How many shoppable procedure prices are published for Atrium Health Pineville?

Atrium Health Pineville in Charlotte, NC currently has 128 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Atrium Health Pineville's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Atrium Health Pineville's median negotiated commercial rate is 0.9× the regionally adjusted fair BaseRate benchmark.

What is Atrium Health Pineville's CMS Care Compare overall star rating?

CMS Care Compare assigns Atrium Health Pineville an overall hospital quality rating of 3 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Government - Hospital District or Authority 352 Beds · urban Updated: 2025-12-05

Atrium Health Pineville

10628 Park Rd, Charlotte, NC 28210 · 128 Priced Procedures · 75% Patient Recommendation

CMS Overall Rating 3 / 5 Stars

Good Deal · Below Fair Market

0.90×vs. Fair Market Price

Typical commercial prices here are 10% below the fair benchmark (0.90×) after accounting for local nurse/doctor wages and patient complexity.

79/100 · Corroborated

79/100Self-Pay Cash Beats Insurance 49% of the Time

File Completeness51

Price Logic94

Peer Alignment58

Clean Billing92

Real Cash Discount100

Regional Benchmark Tier

3-Star CMS clinical quality rating paired with 0.90× fair market pricing.

Behavioral Pricing FingerprintLow Shoppable & Low Captive Rates

Uniform Value Leader · Low-Cost Across Departments

Atrium Health Pineville maintains low, disciplined commercial pricing across both routine shoppable procedures (0.7× Medicare, p50 0.84× Fair BaseRate) and emergency/ancillary services (1.3× Medicare, p75 1.07× Fair BaseRate). Both insured and self-pay patients benefit from below-benchmark rates across departments.

#11 of 69 in NC · 14th State Percentile#651 of 3,385 in U.S. · 19th National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Elective shoppable care is priced 10% below peer Fair BaseRate (0.90×)
Self-pay cash beats commercial insurance on 49% of shoppable procedures (99/100 Cash Honesty)
CMS clinical safety score (66/100 safety score) with 75% patient recommendation
Binding Good Faith Estimate rights under 45 CFR § 149.610 protect self-pay patients before scheduling

Watchout

Where You Can Get Burned (Markup Traps)

Even at low-cost facilities (0.90× Fair BaseRate), out-of-network or unnegotiated chargemaster bills can exceed commercial medians — confirm in-network status or request a self-pay cash quote up front.
Captive ER (1.3×) & laboratory (4.1×) services average 1.86× higher multiples than routine shoppable care (0.7×)
Upper-quartile procedures (Q75 1.07×) jump +27% above the median procedure ratio (Q50 0.84×)
Unnegotiated chargemaster list prices average 14.3× Medicare (15¢ true HCRIS cost per $1 gross)

Front-Door ShoppableElective / Imaging

0.7× Medicare

Pre-scheduled outpatient procedures where patients can comparison-shop.

Back-Door Captive & ER1.86× Divergence

1.3× Medicare

Emergency, inpatient DRG, lab, and specialty drug lines billed after admission.

Quantile Tail Spread+27% Upper Tail

Q25 0.58× · Q50 0.84× · Q75 1.07×

Detects median-gaming when upper-quartile codes spike above the p50 median.

Select any lens to inspect department markups, federal cost accounting, or insurer discounts.

Department & Integrity Multiples (vs. CMS Medicare Cost Anchor) Green ≤1.3× · Teal 1.3–1.8× · Amber 1.8–2.5× · Rose >2.5×

Front-Door Shoppable CareFront-Door Shoppable

0.7× MedicareGood

Outpatient Surgery & ORBack-Door Captive

0.5× MedicareGood

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

2.0× MedicareGood

Back-Door Captive ER VisitsBack-Door Captive

1.3× MedicareGood

Inpatient Lab & PathologyBack-Door Captive

4.1× MedicareElevated

Specialty & Infusion Drugs (J-Codes)Back-Door Captive

1.4× MedicareGood

Self-Pay Cash Honesty & 501(r)Integrity & Outcomes

49% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

3 CMS · 66/100Fair

Procedure Prices at Atrium Health Pineville

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 128 published procedures.

