Simple pneumonia and pleurisy with complications in Rhode Island
What 7 hospitals in Rhode Island charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with complications (DRG 194), from 2024 Medicare claims.
Average charge
$24,322
Hospital list price billed
Average payment
$7,836
Medicare + patient + other payers
Medicare paid
$5,911
Average per stay
State rank
#31 of 47
1 = lowest average payment
Hospitals in Rhode Island billed an average of $24,322 for simple pneumonia and pleurisy with complications, about 3.1 times the average total payment of $7,836. That payment is 1% 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 $7,836Billed $24,322
About 32¢ was paid for every $1 hospitals in Rhode Island billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Rhode Island:
Rhode Island hospitals: simple pneumonia and pleurisy with complications
Every Rhode Island hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Miriam HospitalProvidence | 43 | $21,688 | $8,460 | $5,888 |
| Kent County Memorial HospitalWarwick | 41 | $21,950 | $8,330 | $6,230 |
| Newport HospitalNewport | 28 | $24,829 | $6,868 | $5,138 |
| South County Hospital INCWakefield | 23 | $22,461 | $6,314 | $5,037 |
| Rhode Island HospitalProvidence | 22 | $34,387 | $9,934 | $7,812 |
| Our Lady of Fatima HospitalNorth Providence | 13 | $22,394 | $6,657 | $5,276 |
| Westerly HospitalWesterly | 13 | $27,610 | $6,623 | $5,619 |
Lowest and highest payments in Rhode Island
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
| South County Hospital INCWakefield, RI | $6,314 |
|---|---|
| Westerly HospitalWesterly, RI | $6,623 |
| Our Lady of Fatima HospitalNorth Providence, RI | $6,657 |
| Newport HospitalNewport, RI | $6,868 |
| Kent County Memorial HospitalWarwick, RI | $8,330 |
Highest
| Rhode Island HospitalProvidence, RI | $9,934 |
|---|---|
| Miriam HospitalProvidence, RI | $8,460 |
| Kent County Memorial HospitalWarwick, RI | $8,330 |
| Newport HospitalNewport, RI | $6,868 |
| Our Lady of Fatima HospitalNorth Providence, RI | $6,657 |
Simple pneumonia and pleurisy with complications in other states
Questions
How much does simple pneumonia and pleurisy with complications cost in Rhode Island?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with complications (DRG 194) at 7 hospitals in Rhode Island was billed at $24,322 on average, while the average total payment was $7,836, of which Medicare paid $5,911. 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 Rhode Island, average charges were 3.1 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.