Pennsylvania / Pottstown Hospital
CMS certification 390123 · Pottstown, PA · 3 entries in CMS's price-transparency list
Pottstown Hospital: charges and Medicare payments
Pottstown Hospital reported 1,263 Medicare inpatient stays across 48 DRGs in 2024. Across them it charged 6.99 times what it was paid — among the higher ratios in Pennsylvania, number 20 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: 162 stays at an average charge of $83,505, 8% below the national average. It also billed 877 outpatient services, charging 8.11 times what Medicare paid.
- 1Medicare inpatient stays 1,263
- 2Charge ÷ paid, inpatient 6.99×
- 3Rank in PA (highest ratio = 1) 20 of 117
- 4CMS price-transparency actions 3
Inpatient stays
For the 48 DRGs that can be compared with the national average, Pottstown Hospital charged more than the national average in 34 (71%). 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 | 162 | $83,505 | -8% | $13,174 |
| 291 Heart Failure and Shock with MCC | 114 | $61,344 | +9% | $8,955 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 53 | $48,019 | +20% | $5,849 |
| 690 Kidney and Urinary Tract Infections without MCC | 45 | $45,648 | +21% | $5,844 |
| 193 Simple Pneumonia and Pleurisy with MCC | 42 | $79,928 | +34% | $9,567 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 41 | $59,444 | +21% | $7,381 |
| 177 Respiratory Infections and Inflammations with MCC | 39 | $72,012 | +2% | $11,153 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 35 | $74,273 | +1% | $11,052 |
| 689 Kidney and Urinary Tract Infections with MCC | 34 | $56,424 | +10% | $8,354 |
| 603 Cellulitis without MCC | 33 | $40,876 | +10% | $6,391 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 32 | $43,865 | +18% | $5,722 |
| 202 Bronchitis and Asthma with CC/MCC | 28 | $45,431 | -2% | $6,926 |
| 312 Syncope and Collapse | 28 | $53,922 | +18% | $6,271 |
| 683 Renal Failure with CC | 28 | $47,743 | +17% | $6,261 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 28 | $163,712 | -28% | $32,557 |
| 378 Gastrointestinal Hemorrhage with CC | 26 | $53,625 | +10% | $7,116 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 24 | $82,259 | -12% | $13,477 |
| 069 Transient Ischemia without Thrombolytic | 22 | $47,757 | -5% | $5,832 |
| 057 Degenerative Nervous System Disorders without MCC | 20 | $60,782 | +7% | $9,205 |
| 189 Pulmonary Edema and Respiratory Failure | 20 | $58,863 | +2% | $8,620 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 20 | $49,276 | +36% | $5,454 |
| 481 Hip and Femur Procedures except Major Joint with CC | 20 | $107,781 | +7% | $14,175 |
| 194 Simple Pneumonia and Pleurisy with CC | 19 | $52,875 | +38% | $5,897 |
| 389 Gastrointestinal Obstruction with CC | 19 | $46,475 | +19% | $5,826 |
| 092 Other Disorders of Nervous System with CC | 18 | $76,037 | +47% | $9,204 |
| 149 Dysequilibrium | 17 | $54,881 | +24% | $5,462 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 17 | $72,404 | +20% | $9,026 |
| 884 Organic Disturbances and Intellectual Disability | 17 | $94,623 | +52% | $12,858 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 16 | $71,076 | +28% | $7,194 |
| 552 Medical Back Problems without MCC | 16 | $47,036 | -4% | $6,982 |
| 638 Diabetes with CC | 16 | $58,891 | +41% | $6,570 |
| 682 Renal Failure with MCC | 16 | $56,932 | -14% | $10,314 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 15 | $47,700 | +20% | $6,435 |
| 812 Red Blood Cell Disorders without MCC | 15 | $66,690 | +50% | $6,662 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 14 | $75,586 | 0% | $11,402 |
| 305 Hypertension without MCC | 13 | $47,105 | +17% | $5,515 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 13 | $75,549 | +24% | $9,110 |
| 101 Seizures without MCC | 12 | $40,268 | -17% | $6,338 |
| 176 Pulmonary Embolism without MCC | 12 | $57,477 | +39% | $5,856 |
| 300 Peripheral Vascular Disorders with CC | 12 | $61,681 | +25% | $7,668 |
| 377 Gastrointestinal Hemorrhage with MCC | 12 | $74,563 | -13% | $12,713 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 12 | $34,822 | -18% | $6,074 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 12 | $47,278 | 0% | $7,229 |
| 948 Signs and Symptoms without MCC | 12 | $45,668 | +20% | $5,840 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 11 | $99,693 | 0% | $14,084 |
| 460 Spinal Fusion except Cervical without MCC | 11 | $138,175 | -19% | $25,404 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 11 | $112,008 | +9% | $14,813 |
| 617 Amputation of Lower Limb for Endocrine, Nutritional and... | 11 | $104,459 | +20% | $13,870 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 267 | $22,678 | $2,530 |
| Level 1 Intraocular Procedures | 107 | $11,551 | $2,186 |
| Level 5 Musculoskeletal Procedures | 88 | $68,093 | $12,218 |
| Level 5 Urology and Related Services | 77 | $29,888 | $4,772 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 54 | $12,860 | $1,521 |
| Level 3 Vascular Procedures | 38 | $23,630 | $2,990 |
| Level 4 Urology and Related Services | 38 | $20,940 | $3,270 |
| Level 3 Musculoskeletal Procedures | 34 | $16,489 | $3,037 |
| Level 1 Laparoscopy and Related Services | 34 | $29,318 | $5,413 |
| Level 2 Upper GI Procedures | 32 | $7,859 | $1,785 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 30 | $23,356 | $2,666 |
| Level 4 Musculoskeletal Procedures | 26 | $46,474 | $6,506 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 22 | $17,495 | $3,128 |
| Level 3 Urology and Related Services | 16 | $18,031 | $1,911 |
| Level 2 Endovascular Procedures | 14 | $27,291 | $5,057 |
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Pottstown Hospital charged $83,505 on average, 5% less than the Pennsylvania average of $88,167, and was paid $13,174 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), Pottstown Hospital charged $61,344 on average, 7% more than the Pennsylvania average of $57,362, and was paid $8,955 against a state average of $11,112. For Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC (DRG 392), Pottstown Hospital charged $48,019 on average, 20% more than the Pennsylvania average of $40,091, and was paid $5,849 against a state average of $7,126. For Kidney and Urinary Tract Infections without MCC (DRG 690), Pottstown Hospital charged $45,648 on average, 25% more than the Pennsylvania average of $36,664, and was paid $5,844 against a state average of $7,034. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $22,678 was 4% above the state average of $21,732. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $11,551 was 20% below the state average of $14,403. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $68,093 was 7% above the state average of $63,627. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $29,888 was 18% below the state average of $36,329.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Pottstown Hospital in Pottstown, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-06-30 (CMS case 5396)
- Warning Notice — 2026-04-27 (CMS case 7593)
- Closure Notice — 2026-07-31 (CMS case 7593)
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.