West Penn Hospital
West Penn Hospital in Pittsburgh, PA charges 6.8x the Medicare reimbursement rate across 21 analyzed procedures, reflecting the pricing patterns common among nonprofit-private healthcare facilities.
Pittsburgh, PA 15224 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.
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Pricing grade
D
High
Avg markup vs Medicare
6.75x
Charge / Medicare rate
Max markup
7.9x
Worst procedure
Procedures analyzed
21
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 |
|---|---|---|---|---|---|
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $39,656 | $19,828 | — | 7.9x |
| CHEMOTHERAPY WITHOUT ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC | 847 | $67,919 | $33,959 | — | 7.9x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $49,030 | $24,515 | — | 7.8x |
| MALIGNANCY OF HEPATOBILIARY SYSTEM OR PANCREAS WITH MCC | 435 | $81,909 | $40,955 | — | 7.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $85,823 | $42,912 | — | 7.5x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $71,962 | $35,981 | — | 7.5x |
| STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH CC | 327 | $154,891 | $77,445 | — | 7.5x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $94,825 | $47,412 | — | 7x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $105,188 | $52,594 | — | 7x |
| STOMACH, ESOPHAGEAL AND DUODENAL PROCEDURES WITH MCC | 326 | $307,456 | $153,728 | — | 6.9x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $97,581 | $48,791 | — | 6.7x |
| LYMPHOMA AND NON-ACUTE LEUKEMIA WITH MCC | 840 | $171,438 | $85,719 | — | 6.6x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $174,054 | $87,027 | — | 6.6x |
| UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITH CC/MCC | 742 | $103,769 | $51,885 | — | 6.5x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $271,471 | $135,736 | — | 6.3x |
| ACUTE LEUKEMIA WITH MCC | 834 | $326,247 | $163,124 | — | 6.3x |
| DISORDERS OF THE BILIARY TRACT WITH CC | 445 | $45,385 | $22,692 | — | 6.2x |
| UTERINE AND ADNEXA PROCEDURES FOR NON-MALIGNANCY WITHOUT CC/MCC | 743 | $43,343 | $21,672 | — | 5.8x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $47,273 | $23,636 | — | 5.8x |
| AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | 617 | $73,450 | $36,725 | — | 5.5x |
| CHEMOTHERAPY WITH ACUTE LEUKEMIA AS SECONDARY DIAGNOSIS WITH CC OR HIGH DOSE CHEMOTHERAP | 838 | $79,034 | $39,517 | — | 4.9x |
How WEST PENN HOSPITAL 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