Pennsylvania / Jefferson Hospital
CMS certification 390265 · Jefferson Hills, PA
Jefferson Hospital: charges and Medicare payments
Jefferson Hospital reported 1,124 Medicare inpatient stays across 43 DRGs in 2024. Across them it charged 5.32 times what it was paid — mid-range in Pennsylvania, number 41 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: 128 stays at an average charge of $67,923, 25% below the national average. It also billed 1,846 outpatient services, charging 7.32 times what Medicare paid.
- 1Medicare inpatient stays 1,124
- 2Charge ÷ paid, inpatient 5.32×
- 3Rank in PA (highest ratio = 1) 41 of 117
- 4CMS price-transparency actions 0
Inpatient stays
For the 43 DRGs that can be compared with the national average, Jefferson Hospital charged more than the national average in 3 (7%). 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 | 128 | $67,923 | -25% | $13,510 |
| 291 Heart Failure and Shock with MCC | 127 | $43,515 | -23% | $8,557 |
| 193 Simple Pneumonia and Pleurisy with MCC | 68 | $52,144 | -13% | $9,230 |
| 177 Respiratory Infections and Inflammations with MCC | 61 | $61,364 | -13% | $10,951 |
| 683 Renal Failure with CC | 36 | $28,828 | -29% | $6,211 |
| 189 Pulmonary Edema and Respiratory Failure | 35 | $43,072 | -25% | $8,167 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 32 | $34,927 | -29% | $6,998 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 29 | $35,387 | -12% | $5,568 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 26 | $42,083 | -26% | $8,107 |
| 682 Renal Failure with MCC | 26 | $46,875 | -29% | $9,689 |
| 690 Kidney and Urinary Tract Infections without MCC | 26 | $29,290 | -23% | $5,538 |
| 603 Cellulitis without MCC | 25 | $33,267 | -11% | $5,915 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 25 | $112,954 | -51% | $31,144 |
| 378 Gastrointestinal Hemorrhage with CC | 24 | $34,660 | -29% | $6,473 |
| 552 Medical Back Problems without MCC | 24 | $31,613 | -35% | $6,375 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 21 | $30,470 | -18% | $5,914 |
| 194 Simple Pneumonia and Pleurisy with CC | 20 | $31,876 | -17% | $5,590 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 20 | $96,377 | -16% | $12,176 |
| 811 Red Blood Cell Disorders with MCC | 20 | $61,184 | -10% | $9,524 |
| 377 Gastrointestinal Hemorrhage with MCC | 19 | $60,945 | -29% | $11,730 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 18 | $157,607 | -29% | $31,836 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 18 | $46,363 | -37% | $10,332 |
| 312 Syncope and Collapse | 17 | $27,028 | -41% | $5,885 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 17 | $47,147 | -23% | $8,510 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 16 | $47,664 | -14% | $6,338 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 16 | $36,345 | +1% | $5,471 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 16 | $62,985 | -32% | $13,470 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 16 | $72,125 | -30% | $14,064 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 15 | $102,802 | -24% | $16,955 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 15 | $123,523 | +11% | $17,975 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 15 | $56,886 | -6% | $8,838 |
| 178 Respiratory Infections and Inflammations with CC | 14 | $38,091 | -16% | $6,390 |
| 234 Coronary Bypass with Cardiac Catheterization or Open... | 14 | $201,109 | -25% | $33,090 |
| 270 Other Major Cardiovascular Procedures with MCC | 14 | $184,027 | -29% | $33,582 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 14 | $58,911 | -22% | $11,791 |
| 481 Hip and Femur Procedures except Major Joint with CC | 14 | $74,404 | -26% | $13,722 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 13 | $146,251 | -11% | $22,043 |
| 389 Gastrointestinal Obstruction with CC | 13 | $28,482 | -27% | $5,487 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 13 | $25,893 | -45% | $6,673 |
| 057 Degenerative Nervous System Disorders without MCC | 11 | $29,573 | -48% | $8,706 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 11 | $52,973 | +5% | $7,293 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 11 | $61,081 | -46% | $14,346 |
| 689 Kidney and Urinary Tract Infections with MCC | 11 | $40,950 | -20% | $7,052 |
Outpatient services
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Jefferson Hospital charged $67,923 on average, 23% less than the Pennsylvania average of $88,167, and was paid $13,510 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Jefferson Hospital charged $43,515 on average, 24% less than the Pennsylvania average of $57,362, and was paid $8,557 against a state average of $11,112. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Jefferson Hospital charged $52,144 on average, 12% less than the Pennsylvania average of $59,404, and was paid $9,230 against a state average of $11,319. For Respiratory Infections and Inflammations with MCC (DRG 177), Jefferson Hospital charged $61,364 on average, 15% less than the Pennsylvania average of $72,025, and was paid $10,951 against a state average of $14,034. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $16,520 was 24% below the state average of $21,732. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $48,715 was 23% below the state average of $63,627. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,637 was 22% below the state average of $13,651. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $15,843 was 44% below the state average of $28,496.
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.