Simple pneumonia and pleurisy with major complications in Massachusetts
What 49 hospitals in Massachusetts charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy with major complications (DRG 193), from 2024 Medicare claims.
Average charge
$28,103
Hospital list price billed
Average payment
$12,619
Medicare + patient + other payers
Medicare paid
$10,654
Average per stay
State rank
#39 of 50
1 = lowest average payment
Hospitals in Massachusetts billed an average of $28,103 for simple pneumonia and pleurisy with major complications, about 2.2 times the average total payment of $12,619. That payment is 5% above the U.S. average of $12,020.
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 $12,619Billed $28,103
About 45¢ was paid for every $1 hospitals in Massachusetts billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Massachusetts:
Massachusetts hospitals: simple pneumonia and pleurisy with major complications
Every Massachusetts hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Southcoast Hospital Group, INCFall River | 304 | $30,795 | $11,253 | $9,991 |
| South Shore HospitalSouth Weymouth | 270 | $20,001 | $11,047 | $8,988 |
| Umass Memorial Medical Center INCWorcester | 221 | $44,045 | $17,211 | $14,188 |
| Cape Cod HospitalHyannis | 207 | $23,858 | $13,718 | $12,607 |
| Beverly Hospital CorporationBeverly | 180 | $23,913 | $11,034 | $9,296 |
| Lowell General HospitalLowell | 159 | $25,077 | $11,312 | $9,960 |
| Milford Regional Medical CenterMilford | 158 | $15,988 | $11,099 | $9,710 |
| Winchester HospitalWinchester | 158 | $19,957 | $10,472 | $9,110 |
| Union HospitalLynn | 157 | $34,200 | $12,274 | $10,629 |
| Good Samaritan Medical Center, a Caritas Family HoBrockton | 155 | $15,744 | $10,773 | $9,396 |
| Massachusetts General HospitalBoston | 149 | $70,792 | $17,882 | $13,295 |
| Baystate Medical CenterSpringfield | 136 | $21,779 | $14,396 | $12,017 |
| Newton-Wellesley HospitalNewton Lower Falls | 136 | $36,018 | $11,954 | $10,042 |
| Morton Hospital & Medical CenterTaunton | 124 | $18,645 | $10,852 | $9,629 |
| Berkshire Medical Center INCPittsfield | 123 | $24,775 | $14,374 | $12,455 |
| Holy Family Hospital, a Caritas Family HospitalMethuen | 113 | $19,161 | $11,180 | $9,869 |
| Beth Israel Deaconess Hospital PlymouthPlymouth | 111 | $24,393 | $10,860 | $9,202 |
| Healthalliance Hospitals, INCLeominster | 107 | $30,207 | $12,166 | $10,379 |
| Lawrence General HospitalLawrence | 104 | $23,445 | $12,883 | $10,985 |
| Beth Israel Deaconess Hospital - NeedhamNeedham | 102 | $16,792 | $10,269 | $8,365 |
| Heywood HospitalGardner | 100 | $21,569 | $10,997 | $9,797 |
| Falmouth HospitalFalmouth | 100 | $22,478 | $10,294 | $9,136 |
| Melrosewakefield HealthcareMelrose | 98 | $19,279 | $12,259 | $9,705 |
| St Vincent HospitalWorcester | 98 | $63,849 | $14,842 | $11,941 |
| Milton HospitalMilton | 95 | $18,874 | $10,123 | $8,922 |
| Saint Anne's Hospital, a Caritas Family HospitalFall River | 91 | $24,846 | $11,127 | $10,018 |
| Brigham and Women's HosptialBoston | 90 | $77,969 | $17,624 | $13,117 |
| Lahey Clinic HospitalBurlington | 90 | $23,879 | $14,725 | $11,287 |
| Sturdy Memorial HospitalAttleboro | 88 | $19,546 | $11,044 | $9,207 |
| Anna Jaques HospitalNewburyport | 88 | $25,400 | $11,372 | $10,353 |
| Mount Auburn HospitalCambridge | 79 | $20,704 | $13,695 | $11,548 |
| Marlborough HospitalMarlborough | 70 | $26,335 | $11,349 | $9,159 |
| Cooley Dickinson Hospital Inc,TheNorthampton | 62 | $27,084 | $10,504 | $9,188 |
| Beth Israel Deaconess Medical CenterBoston | 62 | $32,849 | $19,375 | $13,974 |
| Metrowest Medical CenterFramingham | 62 | $57,063 | $12,781 | $10,951 |
| Faulkner HospitalBoston | 61 | $34,502 | $13,085 | $10,878 |
| Holyoke Medical CenterHolyoke | 57 | $14,209 | $11,354 | $9,987 |
| Harrington Memorial HospitalSouthbridge | 56 | $23,460 | $11,119 | $10,129 |
| Emerson HospitalConcord | 54 | $18,976 | $9,720 | $8,512 |
| Cambridge Health AllianceCambridge | 53 | $23,171 | $21,212 | $18,610 |
| Mercy Medical CenterSpringfield | 49 | $22,126 | $11,038 | $9,659 |
| Tufts Medical CenterBoston | 44 | $36,089 | $18,425 | $13,599 |
| Wing Memorial Hospital and Medical CenterPalmer | 42 | $18,663 | $11,041 | $9,404 |
| Noble HospitalWestfield | 37 | $19,148 | $11,047 | $9,357 |
| Baystate Franklin Medical CenterGreenfield | 36 | $17,859 | $10,966 | $9,632 |
| Boston Medical Center CorporationBoston | 32 | $36,715 | $25,272 | $20,683 |
| Nashoba Valley Medical CenterAyer | 30 | $15,885 | $10,191 | $8,495 |
| Brockton HospitalBrockton | 26 | $30,633 | $14,977 | $11,322 |
| Boston Medical Center-BrightonBrighton | 19 | $15,194 | $14,564 | $12,572 |
Lowest and highest payments in Massachusetts
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
| Emerson HospitalConcord, MA | $9,720 |
|---|---|
| Milton HospitalMilton, MA | $10,123 |
| Nashoba Valley Medical CenterAyer, MA | $10,191 |
| Beth Israel Deaconess Hospital - NeedhamNeedham, MA | $10,269 |
| Falmouth HospitalFalmouth, MA | $10,294 |
Highest
| Boston Medical Center CorporationBoston, MA | $25,272 |
|---|---|
| Cambridge Health AllianceCambridge, MA | $21,212 |
| Beth Israel Deaconess Medical CenterBoston, MA | $19,375 |
| Tufts Medical CenterBoston, MA | $18,425 |
| Massachusetts General HospitalBoston, MA | $17,882 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in Massachusetts?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 49 hospitals in Massachusetts was billed at $28,103 on average, while the average total payment was $12,619, of which Medicare paid $10,654. 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 Massachusetts, average charges were 2.2 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.