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
- $9,868
- Average billed charge
- $60,101
- Hospitals reporting
- 2,442
Hospitals in Wisconsin
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.
- Average payment across these 53 hospitals
- $11,266
- Median hospital
- $10,557
- Lowest to highest
- $8,602–$16,522
- Medicare stays
- 1,776
53 hospitals reported at least 11 Medicare stays for this in 2024; showing 1–50. Download as CSV
| Hospital | Cases | Average payment | vs national average | Medicare paid | Billed charge |
|---|---|---|---|---|---|
| St Josephs Community Hospital West Bend | 18 | $8,602 | 28% below the national average | $7,424 | $41,194 |
| Waukesha Memorial Hospital | 53 | $8,618 | 28% below the national average | $7,451 | $44,575 |
| Marshfield Medical Center - Minocqua | 12 | $8,875 | 26% below the national average | $7,518 | $22,506 |
| Oconomowoc Memorial Hospital | 14 | $8,910 | 26% below the national average | $7,627 | $32,498 |
| Marshfield Medical Center - Weston | 21 | $8,960 | 25% below the national average | $7,718 | $34,854 |
| Aurora Medical Center | 40 | $8,963 | 25% below the national average | $7,984 | $41,454 |
| Aurora Medical Center - Summit | 17 | $9,228 | 23% below the national average | $7,092 | $29,160 |
| SSM Health St Mary's Hospital - Janesville | 18 | $9,269 | 23% below the national average | $7,999 | $42,374 |
| Marshfield Medical Center - Eau Claire | 32 | $9,269 | 23% below the national average | $7,994 | $34,525 |
| Aurora BayCare Medical Center | 12 | $9,297 | 23% below the national average | $8,100 | $34,919 |
| St Marys Hospital Medical Center | 15 | $9,324 | 22% below the national average | $8,238 | $47,068 |
| Bellin Memorial Hospital | 17 | $9,440 | 21% below the national average | $8,096 | $23,912 |
| Aurora Memorial Hospital Burlington | 22 | $9,546 | 21% below the national average | $8,062 | $31,284 |
| St Vincent Hospital | 27 | $9,692 | 19% below the national average | $8,724 | $44,898 |
| Froedtert South Inc. | 48 | $9,754 | 19% below the national average | $8,564 | $32,226 |
| St Nicholas Hospital | 13 | $9,941 | 17% below the national average | $7,263 | $35,314 |
| Ascension Ne Wisconsin - St Elizabeth Campus | 29 | $9,963 | 17% below the national average | $8,590 | $26,236 |
| SSM Health St Agnes Hospital-Fond Du Lac | 30 | $10,028 | 17% below the national average | $8,942 | $32,140 |
| Aurora Medical Center Oshkosh | 20 | $10,055 | 16% below the national average | $7,809 | $31,406 |
| Aspirus Stevens Point Hospital & Clinics, Inc. | 15 | $10,092 | 16% below the national average | $9,221 | $27,961 |
| Aurora Medical Center Sheboygan County | 35 | $10,120 | 16% below the national average | $8,283 | $34,705 |
| Aurora Medical Center Kenosha | 64 | $10,142 | 16% below the national average | $7,841 | $39,235 |
| Community Memorial Hospital | 42 | $10,194 | 15% below the national average | $8,129 | $37,790 |
| West Allis Memorial Hospital | 20 | $10,296 | 14% below the national average | $7,262 | $49,834 |
| Aurora Medical Center Bay Area | 25 | $10,308 | 14% below the national average | $9,084 | $48,320 |
| Mayo Clinic Health System Eau Claire Hospital | 74 | $10,459 | 13% below the national average | $8,949 | $35,147 |
| SSM Health St Mary's Hospital - Madison | 80 | $10,557 | 12% below the national average | $8,180 | $44,209 |
| Aspirus Wausau Hospital | 37 | $10,822 | About average | $8,411 | $43,456 |
| Fort Memorial Hospital | 14 | $10,979 | About average | $9,580 | $32,220 |
| Ascension All Saints Hospital | 30 | $11,012 | About average | $9,680 | $32,838 |
| Thedacare Regional Medical Center - Appleton Inc | 22 | $11,082 | About average | $8,135 | $27,450 |
| Howard Young Medical Center | 30 | $11,087 | About average | $9,891 | $26,324 |
| Watertown Memorial Hospital | 14 | $11,096 | About average | $8,962 | $34,936 |
| Marshfield Medical Center - Rice Lake | 23 | $11,164 | About average | $9,958 | $21,632 |
| Ascension Se Wisconsin Hospital | 49 | $11,184 | About average | $9,089 | $31,361 |
| Aspirus Riverview Hospital & Clinics Inc | 19 | $11,300 | About average | $9,926 | $28,404 |
| Gundersen Lutheran Medical Center | 38 | $11,551 | About average | $9,338 | $21,755 |
| Mayo Clinic Health System-Franciscan Medical Center Inc | 31 | $11,619 | About average | $8,664 | $34,273 |
| Aspirus Divine Savior Hospital | 13 | $11,629 | About average | $10,125 | $29,974 |
| Aurora Lakeland Medical Center | 30 | $11,708 | About average | $8,938 | $39,810 |
| Ascension Columbia St Marys Hospital Milwaukee | 61 | $11,773 | About average | $9,584 | $47,754 |
| SSM Health St Clare Hospital - Baraboo | 38 | $11,798 | About average | $10,382 | $36,103 |
| Marshfield Medical Center | 39 | $11,834 | About average | $10,237 | $26,977 |
| The Monroe Clinic | 29 | $11,938 | About average | $10,041 | $37,742 |
| Mile Bluff Medical Center | 15 | $12,003 | About average | $10,590 | $38,341 |
| UnityPoint Health - Meriter | 67 | $12,123 | About average | $9,877 | $61,421 |
| Aurora Medical Center Washington County | 14 | $12,189 | About average | $7,674 | $29,807 |
| Aurora St Lukes Medical Center | 80 | $12,623 | About average | $9,091 | $64,609 |
| Beloit Health System | 44 | $12,835 | About average | $11,687 | $49,562 |
| Mercy Health System Corp | 33 | $13,609 | 13% above the national average | $8,988 | $66,593 |
National trend
Average payment and billed charge per stay, and how many Medicare stays were reported each year.
- Average payment
- Average billed charge
View data as a table
| 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
| 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.