Upmc Horizon - Shenango Valley Medicare inpatient and outpatient services
Every DRG and outpatient service group CMS publishes for Upmc Horizon - Shenango Valley, Farrell, PA in 2024, from traditional Medicare claims. Back to the Upmc Horizon - Shenango Valley profile, with quality ratings, finances and negotiated rates.
292
Medicare inpatient discharges
In 14 published DRGs
1.30
Case mix index
IPPS FY 2027
9%
Surgical stays
62%
Stays with complications
In DRGs with a CC or MCC
483
Medicare outpatient services
In 13 service groups
Inpatient stays by major diagnostic category
Respiratory system117 discharges in 6 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Simple pneumonia and pleurisy with MCCMS-DRG 193, medical | 38 | $39,918 | $7,968 | $8,343 | 1.33 |
| Simple pneumonia and pleurisy with CCMS-DRG 194, medical | 19 | $33,675 | $5,087 | $7,038 | 0.82 |
| Respiratory infections and inflammations with MCCMS-DRG 177, medical | 18 | $50,313 | $10,158 | $10,515 | 1.70 |
| Pulmonary edema and respiratory failureMS-DRG 189, medical | 15 | $48,100 | $7,270 | $10,053 | 1.23 |
| Respiratory infections and inflammations with CCMS-DRG 178, medical | 14 | $34,938 | $6,271 | $7,302 | 0.99 |
| Chronic obstructive pulmonary disease with MCCMS-DRG 190, medical | 13 | $38,918 | $7,144 | $8,134 | 1.10 |
Circulatory system62 discharges in 3 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Heart failure and shock with MCCMS-DRG 291, medical | 39 | $32,677 | $8,028 | $6,830 | 1.28 |
| Syncope and collapseMS-DRG 312, medical | 12 | $36,016 | $5,380 | $7,527 | 0.86 |
| Cardiac arrhythmia and conduction disorders with CCMS-DRG 309, medical | 11 | $27,840 | $4,128 | $5,819 | 0.74 |
Infectious and parasitic diseases29 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Septicemia or severe sepsis without MV >96 hours with MCCMS-DRG 871, medical | 29 | $45,917 | $11,434 | $9,597 | 1.98 |
Musculoskeletal system and connective tissue27 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Major hip and knee joint replacement or reattachment of lower extremity without MCCMS-DRG 470, surgical | 27 | $73,811 | $11,949 | $15,426 | 1.88 |
Kidney and urinary tract23 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Kidney and urinary tract infections without MCCMS-DRG 690, medical | 23 | $28,649 | $5,114 | $5,988 | 0.81 |
Digestive system17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Esophagitis, gastroenteritis and miscellaneous digestive disorders without MCCMS-DRG 392, medical | 17 | $29,352 | $4,512 | $6,135 | 0.79 |
Skin, subcutaneous tissue and breast17 discharges in 1 DRGs
| Condition or procedure | Discharges | Average charges | Average Medicare payment | Estimated cost | DRG weight |
|---|---|---|---|---|---|
| Cellulitis without MCCMS-DRG 603, medical | 17 | $25,488 | $5,500 | $5,327 | 0.88 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service (2024 data, released 2026-04-10), traditional Medicare only; CMS omits DRGs with fewer than 11 discharges. Estimated cost is average charges times the hospital's Medicare cost-to-charge ratio from the IPPS Impact File. Weights are the MS-DRG relative weights for the same year.
Outpatient services
| Service group | Services | Patients | Average charges | Average Medicare payment | US average payment |
|---|---|---|---|---|---|
| Level 5 Musculoskeletal ProceduresAPC 5115 | 79 | 76 | $63,444 | $10,108 | $10,772 |
| Level 3 Urology and Related ServicesAPC 5373 | 65 | 64 | $16,901 | $1,449 | $1,516 |
| Level 4 Urology and Related ServicesAPC 5374 | 59 | 49 | $25,473 | $2,477 | $2,629 |
| Level 5 Urology and Related ServicesAPC 5375 | 48 | 48 | $48,404 | $3,648 | $3,918 |
| Level 2 Excision/ Biopsy/ Incision and DrainageAPC 5072 | 46 | 41 | $9,271 | $1,154 | $1,220 |
| Level 1 Nerve ProceduresAPC 5431 | 41 | 38 | $8,215 | $1,374 | $1,407 |
| Comprehensive Observation ServicesAPC 8011 | 33 | 32 | $18,162 | $1,883 | $2,090 |
| Level 3 Vascular ProceduresAPC 5183 | 26 | 26 | $22,316 | $2,268 | $2,405 |
| Level 4 Musculoskeletal ProceduresAPC 5114 | 21 | 21 | $52,277 | $5,091 | $5,339 |
| Level 2 Upper GI ProceduresAPC 5302 | 20 | 18 | $14,081 | $1,367 | $1,445 |
| Level 2 Musculoskeletal ProceduresAPC 5112 | 19 | 19 | $10,159 | $1,084 | $1,196 |
| Level 3 Musculoskeletal ProceduresAPC 5113 | 13 | 13 | $31,585 | $2,303 | $2,373 |
| Level 4 Gynecologic ProceduresAPC 5414 | 13 | 13 | $25,741 | $2,202 | $2,389 |
Source: CMS Medicare Outpatient Hospitals by Provider and Service (2024 data, released 2026-06-24), comprehensive APCs for traditional Medicare; CMS omits services with fewer than 11 claims. The US average weights every hospital by its services.