Florida / HCA Florida Mercy Hospital
CMS certification 100167 · Miami, FL · 4 entries in CMS's price-transparency list
HCA Florida Mercy Hospital: charges and Medicare payments
HCA Florida Mercy Hospital reported 705 Medicare inpatient stays across 28 DRGs in 2024. Across them it charged 12.79 times what it was paid — among the higher ratios in Florida, number 10 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: 107 stays at an average charge of $237,343, 163% above the national average. It also billed 544 outpatient services, charging 14.15 times what Medicare paid.
- 1Medicare inpatient stays 705
- 2Charge ÷ paid, inpatient 12.79×
- 3Rank in FL (highest ratio = 1) 10 of 159
- 4CMS price-transparency actions 4
Inpatient stays
For the 28 DRGs that can be compared with the national average, HCA Florida Mercy Hospital charged more than the national average in 28 (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 | 107 | $237,343 | +163% | $17,091 |
| 291 Heart Failure and Shock with MCC | 59 | $162,076 | +187% | $12,069 |
| 193 Simple Pneumonia and Pleurisy with MCC | 41 | $159,773 | +167% | $12,725 |
| 682 Renal Failure with MCC | 33 | $163,917 | +149% | $13,034 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 30 | $103,652 | +158% | $9,462 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 29 | $147,729 | +145% | $12,469 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 29 | $593,475 | +159% | $39,271 |
| 177 Respiratory Infections and Inflammations with MCC | 27 | $168,596 | +139% | $14,857 |
| 552 Medical Back Problems without MCC | 26 | $92,545 | +89% | $9,645 |
| 683 Renal Failure with CC | 26 | $114,051 | +180% | $9,755 |
| 312 Syncope and Collapse | 25 | $107,339 | +136% | $9,147 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 24 | $120,968 | +147% | $10,569 |
| 689 Kidney and Urinary Tract Infections with MCC | 22 | $168,076 | +227% | $11,240 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 20 | $196,565 | +168% | $14,429 |
| 690 Kidney and Urinary Tract Infections without MCC | 19 | $106,309 | +181% | $9,779 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 18 | $189,097 | +149% | $13,572 |
| 378 Gastrointestinal Hemorrhage with CC | 17 | $138,472 | +185% | $9,334 |
| 812 Red Blood Cell Disorders without MCC | 17 | $98,470 | +122% | $9,720 |
| 189 Pulmonary Edema and Respiratory Failure | 16 | $191,914 | +233% | $11,525 |
| 699 Other Kidney and Urinary Tract Diagnoses with CC | 16 | $112,961 | +138% | $10,874 |
| 811 Red Blood Cell Disorders with MCC | 16 | $141,290 | +107% | $12,707 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $171,516 | +181% | $11,489 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 14 | $89,102 | +140% | $8,403 |
| 252 Other Vascular Procedures with MCC | 12 | $315,175 | +84% | $28,115 |
| 389 Gastrointestinal Obstruction with CC | 12 | $80,883 | +108% | $8,978 |
| 638 Diabetes with CC | 12 | $80,410 | +93% | $10,637 |
| 884 Organic Disturbances and Intellectual Disability | 12 | $104,849 | +68% | $12,603 |
| 305 Hypertension without MCC | 11 | $88,026 | +120% | $8,008 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 182 | $56,193 | $2,469 |
| Level 1 Endovascular Procedures | 60 | $37,010 | $2,921 |
| Level 3 Electrophysiologic Procedures | 58 | $177,202 | $21,459 |
| Level 5 Musculoskeletal Procedures | 47 | $117,135 | $11,906 |
| Level 3 Endovascular Procedures | 40 | $135,079 | $9,957 |
| Level 3 Pacemaker and Similar Procedures | 32 | $110,856 | $9,168 |
| Level 1 Laparoscopy and Related Services | 29 | $84,874 | $5,083 |
| Level 4 Vascular Procedures | 18 | $60,736 | $4,978 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 17 | $20,263 | $1,352 |
| Level 4 Endovascular Procedures | 16 | $185,847 | $15,852 |
| Level 3 Vascular Procedures | 12 | $53,231 | $2,887 |
| Level 2 Pacemaker and Similar Procedures | 11 | $69,082 | $7,696 |
| Level 2 Upper GI Procedures | 11 | $33,279 | $1,724 |
| Level 2 Laparoscopy and Related Services | 11 | $100,496 | $9,319 |
Against the Florida average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), HCA Florida Mercy Hospital charged $237,343 on average, 110% more than the Florida average of $112,838, and was paid $17,091 against a state average of $15,663. For Heart Failure and Shock with MCC (DRG 291), HCA Florida Mercy Hospital charged $162,076 on average, 140% more than the Florida average of $67,659, and was paid $12,069 against a state average of $10,715. For Simple Pneumonia and Pleurisy with MCC (DRG 193), HCA Florida Mercy Hospital charged $159,773 on average, 104% more than the Florida average of $78,292, and was paid $12,725 against a state average of $10,939. For Renal Failure with MCC (DRG 682), HCA Florida Mercy Hospital charged $163,917 on average, 96% more than the Florida average of $83,694, and was paid $13,034 against a state average of $11,992. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $56,193 was 98% above the state average of $28,431. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $37,010 was 12% below the state average of $41,880. For Level 3 Electrophysiologic Procedures (outpatient APC 5213), its average charge of $177,202 was 9% below the state average of $195,231. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $117,135 was 9% above the state average of $106,979.
Price-transparency record
CMS's enforcement list records these actions for a hospital named HCA Florida Mercy Hospital in Miami, FL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2023-06-21 (CMS case 631)
- Closure Notice — 2023-10-10 (CMS case 631)
- Met Requirements — 2025-05-05 (CMS case 4328)
- Met Requirements — 2026-01-23 (CMS case 6868)
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.