CMS certification 390107 · Pittsburgh, PA · 2 entries in CMS's price-transparency list

UPMC Passavant: charges and Medicare payments

UPMC Passavant reported 2,073 Medicare inpatient stays across 76 DRGs in 2024. Across them it charged 7.35 times what it was paid — among the higher ratios in Pennsylvania, number 13 of 117 hospitals with at least 100 stays (state median 4.27×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 143 stays at an average charge of $54,711, 3% below the national average. It also billed 1,993 outpatient services, charging 9.7 times what Medicare paid.

1Medicare inpatient stays 2,073
2Charge ÷ paid, inpatient 7.35×
3Rank in PA (highest ratio = 1) 13 of 117
4CMS price-transparency actions 2

Average charge per stay at UPMC Passavant, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 76 DRGs that can be compared with the national average, UPMC Passavant charged more than the national average in 50 (66%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
291 Heart Failure and Shock with MCC	143	$54,711	-3%	$8,503
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	106	$104,488	+16%	$13,641
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	85	$42,146	+5%	$5,700
177 Respiratory Infections and Inflammations with MCC	82	$80,101	+13%	$11,154
193 Simple Pneumonia and Pleurisy with MCC	59	$63,097	+6%	$9,395
378 Gastrointestinal Hemorrhage with CC	55	$57,011	+17%	$6,741
683 Renal Failure with CC	53	$43,714	+7%	$6,593
552 Medical Back Problems without MCC	46	$43,927	-10%	$7,134
690 Kidney and Urinary Tract Infections without MCC	46	$42,693	+13%	$5,449
330 Major Small and Large Bowel Procedures with CC	44	$143,019	+20%	$17,886
164 Major Chest Procedures with CC	43	$157,413	+24%	$19,278
460 Spinal Fusion except Cervical without MCC	43	$131,576	-23%	$24,117
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	41	$29,303	+2%	$4,035
603 Cellulitis without MCC	39	$37,428	0%	$6,033
178 Respiratory Infections and Inflammations with CC	38	$51,927	+15%	$7,309
483 Major Joint or Limb Reattachment Procedures of Upper...	38	$104,768	-17%	$17,369
309 Cardiac Arrhythmia and Conduction Disorders with CC	37	$39,564	+10%	$5,275
389 Gastrointestinal Obstruction with CC	34	$44,260	+14%	$6,148
698 Other Kidney and Urinary Tract Diagnoses with MCC	34	$64,284	-12%	$10,355
470 Major Hip and Knee Joint Replacement or Reattachment of...	29	$91,318	-2%	$12,848
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	27	$61,437	+25%	$7,435
057 Degenerative Nervous System Disorders without MCC	26	$66,150	+17%	$9,050
280 Acute Myocardial Infarction, Discharged Alive with MCC	26	$93,605	+23%	$10,420
322 Percutaneous Cardiovascular Procedures with Intraluminal...	26	$148,710	+30%	$14,514
472 Cervical Spinal Fusion with CC	26	$114,394	-20%	$21,095
189 Pulmonary Edema and Respiratory Failure	25	$67,063	+16%	$10,089
377 Gastrointestinal Hemorrhage with MCC	25	$70,259	-18%	$12,044
853 Infectious and Parasitic Diseases with O.R. Procedures with...	25	$195,789	-14%	$35,437
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	24	$34,346	-19%	$6,136
682 Renal Failure with MCC	24	$71,134	+8%	$9,376
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	23	$35,404	-4%	$5,575
689 Kidney and Urinary Tract Infections with MCC	23	$63,347	+23%	$7,593
699 Other Kidney and Urinary Tract Diagnoses with CC	23	$40,912	-14%	$7,589
327 Stomach, Esophageal and Duodenal Procedures with CC	22	$175,181	+38%	$16,372
194 Simple Pneumonia and Pleurisy with CC	21	$37,977	-1%	$5,475
286 Circulatory Disorders except AMI, with Cardiac...	21	$121,617	+8%	$15,573
312 Syncope and Collapse	21	$56,987	+25%	$5,937
321 Percutaneous Cardiovascular Procedures with Intraluminal...	21	$261,414	+60%	$21,297
394 Other Digestive System Diagnoses with CC	21	$45,909	-2%	$6,564
481 Hip and Femur Procedures except Major Joint with CC	20	$90,755	-10%	$14,051
329 Major Small and Large Bowel Procedures with MCC	19	$240,131	+12%	$28,537
812 Red Blood Cell Disorders without MCC	19	$57,738	+30%	$7,428
165 Major Chest Procedures without CC/MCC	18	$159,825	+55%	$13,772
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	18	$100,117	+64%	$9,501
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	17	$57,324	+3%	$6,834
266 Endovascular Cardiac Valve Replacement and Supplement...	17	$189,802	-33%	$41,874
281 Acute Myocardial Infarction, Discharged Alive with CC	17	$56,059	+11%	$5,882
308 Cardiac Arrhythmia and Conduction Disorders with MCC	17	$42,482	-25%	$8,397
163 Major Chest Procedures with MCC	16	$246,023	+17%	$36,059
326 Stomach, Esophageal and Duodenal Procedures with MCC	16	$286,508	+19%	$36,614
314 Other Circulatory System Diagnoses with MCC	15	$100,507	+6%	$14,599
393 Other Digestive System Diagnoses with MCC	15	$74,490	-3%	$11,690
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	15	$88,760	-13%	$15,735
556 Signs and Symptoms of Musculoskeletal System and Connective...	15	$32,481	-19%	$7,125
069 Transient Ischemia without Thrombolytic	14	$47,682	-5%	$5,480
176 Pulmonary Embolism without MCC	14	$44,598	+8%	$5,497
274 Percutaneous and Other Intracardiac Procedures without MCC	14	$265,433	+69%	$23,546
299 Peripheral Vascular Disorders with MCC	14	$113,781	+51%	$10,928
445 Disorders of The Biliary Tract with CC	14	$67,828	+17%	$8,736
536 Fractures of Hip and Pelvis without MCC	14	$31,593	-16%	$5,337

