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 2,001–2,050. 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
John T Mather Memorial Hospital Of Port JeffersonPort Jefferson, NY · CCN 330185	88	$14,073	17% above the national average	$10,075	$76,523
Grossmont HospitalLa Mesa, CA · CCN 050026	99	$14,081	17% above the national average	$12,146	$102,393
Mid-Columbia Medical CenterThe Dalles, OR · CCN 380001	18	$14,086	17% above the national average	$12,726	$22,070
Glendale Memorial Hospital & Health CenterGlendale, CA · CCN 050058	76	$14,093	17% above the national average	$12,976	$97,423
Greater El Monte Community HospitalSouth El Monte, CA · CCN 050738	38	$14,095	17% above the national average	$13,065	$68,908
Christus St Vincent Regional Medical CenterSanta Fe, NM · CCN 320002	83	$14,114	17% above the national average	$12,344	$41,330
Novato Community HospitalNovato, CA · CCN 050131	16	$14,115	17% above the national average	$12,993	$44,780
MacNeal HospitalBerwyn, IL · CCN 140054	24	$14,118	17% above the national average	$11,466	$52,928
Petaluma Valley HospitalPetaluma, CA · CCN 050136	32	$14,120	17% above the national average	$12,451	$114,641
McLaren OaklandPontiac, MI · CCN 230207	18	$14,124	18% above the national average	$10,772	$22,435
Javon Bea HospitalRockford, IL · CCN 140239	32	$14,125	18% above the national average	$10,046	$56,137
Stanford Health Care Tri-ValleyPleasanton, CA · CCN 050283	42	$14,132	18% above the national average	$12,811	$126,487
AdventHealth OttawaOttawa, KS · CCN 170014	20	$14,135	18% above the national average	$11,073	$40,619
Overlook Medical CenterSummit, NJ · CCN 310051	170	$14,141	18% above the national average	$11,150	$83,373
HCA Florida Osceola HospitalKissimmee, FL · CCN 100110	35	$14,153	18% above the national average	$11,789	$126,046
University Of Arkansas Medical SciencesLittle Rock, AR · CCN 040016	30	$14,153	18% above the national average	$10,045	$43,222
Providence St. Jude Medical CenterFullerton, CA · CCN 050168	109	$14,155	18% above the national average	$11,073	$70,826
Straub Clinic And HospitalHonolulu, HI · CCN 120022	59	$14,155	18% above the national average	$11,387	$53,559
Centinela Hospital Medical CenterInglewood, CA · CCN 050739	37	$14,155	18% above the national average	$13,334	$59,272
Mercy Hospital LebanonLebanon, MO · CCN 260059	14	$14,157	18% above the national average	$12,758	$21,175
The Hospital Of Central ConnecticutNew Britain, CT · CCN 070035	72	$14,165	18% above the national average	$11,616	$56,146
St Vincent's Medical CenterBridgeport, CT · CCN 070028	71	$14,176	18% above the national average	$12,756	$59,792
The University Of Vermont Health Network - ChamplPlattsburgh, NY · CCN 330250	71	$14,179	18% above the national average	$12,520	$58,189
Indiana University HealthIndianapolis, IN · CCN 150056	64	$14,188	18% above the national average	$10,490	$56,276
Santa Barbara Cottage HospitalSanta Barbara, CA · CCN 050396	80	$14,197	18% above the national average	$12,795	$81,541
St Elizabeth Community HospitalRed Bluff, CA · CCN 050042	28	$14,200	18% above the national average	$13,092	$73,268
Northridge Hospital Medical CenterNorthridge, CA · CCN 050116	63	$14,200	18% above the national average	$12,712	$146,859
Froedtert Memorial Lutheran HospitalMilwaukee, WI · CCN 520177	83	$14,206	18% above the national average	$10,358	$44,808
Watsonville Community HospitalWatsonville, CA · CCN 050194	21	$14,208	18% above the national average	$13,277	$106,911
Capital Health Medical Center - HopewellPennington, NJ · CCN 310044	90	$14,212	18% above the national average	$10,294	$300,760
Baylor Scott & White Medical Center - TempleTemple, TX · CCN 450054	40	$14,214	18% above the national average	$11,179	$63,992
Sinai-Grace HospitalDetroit, MI · CCN 230024	20	$14,219	18% above the national average	$11,135	$63,765
Rochester General HospitalRochester, NY · CCN 330125	45	$14,219	18% above the national average	$10,553	$29,959
Chenango Memorial HospitalNorwich, NY · CCN 330033	11	$14,221	18% above the national average	$11,573	$30,160
Self Regional HealthcareGreenwood, SC · CCN 420071	90	$14,224	18% above the national average	$11,362	$43,814
San Ramon Regional Medical CenterSan Ramon, CA · CCN 050689	50	$14,233	18% above the national average	$12,428	$247,858
West Anaheim Medical CenterAnaheim, CA · CCN 050426	93	$14,234	18% above the national average	$13,004	$54,044
Fairview Northland Regional HospitalPrinceton, MN · CCN 240141	16	$14,235	18% above the national average	$8,807	$48,521
Luminis Health Doctors Community Medical Center, IncLanham, MD · CCN 210051	71	$14,236	18% above the national average	$12,524	$15,245
Orange County Global Medical CenterSanta Ana, CA · CCN 050746	17	$14,241	18% above the national average	$13,372	$63,638
Pali Momi Medical CenterAiea, HI · CCN 120026	79	$14,246	19% above the national average	$11,109	$47,557
Kent County Memorial HospitalWarwick, RI · CCN 410009	77	$14,249	19% above the national average	$10,223	$31,951
Garrett Regional Medical CenterOakland, MD · CCN 210017	14	$14,256	19% above the national average	$12,741	$16,053
Geisinger Medical CenterDanville, PA · CCN 390006	65	$14,259	19% above the national average	$11,095	$93,855
Huntington HospitalPasadena, CA · CCN 050438	134	$14,260	19% above the national average	$12,350	$133,777
Northwestern Memorial HospitalChicago, IL · CCN 140281	22	$14,283	19% above the national average	$10,894	$55,579
Hollywood Presbyterian Medical CenterLos Angeles, CA · CCN 050063	31	$14,289	19% above the national average	$13,053	$62,877
Paradise Valley HospitalNational City, CA · CCN 050024	16	$14,309	19% above the national average	$12,985	$54,039
Aspirus Rhinelander HospitalRhinelander, WI · CCN 520019	15	$14,322	19% above the national average	$9,495	$44,295
Mayo Clinic Health System - FairmontFairmont, MN · CCN 240166	16	$14,326	19% above the national average	$11,715	$17,310

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.