Health Care (E210) IRS Verified DX Registered 990 on File

DUKE UNIVERSITY HEALTH SYSTEM INC

EIN: 56-2070036 · DURHAM, NC 27705-4677 · United States · FY 2023 Data

3 out of 5 55 / 100 Based on 2+ years of filings

Financial strength (30%) 73/100

Reliability (20%) 55/100

Effectiveness (25%) 88/100

Impact (25%) No data yet

Financial data: FY 2023 · Scored 9/13/2026

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CharityAI™ Score

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Financial Overview — FY 2023

$4672.8M

Total Revenue

$4623.2M

Total Expenses

$5123.5M

Net Assets

26017

Employees

Revenue Sources

Expense Breakdown

Program Expense Ratio 83.1%

Fundraising Efficiency 214.9%

Operating Reserve 13.30x

Liability-to-Asset 35.6%

Revenue Diversification 95.1%

Executive Compensation $11.6M

Compared with Peers

FY 2023

Compared with 1,811 similar organizations (United States, Health Care, $100M and over in expenses), FY 2023.

This organization Middle half of peers (P25–P75) Peer median

Ratio	This org	Peer median	Position (P10 → P90)
Program expense ratio Program expenses / total expenses · higher is better	83.1%	87.3%	P10P90	Below median
Admin expense ratio Management and general / total expenses · lower is better	16.9%	12.7%	P10P90	Below median
Fundraising expense ratio Fundraising expenses / total expenses · lower is better	0.0%	0.0%	P10P90	Bottom quarter
Fundraising efficiency Fundraising expenses / gross fundraising income · lower is better	214.9%	478.2%	P10P90	Above median
Operating reserve Months of expenses covered by net assets · higher is better	13.3 mo	6.0 mo	P10P90	Top quarter
Liabilities to assets Total liabilities / total assets · lower is better	35.6%	46.1%	P10P90	Above median
Revenue concentration Share of revenue from the largest source · lower is better	95.1%	96.8%	P10P90	Above median
Revenue growth Year over year revenue growth	1.6%	6.3%	P10P90
Expense growth Year over year expense growth	10.8%	6.6%	P10P90
Surplus margin Surplus as a share of revenue	1.1%	1.3%	P10P90

Financial History

Year	Revenue	Expenses	Net Assets	Program %	Staff
2023	$4672.8M	$4623.2M	$5123.5M	83.1%	26017
2022	$4600.5M	$4174.1M	$5460.7M	82.8%	25613
2021	$4625.5M	$3870.5M	N/A	—	23808

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Organization Details

EIN: 56-2070036
State: NC
City: DURHAM
ZIP: 27705-4677
Classification: E210
Category: Health Care
Rating: 3★
Coverage: A
Last Updated: Aug 2026
IRS Ruling Year: 2022
Foundation Code: 12
Form 990: On File

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CharityAI™ rates charities from 0 to 100 using public filings (IRS Form 990 and the equivalent registries outside the US) together with the information the charity itself provides on DonationX. Ratings are recalculated every quarter, without human bias, and shown as stars.

Four pillars

Financial strength30%

Program expense ratio, fundraising efficiency, operating reserves, liabilities and revenue diversification, compared with similar organizations.

Reliability20%

Standing with the registry, filing history, verification and how complete the profile is.

Effectiveness25%

How much goes to programs and how consistently the organization delivers them.

Impact25%

The outcomes the charity reports on DonationX: people served, cost per service and results.

Stars

★★★★★ 80–100 ★★★★☆ 60–79 ★★★☆☆ 40–59 ★★☆☆☆ 20–39 ★☆☆☆☆ 1–19

A pillar with no data counts as zero. Without impact metrics the score is capped at 59 (three stars): only the charity can supply that data.
The coverage grade (A to D) says how much filing data the score rests on; NONE means there is not enough to rate.
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