Pennsylvania / UPMC Bedford Memorial
CMS certification 390117 · Everett, PA
UPMC Bedford Memorial: charges and Medicare payments
UPMC Bedford Memorial reported 115 Medicare inpatient stays across 6 DRGs in 2024. Across them it charged 2.37 times what it was paid — among the lower ratios in Pennsylvania, number 109 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: 26 stays at an average charge of $29,414, 67% below the national average. It also billed 231 outpatient services, charging 4.52 times what Medicare paid.
- 1Medicare inpatient stays 115
- 2Charge ÷ paid, inpatient 2.37×
- 3Rank in PA (highest ratio = 1) 109 of 117
- 4CMS price-transparency actions 0
Inpatient stays
For the 6 DRGs that can be compared with the national average, UPMC Bedford Memorial 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 | 26 | $29,414 | -67% | $15,658 |
| 193 Simple Pneumonia and Pleurisy with MCC | 24 | $30,787 | -48% | $11,119 |
| 690 Kidney and Urinary Tract Infections without MCC | 20 | $16,722 | -56% | $6,981 |
| 177 Respiratory Infections and Inflammations with MCC | 16 | $32,605 | -54% | $13,262 |
| 291 Heart Failure and Shock with MCC | 16 | $26,194 | -54% | $10,728 |
| 194 Simple Pneumonia and Pleurisy with CC | 13 | $20,855 | -46% | $7,080 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 1 Intraocular Procedures | 80 | $8,264 | $2,229 |
| Level 5 Urology and Related Services | 69 | $15,944 | $4,950 |
| Comprehensive Observation Services | 30 | $14,568 | $2,618 |
| Level 4 Urology and Related Services | 25 | $11,043 | $3,335 |
| Level 3 Urology and Related Services | 14 | $6,951 | $1,948 |
| Level 4 Gynecologic Procedures | 13 | $9,506 | $2,991 |
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), UPMC Bedford Memorial charged $29,414 on average, 67% less than the Pennsylvania average of $88,167, and was paid $15,658 against a state average of $16,881. For Simple Pneumonia and Pleurisy with MCC (DRG 193), UPMC Bedford Memorial charged $30,787 on average, 48% less than the Pennsylvania average of $59,404, and was paid $11,119 against a state average of $11,319. For Kidney and Urinary Tract Infections without MCC (DRG 690), UPMC Bedford Memorial charged $16,722 on average, 54% less than the Pennsylvania average of $36,664, and was paid $6,981 against a state average of $7,034. For Respiratory Infections and Inflammations with MCC (DRG 177), UPMC Bedford Memorial charged $32,605 on average, 55% less than the Pennsylvania average of $72,025, and was paid $13,262 against a state average of $14,034. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $8,264 was 43% below the state average of $14,403. For Level 5 Urology and Related Services (outpatient APC 5375), its average charge of $15,944 was 56% below the state average of $36,329. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $14,568 was 33% below the state average of $21,732. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $11,043 was 57% below the state average of $25,570.
Price-transparency record
No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.
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.