Inpatient stays / DRG 194
MS-DRG 194 · 1,522 hospitals · 48,668 stays
DRG 194: Simple Pneumonia and Pleurisy with CC
Medicare patients had 48,668 stays in DRG 194 in 2024. Hospitals charged an average of $38,379 per stay and were paid $8,028 — a ratio of 4.8 to 1 — of which Medicare's own share averaged $5,976. Average charges ran from $7,783 at the least expensive hospital to $239,335 at the most; half of hospitals charged between $23,485 and $47,216.
- 1Average charge $38,379
- 2Average paid $8,028
- 3Reporting hospitals 1,522
- 4Medicare stays 48,668
By state
Average charges for DRG 194 were highest in Nevada ($74,167) and lowest in Maryland ($12,247). Payments vary far less than charges, because Medicare sets them: they range across states from $6,313 to $13,587.
| State | Stays | Avg charge | Avg paid | Ratio |
|---|---|---|---|---|
| Nevada | 247 | $74,167 | $8,563 | 8.7× |
| California | 3,390 | $70,084 | $10,026 | 7× |
| New Jersey | 1,925 | $66,686 | $8,362 | 8× |
| Florida | 4,341 | $52,251 | $7,505 | 7× |
| Colorado | 308 | $49,962 | $7,572 | 6.6× |
| New York | 3,009 | $47,971 | $10,196 | 4.7× |
| Texas | 2,778 | $45,765 | $8,550 | 5.4× |
| Alaska | 70 | $43,757 | $13,587 | 3.2× |
| Arizona | 924 | $40,504 | $7,954 | 5.1× |
| Pennsylvania | 2,419 | $39,961 | $7,319 | 5.5× |
| Hawaii | 120 | $39,705 | $12,185 | 3.3× |
| District of Columbia | 74 | $38,884 | $9,461 | 4.1× |
| Kansas | 415 | $36,070 | $6,530 | 5.5× |
| Georgia | 1,261 | $35,914 | $8,374 | 4.3× |
| Washington | 447 | $35,740 | $8,110 | 4.4× |
| Oklahoma | 936 | $35,025 | $7,057 | 5× |
| South Carolina | 925 | $34,346 | $7,516 | 4.6× |
| Mississippi | 670 | $33,611 | $6,683 | 5× |
| New Mexico | 183 | $33,316 | $8,131 | 4.1× |
| Illinois | 2,203 | $33,129 | $7,753 | 4.3× |
| Tennessee | 945 | $32,562 | $7,365 | 4.4× |
| Connecticut | 553 | $31,922 | $9,165 | 3.5× |
| Missouri | 1,289 | $31,591 | $7,130 | 4.4× |
| Kentucky | 1,055 | $30,875 | $6,356 | 4.9× |
| Louisiana | 990 | $30,402 | $6,593 | 4.6× |
| Indiana | 1,331 | $29,906 | $6,907 | 4.3× |
| South Dakota | 153 | $29,443 | $7,184 | 4.1× |
| Virginia | 1,097 | $29,342 | $7,299 | 4× |
| North Carolina | 1,959 | $28,784 | $7,916 | 3.6× |
| Ohio | 1,868 | $28,423 | $6,948 | 4.1× |
| Alabama | 1,089 | $28,294 | $6,976 | 4.1× |
| Delaware | 360 | $27,976 | $7,758 | 3.6× |
| New Hampshire | 214 | $27,856 | $7,321 | 3.8× |
| West Virginia | 491 | $27,653 | $6,593 | 4.2× |
| Oregon | 260 | $27,515 | $8,687 | 3.2× |
| Wisconsin | 632 | $27,387 | $7,149 | 3.8× |
| Nebraska | 291 | $26,969 | $7,059 | 3.8× |
| Arkansas | 599 | $26,620 | $6,320 | 4.2× |
| Idaho | 82 | $26,535 | $6,873 | 3.9× |
| Vermont | 72 | $26,047 | $6,592 | 4× |
| Maine | 203 | $25,380 | $7,784 | 3.3× |
| Utah | 104 | $25,001 | $7,945 | 3.1× |
| Rhode Island | 197 | $24,715 | $7,915 | 3.1× |
| Michigan | 1,259 | $23,812 | $7,603 | 3.1× |
| Iowa | 515 | $23,660 | $6,313 | 3.7× |
| Wyoming | 112 | $23,550 | $9,493 | 2.5× |
| Minnesota | 632 | $23,361 | $7,915 | 3× |
| Montana | 83 | $21,574 | $6,625 | 3.3× |
| North Dakota | 128 | $20,746 | $7,519 | 2.8× |
| Massachusetts | 1,828 | $19,431 | $8,195 | 2.4× |
| Maryland | 1,632 | $12,247 | $11,066 | 1.1× |
Highest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Capital Health Medical Center - Hopewell Pennington, NJ · 22 stays | $239,335 | $12,200 |
| Capital Health Regional Medical Center Trenton, NJ · 14 stays | $231,751 | $9,474 |
| Carepoint Health - Bayonne Medical Center Bayonne, NJ · 26 stays | $204,470 | $10,162 |
| Regional Medical Center of San Jose San Jose, CA · 13 stays | $161,184 | $10,565 |
| San Ramon Regional Medical Center San Ramon, CA · 19 stays | $157,041 | $8,841 |
| Doctors Medical Center Modesto, CA · 12 stays | $154,982 | $8,800 |
| Good Samaritan Hospital San Jose, CA · 31 stays | $152,200 | $9,849 |
| HCA Healthone Sky Ridge Lone Tree, CO · 11 stays | $152,151 | $8,324 |
| Cedars-Sinai Medical Center Los Angeles, CA · 89 stays | $146,002 | $12,662 |
| Uci Health-Los Alamitos Los Alamitos, CA · 21 stays | $144,509 | $9,222 |
Lowest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Holy Cross Germantown Hospital Germantown, MD · 13 stays | $7,783 | $7,137 |
| Johns Hopkins Howard County Medical Center Columbia, MD · 60 stays | $7,977 | $7,312 |
| Lake Martin Community Hospital Dadeville, AL · 18 stays | $8,056 | $7,439 |
| Bibb Medical Center Centreville, AL · 13 stays | $8,926 | $10,467 |
| Bertrand Chaffee Hospital Springville, NY · 16 stays | $9,008 | $8,120 |
| Union Hospital of Cecil County Elkton, MD · 51 stays | $9,220 | $8,281 |
| Suburban Hospital Bethesda, MD · 40 stays | $9,487 | $8,494 |
| Medstar Franklin Square Medical Center Rosedale, MD · 34 stays | $9,715 | $8,859 |
| Baystate Noble Hospital Westfield, MA · 18 stays | $9,738 | $6,601 |
| Meritus Medical Center Hagerstown, MD · 78 stays | $9,741 | $9,207 |
These are averages over each hospital's Medicare stays in this DRG, which mix simple and complicated cases. A high average charge is the hospital's pricing, not a sign of better or worse care, and not what a patient pays: Medicare patients owe the inpatient deductible, and people with other coverage pay their plan's negotiated rate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024. Hospitals with fewer than 11 stays are suppressed by CMS. Checked 2026-10-24. Methodology.