CMS certification 340114 · Raleigh, NC

Rex Hospital: charges and Medicare payments

Rex Hospital reported 6,565 Medicare inpatient stays across 171 DRGs in 2024. Across them it charged 3.54 times what it was paid — mid-range in North Carolina, number 38 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: 316 stays at an average charge of $52,272, 42% below the national average. It also billed 8,660 outpatient services, charging 5.5 times what Medicare paid.

1Medicare inpatient stays 6,565
2Charge ÷ paid, inpatient 3.54×
3Rank in NC (highest ratio = 1) 38 of 73
4CMS price-transparency actions 0

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

Inpatient stays

For the 171 DRGs that can be compared with the national average, Rex 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	316	$52,272	-42%	$13,650
291 Heart Failure and Shock with MCC	295	$29,801	-47%	$9,499
309 Cardiac Arrhythmia and Conduction Disorders with CC	181	$20,947	-42%	$5,671
177 Respiratory Infections and Inflammations with MCC	144	$42,333	-40%	$11,778
690 Kidney and Urinary Tract Infections without MCC	131	$21,139	-44%	$5,818
274 Percutaneous and Other Intracardiac Procedures without MCC	116	$81,962	-48%	$22,466
322 Percutaneous Cardiovascular Procedures with Intraluminal...	115	$67,062	-41%	$12,918
689 Kidney and Urinary Tract Infections with MCC	102	$24,345	-53%	$8,022
378 Gastrointestinal Hemorrhage with CC	96	$24,807	-49%	$7,218
287 Circulatory Disorders except AMI, with Cardiac...	95	$35,546	-44%	$7,951
308 Cardiac Arrhythmia and Conduction Disorders with MCC	95	$34,602	-39%	$8,755
321 Percutaneous Cardiovascular Procedures with Intraluminal...	95	$91,210	-44%	$21,141
193 Simple Pneumonia and Pleurisy with MCC	91	$28,781	-52%	$9,314
330 Major Small and Large Bowel Procedures with CC	91	$46,388	-61%	$17,028
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	91	$21,003	-43%	$5,650
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	86	$28,250	-53%	$9,706
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	84	$22,396	-44%	$5,937
178 Respiratory Infections and Inflammations with CC	83	$26,289	-42%	$7,051
280 Acute Myocardial Infarction, Discharged Alive with MCC	78	$54,079	-29%	$11,569
267 Endovascular Cardiac Valve Replacement and Supplement...	74	$139,110	-37%	$33,964
194 Simple Pneumonia and Pleurisy with CC	72	$20,512	-47%	$6,043
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	70	$33,968	-39%	$7,836
286 Circulatory Disorders except AMI, with Cardiac...	69	$48,324	-57%	$16,122
683 Renal Failure with CC	69	$22,791	-44%	$6,411
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	66	$47,223	-53%	$13,394
329 Major Small and Large Bowel Procedures with MCC	64	$109,766	-49%	$36,110
292 Heart Failure and Shock with CC	63	$28,505	-27%	$6,554
853 Infectious and Parasitic Diseases with O.R. Procedures with...	63	$130,384	-43%	$40,191
603 Cellulitis without MCC	62	$17,746	-52%	$6,306
552 Medical Back Problems without MCC	60	$22,667	-54%	$6,673
243 Permanent Cardiac Pacemaker Implant with CC	58	$65,907	-41%	$15,644
698 Other Kidney and Urinary Tract Diagnoses with MCC	58	$38,783	-47%	$11,473
266 Endovascular Cardiac Valve Replacement and Supplement...	56	$168,564	-41%	$44,241
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	56	$30,660	-37%	$7,922
481 Hip and Femur Procedures except Major Joint with CC	52	$54,205	-46%	$15,190
377 Gastrointestinal Hemorrhage with MCC	51	$44,972	-47%	$12,377
699 Other Kidney and Urinary Tract Diagnoses with CC	49	$17,997	-62%	$7,415
312 Syncope and Collapse	48	$29,964	-34%	$6,309
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	48	$66,906	-35%	$14,918
682 Renal Failure with MCC	48	$28,086	-57%	$10,336
164 Major Chest Procedures with CC	47	$51,122	-60%	$18,928
331 Major Small and Large Bowel Procedures without CC/MCC	47	$33,281	-61%	$12,853
460 Spinal Fusion except Cervical without MCC	47	$94,049	-45%	$27,556
189 Pulmonary Edema and Respiratory Failure	46	$39,554	-31%	$8,995
252 Other Vascular Procedures with MCC	45	$85,617	-50%	$24,601
389 Gastrointestinal Obstruction with CC	44	$21,800	-44%	$6,225
057 Degenerative Nervous System Disorders without MCC	43	$31,307	-45%	$9,653
242 Permanent Cardiac Pacemaker Implant with MCC	43	$90,534	-44%	$24,148
811 Red Blood Cell Disorders with MCC	43	$32,978	-52%	$9,911
236 Coronary Bypass without Cardiac Catheterization without MCC	42	$98,088	-53%	$31,233
314 Other Circulatory System Diagnoses with MCC	42	$44,958	-53%	$14,101
812 Red Blood Cell Disorders without MCC	42	$24,171	-46%	$6,748
202 Bronchitis and Asthma with CC/MCC	41	$22,981	-50%	$7,376
253 Other Vascular Procedures with CC	41	$67,055	-49%	$20,112
470 Major Hip and Knee Joint Replacement or Reattachment of...	41	$73,623	-21%	$13,126
884 Organic Disturbances and Intellectual Disability	40	$28,372	-55%	$11,341
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	39	$35,544	-42%	$9,619
281 Acute Myocardial Infarction, Discharged Alive with CC	38	$34,442	-32%	$6,631
394 Other Digestive System Diagnoses with CC	37	$19,600	-58%	$6,727
418 Laparoscopic Cholecystectomy without C.D.E. with CC	37	$48,889	-48%	$11,844

