Pleural effusion with major complications
What 123 hospitals in the U.S. charged and were paid for a Medicare hospital stay for pleural effusion with major complications (DRG 186), from 2024 Medicare claims.
Average charge
$81,946
Hospital list price billed
Average payment
$14,801
Medicare + patient + other payers
Medicare paid
$12,139
Average per stay
Volume
1,751
Medicare hospital stays
Hospitals in the U.S. billed an average of $81,946 for pleural effusion with major complications, about 5.5 times the average total payment of $14,801.
These are averages for patients with original (fee-for-service) Medicare. Private insurance pays different, negotiated prices, and what you owe depends on your plan's deductible and coinsurance. Use these figures to compare hospitals, not as a quote.
Paid $14,801Billed $81,946
About 18¢ was paid for every $1 hospitals in the U.S. billed for this stay.
Medicare prices this stay in 2 versions, by how sick the patient was. Compare them:
Lowest and highest payments
Among hospitals with at least 20 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Holmes Regional Medical CenterMelbourne, FL | $11,365 |
|---|---|
| Iowa Methodist Medical CenterDes Moines, IA | $11,775 |
| Sarasota Memorial HospitalSarasota, FL | $11,827 |
| Adventhealth OrlandoOrlando, FL | $12,834 |
| New Hanover Regional Medical CenterWilmington, NC | $13,252 |
| St Luke's Hospital BethlehemBethlehem, PA | $14,167 |
| Renown Regional Medical CenterReno, NV | $16,553 |
| Long Island Jewish Medical CenterNew Hyde Park, NY | $20,387 |
| New York-Presbyterian HospitalNew York, NY | $21,532 |
| NYU Hospitals CenterNew York, NY | $25,545 |
Highest
| NYU Hospitals CenterNew York, NY | $25,545 |
|---|---|
| New York-Presbyterian HospitalNew York, NY | $21,532 |
| Long Island Jewish Medical CenterNew Hyde Park, NY | $20,387 |
| Renown Regional Medical CenterReno, NV | $16,553 |
| St Luke's Hospital BethlehemBethlehem, PA | $14,167 |
| New Hanover Regional Medical CenterWilmington, NC | $13,252 |
| Adventhealth OrlandoOrlando, FL | $12,834 |
| Sarasota Memorial HospitalSarasota, FL | $11,827 |
| Iowa Methodist Medical CenterDes Moines, IA | $11,775 |
| Holmes Regional Medical CenterMelbourne, FL | $11,365 |
Pleural effusion with major complications cost by state
Volume-weighted averages for each state's hospitals. Select a state to see every hospital.
| State | Hospitals | Avg charge | Avg payment | Range |
|---|---|---|---|---|
| Alabama | 1 | $77,798 | $21,094 | – |
| Arizona | 6 | $67,832 | $14,328 | $11,482 – $22,672 |
| Arkansas | 1 | $86,590 | $11,055 | – |
| California | 13 | $123,153 | $19,352 | $14,930 – $37,043 |
| Colorado | 1 | $75,921 | $10,976 | – |
| Connecticut | 2 | $72,988 | $19,321 | $16,598 – $21,654 |
| Delaware | 1 | $45,282 | $14,051 | – |
| Florida | 19 | $71,926 | $11,870 | $9,653 – $15,955 |
| Georgia | 4 | $94,053 | $15,079 | $11,632 – $20,104 |
| Hawaii | 1 | $96,106 | $20,311 | – |
| Illinois | 6 | $56,961 | $13,206 | $10,461 – $17,579 |
| Iowa | 2 | $66,886 | $12,313 | $11,775 – $12,945 |
| Kansas | 3 | $115,316 | $13,865 | $12,785 – $15,002 |
| Kentucky | 1 | $54,781 | $10,980 | – |
| Louisiana | 2 | $54,335 | $11,024 | $10,331 – $11,660 |
| Maryland | 3 | $14,050 | $12,755 | $9,465 – $16,873 |
| Massachusetts | 3 | $42,303 | $16,607 | $12,071 – $20,014 |
| Michigan | 1 | $52,469 | $19,973 | – |
| Mississippi | 1 | $47,813 | $9,947 | – |
