The Price of Medicare Procedures in Pennsylvania



This table shows the 100 most frequently charged procedures/diagnosis in Pennsylvania to the Inpatient Prospective Payment System (IPPS). This table will give a basic idea of the cost of medicare for hospital procedures. Hospitals determine what they bill according to a "chargemaster". The charge master serves as a price point for the beginning of negotiations between you and the health care provider.



ProcedureProvider StateTotal DischargesHospital Charge(s)Medicare Payment(s)Your Cost
Acute Myocardial Infarction Discharged Alive No Complications
 Pennsylvania 1042 $24778 $5248 $19530
Acute Myocardial Infarction Discharged Alive With Complications
 Pennsylvania 2009 $35398 $7813 $27585
Acute Myocardial Infarction Discharged Alive With Major Complications
 Pennsylvania 3477 $49161 $11984 $37177
Alcohol Drug Abuse No Rehabilitation Therapy No Major Complications
 Pennsylvania 1293 $16644 $4858 $11786
Atherosclerosis No Major Complications
 Pennsylvania 1105 $18959 $3975 $14984
Back And Neck Proc Exc Spinal Fusion No Complications
 Pennsylvania 1524 $29507 $6877 $22630
Bronchitis And Asthma No Complications
 Pennsylvania 949 $22200 $4119 $18081
Bronchitis And Asthma With Complications
 Pennsylvania 1985 $29111 $5893 $23218
Cardiac Arrhythmia And Conduction Disorders No Complications
 Pennsylvania 5855 $17588 $3835 $13753
Cardiac Arrhythmia And Conduction Disorders With Complications
 Pennsylvania 5265 $24639 $5656 $18983
Cardiac Arrhythmia And Conduction Disorders With Major Complications
 Pennsylvania 3193 $36008 $8468 $27540
Cellulitis No Major Complications
 Pennsylvania 7202 $21833 $5569 $16264
Cellulitis With Major Complications
 Pennsylvania 823 $41327 $9905 $31422
Cervical Spinal Fusion No Complications
 Pennsylvania 645 $65108 $15116 $49992
Chest Pain
 Pennsylvania 4876 $21791 $3879 $17912
Chronic Obstructive Pulmonary Disease No Complications
 Pennsylvania 5419 $21975 $4841 $17134
Chronic Obstructive Pulmonary Disease With Complications
 Pennsylvania 6768 $29850 $6479 $23371
Chronic Obstructive Pulmonary Disease With Major Complications
 Pennsylvania 6276 $35841 $7862 $27979
Circulatory Disorders Except Ami With Card Cath No Major Complications
 Pennsylvania 5132 $41468 $7854 $33614
Circulatory Disorders Except Ami With Card Cath With Major Complications
 Pennsylvania 1146 $87796 $16602 $71194
Cranial And Peripheral Nerve Disorders No Major Complications
 Pennsylvania 1094 $39486 $6703 $32783
Degenerative Nervous System Disorders No Major Complications
 Pennsylvania 1655 $29684 $6655 $23029
Diabetes With Complications
 Pennsylvania 2129 $27059 $5943 $21116
Disorders Of Pancreas Except Malignancy With Complications
 Pennsylvania 648 $33712 $7608 $26104
Dysequilibrium
 Pennsylvania 1438 $22784 $4395 $18389
Esophagitis Gastroent And Misc Digest Disorders No Major Complications
 Pennsylvania 11701 $24456 $4986 $19470
Esophagitis Gastroent And Misc Digest Disorders With Major Complications
 Pennsylvania 1918 $40947 $8470 $32477
Extracranial Procedures No Complications
 Pennsylvania 1003 $32783 $6751 $26032
Fractures Of Hip And Pelvis No Major Complications
 Pennsylvania 1132 $21079 $4697 $16382
Fx Sprn Strn And Disl Except Femur Hip Pelvis Thigh No Major Complications
 Pennsylvania 1305 $22815 $4922 $17893
Gi Hemorrhage No Complications
 Pennsylvania 1620 $23995 $4905 $19090
