How many shoppable procedure prices are published for Novant Health Forsyth Medical Center?

Novant Health Forsyth Medical Center in Winston-Salem, NC currently has 122 standardized procedure price records indexed from its public 45 CFR § 180 machine-readable file.

How do Novant Health Forsyth Medical Center's commercial prices compare to the fair BaseRate?

Across scored shoppable procedures, Novant Health Forsyth Medical Center's median negotiated commercial rate is 1.6× the regionally adjusted fair BaseRate benchmark.

What is Novant Health Forsyth Medical Center's CMS Care Compare overall star rating?

CMS Care Compare assigns Novant Health Forsyth Medical Center an overall hospital quality rating of 4 out of 5 stars based on public federal clinical and patient-experience measures.

Hospital Profile Acute Care Hospital Voluntary non-profit - Private 906 Beds · rural Updated: 2026-03-29

Novant Health Forsyth Medical Center

3333 Silas Creek Parkway, Winston-Salem, NC 27103 · 122 Priced Procedures · 71% Patient Recommendation

CMS Overall Rating 4 / 5 Stars

High Markup · Shop Alternatives

1.62×vs. Fair Market Price

Typical commercial prices here are +62% above the fair benchmark (1.62×) even after accounting for local nurse/doctor wages and patient complexity.

69/100 · Caution

69/100Self-Pay Cash Beats Insurance 71% of the Time

File Completeness61

Price Logic45

Peer Alignment75

Clean Billing74

Real Cash Discount100

High-Markup · Check Safety

3-Star CMS clinical quality rating paired with 1.62× fair market pricing.

Behavioral Pricing FingerprintUpper-Quartile Spread · +50% Tail Jump

Wide Procedure Spread · Upper-Quartile Skew Pricer

Novant Health Forsyth Medical Center prices routine shoppable procedures at 2.9× Medicare (median 1.68× Fair BaseRate) while upper-quartile commercial rates jump +50% to 2.52× Fair BaseRate. Self-pay cash discounts and comparing specific CPT procedure codes before scheduling yield the strongest savings.

#59 of 69 in NC · 84th State Percentile#2,795 of 3,385 in U.S. · 82nd National Percentile

Advantage

Where They're Good (Patient & Payer Edge)

Bottom-quartile procedures (Q25) price at 0.97× the peer BaseRate benchmark
Self-pay cash beats commercial insurance on 71% of shoppable procedures (99/100 Cash Honesty)
4-Star CMS clinical rating with 71% patient recommendation (71/100 safety score)
IRS 501(c)(3) charity care provides free care up to 200% FPL and discounted care up to 400% FPL (62.2% AGB cap)

Watchout

Where You Can Get Burned (Markup Traps)

Outpatient surgery & OR suites carry a 3.6× markup over Medicare rates
Commercial insurance median sits at 1.68× Fair BaseRate (2.9× Medicare), so insured patients should always compare the self-pay cash price before paying.
Upper-quartile procedures (Q75 2.52×) jump +50% above the median procedure ratio (Q50 1.68×)
Consolidated metro market (HHI 3,761) limits in-network hospital competition (Highly Concentrated Monopoly (>2,500))

Front-Door ShoppableElective / Imaging

2.9× Medicare

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

Back-Door Captive & ER0.55× Divergence

1.6× Medicare

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

Quantile Tail Spread+50% Upper Tail

Q25 0.97× · Q50 1.68× · Q75 2.52×

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

2.9× MedicareFair

Outpatient Surgery & ORBack-Door Captive

3.6× MedicareElevated

Diagnostic Imaging (CT/MRI)Front-Door Shoppable

3.4× MedicareElevated

Back-Door Captive ER VisitsBack-Door Captive

4.2× MedicareElevated

Inpatient Lab & PathologyBack-Door Captive

4.7× MedicareWatchout

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

3.3× MedicareElevated

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

71% Cash Edge · 99/100Good

CMS Clinical Safety & Star ValueIntegrity & Outcomes

4 CMS · 71/100Fair

Procedure Prices at Novant Health Forsyth Medical Center

High-impact clinical procedures (MRIs, surgeries, inpatient stays, visits) are prioritized first. Use the category pills or search bar to filter all 122 published procedures.

