Simple pneumonia and pleurisy, with CCMS-DRG 194Pulmonology

How to read “% of Medicare”: Medicare’s payment is a hospital-specific benchmark built from CMS files — adjusted for local wages and case complexity, and roughly pegged to the cost of care. A commercial rate at 300% means a private plan pays about triple that benchmark for the same care at the same hospital. The gap is negotiation, not quality. Full methodology →

*Cost estimates use hospital-level cost-to-charge ratios from federal cost reports and are approximate; ~ marks categories (imaging, labs) where they are least precise. "Plan rows" is how many distinct plan rates the hospital published; medians over more rows are sturdier.