HCA Florida Fort Walton-destin Hospital
HCA Florida Fort Walton-Destin Hospital in Fort Walton Beach charges 17.1x the Medicare reimbursement rate across 103 analyzed procedures, with 85% showing significant price variations.
Fort Walton Beach, FL 32547 · Acute Care Hospitals · CMS Rating: 3/5
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 — for-profit
For-profit hospitals in our dataset demonstrate distinct billing patterns, with 628 facilities showing an average markup of 7.8 times Medicare rates. These hospitals typically maintain higher charge structures across most service categories compared to non-profit and government facilities. Common patterns include substantial charges above benchmark rates for emergency services, surgical procedures, and diagnostic imaging. Patients should be aware that initial bills from for-profit hospitals often reflect chargemaster rates rather than negotiated insurance amounts. The billing structure frequently includes separate charges for facility fees, physician services, and ancillary services that may appear as multiple line items. Before receiving care, patients can request cost estimates and inquire about financial assistance programs, which are federally required at all hospital types. Understanding that insurance negotiations typically result in significantly lower actual payments than initial charges can help patients navigate the billing process more effectively when receiving care at for-profit facilities.
Pricing grade
F
Very high
Avg markup vs Medicare
17.15x
Charge / Medicare rate
Max markup
33.83x
Worst procedure
Procedures analyzed
103
With pricing data
Outlier procedures
85.4%
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 |
|---|---|---|---|---|---|
| CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC | 287 | $217,145 | $108,573 | — | 33.8x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITHOUT CC/MCC | 282 | $125,690 | $62,845 | — | 30x |
| DISORDERS OF PANCREAS EXCEPT MALIGNANCY WITH CC | 439 | $108,748 | $54,374 | — | 29.3x |
| MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC | 330 | $355,113 | $177,556 | — | 27.7x |
| EXTRACRANIAL PROCEDURES WITHOUT CC/MCC | 039 | $184,335 | $92,168 | — | 25.8x |
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $286,296 | $143,148 | — | 25x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $125,165 | $62,582 | — | 23.3x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC | 394 | $119,359 | $59,679 | — | 23.1x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC | 660 | $185,079 | $92,539 | — | 22.9x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $106,847 | $53,423 | — | 22.9x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC | 661 | $146,421 | $73,211 | — | 22.8x |
| TRAUMA TO THE SKIN, SUBCUTANEOUS TISSUE AND BREAST WITHOUT MCC | 605 | $121,743 | $60,871 | — | 22x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITHOUT CC/MCC | 494 | $252,233 | $126,117 | — | 21.7x |
| CHEST PAIN | 313 | $92,401 | $46,200 | — | 21.3x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC | 872 | $133,019 | $66,510 | — | 21.2x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC | 066 | $79,562 | $39,781 | — | 21x |
| SYNCOPE AND COLLAPSE | 312 | $107,446 | $53,723 | — | 20.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $98,302 | $49,151 | — | 20.8x |
| SEIZURES WITHOUT MCC | 101 | $113,725 | $56,862 | — | 20.7x |
| DYSEQUILIBRIUM | 149 | $88,007 | $44,004 | — | 20.5x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC | 482 | $202,730 | $101,365 | — | 20.4x |
| MAJOR GASTROINTESTINAL DISORDERS AND PERITONEAL INFECTIONS WITH CC | 372 | $134,564 | $67,282 | — | 20.3x |
| CORONARY BYPASS WITHOUT CARDIAC CATHETERIZATION WITHOUT MCC | 236 | $459,927 | $229,963 | — | 20.2x |
| DIABETES WITH MCC | 637 | $179,881 | $89,941 | — | 20.2x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $98,129 | $49,065 | — | 19.9x |
| CELLULITIS WITHOUT MCC | 603 | $107,845 | $53,922 | — | 19.7x |
| OTHER DIGESTIVE SYSTEM DIAGNOSES WITH MCC | 393 | $181,057 | $90,528 | — | 19.6x |
| OTHER VASCULAR PROCEDURES WITH CC | 253 | $327,990 | $163,995 | — | 19.6x |
| SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC | 460 | $343,072 | $171,536 | — | 19.6x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC | 481 | $248,552 | $124,276 | — | 19.4x |
| CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITHOUT MCC | 234 | $613,051 | $306,526 | — | 19.3x |
| LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC | 493 | $328,410 | $164,205 | — | 18.8x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC | 854 | $229,518 | $114,759 | — | 18.6x |
| KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH MCC | 659 | $300,077 | $150,038 | — | 18.6x |
| ATHEROSCLEROSIS WITHOUT MCC | 303 | $77,988 | $38,994 | — | 18.6x |
| FRACTURE, SPRAIN, STRAIN AND DISLOCATION EXCEPT FEMUR, HIP, PELVIS AND THIGH WITHOUT MCC | 563 | $90,712 | $45,356 | — | 18.6x |
| TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC | 069 | $83,827 | $41,914 | — | 18.5x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $79,391 | $39,695 | — | 18.3x |
| DIABETES WITH CC | 638 | $98,208 | $49,104 | — | 18.3x |
| FRACTURES OF HIP AND PELVIS WITHOUT MCC | 536 | $84,282 | $42,141 | — | 18.1x |
| AMPUTATION OF LOWER LIMB FOR ENDOCRINE, NUTRITIONAL AND METABOLIC DISORDERS WITH CC | 617 | $224,290 | $112,145 | — | 18x |
| HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH MCC | 480 | $323,319 | $161,660 | — | 17.9x |
| RENAL FAILURE WITH CC | 683 | $95,865 | $47,932 | — | 17.9x |
| NONSPECIFIC CEREBROVASCULAR DISORDERS WITH CC | 071 | $127,423 | $63,712 | — | 17.9x |
| RESPIRATORY NEOPLASMS WITH MCC | 180 | $206,151 | $103,076 | — | 17.7x |
| MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC | 470 | $209,521 | $104,760 | — | 17.6x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $79,128 | $39,564 | — | 17.5x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC | 310 | $54,636 | $27,318 | — | 17.5x |
| MAJOR CHEST PROCEDURES WITH MCC | 163 | $497,812 | $248,906 | — | 17.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $102,670 | $51,335 | — | 17.4x |
Showing 50 of 103 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