Pennsylvania / UPMC Mercy
CMS certification 390028 · Pittsburgh, PA · 1 entry in CMS's price-transparency list
UPMC Mercy: charges and Medicare payments
UPMC Mercy reported 933 Medicare inpatient stays across 44 DRGs in 2024. Across them it charged 5.72 times what it was paid — among the higher ratios in Pennsylvania, number 35 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: 85 stays at an average charge of $107,506, 19% above the national average. It also billed 2,145 outpatient services, charging 9.52 times what Medicare paid.
- 1Medicare inpatient stays 933
- 2Charge ÷ paid, inpatient 5.72×
- 3Rank in PA (highest ratio = 1) 35 of 117
- 4CMS price-transparency actions 1
Inpatient stays
For the 44 DRGs that can be compared with the national average, UPMC Mercy charged more than the national average in 35 (80%). 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 | 85 | $107,506 | +19% | $18,660 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 61 | $101,361 | +1% | $18,518 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 43 | $72,008 | +29% | $10,372 |
| 690 Kidney and Urinary Tract Infections without MCC | 38 | $44,900 | +19% | $8,559 |
| 481 Hip and Femur Procedures except Major Joint with CC | 37 | $126,673 | +26% | $19,518 |
| 552 Medical Back Problems without MCC | 36 | $65,242 | +34% | $10,057 |
| 291 Heart Failure and Shock with MCC | 31 | $53,337 | -5% | $12,865 |
| 897 Alcohol, Drug Abuse or Dependence without Rehabilitation... | 31 | $31,786 | -14% | $9,129 |
| 184 Major Chest Trauma with CC | 28 | $60,101 | +8% | $10,703 |
| 460 Spinal Fusion except Cervical without MCC | 25 | $164,299 | -4% | $33,315 |
| 057 Degenerative Nervous System Disorders without MCC | 23 | $51,547 | -9% | $12,827 |
| 083 Traumatic Stupor and Coma >1 Hour with CC | 23 | $96,001 | +31% | $13,237 |
| 023 Craniotomy with Major Device Implant or Acute Complex Cns... | 22 | $224,194 | -20% | $45,147 |
| 177 Respiratory Infections and Inflammations with MCC | 22 | $66,952 | -5% | $16,216 |
| 493 Lower Extremity and Humerus Procedures except Hip, Foot and... | 20 | $145,171 | +22% | $21,454 |
| 086 Traumatic Stupor and Coma <1 Hour with CC | 19 | $57,991 | -15% | $12,753 |
| 101 Seizures without MCC | 19 | $60,729 | +25% | $10,007 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 19 | $40,126 | +11% | $8,106 |
| 183 Major Chest Trauma with MCC | 18 | $81,328 | +9% | $15,824 |
| 551 Medical Back Problems with MCC | 17 | $92,595 | +18% | $16,870 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 17 | $330,915 | +45% | $47,609 |
| 100 Seizures with MCC | 16 | $120,882 | +28% | $20,882 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 16 | $140,665 | +37% | $20,408 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 15 | $49,054 | +16% | $7,339 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 15 | $97,965 | +29% | $14,574 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 14 | $236,493 | +2% | $40,269 |
| 082 Traumatic Stupor and Coma >1 Hour with MCC | 14 | $184,153 | +60% | $23,257 |
| 193 Simple Pneumonia and Pleurisy with MCC | 14 | $84,408 | +41% | $12,993 |
| 194 Simple Pneumonia and Pleurisy with CC | 14 | $44,911 | +17% | $8,872 |
| 085 Traumatic Stupor and Coma <1 Hour with MCC | 13 | $119,289 | +10% | $19,914 |
| 200 Pneumothorax with CC | 13 | $56,569 | +6% | $10,376 |
| 327 Stomach, Esophageal and Duodenal Procedures with CC | 13 | $175,678 | +39% | $23,434 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 13 | $57,467 | +43% | $8,707 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 13 | $69,068 | +15% | $13,741 |
| 689 Kidney and Urinary Tract Infections with MCC | 13 | $73,488 | +43% | $12,328 |
| 189 Pulmonary Edema and Respiratory Failure | 12 | $62,004 | +8% | $12,224 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $42,317 | +14% | $8,716 |
| 682 Renal Failure with MCC | 12 | $99,989 | +52% | $15,340 |
| 683 Renal Failure with CC | 12 | $56,540 | +39% | $9,881 |
| 125 Other Disorders of The Eye without MCC | 11 | $39,139 | -11% | $8,597 |
| 378 Gastrointestinal Hemorrhage with CC | 11 | $60,177 | +24% | $9,397 |
| 472 Cervical Spinal Fusion with CC | 11 | $116,369 | -19% | $26,943 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 11 | $84,399 | +15% | $16,607 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 11 | $50,188 | +2% | $10,349 |
Outpatient services
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), UPMC Mercy charged $107,506 on average, 22% more than the Pennsylvania average of $88,167, and was paid $18,660 against a state average of $16,881. For Intracranial Hemorrhage or Cerebral Infarction with MCC (DRG 064), UPMC Mercy charged $101,361 on average, 4% less than the Pennsylvania average of $106,032, and was paid $18,518 against a state average of $18,089. For Intracranial Hemorrhage or Cerebral Infarction with CC or Tpa in 24 Hours (DRG 065), UPMC Mercy charged $72,008 on average, 27% more than the Pennsylvania average of $56,851, and was paid $10,372 against a state average of $9,162. For Kidney and Urinary Tract Infections without MCC (DRG 690), UPMC Mercy charged $44,900 on average, 22% more than the Pennsylvania average of $36,664, and was paid $8,559 against a state average of $7,034. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $16,446 was 14% above the state average of $14,403. For Level 2 Intraocular Procedures (outpatient APC 5492), its average charge of $29,917 was 22% above the state average of $24,551. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $22,521 was 4% above the state average of $21,732. For Level 3 Extraocular, Repair, and Plastic Eye Procedures (outpatient APC 5503), its average charge of $15,938 was 11% below the state average of $17,951.
Price-transparency record
CMS's enforcement list records these actions for a hospital named UPMC Mercy in Pittsburgh, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2025-07-21 (CMS case 5897)
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.