Florida / Adventhealth Lake Wales
CMS certification 100099 · Lake Wales, FL · 2 entries in CMS's price-transparency list
Adventhealth Lake Wales: charges and Medicare payments
Adventhealth Lake Wales reported 362 Medicare inpatient stays across 15 DRGs in 2024. Across them it charged 7.92 times what it was paid — mid-range in Florida, number 68 of 159 hospitals with at least 100 stays (state median 7.04×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 97 stays at an average charge of $119,999, 33% above the national average. It also billed 330 outpatient services, charging 25.49 times what Medicare paid.
- 1Medicare inpatient stays 362
- 2Charge ÷ paid, inpatient 7.92×
- 3Rank in FL (highest ratio = 1) 68 of 159
- 4CMS price-transparency actions 2
Inpatient stays
For the 15 DRGs that can be compared with the national average, Adventhealth Lake Wales charged more than the national average in 14 (93%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 97 | $119,999 | +33% | $15,347 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 29 | $71,386 | -6% | $11,666 |
| 291 Heart Failure and Shock with MCC | 29 | $100,672 | +79% | $10,758 |
| 690 Kidney and Urinary Tract Infections without MCC | 29 | $57,834 | +53% | $6,733 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 21 | $64,941 | +62% | $9,033 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 21 | $337,468 | +47% | $42,108 |
| 689 Kidney and Urinary Tract Infections with MCC | 19 | $75,392 | +47% | $9,400 |
| 177 Respiratory Infections and Inflammations with MCC | 18 | $107,943 | +53% | $12,397 |
| 193 Simple Pneumonia and Pleurisy with MCC | 16 | $70,906 | +19% | $10,279 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 16 | $112,242 | +53% | $12,072 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 15 | $63,435 | +29% | $7,917 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 14 | $50,471 | +40% | $6,368 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $51,218 | +38% | $6,590 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 12 | $71,862 | +42% | $9,092 |
| 194 Simple Pneumonia and Pleurisy with CC | 12 | $62,021 | +62% | $8,145 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 155 | $41,307 | $2,484 |
| Level 1 Intraocular Procedures | 59 | $69,525 | $2,125 |
| Level 2 Upper GI Procedures | 33 | $26,996 | $1,735 |
| Level 3 Urology and Related Services | 21 | $43,443 | $1,858 |
| Level 1 Laparoscopy and Related Services | 20 | $104,974 | $5,262 |
| Level 5 Urology and Related Services | 17 | $100,027 | $4,719 |
| Level 3 Vascular Procedures | 14 | $55,393 | $2,907 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 11 | $28,504 | $1,479 |
Against the Florida average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Adventhealth Lake Wales charged $119,999 on average, 6% more than the Florida average of $112,838, and was paid $15,347 against a state average of $15,663. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Adventhealth Lake Wales charged $71,386 on average, 24% less than the Florida average of $93,403, and was paid $11,666 against a state average of $12,779. For Heart Failure and Shock with MCC (DRG 291), Adventhealth Lake Wales charged $100,672 on average, 49% more than the Florida average of $67,659, and was paid $10,758 against a state average of $10,715. For Kidney and Urinary Tract Infections without MCC (DRG 690), Adventhealth Lake Wales charged $57,834 on average, 20% more than the Florida average of $48,190, and was paid $6,733 against a state average of $7,285. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $41,307 was 45% above the state average of $28,431. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $69,525 was 191% above the state average of $23,896. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $26,996 was 43% above the state average of $18,929. For Level 3 Urology and Related Services (outpatient APC 5373), its average charge of $43,443 was 85% above the state average of $23,471.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Adventhealth Lake Wales in Lake Wales, FL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2025-03-05 (CMS case 3171)
- Closure Notice — 2025-06-06 (CMS case 3171)
A warning notice or corrective-action request is not a finding of wrongdoing; "Met Requirements" and closure notices record that CMS's review ended. Matched to this hospital by exact name, city and state.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.