Hawaii / Wilcox Memorial Hospital
CMS certification 120014 · Lihue, HI
Wilcox Memorial Hospital: charges and Medicare payments
Wilcox Memorial Hospital reported 201 Medicare inpatient stays across 9 DRGs in 2024. Across them it charged 2.2 times what it was paid — among the lower ratios in Hawaii, number 10 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: 46 stays at an average charge of $54,739, 39% below the national average. It also billed 625 outpatient services, charging 4.18 times what Medicare paid.
- 1Medicare inpatient stays 201
- 2Charge ÷ paid, inpatient 2.2×
- 3Rank in HI (highest ratio = 1) 10 of 11
- 4CMS price-transparency actions 0
Inpatient stays
For the 9 DRGs that can be compared with the national average, Wilcox Memorial Hospital 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 | 46 | $54,739 | -39% | $25,913 |
| 291 Heart Failure and Shock with MCC | 32 | $30,713 | -46% | $17,834 |
| 193 Simple Pneumonia and Pleurisy with MCC | 27 | $40,573 | -32% | $16,488 |
| 177 Respiratory Infections and Inflammations with MCC | 24 | $50,361 | -29% | $20,977 |
| 603 Cellulitis without MCC | 17 | $29,269 | -22% | $11,015 |
| 064 Intracranial Hemorrhage or Cerebral Infarction with MCC | 15 | $60,021 | -40% | $24,830 |
| 481 Hip and Femur Procedures except Major Joint with CC | 15 | $64,507 | -36% | $27,198 |
| 378 Gastrointestinal Hemorrhage with CC | 13 | $30,027 | -38% | $13,044 |
| 682 Renal Failure with MCC | 12 | $33,867 | -49% | $18,618 |
Outpatient services
| Service (APC) | Services | Avg charge | Medicare allowed |
|---|---|---|---|
| Comprehensive Observation Services | 167 | $15,465 | $3,323 |
| Level 5 Musculoskeletal Procedures | 85 | $49,057 | $15,494 |
| Level 1 Intraocular Procedures | 76 | $10,168 | $2,871 |
| Level 2 Musculoskeletal Procedures | 64 | $7,777 | $1,931 |
| Level 4 Musculoskeletal Procedures | 55 | $27,256 | $8,418 |
| Level 2 Excision/ Biopsy/ Incision and Drainage | 46 | $6,011 | $1,875 |
| Level 3 Musculoskeletal Procedures | 29 | $12,690 | $3,899 |
| Level 1 Laparoscopy and Related Services | 23 | $25,961 | $7,107 |
| Level 3 Excision/ Biopsy/ Incision and Drainage | 22 | $13,468 | $3,259 |
| Level 6 Musculoskeletal Procedures | 18 | $73,371 | $21,714 |
| Level 4 Urology and Related Services | 16 | $13,006 | $4,294 |
| Level 3 Vascular Procedures | 13 | $13,722 | $3,686 |
| Level 1 Abdominal/Peritoneal/Biliary and Related Procedures | 11 | $15,838 | $4,262 |
Against the Hawaii average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Wilcox Memorial Hospital charged $54,739 on average, 21% less than the Hawaii average of $69,229, and was paid $25,913 against a state average of $23,514. For Heart Failure and Shock with MCC (DRG 291), Wilcox Memorial Hospital charged $30,713 on average, 41% less than the Hawaii average of $51,774, and was paid $17,834 against a state average of $16,264. For Simple Pneumonia and Pleurisy with MCC (DRG 193), Wilcox Memorial Hospital charged $40,573 on average, 20% less than the Hawaii average of $50,424, and was paid $16,488 against a state average of $16,146. For Respiratory Infections and Inflammations with MCC (DRG 177), Wilcox Memorial Hospital charged $50,361 on average, 19% less than the Hawaii average of $61,878, and was paid $20,977 against a state average of $19,768. For Comprehensive Observation Services (outpatient APC 8011), its average charge of $15,465 was 16% below the state average of $18,402. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $49,057 was 10% below the state average of $54,220. For Level 1 Intraocular Procedures (outpatient APC 5491), its average charge of $10,168 was 2% below the state average of $10,339. For Level 2 Musculoskeletal Procedures (outpatient APC 5112), its average charge of $7,777 was 15% below 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.