Pennsylvania / Lehigh Valley Hospital - Pocono
CMS certification 390201 · East Stroudsburg, PA · 2 entries in CMS's price-transparency list
Lehigh Valley Hospital - Pocono: charges and Medicare payments
Lehigh Valley Hospital - Pocono reported 1,359 Medicare inpatient stays across 58 DRGs in 2024. Across them it charged 6.68 times what it was paid — among the higher ratios in Pennsylvania, number 23 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: 121 stays at an average charge of $62,918, 12% above the national average. It also billed 1,167 outpatient services, charging 10.57 times what Medicare paid.
- 1Medicare inpatient stays 1,359
- 2Charge ÷ paid, inpatient 6.68×
- 3Rank in PA (highest ratio = 1) 23 of 117
- 4CMS price-transparency actions 2
Inpatient stays
For the 58 DRGs that can be compared with the national average, Lehigh Valley Hospital - Pocono charged more than the national average in 43 (74%). 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 | 121 | $62,918 | +12% | $9,674 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 120 | $107,223 | +19% | $15,339 |
| 193 Simple Pneumonia and Pleurisy with MCC | 45 | $66,791 | +12% | $10,172 |
| 690 Kidney and Urinary Tract Infections without MCC | 42 | $44,689 | +18% | $6,774 |
| 885 Psychoses | 37 | $76,996 | +75% | $12,566 |
| 177 Respiratory Infections and Inflammations with MCC | 35 | $78,433 | +11% | $13,369 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 34 | $43,587 | +21% | $6,233 |
| 552 Medical Back Problems without MCC | 32 | $45,882 | -6% | $7,681 |
| 682 Renal Failure with MCC | 32 | $69,042 | +5% | $11,544 |
| 683 Renal Failure with CC | 32 | $49,295 | +21% | $7,163 |
| 378 Gastrointestinal Hemorrhage with CC | 31 | $48,300 | -1% | $8,268 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 31 | $55,765 | +14% | $8,519 |
| 194 Simple Pneumonia and Pleurisy with CC | 30 | $41,579 | +8% | $6,791 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 27 | $56,858 | +2% | $7,776 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 26 | $78,186 | +6% | $13,963 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 24 | $116,323 | +2% | $14,023 |
| 377 Gastrointestinal Hemorrhage with MCC | 23 | $82,699 | -3% | $13,470 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 23 | $35,535 | -12% | $6,639 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 23 | $41,595 | +12% | $6,107 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 21 | $78,976 | +31% | $10,662 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $65,109 | +13% | $10,410 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 20 | $54,142 | +7% | $8,408 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 20 | $84,347 | -9% | $14,481 |
| 330 Major Small and Large Bowel Procedures with CC | 19 | $124,159 | +4% | $20,202 |
| 948 Signs and Symptoms without MCC | 19 | $41,411 | +9% | $6,204 |
| 253 Other Vascular Procedures with CC | 18 | $136,318 | +3% | $19,474 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 18 | $103,061 | +20% | $13,846 |
| 069 Transient Ischemia without Thrombolytic | 17 | $49,437 | -2% | $6,427 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 17 | $64,228 | -1% | $10,862 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 17 | $100,230 | +153% | $12,221 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 17 | $88,110 | +56% | $9,927 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 17 | $33,001 | +15% | $4,624 |
| 481 Hip and Femur Procedures except Major Joint with CC | 17 | $142,467 | +41% | $17,049 |
| 689 Kidney and Urinary Tract Infections with MCC | 17 | $56,856 | +11% | $9,104 |
| 812 Red Blood Cell Disorders without MCC | 17 | $49,668 | +12% | $7,306 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 17 | $272,943 | +19% | $38,592 |
| 178 Respiratory Infections and Inflammations with CC | 16 | $51,111 | +13% | $7,624 |
| 312 Syncope and Collapse | 16 | $45,097 | -1% | $6,946 |
| 101 Seizures without MCC | 15 | $43,056 | -12% | $7,591 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $67,189 | +10% | $10,736 |
| 603 Cellulitis without MCC | 15 | $37,972 | +2% | $6,997 |
| 057 Degenerative Nervous System Disorders without MCC | 14 | $51,502 | -9% | $10,335 |
| 638 Diabetes with CC | 14 | $33,105 | -21% | $6,966 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 13 | $117,675 | +18% | $15,408 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 13 | $235,284 | +50% | $24,688 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 13 | $166,836 | +20% | $24,248 |
| 884 Organic Disturbances and Intellectual Disability | 13 | $69,478 | +11% | $12,657 |
| 176 Pulmonary Embolism without MCC | 12 | $60,060 | +45% | $6,583 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 12 | $173,000 | +6% | $24,381 |
| 329 Major Small and Large Bowel Procedures with MCC | 12 | $197,427 | -8% | $42,266 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 12 | $119,738 | +17% | $16,210 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 12 | $50,248 | +18% | $7,521 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 11 | $42,596 | +1% | $5,578 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 11 | $65,948 | +31% | $7,277 |
| 313 Chest Pain | 11 | $38,330 | -4% | $5,882 |
| 394 Other Digestive System Diagnoses with CC | 11 | $46,206 | -2% | $7,503 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 11 | $40,148 | -15% | $7,726 |
| 813 Coagulation Disorders | 11 | $96,323 | +20% | $11,979 |
Outpatient services
Against the Pennsylvania average
For Heart Failure and Shock with MCC (DRG 291), Lehigh Valley Hospital - Pocono charged $62,918 on average, 10% more than the Pennsylvania average of $57,362, and was paid $9,674 against a state average of $11,112. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Lehigh Valley Hospital - Pocono charged $107,223 on average, 22% more than the Pennsylvania average of $88,167, and was paid $15,339 against a state average of $16,881. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Lehigh Valley Hospital - Pocono charged $66,791 on average, 12% more than the Pennsylvania average of $59,404, and was paid $10,172 against a state average of $11,319. For Kidney and Urinary Tract Infections without MCC (DRG 690), Lehigh Valley Hospital - Pocono charged $44,689 on average, 22% more than the Pennsylvania average of $36,664, and was paid $6,774 against a state average of $7,034. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $21,440 was 1% below the state average of $21,732. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $20,201 was 48% above the state average of $13,651. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $30,170 was 32% above the state average of $22,799. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $56,194 was 40% above the state average of $40,125.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Lehigh Valley Hospital - Pocono in East Stroudsburg, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2025-07-18 (CMS case 5867)
- Closure Notice — 2025-11-03 (CMS case 5867)
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.