Hawaii / Adventist Health Castle
CMS certification 120006 · Kailua, HI · 3 entries in CMS's price-transparency list
Adventist Health Castle: charges and Medicare payments
Adventist Health Castle reported 775 Medicare inpatient stays across 26 DRGs in 2024. Across them it charged 2.84 times what it was paid — mid-range in Hawaii, number 6 of 11 hospitals with at least 100 stays (state median 2.84×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 145 stays at an average charge of $50,846, 44% below the national average. It also billed 779 outpatient services, charging 5.11 times what Medicare paid.
- 1Medicare inpatient stays 775
- 2Charge ÷ paid, inpatient 2.84×
- 3Rank in HI (highest ratio = 1) 6 of 11
- 4CMS price-transparency actions 3
Inpatient stays
For the 26 DRGs that can be compared with the national average, Adventist Health Castle charged more than the national average in 0 (0%). 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 | 145 | $50,846 | -44% | $19,327 |
| 885 Psychoses | 80 | $31,216 | -29% | $13,913 |
| 177 Respiratory Infections and Inflammations with MCC | 61 | $48,899 | -31% | $16,444 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 51 | $56,648 | -25% | $17,297 |
| 291 Heart Failure and Shock with MCC | 42 | $31,390 | -44% | $13,715 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 32 | $31,714 | -35% | $11,751 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 29 | $128,619 | -44% | $42,613 |
| 481 Hip and Femur Procedures except Major Joint with CC | 26 | $56,955 | -43% | $21,003 |
| 193 Simple Pneumonia and Pleurisy with MCC | 25 | $42,071 | -30% | $13,004 |
| 378 Gastrointestinal Hemorrhage with CC | 24 | $39,468 | -19% | $10,708 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 23 | $27,735 | -54% | $12,807 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 21 | $36,093 | -29% | $8,960 |
| 377 Gastrointestinal Hemorrhage with MCC | 21 | $60,198 | -30% | $17,451 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 19 | $39,546 | -29% | $11,223 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 17 | $52,014 | -48% | $18,531 |
| 189 Pulmonary Edema and Respiratory Failure | 17 | $37,109 | -36% | $14,216 |
| 683 Renal Failure with CC | 17 | $32,988 | -19% | $10,729 |
| 389 Gastrointestinal Obstruction with CC | 16 | $27,828 | -29% | $8,481 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 16 | $64,644 | -37% | $20,519 |
| 603 Cellulitis without MCC | 16 | $28,882 | -23% | $10,252 |
| 074 Cranial and Peripheral Nerve Disorders without MCC | 15 | $25,987 | -52% | $10,225 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 13 | $28,666 | -29% | $8,222 |
| 641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 13 | $25,785 | -30% | $7,842 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 13 | $35,666 | -51% | $15,644 |
| 682 Renal Failure with MCC | 12 | $54,168 | -18% | $14,465 |
| 329 Major Small and Large Bowel Procedures with MCC | 11 | $129,453 | -40% | $48,517 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 147 | $19,341 | $3,099 |
| Level 2 Urology and Related Services | 101 | $2,082 | $769 |
| Level 5 Musculoskeletal Procedures | 71 | $48,801 | $15,108 |
| Level 1 Endovascular Procedures | 61 | $19,903 | $3,621 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 52 | $6,864 | $1,808 |
| Level 3 Airway Endoscopy | 47 | $7,101 | $1,952 |
| Level 4 Musculoskeletal Procedures | 34 | $30,187 | $8,035 |
| Level 1 Laparoscopy and Related Services | 34 | $28,649 | $6,481 |
| Level 3 Urology and Related Services | 33 | $14,916 | $2,286 |
| Level 3 Endovascular Procedures | 30 | $55,643 | $12,634 |
| Level 5 Urology and Related Services | 28 | $24,855 | $5,951 |
| Level 4 Urology and Related Services | 27 | $23,856 | $4,010 |
| Level 3 Vascular Procedures | 25 | $16,387 | $3,549 |
| Level 2 Vascular Procedures | 20 | $5,997 | $1,842 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 19 | $7,972 | $3,268 |
| Level 4 Endovascular Procedures | 18 | $98,683 | $20,118 |
| Level 5 Airway Endoscopy | 16 | $27,429 | $7,872 |
| Level 2 Endovascular Procedures | 16 | $18,407 | $6,574 |
Against the Hawaii average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Adventist Health Castle charged $50,846 on average, 27% less than the Hawaii average of $69,229, and was paid $19,327 against a state average of $23,514. For Psychoses (DRG 885), Adventist Health Castle charged $31,216 on average, 33% less than the Hawaii average of $46,248, and was paid $13,913 against a state average of $15,921. For Respiratory Infections and Inflammations with MCC (DRG 177), Adventist Health Castle charged $48,899 on average, 21% less than the Hawaii average of $61,878, and was paid $16,444 against a state average of $19,768. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Adventist Health Castle charged $56,648 on average, 14% less than the Hawaii average of $65,543, and was paid $17,297 against a state average of $18,690. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $19,341 was 5% above the state average of $18,402. For Level 2 Urology and Related Services (outpatient APC 5372), its average charge of $2,082 was 32% above the state average of $1,583. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $48,801 was 10% below the state average of $54,220. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $19,903 was 13% above the state average of $17,589.
Price-transparency record
CMS's enforcement list records these actions for a hospital named Adventist Health Castle in Kailua, HI, under the federal hospital price-transparency rule (45 CFR part 180), which requires hospitals to post their standard charges online:
- Met Requirements — 2022-11-30 (CMS case 367)
- Met Requirements — 2024-02-20 (CMS case 2152)
- Met Requirements — 2025-08-26 (CMS case 6378)
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.