UPMC Presbyterian Shadyside: charges and Medicare payments

UPMC Presbyterian Shadyside reported 6,147 Medicare inpatient stays across 197 DRGs in 2024. Across them it charged 9.72 times what it was paid — among the higher ratios in Pennsylvania, number 2 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: 306 stays at an average charge of $233,517, 159% above the national average. It also billed 4,201 outpatient services, charging 14.83 times what Medicare paid.

1Medicare inpatient stays 6,147
2Charge ÷ paid, inpatient 9.72×
3Rank in PA (highest ratio = 1) 2 of 117
4CMS price-transparency actions 0

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

Inpatient stays

For the 197 DRGs that can be compared with the national average, UPMC Presbyterian Shadyside charged more than the national average in 197 (100%). 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	306	$233,517	+159%	$22,790
291 Heart Failure and Shock with MCC	177	$128,276	+128%	$14,435
025 Craniotomy and Endovascular Intracranial Procedures with MCC	104	$394,623	+70%	$42,513
177 Respiratory Infections and Inflammations with MCC	103	$177,336	+151%	$18,660
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	85	$82,618	+106%	$8,825
330 Major Small and Large Bowel Procedures with CC	76	$243,067	+104%	$34,052
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	75	$199,632	+100%	$20,594
314 Other Circulatory System Diagnoses with MCC	74	$257,287	+171%	$26,961
699 Other Kidney and Urinary Tract Diagnoses with CC	70	$74,167	+56%	$11,284
853 Infectious and Parasitic Diseases with O.R. Procedures with...	70	$681,523	+198%	$56,716
470 Major Hip and Knee Joint Replacement or Reattachment of...	68	$126,828	+36%	$18,146
394 Other Digestive System Diagnoses with CC	67	$115,974	+146%	$10,975
552 Medical Back Problems without MCC	67	$91,435	+87%	$10,244
683 Renal Failure with CC	66	$83,690	+106%	$9,900
698 Other Kidney and Urinary Tract Diagnoses with MCC	65	$164,519	+124%	$17,653
189 Pulmonary Edema and Respiratory Failure	64	$157,287	+173%	$13,336
219 Cardiac Valve and Other Major Cardiothoracic Procedures...	60	$842,515	+111%	$71,439
690 Kidney and Urinary Tract Infections without MCC	59	$90,135	+138%	$9,492
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	56	$137,575	+128%	$14,553
847 Chemotherapy without Acute Leukemia As Secondary Diagnosis...	56	$119,676	+77%	$13,630
460 Spinal Fusion except Cervical without MCC	55	$255,373	+50%	$35,070
193 Simple Pneumonia and Pleurisy with MCC	54	$147,118	+146%	$13,901
329 Major Small and Large Bowel Procedures with MCC	54	$552,341	+157%	$50,688
682 Renal Failure with MCC	54	$140,076	+112%	$15,800
919 Complications of Treatment with MCC	53	$163,292	+85%	$18,384
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	51	$134,154	+120%	$14,884
280 Acute Myocardial Infarction, Discharged Alive with MCC	50	$170,170	+124%	$17,802
054 Nervous System Neoplasms with MCC	49	$156,528	+102%	$17,298
266 Endovascular Cardiac Valve Replacement and Supplement...	49	$351,489	+23%	$56,408
205 Other Respiratory System Diagnoses with MCC	48	$281,584	+219%	$24,721
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	47	$150,231	+170%	$11,414
389 Gastrointestinal Obstruction with CC	47	$80,504	+107%	$9,430
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	47	$91,198	+146%	$9,112
603 Cellulitis without MCC	46	$86,525	+132%	$10,131
406 Pancreas, Liver and Shunt Procedures with CC	45	$267,843	+65%	$28,025
435 Malignancy of Hepatobiliary System or Pancreas with MCC	45	$192,876	+104%	$19,591
445 Disorders of The Biliary Tract with CC	45	$105,811	+82%	$12,152
481 Hip and Femur Procedures except Major Joint with CC	44	$218,576	+117%	$20,986
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	44	$104,517	+113%	$10,974
003 ECMO or Tracheostomy with MV >96 Hours or Principal...	42	$1,856,698	+76%	$189,679
327 Stomach, Esophageal and Duodenal Procedures with CC	42	$278,939	+120%	$26,023
981 Extensive O.R. Procedures Unrelated To Principal Diagnosis...	42	$508,555	+135%	$51,581
101 Seizures without MCC	41	$86,005	+76%	$9,995
312 Syncope and Collapse	41	$89,522	+97%	$9,803
321 Percutaneous Cardiovascular Procedures with Intraluminal...	41	$287,441	+76%	$31,008
378 Gastrointestinal Hemorrhage with CC	41	$82,360	+70%	$10,614
267 Endovascular Cardiac Valve Replacement and Supplement...	40	$253,695	+15%	$43,654
315 Other Circulatory System Diagnoses with CC	40	$98,632	+106%	$10,487
393 Other Digestive System Diagnoses with MCC	40	$147,738	+92%	$17,758
235 Coronary Bypass without Cardiac Catheterization with MCC	39	$723,350	+147%	$53,378
322 Percutaneous Cardiovascular Procedures with Intraluminal...	39	$179,679	+57%	$20,133
441 Disorders of Liver except Malignancy, Cirrhosis or Alcoholic...	39	$170,740	+98%	$20,112
309 Cardiac Arrhythmia and Conduction Disorders with CC	38	$67,764	+88%	$8,416
252 Other Vascular Procedures with MCC	37	$315,280	+85%	$34,213
286 Circulatory Disorders except AMI, with Cardiac...	37	$300,488	+168%	$24,571
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	37	$40,731	+42%	$7,372
454 Combined Anterior and Posterior Spinal Fusion with CC	37	$380,287	+36%	$55,566
472 Cervical Spinal Fusion with CC	37	$209,996	+47%	$28,055
023 Craniotomy with Major Device Implant or Acute Complex Cns...	36	$520,013	+85%	$56,673
467 Revision of Hip or Knee Replacement with CC	35	$248,280	+57%	$33,493

