Hilo Benioff Medical Center: charges and Medicare payments

Hilo Benioff Medical Center reported 1,094 Medicare inpatient stays across 40 DRGs in 2024. Across them it charged 2.57 times what it was paid — mid-range in Hawaii, number 7 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: 177 stays at an average charge of $58,769, 35% below the national average. It also billed 871 outpatient services, charging 4.88 times what Medicare paid.

1Medicare inpatient stays 1,094
2Charge ÷ paid, inpatient 2.57×
3Rank in HI (highest ratio = 1) 7 of 11
4CMS price-transparency actions 0

Average charge per stay at Hilo Benioff Medical Center, its 10 most frequent DRGs, bars to scale. Source: CMS DY2024.

Inpatient stays

For the 40 DRGs that can be compared with the national average, Hilo Benioff Medical Center charged more than the national average in 1 (3%). 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	177	$58,769	-35%	$24,514
291 Heart Failure and Shock with MCC	78	$40,932	-27%	$16,965
193 Simple Pneumonia and Pleurisy with MCC	64	$50,002	-16%	$16,865
378 Gastrointestinal Hemorrhage with CC	59	$45,005	-7%	$12,768
065 Intracranial Hemorrhage or Cerebral Infarction with CC or...	49	$30,852	-45%	$14,033
872 Septicemia or Severe Sepsis without MV >96 Hours without MCC	45	$37,917	-23%	$14,064
190 Chronic Obstructive Pulmonary Disease with MCC	35	$54,571	+8%	$13,894
885 Psychoses	35	$31,005	-30%	$17,064
177 Respiratory Infections and Inflammations with MCC	34	$59,919	-15%	$21,939
064 Intracranial Hemorrhage or Cerebral Infarction with MCC	28	$79,013	-21%	$31,736
641 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	26	$22,724	-39%	$9,917
853 Infectious and Parasitic Diseases with O.R. Procedures with...	24	$178,810	-22%	$63,297
689 Kidney and Urinary Tract Infections with MCC	23	$34,387	-33%	$14,819
322 Percutaneous Cardiovascular Procedures with Intraluminal...	22	$46,020	-60%	$23,408
189 Pulmonary Edema and Respiratory Failure	21	$40,333	-30%	$16,844
603 Cellulitis without MCC	21	$22,616	-39%	$11,178
640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and...	21	$55,150	-9%	$16,459
309 Cardiac Arrhythmia and Conduction Disorders with CC	20	$22,198	-39%	$10,908
481 Hip and Femur Procedures except Major Joint with CC	19	$61,514	-39%	$25,591
377 Gastrointestinal Hemorrhage with MCC	18	$75,309	-12%	$21,649
066 Intracranial Hemorrhage or Cerebral Infarction without...	17	$21,337	-50%	$8,621
690 Kidney and Urinary Tract Infections without MCC	17	$23,178	-39%	$10,168
208 Respiratory System Diagnosis with Ventilator Support <=96...	16	$120,450	-11%	$38,692
312 Syncope and Collapse	16	$29,980	-34%	$10,947
522 Hip Replacement with Principal Diagnosis of Hip Fracture...	16	$61,453	-40%	$26,344
310 Cardiac Arrhythmia and Conduction Disorders without CC/MCC	15	$17,132	-40%	$6,946
392 Esophagitis, Gastroenteritis and Miscellaneous Digestive...	15	$25,881	-36%	$9,984
194 Simple Pneumonia and Pleurisy with CC	14	$27,028	-30%	$10,323
308 Cardiac Arrhythmia and Conduction Disorders with MCC	14	$49,070	-13%	$16,936
314 Other Circulatory System Diagnoses with MCC	14	$41,970	-56%	$24,451
389 Gastrointestinal Obstruction with CC	14	$16,449	-58%	$9,972
280 Acute Myocardial Infarction, Discharged Alive with MCC	13	$61,898	-18%	$18,580
321 Percutaneous Cardiovascular Procedures with Intraluminal...	13	$59,159	-64%	$35,454
683 Renal Failure with CC	13	$24,812	-39%	$11,284
286 Circulatory Disorders except AMI, with Cardiac...	12	$52,916	-53%	$27,730
287 Circulatory Disorders except AMI, with Cardiac...	12	$35,049	-45%	$13,577
552 Medical Back Problems without MCC	11	$23,490	-52%	$12,452
638 Diabetes with CC	11	$30,004	-28%	$11,436
682 Renal Failure with MCC	11	$44,274	-33%	$18,979
870 Septicemia or Severe Sepsis with MV >96 Hours	11	$238,568	-26%	$82,263

