HCA Houston Healthcare Medical Center
HCA Houston Healthcare Medical Center in Houston, TX charges 14.0x the Medicare reimbursement rate on average, with 92% of analyzed procedures showing significant pricing variations.
Houston, TX 77004 · 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 — 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
14.02x
Charge / Medicare rate
Max markup
18.14x
Worst procedure
Procedures analyzed
13
With pricing data
Outlier procedures
92.3%
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 | $298,527 | $149,264 | — | 18.1x |
| PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITH MCC | 273 | $570,749 | $285,375 | — | 17.7x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $513,287 | $256,643 | — | 17.1x |
| PERCUTANEOUS AND OTHER INTRACARDIAC PROCEDURES WITHOUT MCC | 274 | $385,826 | $192,913 | — | 16.7x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $209,344 | $104,672 | — | 15.9x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $71,938 | $35,969 | — | 15.2x |
| CARDIAC VALVE AND OTHER MAJOR CARDIOTHORACIC PROCEDURES WITHOUT CARDIAC CATHETERIZATION | 219 | $957,935 | $478,968 | — | 14.4x |
| ECMO OR TRACHEOSTOMY WITH MV >96 HOURS OR PRINCIPAL DIAGNOSIS EXCEPT FACE, MOUTH AND NEC | 003 | $2,256,632 | $1,128,316 | — | 12.9x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITH MCC | 266 | $567,909 | $283,955 | — | 11.7x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $135,328 | $67,664 | — | 11.4x |
| RENAL FAILURE WITH MCC | 682 | $112,574 | $56,287 | — | 10.7x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $91,545 | $45,773 | — | 10.3x |
| ENDOVASCULAR CARDIAC VALVE REPLACEMENT AND SUPPLEMENT PROCEDURES WITHOUT MCC | 267 | $340,228 | $170,114 | — | 10.1x |
How HCA HOUSTON HEALTHCARE MEDICAL CENTER 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.
FAQ — for-profit 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