MS‑DRG 194: Simple Pneumonia and Pleurisy with CC

What Medicare paid hospitals for MS‑DRG 194 in 2024: nationally, state by state and across hospitals.

Paid per case$5,8800.4× the all-DRG average

Discharges41,9480.85% of all Medicare discharges

Total paid$246.7M70th largest MS‑DRG by spending

Hospitals1,522in 50 states and DC

Charges ÷ paid6.6×$38,636 average charge

Relative weight0.7888FY2027, 2.7-day geometric mean stay; FY2026 0.8059 (−2.1%)

In 2024 Medicare paid hospitals an average of $5,880 per discharge for MS‑DRG 194, across 41,948 fee-for-service discharges at 1,522 hospitals: 0.85% of all Medicare inpatient discharges and $246.7M in total, the 70th largest MS‑DRG by Medicare spending.

By state, the average ran from $4,469 in Kentucky to $12,937 in Alaska. Across hospitals, half were paid between $4,864 and $6,384 per case, and the median hospital $5,460; the payment moves with each hospital’s wage index, teaching and low-income share, and with outlier cases.

Hospitals charged $38,636 on average for these stays, 6.6 times what Medicare paid: charges are list prices, while Medicare pays a fixed amount per MS‑DRG.

See MS‑DRG 194 on the interactive map Price an MS‑DRG 194 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 194, FY2026 and FY2027
	FY2026	FY2027	Change
Relative weight	0.8059	0.7888	−2.1%
Geometric mean stay (days)	2.8	2.7	−0.1
Average stay (days)	3.4	3.3	−0.1

Not capped: the −2.1% 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)

$5,827.61

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 194
MS‑DRG	Severity	Payment ($)	Step ($)
193	with MCC	9,475.05	+3,647.44
194	with CC	5,827.61	—
195	without CC/MCC	4,479.31	−1,348.30

FY2027 inpatient rates: what else changed on October 1 · Price MS‑DRG 194 at a hospital

Paid per case, by state

MS‑DRG 194 by state, 2024
State	Paid per case	Discharges	Hospitals	Charges ÷ paid
Alaska	$12,937	40	3	2.8×
Maryland*	$9,465	1,592	37	1.3×
California	$7,630	2,664	109	9.6×
Wyoming	$7,575	89	5	3.3×
New York	$7,289	2,821	93	6.8×
Hawaii	$7,012	81	3	6.3×
Connecticut	$6,754	510	18	4.8×
Oregon	$6,498	148	8	4.2×
New Mexico	$6,412	88	4	4.8×
Georgia	$6,159	989	45	5.9×
Massachusetts	$6,095	1,792	46	3.2×
Texas	$6,091	2,194	94	7.6×
Nevada	$5,951	204	11	13.1×
Rhode Island	$5,911	183	7	4.1×
New Jersey	$5,907	1,869	49	11.2×
Washington	$5,871	289	14	6.0×
Maine	$5,846	153	8	4.1×
Delaware	$5,751	358	5	4.9×
North Carolina	$5,702	1,786	48	5.2×
District of Columbia	$5,657	39	2	6.2×
Arizona	$5,616	733	26	6.9×
Minnesota	$5,599	524	26	4.2×
Florida	$5,542	4,048	121	9.3×
Oklahoma	$5,517	774	30	6.7×
New Hampshire	$5,498	191	9	4.8×
South Dakota	$5,438	110	4	6.0×
Utah	$5,428	48	2	4.8×
Colorado	$5,422	187	9	10.1×
South Carolina	$5,341	826	33	6.5×
Virginia	$5,310	949	42	5.6×
Michigan	$5,296	1,066	42	4.6×
Indiana	$5,274	1,212	49	5.7×
Illinois	$5,262	1,960	67	6.3×
Pennsylvania	$5,261	2,190	80	7.8×
Missouri	$5,237	1,148	37	6.0×
Nebraska	$5,228	232	7	5.2×
Montana	$5,146	26	2	3.8×
Wisconsin	$5,116	444	23	5.5×
Mississippi	$5,057	532	25	6.7×
Tennessee	$5,025	732	33	6.6×
Idaho	$5,009	26	1	4.6×
Alabama	$4,986	891	37	5.6×
Ohio	$4,962	1,635	71	5.8×
Vermont	$4,861	51	3	5.2×
North Dakota	$4,857	113	4	4.2×
Arkansas	$4,664	528	25	5.7×
Iowa	$4,662	421	15	5.2×
Kansas	$4,662	329	14	7.9×
Louisiana	$4,659	806	32	6.6×
West Virginia	$4,650	453	17	6.0×
Kentucky	$4,469	874	27	6.7×
United States	$5,880	41,948	1,522	6.6×

* 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 194.

10th percentile	$4,364
25th percentile	$4,864
Median hospital	$5,460
75th percentile	$6,384
90th percentile	$7,633

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

193Simple Pneumonia and Pleurisy with MCC · $9,868
195Simple Pneumonia and Pleurisy without CC/MCC · $4,015

Nearby MS‑DRG numbers

196Interstitial Lung Disease with MCC

Questions

What did Medicare pay for MS‑DRG 194 in 2024?

An average of $5,880 per discharge across 41,948 fee-for-service discharges at 1,522 hospitals, $246.7M in total.

Which state paid the most for MS‑DRG 194?

Alaska, at $12,937 per case; Kentucky paid the least, $4,469.

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.