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Inpatient stay · MS-DRG 195

Simple pneumonia and pleurisy without CC/MCC

In 2024, Medicare and patients paid an average of $6,019 per stay at 115 hospitals. Half of hospitals averaged between $4,947 and $6,443.

Also known as: Pneumonia

National figures, 2024

Average payment per case
$6,019
Typical range (middle half of hospitals)
$4,947–$6,443
Medicare’s share
$4,01567% of the payment
Average billed charge
$29,430
Hospitals reporting
1151,837 stays

Compare hospitals

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.

Location
Specific hospitals up to 10

115 hospitals reported at least 11 Medicare stays for this in 2024; showing 101–115. Download as CSV

Medicare payments per case for Simple pneumonia and pleurisy without CC/MCC by hospital, 2024
HospitalCasesAverage paymentvs national averageMedicare paidBilled charge
Sharp Chula Vista Medical CenterChula Vista, CA · CCN 05022212$7,59626% above the national average$4,819$65,516
Long Island Jewish Medical CenterNew Hyde Park, NY · CCN 33019516$7,75929% above the national average$5,477$57,587
Northwest Community Hospital 1Arlington Heights, IL · CCN 14025213$7,99733% above the national average$2,536$20,740
Frederick Health HospitalFrederick, MD · CCN 21000522$8,45740% above the national average$6,973$9,269
SUNY/Stony Brook University HospitalStony Brook, NY · CCN 33039314$8,47641% above the national average$6,146$48,926
Luminis Health Anne Arundel Medical Center, IncAnnapolis, MD · CCN 21002336$8,49441% above the national average$7,001$9,158
Cooperman Barnabas Medical CenterLivingston, NJ · CCN 31007612$8,53042% above the national average$5,429$69,148
New York-Presbyterian HospitalNew York, NY · CCN 33010119$8,56542% above the national average$6,116$52,448
Chinle Comprehensive Health Care FacilityChinle, AZ · CCN 03008418$8,76746% above the national average$7,317$10,805
North Shore University HospitalManhasset, NY · CCN 33010613$8,86147% above the national average$4,982$52,908
UMD Upper Chesapeake Medical CenterBel Air, MD · CCN 21004912$9,61760% above the national average$6,750$10,522
Greater Baltimore Medical CenterBaltimore, MD · CCN 21004419$9,63860% above the national average$7,918$10,833
Northwestern Medicine MCHenryMchenry, IL · CCN 14011611$9,76362% above the national average$3,039$35,444
Nyu Langone HospitalsNew York, NY · CCN 33021415$10,22670% above the national average$5,463$56,773
Jackson Health SystemMiami, FL · CCN 10002221$14,730145% above the national average$11,822$32,686

National trend

Average payment and billed charge per stay, and how many Medicare stays were reported each year.

  • Average payment
  • Average billed charge
2020: 5,705 stays at 339 hospitals · 2021: 1,376 stays at 94 hospitals · 2022: 1,757 stays at 112 hospitals · 2023: 1,801 stays at 115 hospitals · 2024: 1,837 stays at 115 hospitals
View data as a table
National average payment and billed charge for Simple pneumonia and pleurisy without CC/MCC
Year of careAverage paymentAverage billed charge
2020$5,752$25K
2021$5,571$24K
2022$5,757$25K
2023$6,029$29K
2024$6,019$29K

By state, 2024

Case-weighted average payment across each state’s reporting hospitals, lowest first.

Show all 33 states
Average payment by state for Simple pneumonia and pleurisy without CC/MCC, 2024
StateHospitalsCasesAverage paymentTypical range
Iowa113$4,145$4,145–$4,145
West Virginia117$4,281$4,281–$4,281
Wisconsin111$4,344$4,344–$4,344
Michigan113$4,523$4,523–$4,523
Kentucky575$4,623$4,390–$4,928
Indiana345$4,675$4,583–$4,912
Kansas111$4,789$4,789–$4,789
Ohio338$4,948$4,665–$5,255
Tennessee115$4,951$4,951–$4,951
Louisiana236$5,039$4,616–$5,379
Nebraska119$5,118$5,118–$5,118
Mississippi117$5,119$5,119–$5,119
Alabama231$5,267$5,047–$5,417
Missouri559$5,300$4,579–$5,972
North Carolina587$5,419$5,080–$5,882
Virginia120$5,478$5,478–$5,478
Massachusetts8132$5,532$5,383–$5,791
Pennsylvania458$5,553$5,364–$5,870
Oklahoma225$5,647$5,226–$5,905
Minnesota112$5,709$5,709–$5,709
Arizona465$5,842$4,444–$6,248
Delaware249$5,946$5,827–$6,024
Florida14284$6,025$4,957–$5,936
Georgia346$6,105$5,639–$6,671
New Jersey9125$6,153$5,332–$6,752
South Carolina119$6,360$6,360–$6,360
Texas345$6,442$5,665–$6,921
Illinois578$6,463$5,052–$7,997
California574$6,969$6,909–$7,448
Rhode Island112$7,155$7,155–$7,155
Connecticut113$7,214$7,214–$7,214
New York12178$7,218$6,218–$8,498
Maryland6115$8,177$6,464–$9,336

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.