Simple pneumonia and pleurisy with complications in New Mexico
What 4 hospitals in New Mexico charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with complications (DRG 194), from 2024 Medicare claims.
Average charge
$31,101
Hospital list price billed
Average payment
$7,729
Medicare + patient + other payers
Medicare paid
$6,412
Average per stay
State rank
#28 of 47
1 = lowest average payment
Hospitals in New Mexico billed an average of $31,101 for simple pneumonia and pleurisy with complications, about 4.0 times the average total payment of $7,729. That payment is 3% below the U.S. average of $7,941.
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 $7,729Billed $31,101
About 25¢ was paid for every $1 hospitals in New Mexico billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in New Mexico:
New Mexico hospitals: simple pneumonia and pleurisy with complications
Every New Mexico hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Presbyterian HospitalAlbuquerque | 30 | $18,485 | $6,517 | $4,857 |
| Gallup Indian Medical CenterGallup | 30 | $31,023 | $10,425 | $9,338 |
| Eastern New Mexico Medical CenterRoswell | 16 | $50,127 | $5,997 | $4,977 |
| Mountain View Regional Medical CenterLas Cruces | 12 | $37,470 | $6,330 | $4,901 |
Lowest and highest payments in New Mexico
Among hospitals with at least 11 Medicare hospital stays. Differences reflect local wage costs, teaching status and how sick patients were, as well as price.
Lowest
| Eastern New Mexico Medical CenterRoswell, NM | $5,997 |
|---|---|
| Mountain View Regional Medical CenterLas Cruces, NM | $6,330 |
| Presbyterian HospitalAlbuquerque, NM | $6,517 |
| Gallup Indian Medical CenterGallup, NM | $10,425 |
Highest
| Gallup Indian Medical CenterGallup, NM | $10,425 |
|---|---|
| Presbyterian HospitalAlbuquerque, NM | $6,517 |
| Mountain View Regional Medical CenterLas Cruces, NM | $6,330 |
| Eastern New Mexico Medical CenterRoswell, NM | $5,997 |
Simple pneumonia and pleurisy with complications in other states
Questions
How much does simple pneumonia and pleurisy with complications cost in New Mexico?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with complications (DRG 194) at 4 hospitals in New Mexico was billed at $31,101 on average, while the average total payment was $7,729, of which Medicare paid $6,412. Your own cost depends on your insurance, deductible and the hospital.
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 New Mexico, average charges were 4.0 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.