UPMC NORTHWEST
SENECA, PA 16346 · Acute Care Hospitals
24 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024
By BillRazor Research · Last updated March 27, 2026 · Methodology
Procedures Analyzed
24
With CMS pricing data
Avg Charge-to-Medicare Ratio
5.0x
Chargemaster ÷ Medicare
CMS Quality Rating
Patient experience & outcomes
Hospital Type
Acute Care Hospitals
Voluntary non-profit - Other
Above 90th Percentile
0%
Compared to PA hospitals
Understanding Your Costs
When you receive a bill from UPMC NORTHWEST, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, UPMC NORTHWEST lists chargemaster rates that average 5.0x the corresponding Medicare reimbursement amount across 24 procedures with publicly available pricing data (Source: CMS IPPS Provider Summary, FY2024).
The median hospital in PA has a chargemaster-to-Medicare ratio of 5.3x, with ratios across the state ranging from 1.1x to 13.8x. At 5.0x, this facility’s average ratio is below the state median. 128 hospitals in PA report pricing data to CMS (Source: CMS IPPS Provider Summary).
The procedure with the largest gap between the listed price and Medicare reimbursement at UPMC NORTHWEST is Kidney and Urinary Tract Infections with Major Complications or Comorbidities (DRG 689). The listed chargemaster rate is $44,225, while Medicare reimburses $6,433 for the same procedure — a ratio of 6.9x (Source: CMS IPPS Provider Summary, FY2024).
What does this actually mean for your bill? Chargemaster rates are rarely what patients pay. If you have insurance, your insurer has negotiated a separate rate — often 40–60% less than the listed price. If you are uninsured, you may be able to negotiate directly with the hospital or request financial assistance. The chargemaster-to-Medicare ratio is a useful reference point for understanding listed pricing, but it does not represent what most patients will owe out of pocket.
UPMC NORTHWEST is a voluntary non-profit - other acute care hospitals facility with a CMS quality rating of 4/5 stars. Note: CMS quality ratings measure patient outcomes and experience, not pricing. A hospital with high listed prices may provide excellent care, and pricing data alone should not be used to evaluate the quality of a healthcare provider.
Listed Chargemaster Rates vs Medicare Reimbursement — Top Procedures by Ratio
Source: CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Procedure Pricing Lookup
Search for a specific procedure or DRG code to see listed chargemaster rates and Medicare reimbursement amounts.
| Procedure | DRG | Listed Charge | Medicare Reimb. | Ratio | State Position | |
|---|---|---|---|---|---|---|
| Kidney and Urinary Tract Infections with Major Complications or Comorbidities | 689 | $44,225 | $6,433 | 6.9x | 1th | Compare your bill |
| Simple Pneumonia and Pleurisy with Complications | 194 | $28,689 | $4,387 | 6.5x | 0th | Compare your bill |
| Intracranial Hemorrhage or Cerebral Infarction with Complications or Tpa in 24 Hours | 065 | $31,249 | $4,876 | 6.4x | 0th | Compare your bill |
| Psychoses | 885 | $51,235 | $8,504 | 6.0x | 1th | Compare your bill |
| Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without Major Complications | 641 | $22,781 | $3,845 | 5.9x | 0th | Compare your bill |
| Pulmonary Edema and Respiratory Failure | 189 | $37,833 | $6,733 | 5.6x | 0th | Compare your bill |
| Cardiac Arrhythmia and Conduction Disorders with Complications | 309 | $20,225 | $3,660 | 5.5x | 0th | Compare your bill |
| Kidney and Urinary Tract Infections without Major Complications | 690 | $21,609 | $3,986 | 5.4x | 0th | Compare your bill |
| Diabetes with Complications | 638 | $21,583 | $4,007 | 5.4x | 0th | Compare your bill |
| Septicemia or Severe Sepsis without Mechanical Ventilation over 96 Hours without Major Complications | 872 | $28,495 | $5,330 | 5.3x | 0th | Compare your bill |
| Simple Pneumonia and Pleurisy with Major Complications or Comorbidities | 193 | $38,890 | $7,330 | 5.3x | 0th | Compare your bill |
| Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without Major Complications | 392 | $20,381 | $3,992 | 5.1x | 0th | Compare your bill |
| Renal Failure with Complications | 683 | $22,177 | $4,454 | 5.0x | 0th | Compare your bill |
