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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2,442 hospitals reported at least 11 Medicare stays for this in 2024; showing 1,951–2,000. 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
Houston Methodist HospitalHouston, TX · CCN 450358	123	$13,750	14% above the national average	$9,851	$104,234
Parkview Community Hospital Medical CenterRiverside, CA · CCN 050102	42	$13,753	14% above the national average	$12,533	$79,300
Trinity Health Livingston HospitalHowell, MI · CCN 230069	26	$13,762	14% above the national average	$11,337	$32,293
Cascade Valley HospitalArlington, WA · CCN 500060	19	$13,768	15% above the national average	$10,153	$46,922
Memorial Hospital Of GardenaGardena, CA · CCN 050468	16	$13,771	15% above the national average	$12,623	$83,085
Doctors Medical CenterModesto, CA · CCN 050464	70	$13,783	15% above the national average	$12,094	$246,652
Adventist Health St HelenaSaint Helena, CA · CCN 050013	16	$13,787	15% above the national average	$12,767	$126,537
John F Kennedy Memorial HospitalIndio, CA · CCN 050534	26	$13,797	15% above the national average	$12,542	$138,762
Pomona Valley Hospital Medical CenterPomona, CA · CCN 050231	35	$13,809	15% above the national average	$12,630	$121,451
Garden Grove Hospital & Medical CenterGarden Grove, CA · CCN 050230	24	$13,819	15% above the national average	$12,935	$62,906
Whittier Hospital Medical CenterWhittier, CA · CCN 050735	31	$13,831	15% above the national average	$13,037	$87,086
Providence St Mary Medical CenterApple Valley, CA · CCN 050300	87	$13,836	15% above the national average	$11,966	$60,392
Emory University Hospital MidtownAtlanta, GA · CCN 110078	36	$13,840	15% above the national average	$11,355	$49,407
Hackensack Meridian Mountainside MedicalMontclair, NJ · CCN 310054	65	$13,841	15% above the national average	$11,227	$66,861
Desoto Memorial HospitalArcadia, FL · CCN 100175	21	$13,843	15% above the national average	$12,657	$34,871
Uchicago Medicine AdventHealth GlenoaksGlendale Heights, IL · CCN 140292	31	$13,843	15% above the national average	$8,163	$36,026
Corona Regional Medical CenterCorona, CA · CCN 050329	46	$13,847	15% above the national average	$11,997	$105,039
Mercy Medical Center ReddingRedding, CA · CCN 050280	90	$13,848	15% above the national average	$12,189	$89,454
Englewood Hospital And Medical CenterEnglewood, NJ · CCN 310045	98	$13,854	15% above the national average	$11,369	$59,648
University Of Kentucky HospitalLexington, KY · CCN 180067	66	$13,856	15% above the national average	$10,010	$54,155
St Lukes HospitalBethlehem, PA · CCN 390049	53	$13,857	15% above the national average	$9,288	$91,242
St Joseph Medical CenterTacoma, WA · CCN 500108	29	$13,862	15% above the national average	$10,649	$90,334
Southside HospitalBay Shore, NY · CCN 330043	81	$13,867	15% above the national average	$11,332	$88,759
Sharp Chula Vista Medical CenterChula Vista, CA · CCN 050222	99	$13,870	15% above the national average	$12,334	$115,564
MUSC Health Chester Medical CenterChester, SC · CCN 420019	13	$13,878	15% above the national average	$12,468	$44,136
Tampa General HospitalTampa, FL · CCN 100128	76	$13,892	16% above the national average	$10,708	$66,177
Bridgeport HospitalBridgeport, CT · CCN 070010	127	$13,893	16% above the national average	$11,876	$40,223
St Luke's Warren HospitalPhillipsburg, NJ · CCN 310060	28	$13,898	16% above the national average	$11,715	$97,514
El Centro Regional Medical CenterEl Centro, CA · CCN 050045	57	$13,899	16% above the national average	$12,554	$61,380
UPMC Presbyterian ShadysidePittsburgh, PA · CCN 390164	54	$13,901	16% above the national average	$9,762	$147,118
Mercy San Juan Medical CenterCarmichael, CA · CCN 050516	106	$13,902	16% above the national average	$12,841	$102,850
Lonesome Pine HospitalBig Stone Gap, VA · CCN 490114	33	$13,904	16% above the national average	$10,268	$36,375
Atrium Health Navicent The Medical CenterMacon, GA · CCN 110107	70	$13,915	16% above the national average	$11,337	$66,820
Legacy Emanuel Medical CenterPortland, OR · CCN 380007	17	$13,921	16% above the national average	$12,542	$40,016
Victor Valley Global Medical CenterVictorville, CA · CCN 050517	47	$13,936	16% above the national average	$12,859	$52,599
Danbury HospitalDanbury, CT · CCN 070033	97	$13,940	16% above the national average	$11,546	$35,592
Western Missouri Medical CenterWarrensburg, MO · CCN 260097	36	$13,955	16% above the national average	$12,754	$24,709
Hillsboro Medical CenterHillsboro, OR · CCN 380021	28	$13,968	16% above the national average	$11,590	$49,221
McLeod Health ClarendonManning, SC · CCN 420109	20	$13,979	16% above the national average	$12,251	$41,249
Northern Light Maine Coast HospitalEllsworth, ME · CCN 200050	15	$13,998	16% above the national average	$12,912	$35,360
Skagit Valley HospitalMount Vernon, WA · CCN 500003	52	$14,002	16% above the national average	$10,883	$54,758
Southern California Hospital At HollywoodHollywood, CA · CCN 050135	155	$14,028	17% above the national average	$12,838	$68,428
Grant Medical CenterColumbus, OH · CCN 360017	75	$14,033	17% above the national average	$11,310	$53,731
Holy Cross HospitalSilver Spring, MD · CCN 210004	54	$14,033	17% above the national average	$12,268	$15,267
Los Angeles Community HospitalLos Angeles, CA · CCN 050663	87	$14,037	17% above the national average	$12,745	$50,430
HCA Florida Kendall HospitalMiami, FL · CCN 100209	74	$14,044	17% above the national average	$12,080	$128,594
Eisenhower Medical CenterRancho Mirage, CA · CCN 050573	126	$14,046	17% above the national average	$12,084	$73,930
Providence Holy Cross Medical CenterMission Hills, CA · CCN 050278	47	$14,052	17% above the national average	$12,228	$86,433
Cherokee Nation W W Hastings Indian HospitalTahlequah, OK · CCN 370171	16	$14,067	17% above the national average	$12,639	$22,077
Legacy Good Samaritan Medical CenterPortland, OR · CCN 380017	20	$14,071	17% above the national average	$11,074	$30,437

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.