MS-DRG 195
SIMPLE PNEUMONIA AND PLEUR
Relative Weight
0.6285
Geometric Mean LOS
2.2 Days
Arithmetic Mean LOS
2.7 Days
National Average Medicare Payments (FY 2024)
| Discharges | Avg Submitted Covered Charge | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| 1,837 | $29,678.67 | $5,989.34 | $3,957.12 |
State Average Medicare Payments (FY 2024)
| State | Discharges | Avg Total Payment | Avg Medicare Payment |
|---|---|---|---|
| AL | 31 | $5,231.65 | $3,290.04 |
| AZ | 65 | $5,724.79 | $4,235.31 |
| CA | 74 | $7,024.09 | $4,891.18 |
| CT | 13 | $7,213.85 | $5,471.15 |
| DE | 49 | $5,925.75 | $3,754.44 |
| FL | 284 | $6,040.96 | $4,127.23 |
| GA | 46 | $6,051.39 | $4,397.89 |
| IA | 13 | $4,144.54 | $2,891.62 |
| IL | 78 | $6,680.11 | $3,330.17 |
| IN | 45 | $4,753.44 | $3,270.67 |
| KS | 11 | $4,788.73 | $2,352.64 |
| KY | 75 | $4,581.37 | $2,964.80 |
| LA | 36 | $4,997.06 | $2,763.34 |
| MA | 132 | $5,563.33 | $3,724.04 |
| MD | 115 | $7,955.03 | $6,168.60 |
| MI | 13 | $4,522.62 | $2,807.15 |
| MN | 12 | $5,708.67 | $3,076.08 |
| MO | 59 | $5,383.96 | $3,533.25 |
| MS | 17 | $5,119.00 | $2,827.41 |
| NC | 87 | $5,487.94 | $3,577.02 |
| NE | 19 | $5,117.89 | $3,162.84 |
| NJ | 125 | $6,194.47 | $4,215.27 |
| NY | 178 | $7,227.74 | $4,859.39 |
| OH | 38 | $4,965.57 | $3,029.31 |
| OK | 25 | $5,565.36 | $3,703.05 |
| PA | 58 | $5,531.44 | $3,270.55 |
| RI | 12 | $7,154.83 | $4,142.25 |
| SC | 19 | $6,360.16 | $4,663.89 |
| TN | 15 | $4,950.53 | $3,098.07 |
| TX | 45 | $6,244.33 | $3,403.21 |
| VA | 20 | $5,478.20 | $3,438.60 |
| WI | 11 | $4,343.64 | $2,629.55 |
| WV | 17 | $4,281.47 | $2,841.47 |
Historical DRG Logic
| Effective Date | Weight | GMLOS | Post Acute Care |
|---|---|---|---|
| 2025-10-01 | 0.6285 | 2.2 | Yes |
| 2024-10-01 | 0.6227 | 2.3 | Yes |
| 2023-10-01 | 0.6256 | 2.4 | Yes |
| 2022-10-01 | 0.6418 | 2.3 | Yes |
| 2021-10-01 | 0.6658 | 2.5 | Yes |
| 2020-10-01 | 0.6650 | 2.5 | Yes |
| 2019-10-01 | 0.6821 | 2.6 | Yes |
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