UPMC PINNACLE HOSPITALS
HARRISBURG, PA 17104 · Acute Care Hospitals
164 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024
By BillRazor Research · Last updated March 26, 2026 · Methodology
Procedures Analyzed
164
With CMS pricing data
Avg Charge-to-Medicare Ratio
5.2x
Chargemaster ÷ Medicare
CMS Quality Rating
Patient experience & outcomes
Hospital Type
Acute Care Hospitals
Voluntary non-profit - Private
Above 90th Percentile
0%
Compared to PA hospitals
Understanding Your Costs
When you receive a bill from UPMC PINNACLE HOSPITALS, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, UPMC PINNACLE HOSPITALS lists chargemaster rates that average 5.2x the corresponding Medicare reimbursement amount across 164 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 5.2x, 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 PINNACLE HOSPITALS is KIDNEY TRANSPLANT (DRG 652). The listed chargemaster rate is $293,207, while Medicare reimburses $21,095 for the same procedure — a ratio of 13.9x (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 PINNACLE HOSPITALS is a voluntary non-profit - private 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 TRANSPLANT | 652 | $293,207 | $21,095 | 13.9x | 1th | Compare your bill |
| MAJOR MALE PELVIC PROCEDURES WITHOUT CC/MCC | 708 | $84,014 | $9,311 | 9.0x | 1th | Compare your bill |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $39,176 | $4,486 | 8.7x | 1th | Compare your bill |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $23,631 | $2,968 | 8.0x | 1th | Compare your bill |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $38,051 | $4,908 | 7.8x | 1th | Compare your bill |
| MAJOR CHEST PROCEDURES WITHOUT CC/MCC | 165 | $101,275 | $13,364 | 7.6x | 1th | Compare your bill |
| HYPERTENSION WITHOUT MCC | 305 | $32,506 | $4,316 | 7.5x | 1th | Compare your bill |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $56,041 | $7,482 | 7.5x | 1th | Compare your bill |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $50,455 | $7,025 | 7.2x | 1th | Compare your bill |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | 661 | $42,222 | $5,996 | 7.0x | 0th | Compare your bill |
| DYSEQUILIBRIUM | 149 | $31,816 | $4,678 | 6.8x | 0th | Compare your bill |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $21,369 | $3,184 | 6.7x | 0th | Compare your bill |
| RENAL FAILURE WITHOUT CC/MCC | 684 | $23,423 | $3,491 | 6.7x | 0th | Compare your bill |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITHOUT CC/MCC | 244 | $85,789 | $12,793 | 6.7x | 1th | Compare your bill |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $33,717 | $5,056 | 6.7x | 0th | Compare your bill |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $39,052 | $5,912 | 6.6x | 0th | Compare your bill |
| CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC | 847 | $54,616 | $8,277 | 6.6x | 1th | Compare your bill |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $58,339 | $8,951 | 6.5x | 1th | Compare your bill |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $32,631 | $5,001 | 6.5x | 1th | Compare your bill |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $28,517 | $4,372 | 6.5x | 0th | Compare your bill |
| MAJOR BLADDER PROCEDURES WITHOUT CC/MCC | 655 | $97,455 | $15,110 | 6.5x | 1th | Compare your bill |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH CC | 442 | $48,256 | $7,520 | 6.4x | 1th | Compare your bill |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $41,150 | $6,451 | 6.4x | 0th | Compare your bill |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $77,762 | $12,397 | 6.3x | 1th | Compare your bill |
| CHEST PAIN | 313 | $28,715 | $4,585 | 6.3x | 0th | Compare your bill |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $31,597 | $5,071 | 6.2x | 1th | Compare your bill |
| SEIZURES WITHOUT MCC | 101 | $38,000 | $6,124 | 6.2x | 0th | Compare your bill |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $41,158 | $6,635 | 6.2x | 1th | Compare your bill |
| STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITHOUT CC/MCC | 328 | $70,203 | $11,406 | 6.2x | 0th | Compare your bill |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $45,349 | $7,389 | 6.1x | 1th | Compare your bill |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITH MCC | 056 | $101,778 | $16,656 | 6.1x | 1th | Compare your bill |
| HEART FAILURE AND SHOCK WITH CC | 292 | $35,235 | $5,790 | 6.1x | 1th | Compare your bill |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $33,709 | $5,592 | 6.0x | 0th | Compare your bill |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $29,885 | $4,955 | 6.0x | 0th | Compare your bill |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $33,311 | $5,552 | 6.0x | 1th | Compare your bill |
| PERIPHERAL VASCULAR DISORDERS WITH CC | 300 | $41,266 | $6,894 | 6.0x | 1th | Compare your bill |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $40,400 | $6,757 | 6.0x | 0th | Compare your bill |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $38,059 | $6,407 | 5.9x | 1th | Compare your bill |
| PERITONEAL ADHESIOLYSIS WITH CC | 336 | $74,555 | $12,589 | 5.9x | 0th | Compare your bill |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $28,619 | $4,842 | 5.9x | 0th | Compare your bill |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $38,036 | $6,485 | 5.9x | 0th | Compare your bill |
| OTHER FACTORS INFLUENCING HEALTH STATUS | 951 | $20,541 | $3,508 | 5.9x | 1th | Compare your bill |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $80,237 | $13,756 | 5.8x | 0th | Compare your bill |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $51,243 | $8,832 | 5.8x | 1th | Compare your bill |
| HERNIA PROCEDURES EXCEPT INGUINAL AND FEMORAL WITH CC | 354 | $58,875 | $10,188 | 5.8x | 0th | Compare your bill |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $40,662 | $7,046 | 5.8x | 1th | Compare your bill |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $63,588 | $11,024 | 5.8x | 0th | Compare your bill |
| POSTOPERATIVE AND POST-TRAUMATIC INFECTIONS WITHOUT MCC | 863 | $39,962 | $6,964 | 5.7x | 1th | Compare your bill |
| RED BLOOD CELL DISORDERS WITH MCC | 811 | $54,427 | $9,493 | 5.7x | 1th | Compare your bill |
| SIGNS AND SYMPTOMS WITH MCC | 947 | $43,827 | $7,662 | 5.7x | 0th | Compare your bill |
Showing 50 of 164 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 5.2x 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 PINNACLE HOSPITALS
How much does UPMC PINNACLE HOSPITALS charge compared to Medicare?
According to CMS IPPS data, UPMC PINNACLE HOSPITALS's listed chargemaster rates average 5.2x the Medicare reimbursement amount across 164 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 PINNACLE HOSPITALS?
The procedure with the highest chargemaster-to-Medicare ratio at UPMC PINNACLE HOSPITALS is KIDNEY TRANSPLANT (DRG 652), with a listed charge of $293,207 compared to Medicare reimbursement of $21,095 — a ratio of 13.9x. Source: CMS IPPS Provider Summary.
Is UPMC PINNACLE HOSPITALS expensive compared to other PA hospitals?
UPMC PINNACLE HOSPITALS's average chargemaster-to-Medicare ratio is 5.2x. 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 PINNACLE HOSPITALS 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 PINNACLE HOSPITALS 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 PINNACLE HOSPITALS in HARRISBURG, PA accept Medicare?
UPMC PINNACLE HOSPITALS is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact UPMC PINNACLE HOSPITALS directly or check with your insurance provider.
Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.