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 2,251–2,300. 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
Mary Hitchcock Memorial HospitalLebanon, NH · CCN 300003	82	$16,338	36% above the national average	$12,615	$53,648
Alta Bates Summit Medical CenterOakland, CA · CCN 050043	46	$16,360	36% above the national average	$13,380	$79,198
Thomas Jefferson University HospitalPhiladelphia, PA · CCN 390174	61	$16,367	36% above the national average	$11,821	$71,232
St Joseph's Medical CenterYonkers, NY · CCN 330006	25	$16,386	36% above the national average	$14,881	$101,270
Homestead HospitalHomestead, FL · CCN 100125	50	$16,390	36% above the national average	$15,211	$84,931
UH Regional HospitalsChardon, OH · CCN 360075	63	$16,423	37% above the national average	$13,778	$30,340
Advocate Illinois Masonic Medical CenterChicago, IL · CCN 140182	28	$16,480	37% above the national average	$12,252	$50,131
Wilcox Memorial HospitalLihue, HI · CCN 120014	27	$16,488	37% above the national average	$14,978	$40,573
University Of Wisconsin Hospitals & Clinics AuthorityMadison, WI · CCN 520098	95	$16,522	37% above the national average	$11,723	$54,313
Lompoc Valley Medical CenterLompoc, CA · CCN 050110	25	$16,528	38% above the national average	$15,554	$75,770
University Medical CenterLas Vegas, NV · CCN 290007	42	$16,534	38% above the national average	$12,511	$78,826
Henry Ford Health HospitalDetroit, MI · CCN 230053	47	$16,567	38% above the national average	$12,416	$26,877
Sutter Amador HospitalJackson, CA · CCN 050014	22	$16,592	38% above the national average	$15,300	$63,878
Arnot Ogden Medical CenterElmira, NY · CCN 330090	38	$16,598	38% above the national average	$13,422	$31,837
Campbell County HealthGillette, WY · CCN 530002	39	$16,610	38% above the national average	$14,547	$22,449
Trinitas Regional Medical CenterElizabeth, NJ · CCN 310027	19	$16,622	38% above the national average	$14,382	$65,694
Kaiser Foundation Hospital - Los AngelesLos Angeles, CA · CCN 050138	14	$16,627	38% above the national average	$14,618	$65,156
Sharp Memorial HospitalSan Diego, CA · CCN 050100	88	$16,640	38% above the national average	$12,293	$106,382
North Shore University HospitalManhasset, NY · CCN 330106	137	$16,655	39% above the national average	$12,389	$112,788
Jefferson Einstein Philadelphia HospitalPhiladelphia, PA · CCN 390142	22	$16,656	39% above the national average	$12,696	$55,425
Mat-Su Regional Medical CenterPalmer, AK · CCN 020006	44	$16,670	39% above the national average	$15,372	$98,790
Southeast Georgia Health System -- Camden CampusSaint Marys, GA · CCN 110146	11	$16,713	39% above the national average	$15,230	$19,243
Sutter Medical Center, SacramentoSacramento, CA · CCN 050108	66	$16,713	39% above the national average	$14,992	$83,191
Adventist Healthcare White Oak Medical CenterSilver Spring, MD · CCN 210016	98	$16,719	39% above the national average	$15,331	$18,618
Cooperman Barnabas Medical CenterLivingston, NJ · CCN 310076	116	$16,722	39% above the national average	$11,432	$116,023
Harper University HospitalDetroit, MI · CCN 230104	14	$16,729	39% above the national average	$13,071	$53,254
Ivinson Memorial HospitalLaramie, WY · CCN 530025	23	$16,744	39% above the national average	$15,065	$26,164
Memorial Hospital Sweetwater CountyRock Springs, WY · CCN 530011	28	$16,771	40% above the national average	$13,838	$34,113
Regional Medical Center Of San JoseSan Jose, CA · CCN 050125	56	$16,775	40% above the national average	$14,890	$228,524
Mercy Hospital Of FolsomFolsom, CA · CCN 050414	48	$16,802	40% above the national average	$11,451	$87,047
Long Island Jewish Medical CenterNew Hyde Park, NY · CCN 330195	127	$16,822	40% above the national average	$13,614	$110,334
Banner - University Medical Center Tucson CampusTucson, AZ · CCN 030064	36	$16,827	40% above the national average	$12,444	$42,304
Sharon HospitalSharon, CT · CCN 070004	24	$16,828	40% above the national average	$15,536	$30,226
University Of Cincinnati Medical Center, LLCCincinnati, OH · CCN 360003	53	$16,835	40% above the national average	$11,180	$49,814
Tuba City Regional Health Care CorporationTuba City, AZ · CCN 030073	12	$16,848	40% above the national average	$15,352	$9,396
Hilo Benioff Medical CenterHilo, HI · CCN 120005	64	$16,865	40% above the national average	$14,351	$50,002
California Hospital Medical Center LaLos Angeles, CA · CCN 050149	13	$16,867	40% above the national average	$15,682	$62,906
St Joseph's University Medical Center IncPaterson, NJ · CCN 310019	107	$16,881	40% above the national average	$14,091	$119,153
OHSU Hospital And ClinicsPortland, OR · CCN 380009	28	$16,969	41% above the national average	$13,516	$51,069
California Pacific Medical Center - Mission BernalSan Francisco, CA · CCN 050055	21	$16,972	41% above the national average	$15,838	$76,731
Temecula Valley HospitalTemecula, CA · CCN 050775	58	$17,061	42% above the national average	$14,863	$90,843
Adventist Health Ukiah ValleyUkiah, CA · CCN 050301	36	$17,098	42% above the national average	$14,271	$80,833
Memorial Hermann - Texas Medical CenterHouston, TX · CCN 450068	51	$17,106	42% above the national average	$13,235	$56,245
M Health Fairview University Of Mn Medical CenterMinneapolis, MN · CCN 240080	47	$17,139	43% above the national average	$10,767	$82,957
Northeast Regional Medical CenterKirksville, MO · CCN 260022	12	$17,149	43% above the national average	$13,239	$72,105
Temple University HospitalPhiladelphia, PA · CCN 390027	73	$17,183	43% above the national average	$12,966	$140,626
UMass Memorial Medical Center/University CampusWorcester, MA · CCN 220163	221	$17,211	43% above the national average	$14,188	$44,045
St Joseph's Medical Center Of StocktonStockton, CA · CCN 050084	59	$17,211	43% above the national average	$15,573	$103,779
Shands JacksonvilleJacksonville, FL · CCN 100001	48	$17,263	44% above the national average	$13,812	$57,649
MUSC Medical CenterCharleston, SC · CCN 420004	75	$17,277	44% above the national average	$11,307	$38,876

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.