Cape Coral Hospital
Cape Coral Hospital in Cape Coral, FL charges 7.1x the Medicare reimbursement rate across 87 analyzed procedures, representing a significant markup for this government-owned facility.
Cape Coral, FL 33990 · Acute Care Hospitals · CMS Rating: 4/5
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 — government
Government hospitals in our dataset demonstrate distinct billing patterns compared to other ownership types. With 374 facilities analyzed, these hospitals show an average markup of 4.2x Medicare rates, which typically falls below the industry average for comparable services. Government hospitals often maintain more standardized pricing structures due to regulatory oversight and public accountability requirements. Patients may encounter charges above the benchmark for certain procedures, though the potential difference between government hospital billing and private facilities can vary significantly by service type and geographic region. Common charge patterns include transparent itemization of services and adherence to established fee schedules. Patients should be aware that government hospitals frequently offer financial assistance programs and sliding scale payment options based on income eligibility. These facilities often provide detailed cost estimates upon request and maintain patient financial counselors to discuss billing arrangements before treatment when possible.
Pricing grade
D
High
Avg markup vs Medicare
7.08x
Charge / Medicare rate
Max markup
13.01x
Worst procedure
Procedures analyzed
87
With pricing data
Outlier procedures
0%
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 |
|---|---|---|---|---|---|
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $150,738 | $75,369 | — | 13x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $44,923 | $22,462 | — | 12.1x |
| OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITHOUT CC/MCC | 517 | $75,246 | $37,623 | — | 10.2x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $110,915 | $55,458 | — | 9.7x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC | 419 | $71,770 | $35,885 | — | 9.4x |
| SIMPLE PNEUMONIA AND PLEURISY WITHOUT CC/MCC | 195 | $30,121 | $15,061 | — | 9.2x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $51,814 | $25,907 | — | 9x |
| GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC | 390 | $24,000 | $12,000 | — | 9x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $48,306 | $24,153 | — | 8.8x |
| LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC | 418 | $87,249 | $43,625 | — | 8.8x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | 659 | $138,025 | $69,013 | — | 8.7x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $69,177 | $34,589 | — | 8.7x |
| PULMONARY EDEMA AND RESPIRATORY FAILURE | 189 | $60,744 | $30,372 | — | 8.7x |
| REVISION OF HIP OR KNEE REPLACEMENT WITH CC | 467 | $137,902 | $68,951 | — | 8.6x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $74,505 | $37,252 | — | 8.6x |
| BACK AND NECK PROCEDURES EXCEPT SPINAL FUSION WITH CC | 519 | $101,041 | $50,521 | — | 8.3x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $38,992 | $19,496 | — | 8.3x |
| SYNCOPE AND COLLAPSE | 312 | $41,360 | $20,680 | — | 8.2x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $106,919 | $53,459 | — | 8.2x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $34,906 | $17,453 | — | 8.2x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $67,093 | $33,546 | — | 8.2x |
| GASTROINTESTINAL OBSTRUCTION WITH MCC | 388 | $76,339 | $38,169 | — | 8.1x |
| HYPERTENSION WITHOUT MCC | 305 | $31,769 | $15,884 | — | 7.8x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | 661 | $47,270 | $23,635 | — | 7.7x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $96,059 | $48,030 | — | 7.5x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $32,365 | $16,183 | — | 7.4x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITH MCC | 521 | $135,368 | $67,684 | — | 7.4x |
| BRONCHITIS AND ASTHMA WITH CC/MCC | 202 | $39,758 | $19,879 | — | 7.3x |
| ENDOCRINE DISORDERS WITH MCC | 643 | $73,820 | $36,910 | — | 7.3x |
| PULMONARY EMBOLISM WITH MCC OR ACUTE COR PULMONALE | 175 | $58,956 | $29,478 | — | 7.3x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $32,287 | $16,144 | — | 7.3x |
| RESPIRATORY SYSTEM DIAGNOSIS WITH VENTILATOR SUPPORT <=96 HOURS | 208 | $125,616 | $62,808 | — | 7.2x |
| RED BLOOD CELL DISORDERS WITHOUT MCC | 812 | $36,509 | $18,254 | — | 7.2x |
| SIMPLE PNEUMONIA AND PLEURISY WITH CC | 194 | $32,518 | $16,259 | — | 7.2x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $32,324 | $16,162 | — | 7.1x |
| OTHER DISORDERS OF NERVOUS SYSTEM WITH CC | 092 | $44,662 | $22,331 | — | 7.1x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $42,510 | $21,255 | — | 7.1x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $39,326 | $19,663 | — | 7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $82,768 | $41,384 | — | 7x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH CC | 191 | $33,370 | $16,685 | — | 7x |
| MEDICAL BACK PROBLEMS WITHOUT MCC | 552 | $37,425 | $18,713 | — | 6.9x |
| DIABETES WITH CC | 638 | $34,049 | $17,024 | — | 6.9x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH MCC | 329 | $189,332 | $94,666 | — | 6.9x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $42,691 | $21,346 | — | 6.9x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $27,730 | $13,865 | — | 6.8x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH MCC | 371 | $70,680 | $35,340 | — | 6.8x |
| OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH MCC | 515 | $108,248 | $54,124 | — | 6.7x |
| CELLULITIS WITH MCC | 602 | $55,160 | $27,580 | — | 6.7x |
| OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC | 516 | $82,412 | $41,206 | — | 6.6x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $155,134 | $77,567 | — | 6.6x |
Showing 50 of 87 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.
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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