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 701–750. 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
Memorial Hospital BiloxiBiloxi, MS · CCN 250007	19	$10,245	15% below the national average	$8,521	$111,248
UPMC SomersetSomerset, PA · CCN 390039	19	$10,246	15% below the national average	$8,958	$21,209
Intermountain Health St Vincent Regional HospitalBillings, MT · CCN 270049	54	$10,247	15% below the national average	$8,999	$26,370
Schuylkill Medical Center - South Jackson StreetPottsville, PA · CCN 390030	31	$10,249	15% below the national average	$8,454	$55,321
Mercy Hospital WashingtonWashington, MO · CCN 260052	36	$10,250	15% below the national average	$8,260	$30,384
Hancock Regional HospitalGreenfield, IN · CCN 150037	23	$10,252	15% below the national average	$8,921	$28,275
Naples Community HospitalNaples, FL · CCN 100018	209	$10,252	15% below the national average	$8,096	$58,307
UT Health East Texas Athens HospitalAthens, TX · CCN 450389	76	$10,255	15% below the national average	$8,964	$80,204
Sacred Heart Hospital On The Emerald CoastMiramar Beach, FL · CCN 100292	104	$10,256	15% below the national average	$8,870	$39,043
Community HospitalGrand Junction, CO · CCN 060054	17	$10,262	15% below the national average	$8,727	$58,072
Hillcrest Medical CenterTulsa, OK · CCN 370001	83	$10,263	15% below the national average	$8,779	$96,253
Aiken Regional Medical CenterAiken, SC · CCN 420082	51	$10,266	15% below the national average	$8,773	$76,970
Beth Israel Deaconess Hospital - NeedhamNeedham, MA · CCN 220083	102	$10,269	15% below the national average	$8,365	$16,792
Parkview Regional Medical CenterFort Wayne, IN · CCN 150021	113	$10,273	15% below the national average	$8,898	$40,580
AdventHealth ParkerParker, CO · CCN 060114	41	$10,273	15% below the national average	$8,638	$70,011
Cullman Regional Medical CenterCullman, AL · CCN 010035	44	$10,273	15% below the national average	$9,068	$35,161
Rutherford Regional Medical CenterRutherfordton, NC · CCN 340013	23	$10,274	15% below the national average	$8,928	$50,386
Banner Ironwood Medical CenterQueen Creek, AZ · CCN 030130	29	$10,279	14% below the national average	$8,986	$39,420
AdventHealth Lake WalesLake Wales, FL · CCN 100099	16	$10,279	14% below the national average	$8,953	$70,906
MercyOne Siouxland Medical CenterSioux City, IA · CCN 160153	35	$10,280	14% below the national average	$8,040	$38,817
Freeman Health System - Freeman WestJoplin, MO · CCN 260137	82	$10,281	14% below the national average	$7,948	$49,454
Prisma Health Tuomey HospitalSumter, SC · CCN 420070	30	$10,283	14% below the national average	$9,018	$49,973
Three Rivers Medical CenterLouisa, KY · CCN 180128	15	$10,283	14% below the national average	$8,978	$57,898
Rush Oak Park HospitalOak Park, IL · CCN 140063	22	$10,286	14% below the national average	$8,827	$23,744
Geisinger-Community Medical CenterScranton, PA · CCN 390001	64	$10,286	14% below the national average	$9,039	$88,248
University Of Vermont - Fletcher Allen Health CareBurlington, VT · CCN 470003	106	$10,287	14% below the national average	$6,115	$41,838
Northeast Alabama Regional Medical CenterAnniston, AL · CCN 010078	58	$10,290	14% below the national average	$7,249	$57,039
Parkland Health CenterFarmington, MO · CCN 260163	70	$10,291	14% below the national average	$8,826	$30,608
Falmouth HospitalFalmouth, MA · CCN 220135	100	$10,294	14% below the national average	$9,136	$22,478
West Allis Memorial HospitalWest Allis, WI · CCN 520139	20	$10,296	14% below the national average	$7,262	$49,834
Christus Santa Rosa Medical CenterSan Antonio, TX · CCN 450237	140	$10,299	14% below the national average	$8,947	$48,111
Stafford Hospital, LLCStafford, VA · CCN 490140	37	$10,299	14% below the national average	$8,352	$26,658
Community Medical CenterMissoula, MT · CCN 270023	18	$10,301	14% below the national average	$8,290	$43,524
Northern Westchester HospitalMount Kisco, NY · CCN 330162	50	$10,304	14% below the national average	$8,821	$46,668
Southeast Health Medical CenterDothan, AL · CCN 010001	83	$10,306	14% below the national average	$8,247	$49,609
M Health Fairview Ridges HospitalBurnsville, MN · CCN 240207	83	$10,306	14% below the national average	$8,601	$44,865
Aurora Medical Center Bay AreaMarinette, WI · CCN 520113	25	$10,308	14% below the national average	$9,084	$48,320
Bothwell Regional Health CenterSedalia, MO · CCN 260009	41	$10,308	14% below the national average	$9,026	$31,659
Tug Valley ARH Regional Medical CenterSouth Williamson, KY · CCN 180069	33	$10,310	14% below the national average	$9,432	$43,277
AdventHealth Wesley ChapelWesley Chapel, FL · CCN 100319	62	$10,310	14% below the national average	$8,074	$74,067
Sanford Medical Center AberdeenAberdeen, SD · CCN 430097	22	$10,310	14% below the national average	$8,756	$23,885
Presence St Marys HospitalKankakee, IL · CCN 140155	45	$10,311	14% below the national average	$9,152	$89,504
Plains Regional Medical CenterClovis, NM · CCN 320022	31	$10,315	14% below the national average	$9,316	$31,139
Cape Canaveral HospitalCocoa Beach, FL · CCN 100177	60	$10,316	14% below the national average	$8,371	$49,330
Holy Redeemer Hospital And Medical CenterMeadowbrook, PA · CCN 390097	66	$10,317	14% below the national average	$8,133	$31,587
Atrium Health UnionMonroe, NC · CCN 340130	78	$10,318	14% below the national average	$8,715	$43,889
University Of Mississippi Medical Center- GrenadaGrenada, MS · CCN 250168	41	$10,318	14% below the national average	$8,947	$19,791
Lakeland Regional Medical CenterLakeland, FL · CCN 100157	101	$10,319	14% below the national average	$9,093	$45,820
Stormont Vail HospitalTopeka, KS · CCN 170086	83	$10,322	14% below the national average	$6,974	$49,052
Novant Health Rowan Medical CenterSalisbury, NC · CCN 340015	54	$10,323	14% below the national average	$8,205	$39,884

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.