Simple pneumonia and pleurisy with major complications in Wisconsin
What 53 hospitals in Wisconsin 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
$40,569
Hospital list price billed
Average payment
$11,266
Medicare + patient + other payers
Medicare paid
$9,072
Average per stay
State rank
#22 of 50
1 = lowest average payment
Hospitals in Wisconsin billed an average of $40,569 for simple pneumonia and pleurisy with major complications, about 3.6 times the average total payment of $11,266. That payment is 6% 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 $11,266Billed $40,569
About 28¢ was paid for every $1 hospitals in Wisconsin billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in Wisconsin:
Wisconsin hospitals: simple pneumonia and pleurisy with major complications
Every Wisconsin hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| University of Wi Hospitals & Clinics AuthorityMadison | 95 | $54,313 | $16,522 | $11,723 |
| Froedtert Mem Lutheran HsptlMilwaukee | 83 | $44,808 | $14,206 | $10,358 |
| St Mary's HospitalMadison | 80 | $44,209 | $10,557 | $8,180 |
| Aurora St Lukes Medical CenterMilwaukee | 80 | $64,609 | $12,623 | $9,091 |
| Luther Hospital Mayo Health SystemEau Claire | 74 | $35,147 | $10,459 | $8,949 |
| Meriter HsptlMadison | 67 | $61,421 | $12,123 | $9,877 |
| Aurora Med Ctr KenoshaKenosha | 64 | $39,235 | $10,142 | $7,841 |
| Columbia St Marys Hsptl Milw (Col & Milw Campus)Milwaukee | 61 | $47,754 | $11,773 | $9,584 |
| Waukesha Memorial HospitalWaukesha | 53 | $44,575 | $8,618 | $7,451 |
| Ascension SE Wisconsin HospitalMilwaukee | 49 | $31,361 | $11,184 | $9,089 |
| Froedtert SouthKenosha | 48 | $32,226 | $9,754 | $8,564 |
| Beloit Mem HsptlBeloit | 44 | $49,562 | $12,835 | $11,687 |
| Community Mem HsptlMenomonee Falls | 42 | $37,790 | $10,194 | $8,129 |
| Aurora Medical CenterGrafton | 40 | $41,454 | $8,963 | $7,984 |
| Marshfield Medical CenterMarshfield | 39 | $26,977 | $11,834 | $10,237 |
| St Clare Hsptl Hlth SvcsBaraboo | 38 | $36,103 | $11,798 | $10,382 |
| Gundersen Luth Med CtrLa Crosse | 38 | $21,755 | $11,551 | $9,338 |
| Aspirus Wausau HospitalWausau | 37 | $43,456 | $10,822 | $8,411 |
| Aurora Sheboygan Mem Med CtrSheboygan | 35 | $34,705 | $10,120 | $8,283 |
| Mercy Hlth Sys CorpJanesville | 33 | $66,593 | $13,609 | $8,988 |
| Marshfield Medical Center - Eau ClaireEau Claire | 32 | $34,525 | $9,269 | $7,994 |
| Mayo Clinic Health System-Franciscan Medical CenterLa Crosse | 31 | $34,273 | $11,619 | $8,664 |
| St Agnes HsptlFond du Lac | 30 | $32,140 | $10,028 | $8,942 |
| Howard Young Med CtrWoodruff | 30 | $26,324 | $11,087 | $9,891 |
| Wheaton Franciscan Healthcare- All SaintsRacine | 30 | $32,838 | $11,012 | $9,680 |
| Aurora Lakeland Med CtrElkhorn | 30 | $39,810 | $11,708 | $8,938 |
| St Elizabeth HsptlAppleton | 29 | $26,236 | $9,963 | $8,590 |
| Monroe ClinicMonroe | 29 | $37,742 | $11,938 | $10,041 |
| St Vincent HsptlGreen Bay | 27 | $44,898 | $9,692 | $8,724 |
