Lehigh Valley Hospital: charges and Medicare payments

Lehigh Valley Hospital reported 15,219 Medicare inpatient stays across 272 DRGs in 2024. Across them it charged 7.04 times what it was paid — among the higher ratios in Pennsylvania, number 19 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: 992 stays at an average charge of $110,274, 22% above the national average. It also billed 12,607 outpatient services, charging 10.99 times what Medicare paid.

1Medicare inpatient stays 15,219
2Charge ÷ paid, inpatient 7.04×
3Rank in PA (highest ratio = 1) 19 of 117
4CMS price-transparency actions 0

Average charge per stay at Lehigh Valley Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 272 DRGs that can be compared with the national average, Lehigh Valley Hospital charged more than the national average in 245 (90%). 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	992	$110,274	+22%	$17,438
291 Heart Failure and Shock with MCC	830	$67,971	+21%	$11,706
552 Medical Back Problems without MCC	276	$55,519	+14%	$8,798
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	271	$48,630	+21%	$7,527
177 Respiratory Infections and Inflammations with MCC	243	$85,185	+21%	$14,728
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	227	$59,240	+21%	$9,639
267 Endovascular Cardiac Valve Replacement and Supplement...	213	$463,148	+109%	$41,992
683 Renal Failure with CC	213	$48,723	+20%	$8,354
312 Syncope and Collapse	206	$53,037	+16%	$7,857
189 Pulmonary Edema and Respiratory Failure	193	$77,775	+35%	$11,185
470 Major Hip and Knee Joint Replacement or Reattachment of...	186	$107,791	+16%	$16,472
378 Gastrointestinal Hemorrhage with CC	181	$67,435	+39%	$9,337
698 Other Kidney and Urinary Tract Diagnoses with MCC	176	$87,558	+19%	$14,993
853 Infectious and Parasitic Diseases with O.R. Procedures with...	176	$277,743	+21%	$43,737
884 Organic Disturbances and Intellectual Disability	171	$70,518	+13%	$14,573
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	169	$71,525	+28%	$9,386
682 Renal Failure with MCC	166	$83,708	+27%	$13,287
690 Kidney and Urinary Tract Infections without MCC	164	$46,135	+22%	$7,783
193 Simple Pneumonia and Pleurisy with MCC	159	$74,604	+25%	$11,975
322 Percutaneous Cardiovascular Procedures with Intraluminal...	147	$178,947	+56%	$16,746
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	141	$144,592	+45%	$17,504
309 Cardiac Arrhythmia and Conduction Disorders with CC	141	$46,769	+30%	$7,033
603 Cellulitis without MCC	139	$41,920	+12%	$8,224
543 Pathological Fractures and Musculoskeletal and Connective...	138	$60,996	+24%	$9,880
481 Hip and Femur Procedures except Major Joint with CC	132	$148,049	+47%	$18,843
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	132	$46,995	+27%	$7,400
178 Respiratory Infections and Inflammations with CC	131	$49,849	+10%	$9,233
057 Degenerative Nervous System Disorders without MCC	130	$71,030	+25%	$12,845
274 Percutaneous and Other Intracardiac Procedures without MCC	119	$263,489	+68%	$27,320
194 Simple Pneumonia and Pleurisy with CC	118	$47,429	+24%	$7,645
286 Circulatory Disorders except AMI, with Cardiac...	116	$169,287	+51%	$20,607
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	113	$474,354	+19%	$68,427
377 Gastrointestinal Hemorrhage with MCC	112	$118,872	+39%	$15,884
638 Diabetes with CC	104	$49,437	+19%	$8,308
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	104	$67,975	+1%	$12,391
689 Kidney and Urinary Tract Infections with MCC	103	$62,414	+22%	$10,012
092 Other Disorders of Nervous System with CC	102	$58,797	+14%	$9,367
321 Percutaneous Cardiovascular Procedures with Intraluminal...	98	$238,080	+45%	$25,836
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	98	$79,461	+32%	$11,516
280 Acute Myocardial Infarction, Discharged Alive with MCC	97	$107,295	+42%	$14,249
394 Other Digestive System Diagnoses with CC	97	$52,139	+11%	$8,656
885 Psychoses	95	$80,317	+82%	$14,693
389 Gastrointestinal Obstruction with CC	93	$51,602	+33%	$7,982
330 Major Small and Large Bowel Procedures with CC	91	$149,612	+26%	$21,766
329 Major Small and Large Bowel Procedures with MCC	88	$294,185	+37%	$41,435
699 Other Kidney and Urinary Tract Diagnoses with CC	88	$61,361	+29%	$9,430
308 Cardiac Arrhythmia and Conduction Disorders with MCC	87	$75,956	+34%	$11,083
467 Revision of Hip or Knee Replacement with CC	87	$164,891	+5%	$31,193
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	84	$48,715	+14%	$8,100
175 Pulmonary Embolism with MCC or Acute Cor Pulmonale	83	$92,227	+42%	$12,794
190 Chronic Obstructive Pulmonary Disease with MCC	83	$65,335	+29%	$10,311
281 Acute Myocardial Infarction, Discharged Alive with CC	80	$77,715	+54%	$8,701
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	79	$79,679	+31%	$11,571
202 Bronchitis and Asthma with CC/MCC	73	$45,636	-1%	$9,285
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	72	$139,469	+36%	$20,680
056 Degenerative Nervous System Disorders with MCC	70	$84,541	-12%	$20,346
025 Craniotomy and Endovascular Intracranial Procedures with MCC	69	$362,248	+56%	$40,952
069 Transient Ischemia without Thrombolytic	68	$61,147	+21%	$7,472
300 Peripheral Vascular Disorders with CC	68	$55,301	+12%	$9,488
314 Other Circulatory System Diagnoses with MCC	68	$103,090	+9%	$17,676

