Pennsylvania / Pennsylvania Hospital

CMS certification 390226 · Philadelphia, PA · 13 entries in CMS's price-transparency list

Pennsylvania Hospital: charges and Medicare payments

Pennsylvania Hospital reported 1,935 Medicare inpatient stays across 68 DRGs in 2024. Across them it charged 6.38 times what it was paid — among the higher ratios in Pennsylvania, number 26 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: 159 stays at an average charge of $91,869, 1% below the national average. It also billed 4,691 outpatient services, charging 8.63 times what Medicare paid.

1Medicare inpatient stays 1,935
2Charge ÷ paid, inpatient 6.38×
3Rank in PA (highest ratio = 1) 26 of 117
4CMS price-transparency actions 13

Average charge per stay at Pennsylvania Hospital, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 68 DRGs that can be compared with the national average, Pennsylvania Hospital charged more than the national average in 59 (87%). 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...	159	$91,869	-1%	$18,278
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	143	$139,673	+55%	$19,415
291 Heart Failure and Shock with MCC	118	$110,377	+96%	$13,643
812 Red Blood Cell Disorders without MCC	112	$63,601	+43%	$9,510
027 Craniotomy and Endovascular Intracranial Procedures without...	85	$92,296	-34%	$22,757
460 Spinal Fusion except Cervical without MCC	75	$146,635	-14%	$34,029
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	44	$60,508	+51%	$7,887
193 Simple Pneumonia and Pleurisy with MCC	37	$114,527	+92%	$12,967
177 Respiratory Infections and Inflammations with MCC	36	$105,427	+49%	$16,240
286 Circulatory Disorders except AMI, with Cardiac...	35	$161,251	+44%	$21,983
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	35	$100,183	+66%	$13,649
190 Chronic Obstructive Pulmonary Disease with MCC	34	$112,519	+122%	$11,147
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	32	$79,992	+116%	$8,562
472 Cervical Spinal Fusion with CC	31	$154,202	+8%	$27,046
690 Kidney and Urinary Tract Infections without MCC	31	$60,764	+61%	$8,302
454 Combined Anterior and Posterior Spinal Fusion with CC	30	$253,471	-9%	$56,454
330 Major Small and Large Bowel Procedures with CC	29	$152,225	+28%	$22,031
378 Gastrointestinal Hemorrhage with CC	29	$73,486	+51%	$10,009
683 Renal Failure with CC	28	$68,255	+68%	$9,225
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	27	$101,949	+108%	$10,870
455 Combined Anterior and Posterior Spinal Fusion without CC/MCC	25	$180,994	-11%	$49,216
811 Red Blood Cell Disorders with MCC	25	$110,479	+62%	$15,199
274 Percutaneous and Other Intracardiac Procedures without MCC	24	$228,387	+46%	$30,515
853 Infectious and Parasitic Diseases with O.R. Procedures with...	23	$387,108	+69%	$54,434
194 Simple Pneumonia and Pleurisy with CC	22	$60,536	+58%	$8,409
287 Circulatory Disorders except AMI, with Cardiac...	22	$106,977	+67%	$10,885
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	22	$98,263	+61%	$14,132
603 Cellulitis without MCC	22	$60,704	+63%	$9,092
025 Craniotomy and Endovascular Intracranial Procedures with MCC	21	$256,467	+11%	$37,349
178 Respiratory Infections and Inflammations with CC	21	$81,233	+79%	$10,144
292 Heart Failure and Shock with CC	21	$108,594	+179%	$8,997
519 Back and Neck Procedures except Spinal Fusion with CC	20	$122,025	+17%	$18,959
309 Cardiac Arrhythmia and Conduction Disorders with CC	19	$61,536	+70%	$7,568
638 Diabetes with CC	19	$61,129	+47%	$9,170
682 Renal Failure with MCC	19	$156,688	+138%	$18,882
948 Signs and Symptoms without MCC	19	$98,803	+159%	$10,384
329 Major Small and Large Bowel Procedures with MCC	18	$271,808	+26%	$47,783
393 Other Digestive System Diagnoses with MCC	18	$138,392	+80%	$18,058
552 Medical Back Problems without MCC	18	$64,335	+32%	$9,783
448 Multiple Level Spinal Fusion except Cervical without MCC	17	$132,827	-34%	$37,681
026 Craniotomy and Endovascular Intracranial Procedures with CC	16	$134,177	-19%	$28,670
252 Other Vascular Procedures with MCC	16	$188,601	+10%	$32,085
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	16	$300,151	+39%	$51,157
202 Bronchitis and Asthma with CC/MCC	15	$87,407	+89%	$10,413
517 Other Musculoskeletal System and Connective Tissue O.R....	15	$82,965	+6%	$15,158
189 Pulmonary Edema and Respiratory Failure	14	$100,530	+75%	$14,626
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	14	$55,739	+94%	$5,795
312 Syncope and Collapse	14	$98,538	+116%	$9,034
377 Gastrointestinal Hemorrhage with MCC	14	$140,676	+65%	$19,498
389 Gastrointestinal Obstruction with CC	14	$69,161	+78%	$8,105
390 Gastrointestinal Obstruction without CC/MCC	14	$50,731	+82%	$6,129
057 Degenerative Nervous System Disorders without MCC	13	$84,891	+50%	$13,515
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	13	$132,135	+137%	$10,299
180 Respiratory Neoplasms with MCC	13	$125,855	+43%	$17,141
322 Percutaneous Cardiovascular Procedures with Intraluminal...	13	$192,344	+68%	$18,009
457 Spinal Fusion except Cervical with Spinal Curvature,...	13	$237,337	-18%	$51,175
520 Back and Neck Procedures except Spinal Fusion without CC/MCC	13	$86,080	+9%	$13,881
870 Septicemia or Severe Sepsis with MV >96 Hours	13	$676,577	+109%	$91,847
281 Acute Myocardial Infarction, Discharged Alive with CC	12	$113,387	+125%	$9,292
308 Cardiac Arrhythmia and Conduction Disorders with MCC	12	$135,744	+140%	$12,515

