Florida / HCA Florida Highlands Hospital
CMS certification 100049 · Sebring, FL · 2 entries in CMS's price-transparency list
HCA Florida Highlands Hospital: charges and Medicare payments
HCA Florida Highlands Hospital reported 522 Medicare inpatient stays across 21 DRGs in 2024. Across them it charged 8.72 times what it was paid — among the higher ratios in Florida, number 53 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: 128 stays at an average charge of $125,821, 39% above the national average. It also billed 470 outpatient services, charging 17.82 times what Medicare paid.
- 1Medicare inpatient stays 522
- 2Charge ÷ paid, inpatient 8.72×
- 3Rank in FL (highest ratio = 1) 53 of 159
- 4CMS price-transparency actions 2
Inpatient stays
For the 21 DRGs that can be compared with the national average, HCA Florida Highlands Hospital charged more than the national average in 18 (86%). 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 | 128 | $125,821 | +39% | $13,022 |
| 291 Heart Failure and Shock with MCC | 57 | $64,471 | +14% | $8,709 |
| 193 Simple Pneumonia and Pleurisy with MCC | 49 | $95,860 | +60% | $9,262 |
| 177 Respiratory Infections and Inflammations with MCC | 26 | $121,326 | +72% | $11,153 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 22 | $84,390 | +11% | $10,746 |
| 682 Renal Failure with MCC | 22 | $70,886 | +8% | $9,357 |
| 455 Combined Anterior and Posterior Spinal Fusion without CC/MCC | 21 | $221,426 | +9% | $30,248 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 18 | $51,322 | +5% | $7,026 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 17 | $283,502 | +1% | $40,048 |
| 683 Renal Failure with CC | 17 | $44,093 | +8% | $7,651 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 16 | $69,262 | +37% | $8,496 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 16 | $49,692 | +24% | $5,530 |
| 287 Circulatory Disorders except AMI, with Cardiac... | 15 | $69,857 | +9% | $7,416 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 15 | $48,273 | -20% | $8,685 |
| 689 Kidney and Urinary Tract Infections with MCC | 15 | $45,457 | -11% | $7,710 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 12 | $199,212 | +95% | $14,017 |
| 690 Kidney and Urinary Tract Infections without MCC | 12 | $40,263 | +6% | $5,840 |
| 069 Transient Ischemia without Thrombolytic | 11 | $47,487 | -6% | $10,448 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 11 | $65,313 | +29% | $6,330 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 11 | $89,792 | +59% | $8,074 |
| 324 Coronary Intravascular Lithotripsy with Intraluminal Device... | 11 | $301,328 | +73% | $25,947 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 5 Musculoskeletal Procedures | 74 | $130,993 | $11,767 |
| Comprehensive Observation Services | 61 | $26,792 | $2,479 |
| Level 1 Endovascular Procedures | 46 | $44,653 | $2,956 |
| Level 3 Airway Endoscopy | 43 | $29,695 | $1,537 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 30 | $25,282 | $1,469 |
| Level 4 Endovascular Procedures | 27 | $199,947 | $15,852 |
| Level 3 Extraocular, Repair, and Plastic Eye Procedures | 25 | $41,728 | $2,117 |
| Level 1 Laparoscopy and Related Services | 23 | $136,726 | $5,046 |
| Level 5 Urology and Related Services | 23 | $84,793 | $4,687 |
| Level 2 Vascular Procedures | 21 | $14,659 | $1,451 |
| Level 3 Urology and Related Services | 15 | $73,020 | $1,845 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 12 | $56,133 | $2,574 |
| Level 4 Musculoskeletal Procedures | 12 | $119,303 | $6,480 |
| Level 2 Endovascular Procedures | 12 | $69,169 | $5,177 |
| Level 3 Endovascular Procedures | 12 | $162,674 | $9,957 |
| Level 1 Nerve Procedures | 12 | $85,005 | $1,644 |
| Level 2 Musculoskeletal Procedures | 11 | $60,242 | $1,456 |
| Level 4 Urology and Related Services | 11 | $60,906 | $3,158 |
Against the Florida average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), HCA Florida Highlands Hospital charged $125,821 on average, 12% more than the Florida average of $112,838, and was paid $13,022 against a state average of $15,663. For Heart Failure and Shock with MCC (DRG 291), HCA Florida Highlands Hospital charged $64,471 on average, 5% less than the Florida average of $67,659, and was paid $8,709 against a state average of $10,715. For Simple Pneumonia and Pleurisy with MCC (DRG 193), HCA Florida Highlands Hospital charged $95,860 on average, 22% more than the Florida average of $78,292, and was paid $9,262 against a state average of $10,939. For Respiratory Infections and Inflammations with MCC (DRG 177), HCA Florida Highlands Hospital charged $121,326 on average, 42% more than the Florida average of $85,454, and was paid $11,153 against a state average of $13,200. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $130,993 was 22% above the state average of $106,979. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $26,792 was 6% below the state average of $28,431. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $44,653 was 7% above the state average of $41,880. For Level 3 Airway Endoscopy (outpatient APC 5153), its average charge of $29,695 was 56% above the state average of $19,034.
Price-transparency record
CMS's enforcement list records these actions for a hospital named HCA Florida Highlands Hospital in Sebring, FL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2024-02-14 (CMS case 1945)
- Met Requirements — 2025-05-01 (CMS case 4245)
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.