Physicians Regional Medical Center - Pine Ridge: charges and Medicare payments

Physicians Regional Medical Center - Pine Ridge reported 5,215 Medicare inpatient stays across 131 DRGs in 2024. Across them it charged 11.75 times what it was paid — among the higher ratios in Florida, number 19 of 159 hospitals with at least 100 stays (state median 7.04×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 287 stays at an average charge of $90,639, 61% above the national average. It also billed 5,638 outpatient services, charging 15.37 times what Medicare paid.

1Medicare inpatient stays 5,215
2Charge ÷ paid, inpatient 11.75×
3Rank in FL (highest ratio = 1) 19 of 159
4CMS price-transparency actions 0

Average charge per stay at Physicians Regional Medical Center - Pine Ridge, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 131 DRGs that can be compared with the national average, Physicians Regional Medical Center - Pine Ridge charged more than the national average in 131 (100%). Payments follow Medicare's rates, so they usually vary far less than charges.

DRG	Stays	Avg charge	vs US	Avg paid
291 Heart Failure and Shock with MCC	287	$90,639	+61%	$8,596
871 Septicemia or Severe Sepsis without MV >96 Hours with MCC	256	$138,262	+53%	$13,044
690 Kidney and Urinary Tract Infections without MCC	163	$61,538	+63%	$5,780
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	141	$60,933	+52%	$5,465
309 Cardiac Arrhythmia and Conduction Disorders with CC	129	$64,777	+79%	$5,067
193 Simple Pneumonia and Pleurisy with MCC	124	$102,264	+71%	$8,756
177 Respiratory Infections and Inflammations with MCC	118	$106,961	+52%	$10,756
378 Gastrointestinal Hemorrhage with CC	109	$87,741	+81%	$6,813
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	108	$60,487	+63%	$5,447
274 Percutaneous and Other Intracardiac Procedures without MCC	103	$232,259	+48%	$21,753
312 Syncope and Collapse	92	$65,356	+44%	$5,916
194 Simple Pneumonia and Pleurisy with CC	90	$63,206	+65%	$5,577
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	89	$46,820	+63%	$3,799
603 Cellulitis without MCC	88	$52,911	+42%	$6,040
689 Kidney and Urinary Tract Infections with MCC	86	$80,199	+56%	$8,008
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	84	$79,731	+63%	$7,498
552 Medical Back Problems without MCC	81	$73,723	+51%	$6,771
266 Endovascular Cardiac Valve Replacement and Supplement...	77	$378,677	+33%	$43,218
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	72	$103,745	+86%	$6,719
481 Hip and Femur Procedures except Major Joint with CC	72	$210,149	+109%	$13,983
683 Renal Failure with CC	70	$71,335	+75%	$6,235
330 Major Small and Large Bowel Procedures with CC	69	$259,795	+118%	$15,659
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	68	$204,514	+100%	$15,086
322 Percutaneous Cardiovascular Procedures with Intraluminal...	63	$189,326	+65%	$14,665
305 Hypertension without MCC	62	$56,387	+41%	$5,552
190 Chronic Obstructive Pulmonary Disease with MCC	60	$85,440	+69%	$7,561
178 Respiratory Infections and Inflammations with CC	58	$76,874	+70%	$7,172
308 Cardiac Arrhythmia and Conduction Disorders with MCC	57	$110,543	+95%	$8,727
267 Endovascular Cardiac Valve Replacement and Supplement...	55	$274,618	+24%	$32,473
682 Renal Failure with MCC	54	$103,763	+57%	$10,219
698 Other Kidney and Urinary Tract Diagnoses with MCC	54	$100,047	+36%	$10,340
377 Gastrointestinal Hemorrhage with MCC	49	$139,887	+64%	$11,642
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	49	$100,567	+67%	$8,941
470 Major Hip and Knee Joint Replacement or Reattachment of...	46	$208,233	+123%	$12,809
483 Major Joint or Limb Reattachment Procedures of Upper...	46	$233,422	+85%	$16,840
329 Major Small and Large Bowel Procedures with MCC	45	$442,322	+106%	$33,513
699 Other Kidney and Urinary Tract Diagnoses with CC	45	$77,805	+64%	$6,770
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	44	$153,493	+54%	$12,850
280 Acute Myocardial Infarction, Discharged Alive with MCC	44	$139,675	+84%	$10,532
389 Gastrointestinal Obstruction with CC	42	$57,320	+47%	$5,831
321 Percutaneous Cardiovascular Procedures with Intraluminal...	40	$277,071	+69%	$20,425
069 Transient Ischemia without Thrombolytic	39	$74,744	+48%	$5,561
418 Laparoscopic Cholecystectomy without C.D.E. with CC	39	$160,014	+72%	$11,114
313 Chest Pain	37	$54,474	+36%	$4,882
287 Circulatory Disorders except AMI, with Cardiac...	36	$91,615	+43%	$7,916
281 Acute Myocardial Infarction, Discharged Alive with CC	35	$88,144	+75%	$6,469
189 Pulmonary Edema and Respiratory Failure	34	$87,214	+51%	$8,310
234 Coronary Bypass with Cardiac Catheterization or Open...	33	$499,267	+86%	$33,779
391 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	33	$85,863	+41%	$8,736
563 Fracture, Sprain, Strain and Dislocation except Femur, Hip,...	32	$65,253	+53%	$6,116
853 Infectious and Parasitic Diseases with O.R. Procedures with...	32	$307,537	+34%	$31,593
372 Major Gastrointestinal Disorders and Peritoneal Infections...	31	$92,681	+95%	$7,411
460 Spinal Fusion except Cervical without MCC	31	$383,887	+125%	$24,786
660 Kidney and Ureter Procedures for Non-Neoplasm with CC	29	$108,847	+61%	$11,459
286 Circulatory Disorders except AMI, with Cardiac...	28	$144,789	+29%	$14,592
812 Red Blood Cell Disorders without MCC	28	$74,722	+68%	$6,192
195 Simple Pneumonia and Pleurisy without CC/MCC	27	$48,220	+60%	$4,299
208 Respiratory System Diagnosis with Ventilator Support <=96...	27	$199,888	+47%	$18,071
390 Gastrointestinal Obstruction without CC/MCC	26	$49,354	+77%	$4,010
536 Fractures of Hip and Pelvis without MCC	26	$68,166	+81%	$5,378

