Johnston Health

JOHNSTON HEALTH in Smithfield, NC charges 5.0x the Medicare reimbursement rate on average across 59 analyzed procedures at this government-owned facility.

Smithfield, NC 27577 · Acute Care Hospitals · CMS Rating: 3/5

By Priya Iyengar , Senior Billing Analyst · Published March 15, 2026 · Updated April 3, 2026

Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.

About the analyst

Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.

59 procedures analyzed

CMS price transparency data

Updated 2026-04-03

5.0x

Medicare markup ratio

NC lowestJohnston HealthNC highest

5.0x

Avg markup ratio

5.0x

Median markup

Procedures

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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

High

Avg markup vs Medicare

5.05x

Charge / Medicare rate

Max markup

7.74x

Worst procedure

Procedures analyzed

With pricing data

Outlier procedures

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 GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC	372	$45,479	$22,740	—	7.7x
OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC	699	$44,917	$22,459	—	7.6x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC	308	$47,593	$23,796	—	6.5x
GASTROINTESTINAL HEMORRHAGE WITH CC	378	$38,269	$19,135	—	6.5x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC	066	$27,475	$13,738	—	6.5x
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC	439	$33,902	$16,951	—	6.4x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC	392	$28,824	$14,412	—	6.4x
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC	243	$96,337	$48,169	—	6.3x
SEIZURES WITHOUT MCC	101	$35,463	$17,732	—	6.3x
SIMPLE PNEUMONIA AND PLEURISY WITH CC	194	$31,823	$15,912	—	6.2x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC	287	$37,681	$18,840	—	6.1x
PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE	175	$54,754	$27,377	—	5.9x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC	281	$33,273	$16,636	—	5.9x
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC	329	$177,630	$88,815	—	5.9x
DIABETES WITH MCC	637	$43,399	$21,699	—	5.8x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC	872	$36,539	$18,269	—	5.8x
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC	190	$38,316	$19,158	—	5.7x
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC	470	$62,598	$31,299	—	5.6x
PULMONARY EDEMA AND RESPIRATORY FAILURE	189	$43,998	$21,999	—	5.6x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS	065	$31,224	$15,612	—	5.3x
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS	208	$89,706	$44,853	—	5.3x
CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC	191	$28,239	$14,120	—	5.3x
CELLULITIS WITHOUT MCC	603	$29,048	$14,524	—	5.2x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC	247	$64,939	$32,469	—	5.2x
MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC	641	$24,601	$12,300	—	5.1x
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC	690	$26,179	$13,090	—	5.1x
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC	178	$35,875	$17,938	—	5.1x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC	871	$61,474	$30,737	—	5x
RENAL FAILURE WITH CC	683	$25,636	$12,818	—	5x
SIMPLE PNEUMONIA AND PLEURISY WITH MCC	193	$41,505	$20,753	—	5x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC	280	$42,790	$21,395	—	4.9x
HEART FAILURE AND SHOCK WITH MCC	291	$40,587	$20,294	—	4.9x
GASTROINTESTINAL OBSTRUCTION WITH CC	389	$24,541	$12,270	—	4.9x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC	394	$32,065	$16,033	—	4.9x
HEART FAILURE AND SHOCK WITH CC	292	$28,665	$14,333	—	4.8x
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC	177	$55,644	$27,822	—	4.8x
RED BLOOD CELL DISORDERS WITH MCC	811	$42,596	$21,298	—	4.8x
KIDNEY AND URINARY TRACT INFECTIONS WITH MCC	689	$34,648	$17,324	—	4.7x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC	309	$22,205	$11,103	—	4.7x
RED BLOOD CELL DISORDERS WITHOUT MCC	812	$26,395	$13,197	—	4.6x
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC	522	$63,458	$31,729	—	4.5x
SYNCOPE AND COLLAPSE	312	$25,615	$12,807	—	4.5x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC	481	$60,691	$30,345	—	4.5x
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC	179	$22,773	$11,387	—	4.5x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC	064	$53,306	$26,653	—	4.3x
ORGANIC DISTURBANCES AND INTELLECTUAL DISABILITY	884	$45,197	$22,598	—	4.3x
DIABETES WITH CC	638	$23,131	$11,566	—	4.3x
SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS	870	$175,973	$87,987	—	4.2x
RENAL FAILURE WITH MCC	682	$40,787	$20,394	—	4.1x
CELLULITIS WITH MCC	602	$37,559	$18,780	—	4.1x

Showing 50 of 59 procedures

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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.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — government hospital billing

How do government hospital billing rates compare to Medicare benchmarks?

Based on available data from 374 government hospitals, charges average 4.2 times the Medicare benchmark rates. Government hospitals, while publicly owned, still establish their own pricing structures that can result in charges above standard Medicare rates.

Why do government hospitals charge above Medicare rates if they're publicly owned?

Government hospitals operate as independent entities that must cover operational costs, equipment, and staffing expenses. Public ownership doesn't require hospitals to limit charges to Medicare benchmark levels, as they still need to maintain financial sustainability for continued operations.

What should I expect when reviewing a government hospital bill?

Government hospital bills typically show charges that may be several times higher than Medicare benchmark rates, with the average markup being approximately 4.2x across sampled facilities. The final amount you pay will depend on your insurance coverage, negotiated rates, and any applicable financial assistance programs.

Are there potential billing differences between government hospitals and other facility types?

Government hospitals show similar billing patterns to other hospital types, with charges typically set above Medicare benchmarks. The potential difference in what patients ultimately pay often depends more on individual insurance plans and hospital financial assistance policies than on the ownership structure of the facility.

Related pricing data

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Smithfield, NC costsCity-level pricing data

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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