Pennsylvania / UPMC Carlisle
CMS certification 390058 · Carlisle, PA · 2 entries in CMS's price-transparency list
UPMC Carlisle: charges and Medicare payments
UPMC Carlisle reported 839 Medicare inpatient stays across 35 DRGs in 2024. Across them it charged 4.53 times what it was paid — mid-range in Pennsylvania, number 53 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: 168 stays at an average charge of $56,269, 38% below the national average. It also billed 1,381 outpatient services, charging 5.59 times what Medicare paid.
- 1Medicare inpatient stays 839
- 2Charge ÷ paid, inpatient 4.53×
- 3Rank in PA (highest ratio = 1) 53 of 117
- 4CMS price-transparency actions 2
Inpatient stays
For the 35 DRGs that can be compared with the national average, UPMC Carlisle 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 | 168 | $56,269 | -38% | $12,760 |
| 291 Heart Failure and Shock with MCC | 114 | $42,886 | -24% | $8,638 |
| 193 Simple Pneumonia and Pleurisy with MCC | 29 | $48,588 | -19% | $10,724 |
| 689 Kidney and Urinary Tract Infections with MCC | 25 | $39,207 | -24% | $8,013 |
| 189 Pulmonary Edema and Respiratory Failure | 24 | $55,231 | -4% | $8,548 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 24 | $42,416 | -42% | $10,639 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 23 | $35,270 | -28% | $7,119 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 22 | $39,297 | -29% | $6,785 |
| 177 Respiratory Infections and Inflammations with MCC | 22 | $48,228 | -32% | $11,146 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 21 | $25,093 | -31% | $5,244 |
| 312 Syncope and Collapse | 21 | $31,223 | -31% | $6,112 |
| 556 Signs and Symptoms of Musculoskeletal System and Connective... | 21 | $27,625 | -32% | $5,804 |
| 683 Renal Failure with CC | 19 | $22,993 | -44% | $6,088 |
| 603 Cellulitis without MCC | 18 | $25,773 | -31% | $7,512 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 17 | $53,800 | -11% | $8,866 |
| 682 Renal Failure with MCC | 17 | $49,044 | -26% | $9,985 |
| 481 Hip and Femur Procedures except Major Joint with CC | 16 | $59,820 | -41% | $13,703 |
| 951 Other Factors Influencing Health Status | 16 | $15,039 | -41% | $4,203 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 15 | $46,821 | -17% | $9,417 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $24,690 | -39% | $6,145 |
| 690 Kidney and Urinary Tract Infections without MCC | 15 | $21,683 | -43% | $5,625 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 14 | $40,417 | -57% | $12,867 |
| 884 Organic Disturbances and Intellectual Disability | 14 | $36,887 | -41% | $11,115 |
| 069 Transient Ischemia without Thrombolytic | 13 | $34,405 | -32% | $6,602 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 13 | $34,012 | -14% | $6,922 |
| 194 Simple Pneumonia and Pleurisy with CC | 13 | $38,407 | 0% | $5,817 |
| 378 Gastrointestinal Hemorrhage with CC | 13 | $35,071 | -28% | $6,584 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 13 | $28,469 | -23% | $5,566 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 13 | $35,266 | -26% | $7,142 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 12 | $38,180 | -62% | $12,723 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 12 | $41,999 | -17% | $7,450 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 12 | $83,010 | -40% | $18,364 |
| 552 Medical Back Problems without MCC | 12 | $24,769 | -49% | $6,618 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 12 | $87,234 | -62% | $28,000 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 11 | $21,105 | -58% | $5,974 |
Outpatient services
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), UPMC Carlisle charged $56,269 on average, 36% less than the Pennsylvania average of $88,167, and was paid $12,760 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), UPMC Carlisle charged $42,886 on average, 25% less than the Pennsylvania average of $57,362, and was paid $8,638 against a state average of $11,112. For Simple Pneumonia and Pleurisy with MCC (DRG 193), UPMC Carlisle charged $48,588 on average, 18% less than the Pennsylvania average of $59,404, and was paid $10,724 against a state average of $11,319. For Kidney and Urinary Tract Infections with MCC (DRG 689), UPMC Carlisle charged $39,207 on average, 24% less than the Pennsylvania average of $51,579, and was paid $8,013 against a state average of $9,915. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $15,341 was 29% below the state average of $21,732. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $33,225 was 48% below the state average of $63,627. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $8,333 was 42% below the state average of $14,403. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,381 was 24% below the state average of $13,651.
Price-transparency record
CMS's enforcement list records these actions for a hospital named UPMC Carlisle in Carlisle, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2023-05-17 (CMS case 249)
- Met Requirements — 2025-04-03 (CMS case 3573)
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.