DRG 199 Medical
Pneumothorax with MCC
Hospital inpatient stay cost data from CMS
Avg Medicare Payment
$11,467
National average
Avg Total Costs
$16,922
CMS Inpatient data
Avg Length of Stay
4.8 days
CMS MS-DRG
Est. Commercial Insurance
$17,200 — $28,667
1.5x — 2.5x Medicare
Annual Discharges
1,391
Medicare beneficiaries
CMS Inpatient National Data
From CMS Medicare Provider Utilization & Payment Data (FY 2023)
1,391
Total Discharges
$16,922
Avg Total Costs
$13,796
Avg Medicare Payment
Cost by Severity Level
NY SPARCS hospital discharge data (2022) — costs reflect New York State hospitals
| Severity | Discharges | Avg LOS | Avg Charges | Avg Costs | Median Costs |
|---|---|---|---|---|---|
| Extreme | 122 | 8.5 days | $73,223 | $24,254 | $18,320 |
| Major | 1,209 | 4.3 days | $34,290 | $11,493 | $8,727 |
| Minor | 2,380 | 2.5 days | $26,982 | $8,976 | $5,243 |
| Moderate | 3,288 | 2.9 days | $23,883 | $7,798 | $6,072 |
Frequently Asked Questions
How much does a hospital stay for pneumothorax with mcc cost?
The average Medicare payment for DRG 199 is $11,467. Average hospital costs are $16,922. Commercial insurance typically pays 150-250% of Medicare rates ($17,200 — $28,667).
How long is the hospital stay for DRG 199?
The average length of stay is 4.8 days. This varies by severity — NY data shows stays from 2.5 to 8.5 days depending on severity.
How much does this hospital stay cost without insurance?
Without insurance, you may be billed the hospital's chargemaster rate, which can be 3-5x the actual cost. Request an itemized bill and ask about financial assistance programs. Many hospitals offer 40-60% discounts for self-pay patients.