Pennsylvania / Surgical Institute of Reading
CMS certification 390316 · Wyomissing, PA · 1 entry in CMS's price-transparency list
Surgical Institute of Reading: charges and Medicare payments
Surgical Institute of Reading reported 141 Medicare inpatient stays across 4 DRGs in 2024. Across them it charged 4.99 times what it was paid — mid-range in Pennsylvania, number 45 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: 91 stays at an average charge of $66,020, 29% below the national average. It also billed 1,357 outpatient services, charging 6.31 times what Medicare paid.
- 1Medicare inpatient stays 141
- 2Charge ÷ paid, inpatient 4.99×
- 3Rank in PA (highest ratio = 1) 45 of 117
- 4CMS price-transparency actions 1
Inpatient stays
For the 4 DRGs that can be compared with the national average, Surgical Institute of Reading 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 |
|---|---|---|---|---|
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 91 | $66,020 | -29% | $12,492 |
| 460 Spinal Fusion except Cervical without MCC | 19 | $158,006 | -7% | $29,017 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 16 | $68,218 | -45% | $17,770 |
| 462 Bilateral or Multiple Major Joint Procedures of Lower... | 15 | $108,617 | -21% | $25,263 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 5 Musculoskeletal Procedures | 338 | $64,016 | $11,741 |
| Level 2 Musculoskeletal Procedures | 279 | $12,779 | $1,441 |
| Level 1 Nerve Procedures | 157 | $14,386 | $1,738 |
| Level 3 Musculoskeletal Procedures | 144 | $17,114 | $2,897 |
| Level 4 Musculoskeletal Procedures | 100 | $29,918 | $6,337 |
| Level 1 Intraocular Procedures | 86 | $13,425 | $2,081 |
| Level 1 Laparoscopy and Related Services | 83 | $16,054 | $5,155 |
| Level 6 Musculoskeletal Procedures | 42 | $56,417 | $16,739 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 39 | $8,901 | $1,460 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 28 | $10,554 | $2,467 |
| Level 5 ENT Procedures | 17 | $19,756 | $5,271 |
| Level 5 Neurostimulator and Related Procedures | 16 | $114,463 | $26,230 |
| Level 5 Airway Endoscopy | 14 | $52,903 | $6,161 |
| Level 3 Intraocular Procedures | 14 | $17,338 | $4,705 |
Against the Pennsylvania average
For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Surgical Institute of Reading charged $66,020 on average, 14% less than the Pennsylvania average of $77,050, and was paid $12,492 against a state average of $15,450. For Spinal Fusion except Cervical without MCC (DRG 460), Surgical Institute of Reading charged $158,006 on average, 2% more than the Pennsylvania average of $155,014, and was paid $29,017 against a state average of $32,289. For Revision of Hip or Knee Replacement without CC/MCC (DRG 468), Surgical Institute of Reading charged $68,218 on average, 36% less than the Pennsylvania average of $106,620, and was paid $17,770 against a state average of $22,350. For Bilateral or Multiple Major Joint Procedures of Lower Extremity without MCC (DRG 462), Surgical Institute of Reading charged $108,617 on average, 14% more than the Pennsylvania average of $95,218, and was paid $25,263 against a state average of $24,255. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $64,016 was 1% above the state average of $63,627. For Level 2 Musculoskeletal Procedures (outpatient APC 5112), its average charge of $12,779 was 3% above the state average of $12,460. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $14,386 was 14% above the state average of $12,623. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $17,114 was 31% below the state average of $24,818.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Surgical Institute of Reading in Wyomissing, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-07-15 (CMS case 5758)
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.