Florida / Orlando Health Sebastian River Hospital
CMS certification 100217 · Sebastian, FL
Orlando Health Sebastian River Hospital: charges and Medicare payments
Orlando Health Sebastian River Hospital reported 499 Medicare inpatient stays across 25 DRGs in 2024. Across them it charged 8.11 times what it was paid — mid-range in Florida, number 63 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: 61 stays at an average charge of $86,718, 4% below the national average. It also billed 872 outpatient services, charging 18.6 times what Medicare paid.
- 1Medicare inpatient stays 499
- 2Charge ÷ paid, inpatient 8.11×
- 3Rank in FL (highest ratio = 1) 63 of 159
- 4CMS price-transparency actions 0
Inpatient stays
For the 25 DRGs that can be compared with the national average, Orlando Health Sebastian River Hospital charged more than the national average in 17 (68%). 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 | 61 | $86,718 | -4% | $12,381 |
| 291 Heart Failure and Shock with MCC | 51 | $63,523 | +13% | $8,610 |
| 177 Respiratory Infections and Inflammations with MCC | 33 | $65,371 | -7% | $9,889 |
| 193 Simple Pneumonia and Pleurisy with MCC | 31 | $59,772 | 0% | $8,868 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 27 | $81,862 | +8% | $10,514 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 23 | $62,285 | +3% | $8,654 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 21 | $45,257 | +13% | $5,357 |
| 481 Hip and Femur Procedures except Major Joint with CC | 21 | $142,304 | +41% | $13,229 |
| 190 Chronic Obstructive Pulmonary Disease with MCC | 19 | $59,494 | +18% | $7,482 |
| 690 Kidney and Urinary Tract Infections without MCC | 19 | $48,820 | +29% | $5,461 |
| 689 Kidney and Urinary Tract Infections with MCC | 17 | $60,457 | +18% | $6,812 |
| 330 Major Small and Large Bowel Procedures with CC | 16 | $179,780 | +51% | $15,715 |
| 682 Renal Failure with MCC | 16 | $54,777 | -17% | $10,229 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 15 | $148,703 | +45% | $13,469 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 13 | $42,968 | +19% | $5,054 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 13 | $175,873 | +54% | $12,395 |
| 310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC | 12 | $33,654 | +17% | $3,777 |
| 329 Major Small and Large Bowel Procedures with MCC | 12 | $215,459 | 0% | $26,571 |
| 378 Gastrointestinal Hemorrhage with CC | 12 | $49,928 | +3% | $6,677 |
| 389 Gastrointestinal Obstruction with CC | 12 | $38,502 | -1% | $5,419 |
| 189 Pulmonary Edema and Respiratory Failure | 11 | $54,191 | -6% | $8,325 |
| 312 Syncope and Collapse | 11 | $56,319 | +24% | $5,872 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 11 | $39,907 | +8% | $5,338 |
| 683 Renal Failure with CC | 11 | $50,835 | +25% | $6,099 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 11 | $180,968 | -21% | $27,529 |
Outpatient services
Against the Florida average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Orlando Health Sebastian River Hospital charged $86,718 on average, 23% less than the Florida average of $112,838, and was paid $12,381 against a state average of $15,663. For Heart Failure and Shock with MCC (DRG 291), Orlando Health Sebastian River Hospital charged $63,523 on average, 6% less than the Florida average of $67,659, and was paid $8,610 against a state average of $10,715. For Respiratory Infections and Inflammations with MCC (DRG 177), Orlando Health Sebastian River Hospital charged $65,371 on average, 24% less than the Florida average of $85,454, and was paid $9,889 against a state average of $13,200. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Orlando Health Sebastian River Hospital charged $59,772 on average, 24% less than the Florida average of $78,292, and was paid $8,868 against a state average of $10,939. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $35,341 was 24% above the state average of $28,431. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $65,707 was 57% above the state average of $41,880. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $148,140 was 44% above the state average of $102,708. For Level 1 Laparoscopy and Related Services (outpatient APC 5361), its average charge of $86,621 was 27% above the state average of $68,202.
Price-transparency record
No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.
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.