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

Hospitals in California

Narrow by a state, city or ZIP code (optionally a distance around it), and/or pick specific hospitals. With both, your picks are added to the area’s hospitals.

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Year of care

Average payment across these 223 hospitals: $15,080National $12,020 · California $15,080
Median hospital: $14,391
Lowest to highest: $10,483–$60,274
Medicare stays: 12,363

223 hospitals reported at least 11 Medicare stays for this in 2024; showing 201–223. 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
Uci Health-OrangeOrange, CA · CCN 050348	30	$20,706	72% above the national average	$17,297	$81,427
Kaiser Foundation Hospital - South San FranciscoSouth San Francisco, CA · CCN 050070	12	$20,892	74% above the national average	$10,011	$42,177
Kaiser Foundation Hospital - South BayHarbor City, CA · CCN 050411	11	$21,047	75% above the national average	$6,281	$43,238
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
California Pacific Medical Center- Van Ness CampusSan Francisco, CA · CCN 050047	22	$22,465	87% above the national average	$16,826	$82,493
Highland HospitalOakland, CA · CCN 050320	58	$22,648	88% above the national average	$21,232	$74,332
UCSan Diego Health Hillcrest - Hillcrest Medical CenterSan Diego, CA · CCN 050025	64	$23,035	92% above the national average	$16,002	$91,147
University Of California Davis Medical CenterSacramento, CA · CCN 050599	86	$23,200	93% above the national average	$16,896	$120,265
Ronald Reagan UCLA Medical CenterLos Angeles, CA · CCN 050262	39	$23,499	95% above the national average	$18,445	$69,396
Santa Clara Valley Medical CenterSan Jose, CA · CCN 050038	93	$24,599	105% above the national average	$22,424	$134,256
Kaiser Foundation Hospital MantecaManteca, CA · CCN 050748	11	$25,558	113% above the national average	$6,736	$86,369
Zuckerberg San Francisco General Hospital & Trauma CenterSan Francisco, CA · CCN 050228	36	$26,244	118% above the national average	$23,614	$91,139
Lac/Harbor-UCLA Medical CenterTorrance, CA · CCN 050376	15	$27,680	130% above the national average	$24,672	$51,147
Stanford Health CareStanford, CA · CCN 050441	112	$27,695	130% above the national average	$20,920	$257,291
Adventist Health ReedleyReedley, CA · CCN 050192	12	$27,871	132% above the national average	$26,388	$48,507
UCSF Medical CenterSan Francisco, CA · CCN 050454	55	$28,073	134% above the national average	$22,965	$151,740
Los Angeles General Medical CenterLos Angeles, CA · CCN 050373	30	$29,319	144% above the national average	$25,062	$49,079
Kaiser Foundation Hospital - Oakland/RichmondOakland, CA · CCN 050075	28	$30,031	150% above the national average	$22,269	$99,940
Memorial Hospital Los BanosLos Banos, CA · CCN 050528	18	$32,775	173% above the national average	$31,687	$47,720
Lac/Olive View-UCLA Medical CenterSylmar, CA · CCN 050040	13	$34,368	186% above the national average	$27,835	$56,242
Contra Costa Regional Medical CenterMartinez, CA · CCN 050276	12	$38,078	217% above the national average	$22,964	$66,028
Kaiser Foundation Hospital - RosevilleRoseville, CA · CCN 050772	14	$60,274	401% above the national average	$9,556	$194,190

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.