Pennsylvania / Lehigh Valley Hospital-Schuylkill
CMS certification 390030 · Pottsville, PA · 1 entry in CMS's price-transparency list
Lehigh Valley Hospital-Schuylkill: charges and Medicare payments
Lehigh Valley Hospital-Schuylkill reported 723 Medicare inpatient stays across 29 DRGs in 2024. Across them it charged 5.36 times what it was paid — mid-range in Pennsylvania, number 40 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: 106 stays at an average charge of $85,802, 5% below the national average. It also billed 343 outpatient services, charging 11.69 times what Medicare paid.
- 1Medicare inpatient stays 723
- 2Charge ÷ paid, inpatient 5.36×
- 3Rank in PA (highest ratio = 1) 40 of 117
- 4CMS price-transparency actions 1
Inpatient stays
For the 29 DRGs that can be compared with the national average, Lehigh Valley Hospital-Schuylkill charged more than the national average in 5 (17%). 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 | 106 | $85,802 | -5% | $15,731 |
| 291 Heart Failure and Shock with MCC | 82 | $53,424 | -5% | $9,897 |
| 177 Respiratory Infections and Inflammations with MCC | 38 | $62,060 | -12% | $13,022 |
| 683 Renal Failure with CC | 34 | $31,627 | -22% | $7,752 |
| 193 Simple Pneumonia and Pleurisy with MCC | 31 | $55,321 | -7% | $10,249 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 29 | $117,066 | +26% | $14,719 |
| 689 Kidney and Urinary Tract Infections with MCC | 27 | $39,836 | -22% | $8,991 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 25 | $38,568 | -4% | $6,744 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 24 | $43,986 | +22% | $6,320 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 23 | $75,699 | +3% | $12,747 |
| 189 Pulmonary Edema and Respiratory Failure | 22 | $56,092 | -3% | $9,850 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 22 | $42,920 | -12% | $8,734 |
| 690 Kidney and Urinary Tract Infections without MCC | 21 | $33,785 | -11% | $6,417 |
| 603 Cellulitis without MCC | 20 | $32,994 | -12% | $7,161 |
| 057 Degenerative Nervous System Disorders without MCC | 19 | $41,060 | -27% | $10,198 |
| 884 Organic Disturbances and Intellectual Disability | 19 | $46,563 | -25% | $12,287 |
| 378 Gastrointestinal Hemorrhage with CC | 18 | $50,015 | +3% | $7,749 |
| 194 Simple Pneumonia and Pleurisy with CC | 16 | $38,599 | +1% | $7,055 |
| 682 Renal Failure with MCC | 16 | $64,579 | -2% | $11,168 |
| 312 Syncope and Collapse | 15 | $44,827 | -2% | $7,041 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 15 | $50,563 | -16% | $10,094 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 14 | $39,867 | -28% | $8,018 |
| 069 Transient Ischemia without Thrombolytic | 14 | $30,872 | -39% | $6,674 |
| 092 Other Disorders of Nervous System with CC | 14 | $32,762 | -36% | $8,013 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 12 | $46,518 | -18% | $8,809 |
| 377 Gastrointestinal Hemorrhage with MCC | 12 | $63,516 | -26% | $13,649 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 12 | $37,073 | -13% | $7,206 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $36,443 | -2% | $6,445 |
| 637 Diabetes with MCC | 11 | $57,841 | -13% | $11,653 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 3 Vascular Procedures | 71 | $34,499 | $2,819 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 44 | $15,366 | $1,384 |
| Level 1 Laparoscopy and Related Services | 40 | $44,019 | $5,058 |
| Comprehensive Observation Services | 32 | $17,285 | $2,448 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 28 | $19,935 | $2,269 |
| Level 2 Vascular Procedures | 24 | $9,266 | $1,337 |
| Level 3 Urology and Related Services | 24 | $22,893 | $1,822 |
| Level 4 Gynecologic Procedures | 18 | $15,798 | $2,796 |
| Level 4 Urology and Related Services | 16 | $25,819 | $3,118 |
| Level 1 Nerve Procedures | 16 | $14,909 | $1,727 |
| Level 4 Vascular Procedures | 15 | $38,383 | $4,915 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 15 | $22,988 | $3,095 |
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Lehigh Valley Hospital-Schuylkill charged $85,802 on average, 3% less than the Pennsylvania average of $88,167, and was paid $15,731 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Lehigh Valley Hospital-Schuylkill charged $53,424 on average, 7% less than the Pennsylvania average of $57,362, and was paid $9,897 against a state average of $11,112. For Respiratory Infections and Inflammations with MCC (DRG 177), Lehigh Valley Hospital-Schuylkill charged $62,060 on average, 14% less than the Pennsylvania average of $72,025, and was paid $13,022 against a state average of $14,034. For Renal Failure with CC (DRG 683), Lehigh Valley Hospital-Schuylkill charged $31,627 on average, 25% less than the Pennsylvania average of $42,240, and was paid $7,752 against a state average of $7,926. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $34,499 was 51% above the state average of $22,799. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $15,366 was 13% above the state average of $13,651. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $44,019 was 10% above the state average of $40,125. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $17,285 was 20% below the state average of $21,732.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Lehigh Valley Hospital-Schuylkill in Pottsville, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-07-18 (CMS case 5853)
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.