MS‑DRG 193: Simple Pneumonia and Pleurisy with MCC

What Medicare paid hospitals for MS‑DRG 193 in 2024: nationally, state by state and across hospitals.

Paid per case$9,8680.7× the all-DRG average

Discharges136,6492.76% of all Medicare discharges

Total paid$1.3B8th largest MS‑DRG by spending

Hospitals2,442in 50 states and DC

Charges ÷ paid6.1×$60,101 average charge

Relative weight1.2825FY2027, 3.8-day geometric mean stay; FY2026 1.3144 (−2.4%)

In 2024 Medicare paid hospitals an average of $9,868 per discharge for MS‑DRG 193, across 136,649 fee-for-service discharges at 2,442 hospitals: 2.76% of all Medicare inpatient discharges and $1.3B in total, the 8th largest MS‑DRG by Medicare spending.

By state, the average ran from $6,593 in Vermont to $15,263 in Alaska. Across hospitals, half were paid between $8,305 and $10,927 per case, and the median hospital $9,330; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $60,101 on average for these stays, 6.1 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 193 on the interactive map Price an MS‑DRG 193 claim at any hospital Every MS‑DRG

What changed in FY2027

The rates for discharges from October 1, 2026 (MS‑DRG version 44) against FY2026.

MS‑DRG 193, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	1.3144	1.2825	−2.4%
Geometric mean stay (days)	3.9	3.8	−0.1
Average stay (days)	4.9	4.8	−0.1

Not capped: the −2.4% is CMS’s yearly recalibration of every weight from recent claims and cost data.
Name, MDC and transfer status are unchanged.

FY2027 national base payment (illustration)

$9,475.05

The FY2027 weight times the operating standardized amount and the capital rate ($6,848.00 + $539.95) at a wage index of 1.0. No IME, DSH, outlier or other hospital-specific adjustment, so it is not what any hospital is paid; price it at a hospital for that.

FY2027 national base payment across the severity levels of MS‑DRG 193
MS‑DRG	Severity	Payment ($)	Step ($)
193	with MCC	9,475.05	—
194	with CC	5,827.61	−3,647.44
195	without CC/MCC	4,479.31	−4,995.74

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 193 at a hospital

Paid per case, by state

MS‑DRG 193 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Alaska	$15,263	278	7	5.3×
Maryland*	$13,806	2,223	40	1.2×
Hawaii	$13,328	475	11	3.8×
California	$13,033	12,363	223	8.0×
Wyoming	$12,845	381	7	2.8×
New York	$12,580	7,313	116	6.2×
Connecticut	$11,728	1,807	25	4.2×
District of Columbia	$11,224	223	5	6.1×
Oregon	$11,218	903	24	3.4×
Massachusetts	$10,654	5,043	49	2.6×
New Jersey	$10,620	4,920	56	9.4×
Nevada	$10,347	1,412	19	10.7×
Rhode Island	$10,144	390	9	3.5×
New Mexico	$10,038	891	20	4.8×
Washington	$9,975	2,122	42	5.5×
Delaware	$9,830	888	6	4.0×
Arizona	$9,809	2,886	49	6.1×
Maine	$9,725	522	13	4.2×
Minnesota	$9,715	1,680	42	3.9×
South Dakota	$9,665	482	9	4.3×
Georgia	$9,652	3,741	73	5.9×
Texas	$9,602	9,947	179	7.8×
New Hampshire	$9,402	951	13	4.3×
Colorado	$9,288	1,429	38	7.5×
North Carolina	$9,259	4,202	72	4.3×
Illinois	$9,227	5,608	102	5.3×
Michigan	$9,169	3,790	69	3.9×
Wisconsin	$9,072	1,776	53	4.5×
Florida	$9,070	11,649	159	8.6×
Idaho	$9,070	463	10	4.9×
Pennsylvania	$9,063	5,303	109	6.6×
Missouri	$9,012	3,051	56	5.4×
Utah	$8,909	709	22	4.2×
South Carolina	$8,894	2,319	46	6.0×
Indiana	$8,888	3,772	70	4.9×
Montana	$8,867	539	10	3.3×
Nebraska	$8,857	628	16	4.7×
North Dakota	$8,777	357	6	3.6×
Oklahoma	$8,730	2,073	47	6.1×
Virginia	$8,652	3,796	66	5.2×
Kansas	$8,590	1,425	29	6.5×
Ohio	$8,469	5,322	101	4.9×
Iowa	$8,347	1,449	27	4.0×
Mississippi	$8,214	1,478	37	5.9×
Tennessee	$8,209	3,473	63	5.9×
Kentucky	$8,151	2,917	55	5.4×
West Virginia	$8,077	1,236	21	5.1×
Alabama	$8,054	2,103	45	6.4×
Louisiana	$8,043	1,716	37	6.2×
Arkansas	$7,964	1,963	33	5.2×
Vermont	$6,593	262	6	5.1×
United States	$9,868	136,649	2,442	6.1×

* Maryland hospitals are paid under the state’s all-payer model, not the IPPS, so Maryland is left out of the state range above.

How much hospitals vary

Each hospital’s own average Medicare payment for MS‑DRG 193.

10th percentile	$7,595
25th percentile	$8,305
Median hospital	$9,330
75th percentile	$10,927
90th percentile	$13,052

Related analysis

Transfers and the per-diem rule: when a short stay pays less than the full DRG · Inpatient DRG
DRG validation and the single-MCC claim: when one code moves the payment · Payment integrity

The same condition at other severities

194Simple Pneumonia and Pleurisy with CC · $5,880
195Simple Pneumonia and Pleurisy without CC/MCC · $4,015

Questions

What did Medicare pay for MS‑DRG 193 in 2024?

An average of $9,868 per discharge across 136,649 fee-for-service discharges at 2,442 hospitals, $1.3B in total.

Which state paid the most for MS‑DRG 193?

Alaska, at $15,263 per case; Vermont paid the least, $6,593.

Where do these figures come from?

From the Medicare Inpatient Hospitals - by Provider and Service (data year 2024): the published hospital-by-DRG averages of Medicare fee-for-service inpatient discharges in 2024. Cells with fewer than 11 discharges are not published, so a hospital with a handful of cases is not counted. Average Medicare payment excludes the patient’s deductible and coinsurance.