Sort:

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`	—	$32,016	$30,775	1.0×
Hip or knee replacement (inpatient stay) MS-DRG Code: `470`	—	$20,083	$19,432	1.0×
Sepsis treatment (inpatient stay) MS-DRG Code: `871`	—	$19,385	$19,087	1.0×
Heart stent placement (inpatient stay) MS-DRG Code: `322`	—	$18,037	$17,936	1.0×
Total hip replacement CPT Code: `27130`	—	$12,607	$13,413	0.9×
Total knee replacement CPT Code: `27447`	—	$12,607	$13,523	0.9×
Digestive disorders treatment (inpatient stay) MS-DRG Code: `392`	—	$7,148	$8,223	0.9×
Gallbladder removal (laparoscopic) CPT Code: `47562`	—	$5,937	$6,109	1.0×
Breast lump removal CPT Code: `19120`	—	$3,845	$3,875	unverified
Inguinal hernia repair CPT Code: `49505`	—	$3,516	$3,629	1.0×
Bunion correction surgery CPT Code: `28296`	—	$3,213	$3,446	0.9×
Knee arthroscopy with meniscus repair CPT Code: `29881`	—	$3,213	$3,372	unverified
CT scan, abdomen and pelvis (with contrast) CPT Code: `74177`	$2,469	$2,469	$448	unverified
Cataract surgery with lens implant CPT Code: `66984`	—	$2,266	$2,540	0.9×
MRI, brain (with and without contrast) CPT Code: `70553`	$2,074	$2,102	$511	unverified
CT scan, abdomen and pelvis (no contrast) CPT Code: `74176`	$2,008	$2,008	$303	unverified
MRI, brain (no contrast) CPT Code: `70551`	$1,321	$1,430	$343	4.2×
MRI, lower back (no contrast) CPT Code: `72148`	$1,579	$1,413	$338	unverified
CT scan, head (with and without contrast) CPT Code: `70470`	$1,282	$1,337	$258	5.2×
Echocardiogram (heart ultrasound) CPT Code: `93306`	$1,331	$1,360	$583	2.3×
MRI, knee or other leg joint CPT Code: `73721`	$1,281	$1,284	$369	3.5×
Trauma team activation HCPCS Code: `G0390`	—	$1,309	$1,453	0.9×
CT scan, lower back (lumbar spine) CPT Code: `72131`	$1,213	$1,265	$168	unverified
CT scan, neck (cervical spine) CPT Code: `72125`	$1,169	$1,219	$169	7.2×
CT scan, head (with contrast) CPT Code: `70460`	$1,117	$1,165	$242	4.8×
Colonoscopy with biopsy CPT Code: `45380`	—	$1,175	$1,256	0.9×
CT scan, pelvis CPT Code: `72192`	$1,030	$1,140	$163	unverified
CT scan, sinuses CPT Code: `70486`	$999	$1,077	$166	unverified
CT scan, chest (no contrast) CPT Code: `71250`	$980	$1,013	$167	unverified
CT scan, head (no contrast) CPT Code: `70450`	$940	$981	$160	6.1×
Colonoscopy (diagnostic) CPT Code: `45378`	—	$913	$981	0.9×
Upper endoscopy with biopsy CPT Code: `43239`	—	$891	$987	0.9×
Sleep study (overnight, in lab) CPT Code: `95810`	—	$843	$1,021	0.8×
Injection procedure for pain management HCPCS Code: `G0260`	—	$693	$855	0.8×
Ultrasound, abdomen (complete) CPT Code: `76700`	$586	$604	$134	unverified
Ultrasound, pelvis CPT Code: `76856`	$574	$592	$130	unverified
Blood transfusion CPT Code: `36430`	$586	$563	$498	1.1×
Ultrasound, abdomen (limited) CPT Code: `76705`	$465	$476	$126	3.8×
Ultrasound, leg veins (duplex) CPT Code: `93970`	$513	$472	$272	1.7×
Ultrasound, thyroid and neck CPT Code: `76536`	$406	$419	$132	3.2×
Psychological testing by technician CPT Code: `96138`	—	$439	$395	1.1×
Diagnostic mammogram (both breasts) CPT Code: `77066`	$274	$314	$148	2.1×
X-ray, chest (two views) CPT Code: `71046`	$231	$268	$93	2.9×
X-ray, hip CPT Code: `73502`	$222	$264	$93	2.8×
X-ray, foot CPT Code: `73630`	$247	$258	$92	2.8×
X-ray, hand CPT Code: `73130`	$247	$258	$93	2.8×
X-ray, lower back CPT Code: `72110`	$263	$274	$112	2.4×
Psychiatric evaluation (first visit) CPT Code: `90791`	$241	$266	$185	1.4×
Rabies immune globulin HCPCS Code: `90375`	—	$273	$322	0.8×
New patient office visit (30-44 min) CPT Code: `99203`	$190	$218	$110	2.0×
Office visit, established patient (30-39 min) CPT Code: `99214`	$211	$243	$123	2.0×
X-ray, neck (cervical spine) CPT Code: `72040`	$247	$258	$93	unverified
X-ray, ankle CPT Code: `73610`	$247	$258	$93	unverified
X-ray, shoulder CPT Code: `73030`	$205	$214	$92	2.3×
X-ray, chest (single view) CPT Code: `71045`	$173	$204	$92	2.2×
X-ray, pelvis CPT Code: `72170`	$205	$214	$110	1.9×
Screening mammogram (both breasts) CPT Code: `77067`	$197	$228	$123	1.9×
Family therapy session CPT Code: `90847`	$238	$232	$173	1.3×
Breathing treatment (nebulizer) CPT Code: `94640`	$241	$227	$201	1.1×
Office visit, established patient (20-29 min) CPT Code: `99213`	$168	$190	$87	2.2×