Showing the 60 most frequent of 76 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 5 Musculoskeletal Procedures	218	$77,952	$11,694
Level 3 Urology and Related Services	131	$18,896	$1,808
Comprehensive Observation Services	130	$28,860	$2,430
Level 4 Musculoskeletal Procedures	119	$55,826	$6,390
Level 2 Upper GI Procedures	115	$17,722	$1,688
Level 2 Excision/ Biopsy/ Incision and Drainage	87	$14,653	$1,435
Level 6 Musculoskeletal Procedures	85	$85,182	$16,259
Level 3 Musculoskeletal Procedures	83	$30,438	$2,863
Level 2 Musculoskeletal Procedures	76	$17,153	$1,410
Level 4 Urology and Related Services	70	$27,586	$3,114
Level 1 Laparoscopy and Related Services	69	$43,664	$5,154
Level 3 Vascular Procedures	67	$24,319	$2,779
Level 5 Urology and Related Services	63	$36,175	$4,446
Level 1 Endovascular Procedures	58	$31,959	$2,843
Level 4 Airway Endoscopy	53	$33,204	$3,345
Level 1 Nerve Procedures	52	$14,100	$1,725
Level 1 Intraocular Procedures	51	$10,980	$2,081
Level 3 Endovascular Procedures	41	$121,580	$9,819
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	40	$33,924	$3,090
Level 2 Laparoscopy and Related Services	40	$61,962	$8,845
Level 3 Lower GI Procedures	37	$21,987	$2,507
Level 2 Vascular Procedures	33	$8,293	$1,430
Level 3 Electrophysiologic Procedures	30	$237,196	$20,509
Level 5 Airway Endoscopy	29	$49,694	$6,113
Level 1 Breast/Lymphatic Surgery and Related Procedures	27	$30,840	$3,404

Against the Pennsylvania average

For Heart Failure and Shock with MCC (DRG 291), UPMC Passavant charged $54,711 on average, 5% less than the Pennsylvania average of $57,362, and was paid $8,503 against a state average of $11,112. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), UPMC Passavant charged $104,488 on average, 19% more than the Pennsylvania average of $88,167, and was paid $13,641 against a state average of $16,881. For Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC (DRG 392), UPMC Passavant charged $42,146 on average, 5% more than the Pennsylvania average of $40,091, and was paid $5,700 against a state average of $7,126. For Respiratory Infections and Inflammations with MCC (DRG 177), UPMC Passavant charged $80,101 on average, 11% more than the Pennsylvania average of $72,025, and was paid $11,154 against a state average of $14,034. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $77,952 was 23% above the state average of $63,627. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $18,896 was 14% above the state average of $16,557. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $28,860 was 33% above the state average of $21,732. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $55,826 was 18% above the state average of $47,486.

Price-transparency record

CMS's enforcement list records these actions for a hospital named UPMC Passavant in Pittsburgh, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2024-10-02 (CMS case 2756)
Closure Notice — 2025-01-13 (CMS case 2756)

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.