Inpatient stays / DRG 195
MS-DRG 195 · 115 hospitals · 8,023 stays
DRG 195: Simple Pneumonia and Pleurisy without CC/MCC
Medicare patients had 8,023 stays in DRG 195 in 2024. Hospitals charged an average of $30,173 per stay and were paid $6,244 — a ratio of 4.8 to 1 — of which Medicare's own share averaged $4,312. Average charges ran from $6,199 at the least expensive hospital to $74,817 at the most; half of hospitals charged between $19,724 and $36,714.
- 1Average charge $30,173
- 2Average paid $6,244
- 3Reporting hospitals 115
- 4Medicare stays 8,023
By state
Average charges for DRG 195 were highest in Nevada ($60,653) and lowest in Maryland ($9,358). Payments vary far less than charges, because Medicare sets them: they range across states from $4,786 to $10,524.
| State | Stays | Avg charge | Avg paid | Ratio |
|---|---|---|---|---|
| Nevada | 32 | $60,653 | $5,900 | 10.3× |
| California | 592 | $53,199 | $7,631 | 7× |
| New Jersey | 313 | $53,174 | $6,636 | 8× |
| Alaska | 19 | $47,577 | $10,524 | 4.5× |
| Florida | 784 | $40,436 | $6,025 | 6.7× |
| New York | 514 | $35,706 | $7,655 | 4.7× |
| Colorado | 43 | $35,440 | $5,702 | 6.2× |
| Texas | 518 | $34,666 | $6,787 | 5.1× |
| Arizona | 233 | $32,880 | $6,689 | 4.9× |
| Kansas | 55 | $32,440 | $4,925 | 6.6× |
| Washington | 40 | $29,511 | $5,840 | 5.1× |
| Pennsylvania | 357 | $29,032 | $5,559 | 5.2× |
| New Mexico | 34 | $28,975 | $6,676 | 4.3× |
| Tennessee | 162 | $28,931 | $5,523 | 5.2× |
| Connecticut | 62 | $28,058 | $7,462 | 3.8× |
| District of Columbia | 13 | $27,612 | $7,753 | 3.6× |
| South Carolina | 140 | $27,311 | $6,100 | 4.5× |
| Georgia | 223 | $27,055 | $6,759 | 4× |
| Mississippi | 161 | $26,659 | $5,383 | 5× |
| Illinois | 358 | $26,415 | $6,152 | 4.3× |
| Missouri | 219 | $25,885 | $5,637 | 4.6× |
| Louisiana | 177 | $24,764 | $5,184 | 4.8× |
| Oklahoma | 142 | $23,765 | $5,756 | 4.1× |
| Indiana | 200 | $23,532 | $5,233 | 4.5× |
| Virginia | 147 | $23,396 | $5,375 | 4.4× |
| New Hampshire | 44 | $22,822 | $5,473 | 4.2× |
| North Carolina | 298 | $22,710 | $6,115 | 3.7× |
| Wisconsin | 84 | $22,603 | $5,314 | 4.3× |
| Hawaii | 12 | $22,485 | $8,599 | 2.6× |
| Oregon | 35 | $22,365 | $6,701 | 3.3× |
| Nebraska | 58 | $21,970 | $5,389 | 4.1× |
| Maine | 19 | $21,797 | $5,541 | 3.9× |
| Alabama | 224 | $21,778 | $5,730 | 3.8× |
| Delaware | 62 | $21,640 | $5,919 | 3.7× |
| Ohio | 288 | $21,298 | $5,261 | 4× |
| Kentucky | 178 | $21,188 | $4,906 | 4.3× |
| South Dakota | 34 | $20,788 | $5,903 | 3.5× |
| West Virginia | 66 | $20,783 | $5,056 | 4.1× |
| Arkansas | 120 | $20,404 | $4,925 | 4.1× |
| Rhode Island | 36 | $20,381 | $6,148 | 3.3× |
| Minnesota | 66 | $19,515 | $5,783 | 3.4× |
| Utah | 30 | $18,986 | $6,303 | 3× |
| Michigan | 176 | $18,257 | $5,810 | 3.1× |
| North Dakota | 15 | $18,069 | $5,872 | 3.1× |
| Iowa | 57 | $18,016 | $4,786 | 3.8× |
| Wyoming | 16 | $17,345 | $7,612 | 2.3× |
| Massachusetts | 304 | $14,677 | $6,029 | 2.4× |
| Maryland | 238 | $9,358 | $8,512 | 1.1× |
Highest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Exceptional Community Hospital Yuma Yuma, AZ · 15 stays | $74,817 | $4,197 |
| Cooperman Barnabas Medical Center Livingston, NJ · 12 stays | $69,148 | $8,530 |
| Sharp Chula Vista Medical Center Chula Vista, CA · 12 stays | $65,516 | $7,596 |
| HCA Florida Ocala Hospital Ocala, FL · 13 stays | $63,715 | $5,626 |
| Torrance Memorial Medical Center Torrance, CA · 18 stays | $59,683 | $6,224 |
| Long Island Jewish Medical Center New Hyde Park, NY · 16 stays | $57,587 | $7,759 |
| NYU Langone Hospitals New York, NY · 15 stays | $56,773 | $10,226 |
| West Jersey Hospital Voorhees, NJ · 25 stays | $55,774 | $5,830 |
| Community Medical Center Toms River, NJ · 11 stays | $53,681 | $5,628 |
| North Shore University Hospital Manhasset, NY · 13 stays | $52,908 | $8,861 |
Lowest average charges
| Hospital | Charge | Paid |
|---|---|---|
| Umd Baltimore Washington Medical Center Glen Burnie, MD · 11 stays | $6,199 | $5,725 |
| Johns Hopkins Howard County Medical Center Columbia, MD · 15 stays | $6,287 | $5,800 |
| Luminis Health Anne Arundel Medical Center, Inc Annapolis, MD · 36 stays | $9,158 | $8,494 |
| Frederick Health Hospital Frederick, MD · 22 stays | $9,269 | $8,457 |
| University of MD Upper Chesapeake Medical Center Bel Air, MD · 12 stays | $10,522 | $9,617 |
| Chinle Comprehensive Health Care Facility Chinle, AZ · 18 stays | $10,805 | $8,767 |
| Greater Baltimore Medical Center Baltimore, MD · 19 stays | $10,833 | $9,638 |
| Crouse Hospital Syracuse, NY · 11 stays | $12,208 | $6,319 |
| Winchester Hospital Winchester, MA · 17 stays | $12,212 | $5,510 |
| Anna Jaques Hospital Newburyport, MA · 14 stays | $12,629 | $5,652 |
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.