Upmc Mercy
UPMC Mercy in Pittsburgh charges 7.8x the Medicare reimbursement rate across 42 analyzed procedures, positioning this nonprofit hospital significantly above standard government pricing benchmarks.
Pittsburgh, PA 15219 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
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Pricing grade
D
High
Avg markup vs Medicare
7.83x
Charge / Medicare rate
Max markup
14.19x
Worst procedure
Procedures analyzed
42
With pricing data
Outlier procedures
4.8%
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 |
|---|---|---|---|---|---|
| PNEUMOTHORAX WITH CC | 200 | $71,134 | $35,567 | — | 14.2x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $60,432 | $30,216 | — | 10.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $70,697 | $35,348 | — | 10.6x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $331,154 | $165,577 | — | 10.1x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $96,648 | $48,324 | — | 10x |
| DIABETES WITH CC | 638 | $57,949 | $28,974 | — | 9.9x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $153,017 | $76,509 | — | 9.2x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $62,238 | $31,119 | — | 9.2x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $64,797 | $32,398 | — | 9.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $49,517 | $24,758 | — | 8.9x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $129,260 | $64,630 | — | 8.8x |
| RENAL FAILURE WITH MCC | 682 | $93,816 | $46,908 | — | 8.6x |
| TRAUMATIC STUPOR AND COMA <1 HOUR WITH CC | 086 | $81,888 | $40,944 | — | 8.5x |
| MAJOR CHEST TRAUMA WITH CC | 184 | $59,021 | $29,511 | — | 8.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $65,201 | $32,601 | — | 8.4x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $59,691 | $29,845 | — | 8.3x |
| SEIZURES WITHOUT MCC | 101 | $49,661 | $24,831 | — | 8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $100,029 | $50,014 | — | 8x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $39,599 | $19,800 | — | 8x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $46,811 | $23,405 | — | 7.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $37,320 | $18,660 | — | 7.9x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $62,894 | $31,447 | — | 7.9x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $53,316 | $26,658 | — | 7.8x |
| TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | 082 | $140,115 | $70,058 | — | 7.8x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $121,024 | $60,512 | — | 7.7x |
| CELLULITIS WITHOUT MCC | 603 | $43,534 | $21,767 | — | 7.6x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $232,738 | $116,369 | — | 7.5x |
| POISONING AND TOXIC EFFECTS OF DRUGS WITH MCC | 917 | $86,290 | $43,145 | — | 7.4x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $186,880 | $93,440 | — | 7.3x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $66,821 | $33,410 | — | 7.1x |
| STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC | 327 | $139,078 | $69,539 | — | 7x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH MCC | 025 | $242,442 | $121,221 | — | 6.7x |
| TRAUMATIC STUPOR AND COMA >1 HOUR WITH CC | 083 | $65,184 | $32,592 | — | 6.4x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $148,297 | $74,149 | — | 6.3x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $87,997 | $43,999 | — | 6.3x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $92,253 | $46,126 | — | 6.3x |
| CERVICAL SPINAL FUSION WITH CC | 472 | $128,274 | $64,137 | — | 6x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC | 897 | $28,390 | $14,195 | — | 5.6x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $49,311 | $24,656 | — | 5x |
| CRANIOTOMY WITH MAJOR DEVICE IMPLANT OR ACUTE COMPLEX CNS PRINCIPAL DIAGNOSIS WITH MCC O | 023 | $221,904 | $110,952 | — | 5x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $86,014 | $43,007 | — | 4x |
| ALCOHOL, DRUG ABUSE OR DEPENDENCE, LEFT AMA | 894 | $12,933 | $6,466 | — | 3.1x |
How UPMC MERCY 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