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Audit a Bill & 501(r) Cap ↓

Procedure & Billing Code	Self-Pay Cash	This Hospital	Fair BaseRate	vs. Fair
Spinal fusion, single level (inpatient stay) MS-DRG Code: `451`	—	$48,843	$30,775	unverified
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$29,597	$19,432	unverified
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$28,719	$19,087	unverified
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$25,270	$17,936	unverified
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$10,476	$8,223	unverified
Breast lump removal CPT Code: `19120`	$4,632	$4,632	$3,875	1.2×
C-section delivery (full package) CPT Code: `59510`	—	$2,466	$2,975	0.8×
Vaginal delivery (full package) CPT Code: `59400`	—	$2,229	$2,680	unverified
Trauma team activation HCPCS Code: `G0390`	$4,619	$1,321	$1,453	0.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$1,014	$6,109	0.2×
Blood transfusion CPT Code: `36430`	$738	$738	$498	1.5×
Injection procedure for pain management HCPCS Code: `G0260`	$917	$692	$855	0.8×
Sleep study (overnight, in lab) CPT Code: `95810`	$3,183	$573	$1,021	0.6×
Cataract surgery with lens implant CPT Code: `66984`	—	$521	$2,540	0.2×
Colonoscopy with biopsy CPT Code: `45380`	—	$491	$1,256	0.4×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$504	$3,372	0.1×
Bunion correction surgery CPT Code: `28296`	—	$484	$3,446	0.1×
Inguinal hernia repair CPT Code: `49505`	—	$480	$3,629	0.1×
Upper endoscopy with biopsy CPT Code: `43239`	—	$358	$987	0.4×
Rabies immune globulin HCPCS Code: `90375`	$2,768	$294	$322	0.9×
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$3,217	$276	$448	0.6×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,659	$301	$511	0.6×
MRI, lower back (no contrast) CPT Code: `72148`	$2,013	$228	$338	0.7×
MRI, knee or other leg joint CPT Code: `73721`	$1,922	$235	$369	0.6×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,780	$209	$583	0.4×
Hepatitis B immune globulin HCPCS Code: `90371`	$841	$141	$151	0.9×
Psychotherapy session (45 minutes) CPT Code: `90834`	$94	$148	$166	0.9×
Psychotherapy session (60 minutes) CPT Code: `90837`	$110	$159	$181	0.9×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$1,156	$184	$272	0.7×
Neurobehavioral status check CPT Code: `96116`	$353	$154	$231	0.7×
CT scan, head (with and without contrast) CPT Code: `70470`	$1,942	$164	$258	0.6×
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,875	$174	$303	0.6×
MRI, brain (no contrast) CPT Code: `70551`	$1,765	$188	$343	0.5×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$175	$981	0.2×
New patient office visit (30-44 min) CPT Code: `99203`	—	$108	$110	1.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	—	$119	$123	1.0×
Screening mammogram (both breasts) CPT Code: `77067`	$320	$102	$123	0.8×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$443	$120	$148	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$665	$106	$134	0.8×
CT scan, chest (no contrast) CPT Code: `71250`	$1,350	$123	$167	0.7×
CT scan, head (with contrast) CPT Code: `70460`	$1,520	$140	$242	0.6×
Care planning with family CPT Code: `90887`	$109	$84	$107	0.8×
Ultrasound, pelvis CPT Code: `76856`	$644	$95	$130	0.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$545	$86	$132	0.7×
CT scan, pelvis CPT Code: `72192`	$1,390	$105	$163	0.6×
CT scan, head (no contrast) CPT Code: `70450`	$1,269	$102	$160	0.6×
CT scan, sinuses CPT Code: `70486`	$1,145	$105	$166	0.6×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,504	$105	$168	0.6×
CT scan, neck (cervical spine) CPT Code: `72125`	$1,514	$105	$169	0.6×
Typhoid vaccine HCPCS Code: `90675`	$757	$330	$347	1.0×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	$280	$183	$203	0.9×
Drug screening test HCPCS Code: `G0480`	$141	$141	$116	1.2×
Pneumococcal vaccine HCPCS Code: `90732`	$182	$141	$140	1.0×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	$195	$103	$111	0.9×
Office visit, established patient (20-29 min) CPT Code: `99213`	—	$78	$87	0.9×
Speech therapy (language evaluation) CPT Code: `92507`	$177	$72	$86	0.8×
Ultrasound, abdomen (limited) CPT Code: `76705`	$473	$75	$126	0.6×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	$107	$76	$56	unverified
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	$64	$45	$39	1.2×
Psychiatric evaluation (first visit) CPT Code: `90791`	$70	$70	$185	0.4×
