Simple pneumonia and pleurisy with major complications in Rhode Island
What 9 hospitals in Rhode Island 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
$35,281
Hospital list price billed
Average payment
$12,735
Medicare + patient + other payers
Medicare paid
$10,144
Average per stay
State rank
#41 of 50
1 = lowest average payment
Hospitals in Rhode Island billed an average of $35,281 for simple pneumonia and pleurisy with major complications, about 2.8 times the average total payment of $12,735. That payment is 6% 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 $12,735Billed $35,281
About 36¢ 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 major 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 |
|---|---|---|---|---|
| Kent County Memorial HospitalWarwick | 77 | $31,951 | $14,249 | $10,223 |
| Miriam HospitalProvidence | 75 | $29,747 | $12,211 | $10,005 |
| Rhode Island HospitalProvidence | 60 | $41,309 | $15,726 | $12,805 |
| South County Hospital INCWakefield | 45 | $33,703 | $10,086 | $8,854 |
| Westerly HospitalWesterly | 44 | $35,826 | $10,611 | $9,180 |
| Newport HospitalNewport | 32 | $29,114 | $10,495 | $9,169 |
| Landmark Medical Center, INCWoonsocket | 21 | $58,704 | $13,261 | $9,773 |
| Roger Williams Medical CenterProvidence | 18 | $47,155 | $16,313 | $10,925 |
| Our Lady of Fatima HospitalNorth Providence | 18 | $26,872 | $10,074 | $8,480 |
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
| Our Lady of Fatima HospitalNorth Providence, RI | $10,074 |
|---|---|
| South County Hospital INCWakefield, RI | $10,086 |
| Newport HospitalNewport, RI | $10,495 |
| Westerly HospitalWesterly, RI | $10,611 |
| Miriam HospitalProvidence, RI | $12,211 |
Highest
| Roger Williams Medical CenterProvidence, RI | $16,313 |
|---|---|
| Rhode Island HospitalProvidence, RI | $15,726 |
| Kent County Memorial HospitalWarwick, RI | $14,249 |
| Landmark Medical Center, INCWoonsocket, RI | $13,261 |
| Miriam HospitalProvidence, RI | $12,211 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in Rhode Island?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 9 hospitals in Rhode Island was billed at $35,281 on average, while the average total payment was $12,735, of which Medicare paid $10,144. 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 2.8 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.