ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL
SEBASTIAN, FL 32958 · Acute Care Hospitals
27 procedures with CMS pricing data · Source: CMS IPPS Provider Summary, FY2024
By BillRazor Research · Last updated March 27, 2026 · Methodology
Procedures Analyzed
27
With CMS pricing data
Avg Charge-to-Medicare Ratio
11.7x
Chargemaster ÷ Medicare
CMS Quality Rating
Patient experience & outcomes
Hospital Type
Acute Care Hospitals
Voluntary non-profit - Private
Above 90th Percentile
15%
Compared to FL hospitals
Understanding Your Costs
When you receive a bill from ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL, you are typically seeing the hospital's “chargemaster” rate — its published list price for each service. According to CMS data, ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL lists chargemaster rates that average 11.7x the corresponding Medicare reimbursement amount across 27 procedures with publicly available pricing data (Source: CMS IPPS Provider Summary, FY2024).
The median hospital in FL has a chargemaster-to-Medicare ratio of 8.6x, with ratios across the state ranging from 1.0x to 20.0x. At 11.7x, this facility’s average ratio is above the state median. 165 hospitals in FL report pricing data to CMS (Source: CMS IPPS Provider Summary).
The procedure with the largest gap between the listed price and Medicare reimbursement at ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL is Percutaneous Cardiovascular Procedures with Drug-Eluting Stent without Major Complications (DRG 247). The listed chargemaster rate is $200,448, while Medicare reimburses $10,332 for the same procedure — a ratio of 19.4x (Source: CMS IPPS Provider Summary, FY2024).
What does this actually mean for your bill? Chargemaster rates are rarely what patients pay. If you have insurance, your insurer has negotiated a separate rate — often 40–60% less than the listed price. If you are uninsured, you may be able to negotiate directly with the hospital or request financial assistance. The chargemaster-to-Medicare ratio is a useful reference point for understanding listed pricing, but it does not represent what most patients will owe out of pocket.
4 of 27 procedures (15%) at this facility have listed rates above the 90th percentile compared to other FL hospitals reporting the same procedure data to CMS (Source: CMS IPPS Provider Summary).
ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL is a voluntary non-profit - private acute care hospitals facility with a CMS quality rating of 3/5 stars. Note: CMS quality ratings measure patient outcomes and experience, not pricing. A hospital with high listed prices may provide excellent care, and pricing data alone should not be used to evaluate the quality of a healthcare provider.
Listed Chargemaster Rates vs Medicare Reimbursement — Top Procedures by Ratio
Source: CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Procedure Pricing Lookup
Search for a specific procedure or DRG code to see listed chargemaster rates and Medicare reimbursement amounts.
| Procedure | DRG | Listed Charge | Medicare Reimb. | Ratio | State Position | |
|---|---|---|---|---|---|---|
| Percutaneous Cardiovascular Procedures with Drug-Eluting Stent without Major Complications | 247 | $200,448 | $10,332 | 19.4x | 1th | Compare your bill |
| Cardiac Arrhythmia and Conduction Disorders with Complications | 309 | $59,557 | $3,244 | 18.4x | 1th | Compare your bill |
| Intracranial Hemorrhage or Cerebral Infarction with Complications or Tpa in 24 Hours | 065 | $74,118 | $4,267 | 17.4x | 1th | Compare your bill |
| Acute Myocardial Infarction, Discharged Alive with Complications | 281 | $77,673 | $4,701 | 16.5x | 1th | Compare your bill |
| Combined Anterior and Posterior Spinal Fusion without Complications | 455 | $482,246 | $32,966 | 14.6x | 1th | Compare your bill |
| Hip Replacement with Principal Diagnosis of Hip Fracture without Major Complications | 522 | $158,814 | $11,390 | 13.9x | 1th | Compare your bill |
| Combined Anterior and Posterior Spinal Fusion with Complications | 454 | $536,697 | $40,756 | 13.2x | 1th | Compare your bill |
| Gastrointestinal Hemorrhage with Complications | 378 | $63,044 | $5,078 | 12.4x | 1th | Compare your bill |
| Cellulitis without Major Complications | 603 | $55,823 | $4,568 | 12.2x | 1th | Compare your bill |
| Gastrointestinal Obstruction with Complications | 389 | $46,075 | $3,844 | 12.0x | 1th | Compare your bill |
| Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes without Major Complications | 641 | $40,562 | $3,490 | 11.6x | 1th | Compare your bill |
| Kidney and Urinary Tract Infections without Major Complications | 690 | $44,852 | $3,870 | 11.6x | 1th | Compare your bill |
| Permanent Cardiac Pacemaker Implant with Complications | 243 | $152,066 | $13,179 | 11.5x | 1th | Compare your bill |
| Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without Major Complications | 392 | $41,506 | $3,619 | 11.5x | 1th | Compare your bill |
| Infectious and Parasitic Diseases with Operating Room Procedures with Major Complications or Comorbidities | 853 | $287,368 | $27,554 | 10.4x | 1th | Compare your bill |