Hepatitis B vaccine HCPCS Code: `90744`	$22	$40	$37	1.1×
X-ray, neck (cervical spine) CPT Code: `72040`	$299	$36	$93	0.4×
X-ray, lower back CPT Code: `72110`	$430	$42	$112	0.4×
X-ray, chest (two views) CPT Code: `71046`	$232	$31	$93	0.3×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$40	$4	$3	1.3×
Blood test, lipase CPT Code: `83690`	$141	$9	$7	1.3×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$46	$5	$4	1.3×
Blood test, complete blood count (CBC) CPT Code: `85025`	$135	$10	$8	1.3×
Culture, bacterial CPT Code: `87070`	$171	$11	$9	1.2×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$188	$17	$14	1.2×
Blood test, ferritin (iron stores) CPT Code: `82728`	$157	$17	$14	1.2×
Blood test, PSA (prostate screen) CPT Code: `84153`	$104	$23	$19	1.2×
Hepatitis C antibody test CPT Code: `86803`	$175	$18	$15	1.2×
Blood test, vitamin D CPT Code: `82306`	$225	$37	$31	1.2×
Blood test, calcium CPT Code: `82310`	$62	$6	$5	1.2×
Blood test, creatinine (kidney) CPT Code: `82565`	$53	$6	$5	1.2×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$137	$12	$10	1.2×
Blood test, potassium CPT Code: `84132`	$39	$6	$5	1.2×
Blood test, vitamin B12 CPT Code: `82607`	$159	$19	$16	1.2×
Culture, blood CPT Code: `87040`	$150	$13	$11	1.2×
Blood test, thyroid (TSH) CPT Code: `84443`	$187	$21	$18	1.2×
Diagnostic procedure preparation HCPCS Code: `G0279`	—	$37	$35	1.1×
Blood test, basic metabolic panel CPT Code: `80048`	$177	$10	$9	1.1×
Blood test, liver function panel CPT Code: `80076`	$199	$10	$9	1.1×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	$137	$28	$27	1.0×
Extended office visit (prolonged) HCPCS Code: `G2212`	—	$34	$33	1.0×
Blood test, clotting time (PTT) CPT Code: `85730`	$70	$7	$6	1.2×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$245	$11	$11	1.0×
X-ray, hip CPT Code: `73502`	$230	$34	$93	0.4×
Blood test, amylase CPT Code: `82150`	$130	$8	$7	1.1×
Blood test, magnesium CPT Code: `83735`	$73	$8	$7	1.1×
X-ray, ankle CPT Code: `73610`	$275	$31	$93	0.3×
Blood test, glucose (blood sugar) CPT Code: `82947`	$38	$5	$4	1.3×
Blood test, sodium CPT Code: `84295`	$42	$6	$5	1.2×
X-ray, hand CPT Code: `73130`	$267	$30	$93	0.3×
X-ray, shoulder CPT Code: `73030`	$279	$29	$92	0.3×
Blood test, hemoglobin CPT Code: `85018`	$48	$3	$3	1.0×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$68	$5	$5	1.0×
Flu vaccine (high dose) HCPCS Code: `90656`	$35	$24	$25	1.0×
Flu vaccine injection HCPCS Code: `G0008`	$61	$46	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	$59	$46	$49	0.9×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$104	$20	$20	1.0×
Prosthetic fitting and training CPT Code: `97761`	$40	$39	$45	0.9×
Orthotic fitting and training CPT Code: `97760`	$76	$44	$51	0.9×
Electrical stimulation therapy HCPCS Code: `G0283`	$77	$12	$14	0.9×
Speech therapy (group session) CPT Code: `92508`	$152	$23	$27	0.9×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$101	$34	$40	0.8×
Physical therapy (gait training) CPT Code: `97116`	$83	$28	$33	0.8×
Physical therapy (functional capacity test) CPT Code: `97750`	$42	$32	$38	0.8×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$90	$31	$38	0.8×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$95	$28	$35	0.8×
Physical therapy (manual therapy) CPT Code: `97140`	$122	$27	$34	0.8×
Psychological testing evaluation CPT Code: `96136`	$115	$47	$128	0.4×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$17	$25	0.7×
Blood antibody screen CPT Code: `86850`	$113	$15	$46	0.3×
Group therapy session CPT Code: `90853`	$101	$25	$100	0.3×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$291	$11	$64	0.2×
Family therapy session CPT Code: `90847`	$28	$28	$173	0.2×
Psychological testing by technician CPT Code: `96138`	$95	$50	$395	0.1×
X-ray, foot CPT Code: `73630`	$262	$24	$92	0.3×
X-ray, pelvis CPT Code: `72170`	$201	$20	$110	0.2×
X-ray, chest (single view) CPT Code: `71045`	$187	$16	$92	0.2×
Mental health services (assessment) HCPCS Code: `H0031`	—	$19	$140	0.1×
Behavioral health assessment HCPCS Code: `H0001`	—	$19	$157	0.1×
Breathing treatment (nebulizer) CPT Code: `94640`	$80	$22	$201	0.1×
Occupational therapy (self-care training) CPT Code: `97535`	$82	$32	$38	unverified
Colorectal cancer screening HCPCS Code: `G0010`	$59	$46	$49	unverified
Hospital observation (per hour) HCPCS Code: `G0378`	$2	$2	$86	0.0×

