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 1,901–1,950. 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
Providence Medford Medical CenterMedford, OR · CCN 380075	28	$13,532	13% above the national average	$12,010	$50,698
Adventist Health Lodi MemorialLodi, CA · CCN 050336	97	$13,532	13% above the national average	$12,209	$141,667
UT Health East Texas Jacksonville HospitalJacksonville, TX · CCN 450194	15	$13,541	13% above the national average	$12,344	$90,426
Morristown Medical CenterMorristown, NJ · CCN 310015	251	$13,548	13% above the national average	$10,961	$104,251
Exeter Hospital IncExeter, NH · CCN 300023	47	$13,552	13% above the national average	$9,992	$36,854
St Charles Medical Center - BendBend, OR · CCN 380047	100	$13,553	13% above the national average	$11,756	$34,292
UMD Upper Chesapeake Medical CenterBel Air, MD · CCN 210049	89	$13,554	13% above the national average	$12,399	$15,180
Dameron HospitalStockton, CA · CCN 050122	22	$13,555	13% above the national average	$12,611	$170,769
Mercy HospitalBakersfield, CA · CCN 050295	121	$13,562	13% above the national average	$11,979	$83,964
Adventist Health HanfordHanford, CA · CCN 050121	57	$13,563	13% above the national average	$12,164	$57,748
St James HospitalHornell, NY · CCN 330151	15	$13,567	13% above the national average	$12,372	$18,966
Graham Hospital AssociationCanton, IL · CCN 140001	11	$13,573	13% above the national average	$10,394	$25,859
Providence Mission HospitalMission Viejo, CA · CCN 050567	105	$13,576	13% above the national average	$11,309	$92,762
Doctors Hosptal At RenaissanceEdinburg, TX · CCN 450869	12	$13,577	13% above the national average	$11,548	$54,518
Trinity MuscatineMuscatine, IA · CCN 160013	27	$13,579	13% above the national average	$12,305	$19,331
University Of Kansas HospitalKansas City, KS · CCN 170040	108	$13,581	13% above the national average	$9,907	$85,935
Sherman Oaks HospitalSherman Oaks, CA · CCN 050755	41	$13,584	13% above the national average	$12,318	$51,816
Northeast Georgia Medical Center, IncGainesville, GA · CCN 110029	265	$13,592	13% above the national average	$10,026	$64,034
Plainview HospitalPlainview, NY · CCN 330331	77	$13,599	13% above the national average	$11,054	$79,476
Mercy Health System CorpJanesville, WI · CCN 520066	33	$13,609	13% above the national average	$8,988	$66,593
St Francis Hospital & Medical CenterHartford, CT · CCN 070002	44	$13,613	13% above the national average	$10,583	$39,856
Virtua Our Lady Of Lourdes HospitalCamden, NJ · CCN 310029	52	$13,614	13% above the national average	$10,218	$110,273
Mercy Medical Center IncBaltimore, MD · CCN 210008	18	$13,615	13% above the national average	$12,618	$16,472
Freestone Medical CenterFairfield, TX · CCN 450658	11	$13,625	13% above the national average	$11,177	$36,071
Emanuel Medical CenterTurlock, CA · CCN 050179	82	$13,626	13% above the national average	$12,374	$168,396
Garfield Medical CenterMonterey Park, CA · CCN 050737	51	$13,627	13% above the national average	$12,269	$130,019
St Mary Medical CenterGalesburg, IL · CCN 140064	33	$13,630	13% above the national average	$12,691	$33,721
Stamford HospitalStamford, CT · CCN 070006	109	$13,646	14% above the national average	$11,936	$60,693
Brooks-TLC Hospital System, IncDunkirk, NY · CCN 330229	15	$13,651	14% above the national average	$12,237	$28,672
Saint Mary's HospitalWaterbury, CT · CCN 070016	44	$13,652	14% above the national average	$11,461	$41,219
Wellstar Cobb Medical CenterAustell, GA · CCN 110143	59	$13,655	14% above the national average	$11,389	$119,594
AHMC Anaheim Regional Medical CenterAnaheim, CA · CCN 050226	36	$13,667	14% above the national average	$12,533	$65,255
Allegheny General HospitalPittsburgh, PA · CCN 390050	25	$13,669	14% above the national average	$10,059	$67,339
Monument Health Spearfish HospitalSpearfish, SD · CCN 430048	13	$13,674	14% above the national average	$12,047	$29,405
Unity HospitalRochester, NY · CCN 330226	57	$13,678	14% above the national average	$10,640	$26,315
MedStar Franklin Square Medical CenterRosedale, MD · CCN 210015	71	$13,684	14% above the national average	$12,468	$15,508
Phoebe Putney Memorial HospitalAlbany, GA · CCN 110007	48	$13,685	14% above the national average	$11,046	$48,377
Moberly Regional Medical CenterMoberly, MO · CCN 260074	13	$13,687	14% above the national average	$12,164	$75,698
Mount Auburn HospitalCambridge, MA · CCN 220002	79	$13,695	14% above the national average	$11,548	$20,704
Providence Alaska Medical CenterAnchorage, AK · CCN 020001	62	$13,696	14% above the national average	$10,680	$90,408
Pioneers Memorial Healthcare DistrictBrawley, CA · CCN 050342	35	$13,700	14% above the national average	$12,395	$34,067
Cape Cod HospitalHyannis, MA · CCN 220012	207	$13,719	14% above the national average	$12,607	$23,858
MemorialCare Saddleback Medical CenterLaguna Hills, CA · CCN 050603	37	$13,723	14% above the national average	$9,887	$118,674
San Gabriel Valley Medical CenterSan Gabriel, CA · CCN 050132	33	$13,723	14% above the national average	$12,438	$75,292
McLeod Medical Center - DillonDillon, SC · CCN 420005	23	$13,729	14% above the national average	$10,468	$46,869
Southern Hills Hospital And Medical CenterLas Vegas, NV · CCN 290047	67	$13,735	14% above the national average	$10,656	$121,985
Saint Alphonsus Medical Center - NampaNampa, ID · CCN 130013	20	$13,737	14% above the national average	$8,377	$41,920
Uci Health - Fountain ValleyFountain Valley, CA · CCN 050570	84	$13,738	14% above the national average	$12,404	$189,155
Palmdale Regional Medical CenterPalmdale, CA · CCN 050204	66	$13,740	14% above the national average	$11,971	$129,170
Jefferson Stratford HospitalStratford, NJ · CCN 310086	120	$13,750	14% above the national average	$10,439	$93,421

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.