MS-DRG 193
SIMPLE PNEUMONIA AND PLEUR
Relative Weight
1.3144
Geometric Mean LOS
3.9 Days
Arithmetic Mean LOS
4.9 Days
National Average Medicare Payments (FY 2024)
| Discharges | Avg Submitted Covered Charge | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| 136,649 | $56,184.17 | $12,157.80 | $10,038.65 |
State Average Medicare Payments (FY 2024)
| State | Discharges | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| AK | 278 | $17,947.18 | $16,452.30 |
| AL | 2,103 | $10,240.53 | $8,246.35 |
| AR | 1,963 | $9,659.01 | $8,140.49 |
| AZ | 2,886 | $11,881.10 | $10,034.22 |
| CA | 12,363 | $15,871.33 | $13,448.54 |
| CO | 1,429 | $11,614.00 | $9,626.28 |
| CT | 1,807 | $13,867.10 | $11,589.06 |
| DC | 223 | $17,045.59 | $12,175.99 |
| DE | 888 | $11,902.32 | $9,946.47 |
| FL | 11,649 | $11,044.03 | $9,256.00 |
| GA | 3,741 | $11,994.35 | $9,661.18 |
| HI | 475 | $16,404.08 | $13,686.93 |
| IA | 1,449 | $10,161.86 | $8,540.37 |
| ID | 463 | $11,437.85 | $9,242.51 |
| IL | 5,608 | $12,494.88 | $9,942.36 |
| IN | 3,772 | $11,016.30 | $9,307.12 |
| KS | 1,425 | $10,472.45 | $8,652.33 |
| KY | 2,917 | $10,145.34 | $8,337.33 |
| LA | 1,716 | $10,069.37 | $8,362.86 |
| MA | 5,043 | $12,921.07 | $10,841.93 |
| MD | 2,223 | $16,164.63 | $14,539.93 |
| ME | 522 | $11,953.85 | $9,988.48 |
| MI | 3,790 | $11,781.41 | $9,438.76 |
| MN | 1,680 | $11,997.05 | $9,841.25 |
| MO | 3,051 | $11,413.38 | $9,505.24 |
| MS | 1,478 | $10,133.48 | $8,630.60 |
| MT | 539 | $10,502.39 | $8,888.67 |
| NC | 4,202 | $11,371.73 | $9,262.55 |
| ND | 357 | $10,813.99 | $8,633.74 |
| NE | 628 | $11,215.82 | $8,970.09 |
| NH | 951 | $11,529.36 | $9,488.15 |
| NJ | 4,920 | $13,792.24 | $11,226.82 |
| NM | 891 | $12,492.46 | $10,487.52 |
| NV | 1,412 | $12,883.73 | $10,344.39 |
| NY | 7,313 | $15,736.07 | $12,710.30 |
| OH | 5,322 | $10,739.44 | $8,627.91 |
| OK | 2,073 | $10,406.84 | $8,786.31 |
| OR | 903 | $12,990.29 | $10,896.96 |
| PA | 5,303 | $11,215.82 | $8,942.69 |
| RI | 390 | $12,558.38 | $9,934.90 |
| SC | 2,319 | $11,031.48 | $8,906.48 |
| SD | 482 | $11,017.41 | $9,535.05 |
| TN | 3,473 | $10,294.79 | $8,436.03 |
| TX | 9,947 | $11,925.27 | $10,105.85 |
| UT | 709 | $11,179.51 | $8,803.20 |
| VA | 3,796 | $11,011.52 | $8,791.25 |
| VT | 262 | $8,654.23 | $6,504.55 |
| WA | 2,122 | $12,561.07 | $10,085.62 |
| WI | 1,776 | $10,828.52 | $8,840.92 |
| WV | 1,236 | $10,330.08 | $8,107.19 |
| WY | 381 | $15,285.43 | $13,360.80 |
Historical DRG Logic
| Effective Date | Weight | GMLOS | Post Acute Care |
|---|---|---|---|
| 2025-10-01 | 1.3144 | 3.9 | Yes |
| 2024-10-01 | 1.3177 | 4.0 | Yes |
| 2023-10-01 | 1.3266 | 4.1 | Yes |
| 2022-10-01 | 1.2987 | 4.0 | Yes |
| 2021-10-01 | 1.3120 | 4.1 | Yes |
| 2020-10-01 | 1.3107 | 4.1 | Yes |
| 2019-10-01 | 1.3335 | 4.2 | Yes |
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