Pennsylvania / Penn Highlands Mon Valley
CMS certification 390147 · Monongahela, PA
Penn Highlands Mon Valley: charges and Medicare payments
Penn Highlands Mon Valley reported 288 Medicare inpatient stays across 15 DRGs in 2024. Across them it charged 3.37 times what it was paid — among the lower ratios in Pennsylvania, number 93 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: 48 stays at an average charge of $34,841, 61% below the national average. It also billed 312 outpatient services, charging 5.75 times what Medicare paid.
- 1Medicare inpatient stays 288
- 2Charge ÷ paid, inpatient 3.37×
- 3Rank in PA (highest ratio = 1) 93 of 117
- 4CMS price-transparency actions 0
Inpatient stays
For the 15 DRGs that can be compared with the national average, Penn Highlands Mon Valley charged more than the national average in 0 (0%). 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 | 48 | $34,841 | -61% | $12,824 |
| 291 Heart Failure and Shock with MCC | 28 | $22,569 | -60% | $8,904 |
| 690 Kidney and Urinary Tract Infections without MCC | 23 | $15,871 | -58% | $5,887 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 23 | $19,593 | -60% | $7,210 |
| 885 Psychoses | 22 | $26,187 | -41% | $10,043 |
| 177 Respiratory Infections and Inflammations with MCC | 18 | $31,901 | -55% | $11,372 |
| 193 Simple Pneumonia and Pleurisy with MCC | 17 | $34,513 | -42% | $9,426 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 16 | $34,130 | -55% | $10,276 |
| 683 Renal Failure with CC | 16 | $16,969 | -58% | $6,479 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 15 | $27,715 | -62% | $10,920 |
| 481 Hip and Femur Procedures except Major Joint with CC | 14 | $55,527 | -45% | $14,110 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 13 | $80,625 | -30% | $12,574 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 12 | $17,058 | -58% | $5,752 |
| 603 Cellulitis without MCC | 12 | $14,891 | -60% | $6,345 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 11 | $136,873 | -16% | $20,172 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 74 | $12,696 | $2,316 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 62 | $7,528 | $1,411 |
| Level 5 Musculoskeletal Procedures | 32 | $53,204 | $11,740 |
| Level 3 Urology and Related Services | 28 | $8,069 | $1,819 |
| Level 4 Endovascular Procedures | 18 | $32,419 | $6,947 |
| Level 4 Urology and Related Services | 18 | $15,618 | $2,838 |
| Level 5 Urology and Related Services | 17 | $16,550 | $4,405 |
| Level 2 Musculoskeletal Procedures | 15 | $6,411 | $1,436 |
| Level 3 Vascular Procedures | 14 | $12,098 | $2,847 |
| Level 3 Musculoskeletal Procedures | 12 | $10,432 | $2,891 |
| Level 1 Breast/Lymphatic Surgery and Related Procedures | 11 | $17,215 | $3,404 |
| Level 1 Endovascular Procedures | 11 | $13,253 | $2,916 |
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Penn Highlands Mon Valley charged $34,841 on average, 60% less than the Pennsylvania average of $88,167, and was paid $12,824 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Penn Highlands Mon Valley charged $22,569 on average, 61% less than the Pennsylvania average of $57,362, and was paid $8,904 against a state average of $11,112. For Kidney and Urinary Tract Infections without MCC (DRG 690), Penn Highlands Mon Valley charged $15,871 on average, 57% less than the Pennsylvania average of $36,664, and was paid $5,887 against a state average of $7,034. For Septicemia or Severe Sepsis without MV >96 Hours without MCC (DRG 872), Penn Highlands Mon Valley charged $19,593 on average, 61% less than the Pennsylvania average of $49,758, and was paid $7,210 against a state average of $9,077. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $12,696 was 42% below the state average of $21,732. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $7,528 was 45% below the state average of $13,651. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $53,204 was 16% below the state average of $63,627. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $8,069 was 51% below the state average of $16,557.
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.