Upmc Pinnacle Hospitals
UPMC Pinnacle Hospitals in Harrisburg, PA charges 5.2x the Medicare reimbursement rate across 164 analyzed procedures, reflecting pricing patterns common among nonprofit hospital systems.
Harrisburg, PA 17104 · 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
D
High
Avg markup vs Medicare
5.23x
Charge / Medicare rate
Max markup
13.9x
Worst procedure
Procedures analyzed
164
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 |
|---|---|---|---|---|---|
| KIDNEY TRANSPLANT | 652 | $293,207 | $146,603 | — | 13.9x |
| MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC | 708 | $84,014 | $42,007 | — | 9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $39,176 | $19,588 | — | 8.7x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $23,631 | $11,816 | — | 8x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $38,051 | $19,025 | — | 7.8x |
| MAJOR CHEST PROCEDURES WITHOUT CC/MCC | 165 | $101,275 | $50,637 | — | 7.6x |
| HYPERTENSION WITHOUT MCC | 305 | $32,506 | $16,253 | — | 7.5x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $56,041 | $28,020 | — | 7.5x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $50,455 | $25,227 | — | 7.2x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | 661 | $42,222 | $21,111 | — | 7x |
| DYSEQUILIBRIUM | 149 | $31,816 | $15,908 | — | 6.8x |
| RENAL FAILURE WITHOUT CC/MCC | 684 | $23,423 | $11,712 | — | 6.7x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC | 244 | $85,789 | $42,895 | — | 6.7x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $21,369 | $10,684 | — | 6.7x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $33,717 | $16,858 | — | 6.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $39,052 | $19,526 | — | 6.6x |
| CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC | 847 | $54,616 | $27,308 | — | 6.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $32,631 | $16,316 | — | 6.5x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $58,339 | $29,170 | — | 6.5x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $28,517 | $14,259 | — | 6.5x |
| MAJOR BLADDER PROCEDURES WITHOUT CC/MCC | 655 | $97,455 | $48,727 | — | 6.5x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | 442 | $48,256 | $24,128 | — | 6.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $41,150 | $20,575 | — | 6.4x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $77,762 | $38,881 | — | 6.3x |
| CHEST PAIN | 313 | $28,715 | $14,357 | — | 6.3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $31,597 | $15,798 | — | 6.2x |
| SEIZURES WITHOUT MCC | 101 | $38,000 | $19,000 | — | 6.2x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $41,158 | $20,579 | — | 6.2x |
| STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC | 328 | $70,203 | $35,101 | — | 6.2x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $45,349 | $22,675 | — | 6.1x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | 056 | $101,778 | $50,889 | — | 6.1x |
| HEART FAILURE AND SHOCK WITH CC | 292 | $35,235 | $17,618 | — | 6.1x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $29,885 | $14,943 | — | 6x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $33,709 | $16,855 | — | 6x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $33,311 | $16,655 | — | 6x |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $41,266 | $20,633 | — | 6x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $40,400 | $20,200 | — | 6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $38,059 | $19,030 | — | 5.9x |
| PERITONEAL ADHESIOLYSIS WITH CC | 336 | $74,555 | $37,278 | — | 5.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $28,619 | $14,309 | — | 5.9x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $38,036 | $19,018 | — | 5.9x |
| OTHER FACTORS INFLUENCING HEALTH STATUS | 951 | $20,541 | $10,270 | — | 5.9x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $80,237 | $40,119 | — | 5.8x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $51,243 | $25,622 | — | 5.8x |
| HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | 354 | $58,875 | $29,437 | — | 5.8x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $63,588 | $31,794 | — | 5.8x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $40,662 | $20,331 | — | 5.8x |
| POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | 863 | $39,962 | $19,981 | — | 5.7x |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $54,427 | $27,214 | — | 5.7x |
| SIGNS AND SYMPTOMS WITH MCC | 947 | $43,827 | $21,914 | — | 5.7x |
Showing 50 of 164 procedures
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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