UPMC PRESBYTERIAN SHADYSIDE
PITTSBURGH, PA 15213 · Acute Care Hospitals
207 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024
By BillRazor Research · Last updated March 26, 2026 · Methodology
Procedures Analyzed
207
With CMS pricing data
Avg Charge-to-Medicare Ratio
13.8x
Chargemaster ÷ Medicare
CMS Quality Rating
Patient experience & outcomes
Hospital Type
Acute Care Hospitals
Voluntary non-profit - Private
Above 90th Percentile
77%
Compared to PA hospitals
Understanding Your Costs
When you receive a bill from UPMC PRESBYTERIAN SHADYSIDE, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, UPMC PRESBYTERIAN SHADYSIDE lists chargemaster rates that average 13.8x the corresponding Medicare reimbursement amount across 207 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 13.8x, this facility’s average ratio is above 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 PRESBYTERIAN SHADYSIDE is OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC (DRG 206). The listed chargemaster rate is $243,248, while Medicare reimburses $5,171 for the same procedure — a ratio of 47.0x (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.
159 of 207 procedures (77%) at this facility have listed rates above the 90th percentile compared to other PA hospitals reporting the same procedure data to CMS (Source: CMS IPPS Provider Summary).
UPMC PRESBYTERIAN SHADYSIDE 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 | |
|---|---|---|---|---|---|---|
| OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC | 206 | $243,248 | $5,171 | 47.0x | 1th | Compare your bill |
| COAGULATION DISORDERS | 813 | $446,471 | $9,514 | 46.9x | 1th | Compare your bill |
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITH MCC | 073 | $347,348 | $11,847 | 29.3x | 1th | Compare your bill |
| COMPLICATIONS OF TREATMENT WITH CC | 920 | $146,685 | $6,174 | 23.8x | 1th | Compare your bill |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $155,422 | $6,904 | 22.5x | 1th | Compare your bill |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $191,608 | $8,540 | 22.4x | 1th | Compare your bill |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH MCC | 091 | $316,420 | $14,261 | 22.2x | 1th | Compare your bill |
| MAJOR HEMATOLOGICAL AND IMMUNOLOGICAL DIAGNOSES EXCEPT SICKLE CELL CRISIS AND COAGULATIO | 808 | $398,601 | $19,376 | 20.6x | 1th | Compare your bill |
| DYSEQUILIBRIUM | 149 | $103,814 | $5,496 | 18.9x | 1th | Compare your bill |
| ACUTE LEUKEMIA WITH CC | 835 | $381,057 | $20,569 | 18.5x | 1th | Compare your bill |
| INFLAMMATORY BOWEL DISEASE WITH CC | 386 | $128,208 | $6,934 | 18.5x | 1th | Compare your bill |
| OTHER CIRCULATORY SYSTEM DIAGNOSES WITH CC | 315 | $120,212 | $6,521 | 18.4x | 1th | Compare your bill |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $193,092 | $10,599 | 18.2x | 1th | Compare your bill |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH MCC | 542 | $355,957 | $19,585 | 18.2x | 1th | Compare your bill |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $110,958 | $6,125 | 18.1x | 1th | Compare your bill |
| LUNG TRANSPLANT | 007 | $1,478,689 | $83,331 | 17.7x | 1th | Compare your bill |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $87,568 | $4,980 | 17.6x | 1th | Compare your bill |
| KIDNEY TRANSPLANT | 652 | $430,380 | $24,504 | 17.6x | 1th | Compare your bill |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $121,775 | $6,967 | 17.5x | 1th | Compare your bill |
| DIABETES WITH CC | 638 | $91,542 | $5,242 | 17.5x | 1th | Compare your bill |
| SEPTICEMIA OR SEVERE SEPSIS WITH MV >96 HOURS | 870 | $1,235,010 | $70,781 | 17.4x | 1th | Compare your bill |
| OTHER KIDNEY AND URINARY TRACT PROCEDURES WITH MCC | 673 | $490,908 | $28,199 | 17.4x | 1th | Compare your bill |
| TRAUMATIC STUPOR AND COMA >1 HOUR WITH MCC | 082 | $289,745 | $16,846 | 17.2x | 1th | Compare your bill |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $121,718 | $7,101 | 17.1x | 1th | Compare your bill |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $96,972 | $5,680 | 17.1x | 1th | Compare your bill |
