DUKE REGIONAL HOSPITAL
DURHAM, NC 27704 · Acute Care Hospitals
62 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024
By BillRazor Research · Last updated March 27, 2026 · Methodology
Procedures Analyzed
62
With CMS pricing data
Avg Charge-to-Medicare Ratio
3.8x
Chargemaster ÷ Medicare
CMS Quality Rating
Patient experience & outcomes
Hospital Type
Acute Care Hospitals
Government - Local
Above 90th Percentile
0%
Compared to NC hospitals
Understanding Your Costs
When you receive a bill from DUKE REGIONAL HOSPITAL, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, DUKE REGIONAL HOSPITAL lists chargemaster rates that average 3.8x the corresponding Medicare reimbursement amount across 62 procedures with publicly available pricing data (Source: CMS IPPS Provider Summary, FY2024).
The median hospital in NC has a chargemaster-to-Medicare ratio of 4.3x, with ratios across the state ranging from 1.2x to 8.8x. At 3.8x, this facility’s average ratio is below the state median. 78 hospitals in NC report pricing data to CMS (Source: CMS IPPS Provider Summary).
The procedure with the largest gap between the listed price and Medicare reimbursement at DUKE REGIONAL HOSPITAL is LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC (DRG 493). The listed chargemaster rate is $117,078, while Medicare reimburses $16,440 for the same procedure — a ratio of 7.1x (Source: CMS IPPS Provider Summary, FY2024).
What does this actually mean for your bill? Chargemaster rates are rarely what patients pay. If you have insurance, your insurer has negotiated a separate rate — often 40–60% less than the listed price. If you are uninsured, you may be able to negotiate directly with the hospital or request financial assistance. The chargemaster-to-Medicare ratio is a useful reference point for understanding listed pricing, but it does not represent what most patients will owe out of pocket.
DUKE REGIONAL HOSPITAL is a government - local acute care hospitals facility with a CMS quality rating of 4/5 stars. Note: CMS quality ratings measure patient outcomes and experience, not pricing. A hospital with high listed prices may provide excellent care, and pricing data alone should not be used to evaluate the quality of a healthcare provider.
Listed Chargemaster Rates vs Medicare Reimbursement — Top Procedures by Ratio
Source: CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Procedure Pricing Lookup
Search for a specific procedure or DRG code to see listed chargemaster rates and Medicare reimbursement amounts.
| Procedure | DRG | Listed Charge | Medicare Reimb. | Ratio | State Position | |
|---|---|---|---|---|---|---|
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $117,078 | $16,440 | 7.1x | 1th | Compare your bill |
| PSYCHOSES | 885 | $55,470 | $8,646 | 6.4x | 1th | Compare your bill |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $38,134 | $6,262 | 6.1x | 0th | Compare your bill |
| MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | 483 | $88,117 | $15,880 | 5.5x | 0th | Compare your bill |
| SIGNS AND SYMPTOMS WITHOUT MCC | 948 | $29,438 | $5,779 | 5.1x | 0th | Compare your bill |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $130,851 | $25,876 | 5.1x | 0th | Compare your bill |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $40,103 | $8,050 | 5.0x | 0th | Compare your bill |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH MCC | 070 | $60,831 | $12,326 | 4.9x | 0th | Compare your bill |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $48,173 | $10,244 | 4.7x | 0th | Compare your bill |
| ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY | 884 | $59,859 | $13,055 | 4.6x | 1th | Compare your bill |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $67,334 | $14,923 | 4.5x | 0th | Compare your bill |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $58,127 | $13,083 | 4.4x | 0th | Compare your bill |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $61,456 | $13,943 | 4.4x | 0th | Compare your bill |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $26,263 | $5,982 | 4.4x | 0th | Compare your bill |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $30,339 | $6,935 | 4.4x | 0th | Compare your bill |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $30,423 | $7,118 | 4.3x | 0th | Compare your bill |
| SEIZURES WITHOUT MCC | 101 | $27,852 | $6,708 | 4.2x | 0th | Compare your bill |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $123,855 | $30,488 | 4.1x | 0th | Compare your bill |
| DIABETES WITH MCC | 637 | $40,047 | $9,892 | 4.0x | 0th | Compare your bill |
| DIABETES WITH CC | 638 | $24,516 | $6,103 | 4.0x | 0th | Compare your bill |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $49,396 | $12,273 | 4.0x | 0th | Compare your bill |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $29,906 | $7,474 | 4.0x | 0th | Compare your bill |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $14,912 | $3,865 | 3.9x | 0th | Compare your bill |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $56,412 | $14,726 | 3.8x | 0th | Compare your bill |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $21,539 | $5,688 | 3.8x | 0th | Compare your bill |
