▸ Hospital · PA · CCN 390101
UPMC Memorial
1701 INNOVATION DRIVE, YORK, PA, 17408
81 bedsAcute Care Hospitals2
Compliance grade
B
82/100
Procedures tracked
72
of 209 target codes
Payers
12
with negotiated rates
Rates published
3,701
last crawl 2026-05-24
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 9 | — | — | $10,042 | $14,129 | $32,825 |
| inpatient | ||||||||
| Intracranial hemorrhage/CVA w MCC | MS-DRG | 064 | 10 | — | — | $11,001 | $23,066 | $47,259 |
| Intracranial hemorrhage/CVA w CC | MS-DRG | 065 | 10 | — | — | $4,881.31 | $11,929 | $23,742 |
| Intracranial hemorrhage/CVA w/o CC/MCC | MS-DRG | 066 | 10 | — | — | $4,889.98 | $8,161.99 | $17,966 |
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 10 | — | — | $7,766.55 | $18,077 | $38,042 |
| COPD w MCC | MS-DRG | 190 | 10 | — | — | $6,461.21 | $13,013 | $26,031 |
| COPD w CC | MS-DRG | 191 | 10 | — | — | $6,228.64 | $10,067 | $42,557 |
| COPD w/o CC/MCC | MS-DRG | 192 | 10 | — | — | $4,844.45 | $7,829.41 | $16,964 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 10 | — | — | $5,973.16 | $9,653.6 | $18,939 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 10 | — | — | $4,751.48 | $7,679.15 | $23,675 |
| AMI discharged alive w MCC | MS-DRG | 280 | 10 | — | — | $6,482.4 | $18,537 | $37,696 |
| AMI discharged alive w CC | MS-DRG | 281 | 10 | — | — | $4,184.81 | $10,913 | $21,599 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 10 | — | — | $3,435.32 | $8,623.52 | $17,164 |
| Heart failure & shock w MCC | MS-DRG | 291 | 10 | — | — | $4,915.03 | $14,973 | $30,169 |
| Heart failure & shock w CC | MS-DRG | 292 | 10 | — | — | $6,269.96 | $10,133 | $26,200 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 10 | — | — | $4,321.07 | $6,983.55 | $13,301 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 10 | — | — | $8,714.7 | $14,084 | $28,294 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 10 | — | — | $5,489.72 | $8,773.78 | $17,289 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 10 | — | — | $4,321.75 | $6,984.64 | $13,303 |
| GI hemorrhage w CC | MS-DRG | 378 | 10 | — | — | $6,793.57 | $11,599 | $23,046 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 10 | — | — | $3,086.58 | $7,518 | $14,814 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 10 | — | — | $5,792.03 | $9,360.86 | $30,848 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 9 | — | — | $11,219 | $18,414 | $36,841 |
| Kidney/UTI w MCC | MS-DRG | 689 | 9 | — | — | $8,413.76 | $13,718 | $27,267 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 9 | — | — | $5,997.93 | $9,673.77 | $19,023 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 9 | — | — | $13,800 | $22,735 | $45,649 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 9 | — | — | $7,470.29 | $12,138 | $24,048 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 11 | — | — | $159.03 | $943.98 | $3,397 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 11 | — | — | $188.7 | $943.98 | $5,035 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 11 | — | — | $67.5 | $917.95 | $3,397 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 11 | — | — | $80.86 | $917.95 | $3,397 |
| Colonoscopy diagnostic | CPT | 45378 | 11 | — | — | $229.24 | $917.95 | $5,035 |
| Colonoscopy with biopsy | CPT | 45380 | 11 | — | — | $286.28 | $1,187.15 | $5,035 |
| Colonoscopy with polyp removal | CPT | 45385 | 11 | — | — | $340.46 | $1,198.46 | $5,035 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 9 | — | — | $1,016.56 | $18,516 | $62,147 |
| PCI w drug-eluting stent w MCC | MS-DRG | 246 | 1 | — | — | $5,326.38 | $5,326.38 | $5,326.38 |
| PCI w drug-eluting stent w/o MCC | MS-DRG | 247 | 1 | — | — | $5,329.27 | $5,329.27 | $5,329.27 |
| Total hip replacement | CPT | 27130 | 9 | — | — | $1,016.56 | $19,741 | $43,482 |
