Inpatient stay · MS-DRG 193

Simple pneumonia and pleurisy with MCC

In 2024, Medicare and patients paid an average of $12,020 per stay at 2,442 hospitals. Half of hospitals averaged between $10,078 and $13,215.

Also known as: Pneumonia

National figures, 2024

Average payment per case: $12,020
Typical range (middle half of hospitals): $10,078–$13,215
Medicare’s share: $9,86882% of the payment
Average billed charge: $60,101
Hospitals reporting: 2,442136,649 stays

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Year of care

2,442 hospitals reported at least 11 Medicare stays for this in 2024; showing 651–700. Download as CSV

Medicare payments per case for Simple pneumonia and pleurisy with MCC by hospital, 2024
Hospital	Cases	Average payment	vs national average	Medicare paid	Billed charge
Northwest Community Hospital 1Arlington Heights, IL · CCN 140252	162	$10,154	16% below the national average	$8,138	$31,623
Community Memorial HospitalSouth Hill, VA · CCN 490098	34	$10,155	16% below the national average	$8,308	$35,757
Morton Plant HospitalClearwater, FL · CCN 100127	111	$10,155	16% below the national average	$8,437	$52,089
Carolina Pines Regional Medical CenterHartsville, SC · CCN 420010	29	$10,160	15% below the national average	$7,964	$66,917
Palm Bay HospitalPalm Bay, FL · CCN 100316	61	$10,164	15% below the national average	$8,318	$56,991
MercyOne Waterloo Medical CenterWaterloo, IA · CCN 160067	18	$10,164	15% below the national average	$8,757	$33,067
Spotsylvania Regional Medical CenterFredericksburg, VA · CCN 490141	49	$10,165	15% below the national average	$9,066	$56,103
Lehigh Valley Hospital - PoconoEast Stroudsburg, PA · CCN 390201	45	$10,172	15% below the national average	$8,880	$66,791
Uchicago Medicine AdventHealth La GrangeLa Grange, IL · CCN 140065	62	$10,175	15% below the national average	$8,680	$38,108
Mercy Hospital SoutheastCape Girardeau, MO · CCN 260110	58	$10,175	15% below the national average	$8,522	$38,069
Ascension St Vincent's SouthsideJacksonville, FL · CCN 100307	29	$10,176	15% below the national average	$9,388	$39,897
Mercy Hospital SpringfieldSpringfield, MO · CCN 260065	147	$10,178	15% below the national average	$8,783	$42,815
Tristar Hendersonville Medical CenterHendersonville, TN · CCN 440194	55	$10,185	15% below the national average	$7,782	$98,546
Lakeland Community HospitalHaleyville, AL · CCN 010125	18	$10,186	15% below the national average	$8,920	$27,299
M Health Fairview Woodwinds HospitalWoodbury, MN · CCN 240213	41	$10,186	15% below the national average	$8,873	$50,512
Orlando Health-Health Central HospitalOcoee, FL · CCN 100030	30	$10,188	15% below the national average	$8,278	$64,925
Northside Hospital ForsythCumming, GA · CCN 110005	129	$10,191	15% below the national average	$8,932	$68,705
Nashoba Valley Medical CenterAyer, MA · CCN 220098	30	$10,191	15% below the national average	$8,495	$15,885
Augusta HealthFishersville, VA · CCN 490018	40	$10,194	15% below the national average	$8,765	$27,422
Bon Secours-St Francis Xavier HospitalCharleston, SC · CCN 420065	43	$10,194	15% below the national average	$8,266	$41,513
Community Memorial HospitalMenomonee Falls, WI · CCN 520103	42	$10,194	15% below the national average	$8,129	$37,790
