Simple pneumonia and pleurisy with major complications in Virginia
What 66 hospitals in Virginia 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
$44,680
Hospital list price billed
Average payment
$11,067
Medicare + patient + other payers
Medicare paid
$8,652
Average per stay
State rank
#19 of 50
1 = lowest average payment
Hospitals in Virginia billed an average of $44,680 for simple pneumonia and pleurisy with major complications, about 4.0 times the average total payment of $11,067. That payment is 8% 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 $11,067Billed $44,680
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 major 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 |
|---|---|---|---|---|
| Winchester Medical Center INCWinchester | 215 | $24,550 | $11,174 | $9,176 |
| Mary Washington Hospital, INCFredericksburg | 208 | $21,906 | $10,329 | $8,291 |
| Henrico Doctors' HospitalRichmond | 142 | $93,279 | $9,888 | $7,826 |
| Inova Fairfax HospitalFalls Church | 139 | $33,499 | $13,446 | $9,722 |
| Cjw Medical CenterRichmond | 137 | $124,701 | $10,129 | $7,533 |
| Inova Loudoun HospitalLeesburg | 133 | $35,151 | $10,519 | $8,020 |
| Sentara Leigh HospitalNorfolk | 102 | $39,093 | $9,722 | $7,895 |
| Chesapeake General HospitalChesapeake | 101 | $28,336 | $9,385 | $7,989 |
| Danville Regional Medical CenterDanville | 98 | $52,788 | $10,977 | $8,686 |
| Sentara Virginia Beach General HospitalVirginia Beach | 97 | $40,320 | $9,316 | $7,798 |
| Culpeper Regional HospitalCulpeper | 87 | $30,665 | $11,383 | $10,164 |
| Medical College of Virginia HospitalsRichmond | 84 | $66,030 | $19,951 | $11,446 |
| Inova Alexandria HospitalAlexandria | 83 | $35,639 | $11,168 | $8,914 |
| Sentara Rmh Medical CenterHarrisonburg | 82 | $24,831 | $11,458 | $9,501 |
| Carilion Medical CenterRoanoke | 79 | $42,836 | $11,402 | $7,979 |
| Sentara Northern Virginia Medical CenterWoodbridge | 75 | $39,255 | $11,242 | $9,289 |
| Sentara Obici HospitalSuffolk | 73 | $38,385 | $9,680 | $7,737 |
| Bon Secours - Memorial Regional MedicalMechanicsville | 73 | $42,798 | $10,384 | $7,287 |
| University of Virginia Medical CenterCharlottesville | 68 | $55,738 | $19,874 | $12,734 |
| Johnston Memorial HospitalAbingdon | 68 | $36,778 | $11,792 | $8,159 |
| Sentara Bayside HospitalVirginia Beach | 68 | $35,206 | $9,424 | $7,627 |
| Bon Secours - St Marys Hospital of RichmondRichmond | 67 | $41,159 | $10,223 | $8,442 |
| Reston Hospital CenterReston | 66 | $69,977 | $10,196 | $8,251 |
| Lewisgale Medical CenterSalem | 64 | $67,059 | $12,109 | $8,820 |
| Riverside Regional Medical CenterNewport News | 61 | $26,421 | $10,098 | $7,513 |
| Virginia Hospital Center - ArlingtonArlington | 60 | $30,672 | $10,505 | $8,746 |
| John Randolph Medical CenterHopewell | 58 | $82,858 | $9,638 | $8,372 |
| Martha Jefferson HospitalCharlottesville | 58 | $23,923 | $8,440 | $7,000 |
| Centra Health - Lynchburg Gen HospitalLynchburg | 56 | $37,812 | $9,597 | $8,065 |
| Clinch Valley Medical CenterRichlands | 52 | $64,945 | $10,604 | $7,401 |
| Inova Mount Vernon HospitalAlexandria | 52 | $41,106 | $11,733 | $9,030 |
| Southside Regional Medical CenterPetersburg | 51 | $101,501 | $9,803 | $8,126 |
| Warren Memorial HospitalFront Royal | 49 | $20,790 | $12,596 | $9,704 |
| Spotsylvania Regional Medical CenterFredericksburg | 49 | $56,103 | $10,165 | $9,066 |
| Inova Fair Oaks HospitalFairfax | 45 | $30,981 | $10,535 | $8,613 |
