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HCA Florida West Hospital

HCA Florida West Hospital in Pensacola charges 12.7x the Medicare reimbursement rate on average, based on analysis of 107 common procedures at this for-profit facility.

Pensacola, FL 32514 · Acute Care Hospitals · CMS Rating: 3/5

By Kevin Nyk , Medical Billing Analyst · ·
Data from CMS files published FY 2024 CMS IPPS. Refreshed weekly.
About the analyst

Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.

107 procedures analyzed
CMS price transparency data
Updated 2026-04-03
Median 8.9x5.1x20.3x
12.7x
Medicare markup ratio
FL lowestHCA Florida West HospitalFL highest
12.7x
Avg markup ratio
12.2x
Median markup
107
Procedures
31%
Outlier procedures
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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

12.66x

Charge / Medicare rate

Max markup

23.28x

Worst procedure

Procedures analyzed

107

With pricing data

Outlier procedures

30.8%

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.

ProcedureCodeGross chargeCash priceMedicareMarkup
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITHOUT CC/MCC419$161,979$80,98923.3x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITHOUT CC/MCC066$77,132$38,56622.3x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC247$219,651$109,82621x
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITHOUT CC/MCC661$121,530$60,76520.2x
GASTROINTESTINAL OBSTRUCTION WITHOUT CC/MCC390$56,995$28,49719.9x
MAJOR SMALL AND LARGE BOWEL PROCEDURES WITH CC330$260,443$130,22119.6x
EXTRACRANIAL PROCEDURES WITHOUT CC/MCC039$130,900$65,45019.4x
LAPAROSCOPIC CHOLECYSTECTOMY WITHOUT C.D.E. WITH CC418$190,977$95,48819.2x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITHOUT CC/MCC310$42,286$21,14318x
MAJOR HIP AND KNEE JOINT REPLACEMENT OR REATTACHMENT OF LOWER EXTREMITY WITHOUT MCC470$194,657$97,32817.8x
CHEST PAIN313$63,305$31,65217.5x
INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS065$97,657$48,82817.4x
MAJOR JOINT OR LIMB REATTACHMENT PROCEDURES OF UPPER EXTREMITIES483$246,491$123,24517.3x
DYSEQUILIBRIUM149$68,664$34,33217.3x
PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITH MCC OR 4+ ARTERIES O246$272,973$136,48717.2x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC281$87,267$43,63317.1x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITHOUT MCC287$102,689$51,34416.8x
TRANSIENT ISCHEMIA WITHOUT THROMBOLYTIC069$70,750$35,37516.3x
CERVICAL SPINAL FUSION WITH CC472$257,787$128,89315.9x
OTHER MUSCULOSKELETAL SYSTEM AND CONNECTIVE TISSUE O.R. PROCEDURES WITH CC516$192,972$96,48615.2x
LOWER EXTREMITY AND HUMERUS PROCEDURES EXCEPT HIP, FOOT AND FEMUR WITH CC493$212,662$106,33115.1x
KIDNEY AND URETER PROCEDURES FOR NON-NEOPLASM WITH CC660$126,886$63,44315x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITH CC481$176,350$88,17515x
HYPERTENSION WITHOUT MCC305$62,757$31,37914.9x
OTHER DIGESTIVE SYSTEM DIAGNOSES WITH CC394$95,021$47,51114.9x
SYNCOPE AND COLLAPSE312$72,771$36,38614.8x
HIP AND FEMUR PROCEDURES EXCEPT MAJOR JOINT WITHOUT CC/MCC482$138,728$69,36414.7x
CORONARY BYPASS WITH CARDIAC CATHETERIZATION OR OPEN ABLATION WITH MCC233$705,669$352,83514.7x
PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC243$189,654$94,82714.4x
ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC392$63,265$31,63314.3x
DISORDERS OF THE BILIARY TRACT WITH CC445$91,844$45,92214.2x
CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC308$92,927$46,46413.9x
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH CC854$158,628$79,31413.8x
HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC522$171,749$85,87513.8x
PULMONARY EMBOLISM WITHOUT MCC176$62,534$31,26713.6x
GASTROINTESTINAL OBSTRUCTION WITH CC389$60,287$30,14313.5x
INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC853$370,274$185,13713.4x
SPINAL FUSION EXCEPT CERVICAL WITHOUT MCC460$311,948$155,97413.4x
ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC280$117,168$58,58413.3x
KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC690$56,885$28,44213.3x
OTHER O.R. PROCEDURES FOR INJURIES WITH CC908$142,927$71,46413.1x
ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC267$402,423$201,21112.9x
RENAL FAILURE WITH CC683$65,742$32,87112.7x
SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITHOUT MCC872$70,856$35,42812.6x
RED BLOOD CELL DISORDERS WITHOUT MCC812$66,911$33,45512.5x
MEDICAL BACK PROBLEMS WITHOUT MCC552$66,809$33,40412.4x
SEIZURES WITHOUT MCC101$59,651$29,82512.4x
CIRCULATORY DISORDERS EXCEPT AMI, WITH CARDIAC CATHETERIZATION WITH MCC286$172,396$86,19812.4x
OTHER DISORDERS OF NERVOUS SYSTEM WITH CC092$69,668$34,83412.4x
ALCOHOL, DRUG ABUSE OR DEPENDENCE WITHOUT REHABILITATION THERAPY WITHOUT MCC897$63,191$31,59512.3x

Showing 50 of 107 procedures

How HCA FLORIDA WEST HOSPITAL compares to nearby hospitals

Comparison based on average markup ratios from federal hospital pricing data (FY 2024). Chargemaster rates are gross charges — they are not what most insured patients pay. Actual costs depend on your insurance plan, negotiated rates, and coverage terms. This comparison is for informational purposes only and does not constitute medical, financial, or legal advice. Verify costs directly with your provider and insurer.

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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.

Rates shown are from the 2026 Medicare Physician Fee Schedule and CMS IPPS. BillRazor compares your bill against these data sources. See how it works →

FAQ — for-profit hospital billing

How much do for-profit hospitals typically charge compared to Medicare rates?
Based on data from 628 for-profit hospitals, the average markup is 7.8 times Medicare rates. This means charges are typically set at nearly 8 times what Medicare would pay for the same services.
Why do for-profit hospitals charge more than Medicare rates?
For-profit hospitals operate as businesses with shareholders and must generate revenue to cover operational costs and profit margins. Their pricing structure differs from Medicare's standardized payment rates, which are set by government formula rather than market conditions.
Does insurance typically pay the full hospital charge amount?
Most insurance companies negotiate contracted rates with hospitals that are lower than the posted charges. However, patients may still face significant out-of-pocket costs depending on their insurance coverage and deductible amounts.
What should I know about billing differences between hospital types?
For-profit hospitals generally have different pricing structures than non-profit or government-owned facilities due to their business model. Understanding your hospital's ownership type can provide context for potential billing differences when reviewing medical bills.

Related pricing data

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

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