Bsa HospitalAmarillo, TX · CCN 450231	178	$10,195	15% below the national average	$8,222	$67,005
Reston Hospital CenterReston, VA · CCN 490107	66	$10,196	15% below the national average	$8,251	$69,977
Frankfort Regional Medical CenterFrankfort, KY · CCN 180127	28	$10,199	15% below the national average	$6,892	$64,710
Parkland Medical CenterDerry, NH · CCN 300017	65	$10,203	15% below the national average	$8,158	$70,467
UnityPoint Health - Des Moines Iowa Methodist MediDes Moines, IA · CCN 160082	104	$10,205	15% below the national average	$7,817	$37,847
Claiborne Memorial Medical CenterHomer, LA · CCN 190114	33	$10,205	15% below the national average	$9,044	$41,198
Franciscan Health LafayetteLafayette, IN · CCN 150109	50	$10,205	15% below the national average	$8,444	$35,971
Oviedo Medical CenterOviedo, FL · CCN 100329	46	$10,206	15% below the national average	$8,584	$79,846
Community Hospital South, Inc.Indianapolis, IN · CCN 150128	54	$10,209	15% below the national average	$8,683	$38,534
Salina Regional Health CenterSalina, KS · CCN 170012	51	$10,210	15% below the national average	$8,653	$36,540
Baptist Health Medical Center-Drew CountyMonticello, AR · CCN 040051	37	$10,211	15% below the national average	$8,327	$43,117
Wellstar Paulding Medical CenterHiram, GA · CCN 110042	86	$10,213	15% below the national average	$8,009	$87,637
Nacogdoches Memorial HospitalNacogdoches, TX · CCN 450508	24	$10,216	15% below the national average	$8,778	$52,484
Loyola Gottlieb Memorial HospitalMelrose Park, IL · CCN 140008	35	$10,217	15% below the national average	$8,728	$54,304
Centura Health-Penrose St Francis Health ServicesColorado Springs, CO · CCN 060031	59	$10,218	15% below the national average	$8,208	$58,557
Overland Park Regional Medical CenterOverland Park, KS · CCN 170176	53	$10,219	15% below the national average	$8,501	$100,242
Bon Secours St Marys HospitalRichmond, VA · CCN 490059	67	$10,223	15% below the national average	$8,442	$41,159
The Medical Center At RussellvilleRussellville, KY · CCN 180066	29	$10,224	15% below the national average	$8,986	$56,858
Wellington Regional Medical CenterWellington, FL · CCN 100275	88	$10,228	15% below the national average	$8,836	$128,426
St Marys Medical CenterHuntington, WV · CCN 510007	55	$10,228	15% below the national average	$8,256	$46,405
AdventHealth Castle RockCastle Rock, CO · CCN 060125	36	$10,233	15% below the national average	$8,097	$52,083
AdventHealth SebringSebring, FL · CCN 100109	50	$10,234	15% below the national average	$8,859	$48,896
Union Hospital IncTerre Haute, IN · CCN 150023	195	$10,234	15% below the national average	$8,873	$36,193
Siloam Springs Regional HospitalSiloam Springs, AR · CCN 040001	15	$10,238	15% below the national average	$8,932	$49,809
Banner Del E. Webb Medical CenterSun City West, AZ · CCN 030093	100	$10,238	15% below the national average	$8,518	$43,902
Presbyterian HospitalAlbuquerque, NM · CCN 320021	176	$10,241	15% below the national average	$7,875	$27,248
Havasu Regional Medical CenterLake Havasu City, AZ · CCN 030069	34	$10,243	15% below the national average	$8,510	$108,561
Parkridge Medical CenterChattanooga, TN · CCN 440156	80	$10,243	15% below the national average	$8,532	$79,704
St. Mary's HospitalTucson, AZ · CCN 030010	28	$10,243	15% below the national average	$8,960	$77,881