| CHEST PAIN | 313 | $18,792 | $4,968 | 3.8x | 0th | Compare your bill |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC | 467 | $94,976 | $25,205 | 3.8x | 0th | Compare your bill |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $16,241 | $4,332 | 3.8x | 0th | Compare your bill |
| SYNCOPE AND COLLAPSE | 312 | $21,835 | $5,870 | 3.7x | 0th | Compare your bill |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $20,992 | $5,662 | 3.7x | 0th | Compare your bill |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $55,996 | $15,428 | 3.6x | 0th | Compare your bill |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $23,094 | $6,406 | 3.6x | 0th | Compare your bill |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $34,249 | $9,691 | 3.5x | 0th | Compare your bill |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $19,369 | $5,533 | 3.5x | 0th | Compare your bill |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $16,928 | $4,864 | 3.5x | 0th | Compare your bill |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $25,392 | $7,309 | 3.5x | 0th | Compare your bill |
| RENAL FAILURE WITH CC | 683 | $21,123 | $6,192 | 3.4x | 0th | Compare your bill |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $22,223 | $6,849 | 3.2x | 0th | Compare your bill |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $29,321 | $9,037 | 3.2x | 0th | Compare your bill |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $30,113 | $9,386 | 3.2x | 0th | Compare your bill |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $19,642 | $6,111 | 3.2x | 0th | Compare your bill |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $22,512 | $7,098 | 3.2x | 0th | Compare your bill |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $18,676 | $5,977 | 3.1x | 0th | Compare your bill |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $41,315 | $13,265 | 3.1x | 0th | Compare your bill |
| CELLULITIS WITHOUT MCC | 603 | $19,610 | $6,318 | 3.1x | 0th | Compare your bill |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $28,723 | $9,285 | 3.1x | 0th | Compare your bill |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $33,351 | $10,892 | 3.1x | 0th | Compare your bill |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $37,392 | $12,202 | 3.1x | 0th | Compare your bill |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $19,248 | $6,333 | 3.0x | 0th | Compare your bill |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $24,955 | $8,291 | 3.0x | 0th | Compare your bill |
Showing 50 of 62 procedures
All data from CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Statewide Context
Charge-to-Medicare ratio range across NC hospitals
78 hospitals in NC report pricing data to CMS. This facility's average ratio of 3.8x places it at the lower-middle range of the state range (Source: CMS IPPS Provider Summary).
What You Can Do
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How it worksData: CMS Inpatient Prospective Payment System (IPPS) Provider Summary, FY2024. All data is publicly available under federal law (45 CFR Part 180).
Important: Listed chargemaster rates are not what most insured patients pay. Actual costs depend on your insurance plan's negotiated rates, deductibles, and coverage terms. This information is for educational purposes only and does not constitute medical, legal, or financial advice.
Frequently Asked Questions About DUKE REGIONAL HOSPITAL
How much does DUKE REGIONAL HOSPITAL charge compared to Medicare?
According to CMS IPPS data, DUKE REGIONAL HOSPITAL's listed chargemaster rates average 3.8x the Medicare reimbursement amount across 62 procedures. Chargemaster rates are list prices and are not what most insured patients pay — actual costs depend on insurance negotiations and coverage terms.
What is the most expensive procedure at DUKE REGIONAL HOSPITAL?
The procedure with the highest chargemaster-to-Medicare ratio at DUKE REGIONAL HOSPITAL is LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC (DRG 493), with a listed charge of $117,078 compared to Medicare reimbursement of $16,440 — a ratio of 7.1x. Source: CMS IPPS Provider Summary.
Is DUKE REGIONAL HOSPITAL expensive compared to other NC hospitals?
DUKE REGIONAL HOSPITAL's average chargemaster-to-Medicare ratio is 3.8x. Ratios vary significantly across NC hospitals. This ratio reflects listed chargemaster prices, not what patients actually pay. CMS quality ratings, which measure patient outcomes and experience, are separate from pricing data.
Where does the pricing data for DUKE REGIONAL HOSPITAL come from?
All pricing data comes from the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Provider Summary, published under federal price transparency law (45 CFR Part 180). This data is publicly available and updated annually.
How can I check if my bill from DUKE REGIONAL HOSPITAL is correct?
You can upload your bill to BillRazor for a free comparison against publicly available Medicare reimbursement data. Our system analyzes every line item in 60 seconds. Research suggests 49-80% of hospital bills contain errors, including duplicate charges, incorrect procedure codes, and unbundling.
Does DUKE REGIONAL HOSPITAL in DURHAM, NC accept Medicare?
DUKE REGIONAL HOSPITAL is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact DUKE REGIONAL HOSPITAL directly or check with your insurance provider.
Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.