Showing the 60 most frequent of 272 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	1,465	$85,743	$12,688
Comprehensive Observation Services	1,138	$29,077	$2,620
Level 2 Excision/ Biopsy/ Incision and Drainage	792	$21,920	$1,566
Level 1 Nerve Procedures	697	$12,032	$1,852
Level 4 Musculoskeletal Procedures	622	$50,993	$6,860
Level 1 Endovascular Procedures	619	$42,355	$3,161
Level 1 Intraocular Procedures	511	$16,578	$2,270
Level 5 Urology and Related Services	413	$34,071	$5,018
Level 2 Upper GI Procedures	394	$20,492	$1,815
Level 3 Musculoskeletal Procedures	379	$20,135	$3,086
Level 4 Urology and Related Services	375	$21,605	$3,353
Level 3 Electrophysiologic Procedures	365	$269,605	$22,871
Level 3 Urology and Related Services	349	$19,071	$1,955
Level 3 Vascular Procedures	307	$35,647	$3,028
Level 2 Musculoskeletal Procedures	303	$11,463	$1,547
Level 1 Laparoscopy and Related Services	301	$53,276	$5,613
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	261	$29,173	$3,331
Level 3 Excision/ Biopsy/ Incision and Drainage	239	$26,117	$2,588
Level 3 Endovascular Procedures	215	$130,094	$10,677
Level 2 Laparoscopy and Related Services	201	$104,999	$9,781
Level 6 Musculoskeletal Procedures	200	$146,680	$18,135
Level 4 Vascular Procedures	178	$46,421	$4,451
Level 3 Pacemaker and Similar Procedures	159	$109,398	$10,405
Level 4 Airway Endoscopy	158	$58,142	$3,597
Level 3 Lower GI Procedures	135	$22,934	$2,738

Against the Pennsylvania average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Lehigh Valley Hospital charged $110,274 on average, 25% more than the Pennsylvania average of $88,167, and was paid $17,438 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Lehigh Valley Hospital charged $67,971 on average, 18% more than the Pennsylvania average of $57,362, and was paid $11,706 against a state average of $11,112. For Medical Back Problems without MCC (DRG 552), Lehigh Valley Hospital charged $55,519 on average, 21% more than the Pennsylvania average of $46,037, and was paid $8,798 against a state average of $8,567. For Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC (DRG 392), Lehigh Valley Hospital charged $48,630 on average, 21% more than the Pennsylvania average of $40,091, and was paid $7,527 against a state average of $7,126. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $85,743 was 35% above the state average of $63,627. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $29,077 was 34% above the state average of $21,732. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $21,920 was 61% above the state average of $13,651. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $12,032 was 5% below the state average of $12,623.

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.