National trend

Average payment and billed charge per stay, and how many Medicare stays were reported each year.

Average payment
Average billed charge

2020: 114,641 stays at 2,375 hospitals · 2021: 84,232 stays at 2,205 hospitals · 2022: 120,805 stays at 2,448 hospitals · 2023: 125,793 stays at 2,412 hospitals · 2024: 136,649 stays at 2,442 hospitals

View data as a table

National average payment and billed charge for Simple pneumonia and pleurisy with MCC
Year of care	Average payment	Average billed charge
2020	$11K	$48K
2021	$11K	$51K
2022	$11K	$54K
2023	$11K	$57K
2024	$12K	$60K

By state, 2024

Case-weighted average payment across each state’s reporting hospitals, lowest first.

Show all 51 states

Average payment by state for Simple pneumonia and pleurisy with MCC, 2024
State	Hospitals	Cases	Average payment	Typical range
Vermont	6	262	$9,426	$6,701–$9,770
Arkansas	33	1,963	$9,529	$8,894–$10,238
Louisiana	37	1,716	$9,767	$8,917–$10,825
Mississippi	37	1,478	$9,770	$9,347–$11,005
Kentucky	55	2,917	$9,950	$9,327–$10,515
Iowa	27	1,449	$10,045	$9,260–$10,723
Alabama	45	2,103	$10,084	$9,068–$10,679
Tennessee	63	3,473	$10,291	$9,193–$11,087
West Virginia	21	1,236	$10,349	$9,004–$10,989
Oklahoma	47	2,073	$10,363	$9,418–$11,102
Montana	10	539	$10,500	$10,134–$10,750
Kansas	29	1,425	$10,596	$9,058–$11,411
Indiana	70	3,772	$10,628	$9,943–$11,742
Ohio	101	5,322	$10,698	$9,466–$11,768
North Dakota	6	357	$10,728	$10,588–$11,333
Missouri	56	3,051	$10,786	$9,580–$12,142
Florida	159	11,649	$10,910	$9,822–$11,670
Nebraska	16	628	$11,028	$9,541–$12,211
Virginia	66	3,796	$11,067	$10,106–$11,398
Idaho	10	463	$11,075	$10,623–$12,345
South Carolina	46	2,319	$11,106	$9,432–$12,285
Wisconsin	53	1,776	$11,266	$9,692–$11,708
South Dakota	9	482	$11,284	$10,310–$11,442
Pennsylvania	109	5,303	$11,339	$9,567–$12,100
Colorado	38	1,429	$11,366	$10,240–$11,989
Utah	22	709	$11,433	$10,452–$12,142
New Hampshire	13	951	$11,445	$10,591–$12,024
Texas	179	9,947	$11,464	$10,156–$12,256
North Carolina	72	4,202	$11,518	$9,994–$11,552
Michigan	69	3,790	$11,570	$10,809–$12,332
Arizona	49	2,886	$11,725	$10,136–$12,798
Illinois	102	5,608	$11,824	$10,292–$13,128
Maine	13	522	$11,946	$10,542–$12,978
New Mexico	20	891	$12,045	$9,727–$14,723
Minnesota	42	1,680	$12,046	$10,808–$12,460
Georgia	73	3,741	$12,085	$10,636–$12,356
Delaware	6	888	$12,102	$11,368–$12,438
Washington	42	2,122	$12,459	$11,587–$12,871
Massachusetts	49	5,043	$12,619	$11,034–$14,374
Nevada	19	1,412	$12,697	$12,104–$13,276
Rhode Island	9	390	$12,735	$10,495–$14,249
New Jersey	56	4,920	$13,120	$11,594–$15,542
Oregon	24	903	$13,291	$11,516–$13,994
Connecticut	25	1,807	$14,233	$12,350–$14,176
Wyoming	7	381	$14,626	$14,411–$16,677
California	223	12,363	$15,080	$13,473–$15,942
Maryland	40	2,223	$15,376	$13,600–$18,230
District of Columbia	5	223	$15,648	$16,092–$20,175
New York	116	7,313	$15,898	$12,250–$17,002
Hawaii	11	475	$16,180	$14,201–$17,585
Alaska	7	278	$16,879	$15,183–$21,198

About these numbers

Average payment is what Medicare paid plus the patient’s deductible and coinsurance (and any other insurer), averaged over the hospital’s Medicare cases. It covers the hospital’s part of the care; doctors bill separately. Billed charges are the hospital’s list prices, which few patients pay.

Medicare sets its payments by formula, adjusting for local wages, teaching programs, the share of low-income patients and unusually costly cases. Those adjustments drive most differences between hospitals, so a lower payment doesn’t mean better or worse care, and Medicare patients’ own costs usually vary much less than the totals. Private insurance pays different, usually higher, prices.

Source: CMS Medicare Inpatient Hospitals by Provider and Service (Medicare fee-for-service claims). CMS omits hospitals with fewer than 11 stays. More in the glossary.