Showing the 60 most frequent of 171 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 1 Intraocular Procedures	1,219	$10,156	$2,069
Level 5 Musculoskeletal Procedures	1,077	$55,586	$11,741
Comprehensive Observation Services	724	$14,986	$2,421
Level 1 Endovascular Procedures	683	$15,165	$2,902
Level 3 Electrophysiologic Procedures	344	$121,388	$20,928
Level 1 Laparoscopy and Related Services	314	$20,371	$5,116
Level 3 Endovascular Procedures	303	$45,172	$9,682
Level 2 Intraocular Procedures	302	$14,733	$3,603
Level 2 Excision/ Biopsy/ Incision and Drainage	273	$5,701	$1,420
Level 4 Urology and Related Services	227	$15,710	$3,095
Level 4 Musculoskeletal Procedures	210	$22,896	$6,295
Level 3 Vascular Procedures	206	$12,169	$2,848
Level 2 Upper GI Procedures	193	$7,317	$1,685
Level 3 Pacemaker and Similar Procedures	183	$40,413	$9,482
Level 5 Urology and Related Services	175	$16,753	$4,637
Level 2 Laparoscopy and Related Services	152	$27,897	$8,983
Level 1 Breast/Lymphatic Surgery and Related Procedures	149	$11,836	$3,413
Level 2 Endovascular Procedures	136	$24,939	$5,087
Level 3 Urology and Related Services	130	$9,090	$1,812
Level 2 Breast/Lymphatic Surgery and Related Procedures	125	$20,457	$5,796
Level 6 Musculoskeletal Procedures	111	$87,393	$16,606
Level 4 Endovascular Procedures	93	$66,783	$14,997
Level 2 Pacemaker and Similar Procedures	91	$27,632	$7,485
Level 4 Airway Endoscopy	85	$21,525	$3,308
Level 5 Airway Endoscopy	84	$22,796	$6,045

Against the North Carolina average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Rex Hospital charged $52,272 on average, 8% less than the North Carolina average of $56,936, and was paid $13,650 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Rex Hospital charged $29,801 on average, 17% less than the North Carolina average of $35,799, and was paid $9,499 against a state average of $11,305. For Cardiac Arrhythmia and Conduction Disorders with CC (DRG 309), Rex Hospital charged $20,947 on average, 15% less than the North Carolina average of $24,688, and was paid $5,671 against a state average of $7,153. For Respiratory Infections and Inflammations with MCC (DRG 177), Rex Hospital charged $42,333 on average, 11% less than the North Carolina average of $47,554, and was paid $11,778 against a state average of $14,260. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $10,156 was 0% below the state average of $10,153. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $55,586 was 9% below the state average of $61,166. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $14,986 was 20% below the state average of $18,779. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $15,165 was 38% below the state average of $24,380.

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.