| Missouri | 2 | $36,605 | $12,097 | $11,601 – $12,555 |
| Montana | 1 | $36,201 | $14,585 | – |
| Nebraska | 2 | $45,222 | $10,867 | $10,206 – $11,693 |
| Nevada | 1 | $50,903 | $16,553 | – |
| New Jersey | 5 | $91,275 | $14,205 | $11,894 – $16,750 |
| New Mexico | 1 | $44,215 | $10,780 | – |
| New York | 9 | $139,221 | $21,286 | $14,379 – $29,296 |
| North Carolina | 4 | $46,713 | $13,454 | $11,646 – $16,361 |
| Ohio | 1 | $45,117 | $14,751 | – |
| Oklahoma | 3 | $66,570 | $12,335 | $11,771 – $13,246 |
| Pennsylvania | 4 | $113,281 | $15,350 | $13,157 – $20,485 |
| South Carolina | 2 | $67,039 | $11,982 | $11,563 – $12,478 |
| Tennessee | 6 | $58,372 | $12,174 | $10,021 – $14,588 |
| Texas | 6 | $105,321 | $13,831 | $11,514 – $21,758 |
| Utah | 1 | $56,652 | $14,084 | – |
| Virginia | 3 | $77,708 | $13,569 | $11,104 – $16,780 |
| West Virginia | 1 | $97,357 | $17,272 | – |
Hospitals that treat the most Medicare patients for this
| Hospital | Stays | Avg charge | Avg payment |
|---|---|---|---|
| Adventhealth OrlandoOrlando, FL | 33 | $107,430 | $12,834 |
| New York-Presbyterian HospitalNew York, NY | 33 | $190,702 | $21,532 |
| NYU Hospitals CenterNew York, NY | 28 | $178,072 | $25,545 |
| New Hanover Regional Medical CenterWilmington, NC | 24 | $42,301 | $13,252 |
| Long Island Jewish Medical CenterNew Hyde Park, NY | 23 | $140,515 | $20,387 |
| St Luke's Hospital BethlehemBethlehem, PA | 21 | $107,156 | $14,167 |
| Holmes Regional Medical CenterMelbourne, FL | 20 | $52,988 | $11,365 |
| Sarasota Memorial HospitalSarasota, FL | 20 | $61,677 | $11,827 |
| Iowa Methodist Medical CenterDes Moines, IA | 20 | $50,971 | $11,775 |
| Renown Regional Medical CenterReno, NV | 20 | $50,903 | $16,553 |
| Chandler Regional Medical CenterChandler, AZ | 19 | $79,612 | $11,798 |
| Christiana Care Health Services, INC.Newark, DE | 19 | $45,282 | $14,051 |
| Villages Regional Hospital theLady Lake, FL | 19 | $64,461 | $10,119 |
| Norton Healthcare PavilionLouisville, KY | 19 | $54,781 | $10,980 |
| Methodist HospitalSan Antonio, TX | 19 | $107,811 | $11,634 |
Questions
How much does pleural effusion with major complications cost in the U.S.?
In 2024 Medicare data, a hospital stay for pleural effusion with major complications (DRG 186) at 123 hospitals in the U.S. was billed at $81,946 on average, while the average total payment was $14,801, of which Medicare paid $12,139. Your own cost depends on your insurance, deductible and the hospital.
Which states pay the most and least for pleural effusion with major complications?
Among states with at least three hospitals reporting, the average total payment was highest in New York ($21,286), California ($19,352), Massachusetts ($16,607) and lowest in Florida ($11,870), Tennessee ($12,174), Oklahoma ($12,335).
Why are hospital charges so much higher than payments?
Charges are a hospital's list prices. Medicare pays fixed rates set in advance, and private insurers negotiate their own discounts, so almost nobody pays the full charge. For this stay in the U.S., average charges were 5.5 times the average payment. Uninsured patients can ask the hospital about its financial assistance (charity care) policy and cash prices.
Source: CMS, Medicare Inpatient Hospitals by Provider and Service, 2024. Average total payment includes Medicare's payment, the patient's deductible and coinsurance, and any other payer. CMS omits hospitals with fewer than 11 hospital stays for privacy. About the data.