Pennsylvania / UPMC Hamot
CMS certification 390063 · Erie, PA · 3 entries in CMS's price-transparency list
UPMC Hamot: charges and Medicare payments
UPMC Hamot reported 2,718 Medicare inpatient stays across 101 DRGs in 2024. Across them it charged 7.13 times what it was paid — among the higher ratios in Pennsylvania, number 16 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: 180 stays at an average charge of $140,999, 56% above the national average. It also billed 2,050 outpatient services, charging 9.18 times what Medicare paid.
- 1Medicare inpatient stays 2,718
- 2Charge ÷ paid, inpatient 7.13×
- 3Rank in PA (highest ratio = 1) 16 of 117
- 4CMS price-transparency actions 3
Inpatient stays
For the 101 DRGs that can be compared with the national average, UPMC Hamot charged more than the national average in 89 (88%). 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 | 180 | $140,999 | +56% | $17,707 |
| 291 Heart Failure and Shock with MCC | 170 | $93,616 | +66% | $11,646 |
| 189 Pulmonary Edema and Respiratory Failure | 65 | $87,449 | +52% | $11,255 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 61 | $81,267 | +46% | $9,154 |
| 177 Respiratory Infections and Inflammations with MCC | 56 | $99,099 | +40% | $14,868 |
| 378 Gastrointestinal Hemorrhage with CC | 54 | $61,213 | +26% | $9,217 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 52 | $44,498 | +23% | $7,059 |
| 552 Medical Back Problems without MCC | 52 | $54,756 | +12% | $8,724 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 49 | $109,838 | +45% | $13,728 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 48 | $62,657 | +56% | $7,394 |
| 481 Hip and Femur Procedures except Major Joint with CC | 48 | $114,198 | +13% | $18,303 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 48 | $264,457 | +16% | $41,236 |
| 193 Simple Pneumonia and Pleurisy with MCC | 44 | $94,175 | +58% | $12,100 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 44 | $146,253 | +28% | $16,153 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 43 | $140,934 | +41% | $17,669 |
| 682 Renal Failure with MCC | 41 | $121,932 | +85% | $13,468 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 40 | $181,864 | +11% | $26,108 |
| 683 Renal Failure with CC | 40 | $66,423 | +63% | $8,499 |
| 690 Kidney and Urinary Tract Infections without MCC | 40 | $50,647 | +34% | $7,494 |
| 377 Gastrointestinal Hemorrhage with MCC | 38 | $99,591 | +17% | $15,422 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 37 | $133,910 | +19% | $19,286 |
| 312 Syncope and Collapse | 36 | $51,687 | +14% | $8,566 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 34 | $194,854 | +24% | $27,906 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 33 | $237,456 | +75% | $24,820 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 31 | $32,361 | +13% | $5,281 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 31 | $107,322 | +78% | $12,552 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 29 | $119,049 | +16% | $18,724 |
| 194 Simple Pneumonia and Pleurisy with CC | 28 | $51,844 | +35% | $7,636 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 28 | $85,715 | +34% | $10,042 |
| 329 Major Small and Large Bowel Procedures with MCC | 27 | $326,477 | +52% | $38,115 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 26 | $206,702 | -11% | $36,776 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 26 | $219,334 | -1% | $41,676 |
| 389 Gastrointestinal Obstruction with CC | 26 | $51,652 | +33% | $7,621 |
| 330 Major Small and Large Bowel Procedures with CC | 25 | $169,001 | +42% | $20,862 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 24 | $87,445 | +78% | $9,468 |
| 101 Seizures without MCC | 23 | $69,735 | +43% | $8,409 |
| 556 Signs and Symptoms of Musculoskeletal System and Connective... | 23 | $54,399 | +35% | $7,857 |
| 036 Carotid Artery Stent Procedures without CC/MCC | 22 | $89,633 | +1% | $15,885 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 22 | $242,284 | -15% | $52,496 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 22 | $76,640 | +35% | $11,049 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 22 | $107,418 | +76% | $11,873 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 22 | $105,719 | +13% | $16,667 |
| 981 Extensive O.R. Procedures Unrelated To Principal Diagnosis... | 22 | $311,510 | +44% | $40,487 |
| 445 Disorders of The Biliary Tract with CC | 21 | $74,375 | +28% | $9,976 |
| 689 Kidney and Urinary Tract Infections with MCC | 21 | $72,200 | +41% | $10,280 |
| 394 Other Digestive System Diagnoses with CC | 20 | $56,449 | +20% | $8,711 |
| 603 Cellulitis without MCC | 20 | $59,961 | +61% | $8,415 |
| 092 Other Disorders of Nervous System with CC | 19 | $71,005 | +38% | $10,314 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 19 | $85,196 | +31% | $12,895 |
| 184 Major Chest Trauma with CC | 19 | $98,567 | +78% | $9,523 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 19 | $56,491 | +52% | $7,425 |
| 812 Red Blood Cell Disorders without MCC | 19 | $39,888 | -10% | $8,304 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 18 | $311,408 | +11% | $46,414 |
| 313 Chest Pain | 18 | $33,768 | -15% | $6,585 |
| 432 Cirrhosis and Alcoholic Hepatitis with MCC | 18 | $133,185 | +39% | $18,252 |
| 519 Back and Neck Procedures except Spinal Fusion with CC | 18 | $95,370 | -9% | $17,568 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 18 | $120,086 | +64% | $14,553 |
| 082 Traumatic Stupor and Coma >1 Hour with MCC | 17 | $164,260 | +42% | $25,397 |
| 086 Traumatic Stupor and Coma <1 Hour with CC | 17 | $80,950 | +18% | $12,077 |
| 183 Major Chest Trauma with MCC | 17 | $124,732 | +67% | $12,878 |
Showing the 60 most frequent of 101 DRGs.
Outpatient services
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), UPMC Hamot charged $140,999 on average, 60% more than the Pennsylvania average of $88,167, and was paid $17,707 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), UPMC Hamot charged $93,616 on average, 63% more than the Pennsylvania average of $57,362, and was paid $11,646 against a state average of $11,112. For Pulmonary Edema and Respiratory Failure (DRG 189), UPMC Hamot charged $87,449 on average, 34% more than the Pennsylvania average of $65,329, and was paid $11,255 against a state average of $11,268. For Intracranial Hemorrhage or Cerebral Infarction with CC or Tpa in 24 Hours (DRG 065), UPMC Hamot charged $81,267 on average, 43% more than the Pennsylvania average of $56,851, and was paid $9,154 against a state average of $9,162. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $47,254 was 66% above the state average of $28,496. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $14,488 was 6% above the state average of $13,651. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $81,846 was 29% above the state average of $63,627. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $29,598 was 36% above the state average of $21,732.
Price-transparency record
CMS's enforcement list records these actions for a hospital named UPMC Hamot in Erie, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2022-12-27 (CMS case 1105)
- Closure Notice — 2023-04-21 (CMS case 1105)
- Met Requirements — 2025-04-03 (CMS case 3567)
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.