Hawaii / North Hawaii Community Hospital, Inc
CMS certification 120028 · Kamuela, HI
North Hawaii Community Hospital, Inc: charges and Medicare payments
North Hawaii Community Hospital, Inc reported 121 Medicare inpatient stays across 7 DRGs in 2024. Across them it charged 3.3 times what it was paid — among the higher ratios in Hawaii, number 2 of 11 hospitals with at least 100 stays (state median 2.84×, national 4.15×). Its most frequent stay was DRG 291, Heart Failure and Shock with MCC: 27 stays at an average charge of $60,402, 7% above the national average. It also billed 328 outpatient services, charging 5.29 times what Medicare paid.
- 1Medicare inpatient stays 121
- 2Charge ÷ paid, inpatient 3.3×
- 3Rank in HI (highest ratio = 1) 2 of 11
- 4CMS price-transparency actions 0
Inpatient stays
For the 7 DRGs that can be compared with the national average, North Hawaii Community Hospital, Inc charged more than the national average in 3 (43%). 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 | 27 | $60,402 | +7% | $17,440 |
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 21 | $94,943 | +5% | $24,664 |
| 193 Simple Pneumonia and Pleurisy with MCC | 20 | $48,690 | -19% | $18,305 |
| 177 Respiratory Infections and Inflammations with MCC | 15 | $57,204 | -19% | $24,006 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 15 | $36,193 | -10% | $10,004 |
| 065 Intracranial Hemorrhage or Cerebral Infarction with CC or... | 12 | $55,206 | -1% | $15,793 |
| 189 Pulmonary Edema and Respiratory Failure | 11 | $62,653 | +9% | $15,501 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Level 5 Musculoskeletal Procedures | 63 | $54,405 | $15,948 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 55 | $10,207 | $1,968 |
| Comprehensive Observation Services | 49 | $22,002 | $3,324 |
| Level 2 Musculoskeletal Procedures | 33 | $11,473 | $1,938 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 27 | $25,334 | $4,143 |
| Level 3 Vascular Procedures | 20 | $21,281 | $3,770 |
| Level 4 Musculoskeletal Procedures | 19 | $44,459 | $8,054 |
| Level 1 Laparoscopy and Related Services | 19 | $30,890 | $7,107 |
| Level 1 Nerve Procedures | 18 | $12,592 | $2,378 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 14 | $18,959 | $3,332 |
| Level 2 Breast/Lymphatic Surgery and Related Procedures | 11 | $39,437 | $8,033 |
Against the Hawaii average
For Heart Failure and Shock with MCC (DRG 291), North Hawaii Community Hospital, Inc charged $60,402 on average, 17% more than the Hawaii average of $51,774, and was paid $17,440 against a state average of $16,264. For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), North Hawaii Community Hospital, Inc charged $94,943 on average, 37% more than the Hawaii average of $69,229, and was paid $24,664 against a state average of $23,514. For Simple Pneumonia and Pleurisy with MCC (DRG 193), North Hawaii Community Hospital, Inc charged $48,690 on average, 3% less than the Hawaii average of $50,424, and was paid $18,305 against a state average of $16,146. For Respiratory Infections and Inflammations with MCC (DRG 177), North Hawaii Community Hospital, Inc charged $57,204 on average, 8% less than the Hawaii average of $61,878, and was paid $24,006 against a state average of $19,768. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $54,405 was 0% below the state average of $54,220. For Level 2 Excision/ Biopsy/ Incision and Drainage (outpatient APC 5072), its average charge of $10,207 was 28% above the state average of $8,002. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $22,002 was 20% above the state average of $18,402. For Level 2 Musculoskeletal Procedures (outpatient APC 5112), its average charge of $11,473 was 25% above the state average of $9,172.
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.