Florida / Hialeah Hospital
CMS certification 100053 · Hialeah, FL · 2 entries in CMS's price-transparency list
Hialeah Hospital: charges and Medicare payments
Hialeah Hospital reported 342 Medicare inpatient stays across 13 DRGs in 2024. Across them it charged 7.95 times what it was paid — mid-range in Florida, number 67 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 $118,856, 32% above the national average. It also billed 76 outpatient services, charging 24.21 times what Medicare paid.
- 1Medicare inpatient stays 342
- 2Charge ÷ paid, inpatient 7.95×
- 3Rank in FL (highest ratio = 1) 67 of 159
- 4CMS price-transparency actions 2
Inpatient stays
For the 13 DRGs that can be compared with the national average, Hialeah Hospital charged more than the national average in 13 (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 | $118,856 | +32% | $16,326 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 62 | $114,901 | +52% | $13,919 |
| 193 Simple Pneumonia and Pleurisy with MCC | 43 | $102,880 | +72% | $11,676 |
| 291 Heart Failure and Shock with MCC | 27 | $71,672 | +27% | $11,742 |
| 177 Respiratory Infections and Inflammations with MCC | 20 | $106,392 | +51% | $14,455 |
| 682 Renal Failure with MCC | 20 | $100,136 | +52% | $13,120 |
| 689 Kidney and Urinary Tract Infections with MCC | 20 | $87,131 | +70% | $10,888 |
| 377 Gastrointestinal Hemorrhage with MCC | 17 | $112,233 | +31% | $15,350 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 13 | $118,474 | +134% | $10,825 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 13 | $83,262 | +38% | $11,800 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 13 | $117,919 | +61% | $13,978 |
| 690 Kidney and Urinary Tract Infections without MCC | 12 | $72,553 | +92% | $8,417 |
| 870 Septicemia or Severe Sepsis with MV >96 Hours | 12 | $441,097 | +36% | $48,810 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 76 | $47,494 | $2,480 |
Against the Florida average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Hialeah Hospital charged $118,856 on average, 5% more than the Florida average of $112,838, and was paid $16,326 against a state average of $15,663. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Hialeah Hospital charged $114,901 on average, 23% more than the Florida average of $93,403, and was paid $13,919 against a state average of $12,779. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Hialeah Hospital charged $102,880 on average, 31% more than the Florida average of $78,292, and was paid $11,676 against a state average of $10,939. For Heart Failure and Shock with MCC (DRG 291), Hialeah Hospital charged $71,672 on average, 6% more than the Florida average of $67,659, and was paid $11,742 against a state average of $10,715. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $47,494 was 67% above the state average of $28,431.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Hialeah Hospital in Hialeah, FL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2026-01-26 (CMS case 6873)
- Warning Notice — 2026-07-29 (CMS case 8407)
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.