Outpatient services

Service (APC)	Services	Avg charge	Medicare allowed
Level 1 Endovascular Procedures	103	$14,959	$3,964
Level 3 Vascular Procedures	63	$13,645	$3,828
Level 2 Endovascular Procedures	63	$28,028	$7,041
Level 3 Endovascular Procedures	58	$64,693	$13,529
Level 5 Urology and Related Services	58	$14,787	$6,374
Level 1 Laparoscopy and Related Services	55	$19,474	$6,808
Level 4 Urology and Related Services	51	$14,308	$4,160
Level 2 Excision/ Biopsy/ Incision and Drainage	47	$17,606	$1,930
Level 3 Excision/ Biopsy/ Incision and Drainage	40	$32,438	$3,500
Level 5 Musculoskeletal Procedures	36	$45,150	$15,774
Level 2 Breast/Lymphatic Surgery and Related Procedures	25	$40,663	$7,777
Comprehensive Observation Services	24	$12,915	$3,172
Level 3 Urology and Related Services	21	$19,671	$2,509
Level 4 Musculoskeletal Procedures	19	$30,104	$8,809
Level 4 Endovascular Procedures	19	$92,111	$21,545
Level 3 Pacemaker and Similar Procedures	19	$60,245	$13,133
Level 4 Vascular Procedures	18	$26,313	$6,769
Level 1 Breast/Lymphatic Surgery and Related Procedures	17	$18,674	$4,320
Level 2 Musculoskeletal Procedures	16	$10,469	$1,980
Level 5 ENT Procedures	16	$21,628	$6,854
Level 2 Urology and Related Services	16	$4,430	$842
Level 1 Nerve Procedures	15	$6,053	$2,378
Level 5 Airway Endoscopy	13	$17,460	$7,383
Level 1 Abdominal/Peritoneal/Biliary and Related Procedures	13	$16,602	$4,262
Level 3 Airway Endoscopy	12	$8,487	$2,091

Against the Hawaii average

For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Hilo Benioff Medical Center charged $58,769 on average, 15% less than the Hawaii average of $69,229, and was paid $24,514 against a state average of $23,514. For Heart Failure and Shock with MCC (DRG 291), Hilo Benioff Medical Center charged $40,932 on average, 21% less than the Hawaii average of $51,774, and was paid $16,965 against a state average of $16,264. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Hilo Benioff Medical Center charged $50,002 on average, 1% less than the Hawaii average of $50,424, and was paid $16,865 against a state average of $16,146. For Gastrointestinal Hemorrhage with CC (DRG 378), Hilo Benioff Medical Center charged $45,005 on average, 7% more than the Hawaii average of $42,130, and was paid $12,768 against a state average of $12,623. For Level 1 Endovascular Procedures (outpatient APC 5191), its average charge of $14,959 was 15% below the state average of $17,589. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $13,645 was 13% below the state average of $15,603. For Level 2 Endovascular Procedures (outpatient APC 5192), its average charge of $28,028 was 27% above the state average of $22,110. For Level 3 Endovascular Procedures (outpatient APC 5193), its average charge of $64,693 was 39% above the state average of $46,424.

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.