North Carolina / Wilkes Regional Medical Center
CMS certification 340064 · North Wilkesboro, NC · 1 entry in CMS's price-transparency list
Wilkes Regional Medical Center: charges and Medicare payments
Wilkes Regional Medical Center reported 487 Medicare inpatient stays across 21 DRGs in 2024. Across them it charged 3.33 times what it was paid — mid-range in North Carolina, number 42 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: 116 stays at an average charge of $42,811, 53% below the national average. It also billed 449 outpatient services, charging 9.77 times what Medicare paid.
- 1Medicare inpatient stays 487
- 2Charge ÷ paid, inpatient 3.33×
- 3Rank in NC (highest ratio = 1) 42 of 73
- 4CMS price-transparency actions 1
Inpatient stays
For the 21 DRGs that can be compared with the national average, Wilkes Regional Medical Center 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 | 116 | $42,811 | -53% | $14,218 |
| 291 Heart Failure and Shock with MCC | 44 | $32,092 | -43% | $9,779 |
| 690 Kidney and Urinary Tract Infections without MCC | 24 | $21,651 | -43% | $6,759 |
| 194 Simple Pneumonia and Pleurisy with CC | 23 | $29,354 | -24% | $7,151 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 23 | $23,283 | -37% | $6,658 |
| 177 Respiratory Infections and Inflammations with MCC | 22 | $44,434 | -37% | $13,875 |
| 178 Respiratory Infections and Inflammations with CC | 22 | $29,330 | -35% | $8,093 |
| 193 Simple Pneumonia and Pleurisy with MCC | 22 | $36,911 | -38% | $10,099 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 21 | $28,820 | -41% | $8,621 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $31,200 | -46% | $9,546 |
| 689 Kidney and Urinary Tract Infections with MCC | 16 | $30,540 | -40% | $8,662 |
| 481 Hip and Femur Procedures except Major Joint with CC | 15 | $80,803 | -20% | $15,322 |
| 638 Diabetes with CC | 14 | $23,840 | -43% | $7,839 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $23,539 | -61% | $10,537 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 13 | $28,763 | -48% | $8,821 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 13 | $24,599 | -51% | $8,017 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 13 | $18,000 | -50% | $6,398 |
| 312 Syncope and Collapse | 13 | $26,597 | -42% | $7,378 |
| 378 Gastrointestinal Hemorrhage with CC | 13 | $37,656 | -22% | $8,758 |
| 603 Cellulitis without MCC | 13 | $25,673 | -31% | $7,287 |
| 683 Renal Failure with CC | 13 | $24,102 | -41% | $7,328 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 165 | $20,240 | $2,008 |
| Comprehensive Observation Services | 65 | $14,309 | $2,356 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 36 | $6,621 | $1,340 |
| Level 3 Musculoskeletal Procedures | 30 | $24,122 | $2,670 |
| Level 5 Musculoskeletal Procedures | 28 | $65,826 | $10,388 |
| Level 2 Musculoskeletal Procedures | 24 | $11,301 | $1,399 |
| Level 1 Nerve Procedures | 24 | $13,654 | $1,625 |
| Level 4 Musculoskeletal Procedures | 22 | $54,425 | $6,226 |
| Level 2 Upper GI Procedures | 20 | $14,773 | $1,596 |
| Level 3 Vascular Procedures | 19 | $16,826 | $2,774 |
| Level 4 Urology and Related Services | 16 | $19,748 | $3,034 |
Against the North Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Wilkes Regional Medical Center charged $42,811 on average, 25% less than the North Carolina average of $56,936, and was paid $14,218 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Wilkes Regional Medical Center charged $32,092 on average, 10% less than the North Carolina average of $35,799, and was paid $9,779 against a state average of $11,305. For Kidney and Urinary Tract Infections without MCC (DRG 690), Wilkes Regional Medical Center charged $21,651 on average, 19% less than the North Carolina average of $26,784, and was paid $6,759 against a state average of $7,680. For Simple Pneumonia and Pleurisy with CC (DRG 194), Wilkes Regional Medical Center charged $29,354 on average, 2% more than the North Carolina average of $28,784, and was paid $7,151 against a state average of $7,916. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $20,240 was 99% above the state average of $10,153. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $14,309 was 24% below the state average of $18,779. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $6,621 was 30% below the state average of $9,423. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $24,122 was 20% above the state average of $20,138.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Wilkes Regional Medical Center in North Wilkesboro, NC, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-04-17 (CMS case 3917)
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.