Simple pneumonia and pleurisy without complications in Rhode Island
What 1 hospital in Rhode Island charged and were paid for a Medicare hospital stay for simple pneumonia and pleurisy without complications (DRG 195), from 2024 Medicare claims.
Average charge
$21,166
Hospital list price billed
Average payment
$7,155
Medicare + patient + other payers
Medicare paid
$4,142
Average per stay
Volume
12
Medicare hospital stays
Hospitals in Rhode Island billed an average of $21,166 for simple pneumonia and pleurisy without complications, about 3.0 times the average total payment of $7,155. That payment is 19% 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 $7,155Billed $21,166
About 34¢ 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 without 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 | 12 | $21,166 | $7,155 | $4,142 |
Simple pneumonia and pleurisy without complications in other states
Questions
How much does simple pneumonia and pleurisy without complications cost in Rhode Island?
In 2024 Medicare data, a hospital stay for simple pneumonia and pleurisy without complications (DRG 195) at 1 hospital in Rhode Island was billed at $21,166 on average, while the average total payment was $7,155, of which Medicare paid $4,142. 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 3.0 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.