Orlando Health Sebastian River Hospital
Orlando Health Sebastian River Hospital in Sebastian, FL charges 11.7x the Medicare reimbursement rate on average, based on analysis of 27 procedures at this nonprofit facility.
Sebastian, FL 32958 · Acute Care Hospitals · CMS Rating: 3/5
About the analyst
Elena Vasquez leads hospital billing pattern analysis at BillRazor Research. She focuses on identifying overcharges, markup outliers, and patient advocacy strategies. Expertise: hospital billing patterns, overcharge analysis, patient advocacy.
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Pricing grade
F
Very high
Avg markup vs Medicare
11.66x
Charge / Medicare rate
Max markup
19.4x
Worst procedure
Procedures analyzed
27
With pricing data
Outlier procedures
14.8%
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.
| Procedure | Code | Gross charge | Cash price | Medicare | Markup |
|---|---|---|---|---|---|
| PERCUTANEOUS CARDIOVASCULAR PROCEDURES WITH DRUG-ELUTING STENT WITHOUT MCC | 247 | $200,448 | $100,224 | — | 19.4x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH CC | 309 | $59,557 | $29,779 | — | 18.4x |
| INTRACRANIAL HEMORRHAGE OR CEREBRAL INFARCTION WITH CC OR TPA IN 24 HOURS | 065 | $74,118 | $37,059 | — | 17.4x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH CC | 281 | $77,673 | $38,836 | — | 16.5x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITHOUT CC/MCC | 455 | $482,246 | $241,123 | — | 14.6x |
| HIP REPLACEMENT WITH PRINCIPAL DIAGNOSIS OF HIP FRACTURE WITHOUT MCC | 522 | $158,814 | $79,407 | — | 13.9x |
| COMBINED ANTERIOR AND POSTERIOR SPINAL FUSION WITH CC | 454 | $536,697 | $268,348 | — | 13.2x |
| GASTROINTESTINAL HEMORRHAGE WITH CC | 378 | $63,044 | $31,522 | — | 12.4x |
| CELLULITIS WITHOUT MCC | 603 | $55,823 | $27,911 | — | 12.2x |
| GASTROINTESTINAL OBSTRUCTION WITH CC | 389 | $46,075 | $23,037 | — | 12x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITHOUT MCC | 641 | $40,562 | $20,281 | — | 11.6x |
| KIDNEY AND URINARY TRACT INFECTIONS WITHOUT MCC | 690 | $44,852 | $22,426 | — | 11.6x |
| PERMANENT CARDIAC PACEMAKER IMPLANT WITH CC | 243 | $152,066 | $76,033 | — | 11.5x |
| ESOPHAGITIS, GASTROENTERITIS AND MISCELLANEOUS DIGESTIVE DISORDERS WITHOUT MCC | 392 | $41,506 | $20,753 | — | 11.5x |
| INFECTIOUS AND PARASITIC DISEASES WITH O.R. PROCEDURES WITH MCC | 853 | $287,368 | $143,684 | — | 10.4x |
| KIDNEY AND URINARY TRACT INFECTIONS WITH MCC | 689 | $62,188 | $31,094 | — | 10.3x |
| ACUTE MYOCARDIAL INFARCTION, DISCHARGED ALIVE WITH MCC | 280 | $85,950 | $42,975 | — | 9.9x |
| CHRONIC OBSTRUCTIVE PULMONARY DISEASE WITH MCC | 190 | $55,177 | $27,589 | — | 9.9x |
| RENAL FAILURE WITH CC | 683 | $45,362 | $22,681 | — | 9.7x |
| RENAL FAILURE WITH MCC | 682 | $70,165 | $35,083 | — | 9.2x |
| HEART FAILURE AND SHOCK WITH MCC | 291 | $62,335 | $31,167 | — | 9.1x |
| SEPTICEMIA OR SEVERE SEPSIS WITHOUT MV >96 HOURS WITH MCC | 871 | $94,149 | $47,074 | — | 8.9x |
| MISCELLANEOUS DISORDERS OF NUTRITION, METABOLISM, FLUIDS AND ELECTROLYTES WITH MCC | 640 | $61,937 | $30,968 | — | 8.9x |
| CARDIAC ARRHYTHMIA AND CONDUCTION DISORDERS WITH MCC | 308 | $53,259 | $26,630 | — | 8.5x |
| SIMPLE PNEUMONIA AND PLEURISY WITH MCC | 193 | $55,491 | $27,745 | — | 8.3x |
| GASTROINTESTINAL HEMORRHAGE WITH MCC | 377 | $76,640 | $38,320 | — | 8.1x |
| RESPIRATORY INFECTIONS AND INFLAMMATIONS WITH MCC | 177 | $76,445 | $38,223 | — | 7.5x |
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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