Upmc East
UPMC EAST in Monroeville, PA charges 8.7x the Medicare reimbursement rate across 35 analyzed procedures, reflecting the pricing patterns typical of nonprofit-private hospitals.
Monroeville, PA 15146 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
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Pricing grade
F
Very high
Avg markup vs Medicare
8.74x
Charge / Medicare rate
Max markup
13.61x
Worst procedure
Procedures analyzed
35
With pricing data
Outlier procedures
2.9%
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 |
|---|---|---|---|---|---|
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $28,768 | $14,384 | — | 13.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $69,903 | $34,952 | — | 11x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $70,433 | $35,217 | — | 10.8x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $52,265 | $26,133 | — | 10.7x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $61,012 | $30,506 | — | 10.7x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $44,210 | $22,105 | — | 10.6x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $41,618 | $20,809 | — | 10.2x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $170,211 | $85,106 | — | 10.2x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $34,758 | $17,379 | — | 9.9x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $61,510 | $30,755 | — | 9.8x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $94,573 | $47,287 | — | 9.6x |
| CELLULITIS WITHOUT MCC | 603 | $43,439 | $21,720 | — | 9.6x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $52,428 | $26,214 | — | 9.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $32,527 | $16,264 | — | 9.5x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $66,026 | $33,013 | — | 9.4x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $87,601 | $43,801 | — | 9.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $54,733 | $27,366 | — | 9.3x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $40,375 | $20,187 | — | 8.8x |
| RENAL FAILURE WITH CC | 683 | $40,629 | $20,315 | — | 8.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $34,349 | $17,174 | — | 8.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $85,822 | $42,911 | — | 8.4x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $95,203 | $47,601 | — | 8.4x |
| RENAL FAILURE WITH MCC | 682 | $65,202 | $32,601 | — | 8.3x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $86,608 | $43,304 | — | 7.8x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $32,038 | $16,019 | — | 7.7x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $54,427 | $27,214 | — | 7.5x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $64,199 | $32,100 | — | 7.5x |
| SYNCOPE AND COLLAPSE | 312 | $34,133 | $17,066 | — | 7.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $48,900 | $24,450 | — | 6.9x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $66,707 | $33,354 | — | 6.8x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $34,458 | $17,229 | — | 6.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $43,105 | $21,552 | — | 6.5x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $63,394 | $31,697 | — | 6.4x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $146,062 | $73,031 | — | 5.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $48,458 | $24,229 | — | 5.1x |
How UPMC EAST 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