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 2,101–2,150. 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
Adventist Health SonoraSonora, CA · CCN 050335	45	$14,697	22% above the national average	$12,707	$90,273
Christus Southern New MexicoAlamogordo, NM · CCN 320004	34	$14,714	22% above the national average	$13,306	$112,564
University Of Iowa Hospital & ClinicsIowa City, IA · CCN 160058	60	$14,718	22% above the national average	$10,896	$66,171
Lahey Hospital & Medical Center, BurlingtonBurlington, MA · CCN 220171	90	$14,725	23% above the national average	$11,287	$23,879
Cleveland ClinicCleveland, OH · CCN 360180	52	$14,734	23% above the national average	$9,739	$54,862
Peninsula Medical CenterBurlingame, CA · CCN 050007	44	$14,735	23% above the national average	$13,322	$66,659
Samaritan Medical CenterWatertown, NY · CCN 330157	26	$14,740	23% above the national average	$13,468	$35,317
Sierra View Medical CenterPorterville, CA · CCN 050261	34	$14,744	23% above the national average	$13,007	$50,900
Memorial Medical CenterLas Cruces, NM · CCN 320018	26	$14,748	23% above the national average	$7,336	$90,252
Community Regional Medical CenterFresno, CA · CCN 050060	75	$14,752	23% above the national average	$13,182	$88,998
Hill Country Memorial HospitalFredericksburg, TX · CCN 450604	22	$14,760	23% above the national average	$13,222	$82,683
Providence St. Joseph HospitalOrange, CA · CCN 050069	64	$14,763	23% above the national average	$11,539	$58,409
Val Verde Regional Medical CenterDel Rio, TX · CCN 450154	18	$14,768	23% above the national average	$12,825	$35,775
Advocate Christ Hospital & Medical CenterOak Lawn, IL · CCN 140208	80	$14,784	23% above the national average	$10,127	$47,454
Chippewa County War Memorial HospitalSault Ste Marie, MI · CCN 230239	16	$14,799	23% above the national average	$12,322	$20,147
Sutter Roseville Medical CenterRoseville, CA · CCN 050309	152	$14,803	23% above the national average	$12,215	$77,260
University Of Mississippi Medical CenterJackson, MS · CCN 250001	34	$14,809	23% above the national average	$12,024	$38,094
MarinHealth Medical CenterGreenbrae, CA · CCN 050360	48	$14,814	23% above the national average	$13,541	$129,741
University Of Colorado Hospital AuthorityAurora, CO · CCN 060024	108	$14,835	23% above the national average	$11,579	$89,953
St Vincent HospitalWorcester, MA · CCN 220176	98	$14,842	23% above the national average	$11,941	$63,849
Banner-University Medical Center South CampusTucson, AZ · CCN 030111	22	$14,846	24% above the national average	$12,752	$29,620
Bates County Memorial HospitalButler, MO · CCN 260034	17	$14,857	24% above the national average	$13,325	$29,848
Los Robles Hospital & Medical CenterThousand Oaks, CA · CCN 050549	111	$14,878	24% above the national average	$11,903	$202,466
Piedmont Hospital, IncAtlanta, GA · CCN 110083	44	$14,880	24% above the national average	$8,141	$47,130
Northwestern Lake Forest HospitalLake Forest, IL · CCN 140130	19	$14,884	24% above the national average	$9,516	$58,471
Kaweah Health Medical CenterVisalia, CA · CCN 050057	160	$14,888	24% above the national average	$13,073	$52,572
University Hospital S U N Y Health Science CenterSyracuse, NY · CCN 330241	63	$14,895	24% above the national average	$11,388	$83,680
St John's Riverside HospitalYonkers, NY · CCN 330208	54	$14,913	24% above the national average	$12,573	$63,780
Eden Medical CenterCastro Valley, CA · CCN 050488	41	$14,919	24% above the national average	$12,996	$83,109
Mount Sinai South NassauOceanside, NY · CCN 330198	136	$14,927	24% above the national average	$11,380	$111,030
Albany Medical Center HospitalAlbany, NY · CCN 330013	58	$14,936	24% above the national average	$12,530	$45,897
Dominican HospitalSanta Cruz, CA · CCN 050242	78	$14,938	24% above the national average	$13,683	$144,720
Adventist Health White MemorialLos Angeles, CA · CCN 050103	52	$14,940	24% above the national average	$13,269	$136,307
St Rose HospitalHayward, CA · CCN 050002	16	$14,940	24% above the national average	$13,512	$69,969
Johns Hopkins Bayview Medical CenterBaltimore, MD · CCN 210029	44	$14,944	24% above the national average	$13,374	$17,105
Garnet Health Medical CenterMiddletown, NY · CCN 330126	223	$14,951	24% above the national average	$11,441	$73,009
Methodist Hospital Of SacramentoSacramento, CA · CCN 050590	49	$14,958	24% above the national average	$13,532	$92,917
Franciscan Health Olympia & Chicago HeightsOlympia Fields, IL · CCN 140172	63	$14,965	24% above the national average	$11,608	$48,495
University Of Utah Hospital And ClinicsSalt Lake City, UT · CCN 460009	64	$14,972	25% above the national average	$11,442	$31,378
Signature Healthcare Brockton HospitalBrockton, MA · CCN 220052	26	$14,977	25% above the national average	$11,322	$30,633
Asante Rogue Regional Medical CenterMedford, OR · CCN 380018	44	$14,978	25% above the national average	$11,251	$46,529
Adventist Health DelanoDelano, CA · CCN 050608	19	$15,001	25% above the national average	$14,142	$37,928
John Muir Medical Center - Walnut Creek CampusWalnut Creek, CA · CCN 050180	118	$15,009	25% above the national average	$13,233	$160,429
Penn Presbyterian Medical CenterPhiladelphia, PA · CCN 390223	24	$15,013	25% above the national average	$11,814	$115,436
Desert Regional Medical CenterPalm Springs, CA · CCN 050243	59	$15,016	25% above the national average	$12,873	$171,266
MemorialCare Long Beach Medical CenterLong Beach, CA · CCN 050485	48	$15,037	25% above the national average	$11,966	$121,810
El Camino HealthMountain View, CA · CCN 050308	140	$15,048	25% above the national average	$13,724	$132,783
HCA Houston Healthcare NorthwestHouston, TX · CCN 450638	13	$15,054	25% above the national average	$13,919	$127,505
Virginia Mason Medical CenterSeattle, WA · CCN 500005	17	$15,061	25% above the national average	$11,933	$53,898
Alameda HospitalAlameda, CA · CCN 050211	47	$15,075	25% above the national average	$13,825	$81,322

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.