Pennsylvania / St Clair Hospital
CMS certification 390228 · Pittsburgh, PA · 4 entries in CMS's price-transparency list
St Clair Hospital: charges and Medicare payments
St Clair Hospital reported 1,143 Medicare inpatient stays across 44 DRGs in 2024. Across them it charged 3.68 times what it was paid — among the lower ratios in Pennsylvania, number 80 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: 155 stays at an average charge of $38,328, 58% below the national average. It also billed 3,024 outpatient services, charging 6.44 times what Medicare paid.
- 1Medicare inpatient stays 1,143
- 2Charge ÷ paid, inpatient 3.68×
- 3Rank in PA (highest ratio = 1) 80 of 117
- 4CMS price-transparency actions 4
Inpatient stays
For the 44 DRGs that can be compared with the national average, St Clair Hospital 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 | 155 | $38,328 | -58% | $12,184 |
| 291 Heart Failure and Shock with MCC | 113 | $22,187 | -61% | $8,417 |
| 193 Simple Pneumonia and Pleurisy with MCC | 76 | $26,020 | -56% | $8,753 |
| 177 Respiratory Infections and Inflammations with MCC | 62 | $28,698 | -59% | $10,632 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 33 | $116,146 | -49% | $32,285 |
| 682 Renal Failure with MCC | 30 | $29,561 | -55% | $9,687 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 29 | $30,777 | -58% | $10,448 |
| 189 Pulmonary Edema and Respiratory Failure | 28 | $23,759 | -59% | $8,161 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 28 | $14,817 | -59% | $4,903 |
| 329 Major Small and Large Bowel Procedures with MCC | 27 | $146,631 | -32% | $29,499 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 27 | $22,338 | -44% | $5,174 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 27 | $22,939 | -53% | $6,751 |
| 683 Renal Failure with CC | 26 | $21,015 | -48% | $5,806 |
| 330 Major Small and Large Bowel Procedures with CC | 24 | $91,932 | -23% | $16,172 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 21 | $22,005 | -61% | $6,554 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 20 | $41,821 | -45% | $10,746 |
| 378 Gastrointestinal Hemorrhage with CC | 20 | $30,762 | -37% | $6,465 |
| 481 Hip and Femur Procedures except Major Joint with CC | 20 | $46,639 | -54% | $13,799 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 19 | $11,519 | -60% | $3,683 |
| 377 Gastrointestinal Hemorrhage with MCC | 19 | $41,692 | -51% | $11,569 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 19 | $59,728 | -42% | $13,874 |
| 708 Major Male Pelvic Procedures without CC/MCC | 18 | $70,755 | -21% | $10,061 |
| 389 Gastrointestinal Obstruction with CC | 17 | $19,842 | -49% | $5,276 |
| 603 Cellulitis without MCC | 17 | $16,275 | -56% | $5,836 |
| 813 Coagulation Disorders | 17 | $38,078 | -52% | $10,311 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 16 | $17,490 | -59% | $5,514 |
| 194 Simple Pneumonia and Pleurisy with CC | 16 | $14,878 | -61% | $5,401 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 16 | $30,782 | -50% | $8,414 |
| 689 Kidney and Urinary Tract Infections with MCC | 16 | $17,063 | -67% | $7,253 |
| 690 Kidney and Urinary Tract Infections without MCC | 15 | $15,325 | -59% | $5,697 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 14 | $25,641 | -74% | $13,057 |
| 460 Spinal Fusion except Cervical without MCC | 14 | $125,434 | -26% | $23,818 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 13 | $181,005 | -18% | $31,765 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 13 | $88,743 | -23% | $12,960 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 13 | $47,230 | -49% | $12,269 |
| 637 Diabetes with MCC | 13 | $26,735 | -60% | $9,082 |
| 178 Respiratory Infections and Inflammations with CC | 12 | $19,342 | -57% | $6,583 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 12 | $43,740 | -61% | $14,252 |
| 638 Diabetes with CC | 12 | $20,739 | -50% | $5,964 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $16,399 | -56% | $5,142 |
| 253 Other Vascular Procedures with CC | 11 | $101,460 | -23% | $16,727 |
| 314 Other Circulatory System Diagnoses with MCC | 11 | $43,016 | -55% | $12,073 |
| 552 Medical Back Problems without MCC | 11 | $23,567 | -52% | $6,396 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $34,599 | -43% | $8,643 |
Outpatient services
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), St Clair Hospital charged $38,328 on average, 57% less than the Pennsylvania average of $88,167, and was paid $12,184 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), St Clair Hospital charged $22,187 on average, 61% less than the Pennsylvania average of $57,362, and was paid $8,417 against a state average of $11,112. For Simple Pneumonia and Pleurisy with MCC (DRG 193), St Clair Hospital charged $26,020 on average, 56% less than the Pennsylvania average of $59,404, and was paid $8,753 against a state average of $11,319. For Respiratory Infections and Inflammations with MCC (DRG 177), St Clair Hospital charged $28,698 on average, 60% less than the Pennsylvania average of $72,025, and was paid $10,632 against a state average of $14,034. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $9,481 was 34% below the state average of $14,403. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $11,755 was 46% below the state average of $21,732. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $54,240 was 15% below the state average of $63,627. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $8,611 was 48% below the state average of $16,557.
Price-transparency record
CMS's enforcement list records these actions for a hospital named St Clair Hospital in Pittsburgh, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-02-17 (CMS case 1027)
- Closure Notice — 2023-05-23 (CMS case 1027)
- Warning Notice — 2025-02-18 (CMS case 3096)
- Closure Notice — 2025-05-20 (CMS case 3096)
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.