Speech therapy (language evaluation) CPT Code: `92507`	$161	$181	$86	2.1×
Group therapy session CPT Code: `90853`	$173	$197	$100	2.0×
Psychotherapy session (45 minutes) CPT Code: `90834`	$168	$185	$166	1.1×
Psychotherapy session (60 minutes) CPT Code: `90837`	$181	$199	$181	1.1×
Neurobehavioral status check CPT Code: `96116`	—	$212	$231	0.9×
Electrocardiogram (EKG, tracing only) CPT Code: `93005`	$129	$117	$64	1.8×
Psychological testing evaluation CPT Code: `96136`	—	$131	$128	1.0×
Hepatitis B immune globulin HCPCS Code: `90371`	—	$131	$151	0.9×
Speech therapy (group session) CPT Code: `92508`	$96	$96	$27	3.6×
Physical therapy (gait training) CPT Code: `97116`	$73	$83	$33	2.5×
Physical therapy (manual therapy) CPT Code: `97140`	$73	$83	$34	2.4×
Physical therapy (therapeutic exercise) CPT Code: `97110`	$73	$83	$35	2.4×
Occupational therapy (self-care training) CPT Code: `97535`	$74	$89	$38	2.3×
Physical therapy (neuromuscular re-education) CPT Code: `97112`	$73	$83	$38	2.2×
Physical therapy (functional capacity test) CPT Code: `97750`	$73	$83	$38	2.2×
Occupational therapy (therapeutic activities) CPT Code: `97530`	$73	$83	$40	2.1×
Prosthetic fitting and training CPT Code: `97761`	$72	$84	$45	1.9×
Orthotic fitting and training CPT Code: `97760`	$73	$83	$51	1.6×
Varicella (chickenpox) vaccine HCPCS Code: `90716`	—	$326	$203	1.6×
Typhoid vaccine HCPCS Code: `90675`	—	$306	$347	0.9×
Drug screening test HCPCS Code: `G0480`	$265	$265	$116	unverified
Pneumococcal vaccine HCPCS Code: `90732`	—	$204	$140	1.5×
Prostate cancer screening (blood test) HCPCS Code: `G0103`	$157	$157	$20	7.8×
Blood test, vitamin D CPT Code: `82306`	$164	$164	$31	5.3×
Blood antibody screen CPT Code: `86850`	$175	$175	$46	3.8×
MMR vaccine (measles, mumps, rubella) HCPCS Code: `90707`	—	$169	$111	1.5×
Blood test, lipase CPT Code: `83690`	$94	$94	$7	13.4×
Hepatitis C antibody test CPT Code: `86803`	$111	$111	$15	7.4×
Blood test, thyroid (TSH) CPT Code: `84443`	$104	$104	$18	5.8×
Blood test, complete blood count (CBC) CPT Code: `85025`	$73	$73	$8	9.1×
Culture, bacterial CPT Code: `87070`	$77	$77	$9	8.6×
Blood test, basic metabolic panel CPT Code: `80048`	$76	$76	$9	8.4×
Blood test, vitamin B12 CPT Code: `82607`	$86	$86	$16	5.4×
Blood test, calcium CPT Code: `82310`	$49	$49	$5	9.8×
Blood test, magnesium CPT Code: `83735`	$59	$59	$7	8.4×
Blood test, liver function panel CPT Code: `80076`	$73	$73	$9	8.1×
Blood test, PSA (prostate screen) CPT Code: `84153`	$80	$80	$19	4.2×
Tdap vaccine (tetanus, diphtheria, pertussis) HCPCS Code: `90715`	—	$75	$56	1.3×
Hospital observation (per hour) HCPCS Code: `G0378`	$162	$69	$86	0.8×
Blood test, urea nitrogen (BUN, kidney) CPT Code: `84520`	$42	$42	$4	10.5×
Blood test, creatinine (kidney) CPT Code: `82565`	$47	$47	$5	9.4×
Blood test, potassium CPT Code: `84132`	$42	$42	$5	8.4×
Blood test, clotting time (PTT) CPT Code: `85730`	$46	$46	$6	7.7×
Blood test, amylase CPT Code: `82150`	$51	$51	$7	7.3×
Blood test, comprehensive metabolic panel CPT Code: `80053`	$69	$69	$11	6.3×
Culture, blood CPT Code: `87040`	$64	$64	$11	5.8×
Blood test, average blood sugar (A1c) CPT Code: `83036`	$55	$55	$10	5.5×
Blood test, cholesterol (lipid panel) CPT Code: `80061`	$74	$74	$14	5.3×
Blood test, ferritin (iron stores) CPT Code: `82728`	$73	$73	$14	5.2×
Urinalysis (automated, with microscopy) CPT Code: `81001`	$28	$28	$3	9.3×
Blood test, sodium CPT Code: `84295`	$38	$38	$5	7.6×
Blood test, clotting time (PT/INR) CPT Code: `85610`	$37	$37	$5	7.4×
Blood test, glucose (blood sugar) CPT Code: `82947`	$28	$28	$4	7.0×
DTaP vaccine (diphtheria, tetanus, pertussis) HCPCS Code: `90700`	—	$53	$39	1.4×
Blood test, hemoglobin CPT Code: `85018`	$21	$21	$3	7.0×
Flu vaccine (high dose) HCPCS Code: `90656`	—	$34	$25	1.4×
Hepatitis B vaccine HCPCS Code: `90744`	—	$49	$37	1.3×
Colorectal cancer screening (alternative) HCPCS Code: `G0145`	—	$27	$27	1.0×
Flu vaccine injection HCPCS Code: `G0008`	—	$46	$48	1.0×
Pneumonia vaccine injection HCPCS Code: `G0009`	—	$46	$49	0.9×
Colorectal cancer screening HCPCS Code: `G0010`	—	$46	$49	0.9×
Electrocardiogram (ECG/EKG) CPT Code: `93000`	—	$20	$25	0.8×

