8/100
#2,446 nationally
Orlando Health Sebastian River Hospital
13695 Us Hwy 1, Sebastian, FL 32958 · (772) 589-3187
Among the highest charge markups in the country
For every $1 of care Medicare actually paid for here, Orlando Health Sebastian River Hospital billed $11.49 in list charges. That gap does not change a Medicare patient's bill — but it is where an uninsured or out-of-network bill starts.
- Charge-to-payment
- 11.5x
- volume-weighted across all its priced work
- Procedures priced
- 45
- inpatient and outpatient combined
- Rank in FL
- #110
- lower markup ranks higher
- CMS quality stars
- 4/5
- shown for context, not in the grade
How this grade was reached
Each component is scored against every other U.S. hospital in the same federal files, so the grade is a position in the country, not a pass mark we invented.
Better than 10% of U.S. hospitals.
Better than 5% of U.S. hospitals.
Better than 11% of U.S. hospitals.
Better than 5% of U.S. hospitals.
What this hospital treats most
The ten procedures it billed Medicare for most often, with its charge beside the national middle.
| Procedure | Patients | Charged | Actually paid | vs national |
|---|---|---|---|---|
|
Comprehensive Observation Services
APC 8011 · Hospital outpatient visit |
159 | $35,341 | $2,467 | +82% |
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
154 | $65,707 | $2,930 | +160% |
|
Level 3 Endovascular Procedures
APC 5193 · Hospital outpatient visit |
67 | $148,140 | $9,833 | +119% |
|
Sepsis (severe)
MS-DRG 871 · Inpatient stay |
61 | $86,718 | $12,381 | +33% |
|
Heart Failure (severe)
MS-DRG 291 · Inpatient stay |
51 | $63,523 | $8,610 | +46% |
|
Level 1 Laparoscopy and Related Services
APC 5361 · Hospital outpatient visit |
51 | $86,621 | $5,147 | +147% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
50 | $176,292 | $11,906 | +182% |
|
Level 3 Pacemaker and Similar Procedures
APC 5223 · Hospital outpatient visit |
49 | $83,226 | $9,666 | +62% |
|
Level 4 Musculoskeletal Procedures
APC 5114 · Hospital outpatient visit |
37 | $100,470 | $6,203 | +152% |
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
36 | $56,019 | $1,845 | +334% |
Where its charges run furthest above the national middle
Only procedures it performed at least eleven times, so a single unusual case cannot produce the headline.
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Level 3 Urology and Related Services
APC 5373 · Hospital outpatient visit |
$56,019 | $1,845 | +334% |
|
Level 3 Musculoskeletal Procedures
APC 5113 · Hospital outpatient visit |
$70,479 | $2,932 | +246% |
|
Level 4 Urology and Related Services
APC 5374 · Hospital outpatient visit |
$68,537 | $3,158 | +232% |
|
Level 5 Urology and Related Services
APC 5375 · Hospital outpatient visit |
$82,348 | $4,687 | +200% |
|
Level 5 Musculoskeletal Procedures
APC 5115 · Hospital outpatient visit |
$176,292 | $11,906 | +182% |
|
Level 5 ENT Procedures
APC 5165 · Hospital outpatient visit |
$96,308 | $5,305 | +180% |
|
Level 3 Vascular Procedures
APC 5183 · Hospital outpatient visit |
$53,050 | $2,887 | +178% |
|
Level 1 Endovascular Procedures
APC 5191 · Hospital outpatient visit |
$65,707 | $2,930 | +160% |
Where it charges least relative to everyone else
| Procedure | Charged | Actually paid | vs national |
|---|---|---|---|
|
Infection Needing Surgery (severe)
MS-DRG 853 · Inpatient stay |
$180,968 | $27,529 | about average |
|
Kidney Failure (severe)
MS-DRG 682 · Inpatient stay |
$54,777 | $10,229 | +3% |
|
Respiratory Failure
MS-DRG 189 · Inpatient stay |
$54,191 | $8,325 | +12% |
|
Respiratory Infection (severe)
MS-DRG 177 · Inpatient stay |
$65,371 | $9,889 | +19% |
|
Major Small and Large Bowel Procedures with Major Complications
MS-DRG 329 · Inpatient stay |
$215,459 | $26,571 | +20% |
|
Gastrointestinal Bleeding (with complications)
MS-DRG 378 · Inpatient stay |
$49,928 | $6,677 | +21% |
|
Gastrointestinal Obstruction with Complications
MS-DRG 389 · Inpatient stay |
$38,502 | $5,419 | +23% |
|
Pneumonia (severe)
MS-DRG 193 · Inpatient stay |
$59,772 | $8,868 | +28% |
What this page cannot tell you
- It is not your bill. These are averages across Medicare patients. What you pay depends on your insurance, your plan's negotiated rate and your own case.
- It is not a quality rating. A hospital with a high markup may be excellent, and one with a low markup may not be. We checked: across every U.S. hospital, markup and the CMS quality star rating barely move together.
- A charge is not a cost. Hospitals do not collect their list charges from insured patients. The number matters because it is the opening figure on an uninsured or out-of-network bill.
- Ask for the real number. Every U.S. hospital must publish a machine-readable price file and give you a written good-faith estimate on request.