Florida / HCA Florida Poinciana Hospital
CMS certification 100320 · Kissimmee, FL · 3 entries in CMS's price-transparency list
HCA Florida Poinciana Hospital: charges and Medicare payments
HCA Florida Poinciana Hospital reported 362 Medicare inpatient stays across 19 DRGs in 2024. Across them it charged 11.26 times what it was paid — among the higher ratios in Florida, number 25 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: 68 stays at an average charge of $177,641, 97% above the national average. It also billed 83 outpatient services, charging 31.52 times what Medicare paid.
- 1Medicare inpatient stays 362
- 2Charge ÷ paid, inpatient 11.26×
- 3Rank in FL (highest ratio = 1) 25 of 159
- 4CMS price-transparency actions 3
Inpatient stays
For the 19 DRGs that can be compared with the national average, HCA Florida Poinciana Hospital charged more than the national average in 19 (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 | 68 | $177,641 | +97% | $15,822 |
| 291 Heart Failure and Shock with MCC | 41 | $107,783 | +91% | $10,781 |
| 193 Simple Pneumonia and Pleurisy with MCC | 30 | $141,844 | +137% | $11,313 |
| 682 Renal Failure with MCC | 20 | $105,994 | +61% | $12,382 |
| 683 Renal Failure with CC | 20 | $98,909 | +143% | $8,087 |
| 177 Respiratory Infections and Inflammations with MCC | 18 | $126,715 | +80% | $13,212 |
| 149 Dysequilibrium | 15 | $115,364 | +160% | $7,120 |
| 069 Transient Ischemia without Thrombolytic | 14 | $117,292 | +133% | $8,421 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 14 | $73,231 | +155% | $5,845 |
| 312 Syncope and Collapse | 14 | $117,790 | +159% | $7,972 |
| 189 Pulmonary Edema and Respiratory Failure | 13 | $130,094 | +126% | $10,446 |
| 689 Kidney and Urinary Tract Infections with MCC | 13 | $110,243 | +115% | $10,045 |
| 101 Seizures without MCC | 12 | $108,727 | +123% | $8,323 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $103,085 | +71% | $11,815 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 12 | $82,170 | +122% | $7,236 |
| 690 Kidney and Urinary Tract Infections without MCC | 12 | $88,210 | +133% | $7,511 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 12 | $81,682 | +67% | $10,640 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 11 | $130,709 | +72% | $10,841 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 11 | $90,455 | +125% | $7,326 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 43 | $61,528 | $2,479 |
| Level 2 Upper GI Procedures | 40 | $44,126 | $1,724 |
Against the Florida average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), HCA Florida Poinciana Hospital charged $177,641 on average, 57% more than the Florida average of $112,838, and was paid $15,822 against a state average of $15,663. For Heart Failure and Shock with MCC (DRG 291), HCA Florida Poinciana Hospital charged $107,783 on average, 59% more than the Florida average of $67,659, and was paid $10,781 against a state average of $10,715. For Simple Pneumonia and Pleurisy with MCC (DRG 193), HCA Florida Poinciana Hospital charged $141,844 on average, 81% more than the Florida average of $78,292, and was paid $11,313 against a state average of $10,939. For Renal Failure with MCC (DRG 682), HCA Florida Poinciana Hospital charged $105,994 on average, 27% more than the Florida average of $83,694, and was paid $12,382 against a state average of $11,992. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $61,528 was 116% above the state average of $28,431. For Level 2 Upper GI Procedures (outpatient APC 5302), its average charge of $44,126 was 133% above the state average of $18,929.
Price-transparency record
CMS's enforcement list records these actions for a hospital named HCA Florida Poinciana Hospital in Kissimmee, 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 642)
- Closure Notice — 2023-10-02 (CMS case 642)
- Met Requirements — 2025-04-28 (CMS case 4174)
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.