North Carolina / Rutherford Regional Medical Center
CMS certification 340013 · Rutherfordton, NC
Rutherford Regional Medical Center: charges and Medicare payments
Rutherford Regional Medical Center reported 430 Medicare inpatient stays across 19 DRGs in 2024. Across them it charged 4.73 times what it was paid — among the higher ratios in North Carolina, number 16 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: 109 stays at an average charge of $51,193, 43% below the national average. It also billed 405 outpatient services, charging 10.79 times what Medicare paid.
- 1Medicare inpatient stays 430
- 2Charge ÷ paid, inpatient 4.73×
- 3Rank in NC (highest ratio = 1) 16 of 73
- 4CMS price-transparency actions 0
Inpatient stays
For the 19 DRGs that can be compared with the national average, Rutherford Regional Medical Center charged more than the national average in 3 (16%). 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 | 109 | $51,193 | -43% | $14,510 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 74 | $100,599 | +8% | $15,473 |
| 193 Simple Pneumonia and Pleurisy with MCC | 23 | $50,386 | -16% | $10,274 |
| 291 Heart Failure and Shock with MCC | 21 | $55,219 | -2% | $10,133 |
| 689 Kidney and Urinary Tract Infections with MCC | 21 | $37,612 | -27% | $9,227 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 21 | $34,954 | -29% | $8,475 |
| 177 Respiratory Infections and Inflammations with MCC | 14 | $64,533 | -9% | $12,478 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 13 | $34,668 | -31% | $8,881 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 13 | $30,254 | -16% | $6,501 |
| 481 Hip and Femur Procedures except Major Joint with CC | 13 | $86,081 | -15% | $15,941 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 13 | $36,588 | -39% | $10,785 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 13 | $38,701 | +4% | $6,824 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 13 | $91,750 | -60% | $29,406 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 12 | $125,613 | -1% | $19,670 |
| 682 Renal Failure with MCC | 12 | $55,059 | -17% | $11,731 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 12 | $54,153 | -26% | $12,442 |
| 189 Pulmonary Edema and Respiratory Failure | 11 | $31,635 | -45% | $10,209 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 11 | $91,131 | +6% | $13,373 |
| 378 Gastrointestinal Hemorrhage with CC | 11 | $43,210 | -11% | $8,311 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 122 | $27,356 | $2,493 |
| Level 2 Upper GI Procedures | 66 | $9,287 | $1,720 |
| Level 3 Vascular Procedures | 42 | $21,642 | $2,971 |
| Level 1 Laparoscopy and Related Services | 32 | $40,793 | $5,378 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 28 | $16,516 | $1,511 |
| Level 4 Musculoskeletal Procedures | 23 | $48,417 | $6,437 |
| Level 1 Nerve Procedures | 21 | $13,613 | $1,731 |
| Level 2 Musculoskeletal Procedures | 19 | $11,042 | $1,498 |
| Level 3 Musculoskeletal Procedures | 16 | $20,963 | $3,017 |
| Level 2 Vascular Procedures | 13 | $9,448 | $1,493 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 12 | $33,375 | $2,515 |
| Level 4 Urology and Related Services | 11 | $32,372 | $3,249 |
Against the North Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Rutherford Regional Medical Center charged $51,193 on average, 10% less than the North Carolina average of $56,936, and was paid $14,510 against a state average of $16,444. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Rutherford Regional Medical Center charged $100,599 on average, 42% more than the North Carolina average of $70,932, and was paid $15,473 against a state average of $15,577. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Rutherford Regional Medical Center charged $50,386 on average, 26% more than the North Carolina average of $39,905, and was paid $10,274 against a state average of $11,523. For Heart Failure and Shock with MCC (DRG 291), Rutherford Regional Medical Center charged $55,219 on average, 54% more than the North Carolina average of $35,799, and was paid $10,133 against a state average of $11,305. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $27,356 was 46% above the state average of $18,779. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $9,287 was 18% below the state average of $11,289. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $21,642 was 26% above the state average of $17,111. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $40,793 was 23% above the state average of $33,086.
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.