| FRACTURES OF HIP AND PELVIS WITH MCC | 535 | $183,840 | $10,831 | 17.0x | 1th | Compare your bill |
| DISORDERS OF LIVER EXCEPT MALIGNANCY, CIRRHOSIS OR ALCOHOLIC HEPATITIS WITH MCC | 441 | $254,092 | $15,089 | 16.8x | 1th | Compare your bill |
| SEIZURES WITH MCC | 100 | $283,083 | $16,876 | 16.8x | 1th | Compare your bill |
| DIGESTIVE MALIGNANCY WITH CC | 375 | $146,160 | $8,728 | 16.8x | 1th | Compare your bill |
| PATHOLOGICAL FRACTURES AND MUSCULOSKELETAL AND CONNECTIVE TISSUE MALIGNANCY WITH CC | 543 | $134,954 | $8,094 | 16.7x | 1th | Compare your bill |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $259,634 | $15,593 | 16.6x | 1th | Compare your bill |
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $94,675 | $5,729 | 16.5x | 1th | Compare your bill |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $158,118 | $9,655 | 16.4x | 1th | Compare your bill |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $148,468 | $9,120 | 16.3x | 1th | Compare your bill |
| POSTOPERATIVE OR POST-TRAUMATIC INFECTIONS WITH O.R. PROCEDURES WITH CC | 857 | $267,853 | $16,490 | 16.2x | 1th | Compare your bill |
| CRANIAL AND PERIPHERAL NERVE DISORDERS WITHOUT MCC | 074 | $129,467 | $8,024 | 16.1x | 1th | Compare your bill |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH CC | 436 | $138,641 | $8,606 | 16.1x | 1th | Compare your bill |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $150,277 | $9,342 | 16.1x | 1th | Compare your bill |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $198,213 | $12,427 | 15.9x | 1th | Compare your bill |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $252,618 | $15,909 | 15.9x | 1th | Compare your bill |
| CELLULITIS WITH MCC | 602 | $151,158 | $9,542 | 15.8x | 1th | Compare your bill |
| ACUTE LEUKEMIA WITH MCC | 834 | $1,120,666 | $70,740 | 15.8x | 1th | Compare your bill |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $114,401 | $7,261 | 15.8x | 1th | Compare your bill |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $654,822 | $41,559 | 15.8x | 1th | Compare your bill |
| NERVOUS SYSTEM NEOPLASMS WITH MCC | 054 | $152,711 | $9,711 | 15.7x | 1th | Compare your bill |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | 659 | $386,985 | $24,727 | 15.7x | 1th | Compare your bill |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC | 286 | $276,908 | $17,702 | 15.6x | 1th | Compare your bill |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $91,776 | $5,868 | 15.6x | 1th | Compare your bill |
| EXTENSIVE O.R. PROCEDURES UNRELATED TO PRINCIPAL DIAGNOSIS WITH MCC | 981 | $626,289 | $40,193 | 15.6x | 1th | Compare your bill |
| CRANIOTOMY AND ENDOVASCULAR INTRACRANIAL PROCEDURES WITH CC | 026 | $374,670 | $24,106 | 15.5x | 1th | Compare your bill |
Showing 50 of 207 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 13.8x places it at the upper end 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 PRESBYTERIAN SHADYSIDE
How much does UPMC PRESBYTERIAN SHADYSIDE charge compared to Medicare?
According to CMS IPPS data, UPMC PRESBYTERIAN SHADYSIDE's listed chargemaster rates average 13.8x the Medicare reimbursement amount across 207 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 PRESBYTERIAN SHADYSIDE?
The procedure with the highest chargemaster-to-Medicare ratio at UPMC PRESBYTERIAN SHADYSIDE is OTHER RESPIRATORY SYSTEM DIAGNOSES WITHOUT MCC (DRG 206), with a listed charge of $243,248 compared to Medicare reimbursement of $5,171 — a ratio of 47.0x. Source: CMS IPPS Provider Summary.
Is UPMC PRESBYTERIAN SHADYSIDE expensive compared to other PA hospitals?
UPMC PRESBYTERIAN SHADYSIDE's average chargemaster-to-Medicare ratio is 13.8x. 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 PRESBYTERIAN SHADYSIDE 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 PRESBYTERIAN SHADYSIDE 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 PRESBYTERIAN SHADYSIDE in PITTSBURGH, PA accept Medicare?
UPMC PRESBYTERIAN SHADYSIDE is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact UPMC PRESBYTERIAN SHADYSIDE directly or check with your insurance provider.
Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.