Pennsylvania / Paoli Hospital
CMS certification 390153 · Paoli, PA · 2 entries in CMS's price-transparency list
Paoli Hospital: charges and Medicare payments
Paoli Hospital reported 4,539 Medicare inpatient stays across 119 DRGs in 2024. Across them it charged 7.32 times what it was paid — among the higher ratios in Pennsylvania, number 14 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: 416 stays at an average charge of $107,338, 19% above the national average. It also billed 2,340 outpatient services, charging 5.23 times what Medicare paid.
- 1Medicare inpatient stays 4,539
- 2Charge ÷ paid, inpatient 7.32×
- 3Rank in PA (highest ratio = 1) 14 of 117
- 4CMS price-transparency actions 2
Inpatient stays
For the 119 DRGs that can be compared with the national average, Paoli Hospital charged more than the national average in 82 (69%). 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 | 416 | $107,338 | +19% | $13,955 |
| 291 Heart Failure and Shock with MCC | 323 | $78,337 | +39% | $9,614 |
| 177 Respiratory Infections and Inflammations with MCC | 152 | $94,953 | +35% | $11,563 |
| 193 Simple Pneumonia and Pleurisy with MCC | 120 | $83,248 | +39% | $9,499 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 107 | $46,809 | +17% | $5,903 |
| 689 Kidney and Urinary Tract Infections with MCC | 103 | $69,704 | +36% | $8,104 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 100 | $68,289 | +39% | $7,603 |
| 378 Gastrointestinal Hemorrhage with CC | 90 | $63,432 | +31% | $7,448 |
| 690 Kidney and Urinary Tract Infections without MCC | 89 | $48,368 | +28% | $5,768 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 84 | $71,297 | +28% | $7,419 |
| 481 Hip and Femur Procedures except Major Joint with CC | 81 | $89,598 | -11% | $14,376 |
| 683 Renal Failure with CC | 74 | $56,074 | +38% | $6,436 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 69 | $113,374 | +1% | $15,525 |
| 312 Syncope and Collapse | 69 | $56,446 | +24% | $6,286 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 68 | $47,605 | +28% | $5,827 |
| 194 Simple Pneumonia and Pleurisy with CC | 63 | $52,323 | +36% | $5,839 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 62 | $105,198 | +5% | $13,448 |
| 552 Medical Back Problems without MCC | 61 | $62,149 | +27% | $7,014 |
| 178 Respiratory Infections and Inflammations with CC | 60 | $57,555 | +27% | $6,846 |
| 603 Cellulitis without MCC | 60 | $48,147 | +29% | $6,330 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 56 | $66,109 | +17% | $9,327 |
| 682 Renal Failure with MCC | 54 | $83,300 | +26% | $10,410 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 53 | $60,525 | +20% | $8,009 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 53 | $44,362 | +23% | $5,732 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 53 | $95,182 | -17% | $14,463 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 53 | $70,505 | -24% | $14,351 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 48 | $82,688 | +13% | $11,492 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 47 | $68,082 | +13% | $9,308 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 46 | $57,360 | -10% | $9,119 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 43 | $154,827 | -24% | $36,616 |
| 189 Pulmonary Edema and Respiratory Failure | 42 | $84,436 | +47% | $8,684 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 42 | $89,201 | -13% | $14,770 |
| 202 Bronchitis and Asthma with CC/MCC | 40 | $59,657 | +29% | $7,008 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 38 | $267,348 | +17% | $38,966 |
| 069 Transient Ischemia without Thrombolytic | 34 | $53,751 | +7% | $5,702 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 33 | $84,685 | +30% | $9,869 |
| 377 Gastrointestinal Hemorrhage with MCC | 33 | $103,764 | +22% | $13,906 |
| 101 Seizures without MCC | 32 | $60,187 | +23% | $6,397 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 32 | $87,039 | -22% | $16,646 |
| 389 Gastrointestinal Obstruction with CC | 32 | $52,026 | +34% | $5,684 |
| 330 Major Small and Large Bowel Procedures with CC | 31 | $129,555 | +9% | $17,542 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 31 | $79,674 | +31% | $9,391 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 29 | $211,725 | -9% | $30,226 |
| 305 Hypertension without MCC | 29 | $51,929 | +29% | $5,375 |
| 083 Traumatic Stupor and Coma >1 Hour with CC | 28 | $78,790 | +7% | $9,756 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 27 | $187,977 | -33% | $45,080 |
| 812 Red Blood Cell Disorders without MCC | 27 | $57,144 | +29% | $7,119 |
| 092 Other Disorders of Nervous System with CC | 26 | $70,129 | +36% | $7,174 |
| 394 Other Digestive System Diagnoses with CC | 26 | $55,010 | +17% | $6,704 |
| 418 Laparoscopic Cholecystectomy without C.D.E. with CC | 26 | $89,671 | -4% | $11,636 |
| 460 Spinal Fusion except Cervical without MCC | 26 | $114,050 | -33% | $26,627 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 25 | $52,236 | +32% | $6,044 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 25 | $129,726 | -21% | $19,999 |
| 467 Revision of Hip or Knee Replacement with CC | 25 | $118,327 | -25% | $24,862 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 24 | $37,385 | +30% | $4,123 |
| 176 Pulmonary Embolism without MCC | 23 | $64,115 | +55% | $5,816 |
| 643 Endocrine Disorders with MCC | 23 | $75,622 | +2% | $11,586 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 22 | $135,262 | -3% | $20,009 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 22 | $123,926 | +26% | $14,850 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 21 | $51,165 | +21% | $4,915 |
Showing the 60 most frequent of 119 DRGs.
Outpatient services
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Paoli Hospital charged $107,338 on average, 22% more than the Pennsylvania average of $88,167, and was paid $13,955 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Paoli Hospital charged $78,337 on average, 37% more than the Pennsylvania average of $57,362, and was paid $9,614 against a state average of $11,112. For Respiratory Infections and Inflammations with MCC (DRG 177), Paoli Hospital charged $94,953 on average, 32% more than the Pennsylvania average of $72,025, and was paid $11,563 against a state average of $14,034. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Paoli Hospital charged $83,248 on average, 40% more than the Pennsylvania average of $59,404, and was paid $9,499 against a state average of $11,319. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $22,764 was 5% above the state average of $21,732. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $24,134 was 15% below the state average of $28,496. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $8,005 was 41% below the state average of $13,651. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $42,200 was 34% below the state average of $63,627.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Paoli Hospital in Paoli, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2025-06-11 (CMS case 5034)
- Closure Notice — 2025-06-18 (CMS case 5034)
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.