Gi Hemorrhage With Complications
 Pennsylvania 6565 $29883 $6883 $23000
Gi Hemorrhage With Major Complications
 Pennsylvania 2296 $56055 $12195 $43860
Gi Obstruction No Complications
 Pennsylvania 1412 $21101 $4441 $16660
Gi Obstruction With Complications
 Pennsylvania 2243 $28572 $6337 $22235
Heart Failure And Shock No Complications
 Pennsylvania 5069 $20243 $4587 $15656
Heart Failure And Shock With Complications
 Pennsylvania 11814 $29163 $6918 $22245
Heart Failure And Shock With Major Complications
 Pennsylvania 8542 $40714 $9817 $30897
Hip And Femur Procedures Except Major Joint No Complications
 Pennsylvania 868 $46672 $9880 $36792
Hip And Femur Procedures Except Major Joint With Complications
 Pennsylvania 3378 $51161 $12050 $39111
Hip And Femur Procedures Except Major Joint With Major Complications
 Pennsylvania 662 $94363 $21768 $72595
Hypertension No Major Complications
 Pennsylvania 926 $24179 $4391 $19788
Infectious And Parasitic Diseases Or Procedure With Major Complications
 Pennsylvania 1577 $155828 $38158 $117670
Intracranial Hemorrhage Or Cerebral Infarction No Complications
 Pennsylvania 2665 $28288 $5649 $22639
Intracranial Hemorrhage Or Cerebral Infarction With Complications
 Pennsylvania 4903 $36649 $7863 $28786
Intracranial Hemorrhage Or Cerebral Infarction With Major Complications
 Pennsylvania 2713 $59762 $13212 $46550
Kidney And Urinary Tract Infections No Major Complications
 Pennsylvania 9246 $23346 $5274 $18072
Kidney And Urinary Tract Infections With Major Complications
 Pennsylvania 3169 $33452 $7881 $25571
Laparoscopic Cholecystectomy No Cde No Complications
 Pennsylvania 577 $39613 $8129 $31484
Laparoscopic Cholecystectomy No Cde With Complications
 Pennsylvania 550 $51901 $11459 $40442
Major Cardiovasc Procedures No Major Complications
 Pennsylvania 1403 $104857 $22128 $82729
Major Gastrointestinal Disorders And Peritoneal Infections With Complications
 Pennsylvania 1250 $35955 $8867 $27088
Major Joint Replacement Of Lower Extremity No Major Complications
 Pennsylvania 16712 $51015 $13679 $37336
Major Joint Replacement Of Lower Extremity With Major Complications
 Pennsylvania 699 $95323 $22897 $72426
Major Small And Large Bowel Procedures With Complications
 Pennsylvania 2105 $79691 $17879 $61812
Major Small And Large Bowel Procedures With Major Complications
 Pennsylvania 1613 $156225 $36036 $120189
Medical Back Problems No Major Complications
 Pennsylvania 3611 $26794 $5619 $21175
Misc Disorders Of Metabolism Fluids Electrolytes No Major Complications
 Pennsylvania 6394 $21864 $4771 $17093
Misc Disorders Of Metabolism Fluids Electrolytes With Major Complications
 Pennsylvania 2086 $37349 $8157 $29192
Other Circulatory System Diagnoses With Complications
 Pennsylvania 819 $36429 $7328 $29101
Other Circulatory System Diagnoses With Major Complications
 Pennsylvania 1990 $63291 $13908 $49383
Other Digestive System Diagnoses With Complications
 Pennsylvania 2080 $29869 $6973 $22896
Other Kidney And Urinary Tract Diagnoses With Complications
 Pennsylvania 1213 $37095 $8048 $29047
Other Kidney And Urinary Tract Diagnoses With Major Complications
 Pennsylvania 1151 $50723 $12029 $38694
Other Vascular Procedures No Complications
 Pennsylvania 1037 $52739 $11105 $41634
Other Vascular Procedures With Complications
 Pennsylvania 1623 $82069 $17250 $64819
Other Vascular Procedures With Major Complications