Showing the 60 most frequent of 197 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 2 Upper GI Procedures	420	$26,411	$1,673
Level 2 Excision/ Biopsy/ Incision and Drainage	308	$24,859	$1,435
Level 3 Vascular Procedures	270	$36,232	$2,839
Level 1 Endovascular Procedures	216	$32,730	$2,838
Level 4 Airway Endoscopy	214	$51,861	$3,224
Level 5 Musculoskeletal Procedures	213	$96,644	$11,598
Comprehensive Observation Services	205	$47,501	$2,360
Level 4 Musculoskeletal Procedures	142	$80,288	$6,251
Level 1 Laparoscopy and Related Services	137	$62,019	$5,070
Level 7 Radiation Therapy	131	$58,551	$6,913
Level 4 Urology and Related Services	123	$45,634	$3,094
Level 3 Endovascular Procedures	119	$125,316	$9,750
Level 3 Urology and Related Services	117	$22,757	$1,819
Level 4 Vascular Procedures	109	$61,946	$2,612
Level 3 Electrophysiologic Procedures	104	$237,220	$21,159
Level 5 Urology and Related Services	100	$61,213	$4,622
Level 2 Vascular Procedures	96	$16,093	$1,430
Level 5 ENT Procedures	92	$53,260	$5,157
Level 3 Excision/ Biopsy/ Incision and Drainage	91	$36,540	$2,538
Level 3 Musculoskeletal Procedures	83	$43,013	$2,845
Level 2 Musculoskeletal Procedures	78	$17,001	$1,436
Level 3 Upper GI Procedures	76	$47,872	$3,349
Level 2 Endovascular Procedures	75	$58,665	$5,105
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	73	$44,004	$3,090
Level 1 Nerve Procedures	73	$26,067	$1,675

Against the Pennsylvania average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), UPMC Presbyterian Shadyside charged $233,517 on average, 165% more than the Pennsylvania average of $88,167, and was paid $22,790 against a state average of $16,881. For Heart Failure and Shock with MCC (DRG 291), UPMC Presbyterian Shadyside charged $128,276 on average, 124% more than the Pennsylvania average of $57,362, and was paid $14,435 against a state average of $11,112. For Craniotomy and Endovascular Intracranial Procedures with MCC (DRG 025), UPMC Presbyterian Shadyside charged $394,623 on average, 46% more than the Pennsylvania average of $270,464, and was paid $42,513 against a state average of $43,286. For Respiratory Infections and Inflammations with MCC (DRG 177), UPMC Presbyterian Shadyside charged $177,336 on average, 146% more than the Pennsylvania average of $72,025, and was paid $18,660 against a state average of $14,034. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $26,411 was 72% above the state average of $15,366. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $24,859 was 82% above the state average of $13,651. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $36,232 was 59% above the state average of $22,799. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $32,730 was 15% above the state average of $28,496.

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.