Upmc Presbyterian Shadyside
UPMC Presbyterian Shadyside in Pittsburgh charges 13.8x the Medicare reimbursement rate across 207 analyzed procedures, with 77% showing significant price variations compared to other facilities.
Pittsburgh, PA 15213 · Acute Care Hospitals · CMS Rating: 4/5
About the analyst
Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.
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Pricing grade
F
Very high
Avg markup vs Medicare
13.81x
Charge / Medicare rate
Max markup
47.04x
Worst procedure
Procedures analyzed
207
With pricing data
Outlier procedures
76.8%
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 |
|---|---|---|---|---|---|
| OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC | 206 | $243,248 | $121,624 | — | 47x |
| COAGULATION DISORDERS | 813 | $446,471 | $223,236 | — | 46.9x |
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC | 073 | $347,348 | $173,674 | — | 29.3x |
| COMPLICATIONS OF TREATMENT WITH CC | 920 | $146,685 | $73,342 | — | 23.8x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $155,422 | $77,711 | — | 22.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $191,608 | $95,804 | — | 22.4x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $316,420 | $158,210 | — | 22.2x |
| MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATIO | 808 | $398,601 | $199,301 | — | 20.6x |
| DYSEQUILIBRIUM | 149 | $103,814 | $51,907 | — | 18.9x |
| ACUTE LEUKEMIA WITH CC | 835 | $381,057 | $190,529 | — | 18.5x |
| INFLAMMATORY BOWEL DISEASE WITH CC | 386 | $128,208 | $64,104 | — | 18.5x |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $120,212 | $60,106 | — | 18.4x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $193,092 | $96,546 | — | 18.2x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC | 542 | $355,957 | $177,978 | — | 18.2x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $110,958 | $55,479 | — | 18.1x |
| LUNG TRANSPLANT | 007 | $1,478,689 | $739,345 | — | 17.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $87,568 | $43,784 | — | 17.6x |
| KIDNEY TRANSPLANT | 652 | $430,380 | $215,190 | — | 17.6x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $121,775 | $60,888 | — | 17.5x |
| DIABETES WITH CC | 638 | $91,542 | $45,771 | — | 17.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $1,235,010 | $617,505 | — | 17.5x |
| OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | 673 | $490,908 | $245,454 | — | 17.4x |
| TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | 082 | $289,745 | $144,873 | — | 17.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $121,718 | $60,859 | — | 17.1x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $96,972 | $48,486 | — | 17.1x |
| FRACTURES OF HIP AND PELVIS WITH MCC | 535 | $183,840 | $91,920 | — | 17x |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | 441 | $254,092 | $127,046 | — | 16.8x |
| SEIZURES WITH MCC | 100 | $283,083 | $141,541 | — | 16.8x |
| DIGESTIVE MALIGNANCY WITH CC | 375 | $146,160 | $73,080 | — | 16.8x |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | 543 | $134,954 | $67,477 | — | 16.7x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $259,634 | $129,817 | — | 16.7x |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $94,675 | $47,338 | — | 16.5x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $158,118 | $79,059 | — | 16.4x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $148,468 | $74,234 | — | 16.3x |
| POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC | 857 | $267,853 | $133,927 | — | 16.2x |
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | 074 | $129,467 | $64,734 | — | 16.1x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC | 436 | $138,641 | $69,321 | — | 16.1x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $150,277 | $75,139 | — | 16.1x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $198,213 | $99,107 | — | 16x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $252,618 | $126,309 | — | 15.9x |
| CELLULITIS WITH MCC | 602 | $151,158 | $75,579 | — | 15.8x |
| ACUTE LEUKEMIA WITH MCC | 834 | $1,120,666 | $560,333 | — | 15.8x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $654,822 | $327,411 | — | 15.8x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $114,401 | $57,200 | — | 15.8x |
| NERVOUS SYSTEM NEOPLASMS WITH MCC | 054 | $152,711 | $76,356 | — | 15.7x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | 659 | $386,985 | $193,493 | — | 15.7x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $276,908 | $138,454 | — | 15.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $91,776 | $45,888 | — | 15.6x |
| EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | 981 | $626,289 | $313,144 | — | 15.6x |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC | 026 | $374,670 | $187,335 | — | 15.5x |
Showing 50 of 207 procedures
How UPMC PRESBYTERIAN SHADYSIDE 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