Pennsylvania / UPMC Washington
CMS certification 390042 · Washington, PA
UPMC Washington: charges and Medicare payments
UPMC Washington reported 867 Medicare inpatient stays across 38 DRGs in 2024. Across them it charged 1.92 times what it was paid — among the lower ratios in Pennsylvania, number 114 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: 107 stays at an average charge of $13,955, 75% below the national average. It also billed 997 outpatient services, charging 4.84 times what Medicare paid.
- 1Medicare inpatient stays 867
- 2Charge ÷ paid, inpatient 1.92×
- 3Rank in PA (highest ratio = 1) 114 of 117
- 4CMS price-transparency actions 0
Inpatient stays
For the 38 DRGs that can be compared with the national average, UPMC Washington 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 |
|---|---|---|---|---|
| 291 Heart Failure and Shock with MCC | 107 | $13,955 | -75% | $9,649 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 76 | $24,689 | -73% | $14,216 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 45 | $13,858 | -65% | $6,332 |
| 690 Kidney and Urinary Tract Infections without MCC | 40 | $11,725 | -69% | $6,386 |
| 378 Gastrointestinal Hemorrhage with CC | 30 | $15,505 | -68% | $7,568 |
| 193 Simple Pneumonia and Pleurisy with MCC | 27 | $12,247 | -80% | $9,748 |
| 177 Respiratory Infections and Inflammations with MCC | 26 | $18,145 | -74% | $12,330 |
| 683 Renal Failure with CC | 26 | $15,686 | -61% | $7,329 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 25 | $10,371 | -72% | $6,235 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 25 | $14,079 | -71% | $7,881 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 23 | $55,762 | -51% | $14,689 |
| 312 Syncope and Collapse | 22 | $11,709 | -74% | $6,803 |
| 948 Signs and Symptoms without MCC | 22 | $11,982 | -69% | $6,316 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 20 | $18,571 | -67% | $6,839 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 20 | $8,831 | -69% | $4,720 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 19 | $81,696 | -48% | $23,963 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 18 | $17,038 | -60% | $5,435 |
| 603 Cellulitis without MCC | 18 | $11,085 | -70% | $6,982 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 17 | $13,064 | -74% | $8,086 |
| 194 Simple Pneumonia and Pleurisy with CC | 17 | $12,144 | -68% | $6,250 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 17 | $43,618 | -81% | $31,509 |
| 884 Organic Disturbances and Intellectual Disability | 17 | $15,388 | -75% | $11,761 |
| 189 Pulmonary Edema and Respiratory Failure | 16 | $13,514 | -77% | $9,341 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 16 | $15,566 | -76% | $8,410 |
| 689 Kidney and Urinary Tract Infections with MCC | 16 | $13,762 | -73% | $9,260 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 15 | $43,456 | -53% | $14,588 |
| 313 Chest Pain | 14 | $12,636 | -68% | $5,827 |
| 682 Renal Failure with MCC | 14 | $14,880 | -77% | $10,602 |
| 069 Transient Ischemia without Thrombolytic | 13 | $12,468 | -75% | $6,282 |
| 809 Major Hematological and Immunological Diagnoses except... | 13 | $14,688 | -77% | $9,923 |
| 854 Infectious and Parasitic Diseases with O.R. Procedures with... | 13 | $36,246 | -63% | $15,012 |
| 092 Other Disorders of Nervous System with CC | 12 | $13,850 | -73% | $7,679 |
| 178 Respiratory Infections and Inflammations with CC | 12 | $11,095 | -76% | $7,268 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 12 | $12,719 | -78% | $9,165 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 11 | $25,712 | -74% | $14,710 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 11 | $21,259 | -72% | $12,241 |
| 292 Heart Failure and Shock with CC | 11 | $13,012 | -67% | $6,812 |
| 552 Medical Back Problems without MCC | 11 | $12,731 | -74% | $7,308 |
Outpatient services
Against the Pennsylvania average
For Heart Failure and Shock with MCC (DRG 291), UPMC Washington charged $13,955 on average, 76% less than the Pennsylvania average of $57,362, and was paid $9,649 against a state average of $11,112. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), UPMC Washington charged $24,689 on average, 72% less than the Pennsylvania average of $88,167, and was paid $14,216 against a state average of $16,881. For Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC (DRG 392), UPMC Washington charged $13,858 on average, 65% less than the Pennsylvania average of $40,091, and was paid $6,332 against a state average of $7,126. For Kidney and Urinary Tract Infections without MCC (DRG 690), UPMC Washington charged $11,725 on average, 68% less than the Pennsylvania average of $36,664, and was paid $6,386 against a state average of $7,034. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $9,075 was 58% below the state average of $21,732. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $6,432 was 53% below the state average of $13,651. For Level 4 Urology and Related Services (outpatient APC 5374), its average charge of $15,452 was 40% below the state average of $25,570. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $9,489 was 58% below the state average of $22,799.
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.