What is paid for pneumonia in the United States?
Doctor and hospital prices in the United States, from Centers for Medicare & Medicaid Services. This source is answered live, so the page shows how to ask, not a number.
An official average or median published by a statistics office or regulator, not individual sales.
ProofPrice reads Centers for Medicare & Medicaid Services when you ask, so the answer is always the latest published. It comes with its period, its source and its licence; a range built from records is given only when at least 5 records sit behind it.
Ask for it: /api/v1/medical?country=US&service=pneumonia
Where this comes from
- Source
- Medicare payments by service and state (CMS: Physician & Other Practitioners; Inpatient Hospitals), published by Centers for Medicare & Medicaid Services (CMS)
- Licence
- U.S. Government Works (the licence the Data.gov catalog lists for both datasets; no separate licence is stated on data.cms.gov). CPT(R) codes and descriptions in the physician file are covered by the AMA licence: "CPT codes, descriptions and other data only are copyright 1995 - 2025 American Medical Association." and "CPT is a registered trademark of the American Medical Association (AMA)." (https://www.cms.gov/license/ama). ProofPrice passes on Medicare payment amounts and the code numbers a caller supplies, and writes its own plain labels; it does not copy the CMS/AMA code descriptions. MS-DRG codes and titles in the inpatient file are the Medicare payment classification published by CMS (not AMA CPT).
- Attribution
- Source: Centers for Medicare & Medicaid Services, Medicare Physician & Other Practitioners - by Geography and Service, and Medicare Inpatient Hospitals - by Geography and Service (data.cms.gov). Amounts are what Medicare allowed or paid for fee-for-service patients, passed on as published. CPT is a registered trademark of the American Medical Association (AMA); CPT codes and descriptions are copyright AMA.
- How fresh the source is
- Annual: one calendar year at a time (the 2024 data year was released in 2026); every answer states its data year
- Limits
- What Medicare allowed or paid (Medicare Advantage is not included): Medicare-set rates, which are usually lower than private-insurance and cash prices, and not a quote. Doctor's 'facility' figures are the doctor's fee only; the hospital's or surgery centre's fee is separate. Hospital-stay figures are the hospital's total payment and exclude the surgeon's fee. Annual data, about 16 months old when released. CMS leaves out services and stays with 10 or fewer beneficiaries, so rare services and small states can be missing. What providers billed is a list price and is never shown as a price paid.
- Rule
- A figure built from records is shown only when at least 5 records sit behind it; official statistics are shown as such, with their reference period. See how we earn trust and the method.
Ask your AI
Add the ProofPrice MCP server (https://proofprice.com/api/mcp) to your AI app, then paste this. Not connected yet? See how to connect.
Using the ProofPrice MCP server (pricepaid_medical_prices): What is paid for pneumonia in the United States? Give the figure with its unit, the period it covers, the number of records where the source states one, and cite the source and licence.Use it in code
- MCP tool:
pricepaid_medical_priceswith{"country":"US","service":"pneumonia"} - REST (live answer): /api/v1/medical?country=US&service=pneumonia
- All parameters: openapi.json
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- This source and its licence
Information, not a valuation or offer. Ranges describe past recorded prices.