Pennsylvania / Forbes Hospital
CMS certification 390267 · Monroeville, PA · 2 entries in CMS's price-transparency list
Forbes Hospital: charges and Medicare payments
Forbes Hospital reported 1,443 Medicare inpatient stays across 57 DRGs in 2024. Across them it charged 4.82 times what it was paid — mid-range in Pennsylvania, number 50 of 117 hospitals with at least 100 stays (state median 4.27×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 156 stays at an average charge of $70,896, 21% below the national average. It also billed 1,530 outpatient services, charging 6.61 times what Medicare paid.
- 1Medicare inpatient stays 1,443
- 2Charge ÷ paid, inpatient 4.82×
- 3Rank in PA (highest ratio = 1) 50 of 117
- 4CMS price-transparency actions 2
Inpatient stays
For the 57 DRGs that can be compared with the national average, Forbes Hospital charged more than the national average in 1 (2%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 156 | $70,896 | -21% | $14,701 |
| 291 Heart Failure and Shock with MCC | 130 | $52,991 | -6% | $10,073 |
| 177 Respiratory Infections and Inflammations with MCC | 56 | $59,480 | -16% | $12,100 |
| 552 Medical Back Problems without MCC | 48 | $34,915 | -29% | $7,148 |
| 193 Simple Pneumonia and Pleurisy with MCC | 45 | $48,580 | -19% | $10,450 |
| 378 Gastrointestinal Hemorrhage with CC | 39 | $39,825 | -18% | $7,482 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 36 | $38,265 | -22% | $7,730 |
| 603 Cellulitis without MCC | 33 | $21,264 | -43% | $6,766 |
| 690 Kidney and Urinary Tract Infections without MCC | 33 | $27,226 | -28% | $6,068 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 30 | $57,999 | -24% | $11,694 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 30 | $73,834 | -34% | $16,553 |
| 683 Renal Failure with CC | 29 | $33,021 | -19% | $7,173 |
| 189 Pulmonary Edema and Respiratory Failure | 28 | $51,674 | -10% | $9,732 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 27 | $33,011 | -9% | $6,037 |
| 812 Red Blood Cell Disorders without MCC | 26 | $31,337 | -29% | $6,936 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 25 | $58,021 | -4% | $9,824 |
| 689 Kidney and Urinary Tract Infections with MCC | 25 | $39,671 | -23% | $8,964 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 24 | $56,325 | -44% | $14,896 |
| 638 Diabetes with CC | 24 | $32,196 | -23% | $7,015 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 23 | $29,437 | -27% | $5,989 |
| 394 Other Digestive System Diagnoses with CC | 23 | $33,003 | -30% | $7,201 |
| 481 Hip and Femur Procedures except Major Joint with CC | 23 | $98,925 | -2% | $16,902 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 21 | $40,327 | -28% | $8,303 |
| 377 Gastrointestinal Hemorrhage with MCC | 21 | $75,892 | -11% | $13,400 |
| 682 Renal Failure with MCC | 21 | $54,915 | -17% | $11,406 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 20 | $32,281 | -13% | $6,179 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 19 | $55,109 | -3% | $10,334 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 19 | $86,943 | -24% | $16,791 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 19 | $56,937 | -22% | $12,650 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 19 | $198,719 | -13% | $44,302 |
| 194 Simple Pneumonia and Pleurisy with CC | 18 | $31,869 | -17% | $5,951 |
| 313 Chest Pain | 18 | $26,049 | -35% | $5,517 |
| 178 Respiratory Infections and Inflammations with CC | 17 | $40,682 | -10% | $7,544 |
| 305 Hypertension without MCC | 17 | $22,382 | -44% | $5,824 |
| 069 Transient Ischemia without Thrombolytic | 16 | $34,429 | -32% | $6,099 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 16 | $38,331 | -24% | $6,863 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 16 | $157,829 | -44% | $47,427 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 16 | $33,746 | -29% | $7,847 |
| 312 Syncope and Collapse | 15 | $34,145 | -25% | $6,700 |
| 811 Red Blood Cell Disorders with MCC | 15 | $54,698 | -20% | $10,748 |
| 101 Seizures without MCC | 13 | $38,181 | -22% | $7,131 |
| 164 Major Chest Procedures with CC | 13 | $128,714 | +1% | $19,002 |
| 176 Pulmonary Embolism without MCC | 13 | $29,765 | -28% | $6,205 |
| 184 Major Chest Trauma with CC | 13 | $43,472 | -22% | $8,245 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 13 | $42,613 | -16% | $8,177 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 13 | $139,968 | -37% | $35,404 |
| 602 Cellulitis with MCC | 13 | $36,763 | -39% | $11,576 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 12 | $37,973 | -4% | $6,517 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 12 | $97,374 | -12% | $16,845 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 12 | $113,746 | -18% | $20,214 |
| 551 Medical Back Problems with MCC | 12 | $71,422 | -9% | $12,905 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 12 | $32,993 | -23% | $7,041 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 12 | $177,676 | -18% | $40,378 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 11 | $43,850 | -31% | $8,330 |
| 389 Gastrointestinal Obstruction with CC | 11 | $29,204 | -25% | $6,717 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $49,793 | -18% | $9,991 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 11 | $25,270 | -32% | $6,631 |
Outpatient services
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Forbes Hospital charged $70,896 on average, 20% less than the Pennsylvania average of $88,167, and was paid $14,701 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Forbes Hospital charged $52,991 on average, 8% less than the Pennsylvania average of $57,362, and was paid $10,073 against a state average of $11,112. For Respiratory Infections and Inflammations with MCC (DRG 177), Forbes Hospital charged $59,480 on average, 17% less than the Pennsylvania average of $72,025, and was paid $12,100 against a state average of $14,034. For Medical Back Problems without MCC (DRG 552), Forbes Hospital charged $34,915 on average, 24% less than the Pennsylvania average of $46,037, and was paid $7,148 against a state average of $8,567. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $19,053 was 12% below the state average of $21,732. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $39,951 was 37% below the state average of $63,627. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $16,254 was 43% below the state average of $28,496. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $15,403 was 40% below the state average of $25,570.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Forbes Hospital in Monroeville, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2024-08-16 (CMS case 2455)
- Met Requirements — 2025-06-04 (CMS case 4910)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.