Showing the 60 most frequent of 68 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Urology and Related Services	800	$2,988	$688
Level 3 Urology and Related Services	342	$10,428	$2,047
Comprehensive Observation Services	259	$34,044	$2,743
Level 1 Intraocular Procedures	239	$16,681	$2,348
Level 2 Excision/ Biopsy/ Incision and Drainage	217	$13,216	$1,620
Level 1 Laparoscopy and Related Services	172	$33,553	$5,762
Level 5 Musculoskeletal Procedures	147	$62,864	$13,238
Level 7 Radiation Therapy	143	$147,988	$7,845
Level 4 Musculoskeletal Procedures	139	$42,828	$7,208
Level 3 Vascular Procedures	131	$18,625	$3,211
Level 1 Breast/Lymphatic Surgery and Related Procedures	116	$29,575	$3,840
Level 3 Excision/ Biopsy/ Incision and Drainage	113	$17,059	$2,863
Level 1 Endovascular Procedures	113	$36,236	$3,288
Level 4 Airway Endoscopy	108	$25,459	$3,773
Level 1 Nerve Procedures	107	$11,879	$1,945
Level 5 Neurostimulator and Related Procedures	102	$103,680	$30,900
Level 4 Urology and Related Services	100	$23,665	$3,512
Level 3 Electrophysiologic Procedures	80	$316,626	$23,585
Level 2 Upper GI Procedures	79	$14,629	$1,917
Level 3 Musculoskeletal Procedures	77	$25,483	$3,261
Level 2 Laparoscopy and Related Services	77	$80,851	$10,248
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	75	$24,292	$3,486
Level 2 Pacemaker and Similar Procedures	73	$55,091	$8,462
Level 3 Airway Endoscopy	64	$10,739	$1,710
Level 4 Gynecologic Procedures	64	$24,720	$3,150

Against the Pennsylvania average

For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Pennsylvania Hospital charged $91,869 on average, 19% more than the Pennsylvania average of $77,050, and was paid $18,278 against a state average of $15,450. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Pennsylvania Hospital charged $139,673 on average, 58% more than the Pennsylvania average of $88,167, and was paid $19,415 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Pennsylvania Hospital charged $110,377 on average, 92% more than the Pennsylvania average of $57,362, and was paid $13,643 against a state average of $11,112. For Red Blood Cell Disorders without MCC (DRG 812), Pennsylvania Hospital charged $63,601 on average, 30% more than the Pennsylvania average of $49,026, and was paid $9,510 against a state average of $8,361. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $2,988 was 32% below the state average of $4,364. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $10,428 was 37% below the state average of $16,557. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $34,044 was 57% above the state average of $21,732. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $16,681 was 16% above the state average of $14,403.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Pennsylvania Hospital 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 — 2022-07-27 (CMS case 389)
CAP Request — 2022-11-07 (CMS case 389)
Warning Notice — 2023-01-30 (CMS case 1197)
Closure Notice — 2023-04-18 (CMS case 389)
CAP Request — 2023-05-18 (CMS case 1197)
Closure Notice — 2023-06-28 (CMS case 1197)
Warning Notice — 2024-08-23 (CMS case 2462)
CAP Request — 2024-12-04 (CMS case 2462)
CAP Request — 2025-02-12 (CMS case 2462)
Warning Notice — 2025-03-25 (CMS case 3386)
Closure Notice — 2025-04-16 (CMS case 2462)
CAP Request — 2025-06-30 (CMS case 3386)
Closure Notice — 2025-07-29 (CMS case 3386)

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.