Simple pneumonia and pleurisy without complications in New York
What 12 hospitals in New York charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy without complications (DRG 195), from 2024 Medicare claims.
Average charge
$43,529
Hospital list price billed
Average payment
$7,218
Medicare + patient + other payers
Medicare paid
$4,872
Average per stay
State rank
#15 of 16
1 = lowest average payment
Hospitals in New York billed an average of $43,529 for simple pneumonia and pleurisy without complications, about 6.0 times the average total payment of $7,218. That payment is 20% above the U.S. average of $6,019.
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 $7,218Billed $43,529
About 17¢ was paid for every $1 hospitals in New York billed for this stay.
Medicare prices this stay in 3 versions, by how sick the patient was. Compare them in New York:
New York hospitals: simple pneumonia and pleurisy without complications
Every New York hospital that billed Medicare for this stay at least 11 times. Click a column to sort.
| Hospital | Stays | Avg charge | Avg payment | Medicare paid |
|---|---|---|---|---|
| St Francis Hospital, RoslynRoslyn | 22 | $36,714 | $5,462 | $3,840 |
| New York-Presbyterian HospitalNew York | 19 | $52,448 | $8,565 | $6,116 |
| Long Island Jewish Medical CenterNew Hyde Park | 16 | $57,587 | $7,759 | $5,477 |
| NYU Hospitals CenterNew York | 15 | $56,773 | $10,226 | $5,463 |
| St Joseph HospitalBethpage | 15 | $35,123 | $5,330 | $3,906 |
| Wynn HospitalUtica | 14 | $25,111 | $6,236 | $4,222 |
| Peconic Bay Medical CenterRiverhead | 14 | $47,629 | $6,425 | $4,397 |
| University HospitalStony Brook | 14 | $48,926 | $8,476 | $6,146 |
| New York Community Hospital of Brooklyn, INC.Brooklyn | 13 | $52,175 | $6,910 | $5,413 |
| North Shore University HospitalManhasset | 13 | $52,908 | $8,861 | $4,982 |
| Good Samaritan Hospital Medical CenterWest Islip | 12 | $36,695 | $6,164 | $4,653 |
| Crouse HospitalSyracuse | 11 | $12,208 | $6,319 | $3,698 |
Lowest and highest payments in New York
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 Joseph HospitalBethpage, NY | $5,330 |
|---|---|
| St Francis Hospital, RoslynRoslyn, NY | $5,462 |
| Good Samaritan Hospital Medical CenterWest Islip, NY | $6,164 |
| Wynn HospitalUtica, NY | $6,236 |
| Crouse HospitalSyracuse, NY | $6,319 |
Highest
| NYU Hospitals CenterNew York, NY | $10,226 |
|---|---|
| North Shore University HospitalManhasset, NY | $8,861 |
| New York-Presbyterian HospitalNew York, NY | $8,565 |
| University HospitalStony Brook, NY | $8,476 |
| Long Island Jewish Medical CenterNew Hyde Park, NY | $7,759 |
Simple pneumonia and pleurisy without complications in other states
Questions
How much does simple pneumonia and pleurisy without complications cost in New York?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy without complications (DRG 195) at 12 hospitals in New York was billed at $43,529 on average, while the average total payment was $7,218, of which Medicare paid $4,872. 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 York, average charges were 6.0 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.