MS-DRG 194
SIMPLE PNEUMONIA AND PLEUR
Relative Weight
0.8059
Geometric Mean LOS
2.8 Days
Arithmetic Mean LOS
3.4 Days
National Average Medicare Payments (FY 2024)
| Discharges | Avg Submitted Covered Charge | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| 41,948 | $38,572.83 | $7,904.97 | $5,906.62 |
State Average Medicare Payments (FY 2024)
| State | Discharges | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| AK | 40 | $14,806.16 | $12,763.87 |
| AL | 891 | $6,967.84 | $5,127.78 |
| AR | 528 | $6,448.89 | $4,821.52 |
| AZ | 733 | $7,623.67 | $5,833.11 |
| CA | 2,664 | $9,707.70 | $7,656.18 |
| CO | 187 | $6,996.58 | $5,360.12 |
| CT | 510 | $9,079.68 | $6,686.64 |
| DC | 39 | $9,349.42 | $5,730.85 |
| DE | 358 | $7,624.67 | $5,875.93 |
| FL | 4,048 | $7,545.05 | $5,623.01 |
| GA | 989 | $8,117.85 | $6,091.92 |
| HI | 81 | $11,199.24 | $7,447.04 |
| IA | 421 | $6,337.06 | $4,777.37 |
| ID | 26 | $6,404.54 | $5,008.85 |
| IL | 1,960 | $7,770.27 | $5,372.89 |
| IN | 1,212 | $6,916.58 | $5,327.88 |
| KS | 329 | $6,468.18 | $4,790.49 |
| KY | 874 | $6,549.83 | $4,579.48 |
| LA | 806 | $6,401.32 | $4,803.37 |
| MA | 1,792 | $8,337.83 | $6,315.18 |
| MD | 1,592 | $11,736.65 | $10,126.98 |
| ME | 153 | $7,609.61 | $5,738.85 |
| MI | 1,066 | $7,498.08 | $5,275.76 |
| MN | 524 | $7,525.62 | $5,514.25 |
| MO | 1,148 | $6,832.19 | $5,208.52 |
| MS | 532 | $6,734.50 | $5,236.27 |
| MT | 26 | $6,682.38 | $5,162.50 |
| NC | 1,786 | $7,744.80 | $5,674.43 |
| ND | 113 | $7,392.72 | $4,688.63 |
| NE | 232 | $7,057.30 | $5,374.34 |
| NH | 191 | $7,438.96 | $5,568.39 |
| NJ | 1,869 | $8,606.33 | $6,151.75 |
| NM | 88 | $7,317.12 | $6,018.19 |
| NV | 204 | $8,620.65 | $6,107.10 |
| NY | 2,821 | $9,882.53 | $7,369.46 |
| OH | 1,635 | $6,817.67 | $4,977.84 |
| OK | 774 | $7,119.97 | $5,615.07 |
| OR | 148 | $8,879.71 | $6,659.69 |
| PA | 2,190 | $7,226.75 | $5,140.30 |
| RI | 183 | $7,598.11 | $5,856.93 |
| SC | 826 | $7,312.27 | $5,286.08 |
| SD | 110 | $6,981.56 | $5,417.55 |
| TN | 732 | $7,047.19 | $4,894.71 |
| TX | 2,194 | $8,442.46 | $6,466.68 |
| UT | 48 | $7,733.55 | $5,432.83 |
| VA | 949 | $7,289.29 | $5,276.21 |
| VT | 51 | $7,237.92 | $5,216.28 |
| WA | 289 | $8,027.11 | $5,883.64 |
| WI | 444 | $7,343.72 | $5,201.55 |
| WV | 453 | $6,432.22 | $4,627.34 |
| WY | 89 | $9,512.25 | $7,619.65 |
Historical DRG Logic
| Effective Date | Weight | GMLOS | Post Acute Care |
|---|---|---|---|
| 2025-10-01 | 0.8059 | 2.8 | Yes |
| 2024-10-01 | 0.8200 | 2.8 | Yes |
| 2023-10-01 | 0.8222 | 2.9 | Yes |
| 2022-10-01 | 0.8402 | 2.9 | Yes |
| 2021-10-01 | 0.8639 | 3.1 | Yes |
| 2020-10-01 | 0.8630 | 3.1 | Yes |
| 2019-10-01 | 0.8886 | 3.2 | Yes |
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