Showing the 60 most frequent of 131 DRGs.

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Comprehensive Observation Services	1,179	$37,304	$2,470
Level 5 Musculoskeletal Procedures	611	$149,446	$11,839
Level 1 Endovascular Procedures	320	$40,113	$2,937
Level 6 Musculoskeletal Procedures	281	$181,329	$16,791
Level 4 Urology and Related Services	265	$43,290	$3,152
Level 3 Urology and Related Services	262	$37,688	$1,835
Level 5 Urology and Related Services	252	$59,756	$4,687
Level 3 Endovascular Procedures	238	$127,758	$9,892
Level 4 Musculoskeletal Procedures	222	$108,257	$6,457
Level 2 Musculoskeletal Procedures	182	$25,107	$1,451
Level 1 Laparoscopy and Related Services	181	$87,837	$5,182
Level 2 Upper GI Procedures	174	$20,734	$1,716
Level 3 Electrophysiologic Procedures	102	$149,280	$21,459
Level 3 Musculoskeletal Procedures	96	$65,315	$2,932
Level 2 Excision/ Biopsy/ Incision and Drainage	94	$29,517	$1,469
Level 3 Airway Endoscopy	89	$18,462	$1,524
Level 3 Vascular Procedures	88	$40,146	$2,887
Level 3 Pacemaker and Similar Procedures	83	$209,110	$9,666
Level 4 Gynecologic Procedures	81	$28,894	$2,749
Level 1 Breast/Lymphatic Surgery and Related Procedures	67	$67,792	$3,412
Level 3 Lower GI Procedures	62	$37,674	$2,461
Level 2 Endovascular Procedures	61	$62,136	$5,177
Level 2 Breast/Lymphatic Surgery and Related Procedures	59	$133,361	$5,907
Level 3 Excision/ Biopsy/ Incision and Drainage	57	$54,439	$2,538
Level 4 Endovascular Procedures	54	$191,194	$15,852

Against the Florida average

For Heart Failure and Shock with MCC (DRG 291), Physicians Regional Medical Center - Pine Ridge charged $90,639 on average, 34% more than the Florida average of $67,659, and was paid $8,596 against a state average of $10,715. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Physicians Regional Medical Center - Pine Ridge charged $138,262 on average, 23% more than the Florida average of $112,838, and was paid $13,044 against a state average of $15,663. For Kidney and Urinary Tract Infections without MCC (DRG 690), Physicians Regional Medical Center - Pine Ridge charged $61,538 on average, 28% more than the Florida average of $48,190, and was paid $5,780 against a state average of $7,285. For Esophagitis, Gastroenteritis and Miscellaneous Digestive Disorders without MCC (DRG 392), Physicians Regional Medical Center - Pine Ridge charged $60,933 on average, 14% more than the Florida average of $53,444, and was paid $5,465 against a state average of $7,095. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $37,304 was 31% above the state average of $28,431. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $149,446 was 40% above the state average of $106,979. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $40,113 was 4% below the state average of $41,880. For Level 6 Musculoskeletal Procedures (outpatient APC 5116), its average charge of $181,329 was 29% above the state average of $140,120.

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.