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Simple Pneumonia and Pleurisy without with Complications/with major complications
Medicare DRG 195. What hospitals charge and what Medicare pays, 2024.
Avg hospital charge
$29,679
Avg total payment
$5,989
Avg Medicare pays
$3,957
Hospitals reporting
115
The "charge" is the hospital's list price — almost nobody pays it. "Total payment" is what the hospital actually received (Medicare plus patient copays and other payers). These figures cover Medicare fee-for-service inpatient stays only.
| State | Hospitals | Avg charge | Avg Medicare payment |
|---|---|---|---|
| New Jersey | 9 | $48,331 | $4,215 |
| California | 5 | $46,165 | $4,891 |
| New York | 12 | $42,858 | $4,859 |
| Connecticut | 1 | $39,140 | $5,471 |
| Florida | 14 | $36,480 | $4,127 |
| Arizona | 4 | $36,366 | $4,235 |
| Kansas | 1 | $34,418 | $2,353 |
| Texas | 3 | $33,471 | $3,403 |
| South Carolina | 1 | $31,564 | $4,664 |
| Tennessee | 1 | $30,849 | $3,098 |
| Oklahoma | 2 | $30,088 | $3,703 |
| Missouri | 5 | $28,310 | $3,533 |
| Pennsylvania | 4 | $27,697 | $3,271 |
| Wisconsin | 1 | $25,606 | $2,630 |
| Illinois | 5 | $25,520 | $3,330 |
| Georgia | 3 | $24,263 | $4,398 |
| North Carolina | 5 | $23,718 | $3,577 |
| Louisiana | 2 | $23,114 | $2,763 |
| Delaware | 2 | $22,925 | $3,754 |
| Minnesota | 1 | $22,235 | $3,076 |
| Alabama | 2 | $21,809 | $3,290 |
| Michigan | 1 | $21,701 | $2,807 |
| Kentucky | 5 | $21,535 | $2,965 |
| Rhode Island | 1 | $21,166 | $4,142 |
| Indiana | 3 | $20,561 | $3,271 |
| West Virginia | 1 | $19,724 | $2,841 |
| Ohio | 3 | $19,629 | $3,029 |
| Mississippi | 1 | $17,664 | $2,827 |
| Nebraska | 1 | $16,823 | $3,163 |
| Iowa | 1 | $15,568 | $2,892 |
| Massachusetts | 8 | $14,788 | $3,724 |
| Virginia | 1 | $13,883 | $3,439 |
| Maryland | 6 | $8,711 | $6,169 |
Source: CMS Medicare Inpatient Hospitals by Provider and Service. A DRG (Diagnosis Related Group) is how Medicare classifies an inpatient stay for payment; the description is Medicare's, not a diagnosis for any individual.