Florida / Adventhealth Palm Coast

CMS certification 100118 · Palm Coast, FL · 2 entries in CMS's price-transparency list

Adventhealth Palm Coast: charges and Medicare payments

Adventhealth Palm Coast reported 1,588 Medicare inpatient stays across 54 DRGs in 2024. Across them it charged 4.42 times what it was paid — among the lower ratios in Florida, number 141 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: 316 stays at an average charge of $70,650, 22% below the national average. It also billed 1,355 outpatient services, charging 8.69 times what Medicare paid.

1Medicare inpatient stays 1,588
2Charge ÷ paid, inpatient 4.42×
3Rank in FL (highest ratio = 1) 141 of 159
4CMS price-transparency actions 2

Average charge per stay at Adventhealth Palm Coast, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 54 DRGs that can be compared with the national average, Adventhealth Palm Coast charged more than the national average in 2 (4%). 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	316	$70,650	-22%	$16,841
291 Heart Failure and Shock with MCC	85	$37,280	-34%	$10,694
280 Acute Myocardial Infarction, Discharged Alive with MCC	57	$52,360	-31%	$13,145
853 Infectious and Parasitic Diseases with O.R. Procedures with...	57	$160,274	-30%	$41,217
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	49	$39,991	-18%	$8,603
321 Percutaneous Cardiovascular Procedures with Intraluminal...	46	$124,212	-24%	$25,132
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	44	$40,749	+1%	$6,579
322 Percutaneous Cardiovascular Procedures with Intraluminal...	38	$88,226	-23%	$16,197
287 Circulatory Disorders except AMI, with Cardiac...	36	$41,399	-35%	$10,028
698 Other Kidney and Urinary Tract Diagnoses with MCC	35	$67,779	-8%	$13,673
312 Syncope and Collapse	33	$34,986	-23%	$7,808
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	32	$47,649	-14%	$8,525
690 Kidney and Urinary Tract Infections without MCC	30	$28,319	-25%	$6,714
193 Simple Pneumonia and Pleurisy with MCC	28	$40,737	-32%	$10,947
309 Cardiac Arrhythmia and Conduction Disorders with CC	28	$29,133	-19%	$6,313
069 Transient Ischemia without Thrombolytic	27	$43,822	-13%	$6,707
682 Renal Failure with MCC	26	$57,582	-13%	$12,419
689 Kidney and Urinary Tract Infections with MCC	25	$38,369	-25%	$9,814
189 Pulmonary Edema and Respiratory Failure	24	$46,671	-19%	$10,340
313 Chest Pain	24	$31,019	-22%	$6,483
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	23	$45,193	-25%	$10,972
286 Circulatory Disorders except AMI, with Cardiac...	22	$60,424	-46%	$19,365
330 Major Small and Large Bowel Procedures with CC	22	$108,930	-8%	$19,772
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	21	$60,973	-39%	$16,585
377 Gastrointestinal Hemorrhage with MCC	21	$74,599	-13%	$14,862
481 Hip and Femur Procedures except Major Joint with CC	21	$89,005	-12%	$18,672
683 Renal Failure with CC	20	$28,993	-29%	$7,238
521 Hip Replacement with Principal Diagnosis of Hip Fracture...	19	$109,885	-19%	$24,589
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	19	$29,444	-21%	$6,545
854 Infectious and Parasitic Diseases with O.R. Procedures with...	19	$90,415	-8%	$16,920
378 Gastrointestinal Hemorrhage with CC	18	$46,841	-4%	$8,209
480 Hip and Femur Procedures except Major Joint with MCC	18	$102,718	-26%	$24,435
177 Respiratory Infections and Inflammations with MCC	17	$47,259	-33%	$13,922
329 Major Small and Large Bowel Procedures with MCC	17	$162,691	-24%	$40,110
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	17	$92,864	-9%	$17,684
190 Chronic Obstructive Pulmonary Disease with MCC	16	$37,893	-25%	$9,664
308 Cardiac Arrhythmia and Conduction Disorders with MCC	16	$35,103	-38%	$10,106
483 Major Joint or Limb Reattachment Procedures of Upper...	16	$119,411	-5%	$24,662
813 Coagulation Disorders	16	$50,604	-37%	$13,036
178 Respiratory Infections and Inflammations with CC	15	$36,112	-20%	$8,194
305 Hypertension without MCC	15	$39,887	-1%	$6,309
389 Gastrointestinal Obstruction with CC	15	$34,375	-12%	$6,670
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	14	$48,272	-21%	$10,726
470 Major Hip and Knee Joint Replacement or Reattachment of...	14	$103,105	+11%	$15,743
394 Other Digestive System Diagnoses with CC	13	$35,301	-25%	$7,896
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	13	$53,961	-20%	$11,284
418 Laparoscopic Cholecystectomy without C.D.E. with CC	12	$84,760	-9%	$13,674
603 Cellulitis without MCC	12	$37,196	0%	$8,742
917 Poisoning and Toxic Effects of Drugs with MCC	12	$71,894	-4%	$13,436
149 Dysequilibrium	11	$39,752	-10%	$6,241
270 Other Major Cardiovascular Procedures with MCC	11	$161,348	-38%	$41,706
281 Acute Myocardial Infarction, Discharged Alive with CC	11	$41,587	-18%	$7,674
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	11	$32,925	-23%	$7,473
812 Red Blood Cell Disorders without MCC	11	$36,458	-18%	$7,576

