Florida / West Boca Medical Center
CMS certification 100268 · Boca Raton, FL · 3 entries in CMS's price-transparency list
West Boca Medical Center: charges and Medicare payments
West Boca Medical Center reported 936 Medicare inpatient stays across 36 DRGs in 2024. Across them it charged 11.83 times what it was paid — among the higher ratios in Florida, number 18 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: 160 stays at an average charge of $156,231, 73% above the national average. It also billed 994 outpatient services, charging 14.12 times what Medicare paid.
- 1Medicare inpatient stays 936
- 2Charge ÷ paid, inpatient 11.83×
- 3Rank in FL (highest ratio = 1) 18 of 159
- 4CMS price-transparency actions 3
Inpatient stays
For the 36 DRGs that can be compared with the national average, West Boca Medical Center charged more than the national average in 36 (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 | 160 | $156,231 | +73% | $13,421 |
| 291 Heart Failure and Shock with MCC | 68 | $102,174 | +81% | $8,625 |
| 177 Respiratory Infections and Inflammations with MCC | 57 | $112,001 | +59% | $10,343 |
| 193 Simple Pneumonia and Pleurisy with MCC | 47 | $114,571 | +92% | $8,723 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 44 | $72,852 | +81% | $6,377 |
| 689 Kidney and Urinary Tract Infections with MCC | 36 | $87,590 | +71% | $7,528 |
| 312 Syncope and Collapse | 32 | $85,238 | +87% | $6,347 |
| 690 Kidney and Urinary Tract Infections without MCC | 31 | $78,517 | +108% | $5,997 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 29 | $96,162 | +96% | $8,123 |
| 483 Major Joint or Limb Reattachment Procedures of Upper... | 28 | $216,420 | +71% | $16,498 |
| 603 Cellulitis without MCC | 26 | $69,951 | +88% | $6,014 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 23 | $339,903 | +48% | $29,329 |
| 481 Hip and Femur Procedures except Major Joint with CC | 22 | $203,094 | +102% | $13,234 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 21 | $126,822 | +67% | $10,780 |
| 682 Renal Failure with MCC | 20 | $106,988 | +62% | $9,882 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 19 | $63,878 | +72% | $6,012 |
| 189 Pulmonary Edema and Respiratory Failure | 18 | $88,354 | +53% | $7,856 |
| 454 Combined Anterior and Posterior Spinal Fusion with CC | 18 | $489,917 | +75% | $48,050 |
| 178 Respiratory Infections and Inflammations with CC | 17 | $92,374 | +104% | $7,110 |
| 683 Renal Failure with CC | 16 | $77,278 | +90% | $7,190 |
| 472 Cervical Spinal Fusion with CC | 15 | $223,927 | +57% | $21,404 |
| 552 Medical Back Problems without MCC | 15 | $83,623 | +71% | $6,301 |
| 308 Cardiac Arrhythmia and Conduction Disorders with MCC | 14 | $86,073 | +52% | $9,363 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 14 | $178,862 | +75% | $10,839 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 14 | $116,253 | +58% | $10,134 |
| 194 Simple Pneumonia and Pleurisy with CC | 13 | $80,430 | +110% | $5,930 |
| 305 Hypertension without MCC | 13 | $61,470 | +53% | $6,243 |
| 378 Gastrointestinal Hemorrhage with CC | 13 | $96,162 | +98% | $7,614 |
| 480 Hip and Femur Procedures except Major Joint with MCC | 13 | $237,087 | +71% | $17,596 |
| 389 Gastrointestinal Obstruction with CC | 12 | $79,818 | +105% | $5,107 |
| 391 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 12 | $96,636 | +58% | $8,038 |
| 812 Red Blood Cell Disorders without MCC | 12 | $92,153 | +108% | $6,319 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 11 | $71,164 | +41% | $6,361 |
| 300 Peripheral Vascular Disorders with CC | 11 | $79,643 | +61% | $7,861 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 11 | $68,905 | +91% | $6,060 |
| 377 Gastrointestinal Hemorrhage with MCC | 11 | $111,577 | +31% | $11,262 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 276 | $42,097 | $2,252 |
| Level 6 Musculoskeletal Procedures | 235 | $143,357 | $15,486 |
| Level 4 Musculoskeletal Procedures | 100 | $87,214 | $6,222 |
| Level 3 Musculoskeletal Procedures | 54 | $53,834 | $2,673 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 47 | $18,201 | $1,394 |
| Level 4 Gynecologic Procedures | 47 | $37,672 | $2,688 |
| Level 5 Urology and Related Services | 42 | $62,920 | $4,242 |
| Level 2 Musculoskeletal Procedures | 38 | $28,768 | $1,425 |
| Level 5 Musculoskeletal Procedures | 36 | $140,496 | $11,335 |
| Level 4 Urology and Related Services | 26 | $53,498 | $2,964 |
| Level 3 Urology and Related Services | 23 | $50,712 | $1,717 |
| Level 1 Laparoscopy and Related Services | 22 | $69,880 | $4,469 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 19 | $32,871 | $2,142 |
| Level 3 Vascular Procedures | 16 | $52,715 | $2,744 |
| Level 2 Upper GI Procedures | 13 | $33,414 | $1,618 |
Against the Florida average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), West Boca Medical Center charged $156,231 on average, 38% more than the Florida average of $112,838, and was paid $13,421 against a state average of $15,663. For Heart Failure and Shock with MCC (DRG 291), West Boca Medical Center charged $102,174 on average, 51% more than the Florida average of $67,659, and was paid $8,625 against a state average of $10,715. For Respiratory Infections and Inflammations with MCC (DRG 177), West Boca Medical Center charged $112,001 on average, 31% more than the Florida average of $85,454, and was paid $10,343 against a state average of $13,200. For Simple Pneumonia and Pleurisy with MCC (DRG 193), West Boca Medical Center charged $114,571 on average, 46% more than the Florida average of $78,292, and was paid $8,723 against a state average of $10,939. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $42,097 was 48% above the state average of $28,431. For Level 6 Musculoskeletal Procedures (outpatient APC 5116), its average charge of $143,357 was 2% above the state average of $140,120. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $87,214 was 18% above the state average of $74,087. For Level 3 Musculoskeletal Procedures (outpatient APC 5113), its average charge of $53,834 was 24% above the state average of $43,452.
Price-transparency record
CMS's enforcement list records these actions for a hospital named West Boca Medical Center in Boca Raton, FL, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Warning Notice — 2024-10-10 (CMS case 2807)
- Closure Notice — 2024-10-24 (CMS case 2807)
- Met Requirements — 2025-07-15 (CMS case 5756)
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.