Pennsylvania / Penn Presbyterian Medical Center
CMS certification 390223 · Philadelphia, PA · 4 entries in CMS's price-transparency list
Penn Presbyterian Medical Center: charges and Medicare payments
Penn Presbyterian Medical Center reported 2,931 Medicare inpatient stays across 107 DRGs in 2024. Across them it charged 6.75 times what it was paid — among the higher ratios in Pennsylvania, number 22 of 117 hospitals with at least 100 stays (state median 4.27×, national 4.15×). Its most frequent stay was DRG 470, Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC: 235 stays at an average charge of $104,800, 12% above the national average. It also billed 4,829 outpatient services, charging 11.38 times what Medicare paid.
- 1Medicare inpatient stays 2,931
- 2Charge ÷ paid, inpatient 6.75×
- 3Rank in PA (highest ratio = 1) 22 of 117
- 4CMS price-transparency actions 4
Inpatient stays
For the 107 DRGs that can be compared with the national average, Penn Presbyterian Medical Center charged more than the national average in 104 (97%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 235 | $104,800 | +12% | $20,711 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 159 | $162,306 | +80% | $20,947 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 121 | $275,082 | +24% | $48,882 |
| 291 Heart Failure and Shock with MCC | 107 | $104,498 | +85% | $14,523 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 98 | $224,284 | +43% | $33,464 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 93 | $190,278 | +69% | $25,993 |
| 219 Cardiac Valve and Other Major Cardiothoracic Procedures... | 87 | $523,823 | +31% | $83,244 |
| 481 Hip and Femur Procedures except Major Joint with CC | 49 | $149,069 | +48% | $21,431 |
| 236 Coronary Bypass without Cardiac Catheterization without MCC | 48 | $280,060 | +33% | $41,528 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 45 | $111,244 | +47% | $16,984 |
| 235 Coronary Bypass without Cardiac Catheterization with MCC | 43 | $375,160 | +28% | $58,393 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 41 | $403,696 | +42% | $68,359 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 40 | $198,876 | +74% | $19,047 |
| 252 Other Vascular Procedures with MCC | 39 | $272,800 | +60% | $35,156 |
| 312 Syncope and Collapse | 35 | $63,034 | +38% | $9,557 |
| 460 Spinal Fusion except Cervical without MCC | 35 | $197,334 | +16% | $38,248 |
| 330 Major Small and Large Bowel Procedures with CC | 32 | $152,087 | +28% | $24,249 |
| 164 Major Chest Procedures with CC | 31 | $174,291 | +37% | $28,573 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 31 | $114,494 | +79% | $12,059 |
| 003 ECMO or Tracheostomy with MV >96 Hours or Principal... | 30 | $2,411,638 | +129% | $322,998 |
| 220 Cardiac Valve and Other Major Cardiothoracic Procedures... | 29 | $364,016 | +32% | $54,960 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 29 | $99,887 | +66% | $13,944 |
| 314 Other Circulatory System Diagnoses with MCC | 28 | $144,182 | +52% | $22,291 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 28 | $292,300 | +79% | $32,090 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 28 | $373,463 | +63% | $49,220 |
| 519 Back and Neck Procedures except Spinal Fusion with CC | 27 | $176,357 | +69% | $22,286 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 27 | $118,412 | +61% | $17,119 |
| 552 Medical Back Problems without MCC | 26 | $67,559 | +38% | $10,335 |
| 163 Major Chest Procedures with MCC | 25 | $237,214 | +13% | $47,816 |
| 467 Revision of Hip or Knee Replacement with CC | 25 | $242,195 | +54% | $34,347 |
| 193 Simple Pneumonia and Pleurisy with MCC | 24 | $115,436 | +93% | $15,013 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 24 | $55,605 | +38% | $8,649 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 23 | $175,744 | +76% | $23,178 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 23 | $134,924 | +167% | $12,602 |
| 253 Other Vascular Procedures with CC | 23 | $208,160 | +58% | $27,725 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 23 | $34,183 | +19% | $6,432 |
| 690 Kidney and Urinary Tract Infections without MCC | 23 | $58,823 | +56% | $9,064 |
| 083 Traumatic Stupor and Coma >1 Hour with CC | 22 | $97,694 | +33% | $14,645 |
| 057 Degenerative Nervous System Disorders without MCC | 21 | $72,921 | +29% | $14,246 |
| 086 Traumatic Stupor and Coma <1 Hour with CC | 21 | $82,335 | +21% | $13,187 |
| 177 Respiratory Infections and Inflammations with MCC | 21 | $103,088 | +46% | $17,924 |
| 292 Heart Failure and Shock with CC | 21 | $78,747 | +102% | $10,018 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 21 | $37,114 | +3% | $8,718 |
| 472 Cervical Spinal Fusion with CC | 21 | $180,980 | +27% | $31,657 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 21 | $400,056 | +188% | $41,966 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 21 | $133,506 | +6% | $25,877 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 20 | $345,570 | +49% | $51,150 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $106,038 | +84% | $13,635 |
| 689 Kidney and Urinary Tract Infections with MCC | 20 | $73,190 | +43% | $12,238 |
| 100 Seizures with MCC | 19 | $189,215 | +100% | $23,066 |
| 233 Coronary Bypass with Cardiac Catheterization or Open... | 19 | $538,796 | +40% | $77,330 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 19 | $98,562 | +74% | $13,304 |
| 317 Concomitant Left Atrial Appendage Closure and Cardiac... | 19 | $353,865 | -2% | $62,029 |
| 378 Gastrointestinal Hemorrhage with CC | 19 | $95,123 | +96% | $11,265 |
| 464 Wound Debridement and Skin Graft except Hand for... | 19 | $249,982 | +72% | $33,796 |
| 473 Cervical Spinal Fusion without CC/MCC | 19 | $164,845 | +43% | $26,239 |
| 243 Permanent Cardiac Pacemaker Implant with CC | 18 | $119,918 | +8% | $24,918 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 18 | $102,892 | +104% | $10,258 |
| 377 Gastrointestinal Hemorrhage with MCC | 18 | $149,572 | +75% | $19,343 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 18 | $136,549 | +33% | $21,484 |
Showing the 60 most frequent of 107 DRGs.
Outpatient services
Against the Pennsylvania average
For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Penn Presbyterian Medical Center charged $104,800 on average, 36% more than the Pennsylvania average of $77,050, and was paid $20,711 against a state average of $15,450. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Penn Presbyterian Medical Center charged $162,306 on average, 84% more than the Pennsylvania average of $88,167, and was paid $20,947 against a state average of $16,881. For Endovascular Cardiac Valve Replacement and Supplement Procedures without MCC (DRG 267), Penn Presbyterian Medical Center charged $275,082 on average, 0% less than the Pennsylvania average of $274,715, and was paid $48,882 against a state average of $43,015. For Heart Failure and Shock with MCC (DRG 291), Penn Presbyterian Medical Center charged $104,498 on average, 82% more than the Pennsylvania average of $57,362, and was paid $14,523 against a state average of $11,112. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $27,083 was 88% above the state average of $14,403. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $63,113 was 121% above the state average of $28,496. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $1,915 was 56% below the state average of $4,364. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $29,805 was 80% above the state average of $16,557.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Penn Presbyterian Medical Center in Philadelphia, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-09-29 (CMS case 717)
- CAP Request — 2022-07-27 (CMS case 717)
- Closure Notice — 2022-10-12 (CMS case 717)
- Met Requirements — 2025-04-23 (CMS case 4056)
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.