58/100
#1,029 nationally
Upmc Pinnacle Hospitals
409 South Second Street, Harrisburg, PA 17104 · (717) 782-3131
Charges well above the national norm
For every $1 of care Medicare actually paid for here, Upmc Pinnacle Hospitals billed $4.32 in list charges. That gap does not change a Medicare patient's bill — but it is where an uninsured or out-of-network bill starts.
- Charge-to-payment
- 4.3x
- volume-weighted across all its priced work
- Procedures priced
- 209
- inpatient and outpatient combined
- Rank in PA
- #44
- lower markup ranks higher
- CMS quality stars
- 4/5
- shown for context, not in the grade
How this grade was reached
Each component is scored against every other U.S. hospital in the same federal files, so the grade is a position in the country, not a pass mark we invented.
Better than 47% of U.S. hospitals.
Better than 70% of U.S. hospitals.
Better than 57% of U.S. hospitals.
Better than 72% of U.S. hospitals.
What this hospital treats most
The ten procedures it billed Medicare for most often, with its charge beside the national middle.
| Procedure | Patients | Charged | Actually paid | vs national |
|---|---|---|---|---|
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
1,049 | $16,097 | $2,433 | -17% |
|
Level 2 Urology and Related Services
APC 5372 · Hospital outpatient visit |
697 | $1,585 | $280 | -49% |
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
623 | $7,620 | $1,245 | -41% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
578 | $36,989 | $11,761 | -41% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
496 | $50,605 | $11,260 | +17% |
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
458 | $70,586 | $16,689 | +8% |
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
372 | $17,992 | $2,913 | -29% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
321 | $16,625 | $2,677 | -19% |
|
Level 2 Excision/ Biopsy/ Incision and Drainage
APC 5072 · Hospital outpatient visit |
259 | $9,401 | $1,441 | -7% |
|
Level 3 Vascular Procedures
APC 5183 · Hospital outpatient visit |
221 | $18,627 | $2,846 | about average |
Where its charges run furthest above the national middle
Only procedures it performed at least eleven times, so a single unusual case cannot produce the headline.
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Disorders of Pancreas Except Malignancy with Major Complications
MS-DRG 438 · Inpatient stay |
$109,550 | $17,971 | +58% |
|
Bronchitis and Asthma with Complications/mcc
MS-DRG 202 · Inpatient stay |
$52,295 | $8,446 | +33% |
|
Major Chest Procedures without Complications/mcc
MS-DRG 165 · Inpatient stay |
$104,318 | $17,788 | +25% |
|
Skin Infection (severe)
MS-DRG 602 · Inpatient stay |
$64,186 | $12,962 | +25% |
|
Kidney Failure (severe)
MS-DRG 682 · Inpatient stay |
$65,376 | $13,440 | +23% |
|
COPD (severe)
MS-DRG 190 · Inpatient stay |
$51,056 | $10,117 | +22% |
|
Pulmonary Embolism without Major Complications
MS-DRG 176 · Inpatient stay |
$42,454 | $7,769 | +21% |
|
Respiratory Failure
MS-DRG 189 · Inpatient stay |
$57,822 | $10,626 | +19% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Signs and Symptoms of Musculoskeletal System and Connective Tissue with Major
MS-DRG 555 · Inpatient stay |
$24,340 | $11,429 | -70% |
|
Combined Anterior and Posterior Spinal Fusion without Complications/mcc
MS-DRG 455 · Inpatient stay |
$79,335 | $41,780 | -55% |
|
O.r. Procedures for Obesity without Complications/mcc
MS-DRG 621 · Inpatient stay |
$32,600 | $16,254 | -50% |
|
Level 2 Urology and Related Services
APC 5372 · Hospital outpatient visit |
$1,585 | $280 | -49% |
|
Level 6 Urology and Related Services
APC 5376 · Hospital outpatient visit |
$24,538 | $5,778 | -45% |
|
Other Circulatory System Operating Room Procedures
MS-DRG 264 · Inpatient stay |
$76,280 | $26,000 | -44% |
|
Postoperative or Post-traumatic Infections with Operating Room Procedures with
MS-DRG 857 · Inpatient stay |
$56,374 | $17,294 | -42% |
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
$7,620 | $1,245 | -41% |
What this page cannot tell you
- It is not your bill. These are averages across Medicare patients. What you pay depends on your insurance, your plan's negotiated rate and your own case.
- It is not a quality rating. A hospital with a high markup may be excellent, and one with a low markup may not be. We checked: across every U.S. hospital, markup and the CMS quality star rating barely move together.
- A charge is not a cost. Hospitals do not collect their list charges from insured patients. The number matters because it is the opening figure on an uninsured or out-of-network bill.
- Ask for the real number. Every U.S. hospital must publish a machine-readable price file and give you a written good-faith estimate on request.