Adventhealth Zephyrhills
AdventHealth Zephyrhills charges 9.0x the Medicare reimbursement rate across 58 analyzed procedures, making it essential to understand potential costs at this nonprofit-religious hospital in Zephyrhills, Florida.
Zephyrhills, FL 33541 · Acute Care Hospitals · CMS Rating: 5/5
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
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Billing patterns — nonprofit-religious
Nonprofit religious hospitals, representing 203 facilities in the dataset, demonstrate an average markup of 5.4x Medicare rates, positioning them in the mid-range compared to other ownership types. These institutions typically maintain standardized charge structures across their health system networks, often reflecting their mission-driven approach to healthcare delivery. Patients at nonprofit religious hospitals may encounter charges above the benchmark for routine procedures, though many offer financial assistance programs and charity care policies that can significantly reduce out-of-pocket expenses for qualifying individuals. Common billing patterns include transparent pricing for elective procedures and comprehensive financial counseling services. The potential difference between listed charges and actual patient responsibility can be substantial, particularly for uninsured patients who may qualify for sliding-scale payment options. Patients should inquire about available financial assistance programs during the admissions process, as these hospitals often have more flexible payment arrangements compared to for-profit facilities, reflecting their tax-exempt status and community benefit obligations.
Pricing grade
F
Very high
Avg markup vs Medicare
9.04x
Charge / Medicare rate
Max markup
13.13x
Worst procedure
Procedures analyzed
58
With pricing data
Outlier procedures
1.7%
Above 90th percentile
Pricing grades reflect how this hospital's chargemaster (list) rates compare to Medicare reimbursement benchmarks within the same state. Grades measure pricing patterns only — not quality of care, patient outcomes, or clinical performance. A lower grade does not mean a hospital provides inferior care. Based on publicly available federal data. Not endorsed by or affiliated with any government agency.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| CHEST PAIN | 313 | $46,198 | $23,099 | — | 13.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $70,483 | $35,241 | — | 12.8x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $74,052 | $37,026 | — | 12.8x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $49,602 | $24,801 | — | 12.4x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $56,864 | $28,432 | — | 12.3x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $139,298 | $69,649 | — | 12.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $54,170 | $27,085 | — | 12x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $148,838 | $74,419 | — | 11.9x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $56,694 | $28,347 | — | 11.5x |
| HYPERTENSION WITHOUT MCC | 305 | $51,116 | $25,558 | — | 11.4x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $143,329 | $71,664 | — | 11.1x |
| CAROTID ARTERY STENT PROCEDURES WITH CC | 035 | $175,222 | $87,611 | — | 11x |
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $66,150 | $33,075 | — | 10.3x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $44,401 | $22,200 | — | 10.2x |
| EXTRACRANIAL PROCEDURES WITH CC | 038 | $96,754 | $48,377 | — | 10.1x |
| SEIZURES WITHOUT MCC | 101 | $51,801 | $25,900 | — | 10.1x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $128,994 | $64,497 | — | 10x |
| SYNCOPE AND COLLAPSE | 312 | $49,062 | $24,531 | — | 9.9x |
| AORTIC AND HEART ASSIST PROCEDURES EXCEPT PULSATION BALLOON WITHOUT MCC | 269 | $264,911 | $132,456 | — | 9.8x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $55,289 | $27,644 | — | 9.8x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $83,573 | $41,787 | — | 9.5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $42,229 | $21,114 | — | 9.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $27,356 | $13,678 | — | 9.3x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | 659 | $161,015 | $80,508 | — | 9.3x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $61,634 | $30,817 | — | 9.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $55,621 | $27,811 | — | 9.1x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $39,261 | $19,630 | — | 9.1x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $99,786 | $49,893 | — | 8.9x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $80,999 | $40,500 | — | 8.8x |
| DIABETES WITH CC | 638 | $43,096 | $21,548 | — | 8.8x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O | 246 | $160,510 | $80,255 | — | 8.7x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITH MCC | 391 | $61,068 | $30,534 | — | 8.6x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $51,262 | $25,631 | — | 8.5x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $50,051 | $25,026 | — | 8.5x |
| OTHER KIDNEY AND URINARY TRACT DIAGNOSES WITH CC | 699 | $54,175 | $27,087 | — | 8.4x |
| CELLULITIS WITHOUT MCC | 603 | $40,059 | $20,029 | — | 8.3x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH MCC | 242 | $174,017 | $87,008 | — | 8.2x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $129,635 | $64,818 | — | 8.2x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $48,291 | $24,146 | — | 8.1x |
| RENAL FAILURE WITH CC | 683 | $42,486 | $21,243 | — | 8.1x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH MCC | 064 | $82,032 | $41,016 | — | 8.1x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $45,880 | $22,940 | — | 8x |
| OTHER VASCULAR PROCEDURES WITH MCC | 252 | $151,976 | $75,988 | — | 7.7x |
| DIABETES WITH MCC | 637 | $63,227 | $31,613 | — | 7.7x |
| RENAL FAILURE WITH MCC | 682 | $63,253 | $31,627 | — | 7.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $55,084 | $27,542 | — | 7.3x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $220,203 | $110,101 | — | 7.2x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $68,034 | $34,017 | — | 7.1x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $34,762 | $17,381 | — | 7.1x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $80,944 | $40,472 | — | 7x |
Showing 50 of 58 procedures
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Pricing data from federal hospital transparency files and physician fee schedules. Last updated: . All data is publicly available under federal law.
FAQ — nonprofit-religious hospital billing
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Data: Federal hospital pricing data, updated annually. All data publicly available under federal law.
Methodology: Hospital gross charges divided by Medicare payment for the same DRG. A ratio of 3.0x means the hospital's listed price is 3 times what Medicare pays. Chargemaster rates are list prices — they are not what most insured patients pay. Grades measure pricing patterns only — not quality of care or clinical performance.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use