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Rex Hospital

REX HOSPITAL in Raleigh, NC charges 4.2x the Medicare reimbursement rate on average across 171 procedures analyzed, reflecting the pricing structure at this government-owned facility.

Raleigh, NC 27607 · Acute Care Hospitals · CMS Rating: 5/5

By Michael Glenn , Healthcare Data Analyst · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
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.

171 procedures analyzed
CMS price transparency data
Updated 2026-04-03
Median 3.0x1.7x15.0x
4.2x
Medicare markup ratio
NC lowestRex HospitalNC highest
4.2x
Avg markup ratio
4.0x
Median markup
171
Procedures
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Compare your charges against 4 CMS benchmark datasets — including the rates shown on this page.

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

4.17x

Charge / Medicare rate

Max markup

7.58x

Worst procedure

Procedures analyzed

171

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.

ProcedureCodeGross chargeCash priceMedicareMarkup
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC066$29,079$14,5397.6x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC282$25,889$12,9457.2x
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES483$113,243$56,6226.7x
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC390$17,724$8,8626.5x
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC470$70,046$35,0236x
HYPERTENSION WITHOUT MCC305$25,846$12,9236x
OTITIS MEDIA AND URI WITHOUT MCC153$22,969$11,4856x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS065$34,148$17,0745.9x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH INTRALUMINAL DEVICE WITHOUT MCC322$66,886$33,4435.8x
PERITONEAL ADHESIOLYSIS WITH CC336$64,384$32,1925.8x
REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC468$109,553$54,7765.7x
GASTROINTESTINAL OBSTRUCTION WITH CC389$25,204$12,6025.7x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC281$26,691$13,3455.7x
OTHER VASCULAR PROCEDURES WITHOUT CC/MCC254$60,131$30,0655.6x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC247$65,271$32,6355.6x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC287$34,652$17,3265.5x
PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC273$131,827$65,9145.4x
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC419$41,528$20,7645.4x
SEIZURES WITHOUT MCC101$28,352$14,1765.3x
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC069$24,685$12,3435.3x
O.R. PROCEDURES FOR OBESITY WITHOUT CC/MCC621$43,286$21,6435.3x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITHOUT CC/MCC395$17,632$8,8165.2x
PULMONARY EDEMA AND RESPIRATORY FAILURE189$38,664$19,3325.1x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC310$13,381$6,6915.1x
DIGESTIVE MALIGNANCY WITH CC375$27,769$13,8855x
DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC439$21,890$10,9455x
INTERSTITIAL LUNG DISEASE WITH MCC196$68,587$34,2945x
POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC917$55,970$27,9854.9x
SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC195$16,334$8,1674.9x
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC522$65,974$32,9874.9x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC872$27,734$13,8674.9x
PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC244$54,084$27,0424.9x
REVISION OF HIP OR KNEE REPLACEMENT WITH CC467$121,091$60,5454.9x
HEART FAILURE AND SHOCK WITH CC292$26,169$13,0854.8x
EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH CC982$73,493$36,7474.8x
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC690$21,292$10,6464.8x
DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC057$32,730$16,3654.7x
DISORDERS OF THE BILIARY TRACT WITH CC445$30,391$15,1954.7x
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC660$41,859$20,9294.7x
NON-EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC987$107,426$53,7134.7x
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC854$48,096$24,0484.7x
RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS208$85,497$42,7484.7x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC392$20,931$10,4664.7x
PULMONARY EMBOLISM WITHOUT MCC176$20,876$10,4384.7x
RESPIRATORY INFECTIONS AND INFLAMMATIONS WITHOUT CC/MCC179$21,255$10,6274.6x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O246$88,962$44,4814.6x
MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC435$47,423$23,7124.6x
O.R. PROCEDURES FOR OBESITY WITH CC620$42,089$21,0454.6x
GASTROINTESTINAL OBSTRUCTION WITH MCC388$38,054$19,0274.6x
NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC071$29,934$14,9674.6x

Showing 50 of 171 procedures

How REX 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.

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

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

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