| Total knee replacement | CPT | 27447 | 9 | — | — | $1,016.56 | $17,314 | $43,482 |
| Knee revision arthroplasty single component | CPT | 27486 | 6 | — | — | $1,016.56 | $7,488.49 | $22,309 |
| Knee revision arthroplasty all components | CPT | 27487 | 6 | — | — | $1,140.36 | $7,952.29 | $22,309 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 7 | — | — | $155.61 | $2,655.58 | $10,519 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 9 | — | — | $1,016.56 | $7,329.63 | $24,141 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 11 | — | — | $690.25 | $3,258.56 | $10,965 |
| ACL reconstruction | CPT | 29888 | 9 | — | — | $682.16 | $7,192.63 | $24,141 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 10 | — | — | $4,133.75 | $46,009 | $108,018 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 10 | — | — | $2,796.61 | $27,365 | $56,334 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 10 | — | — | $9,578.62 | $19,414 | $39,548 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 10 | — | — | $9,275.16 | $19,511 | $39,753 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 10 | — | — | $8,952.44 | $15,885 | $32,096 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 10 | — | — | $6,134.63 | $38,605 | $80,067 |
| Open appendectomy | CPT | 44950 | 9 | — | — | $1,016.56 | $6,402.13 | $22,309 |
| Laparoscopic appendectomy | CPT | 44970 | 9 | — | — | $1,016.56 | $5,986.19 | $19,716 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $16,900 | $16,900 | $16,900 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $9,655.69 | $9,655.69 | $9,655.69 |
| Major joint replacement w MCC | MS-DRG | 469 | 9 | — | — | $21,312 | $33,018 | $71,280 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 9 | — | — | $13,707 | $22,578 | $45,329 |
| Laparoscopic cholecystectomy | CPT | 47562 | 9 | — | — | $1,016.56 | $5,986.19 | $19,716 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 9 | — | — | $1,016.56 | $5,986.19 | $19,716 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 10 | — | — | $20,479 | $34,731 | $175,890 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 10 | — | — | $14,847 | $24,979 | $147,466 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 10 | — | — | $11,655 | $19,451 | $38,329 |
| Lap inguinal hernia repair | CPT | 49650 | 9 | — | — | $840.28 | $5,986.19 | $19,716 |
| Total abdominal hysterectomy | CPT | 58150 | 7 | — | — | $679.24 | $5,025.66 | $22,309 |
| Lap salpingo-oophorectomy | CPT | 58661 | 9 | — | — | $1,004.69 | $5,986.19 | $19,716 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 9 | — | — | $20,308 | $33,627 | $67,854 |
| OR procedure for obesity w CC | MS-DRG | 620 | 9 | — | — | $11,444 | $18,790 | $37,607 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 9 | — | — | $10,811 | $17,731 | $35,447 |
| Complex cataract surgery | CPT | 66982 | 9 | — | — | $1,177.17 | $2,985.47 | $9,812 |
| Cataract surgery with lens implant | CPT | 66984 | 11 | — | — | $765.21 | $2,318.21 | $10,102 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 9 | — | — | $8,967.44 | $14,645 | $29,156 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 9 | — | — | $14,535 | $23,227 | $48,154 |
Payer mix (top 12)
| Payer | Codes covered | Median rate |
|---|---|---|
| Aetna | 68 | $7,129.45 |
| keystone health plan | 68 | $13,845 |
| Blue Cross Blue Shield | 68 | $14,603 |
| Cigna | 68 | $12,018 |
| UnitedHealthcare | 68 | $10,739 |
| upmc health plan | 66 | $12,204 |
| keystone autism services | 64 | $11,280 |
| geisinger | 64 | $6,606.14 |
| upmc work partners | 59 | $5,326.38 |
| wellspan population health | 43 | $14,388 |
| health partners plans (jefferson health plan) | 9 | $245.84 |
| amerihealth caritas | 9 | $243.68 |