Duke Regional Hospital
Duke Regional Hospital in Durham, NC charges 3.8x the Medicare reimbursement rate across 62 analyzed procedures, representing typical pricing patterns for government-owned hospitals.
Durham, NC 27704 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Billing patterns — government
Government hospitals in our dataset demonstrate distinct billing patterns compared to other ownership types. With 374 facilities analyzed, these hospitals show an average markup of 4.2x Medicare rates, which typically falls below the industry average for comparable services. Government hospitals often maintain more standardized pricing structures due to regulatory oversight and public accountability requirements. Patients may encounter charges above the benchmark for certain procedures, though the potential difference between government hospital billing and private facilities can vary significantly by service type and geographic region. Common charge patterns include transparent itemization of services and adherence to established fee schedules. Patients should be aware that government hospitals frequently offer financial assistance programs and sliding scale payment options based on income eligibility. These facilities often provide detailed cost estimates upon request and maintain patient financial counselors to discuss billing arrangements before treatment when possible.
Pricing grade
C
Average
Avg markup vs Medicare
3.78x
Charge / Medicare rate
Max markup
7.12x
Worst procedure
Procedures analyzed
62
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 |
|---|---|---|---|---|---|
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $117,078 | $58,539 | — | 7.1x |
| PSYCHOSES | 885 | $55,470 | $27,735 | — | 6.4x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $38,134 | $19,067 | — | 6.1x |
| MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | 483 | $88,117 | $44,058 | — | 5.6x |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $29,438 | $14,719 | — | 5.1x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $130,851 | $65,425 | — | 5.1x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $40,103 | $20,051 | — | 5x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $60,831 | $30,416 | — | 4.9x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $48,173 | $24,087 | — | 4.7x |
| ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | 884 | $59,859 | $29,929 | — | 4.6x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $67,334 | $33,667 | — | 4.5x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $58,127 | $29,063 | — | 4.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $61,456 | $30,728 | — | 4.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $26,263 | $13,131 | — | 4.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $30,339 | $15,170 | — | 4.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $30,423 | $15,212 | — | 4.3x |
| SEIZURES WITHOUT MCC | 101 | $27,852 | $13,926 | — | 4.2x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $123,855 | $61,927 | — | 4.1x |
| DIABETES WITH MCC | 637 | $40,047 | $20,023 | — | 4.1x |
| DIABETES WITH CC | 638 | $24,516 | $12,258 | — | 4x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $49,396 | $24,698 | — | 4x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $29,906 | $14,953 | — | 4x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $14,912 | $7,456 | — | 3.9x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $56,412 | $28,206 | — | 3.8x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $21,539 | $10,770 | — | 3.8x |
| CHEST PAIN | 313 | $18,792 | $9,396 | — | 3.8x |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC | 467 | $94,976 | $47,488 | — | 3.8x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $16,241 | $8,120 | — | 3.8x |
| SYNCOPE AND COLLAPSE | 312 | $21,835 | $10,917 | — | 3.7x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $20,992 | $10,496 | — | 3.7x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $55,996 | $27,998 | — | 3.6x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $23,094 | $11,547 | — | 3.6x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $34,249 | $17,125 | — | 3.5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $19,369 | $9,685 | — | 3.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $16,928 | $8,464 | — | 3.5x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $25,392 | $12,696 | — | 3.5x |
| RENAL FAILURE WITH CC | 683 | $21,123 | $10,562 | — | 3.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $29,321 | $14,661 | — | 3.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $22,223 | $11,111 | — | 3.2x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $30,113 | $15,056 | — | 3.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $19,642 | $9,821 | — | 3.2x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $22,512 | $11,256 | — | 3.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $18,676 | $9,338 | — | 3.1x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $41,315 | $20,657 | — | 3.1x |
| CELLULITIS WITHOUT MCC | 603 | $19,610 | $9,805 | — | 3.1x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $28,723 | $14,361 | — | 3.1x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $33,351 | $16,676 | — | 3.1x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $37,392 | $18,696 | — | 3.1x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $19,248 | $9,624 | — | 3x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $40,652 | $20,326 | — | 3x |
Showing 50 of 62 procedures
How DUKE REGIONAL HOSPITAL compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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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