| Bay Area Med CtrMarinette | 25 | $48,320 | $10,308 | $9,084 |
| Marshfield Medical Center - Rice LakeRice Lake | 23 | $21,632 | $11,164 | $9,958 |
| Aurora Memorial Hsptl BurlingtonBurlington | 22 | $31,284 | $9,546 | $8,062 |
| Appleton Med CtrAppleton | 22 | $27,450 | $11,082 | $8,135 |
| St Clare's Hospital of Weston INCWeston | 21 | $34,854 | $8,960 | $7,718 |
| Aurora West Allis Medical CenterWest Allis | 20 | $49,834 | $10,296 | $7,262 |
| Aurora Med Ctr OshkoshOshkosh | 20 | $31,406 | $10,055 | $7,809 |
| Aspirus Riverview Hospital & ClinicsWisconsin Rapids | 19 | $28,404 | $11,300 | $9,926 |
| St Josephs Com Hsptl West BendWest Bend | 18 | $41,194 | $8,602 | $7,424 |
| SSM Health St Mary's Hospital - JanesvilleJanesville | 18 | $42,374 | $9,269 | $7,999 |
| Bellin Memorial HsptlGreen Bay | 17 | $23,912 | $9,440 | $8,096 |
| Aurora Medical CenterSummit | 17 | $29,160 | $9,228 | $7,092 |
| Ministry St Michaels Hospital of Stevens PointStevens Point | 15 | $27,961 | $10,092 | $9,221 |
| Aspirus Rhinelander HospitalRhinelander | 15 | $44,295 | $14,322 | $9,495 |
| St Marys Hsptl Med CtrGreen Bay | 15 | $47,068 | $9,324 | $8,238 |
| Mile Bluff Medical Center, INCMauston | 15 | $38,341 | $12,003 | $10,590 |
| Aurora Med Center-Washington CountyHartford | 14 | $29,807 | $12,189 | $7,674 |
| Oconomowoc Mem HsptlOconomowoc | 14 | $32,498 | $8,910 | $7,627 |
| Fort HealthcareFort Atkinson | 14 | $32,220 | $10,979 | $9,580 |
| UW Hlth Partners - Watertown Regional Medical CtrWatertown | 14 | $34,936 | $11,096 | $8,962 |
| Divine Savior HlthcarePortage | 13 | $29,974 | $11,629 | $10,125 |
| St Nicholas HospitalSheboygan | 13 | $35,314 | $9,941 | $7,263 |
| Aurora Baycare Med CtrGreen Bay | 12 | $34,919 | $9,297 | $8,100 |
| Marshfield Medical Center - MinocquaMinocqua | 12 | $22,506 | $8,875 | $7,518 |
Lowest and highest payments in Wisconsin
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
| St Josephs Com Hsptl West BendWest Bend, WI | $8,602 |
|---|---|
| Waukesha Memorial HospitalWaukesha, WI | $8,618 |
| Marshfield Medical Center - MinocquaMinocqua, WI | $8,875 |
| Oconomowoc Mem HsptlOconomowoc, WI | $8,910 |
| St Clare's Hospital of Weston INCWeston, WI | $8,960 |
Highest
| University of Wi Hospitals & Clinics AuthorityMadison, WI | $16,522 |
|---|---|
| Aspirus Rhinelander HospitalRhinelander, WI | $14,322 |
| Froedtert Mem Lutheran HsptlMilwaukee, WI | $14,206 |
| Mercy Hlth Sys CorpJanesville, WI | $13,609 |
| Beloit Mem HsptlBeloit, WI | $12,835 |
Simple pneumonia and pleurisy with major complications in other states
Questions
How much does simple pneumonia and pleurisy with major complications cost in Wisconsin?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy with major complications (DRG 193) at 53 hospitals in Wisconsin was billed at $40,569 on average, while the average total payment was $11,266, of which Medicare paid $9,072. 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 Wisconsin, 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.