Pennsylvania / West Penn Hospital
CMS certification 390090 · Pittsburgh, PA
West Penn Hospital: charges and Medicare payments
West Penn Hospital reported 415 Medicare inpatient stays across 26 DRGs in 2024. Across them it charged 5.55 times what it was paid — among the higher ratios in Pennsylvania, number 38 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: 37 stays at an average charge of $113,284, 25% above the national average. It also billed 1,286 outpatient services, charging 8.36 times what Medicare paid.
- 1Medicare inpatient stays 415
- 2Charge ÷ paid, inpatient 5.55×
- 3Rank in PA (highest ratio = 1) 38 of 117
- 4CMS price-transparency actions 0
Inpatient stays
For the 26 DRGs that can be compared with the national average, West Penn Hospital charged more than the national average in 16 (62%). 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 | 37 | $113,284 | +25% | $18,506 |
| 330 Major Small and Large Bowel Procedures with CC | 31 | $132,578 | +11% | $22,961 |
| 291 Heart Failure and Shock with MCC | 27 | $65,456 | +16% | $10,939 |
| 840 Lymphoma and Non-Acute Leukemia with MCC | 20 | $176,214 | +13% | $31,561 |
| 193 Simple Pneumonia and Pleurisy with MCC | 18 | $88,519 | +48% | $13,032 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 17 | $35,511 | -12% | $7,405 |
| 683 Renal Failure with CC | 17 | $47,674 | +17% | $8,032 |
| 847 Chemotherapy without Acute Leukemia As Secondary Diagnosis... | 17 | $80,595 | +19% | $13,693 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 15 | $74,599 | -13% | $15,230 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 15 | $183,087 | -20% | $43,163 |
| 328 Stomach, Esophageal and Duodenal Procedures without CC/MCC | 14 | $54,014 | -38% | $13,156 |
| 389 Gastrointestinal Obstruction with CC | 14 | $40,699 | +5% | $7,421 |
| 834 Acute Leukemia with MCC | 14 | $426,675 | +49% | $71,486 |
| 177 Respiratory Infections and Inflammations with MCC | 13 | $73,661 | +4% | $14,233 |
| 326 Stomach, Esophageal and Duodenal Procedures with MCC | 13 | $223,090 | -7% | $45,226 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 13 | $71,241 | +17% | $13,047 |
| 742 Uterine and Adnexa Procedures for Non-Malignancy with CC/MCC | 13 | $90,363 | -11% | $15,445 |
| 809 Major Hematological and Immunological Diagnoses except... | 13 | $126,780 | +102% | $20,399 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 13 | $48,918 | 0% | $9,831 |
| 314 Other Circulatory System Diagnoses with MCC | 12 | $136,438 | +44% | $19,692 |
| 329 Major Small and Large Bowel Procedures with MCC | 12 | $207,751 | -3% | $45,073 |
| 617 Amputation of Lower Limb for Endocrine, Nutritional and... | 12 | $65,190 | -25% | $14,153 |
| 690 Kidney and Urinary Tract Infections without MCC | 12 | $34,366 | -9% | $7,179 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $61,749 | +2% | $11,604 |
| 755 Malignancy, Female Reproductive System with CC | 11 | $69,753 | +27% | $8,952 |
| 808 Major Hematological and Immunological Diagnoses except... | 11 | $142,086 | +31% | $20,271 |
Outpatient services
Against the Pennsylvania average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), West Penn Hospital charged $113,284 on average, 28% more than the Pennsylvania average of $88,167, and was paid $18,506 against a state average of $16,881. For Major Small and Large Bowel Procedures with CC (DRG 330), West Penn Hospital charged $132,578 on average, 1% more than the Pennsylvania average of $131,000, and was paid $22,961 against a state average of $22,195. For Heart Failure and Shock with MCC (DRG 291), West Penn Hospital charged $65,456 on average, 14% more than the Pennsylvania average of $57,362, and was paid $10,939 against a state average of $11,112. For Lymphoma and Non-Acute Leukemia with MCC (DRG 840), West Penn Hospital charged $176,214 on average, 6% less than the Pennsylvania average of $188,448, and was paid $31,561 against a state average of $32,456. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $10,512 was 32% below the state average of $15,366. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $21,322 was 2% below the state average of $21,732. For Level 2 Laparoscopy and Related Services (outpatient APC 5362), its average charge of $52,830 was 29% below the state average of $74,352. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $12,849 was 22% below the state average of $16,557.
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.