Pennsylvania / Wilkes-Barre General Hospital
CMS certification 390137 · Wilkes-Barre, PA · 3 entries in CMS's price-transparency list
Wilkes-Barre General Hospital: charges and Medicare payments
Wilkes-Barre General Hospital reported 2,120 Medicare inpatient stays across 67 DRGs in 2024. Across them it charged 7.52 times what it was paid — among the higher ratios in Pennsylvania, number 11 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: 175 stays at an average charge of $62,107, 10% above the national average. It also billed 2,492 outpatient services, charging 14.06 times what Medicare paid.
- 1Medicare inpatient stays 2,120
- 2Charge ÷ paid, inpatient 7.52×
- 3Rank in PA (highest ratio = 1) 11 of 117
- 4CMS price-transparency actions 3
Inpatient stays
For the 67 DRGs that can be compared with the national average, Wilkes-Barre General Hospital charged more than the national average in 45 (67%). 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 | 175 | $62,107 | +10% | $9,328 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 139 | $93,629 | +4% | $14,688 |
| 193 Simple Pneumonia and Pleurisy with MCC | 80 | $76,169 | +27% | $9,903 |
| 189 Pulmonary Edema and Respiratory Failure | 76 | $67,919 | +18% | $9,206 |
| 177 Respiratory Infections and Inflammations with MCC | 72 | $72,837 | +3% | $11,827 |
| 690 Kidney and Urinary Tract Infections without MCC | 69 | $38,916 | +3% | $6,082 |
| 689 Kidney and Urinary Tract Infections with MCC | 65 | $51,331 | 0% | $8,535 |
| 312 Syncope and Collapse | 62 | $39,618 | -13% | $6,523 |
| 378 Gastrointestinal Hemorrhage with CC | 57 | $73,850 | +52% | $7,381 |
| 682 Renal Failure with MCC | 54 | $69,721 | +6% | $11,019 |
| 683 Renal Failure with CC | 54 | $44,467 | +9% | $6,871 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 39 | $40,615 | +10% | $5,934 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 38 | $46,430 | +16% | $6,045 |
| 603 Cellulitis without MCC | 38 | $44,957 | +21% | $6,680 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 38 | $51,935 | +6% | $8,107 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 36 | $48,036 | -14% | $7,400 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 36 | $61,857 | +9% | $9,643 |
| 552 Medical Back Problems without MCC | 36 | $43,299 | -11% | $7,057 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 35 | $83,848 | -16% | $13,410 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 35 | $315,341 | +101% | $23,712 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 35 | $42,652 | +18% | $5,958 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 34 | $53,701 | +6% | $7,852 |
| 330 Major Small and Large Bowel Procedures with CC | 33 | $159,455 | +34% | $18,058 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 33 | $152,167 | +63% | $13,699 |
| 069 Transient Ischemia without Thrombolytic | 32 | $43,065 | -15% | $5,983 |
| 481 Hip and Femur Procedures except Major Joint with CC | 32 | $108,543 | +8% | $14,331 |
| 092 Other Disorders of Nervous System with CC | 31 | $41,976 | -19% | $7,573 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 29 | $57,064 | -11% | $8,382 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 28 | $71,549 | +19% | $9,447 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 27 | $84,422 | +15% | $11,527 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 26 | $539,336 | +144% | $54,303 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 25 | $29,716 | +3% | $4,264 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 25 | $218,117 | -5% | $36,026 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 23 | $155,538 | +36% | $13,348 |
| 377 Gastrointestinal Hemorrhage with MCC | 22 | $103,778 | +22% | $13,856 |
| 194 Simple Pneumonia and Pleurisy with CC | 20 | $54,114 | +41% | $5,605 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 19 | $102,898 | -8% | $15,862 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 18 | $152,719 | +13% | $20,565 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 18 | $224,278 | +37% | $25,138 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 18 | $131,111 | +28% | $15,498 |
| 178 Respiratory Infections and Inflammations with CC | 17 | $43,463 | -4% | $7,763 |
| 418 Laparoscopic Cholecystectomy without C.D.E. with CC | 17 | $121,070 | +30% | $12,413 |
| 445 Disorders of The Biliary Tract with CC | 17 | $84,357 | +45% | $8,056 |
| 638 Diabetes with CC | 17 | $53,702 | +29% | $6,788 |
| 313 Chest Pain | 16 | $46,963 | +18% | $5,588 |
| 563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,... | 16 | $41,360 | -3% | $6,771 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 15 | $75,615 | 0% | $12,746 |
| 394 Other Digestive System Diagnoses with CC | 15 | $56,976 | +21% | $7,383 |
| 202 Bronchitis and Asthma with CC/MCC | 14 | $39,812 | -14% | $7,899 |
| 389 Gastrointestinal Obstruction with CC | 14 | $55,514 | +43% | $6,134 |
| 393 Other Digestive System Diagnoses with MCC | 14 | $76,615 | 0% | $12,270 |
| 066 Intracranial Hemorrhage or Cerebral Infarction without... | 13 | $47,494 | +12% | $5,772 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 13 | $59,857 | +26% | $7,733 |
| 086 Traumatic Stupor and Coma <1 Hour with CC | 12 | $50,783 | -26% | $9,657 |
| 149 Dysequilibrium | 12 | $39,727 | -11% | $5,594 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 12 | $79,313 | +57% | $6,707 |
| 314 Other Circulatory System Diagnoses with MCC | 12 | $79,908 | -16% | $14,505 |
| 605 Trauma To The Skin, Subcutaneous Tissue and Breast without... | 12 | $45,852 | -1% | $6,935 |
| 812 Red Blood Cell Disorders without MCC | 12 | $53,772 | +21% | $6,768 |
| 191 Chronic Obstructive Pulmonary Disease with CC | 11 | $47,834 | +21% | $5,828 |
Showing the 60 most frequent of 67 DRGs.
Outpatient services
Against the Pennsylvania average
For Heart Failure and Shock with MCC (DRG 291), Wilkes-Barre General Hospital charged $62,107 on average, 8% more than the Pennsylvania average of $57,362, and was paid $9,328 against a state average of $11,112. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Wilkes-Barre General Hospital charged $93,629 on average, 6% more than the Pennsylvania average of $88,167, and was paid $14,688 against a state average of $16,881. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Wilkes-Barre General Hospital charged $76,169 on average, 28% more than the Pennsylvania average of $59,404, and was paid $9,903 against a state average of $11,319. For Pulmonary Edema and Respiratory Failure (DRG 189), Wilkes-Barre General Hospital charged $67,919 on average, 4% more than the Pennsylvania average of $65,329, and was paid $9,206 against a state average of $11,268. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $27,538 was 3% below the state average of $28,496. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $21,564 was 58% above the state average of $13,651. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $20,436 was 33% above the state average of $15,366. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $30,239 was 83% above the state average of $16,557.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Wilkes-Barre General Hospital in Wilkes-Barre, PA, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2025-04-23 (CMS case 3986)
- Closure Notice — 2025-07-28 (CMS case 3986)
- Warning Notice — 2026-07-30 (CMS case 8387)
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.