Simple pneumonia and pleurisy with complications in Texas
What 94 hospitals in Texas charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with complications (DRG 194), from 2024 Medicare claims.
Average charge
$46,278
Hospital list price billed
Average payment
$8,089
Medicare + patient + other payers
Medicare paid
$6,091
Average per stay
State rank
#34 of 47
1 = lowest average payment
Hospitals in Texas billed an average of $46,278 for simple pneumonia and pleurisy with complications, about 5.7 times the average total payment of $8,089. That payment is 2% above 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 $8,089Billed $46,278
About 17¢ was paid for every $1 hospitals in Texas billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Texas:
Texas hospitals: simple pneumonia and pleurisy with complications
Every Texas hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| United Regional Hlth Care SystWichita Falls | 79 | $32,509 | $7,401 | $5,475 |
| Methodist HospitalSan Antonio | 75 | $66,780 | $8,052 | $4,974 |
| Hendrick Health SystemAbilene | 55 | $62,909 | $6,539 | $5,286 |
| Bsa HospitalAmarillo | 54 | $43,565 | $6,727 | $4,830 |
| Trinity Mother Frances SystTyler | 51 | $56,365 | $6,553 | $5,029 |
| Good Shepherd Medical Center MarshallMarshall | 48 | $38,781 | $8,141 | $6,513 |
| Texas Health Harris Methodist Fort WorthFort Worth | 46 | $34,276 | $7,473 | $5,960 |
| Mem Hermann Southwest HospHouston | 45 | $37,690 | $9,006 | $7,673 |
| Texas Health Presbyterian Hospital DallasDallas | 44 | $34,548 | $8,141 | $5,461 |
| Baylor Regional Medical Center at GrapevineGrapevine | 42 | $32,735 | $5,858 | $3,897 |
| Shannon Medical CenterSan Angelo | 40 | $36,480 | $6,496 | $4,898 |
| UT Southwestern University HospitalDallas | 36 | $29,076 | $8,596 | $5,080 |
| Scott & White Memorial HospitalTemple | 35 | $32,266 | $9,147 | $6,585 |
| East Texas Medical CenterTyler | 35 | $53,661 | $7,184 | $5,856 |
| CHRISTUS St Michael Health SystemTexarkana | 34 | $39,843 | $6,459 | $5,037 |
| Baptist Medical CenterSan Antonio | 30 | $73,023 | $6,968 | $5,509 |
| CHRISTUS Santa Rosa HospitalSan Antonio | 30 | $34,428 | $7,155 | $5,986 |
| Methodist Hospital,TheHouston | 30 | $52,011 | $8,522 | $5,494 |
| Baylor University Medical CenterDallas | 29 | $30,569 | $11,305 | $5,400 |
| Paris Regional Medical CenterParis | 29 | $25,174 | $6,164 | $4,811 |
| Hunt Regional Medical CenterGreenville | 29 | $26,563 | $6,953 | $5,317 |
| Longview Regional Medical CenterLongview | 29 | $60,404 | $6,140 | $4,846 |
| CHRISTUS HospitalBeaumont | 28 | $39,921 | $8,105 | $6,347 |
| East Texas Medical Center AthensAthens | 28 | $47,263 | $7,097 | $5,816 |
| Texas Health Presbyterian Hospital PlanoPlano | 28 | $40,132 | $8,033 | $5,183 |
| Citizens Medical CenterVictoria | 27 | $22,683 | $6,497 | $5,409 |
| Mem Hermann Baptist HospitalBeaumont | 26 | $47,323 | $8,272 | $6,772 |
| Kingwood Medical CenterKingwood | 26 | $88,852 | $7,786 | $6,310 |
| Baylor Regional Medical Center at PlanoPlano | 26 | $29,681 | $5,437 | $3,993 |
| Baylor Scott and White Medical Center McKinneyMc Kinney | 26 | $35,120 | $6,017 | $4,558 |
