North Carolina / Wilson Medical Center
CMS certification 340126 · Wilson, NC · 3 entries in CMS's price-transparency list
Wilson Medical Center: charges and Medicare payments
Wilson Medical Center reported 639 Medicare inpatient stays across 21 DRGs in 2024. Across them it charged 5.37 times what it was paid — among the higher ratios in North Carolina, number 4 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: 151 stays at an average charge of $88,339, 2% below the national average. It also billed 970 outpatient services, charging 14.04 times what Medicare paid.
- 1Medicare inpatient stays 639
- 2Charge ÷ paid, inpatient 5.37×
- 3Rank in NC (highest ratio = 1) 4 of 73
- 4CMS price-transparency actions 3
Inpatient stays
For the 21 DRGs that can be compared with the national average, Wilson Medical Center charged more than the national average in 9 (43%). 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 | 151 | $88,339 | -2% | $16,114 |
| 291 Heart Failure and Shock with MCC | 101 | $54,378 | -4% | $10,656 |
| 189 Pulmonary Edema and Respiratory Failure | 37 | $73,928 | +28% | $10,053 |
| 193 Simple Pneumonia and Pleurisy with MCC | 32 | $47,222 | -21% | $10,782 |
| 177 Respiratory Infections and Inflammations with MCC | 31 | $72,570 | +3% | $13,571 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 28 | $61,238 | -17% | $13,503 |
| 682 Renal Failure with MCC | 27 | $81,107 | +23% | $12,612 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 25 | $44,179 | -22% | $9,770 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 23 | $187,128 | -18% | $44,530 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 23 | $49,924 | +2% | $8,464 |
| 689 Kidney and Urinary Tract Infections with MCC | 22 | $53,422 | +4% | $9,489 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 18 | $64,674 | -15% | $12,627 |
| 683 Renal Failure with CC | 17 | $40,706 | 0% | $7,356 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 15 | $59,855 | +7% | $8,232 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 15 | $35,356 | -30% | $9,031 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 15 | $104,975 | +74% | $12,148 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 14 | $28,254 | -22% | $6,174 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $26,858 | -28% | $6,420 |
| 378 Gastrointestinal Hemorrhage with CC | 11 | $38,548 | -21% | $8,076 |
| 481 Hip and Femur Procedures except Major Joint with CC | 11 | $134,193 | +33% | $16,761 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 11 | $347,024 | +7% | $64,678 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 367 | $19,818 | $2,021 |
| Comprehensive Observation Services | 153 | $34,872 | $2,420 |
| Level 3 Vascular Procedures | 77 | $28,633 | $2,650 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 73 | $12,782 | $1,430 |
| Level 5 Urology and Related Services | 48 | $51,073 | $4,576 |
| Level 3 Urology and Related Services | 45 | $29,914 | $1,681 |
| Level 1 Laparoscopy and Related Services | 40 | $71,006 | $4,899 |
| Level 2 Upper GI Procedures | 38 | $16,137 | $1,638 |
| Level 4 Urology and Related Services | 21 | $37,320 | $3,083 |
| Level 2 Vascular Procedures | 20 | $10,667 | $1,416 |
| Level 6 Urology and Related Services | 20 | $56,878 | $8,146 |
| Level 1 Endovascular Procedures | 19 | $28,521 | $2,886 |
| Level 3 Musculoskeletal Procedures | 18 | $34,639 | $2,862 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 18 | $58,520 | $3,059 |
| Level 4 Endovascular Procedures | 13 | $90,073 | $11,904 |
Against the North Carolina average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Wilson Medical Center charged $88,339 on average, 55% more than the North Carolina average of $56,936, and was paid $16,114 against a state average of $16,444. For Heart Failure and Shock with MCC (DRG 291), Wilson Medical Center charged $54,378 on average, 52% more than the North Carolina average of $35,799, and was paid $10,656 against a state average of $11,305. For Pulmonary Edema and Respiratory Failure (DRG 189), Wilson Medical Center charged $73,928 on average, 80% more than the North Carolina average of $41,108, and was paid $10,053 against a state average of $11,347. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Wilson Medical Center charged $47,222 on average, 18% more than the North Carolina average of $39,905, and was paid $10,782 against a state average of $11,523. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $19,818 was 95% above the state average of $10,153. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $34,872 was 86% above the state average of $18,779. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $28,633 was 67% above the state average of $17,111. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $12,782 was 36% above the state average of $9,423.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Wilson Medical Center in Wilson, NC, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2023-12-13 (CMS case 2101)
- Met Requirements — 2025-04-22 (CMS case 3915)
- Met Requirements — 2025-06-18 (CMS case 5261)
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.