Simple pneumonia and pleurisy with complications in Virginia
What 42 hospitals in Virginia charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with complications (DRG 194), from 2024 Medicare claims.
Average charge
$29,522
Hospital list price billed
Average payment
$7,362
Medicare + patient + other payers
Medicare paid
$5,310
Average per stay
State rank
#20 of 47
1 = lowest average payment
Hospitals in Virginia billed an average of $29,522 for simple pneumonia and pleurisy with complications, about 4.0 times the average total payment of $7,362. That payment is 7% 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 $7,362Billed $29,522
About 25¢ was paid for every $1 hospitals in Virginia billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Virginia:
Virginia hospitals: simple pneumonia and pleurisy with complications
Every Virginia hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Augusta HealthFishersville | 78 | $17,644 | $6,405 | $4,962 |
| Winchester Medical Center INCWinchester | 62 | $16,364 | $6,801 | $5,317 |
| Mary Washington Hospital, INCFredericksburg | 47 | $14,786 | $6,954 | $4,828 |
| University of Virginia Medical CenterCharlottesville | 39 | $42,891 | $13,977 | $7,867 |
| Bon Secours - St Marys Hospital of RichmondRichmond | 34 | $28,335 | $6,322 | $4,899 |
| Carilion Medical CenterRoanoke | 32 | $28,806 | $8,439 | $5,411 |
| Chesapeake General HospitalChesapeake | 32 | $22,910 | $6,042 | $4,821 |
| Inova Fairfax HospitalFalls Church | 29 | $27,397 | $9,098 | $6,328 |
| Bon Secours - St Francis Medical CenterMidlothian | 29 | $25,505 | $7,019 | $4,750 |
| Inova Loudoun HospitalLeesburg | 26 | $25,719 | $6,513 | $5,004 |
| Bon Secours - Memorial Regional MedicalMechanicsville | 26 | $26,718 | $6,550 | $4,744 |
| Culpeper Regional HospitalCulpeper | 25 | $21,033 | $7,419 | $6,048 |
| Carilion New River Vly Med CtrChristiansburg | 24 | $25,632 | $7,862 | $5,152 |
| Carilion Franklin Memorial HospitalRocky Mount | 24 | $24,615 | $7,497 | $6,001 |
| Centra Health - Lynchburg Gen HospitalLynchburg | 23 | $25,670 | $6,353 | $4,604 |
| Henrico Doctors' HospitalRichmond | 23 | $69,119 | $6,616 | $4,550 |
| Cjw Medical CenterRichmond | 22 | $64,400 | $6,152 | $4,526 |
| Medical College of Virginia HospitalsRichmond | 21 | $40,431 | $12,007 | $7,301 |
| Riverside Regional Medical CenterNewport News | 21 | $28,297 | $7,334 | $5,373 |
| The Fauquier Hospital, INCWarrenton | 19 | $40,305 | $6,153 | $4,779 |
| Sentara Leigh HospitalNorfolk | 19 | $30,640 | $6,792 | $4,667 |
| Buchanan General HospitalGrundy | 19 | $31,309 | $7,417 | $6,044 |
| Inova Alexandria HospitalAlexandria | 18 | $22,814 | $7,139 | $5,851 |
| Sentara Virginia Beach General HospitalVirginia Beach | 18 | $36,606 | $6,142 | $5,034 |
| Danville Regional Medical CenterDanville | 18 | $46,158 | $7,087 | $5,177 |
| Sentara Northern Virginia Medical CenterWoodbridge | 18 | $24,292 | $7,215 | $5,690 |
| Reston Hospital CenterReston | 17 | $53,325 | $6,277 | $4,931 |
| Prince William HospitalManassas | 16 | $30,844 | $8,047 | $5,580 |
| Sentara Obici HospitalSuffolk | 15 | $27,275 | $5,921 | $4,576 |
| Sentara Rmh Medical CenterHarrisonburg | 14 | $16,810 | $7,106 | $5,143 |
| Lewisgale Medical CenterSalem | 14 | $46,325 | $7,592 | $5,334 |
| Johnston Memorial HospitalAbingdon | 14 | $31,674 | $8,110 | $5,298 |
| Bon Secours - Maryview Medical CenterPortsmouth | 12 | $22,691 | $7,450 | $5,912 |
| Sentara Bayside HospitalVirginia Beach | 12 | $31,599 | $6,074 | $4,430 |
| UVA Health Haymarket Medical CenterHaymarket | 12 | $22,378 | $5,791 | $4,839 |
| Warren Memorial HospitalFront Royal | 11 | $14,583 | $7,820 | $5,720 |
| Virginia Hospital Center - ArlingtonArlington | 11 | $20,185 | $6,753 | $5,008 |
| Clinch Valley Medical CenterRichlands | 11 | $54,673 | $6,742 | $4,958 |
| Southside Regional Medical CenterPetersburg | 11 | $59,410 | $6,785 | $4,073 |
| Martha Jefferson HospitalCharlottesville | 11 | $28,563 | $5,381 | $4,076 |
| Community Memorial Healthcenter, INCSouth Hill | 11 | $40,607 | $6,585 | $5,249 |
| Wellmont Lonesome Pine HospitalBig Stone Gap | 11 | $21,399 | $10,412 | $6,745 |
Lowest and highest payments in Virginia
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
| Martha Jefferson HospitalCharlottesville, VA | $5,381 |
|---|---|
| UVA Health Haymarket Medical CenterHaymarket, VA | $5,791 |
| Sentara Obici HospitalSuffolk, VA | $5,921 |
| Chesapeake General HospitalChesapeake, VA | $6,042 |
| Sentara Bayside HospitalVirginia Beach, VA | $6,074 |
Highest
| University of Virginia Medical CenterCharlottesville, VA | $13,977 |
|---|---|
| Medical College of Virginia HospitalsRichmond, VA | $12,007 |
| Wellmont Lonesome Pine HospitalBig Stone Gap, VA | $10,412 |
| Inova Fairfax HospitalFalls Church, VA | $9,098 |
| Carilion Medical CenterRoanoke, VA | $8,439 |
Simple pneumonia and pleurisy with complications in other states
Questions
How much does simple pneumonia and pleurisy with complications cost in Virginia?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with complications (DRG 194) at 42 hospitals in Virginia was billed at $29,522 on average, while the average total payment was $7,362, of which Medicare paid $5,310. 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 Virginia, 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.