| University of Texas Medical Branch GalGalveston | 25 | $30,975 | $11,518 | $7,771 |
| Lake Pointe Medical CenterRowlett | 25 | $34,904 | $7,046 | $5,567 |
| Denton Community HospitalDenton | 25 | $32,771 | $7,672 | $5,687 |
| Covenant Medical CenterLubbock | 24 | $72,873 | $7,439 | $5,021 |
| Texas Health Harris Methodist Hospital Southwest FFort Worth | 24 | $51,026 | $8,087 | $4,951 |
| Houston Methodist the Woodlands HospitalThe Woodlands | 23 | $54,403 | $6,144 | $4,148 |
| Sid Peterson Memorial HospitalKerrville | 22 | $26,019 | $6,376 | $4,966 |
| Clear Lake Regional Medical CenterWebster | 22 | $82,743 | $8,997 | $5,204 |
| Methodist Sugar Land HospitalSugar Land | 22 | $39,976 | $6,742 | $4,749 |
| Baylor All Saints Medical Center at FwFort Worth | 21 | $36,635 | $8,120 | $4,990 |
| Denton Regional Medical CenterDenton | 21 | $83,405 | $8,609 | $5,792 |
| Texas Health Presbyterian Hospital AllenAllen | 21 | $31,120 | $7,285 | $5,889 |
| Texas Health Arlington Memorial HospitalArlington | 20 | $36,558 | $8,480 | $6,410 |
| Midland Memorial HospitalMidland | 20 | $55,127 | $8,569 | $7,218 |
| Conroe Regional Medical CenterConroe | 20 | $93,331 | $8,599 | $7,111 |
| Scott & White Hospital-Round RockRound Rock | 20 | $30,507 | $6,254 | $4,590 |
| Texoma Healthcare SystemDenison | 19 | $59,855 | $6,456 | $5,289 |
| Huntsville Memorial HospitalHuntsville | 19 | $34,617 | $7,795 | $6,350 |
| St Davids HospitalAustin | 19 | $56,959 | $8,701 | $4,636 |
| Methodist Richardson Medical CenterRichardson | 19 | $48,658 | $7,136 | $5,366 |
| Texas Health Harris Methodist Hurst-Euless-BedfordBedford | 19 | $38,719 | $6,756 | $4,652 |
| Medical City Dallas HospitalDallas | 19 | $106,159 | $7,919 | $5,904 |
| Methodist Mansfield Medical CenterMansfield | 19 | $37,376 | $7,328 | $5,383 |
| Providence Health CenterWaco | 18 | $23,807 | $7,163 | $5,687 |
| CHRISTUS Spohn Hospital Corpus ChristiCorpus Christi | 17 | $53,396 | $10,257 | $8,765 |
| Nacogdoches Medical CenterNacogdoches | 17 | $99,689 | $5,959 | $4,715 |
| University Medical CenterLubbock | 17 | $45,034 | $11,724 | $10,265 |
| Texas Health Presbyterian Hospital Flower MoundFlower Mound | 17 | $45,783 | $6,868 | $4,389 |
| Laredo Medical CenterLaredo | 16 | $61,341 | $9,222 | $5,968 |
| Seton Medical Center WilliamsonRound Rock | 16 | $58,418 | $7,080 | $5,856 |
| Seton Medical Center HaysKyle | 16 | $34,888 | $7,318 | $6,298 |
| Parkland Health and Hospital SystemDallas | 15 | $39,442 | $44,834 | $42,590 |
| Seton Medical Center AustinAustin | 15 | $47,377 | $8,242 | $6,584 |
| Medical Center of McKinneyMcKinney | 15 | $56,245 | $7,463 | $5,434 |
| St David's South Austin Medical CenterAustin | 15 | $40,268 | $10,224 | $4,845 |
| Corpus Christi Medical Center,TheCorpus Christi | 15 | $78,943 | $9,594 | $5,250 |
| Methodist Willowbrook HospitalHouston | 15 | $45,522 | $6,911 | $5,496 |
| Centennial Medical CenterFrisco | 15 | $23,781 | $6,939 | $5,245 |
| Methodist Stone Oak HospitalSan Antonio | 15 | $71,768 | $5,862 | $4,420 |
| Jps Health NetworkFort Worth | 14 | $34,560 | $39,937 | $38,416 |
