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 2,201–2,250. 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
Penn State Health Hampden Medical CenterEnola, PA · CCN 390336	17	$15,551	29% above the national average	$9,802	$52,449
Saint Francis Hospital-EvanstonEvanston, IL · CCN 140080	49	$15,601	30% above the national average	$11,486	$73,862
Deborah Heart And Lung CenterBrowns Mills, NJ · CCN 310031	18	$15,607	30% above the national average	$12,244	$71,053
Community Hospital Of San BernardinoSan Bernardino, CA · CCN 050089	13	$15,615	30% above the national average	$13,974	$77,955
SSM Health Saint Louis University HospitalSaint Louis, MO · CCN 260105	33	$15,635	30% above the national average	$11,980	$53,347
Research Medical CenterKansas City, MO · CCN 260027	25	$15,648	30% above the national average	$12,361	$153,571
Cooper University HospitalCamden, NJ · CCN 310014	44	$15,656	30% above the national average	$12,350	$75,962
USA Health University HospitalMobile, AL · CCN 010087	11	$15,658	30% above the national average	$10,465	$26,299
Hartford HospitalHartford, CT · CCN 070025	171	$15,665	30% above the national average	$11,895	$62,189
Santa Monica - UCLA Medical Center & Orthopaedic HospitalSanta Monica, CA · CCN 050112	42	$15,706	31% above the national average	$13,940	$77,828
University Medical CenterLubbock, TX · CCN 450686	71	$15,709	31% above the national average	$13,968	$61,989
UNM HospitalAlbuquerque, NM · CCN 320001	55	$15,712	31% above the national average	$12,821	$24,086
Rhode Island HospitalProvidence, RI · CCN 410007	60	$15,726	31% above the national average	$12,805	$41,309
Carepoint Health - Bayonne Medical CenterBayonne, NJ · CCN 310025	26	$15,744	31% above the national average	$12,510	$339,310
Covenant Hospital PlainviewPlainview, TX · CCN 450539	14	$15,789	31% above the national average	$14,507	$40,722
Woodland Memorial HospitalWoodland, CA · CCN 050127	22	$15,791	31% above the national average	$14,604	$93,247
Harborview Medical CenterSeattle, WA · CCN 500064	22	$15,794	31% above the national average	$13,640	$62,757
St Mary's General HospitalPassaic, NJ · CCN 310006	15	$15,794	31% above the national average	$13,676	$51,306
Ventura County Medical CenterVentura, CA · CCN 050159	28	$15,807	32% above the national average	$14,221	$89,267
Sheridan Memorial HospitalSheridan, WY · CCN 530006	59	$15,825	32% above the national average	$14,442	$26,161
Hemet Global Medical CenterHemet, CA · CCN 050390	50	$15,861	32% above the national average	$13,821	$60,385
University Of Washington Medical CenterSeattle, WA · CCN 500008	71	$15,865	32% above the national average	$11,462	$49,574
Western Maryland Regional Medical CenterCumberland, MD · CCN 210027	37	$15,886	32% above the national average	$14,607	$17,923
Sutter Solano Medical CenterVallejo, CA · CCN 050101	32	$15,889	32% above the national average	$14,404	$70,152
Cheyenne Regional Medical CenterCheyenne, WY · CCN 530014	76	$15,893	32% above the national average	$13,375	$54,703
Windham Community Memorial HospitalWillimantic, CT · CCN 070021	45	$15,901	32% above the national average	$14,123	$34,896
Northern Navajo Medical CenterShiprock, NM · CCN 320059	21	$15,902	32% above the national average	$14,267	$32,216
Northwell Hospital Glen CoveGlen Cove, NY · CCN 330181	38	$15,904	32% above the national average	$13,728	$83,014
Lower Keys Medical CenterKey West, FL · CCN 100150	33	$15,919	32% above the national average	$11,725	$70,415
Memorial Regional HospitalHollywood, FL · CCN 100038	59	$15,929	33% above the national average	$11,797	$115,818
Westchester Medical CenterValhalla, NY · CCN 330234	62	$15,990	33% above the national average	$13,746	$159,475
Good Samaritan HospitalSan Jose, CA · CCN 050380	105	$15,994	33% above the national average	$12,764	$253,335
The Queens Medical CenterHonolulu, HI · CCN 120001	94	$16,005	33% above the national average	$12,050	$61,644
University Of Maryland St Joseph Medical CenterTowson, MD · CCN 210063	36	$16,005	33% above the national average	$14,504	$17,922
San Joaquin General HospitalFrench Camp, CA · CCN 050167	17	$16,023	33% above the national average	$14,767	$137,945
University Of Texas Medical Branch GalvestonGalveston, TX · CCN 450018	119	$16,071	34% above the national average	$12,514	$41,155
MedStar Saint Mary's HospitalLeonardtown, MD · CCN 210028	43	$16,076	34% above the national average	$14,143	$17,122
Mercy Catholic Medical Center- Mercy FitzgeraldDarby, PA · CCN 390156	17	$16,091	34% above the national average	$12,822	$52,569
MedStar Washington Hospital CenterWashington, DC · CCN 090011	68	$16,092	34% above the national average	$11,484	$58,303
Kaiser Foundation Hospital - DowneyDowney, CA · CCN 050139	11	$16,134	34% above the national average	$12,083	$83,702
New York-Presbyterian/QueensFlushing, NY · CCN 330055	114	$16,187	35% above the national average	$13,095	$113,189
University Of Maryland Shore Medical Center At EastonEaston, MD · CCN 210037	50	$16,189	35% above the national average	$14,805	$18,046
Chinle Comprehensive Health Care FacilityChinle, AZ · CCN 030084	16	$16,213	35% above the national average	$14,785	$20,014
Sequoia HospitalRedwood City, CA · CCN 050197	25	$16,219	35% above the national average	$14,694	$179,741
Alta Bates Summit Medical Center - Alta Bates CampBerkeley, CA · CCN 050305	23	$16,245	35% above the national average	$14,069	$68,748
Methodist Dallas Medical CenterDallas, TX · CCN 450051	36	$16,266	35% above the national average	$13,043	$81,323
OhioHealth O'Bleness HospitalAthens, OH · CCN 360014	38	$16,267	35% above the national average	$13,964	$26,066
Northside Hospital GwinnettLawrenceville, GA · CCN 110087	94	$16,269	35% above the national average	$11,242	$77,880
Sutter Santa Rosa Regional HospitalSanta Rosa, CA · CCN 050291	48	$16,311	36% above the national average	$14,297	$57,948
Roger Williams Medical CenterProvidence, RI · CCN 410004	18	$16,313	36% above the national average	$10,925	$47,155

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.