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	187	$24,636	$2,479
Level 2 Upper GI Procedures	133	$12,513	$1,724
Level 1 Endovascular Procedures	124	$17,912	$2,957
Level 2 Excision/ Biopsy/ Incision and Drainage	107	$11,943	$1,469
Level 5 Musculoskeletal Procedures	96	$79,076	$11,906
Level 2 Endovascular Procedures	74	$27,849	$5,177
Level 3 Urology and Related Services	64	$20,974	$1,845
Level 3 Excision/ Biopsy/ Incision and Drainage	60	$21,626	$2,540
Level 3 Endovascular Procedures	58	$59,297	$9,786
Level 6 Musculoskeletal Procedures	51	$83,019	$16,567
Level 2 Urology and Related Services	49	$4,819	$612
Level 3 Musculoskeletal Procedures	46	$30,109	$2,881
Level 4 Urology and Related Services	45	$30,519	$3,158
Level 4 Musculoskeletal Procedures	43	$61,224	$6,480
Level 3 Vascular Procedures	42	$20,458	$2,887
Level 1 Laparoscopy and Related Services	37	$45,730	$5,227
Level 5 Urology and Related Services	35	$35,635	$4,687
Level 1 Breast/Lymphatic Surgery and Related Procedures	23	$32,251	$3,453
Level 2 Breast/Lymphatic Surgery and Related Procedures	16	$56,224	$5,907
Level 4 Endovascular Procedures	14	$76,212	$13,587
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	14	$28,507	$3,134
Level 3 Lower GI Procedures	13	$16,861	$2,541
Level 4 Gynecologic Procedures	13	$25,605	$2,832
Level 2 Vascular Procedures	11	$10,243	$1,451

Against the Florida average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Adventhealth Palm Coast charged $70,650 on average, 37% less than the Florida average of $112,838, and was paid $16,841 against a state average of $15,663. For Heart Failure and Shock with MCC (DRG 291), Adventhealth Palm Coast charged $37,280 on average, 45% less than the Florida average of $67,659, and was paid $10,694 against a state average of $10,715. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Adventhealth Palm Coast charged $52,360 on average, 44% less than the Florida average of $93,403, and was paid $13,145 against a state average of $12,779. For Infectious and Parasitic Diseases with O.R. Procedures with MCC (DRG 853), Adventhealth Palm Coast charged $160,274 on average, 46% less than the Florida average of $296,200, and was paid $41,217 against a state average of $39,358. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $24,636 was 13% below the state average of $28,431. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $12,513 was 34% below the state average of $18,929. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $17,912 was 57% below the state average of $41,880. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $11,943 was 18% below the state average of $14,597.

Price-transparency record

CMS's enforcement list records these actions for a hospital named Adventhealth Palm Coast in Palm Coast, FL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:

Warning Notice — 2025-02-28 (CMS case 3169)
Closure Notice — 2025-06-04 (CMS case 3169)

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.