 Pennsylvania 1382 $112209 $23625 $88584
Perc Cardiovasc Proc No Coronary Artery Stent No Major Complications
 Pennsylvania 1636 $89397 $13624 $75773
Perc Cardiovasc Proc With Drug Eluting Stent No Major Complications
 Pennsylvania 4615 $73766 $13722 $60044
Perc Cardiovasc Proc With Drug Eluting Stent With Major Complications
 Pennsylvania 998 $113661 $23373 $90288
Perc Cardiovasc Proc With Nondrug Eluting Stent No Major Complications
 Pennsylvania 1630 $61781 $12135 $49646
Peripheral Vascular Disorders No Complications
 Pennsylvania 851 $20578 $4582 $15996
Peripheral Vascular Disorders With Complications
 Pennsylvania 2043 $28031 $6643 $21388
Permanent Cardiac Pacemaker Implant No Complications
 Pennsylvania 1412 $60306 $13393 $46913
Permanent Cardiac Pacemaker Implant With Complications
 Pennsylvania 1577 $80782 $17545 $63237
Poisoning And Toxic Effects Of Drugs No Major Complications
 Pennsylvania 1180 $22998 $4685 $18313
Poisoning And Toxic Effects Of Drugs With Major Complications
 Pennsylvania 495 $62216 $11985 $50231
Psychoses
 Pennsylvania 3081 $19685 $6362 $13323
Pulmonary Edema And Respiratory Failure
 Pennsylvania 3364 $34570 $11356 $23214
Pulmonary Embolism No Major Complications
 Pennsylvania 1440 $32887 $7414 $25473
Red Blood Cell Disorders No Major Complications
 Pennsylvania 3702 $26165 $5568 $20597
Red Blood Cell Disorders With Major Complications
 Pennsylvania 949 $42805 $9223 $33582
Renal Failure No Complications
 Pennsylvania 961 $22494 $4750 $17744
Renal Failure With Complications
 Pennsylvania 7325 $29333 $7034 $22299
Renal Failure With Major Complications
 Pennsylvania 4682 $43566 $11198 $32368
Respiratory Infections And Inflammations With Complications
 Pennsylvania 2597 $43448 $9800 $33648
Respiratory Infections And Inflammations With Major Complications
 Pennsylvania 3066 $54086 $12976 $41110
Respiratory System Diagnosis With Ventilator Support 96 Plus Hrs
 Pennsylvania 1136 $188023 $38405 $149618
Respiratory System Diagnosis With Ventilator Support Less 96 Hrs
 Pennsylvania 3009 $74959 $16074 $58885
Seizures No Major Complications
 Pennsylvania 2363 $28738 $5717 $23021
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs No Major Complications
 Pennsylvania 5108 $28351 $7480 $20871
Septicemia Or Severe Sepsis No Mv 96 Plus Hrs With Major Complications
 Pennsylvania 12347 $50114 $12705 $37409
Septicemia Or Severe Sepsis With Mv 96 Plus Hrs
 Pennsylvania 827 $201554 $42480 $159074
Signs And Symptoms No Major Complications
 Pennsylvania 2259 $24920 $5242 $19678
Simple Pneumonia And Pleurisy No Complications
 Pennsylvania 3486 $21186 $4668 $16518
Simple Pneumonia And Pleurisy With Complications
 Pennsylvania 8606 $29567 $6703 $22864
Simple Pneumonia And Pleurisy With Major Complications
 Pennsylvania 5595 $41229 $9510 $31719
Spinal Fusion Except Cervical No Major Complications
 Pennsylvania 2431 $100572 $26454 $74118
Syncope And Collapse
 Pennsylvania 7834 $23856 $4892 $18964
Transient Ischemia
 Pennsylvania 4361 $24723 $4885 $19838


Source: CMS

As part of the Obama administration’s goal to make our healthcare more accountable, transparent and affordable the CMS.gov has released data from more then 3000 hospitals that receive payments for the 100 highest frequently billed charges under Medicare. For more information visit CMS.gov.

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