| Kidney and Urinary Tract Infections with Major Complications or Comorbidities | 689 | $62,188 | $6,065 | 10.3x | 1th | Compare your bill |
| Acute Myocardial Infarction, Discharged Alive with Major Complications or Comorbidities | 280 | $85,950 | $8,687 | 9.9x | 1th | Compare your bill |
| Chronic Obstructive Pulmonary Disease with Major Complications or Comorbidities | 190 | $55,177 | $5,597 | 9.9x | 1th | Compare your bill |
| Renal Failure with Complications | 683 | $45,362 | $4,663 | 9.7x | 1th | Compare your bill |
| Renal Failure with Major Complications or Comorbidities | 682 | $70,165 | $7,594 | 9.2x | 1th | Compare your bill |
| Heart Failure and Shock with Major Complications or Comorbidities | 291 | $62,335 | $6,870 | 9.1x | 1th | Compare your bill |
| Septicemia or Severe Sepsis without Mechanical Ventilation over 96 Hours with Major Complications or Comorbidities | 871 | $94,149 | $10,548 | 8.9x | 1th | Compare your bill |
| Miscellaneous Disorders of Nutrition, Metabolism, Fluids and Electrolytes with Major Complications or Comorbidities | 640 | $61,937 | $6,977 | 8.9x | 1th | Compare your bill |
| Cardiac Arrhythmia and Conduction Disorders with Major Complications or Comorbidities | 308 | $53,259 | $6,250 | 8.5x | 1th | Compare your bill |
| Simple Pneumonia and Pleurisy with Major Complications or Comorbidities | 193 | $55,491 | $6,709 | 8.3x | 1th | Compare your bill |
| Gastrointestinal Hemorrhage with Major Complications or Comorbidities | 377 | $76,640 | $9,508 | 8.1x | 1th | Compare your bill |
| Respiratory Infections and Inflammations with Major Complications or Comorbidities | 177 | $76,445 | $10,139 | 7.5x | 1th | Compare your bill |
Showing 27 of 27 procedures
All data from CMS IPPS Provider Summary, FY2024. Chargemaster rates are list prices and may not reflect actual patient costs.
Statewide Context
Charge-to-Medicare ratio range across FL hospitals
165 hospitals in FL report pricing data to CMS. This facility's average ratio of 11.7x places it at the upper-middle range of the state range (Source: CMS IPPS Provider Summary).
What You Can Do
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How it worksData: CMS Inpatient Prospective Payment System (IPPS) Provider Summary, FY2024. All data is publicly available under federal law (45 CFR Part 180).
Important: Listed chargemaster rates are not what most insured patients pay. Actual costs depend on your insurance plan's negotiated rates, deductibles, and coverage terms. This information is for educational purposes only and does not constitute medical, legal, or financial advice.
Frequently Asked Questions About ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL
How much does ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL charge compared to Medicare?
According to CMS IPPS data, ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL's listed chargemaster rates average 11.7x the Medicare reimbursement amount across 27 procedures. Chargemaster rates are list prices and are not what most insured patients pay — actual costs depend on insurance negotiations and coverage terms.
What is the most expensive procedure at ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL?
The procedure with the highest chargemaster-to-Medicare ratio at ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL is Percutaneous Cardiovascular Procedures with Drug-Eluting Stent without Major Complications (DRG 247), with a listed charge of $200,448 compared to Medicare reimbursement of $10,332 — a ratio of 19.4x. Source: CMS IPPS Provider Summary.
Is ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL expensive compared to other FL hospitals?
ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL's average chargemaster-to-Medicare ratio is 11.7x. Ratios vary significantly across FL hospitals. This ratio reflects listed chargemaster prices, not what patients actually pay. CMS quality ratings, which measure patient outcomes and experience, are separate from pricing data.
Where does the pricing data for ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL come from?
All pricing data comes from the Centers for Medicare & Medicaid Services (CMS) Inpatient Prospective Payment System (IPPS) Provider Summary, published under federal price transparency law (45 CFR Part 180). This data is publicly available and updated annually.
How can I check if my bill from ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL is correct?
You can upload your bill to BillRazor for a free comparison against publicly available Medicare reimbursement data. Our system analyzes every line item in 60 seconds. Research suggests 49-80% of hospital bills contain errors, including duplicate charges, incorrect procedure codes, and unbundling.
Does ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL in SEBASTIAN, FL accept Medicare?
ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL is included in the CMS IPPS Provider Summary, which covers Medicare-participating hospitals. For specific coverage questions, contact ORLANDO HEALTH SEBASTIAN RIVER HOSPITAL directly or check with your insurance provider.
Data sourced from CMS IPPS Provider Summary, FY2024. All information is for educational purposes only.