| Memorial Hermann Texas Medical CenterHouston | 14 | $48,178 | $11,946 | $9,750 |
| North Texas Medical CenterGainesville | 14 | $23,940 | $8,423 | $7,024 |
| Texas Health Presbyterian Hospital KaufmanKaufman | 14 | $29,798 | $10,646 | $7,690 |
| Hill Country Memorial HospitalFredericksburg | 14 | $57,474 | $8,211 | $6,812 |
| Palestine Regional Medical CenterPalestine | 14 | $53,558 | $6,856 | $5,690 |
| Texas Health Presbyterian Hospital RockwallRockwall | 14 | $38,506 | $6,031 | $3,907 |
| Guadalupe Regional Medical CenterSeguin | 13 | $18,483 | $6,719 | $5,185 |
| Detar Hospital NavarroVictoria | 13 | $96,572 | $7,252 | $5,043 |
| Methodist Charlton Medical CenterDallas | 13 | $35,462 | $8,120 | $6,375 |
| Texas Health Harris Methodist Hospital AllianceFort Worth | 13 | $29,711 | $7,254 | $5,876 |
| Adventhealth Central TexasKilleen | 12 | $24,114 | $7,304 | $6,216 |
| Mem Hermann Mem City HospHouston | 12 | $35,223 | $8,886 | $6,500 |
| Huguley Health SystemFort Worth | 12 | $51,172 | $8,363 | $5,261 |
| Memorial Hermann NortheastHumble | 12 | $47,415 | $9,273 | $6,132 |
| Memorial Hermann Katy HospitalKaty | 12 | $34,286 | $7,609 | $6,385 |
| St Luke's the Woodlands HospitalConroe | 12 | $49,865 | $7,118 | $5,761 |
| Houston Methodist West HospitalHouston | 12 | $44,346 | $7,138 | $5,778 |
| Baylor Scott & White Medical Center- College StatiCollege Station | 12 | $35,666 | $6,769 | $5,412 |
| Valley Baptist Medical CenterHarlingen | 11 | $130,656 | $6,411 | $5,096 |
| Baylor Medical Center at IrvingIrving | 11 | $31,905 | $8,443 | $7,257 |
| Texas Health Harris Methodist Hospital CleburneCleburne | 11 | $28,663 | $8,116 | $6,781 |
| Medical Center of PlanoPlano | 11 | $73,216 | $6,922 | $5,717 |
| Tomball Regional HospitalTomball | 11 | $70,302 | $8,178 | $6,843 |
| Texas Regional Medical Center at SunnyvaleSunnyvale | 11 | $30,972 | $5,752 | $3,204 |
Lowest and highest payments in Texas
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
| Baylor Regional Medical Center at PlanoPlano, TX | $5,437 |
|---|---|
| Texas Regional Medical Center at SunnyvaleSunnyvale, TX | $5,752 |
| Baylor Regional Medical Center at GrapevineGrapevine, TX | $5,858 |
| Methodist Stone Oak HospitalSan Antonio, TX | $5,862 |
| Nacogdoches Medical CenterNacogdoches, TX | $5,959 |
Highest
| Parkland Health and Hospital SystemDallas, TX | $44,834 |
|---|---|
| Jps Health NetworkFort Worth, TX | $39,937 |
| Memorial Hermann Texas Medical CenterHouston, TX | $11,946 |
| University Medical CenterLubbock, TX | $11,724 |
| University of Texas Medical Branch GalGalveston, TX | $11,518 |
Simple pneumonia and pleurisy with complications in other states
Questions
How much does simple pneumonia and pleurisy with complications cost in Texas?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with complications (DRG 194) at 94 hospitals in Texas was billed at $46,278 on average, while the average total payment was $8,089, of which Medicare paid $6,091. 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 Texas, average charges were 5.7 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.