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Short Term Acute Care HospitalGovernment - Local

Watauga Medical Center

Appalachian Regional Healthcare System · Boone, NC

336 Deerfield Road, Boone, NC 28607(828) 263-1211

3 of 5

CMS star rating

121

Beds

4,365

Inpatient discharges a year

$211.1M

Net patient revenue a year

32

In-network payers

About this hospital

Watauga Medical Center is a 121-bed government - local hospital in Boone, NC, affiliated with Appalachian Regional Healthcare System. Below you'll find publicly disclosed negotiated rates and facility details, including 32 in-network payers and 294 disclosed rate categories.

  • Sole community hospital
  • Rural referral center
  • Disproportionate share hospital
  • Helipad
CCN
340051
NPI
1205859766
Health system
Appalachian Regional Healthcare System
Teaching
Teaching hospital
County
Watauga County
Metro area
Boone, NC MicroSA
Medicare contractor
Jurisdiction M, Palmetto GBA (11501)
In Medicare since
1966
Last CMS survey
1994

Negotiated Rates

The data below comes from CMS-mandated price transparency data. Learn more.

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PayerCategoryCode Type & GroupContract Typevs. State Average

Aetna

Outpatient

CPT Anesthesia

Range: 00100 - 01999

Negotiated

High

Aetna

Outpatient

CPT Anesthesia

Range: 00100 - 01999

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Category II Codes

Range: 0001F - 9007F

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Category III Codes

Range: 0042T - 0810T

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Category III Codes

Range: 0042T - 0810T

Negotiated

Very Low

Aetna

Outpatient

CPT Evaluation and Management

Range: 99091 - 99499

Negotiated

Very Low

Aetna

Outpatient

CPT Evaluation and Management

Range: 99091 - 99499

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Medicine Services and Procedures

Range: 90281 - 99607

Negotiated

Very Low

Aetna

Outpatient

CPT Medicine Services and Procedures

Range: 90281 - 99607

Percentage of Bill Charged

-

Aetna

Outpatient

CPT Multianalyte Assay

Range: 0002M - 0018M

Percentage of Bill Charged

-

Rates shown are negotiated amounts between this hospital and insurance providers. Actual patient costs depend on your insurance plan and coverage details.

...

Insurance Accepted

Acceptance varies by plan and service. Confirm coverage with your insurer or the hospital's billing department.

Medicare
Aetna
BCBS
Cigna
United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health)
Ameri HealthAspirus Health PlanAvera Health PlansBanner HealthCenteneEMI Health

More about this hospital

  • Quality

    3 of 5 stars

    • 192 min in the ER before going home (US median 148)
    • Medicare readmissions penalty (-0.49%)
    See quality ratings
  • Doctors and services

    Accredited by The Joint Commission

    • Teaching hospital
    • 32 services, including trauma care
    • 418 affiliated clinicians
    See doctors and services
  • Finances

    $211.1M net patient revenue

    • Operating margin on patient care 4.9%
    • $8.4M unreimbursed and uncompensated care
    • $20M net income
    See finances
  • Ownership and leadership

    Owned by Appalachian Regional Healthcare System Inc

    • Local
    See ownership and leadership

Tax IDs and NPIs insurers list

The employer identification numbers (EINs) health plans and networks list for Watauga Medical Center in the in-network rate files they publish, with the organization NPIs billed under each.

Tax ID (EIN)Plans and networks listing itOrganization NPIs
56-0510824Watauga Medical Center INC55Aetna, Cigna, United Healthcare (incl Optum, Rocky Mountain, Health Plan of Nevada, Sierra Health), Allied Benefit Systems, Ambetter and 50 more1205859766 Watauga Medical Center Inc1336215821 Watauga Medical Center Inc1255120184 Watauga Medical Center Incand 22 more

Source: PayerPrice analysis of insurers' Transparency in Coverage in-network files. An EIN can cover several hospitals and clinics in a health system, and insurers sometimes list other organizations' NPIs under it.

Location

336 Deerfield Road, Boone, NC 28607

(828) 263-1211

Get directions

Frequently asked questions

About Watauga Medical Center's rates and hospital price transparency.

What is Watauga Medical Center's CMS star rating?