| Prince William HospitalManassas | 42 | $32,384 | $11,559 | $8,466 |
| Bon Secours - St Francis Medical CenterMidlothian | 42 | $38,607 | $10,433 | $8,204 |
| Augusta HealthFishersville | 40 | $27,422 | $10,194 | $8,765 |
| Sentara Williamsburg Regional Medical CenterWilliamsburg | 40 | $42,080 | $9,094 | $7,327 |
| Sentara Norfolk General HospitalNorfolk | 39 | $54,010 | $14,566 | $9,521 |
| Montgomery Regional HospitalBlacksburg | 37 | $46,748 | $12,814 | $9,316 |
| Stafford Hospital CenterStafford | 37 | $26,658 | $10,299 | $8,352 |
| UVA Health Haymarket Medical CenterHaymarket | 36 | $36,714 | $9,902 | $6,836 |
| The Fauquier Hospital, INCWarrenton | 35 | $49,872 | $9,207 | $7,998 |
| Sentara Careplex HospitalHampton | 35 | $38,100 | $10,698 | $8,776 |
| Community Memorial Healthcenter, INCSouth Hill | 34 | $35,757 | $10,155 | $8,308 |
| Wellmont Lonesome Pine HospitalBig Stone Gap | 33 | $36,375 | $13,904 | $10,268 |
| Bon Secours - Maryview Medical CenterPortsmouth | 26 | $28,125 | $11,296 | $8,847 |
| Southside Community Hospital, INCFarmville | 25 | $44,399 | $10,686 | $8,443 |
| Carilion New River Vly Med CtrChristiansburg | 24 | $39,361 | $10,631 | $9,317 |
| Riverside Tappahannock HospitalTappahannock | 24 | $46,570 | $12,388 | $11,440 |
| Carilion Franklin Memorial HospitalRocky Mount | 22 | $30,155 | $10,957 | $9,696 |
| Twin County Regional HospitalGalax | 22 | $53,316 | $10,929 | $9,297 |
| Wythe County Community HospitalWytheville | 20 | $52,573 | $11,539 | $10,296 |
| Alleghany Regional HospitalJackson River | 19 | $60,088 | $11,085 | $9,964 |
| Riverside Doctors' Hospital of WilliamsburgWilliamsburg | 19 | $23,587 | $8,256 | $7,055 |
| Russell County Medical CenterLebanon | 18 | $30,119 | $11,094 | $10,008 |
| Riverside Shore Memorial HospitalNassawadox | 16 | $23,876 | $9,773 | $8,345 |
| Smyth County Community HospitalMarion | 16 | $26,374 | $11,195 | $10,073 |
| Pulaski Community HospitalPulaski | 16 | $58,441 | $12,266 | $9,567 |
| Halifax Regional HospitalSouth Boston | 14 | $26,334 | $10,342 | $9,295 |
| Stonesprings Hospital CenterDulles | 14 | $63,029 | $10,138 | $8,975 |
| Bedford Memorial HospitalBedford | 13 | $26,216 | $10,664 | $9,158 |
| Southampton Memorial HospitalFranklin | 13 | $38,285 | $12,099 | $10,844 |
| Riverside Walter Reed HospitalGloucester | 13 | $20,669 | $8,693 | $7,312 |
| Carilion Tazewell Community HospitalTazewell | 12 | $26,896 | $11,015 | $9,232 |
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
| Riverside Doctors' Hospital of WilliamsburgWilliamsburg, VA | $8,256 |
|---|---|
| Martha Jefferson HospitalCharlottesville, VA | $8,440 |
| Riverside Walter Reed HospitalGloucester, VA | $8,693 |
| Sentara Williamsburg Regional Medical CenterWilliamsburg, VA | $9,094 |
| The Fauquier Hospital, INCWarrenton, VA | $9,207 |
Highest
| Medical College of Virginia HospitalsRichmond, VA | $19,951 |
|---|---|
| University of Virginia Medical CenterCharlottesville, VA | $19,874 |
| Sentara Norfolk General HospitalNorfolk, VA | $14,566 |
| Wellmont Lonesome Pine HospitalBig Stone Gap, VA | $13,904 |
| Inova Fairfax HospitalFalls Church, VA | $13,446 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in Virginia?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 66 hospitals in Virginia was billed at $44,680 on average, while the average total payment was $11,067, of which Medicare paid $8,652. 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.