Showing top 25 high-impact procedures of 122 total

Inline Bill X-Ray & 501(r) Calculator 501(c)(3) Nonprofit · Free Care ≤200% FPL · AGB Cap 62.2%

Audit a Bill or Quote at Novant Health Forsyth Medical Center (Zero PHI Required)

CMS CCN: 340014

CPT 451

Select Procedure to Audit:

Fair BaseRate™ $30,775

Medicare Rate $23,504

Self-Pay Cash Request Quote

Insurer Median $32,016

1. Amount on Your Bill or Quote ($) Pre-filled with Novant Health Forsyth Medical Center’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 501(r) AGB Cap: $47,801 (274% FPL)

Statutory 501(r) AGB Cap Limits Bill to $47,801

At 274% FPL (201%–400% FPL tier), 26 U.S.C. § 501(r)(5) caps FAP-eligible bills at Amounts Generally Billed (62.2% of gross = $47,801).

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

Compare Prompt-Pay Cash Rate Against Remaining Deductible

Ask Novant Health Forsyth Medical Center'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 +$46,063 Above Fair BaseRate

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

Your bill ($76,838) is $46,063 above the denoised Fair BaseRate ($30,775) and 3.3× 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) 501(c)(3) Nonprofit Hospital

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

Free Care Eligibility BenchmarkUp to 200% FPL100% charity write-off income threshold

Discounted Care EligibilityUp to 400% FPLSliding-scale & AGB billing cap tier

Charity Care Share of ExpensesSee Schedule HNet community financial assistance reported

26 U.S.C. § 501(r)(5) AGB Benchmark Method: lookback_commercial_median

Hospital-Specific CMS HCRIS Benchmark (62.2% of gross charges)

Under 26 U.S.C. § 501(r)(5), a tax-exempt hospital organization may not bill FAP-eligible patients more than Amounts Generally Billed (AGB) to individuals with insurance covering emergency or medically necessary care. Derived from this facility’s reported CMS HCRIS cost-to-charge & insurer allowance filings. Verify your exact Financial Assistance Policy (FAP) determination directly with the billing office.

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 Composite71/100

Would Recommend71%

Rated 9 or 10 (HCAHPS)70%

Median ER Wait197 min

Left ER Before Seen1%

30-Day Mortality vs U.S.same

Unplanned Readmissionsame

Hip/Knee Complication Rate1.8%

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 Novant Health Forsyth Medical Center. Prior administrative notices do not necessarily reflect current compliance status.

2025-04-01·administrative_or_closure
Met Requirements
Recorded

Source: CMS Hospital Care Compare (456 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 Value & Quality Leader

2D regional comparison of commercial negotiated price index against CMS clinical quality composite for Novant Health Forsyth Medical Center.

Price Index: 0.99× regional baseline

Quality: 68/100 CMS composite

Median Household Income$65,541U.S. Census ACS

Local Uninsured Share10.5%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 69/100 · Caution CMS CCN 340014

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 340014) ↗ CMS HCRIS Cost Reports ↗

Published MRF FileCMS_45_CFR_180_FILING.json

Publication / Vintage2026-03-29

Validated Rate Rows7,043 (CMS v3.0.0)

File Integrity DigestVerified · CCN 340014

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