| Respiratory Infections and Inflammations with Major Complications or Comorbidities | 177 | $48,467 | $10,261 | 4.7x | 0th | Compare your bill |
| Chronic Obstructive Pulmonary Disease with Major Complications or Comorbidities | 190 | $28,920 | $6,133 | 4.7x | 0th | Compare your bill |
| Cardiac Arrhythmia and Conduction Disorders with Major Complications or Comorbidities | 308 | $31,153 | $6,608 | 4.7x | 0th | Compare your bill |
| Gastrointestinal Obstruction with Complications | 389 | $18,151 | $4,073 | 4.5x | 0th | Compare your bill |
| Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with Major Complications or Comorbidities | 640 | $31,455 | $7,166 | 4.4x | 0th | Compare your bill |
| Cellulitis without Major Complications | 603 | $19,061 | $4,454 | 4.3x | 0th | Compare your bill |
| Septicemia or Severe Sepsis without Mechanical Ventilation over 96 Hours with Major Complications or Comorbidities | 871 | $43,209 | $10,367 | 4.2x | 0th | Compare your bill |
| Medical Back Problems without Major Complications | 552 | $19,800 | $4,933 | 4.0x | 0th | Compare your bill |
| Respiratory Infections and Inflammations with Complications | 178 | $22,519 | $5,982 | 3.8x | 0th | Compare your bill |
| Heart Failure and Shock with Major Complications or Comorbidities | 291 | $26,226 | $7,126 | 3.7x | 0th | Compare your bill |
| Other Kidney and Urinary Tract Diagnoses with Major Complications or Comorbidities | 698 | $32,764 | $9,662 | 3.4x | 0th | Compare your bill |
Showing 24 of 24 procedures
All data from CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Statewide Context
Charge-to-Medicare ratio range across PA hospitals
128 hospitals in PA report pricing data to CMS. This facility's average ratio of 5.0x places it at the lower-middle range of the state range (Source: CMS IPPS Provider Summary).
What You Can Do
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How it worksData: CMS Inpatient Prospective Payment System (IPPS) Provider Summary, FY2024. All data is publicly available under federal law (45 CFR Part 180).
Important: Listed chargemaster rates are not what most insured patients pay. Actual costs depend on your insurance plan's negotiated rates, deductibles, and coverage terms. This information is for educational purposes only and does not constitute medical, legal, or financial advice.
Frequently Asked Questions About UPMC NORTHWEST
How much does UPMC NORTHWEST charge compared to Medicare?
According to CMS IPPS data, UPMC NORTHWEST's listed chargemaster rates average 5.0x the Medicare reimbursement amount across 24 procedures. Chargemaster rates are list prices and are not what most insured patients pay — actual costs depend on insurance negotiations and coverage terms.
What is the most expensive procedure at UPMC NORTHWEST?
The procedure with the highest chargemaster-to-Medicare ratio at UPMC NORTHWEST is Kidney and Urinary Tract Infections with Major Complications or Comorbidities (DRG 689), with a listed charge of $44,225 compared to Medicare reimbursement of $6,433 — a ratio of 6.9x. Source: CMS IPPS Provider Summary.
Is UPMC NORTHWEST expensive compared to other PA hospitals?
UPMC NORTHWEST's average chargemaster-to-Medicare ratio is 5.0x. Ratios vary significantly across PA hospitals. This ratio reflects listed chargemaster prices, not what patients actually pay. CMS quality ratings, which measure patient outcomes and experience, are separate from pricing data.
Where does the pricing data for UPMC NORTHWEST come from?
All pricing data comes from the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Provider Summary, published under federal price transparency law (45 CFR Part 180). This data is publicly available and updated annually.
How can I check if my bill from UPMC NORTHWEST is correct?
You can upload your bill to BillRazor for a free comparison against publicly available Medicare reimbursement data. Our system analyzes every line item in 60 seconds. Research suggests 49-80% of hospital bills contain errors, including duplicate charges, incorrect procedure codes, and unbundling.
Does UPMC NORTHWEST in SENECA, PA accept Medicare?
UPMC NORTHWEST is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact UPMC NORTHWEST directly or check with your insurance provider.
Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.