Caldwell Memorial Hospital
Caldwell Memorial Hospital in Lenoir, NC charges 3.6x the Medicare reimbursement rate on average across 17 analyzed procedures at this nonprofit facility.
Lenoir, NC 28645 · Acute Care Hospitals · CMS Rating: 1/5
About the analyst
Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.
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Pricing grade
C
Average
Avg markup vs Medicare
3.56x
Charge / Medicare rate
Max markup
4.45x
Worst procedure
Procedures analyzed
17
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $49,110 | $24,555 | — | 4.5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $19,249 | $9,624 | — | 4.2x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $24,109 | $12,054 | — | 4.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $21,123 | $10,561 | — | 4.2x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $50,587 | $25,294 | — | 4.1x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $28,358 | $14,179 | — | 4.1x |
| PSYCHOSES | 885 | $29,609 | $14,804 | — | 3.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $20,967 | $10,484 | — | 3.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $16,770 | $8,385 | — | 3.6x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $27,032 | $13,516 | — | 3.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $22,273 | $11,137 | — | 3.3x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $26,036 | $13,018 | — | 3.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $27,414 | $13,707 | — | 3.1x |
| RENAL FAILURE WITH CC | 683 | $16,531 | $8,266 | — | 3x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $33,645 | $16,822 | — | 2.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $32,423 | $16,212 | — | 2.8x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $21,031 | $10,515 | — | 2.7x |
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use