Pennsylvania procedure costs
188 hospitals · 6,818 Medicare providers · 5,422 procedure codes with Pennsylvania locality adjustments.
The short answer
Pennsylvania has 188 hospitals and 6,818 Medicare-billing providers across 5,422 procedure codes. The average Medicare payment per procedure is $284.85; the average submitted (billed) charge is $1,467.69.
- Procedure codes
- 5,422
- Providers per hospital
- 36.3
- Billed-to-Medicare ratio
- 5.2x
- Markup rank
- #39 of 56
Source: CMS Medicare Physician & Other Practitioners, 2023.
About this dataset, nationwide
According to the Centers for Medicare & Medicaid Services (CMS), the 2023 Medicare Physician & Other Practitioners dataset records payments for 9,297 procedure codes billed across 5,426 hospitals in 56 states and territories; see our methodology for how each figure is sourced and computed.
Pennsylvania against every US state
Where the state's average Medicare payment per procedure falls, all 56 tracked jurisdictions
$285 higher than 88% of 56 states
Each bar is a $25-wide band; taller bars hold more states. The dashed line + filled bar mark this entry. Hover or tap any bar for its full count, share, and where it sits relative to this entry.
Source CMS Medicare Physician & Other Practitioners, 2023
The priciest procedures in Pennsylvania
Highest average Medicare payment per procedure billed in Pennsylvania. Hover any bar for the exact figure; even these top procedures are billed well above what Medicare reimburses.
Top procedures by Medicare payment - Pennsylvania
The cost spread in Pennsylvania
The highest- and lowest-paying procedures Medicare reimbursed in Pennsylvania, side by side.
Most expensive
Least expensive
Top Procedures by Volume
Pennsylvania Healthcare Cost Landscape
CMS lists 188 hospitals in Pennsylvania across 131 cities. PHILADELPHIA holds 21 (11%). The three densest cities together hold 19% of the state roster. Statewide that is 6,818 Medicare-billing providers, 36.3 per listed hospital.
122 hospitals carry a CMS overall star rating (15 five-star, 37 four-star, 41 three-star, 25 two-star, 4 one-star) ; five-star share among rated facilities is 12%. 66 hospitals in this extract have no published overall rating.
Facility-type mix: Acute Care Hospitals 133 (71%); Psychiatric 26 (14%); Critical Access Hospitals 17 (9%); Acute Care - Veterans Administration 7 (4%).
Among the 30 highest-volume procedure codes billed in Pennsylvania, Drugs (Administered) leads with 52.8M services (66% of this top-volume slice) across 17 codes. Next is Office Visit at 9%.
Submitted charges average $1,467.69 against $284.85 Medicare payment (5.2x billed-to-Medicare). That ratio ranks #39 of 56 jurisdictions with both figures in this extract. Average Medicare payment itself is #7 of 56.
Volume leaders are not the high-payment codes. Factor Viii (antihemophilic Factor, Recombinant) Per I.u., Not Otherwise Specified is in the top volume slice but not the highest Medicare payments; Sipuleucel-T, Minimum Of 50 Million Autologous Cd54+ Cells Activated With Pap-Gm-Csf, Including Leukapheresis And All Other Preparatory Procedures, Per Infusion is in the high-payment set without matching volume rank.
These are CMS roster and claims aggregates for Pennsylvania, not a quote for any patient, plan, or visit. See the methodology and CMS Medicare Provider Charge Data.
Where Pennsylvania hospitals sit
City of the CMS hospital roster, not a travel or care recommendation. 131 distinct cities appear on 188 listed facilities.
| City | Hospitals | Share of state roster |
|---|---|---|
| PHILADELPHIA | 21 | 11% |
| PITTSBURGH | 11 | 6% |
| ERIE | 4 | 2% |
| NORRISTOWN | 4 | 2% |
| YORK | 4 | 2% |
| LANCASTER | 3 | 2% |
| READING | 3 | 2% |
| ALTOONA | 2 | 1% |
Nationwide states with similar hospital scale or Medicare payment
Two CMS-extract-derived peer sets for Pennsylvania: nearest hospital inventory and nearest statewide average Medicare payment. Not clinical substitutes: registry-scale and payment neighborhoods only.
Similar CMS hospital count
Nearest states with ≥5 hospitals (188 here).
Similar average Medicare payment
Nearest states with published averages ($284.85 here).
Hospitals in Pennsylvania
How Pennsylvania Compares Nationally
Pennsylvania's average Medicare payment is #7 of 56 in this extract. Submitted-over-Medicare markup ranks #39 of 56 (5.2x). Hospital-count peers (nearest CMS roster size to 188): New York 190, Illinois 194, Ohio 196, Louisiana 161. Payment peers (nearest average Medicare payment to $284.85): New Jersey $283.16, Arizona $286.66, Colorado $268.29, Virginia $267.46.
Those peer sets are registry neighborhoods, not clinical substitutes. Markup rank and payment rank can diverge: a jurisdiction can sit high on billed-to-Medicare while sitting mid-pack on payment, or the reverse. Figures remain CMS averages for Pennsylvania, not an out-of-pocket quote.
Related registry pages
Pennsylvania averages sit on two maps: Medicare payment and submitted-over-Medicare markup.
- Procedure codes billed in this extract, in national volume order. Browse procedures
- State payment rank versus markup rank on the rankings hub. Rankings
- How these figures are sourced. Methodology
Figures here are Pennsylvania CMS averages, not a quote for any patient, plan, or visit.
Read our methodology - how this data is sourced, computed, and verified.
Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, the data changelog, or report a data error.