St Luke's Hospital - Upper Bucks Campus
St. Luke's Hospital - Upper Bucks Campus in Quakertown, PA charges 11.0x the Medicare reimbursement rate, with 40% of analyzed procedures showing significant price variations.
Quakertown, PA 18951 · 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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Billing patterns — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
F
Very high
Avg markup vs Medicare
10.98x
Charge / Medicare rate
Max markup
17.75x
Worst procedure
Procedures analyzed
30
With pricing data
Outlier procedures
40%
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 |
|---|---|---|---|---|---|
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $156,836 | $78,418 | — | 17.8x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $118,099 | $59,050 | — | 13.7x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $64,552 | $32,276 | — | 13.6x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $75,705 | $37,853 | — | 13.3x |
| SYNCOPE AND COLLAPSE | 312 | $72,891 | $36,446 | — | 12.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $90,603 | $45,301 | — | 12.7x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $104,414 | $52,207 | — | 12.5x |
| HYPERTENSION WITHOUT MCC | 305 | $61,930 | $30,965 | — | 12.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $82,829 | $41,414 | — | 11.8x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $58,470 | $29,235 | — | 11.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $101,374 | $50,687 | — | 11.1x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $78,373 | $39,186 | — | 11x |
| RENAL FAILURE WITH CC | 683 | $65,142 | $32,571 | — | 11x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $59,303 | $29,651 | — | 10.9x |
| PSYCHOSES | 885 | $95,409 | $47,704 | — | 10.8x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $73,581 | $36,790 | — | 10.8x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $56,144 | $28,072 | — | 10.4x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $70,461 | $35,230 | — | 10.3x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $81,040 | $40,520 | — | 10.2x |
| CELLULITIS WITHOUT MCC | 603 | $57,452 | $28,726 | — | 9.9x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $112,960 | $56,480 | — | 9.6x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $128,857 | $64,429 | — | 9.5x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $133,364 | $66,682 | — | 9.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $83,897 | $41,949 | — | 9.5x |
| RENAL FAILURE WITH MCC | 682 | $107,036 | $53,518 | — | 9.4x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $82,968 | $41,484 | — | 9.3x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $147,274 | $73,637 | — | 9.2x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $133,683 | $66,841 | — | 9.1x |
| ENDOCRINE DISORDERS WITH MCC | 643 | $102,012 | $51,006 | — | 8.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $294,026 | $147,013 | — | 7.7x |
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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