Showing top 25 high-impact procedures of 128 total

Inline Bill X-Ray & 501(r) Calculator For-Profit Facility · Cash & Fair BaseRate Audit

Audit a Bill or Quote at Atrium Health Pineville (Zero PHI Required)

CMS CCN: 340098

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $48,843

1. Amount on Your Bill or Quote ($) Pre-filled with Atrium Health Pineville’s charged/list benchmark

2. Household Annual Income ($) Screened against 2026 HHS Federal Poverty Guidelines

3. Household Size (1–8) 2026 FPL: $15,650 + $5,500 per additional person

Step 1 · 501(r) Charity Care Check 274% of 2026 FPL

Above Standard 400% FPL Financial-Assistance Ceiling

At 274% FPL, you exceed the standard 400% FPL tier, though medical-hardship caps (when bills exceed 10% of annual income) may still apply.

Step 2 · Cash vs. Insurance Arbitrage Request Prompt-Pay Quote

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Atrium Health Pineville's billing desk for their written 45 CFR § 180 discounted self-pay cash price and Good Faith Estimate under the No Surprises Act.

Step 3 · Fair BaseRate Target +$86,448 Above Fair BaseRate

Negotiate Toward $30,775 Fair BaseRate ($23,504 Medicare)

Your bill ($117,223) is $86,448 above the denoised Fair BaseRate ($30,775) and 5.0× the $23,504 Medicare rate.

1-Click Factual Dispute Summary: Copy a citation-backed benchmark memo (with CMS CCN, CPT code, Medicare reference, Fair BaseRate, and 26 U.S.C. § 501(r) calculations) to paste into patient-portal messages or billing appeals.

IRS Form 990 Schedule H & 26 U.S.C. § 501(r) For-Profit / Non-501(c)(3)

Financial Assistance Policy (FAP) & Amounts Generally Billed (AGB)

Public IRS & CMS ownership records classify Atrium Health Pineville as a non-501(c)(3) facility. Federal 26 U.S.C. § 501(r) statutory charity-care caps apply specifically to tax-exempt nonprofit hospitals, though state hospital fair-pricing statutes and prompt-pay self-pay discounts may still apply.

Screen your household size, income, and itemized CPT codes against 2026 HHS Federal Poverty Guidelines: Calculate Your 501(r) Cap Above ↑

CMS Care Compare Public Quality Record

Clinical Quality, Patient Experience & Infection Benchmarks

CMS Overall3/5 Stars (3/5)

Safety Composite66/100

Would Recommend75%

Rated 9 or 10 (HCAHPS)72%

Median ER Wait170 min

Left ER Before Seen2%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate4.4%

Healthcare-Associated Infections (CDC NHSN / CMS HAI)

1.00 SIR = National Predicted Baseline (Lower Is Safer)

Central-Line Bloodstream Infectionbetter

C. diff Hospital-Onset Infectionbetter

CMS Price Transparency Administrative Enforcement Log

Factual public administrative actions published by the Centers for Medicare & Medicaid Services regarding 45 CFR § 180 compliance at Atrium Health Pineville. Prior administrative notices do not necessarily reflect current compliance status.

2026-02-05·administrative_or_closure
Met Requirements
Recorded
2025-02-14·administrative_or_closure
Closure Notice
Recorded
2024-11-06·warning_notice
Warning Notice
Recorded

Source: CMS Hospital Care Compare (1,259 completed HCAHPS patient surveys). Clinical quality metrics summarize historical facility-wide cohorts and are not medical advice for individual care decisions.

Care-Setting Arbitrage, Bilateral SVD Insurer Leverage & Regional Alternatives

How to Pay Less Nearby: Freestanding Centers, Insurer Leverage & Outpatient Savings

Regional Quality & Price Benchmark

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Atrium Health Pineville.

Price Index: 0.99× regional baseline

Quality: 64/100 CMS composite

Notable Payer Contract Outliers (SVD Matrix Anomalies)

Alliance

-46.3%

Median Household Income$83,765U.S. Census ACS

Local Uninsured Share11.6%Regional ACS estimate

200% FPL (1 Person)$31,920Common free-care ceiling

400% FPL (Family of 4)$128,600Common AGB cap ceiling

45 CFR § 180 Primary-Source Lineage & Federal Verification VeriRate 79/100 · Corroborated CMS CCN 340098

Verify the Raw Data: Official Hospital MRF, CMS Medicare.gov & Federal Filings

MRF Portal Indexed (CMS_45_CFR_180_FILING.json) Verify on CMS Medicare.gov (CCN 340098) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2025-12-05

Validated Rate Rows10,784 (CMS v3.0.0)

File Integrity DigestVerified · CCN 340098

Safe-Harbor Data Corrections: Parsed directly from public 45 CFR § 180 hospital filings, CMS Care Compare, and CMS HCRIS cost reports. Hospital compliance officers may submit updated MRF URLs or rate tables for verification.

Submit MRF Update Correction Policy