Pennsylvania / Heritage Valley Sewickley
CMS certification 390037 · Sewickley, PA
Heritage Valley Sewickley: charges and Medicare payments
Heritage Valley Sewickley reported 484 Medicare inpatient stays across 26 DRGs in 2024. Across them it charged 2.03 times what it was paid — among the lower ratios in Pennsylvania, number 112 of 117 hospitals with at least 100 stays (state median 4.27×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 65 stays at an average charge of $17,226, 69% below the national average. It also billed 713 outpatient services, charging 3.1 times what Medicare paid.
- 1Medicare inpatient stays 484
- 2Charge ÷ paid, inpatient 2.03×
- 3Rank in PA (highest ratio = 1) 112 of 117
- 4CMS price-transparency actions 0
Inpatient stays
For the 26 DRGs that can be compared with the national average, Heritage Valley Sewickley charged more than the national average in 0 (0%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 291 Heart Failure and Shock with MCC | 65 | $17,226 | -69% | $8,557 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 35 | $22,149 | -75% | $12,537 |
| 460 Spinal Fusion except Cervical without MCC | 32 | $45,616 | -73% | $23,691 |
| 193 Simple Pneumonia and Pleurisy with MCC | 25 | $17,629 | -70% | $8,874 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 24 | $15,458 | -72% | $6,656 |
| 603 Cellulitis without MCC | 22 | $10,847 | -71% | $5,867 |
| 177 Respiratory Infections and Inflammations with MCC | 19 | $26,070 | -63% | $10,721 |
| 194 Simple Pneumonia and Pleurisy with CC | 18 | $13,808 | -64% | $5,933 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 18 | $10,042 | -73% | $5,640 |
| 683 Renal Failure with CC | 18 | $17,000 | -58% | $6,140 |
| 690 Kidney and Urinary Tract Infections without MCC | 18 | $12,106 | -68% | $5,595 |
| 378 Gastrointestinal Hemorrhage with CC | 15 | $16,190 | -67% | $6,554 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 15 | $58,794 | -71% | $30,697 |
| 176 Pulmonary Embolism without MCC | 14 | $14,231 | -66% | $5,940 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 14 | $12,646 | -69% | $5,781 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $13,373 | -78% | $9,129 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 13 | $12,855 | -70% | $5,219 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 13 | $10,964 | -70% | $5,153 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 12 | $14,538 | -71% | $7,727 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 12 | $17,554 | -69% | $8,323 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 12 | $8,965 | -69% | $3,938 |
| 552 Medical Back Problems without MCC | 12 | $11,070 | -77% | $5,769 |
| 189 Pulmonary Edema and Respiratory Failure | 11 | $19,732 | -66% | $8,774 |
| 377 Gastrointestinal Hemorrhage with MCC | 11 | $24,995 | -71% | $12,661 |
| 682 Renal Failure with MCC | 11 | $19,297 | -71% | $10,232 |
| 689 Kidney and Urinary Tract Infections with MCC | 11 | $16,482 | -68% | $7,468 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 200 | $3,943 | $2,081 |
| Level 5 Musculoskeletal Procedures | 136 | $29,718 | $11,666 |
| Level 4 Urology and Related Services | 68 | $9,810 | $3,044 |
| Comprehensive Observation Services | 52 | $9,528 | $2,407 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 44 | $5,016 | $1,172 |
| Level 5 Urology and Related Services | 39 | $9,882 | $4,622 |
| Level 6 Musculoskeletal Procedures | 35 | $40,728 | $16,610 |
| Level 1 Laparoscopy and Related Services | 26 | $12,395 | $4,725 |
| Level 4 Musculoskeletal Procedures | 25 | $17,740 | $6,219 |
| Level 2 Upper GI Procedures | 23 | $5,755 | $1,699 |
| Level 3 Vascular Procedures | 21 | $10,146 | $2,847 |
| Level 3 Urology and Related Services | 20 | $5,712 | $1,819 |
| Level 1 Nerve Procedures | 13 | $4,769 | $1,088 |
| Level 2 Intraocular Procedures | 11 | $8,307 | $3,631 |
Against the Pennsylvania average
For Heart Failure and Shock with MCC (DRG 291), Heritage Valley Sewickley charged $17,226 on average, 70% less than the Pennsylvania average of $57,362, and was paid $8,557 against a state average of $11,112. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Heritage Valley Sewickley charged $22,149 on average, 75% less than the Pennsylvania average of $88,167, and was paid $12,537 against a state average of $16,881. For Spinal Fusion except Cervical without MCC (DRG 460), Heritage Valley Sewickley charged $45,616 on average, 71% less than the Pennsylvania average of $155,014, and was paid $23,691 against a state average of $32,289. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Heritage Valley Sewickley charged $17,629 on average, 70% less than the Pennsylvania average of $59,404, and was paid $8,874 against a state average of $11,319. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $3,943 was 73% below the state average of $14,403. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $29,718 was 53% below the state average of $63,627. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $9,810 was 62% below the state average of $25,570. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $9,528 was 56% below the state average of $21,732.
Price-transparency record
No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.
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.