Florida / Coral Gables Hospital
CMS certification 100183 · Coral Gables, FL · 5 entries in CMS's price-transparency list
Coral Gables Hospital: charges and Medicare payments
Coral Gables Hospital reported 309 Medicare inpatient stays across 12 DRGs in 2024. Across them it charged 10.39 times what it was paid — among the higher ratios in Florida, number 36 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: 70 stays at an average charge of $148,857, 65% above the national average. It also billed 57 outpatient services, charging 20.84 times what Medicare paid.
- 1Medicare inpatient stays 309
- 2Charge ÷ paid, inpatient 10.39×
- 3Rank in FL (highest ratio = 1) 36 of 159
- 4CMS price-transparency actions 5
Inpatient stays
For the 12 DRGs that can be compared with the national average, Coral Gables Hospital charged more than the national average in 12 (100%). 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 | 70 | $148,857 | +65% | $15,186 |
| 193 Simple Pneumonia and Pleurisy with MCC | 48 | $118,890 | +99% | $10,937 |
| 689 Kidney and Urinary Tract Infections with MCC | 34 | $98,899 | +93% | $9,868 |
| 682 Renal Failure with MCC | 33 | $121,722 | +85% | $11,726 |
| 690 Kidney and Urinary Tract Infections without MCC | 26 | $85,103 | +125% | $7,068 |
| 683 Renal Failure with CC | 19 | $96,577 | +137% | $7,425 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 17 | $99,963 | +66% | $10,864 |
| 177 Respiratory Infections and Inflammations with MCC | 16 | $151,942 | +115% | $13,459 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 13 | $124,140 | +64% | $12,659 |
| 291 Heart Failure and Shock with MCC | 11 | $76,796 | +36% | $10,173 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $80,163 | +100% | $6,857 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 11 | $103,962 | +119% | $8,525 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 57 | $40,077 | $2,445 |
Against the Florida average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Coral Gables Hospital charged $148,857 on average, 32% more than the Florida average of $112,838, and was paid $15,186 against a state average of $15,663. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Coral Gables Hospital charged $118,890 on average, 52% more than the Florida average of $78,292, and was paid $10,937 against a state average of $10,939. For Kidney and Urinary Tract Infections with MCC (DRG 689), Coral Gables Hospital charged $98,899 on average, 58% more than the Florida average of $62,527, and was paid $9,868 against a state average of $9,734. For Renal Failure with MCC (DRG 682), Coral Gables Hospital charged $121,722 on average, 45% more than the Florida average of $83,694, and was paid $11,726 against a state average of $11,992. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $40,077 was 41% above the state average of $28,431.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Coral Gables Hospital in Coral Gables, FL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2021-10-27 (CMS case 201)
- CAP Request — 2022-10-14 (CMS case 201)
- Closure Notice — 2022-12-07 (CMS case 201)
- Met Requirements — 2026-01-28 (CMS case 6895)
- Warning Notice — 2026-07-23 (CMS case 8318)
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.