Simple pneumonia and pleurisy with major complications in Vermont
What 6 hospitals in Vermont 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
$33,721
Hospital list price billed
Average payment
$9,426
Medicare + patient + other payers
Medicare paid
$6,593
Average per stay
State rank
#1 of 50
1 = lowest average payment
Hospitals in Vermont billed an average of $33,721 for simple pneumonia and pleurisy with major complications, about 3.6 times the average total payment of $9,426. That payment is 22% below 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 $9,426Billed $33,721
About 28¢ was paid for every $1 hospitals in Vermont billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Vermont:
Vermont hospitals: simple pneumonia and pleurisy with major complications
Every Vermont hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| Fletcher Allen Hospital of VermontBurlington | 106 | $41,838 | $10,287 | $6,115 |
| Central Vermont Medical CenterGraniteville-East Barre | 48 | $27,411 | $6,627 | $3,575 |
| Northwestern Medical CenterSt Albans | 37 | $21,862 | $15,154 | $13,964 |
| Rutland Regional Medical CenterRutland | 29 | $33,991 | $6,921 | $5,600 |
| Brattleboro Memorial HospitalBrattleboro | 29 | $34,801 | $8,221 | $6,337 |
| Southwestern Vermont Medical CenterBennington | 13 | $21,580 | $4,714 | $3,436 |
Lowest and highest payments in Vermont
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
| Southwestern Vermont Medical CenterBennington, VT | $4,714 |
|---|---|
| Central Vermont Medical CenterGraniteville-East Barre, VT | $6,627 |
| Rutland Regional Medical CenterRutland, VT | $6,921 |
| Brattleboro Memorial HospitalBrattleboro, VT | $8,221 |
| Fletcher Allen Hospital of VermontBurlington, VT | $10,287 |
Highest
| Northwestern Medical CenterSt Albans, VT | $15,154 |
|---|---|
| Fletcher Allen Hospital of VermontBurlington, VT | $10,287 |
| Brattleboro Memorial HospitalBrattleboro, VT | $8,221 |
| Rutland Regional Medical CenterRutland, VT | $6,921 |
| Central Vermont Medical CenterGraniteville-East Barre, VT | $6,627 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in Vermont?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 6 hospitals in Vermont was billed at $33,721 on average, while the average total payment was $9,426, of which Medicare paid $6,593. 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 Vermont, average charges were 3.6 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.