Watauga Medical Center has a CMS overall hospital star rating of 3 out of 5 on Medicare Care Compare (CMS data released 2026-08-13). That is lower than 42% of US hospitals.

Is Watauga Medical Center a teaching hospital?

Yes. CMS counts 0.15 Medicare-funded residents per bed at Watauga Medical Center for fiscal year 2027, so it is a teaching hospital.

Does Medicare penalize Watauga Medical Center for readmissions?

Yes. Under the Hospital Readmissions Reduction Program, Medicare cuts Watauga Medical Center's base inpatient payments by an estimated 0.49% in fiscal year 2027 for more readmissions than expected.

What are the most common Medicare inpatient stays at Watauga Medical Center?

In 2024, the most common were septicemia or severe sepsis without mv >96 hours with mcc (78 discharges), heart failure and shock with mcc (54 discharges), major hip and knee joint replacement or reattachment of lower extremity without mcc (46 discharges).

What is Watauga Medical Center's case mix index?

Watauga Medical Center's Medicare case mix index is 1.62 for fiscal year 2027, higher than 43% of hospitals paid under the inpatient prospective payment system.

How many patients does Watauga Medical Center admit?

Watauga Medical Center reported 4,365 inpatient discharges and 16,892 inpatient days from Jul 1, 2024 to Jun 30, 2025.

How many employees does Watauga Medical Center have?

Watauga Medical Center reported 650 full-time-equivalent employees on payroll from Jul 1, 2024 to Jun 30, 2025.

How much revenue does Watauga Medical Center make?

Watauga Medical Center reported $211.1M in net patient revenue on $621.8M of gross charges for Jul 1, 2024 to Jun 30, 2025, an operating margin of 4.9%, and net income of $20M.

How much charity and uncompensated care does Watauga Medical Center provide?

Watauga Medical Center reported $8.4M of unreimbursed and uncompensated care for Jul 1, 2024 to Jun 30, 2025, including $4.5M of charity care at cost.

What is Watauga Medical Center's tax ID (EIN)?

Insurers' price transparency files list Watauga Medical Center under employer identification number 56-0510824 (Watauga Medical Center INC). 55 health plans and networks list 56-0510824 for it.

For hospital finance and compliance teams

Running price transparency at a hospital like this one?

The data on this page comes from the files hospitals and payers publish. We help hospitals publish theirs correctly, and take a fresh look at their chargemaster.

Compliance MRF

Publish a CMS-compliant machine-readable file

We turn your chargemaster and payer contracts into the CMS template file, then keep it current as rates change.

CMS v3 example: standard_charge_information[0]
{
  "description": "MRI of brain (no contrast)",
  "code_information": [
    { "code": "611", "type": "RC" },
    { "code": "70551", "type": "CPT" }
  ],
  "standard_charges": [{
    "setting": "outpatient",
    "minimum": 250,
    "maximum": 400,
    "gross_charge": 1200,
    "discounted_cash": 1080,
    "payers_information": [
      {
        "payer_name": "Platform Health Insurance",
        "plan_name": "PPO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 400
      },
      {
        "payer_name": "Region Health Insurance",
        "plan_name": "HMO",
        "methodology": "fee schedule",
        "standard_charge_dollar": 250
      }
    ]
  }]
}
  • CMS template layout, in JSON or CSV
  • Gross, discounted cash, payer-specific and de-identified min / max charges
  • cms-hpt.txt file and homepage footer link
  • Refreshed when your contracts change
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Chargemaster analysis

Get your chargemaster right for billing and payer contracts

Your chargemaster sets the gross charge on every claim, and many payer contracts base payment on it through percent-of-charge, lesser-of and stop-loss terms. We audit it line by line and show how your charges and negotiated rates compare with peer hospitals before your next negotiation.

What a review covers

CodingPricingPayer contractsCompliance
  • CPT, HCPCS, revenue code and modifier errors flagged line by line
  • Missing, duplicate and outdated charge lines identified
  • Charges set below payer allowables caught before lesser-of clauses cut payment
  • Revenue impact of charge changes modeled across percent-of-charge and stop-loss terms
  • Your negotiated rates benchmarked against peer hospitals for the same payers
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