Florida / Boca Raton Regional Hospital
CMS certification 100168 · Boca Raton, FL · 4 entries in CMS's price-transparency list
Boca Raton Regional Hospital: charges and Medicare payments
Boca Raton Regional Hospital reported 6,686 Medicare inpatient stays across 164 DRGs in 2024. Across them it charged 6.28 times what it was paid — mid-range in Florida, number 91 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: 385 stays at an average charge of $89,909, 0% below the national average. It also billed 8,382 outpatient services, charging 10.05 times what Medicare paid.
- 1Medicare inpatient stays 6,686
- 2Charge ÷ paid, inpatient 6.28×
- 3Rank in FL (highest ratio = 1) 91 of 159
- 4CMS price-transparency actions 4
Inpatient stays
For the 164 DRGs that can be compared with the national average, Boca Raton Regional Hospital charged more than the national average in 72 (44%). 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 | 385 | $89,909 | 0% | $14,446 |
| 291 Heart Failure and Shock with MCC | 348 | $51,134 | -9% | $9,676 |
| 177 Respiratory Infections and Inflammations with MCC | 252 | $69,877 | -1% | $12,587 |
| 690 Kidney and Urinary Tract Infections without MCC | 221 | $32,808 | -13% | $6,087 |
| 193 Simple Pneumonia and Pleurisy with MCC | 193 | $54,651 | -9% | $10,138 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 174 | $36,885 | -8% | $6,147 |
| 603 Cellulitis without MCC | 155 | $29,052 | -22% | $6,701 |
| 378 Gastrointestinal Hemorrhage with CC | 139 | $45,267 | -7% | $7,766 |
| 689 Kidney and Urinary Tract Infections with MCC | 139 | $49,205 | -4% | $8,847 |
| 312 Syncope and Collapse | 129 | $38,109 | -16% | $6,747 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 113 | $176,508 | +13% | $24,085 |
| 194 Simple Pneumonia and Pleurisy with CC | 111 | $35,586 | -7% | $6,397 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 97 | $34,040 | -6% | $5,820 |
| 683 Renal Failure with CC | 89 | $39,210 | -4% | $6,948 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 86 | $47,749 | -3% | $7,885 |
| 178 Respiratory Infections and Inflammations with CC | 84 | $43,436 | -4% | $7,679 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 83 | $32,048 | -14% | $6,015 |
| 267 Endovascular Cardiac Valve Replacement and Supplement... | 76 | $304,228 | +38% | $38,535 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 74 | $68,161 | +13% | $10,479 |
| 481 Hip and Femur Procedures except Major Joint with CC | 72 | $101,642 | +1% | $15,472 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 66 | $66,691 | +32% | $8,726 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 65 | $56,282 | -1% | $9,423 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 63 | $253,762 | +11% | $41,396 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 62 | $68,417 | +23% | $7,569 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 61 | $77,198 | +2% | $11,840 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 61 | $25,335 | -12% | $4,283 |
| 389 Gastrointestinal Obstruction with CC | 60 | $32,516 | -16% | $6,293 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 58 | $127,170 | +11% | $13,854 |
| 330 Major Small and Large Bowel Procedures with CC | 58 | $116,787 | -2% | $17,739 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 58 | $106,112 | +4% | $16,043 |
| 682 Renal Failure with MCC | 58 | $69,245 | +5% | $10,299 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 57 | $69,097 | -6% | $11,841 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 56 | $38,227 | -19% | $7,627 |
| 329 Major Small and Large Bowel Procedures with MCC | 55 | $200,753 | -7% | $34,140 |
| 266 Endovascular Cardiac Valve Replacement and Supplement... | 54 | $333,519 | +17% | $48,931 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 52 | $94,573 | -5% | $14,585 |
| 812 Red Blood Cell Disorders without MCC | 49 | $41,240 | -7% | $7,086 |
| 394 Other Digestive System Diagnoses with CC | 48 | $41,597 | -12% | $7,158 |
| 377 Gastrointestinal Hemorrhage with MCC | 45 | $75,394 | -12% | $13,557 |
| 552 Medical Back Problems without MCC | 45 | $40,069 | -18% | $7,470 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 44 | $67,702 | +6% | $8,300 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 43 | $73,681 | +21% | $10,746 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 41 | $121,769 | +31% | $14,385 |
| 069 Transient Ischemia without Thrombolytic | 40 | $46,750 | -7% | $6,151 |
| 331 Major Small and Large Bowel Procedures without CC/MCC | 39 | $94,455 | +10% | $13,036 |
| 057 Degenerative Nervous System Disorders without MCC | 38 | $95,344 | +68% | $10,118 |
| 202 Bronchitis and Asthma with CC/MCC | 37 | $39,930 | -13% | $7,689 |
| 390 Gastrointestinal Obstruction without CC/MCC | 34 | $30,904 | +11% | $4,538 |
| 536 Fractures of Hip and Pelvis without MCC | 34 | $33,843 | -10% | $6,168 |
| 195 Simple Pneumonia and Pleurisy without CC/MCC | 33 | $28,393 | -6% | $4,870 |
| 445 Disorders of The Biliary Tract with CC | 33 | $79,240 | +36% | $8,394 |
| 025 Craniotomy and Endovascular Intracranial Procedures with MCC | 32 | $204,178 | -12% | $32,368 |
| 638 Diabetes with CC | 32 | $39,440 | -5% | $6,729 |
| 660 Kidney and Ureter Procedures for Non-Neoplasm with CC | 32 | $67,827 | +1% | $10,405 |
| 313 Chest Pain | 31 | $33,503 | -16% | $5,534 |
| 467 Revision of Hip or Knee Replacement with CC | 31 | $163,182 | +3% | $24,404 |
| 468 Revision of Hip or Knee Replacement without CC/MCC | 31 | $106,780 | -14% | $21,466 |
| 602 Cellulitis with MCC | 31 | $51,231 | -15% | $11,101 |
| 092 Other Disorders of Nervous System with CC | 30 | $46,480 | -10% | $7,708 |
| 314 Other Circulatory System Diagnoses with MCC | 30 | $77,715 | -18% | $16,353 |
Showing the 60 most frequent of 164 DRGs.
Outpatient services
Against the Florida average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Boca Raton Regional Hospital charged $89,909 on average, 20% less than the Florida average of $112,838, and was paid $14,446 against a state average of $15,663. For Heart Failure and Shock with MCC (DRG 291), Boca Raton Regional Hospital charged $51,134 on average, 24% less than the Florida average of $67,659, and was paid $9,676 against a state average of $10,715. For Respiratory Infections and Inflammations with MCC (DRG 177), Boca Raton Regional Hospital charged $69,877 on average, 18% less than the Florida average of $85,454, and was paid $12,587 against a state average of $13,200. For Kidney and Urinary Tract Infections without MCC (DRG 690), Boca Raton Regional Hospital charged $32,808 on average, 32% less than the Florida average of $48,190, and was paid $6,087 against a state average of $7,285. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $20,403 was 28% below the state average of $28,431. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $11,042 was 24% below the state average of $14,597. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $17,334 was 8% below the state average of $18,929. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $34,962 was 17% below the state average of $41,880.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Boca Raton Regional Hospital in Boca Raton, FL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-04-13 (CMS case 226)
- CAP Request — 2023-08-16 (CMS case 226)
- Closure Notice — 2023-10-16 (CMS case 226)
- Met Requirements — 2025-03-25 (CMS case 3400)
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.