Simple pneumonia and pleurisy with major complications in New Mexico
What 20 hospitals in New Mexico 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
$47,872
Hospital list price billed
Average payment
$12,045
Medicare + patient + other payers
Medicare paid
$10,038
Average per stay
State rank
#34 of 50
1 = lowest average payment
Hospitals in New Mexico billed an average of $47,872 for simple pneumonia and pleurisy with major complications, about 4.0 times the average total payment of $12,045. That payment is about the same as 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 $12,045Billed $47,872
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 major 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 | 176 | $27,248 | $10,241 | $7,875 |
| San Juan Regional Medical CenterFarmington | 126 | $42,785 | $12,643 | $11,048 |
| St Vincent HospitalSanta Fe | 83 | $41,330 | $14,114 | $12,344 |
| Eastern New Mexico Medical CenterRoswell | 58 | $75,242 | $9,209 | $8,217 |
| Lovelace Medical CenterAlbuquerque | 56 | $84,506 | $9,479 | $7,840 |
| UNM HospitalAlbuquerque | 55 | $24,086 | $15,712 | $12,821 |
| Carlsbad Medical CenterCarlsbad | 44 | $52,021 | $11,518 | $10,110 |
| Mountain View Regional Medical CenterLas Cruces | 37 | $40,475 | $11,316 | $8,405 |
| CHRISTUS Southern New MexicoAlamogordo | 34 | $112,564 | $14,714 | $13,306 |
| Plains Regional Medical CenterClovis | 31 | $31,139 | $10,315 | $9,316 |
| Memorial Medical Center INCLas Cruces | 26 | $90,252 | $14,748 | $7,336 |
| Lovelace Women's HospitalAlbuquerque | 23 | $71,150 | $9,427 | $7,576 |
| Gallup Indian Medical CenterGallup | 22 | $26,298 | $15,409 | $14,148 |
| Lovelace Westside HospitalAlbuquerque | 22 | $60,739 | $9,809 | $7,351 |
| Three Crosses Regional Hospital LLCLas Cruces | 22 | $19,221 | $7,923 | $6,662 |
| Northern Navajo Medical CenterShiprock | 21 | $32,216 | $15,902 | $14,267 |
| Espanola HospitalEspanola | 17 | $22,274 | $14,594 | $13,042 |
| Los Alamos Medical CenterLos Alamos | 16 | $84,553 | $21,717 | $19,782 |
| Roosevelt General HospitalPortales | 11 | $31,786 | $11,704 | $10,288 |
| Roswell Regional HospitalRoswell | 11 | $87,168 | $9,354 | $8,019 |
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
| Three Crosses Regional Hospital LLCLas Cruces, NM | $7,923 |
|---|---|
| Eastern New Mexico Medical CenterRoswell, NM | $9,209 |
| Roswell Regional HospitalRoswell, NM | $9,354 |
| Lovelace Women's HospitalAlbuquerque, NM | $9,427 |
| Lovelace Medical CenterAlbuquerque, NM | $9,479 |
Highest
| Los Alamos Medical CenterLos Alamos, NM | $21,717 |
|---|---|
| Northern Navajo Medical CenterShiprock, NM | $15,902 |
| UNM HospitalAlbuquerque, NM | $15,712 |
| Gallup Indian Medical CenterGallup, NM | $15,409 |
| Memorial Medical Center INCLas Cruces, NM | $14,748 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in New Mexico?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 20 hospitals in New Mexico was billed at $47,872 on average, while the average total payment was $12,045, of which Medicare paid $10,038. 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.