UPMC ST MARGARET

When you receive a bill from UPMC ST MARGARET, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, UPMC ST MARGARET lists chargemaster rates that average 8.1x the corresponding Medicare reimbursement amount across 44 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 8.1x, 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 ST MARGARET is PULMONARY EMBOLISM WITHOUT MCC (DRG 176). The listed chargemaster rate is $58,423, while Medicare reimburses $4,248 for the same procedure — a ratio of 13.8x (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 ST MARGARET is a voluntary non-profit - private acute care hospitals facility with a CMS quality rating of 3/5 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.