Upmc St Margaret
UPMC St Margaret in Pittsburgh, PA charges 8.1x the Medicare reimbursement rate across 44 analyzed procedures, reflecting the hospital's nonprofit-private pricing structure.
Pittsburgh, PA 15215 · Acute Care Hospitals · CMS Rating: 3/5
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
8.12x
Charge / Medicare rate
Max markup
13.75x
Worst procedure
Procedures analyzed
44
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 |
|---|---|---|---|---|---|
| PULMONARY EMBOLISM WITHOUT MCC | 176 | $58,423 | $29,211 | — | 13.8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $56,308 | $28,154 | — | 11.4x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $170,534 | $85,267 | — | 11.2x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $46,872 | $23,436 | — | 11x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $42,524 | $21,262 | — | 10.7x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $57,171 | $28,585 | — | 10.6x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $41,489 | $20,745 | — | 10.5x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $55,389 | $27,695 | — | 10.3x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $84,283 | $42,142 | — | 10.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $27,569 | $13,785 | — | 9.8x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $288,224 | $144,112 | — | 9.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $36,990 | $18,495 | — | 9.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $41,216 | $20,608 | — | 9.2x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $103,695 | $51,848 | — | 8.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $36,734 | $18,367 | — | 8.7x |
| RENAL FAILURE WITH CC | 683 | $43,074 | $21,537 | — | 8.6x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $119,419 | $59,709 | — | 8.6x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $51,237 | $25,618 | — | 8.5x |
| SEIZURES WITHOUT MCC | 101 | $37,796 | $18,898 | — | 8x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $43,032 | $21,516 | — | 8x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $97,452 | $48,726 | — | 7.8x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $181,693 | $90,846 | — | 7.8x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $61,821 | $30,911 | — | 7.7x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $35,694 | $17,847 | — | 7.7x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $41,448 | $20,724 | — | 7.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $63,205 | $31,602 | — | 7.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $49,014 | $24,507 | — | 7.3x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $75,268 | $37,634 | — | 7.2x |
| DEGENERATIVE NERVOUS SYSTEM DISORDERS WITHOUT MCC | 057 | $53,598 | $26,799 | — | 7.2x |
| DIABETES WITH CC | 638 | $38,414 | $19,207 | — | 7.2x |
| SYNCOPE AND COLLAPSE | 312 | $37,116 | $18,558 | — | 7.1x |
| RENAL FAILURE WITH MCC | 682 | $67,870 | $33,935 | — | 7x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $55,167 | $27,583 | — | 6.8x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH CC | 178 | $44,973 | $22,487 | — | 6.6x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH MCC | 698 | $69,529 | $34,764 | — | 6.6x |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC | 467 | $128,890 | $64,445 | — | 6.4x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $85,943 | $42,972 | — | 6.4x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $39,517 | $19,758 | — | 6.3x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $50,228 | $25,114 | — | 6.2x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $28,334 | $14,167 | — | 6.2x |
| CELLULITIS WITHOUT MCC | 603 | $28,875 | $14,438 | — | 5.8x |
| REVISION OF HIP OR KNEE REPLACEMENT WITHOUT CC/MCC | 468 | $96,422 | $48,211 | — | 5.4x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $62,553 | $31,277 | — | 5.3x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $39,465 | $19,733 | — | 4.5x |
How UPMC ST MARGARET 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