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 2,351–2,400. 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
Sinai Hospital Of BaltimoreBaltimore, MD · CCN 210012	52	$19,175	60% above the national average	$17,583	$21,751
Denver Health & Hospital AuthorityDenver, CO · CCN 060011	12	$19,327	61% above the national average	$17,862	$35,199
Arrowhead Regional Medical CenterColton, CA · CCN 050245	28	$19,347	61% above the national average	$17,374	$84,224
Beth Israel Deaconess Medical CenterBoston, MA · CCN 220086	62	$19,375	61% above the national average	$13,974	$32,849
Robert Wood Johnson University HospitalNew Brunswick, NJ · CCN 310038	80	$19,498	62% above the national average	$12,974	$146,078
Emory University HospitalAtlanta, GA · CCN 110010	42	$19,610	63% above the national average	$10,803	$50,801
Maimonides Medical CenterBrooklyn, NY · CCN 330194	135	$19,635	63% above the national average	$15,003	$86,439
UNC HospitalsChapel Hill, NC · CCN 340061	66	$19,683	64% above the national average	$12,969	$41,951
Cedars-Sinai Medical CenterLos Angeles, CA · CCN 050625	235	$19,803	65% above the national average	$15,078	$223,597
Barnes Jewish HospitalSaint Louis, MO · CCN 260032	51	$19,831	65% above the national average	$13,479	$83,047
University Of Virginia Medical CenterCharlottesville, VA · CCN 490009	68	$19,874	65% above the national average	$12,734	$55,738
Nyu Langone HospitalsNew York, NY · CCN 330214	465	$19,876	65% above the national average	$14,784	$127,394
Medical College Of Virginia HospitalsRichmond, VA · CCN 490032	84	$19,951	66% above the national average	$11,447	$66,030
John Dempsey Hospital Of The University Of ConnectFarmington, CT · CCN 070036	58	$20,036	67% above the national average	$16,662	$44,667
Brookdale Hospital Medical CenterBrooklyn, NY · CCN 330233	39	$20,093	67% above the national average	$16,267	$38,440
Newark Beth Israel Medical CenterNewark, NJ · CCN 310002	17	$20,108	67% above the national average	$15,673	$136,845
Howard University Hospital CorpWashington, DC · CCN 090003	13	$20,175	68% above the national average	$14,861	$44,210
Larkin Community Hospital Palm Springs CampusHialeah, FL · CCN 100050	43	$20,197	68% above the national average	$14,264	$69,698
Ochsner University Hospital And ClinicsLafayette, LA · CCN 190006	11	$20,224	68% above the national average	$14,450	$39,260
MedStar Georgetown University HospitalWashington, DC · CCN 090004	41	$20,279	69% above the national average	$11,681	$73,490
University Of Louisville HospitalLouisville, KY · CCN 180141	20	$20,297	69% above the national average	$9,958	$76,266
University Of Illinois Hospital And ClinicsChicago, IL · CCN 140150	18	$20,367	69% above the national average	$15,325	$50,877
Kaiser Foundation Hospital South SacramentoSacramento, CA · CCN 050674	11	$20,528	71% above the national average	$17,192	$114,538
Kaiser Foundation Hospital - Orange County - AnaheimAnaheim, CA · CCN 050609	15	$20,657	72% above the national average	$9,966	$66,794
New York-Presbyterian HospitalNew York, NY · CCN 330101	371	$20,672	72% above the national average	$15,186	$143,424
Keck Hospital Of USCLos Angeles, CA · CCN 050696	15	$20,684	72% above the national average	$14,143	$90,614
Uci Health-OrangeOrange, CA · CCN 050348	30	$20,706	72% above the national average	$17,297	$81,427
Nassau University Medical CenterEast Meadow, NY · CCN 330027	23	$20,759	73% above the national average	$16,458	$91,876
Kaiser Foundation Hospital - South San FranciscoSouth San Francisco, CA · CCN 050070	12	$20,892	74% above the national average	$10,011	$42,177
Fairbanks Memorial HospitalFairbanks, AK · CCN 020012	35	$20,958	74% above the national average	$19,700	$45,179
Kaiser Foundation Hospital - South BayHarbor City, CA · CCN 050411	11	$21,047	75% above the national average	$6,281	$43,238
The University Of Chicago Medical CenterChicago, IL · CCN 140088	68	$21,062	75% above the national average	$13,713	$93,862
Wellstar McG Health, Affiliated With Medical ColAugusta, GA · CCN 110034	38	$21,121	76% above the national average	$13,067	$64,820
Cambridge Health AllianceCambridge, MA · CCN 220011	53	$21,212	76% above the national average	$18,610	$23,171
University Of Maryland Medical CenterBaltimore, MD · CCN 210002	20	$21,254	77% above the national average	$19,706	$26,507
Maui Memorial Medical CenterWailuku, HI · CCN 120002	49	$21,342	78% above the national average	$19,583	$42,188
Jackson Health SystemMiami, FL · CCN 100022	111	$21,379	78% above the national average	$18,327	$61,724
Central Peninsula General HospitalSoldotna, AK · CCN 020024	50	$21,438	78% above the national average	$20,165	$62,504
South Brooklyn HealthBrooklyn, NY · CCN 330196	106	$21,448	78% above the national average	$18,638	$65,114
Lenox Hill HospitalNew York, NY · CCN 330119	26	$21,457	79% above the national average	$16,542	$126,331
Barton Memorial HospitalSouth Lake Tahoe, CA · CCN 050352	11	$21,552	79% above the national average	$20,365	$122,277
Loma Linda University Medical CenterLoma Linda, CA · CCN 050327	24	$21,594	80% above the national average	$17,505	$82,094
Los Alamos Medical CenterLos Alamos, NM · CCN 320033	16	$21,717	81% above the national average	$19,782	$84,553
Montefiore Medical CenterBronx, NY · CCN 330059	142	$21,718	81% above the national average	$15,103	$130,765
Vail Health HospitalVail, CO · CCN 060096	16	$22,209	85% above the national average	$20,985	$41,277
Bartlett Regional HospitalJuneau, AK · CCN 020008	14	$22,266	85% above the national average	$20,867	$48,246
California Pacific Medical Center- Van Ness CampusSan Francisco, CA · CCN 050047	22	$22,465	87% above the national average	$16,826	$82,493
Hospital Of University Of PennsylvaniaPhiladelphia, PA · CCN 390111	83	$22,598	88% above the national average	$15,316	$176,426
Highland HospitalOakland, CA · CCN 050320	58	$22,648	88% above the national average	$21,232	$74,332
Kona Community HospitalKealakekua, HI · CCN 120019	19	$22,716	89% above the national average	$20,203	$62,026

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.