6,505 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 19 | $23,109 | -77% | $14,971 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 18 | $18,219 | -67% | $7,734 |
| 481 Hip and Femur Procedures except Major Joint with CC | 18 | $26,013 | -74% | $14,581 |
| 689 Kidney and Urinary Tract Infections with MCC | 18 | $14,412 | -72% | $8,726 |
| 690 Kidney and Urinary Tract Infections without MCC | 15 | $11,960 | -68% | $6,417 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 11 | $7,198 | -75% | $4,954 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 2 Urology and Related Services | 325 | $1,045 | $593 |
| Comprehensive Observation Services | 262 | $9,479 | $2,375 |
| Level 1 Intraocular Procedures | 128 | $3,780 | $2,028 |
| Level 5 Musculoskeletal Procedures | 76 | $26,253 | $11,181 |
| Level 3 Urology and Related Services | 62 | $3,621 | $1,773 |
| Level 5 Urology and Related Services | 56 | $10,670 | $4,439 |
| Level 6 Urology and Related Services | 56 | $24,715 | $8,017 |
| Level 4 Urology and Related Services | 47 | $8,829 | $3,034 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 36 | $2,571 | $1,333 |
| Level 1 Laparoscopy and Related Services | 31 | $12,397 | $5,021 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 25 | $6,426 | $2,915 |
| Level 3 Vascular Procedures | 21 | $10,322 | $2,774 |
| Level 2 Upper GI Procedures | 20 | $3,351 | $1,656 |
| Level 4 Musculoskeletal Procedures | 18 | $13,341 | $6,226 |
| Level 1 Nerve Procedures | 17 | $5,612 | $1,680 |
| Level 3 Musculoskeletal Procedures | 15 | $9,079 | $2,772 |
| Level 2 Musculoskeletal Procedures | 13 | $3,719 | $1,399 |
Against the North Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Northern Regional Hospital charged $21,593 on average, 62% less than the North Carolina average of $56,936, and was paid $13,847 against a state average of $16,444. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Northern Regional Hospital charged $16,120 on average, 60% less than the North Carolina average of $39,905, and was paid $9,507 against a state average of $11,523. For Heart Failure and Shock with MCC (DRG 291), Northern Regional Hospital charged $14,196 on average, 60% less than the North Carolina average of $35,799, and was paid $9,460 against a state average of $11,305. For Respiratory Infections and Inflammations with MCC (DRG 177), Northern Regional Hospital charged $18,965 on average, 60% less than the North Carolina average of $47,554, and was paid $11,724 against a state average of $14,260. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,045 was 59% below the state average of $2,536. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $9,479 was 50% below the state average of $18,779. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $3,780 was 63% below the state average of $10,153. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $26,253 was 57% below the state average of $61,166.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Northern Regional Hospital in Mount Airy, NC, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-03-29 (CMS case 1183)
- Closure Notice — 2023-07-24 (CMS case 1183)
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.