St Clair Hospital
ST CLAIR HOSPITAL in Pittsburgh, PA charges 4.8x the Medicare reimbursement rate on average across 64 analyzed procedures, according to our data analysis.
Pittsburgh, PA 15243 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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Pricing grade
C
Average
Avg markup vs Medicare
4.75x
Charge / Medicare rate
Max markup
9.31x
Worst procedure
Procedures analyzed
64
With pricing data
Outlier procedures
0%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $17,404 | $8,702 | — | 9.3x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $100,501 | $50,250 | — | 8.5x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $76,340 | $38,170 | — | 8x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITHOUT CC/MCC | 331 | $67,804 | $33,902 | — | 7.5x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | 419 | $40,036 | $20,018 | — | 6.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $12,031 | $6,015 | — | 6.4x |
| MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES | 483 | $80,724 | $40,362 | — | 6.3x |
| AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | 617 | $62,841 | $31,420 | — | 6.1x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $20,787 | $10,394 | — | 6.1x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $21,829 | $10,914 | — | 6.1x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $19,099 | $9,549 | — | 6x |
| DYSEQUILIBRIUM | 149 | $17,255 | $8,628 | — | 5.8x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | 661 | $29,519 | $14,759 | — | 5.8x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $17,504 | $8,752 | — | 5.8x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $16,694 | $8,347 | — | 5.8x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $48,878 | $24,439 | — | 5.7x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $38,639 | $19,320 | — | 5.6x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $23,708 | $11,854 | — | 5.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $17,147 | $8,573 | — | 5.4x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $137,857 | $68,928 | — | 5.3x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC | 266 | $203,610 | $101,805 | — | 5.3x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $112,160 | $56,080 | — | 5.2x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $48,297 | $24,149 | — | 5x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $57,099 | $28,549 | — | 5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $18,407 | $9,203 | — | 4.9x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $39,954 | $19,977 | — | 4.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $23,126 | $11,563 | — | 4.7x |
| SYNCOPE AND COLLAPSE | 312 | $18,686 | $9,343 | — | 4.7x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $76,120 | $38,060 | — | 4.7x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $27,190 | $13,595 | — | 4.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $23,217 | $11,609 | — | 4.6x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $21,200 | $10,600 | — | 4.6x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $50,815 | $25,407 | — | 4.5x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $29,053 | $14,526 | — | 4.3x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $30,851 | $15,426 | — | 4.3x |
| PERIPHERAL VASCULAR DISORDERS WITH MCC | 299 | $34,344 | $17,172 | — | 4.2x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $17,498 | $8,749 | — | 4.2x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $19,880 | $9,940 | — | 4.2x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $19,568 | $9,784 | — | 4.2x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $36,856 | $18,428 | — | 4.1x |
| DIABETES WITH CC | 638 | $16,228 | $8,114 | — | 4.1x |
| RENAL FAILURE WITH CC | 683 | $17,864 | $8,932 | — | 4.1x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $21,309 | $10,654 | — | 4.1x |
| CHEST PAIN | 313 | $12,417 | $6,209 | — | 4x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $25,553 | $12,777 | — | 3.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $39,341 | $19,671 | — | 3.9x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $44,782 | $22,391 | — | 3.8x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $14,647 | $7,324 | — | 3.7x |
| DIABETES WITH MCC | 637 | $28,665 | $14,332 | — | 3.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $23,486 | $11,743 | — | 3.6x |
Showing 50 of 64 procedures
How ST CLAIR HOSPITAL compares to nearby hospitals
Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use