▸ Hospital · HI · CCN 121300
Kauai Veterans Memorial Hospital
4643 WAIMEA CANYON ROAD, WAIMEA KAUAI, HI, 96796-0337
25 bedsCritical Access Hospitals10
Compliance grade
A
97/100
Procedures tracked
149
of 209 target codes
Payers
7
with negotiated rates
Rates published
9,182
last crawl 2026-05-23
Procedures & rates
| Procedure | Type | Code | Payers | Gross | Cash | Neg min | Neg median | Neg max |
|---|---|---|---|---|---|---|---|---|
| behavioral | ||||||||
| Psychoses | MS-DRG | 885 | 1 | — | — | $16,139 | $16,139 | $16,139 |
| emergency | ||||||||
| ED visit level 1 | CPT | 99281 | 3 | $466 | $302.9 | $332.23 | $588 | $1,400 |
| ED visit level 2 | CPT | 99282 | 3 | $853 | $554.45 | $332.23 | $588 | $1,400 |
| ED visit level 3 | CPT | 99283 | 3 | $1,359 | $883.35 | $332.23 | $588 | $1,400 |
| ED visit level 4 | CPT | 99284 | 3 | $2,360 | $1,534 | $332.23 | $588 | $1,400 |
| ED visit level 5 | CPT | 99285 | 3 | $3,292 | $2,139.8 | $332.23 | $588 | $1,400 |
| Critical care, first hour | CPT | 99291 | 3 | $4,310 | $2,801.5 | $332.23 | $588 | $1,400 |
| imaging | ||||||||
| CT head without contrast | CPT | 70450 | 5 | $1,525 | $991.25 | $139.1 | $208.44 | $410.4 |
| CT head with contrast | CPT | 70460 | 5 | $1,481 | $962.65 | $186.48 | $299.6 | $503.73 |
| CT head with and without contrast | CPT | 70470 | 5 | $2,016.67 | $1,310.84 | $232.9 | $364.13 | $625.53 |
| CT neck with contrast | CPT | 70491 | 5 | $2,061 | $1,339.65 | $186.48 | $411.48 | $544.9 |
| Chest X-ray single view | CPT | 71045 | 3 | $365 | $237.25 | $13.07 | $17.41 | $34.31 |
| Chest X-ray 2 views | CPT | 71046 | 3 | $415 | $269.75 | $20.37 | $23.07 | $45.45 |
| Chest X-ray 3 views | CPT | 71047 | 3 | $448 | $291.2 | $24.39 | $27.67 | $54.53 |
| CT chest without contrast | CPT | 71250 | 5 | $1,525 | $991.25 | $194.84 | $320.07 | $518.82 |
| CT chest with contrast | CPT | 71260 | 5 | $2,137 | $1,389.05 | $232.9 | $476.77 | $627.23 |
| CT chest with and without contrast | CPT | 71270 | 5 | $2,350 | $1,527.5 | $291.1 | $588.41 | $787.72 |
| Lumbosacral spine X-ray | CPT | 72100 | 5 | $458 | $297.7 | $21.96 | $49.03 | $67.11 |
| CT cervical spine without contrast | CPT | 72125 | 5 | $1,400 | $910 | $194.84 | $320.07 | $518.82 |
| CT thoracic spine without contrast | CPT | 72128 | 5 | $1,400 | $910 | $194.84 | $320.07 | $518.82 |
| CT lumbar spine without contrast | CPT | 72131 | 5 | $1,050 | $682.5 | $177.96 | $320.07 | $518.82 |
| CT pelvis without contrast | CPT | 72192 | 5 | $1,066.67 | $693.34 | $194.84 | $259.65 | $510.29 |
| CT pelvis with contrast | CPT | 72193 | 5 | $1,481 | $962.65 | $225.48 | $478.81 | $603.64 |
| Shoulder X-ray | CPT | 73030 | 5 | $416 | $270.4 | $18.84 | $41.94 | $54.83 |
| Humerus X-ray | CPT | 73060 | 5 | $348 | $226.2 | $18.84 | $41.94 | $57.91 |
| Hand X-ray 3 views | CPT | 73130 | 5 | $416 | $270.4 | $19.08 | $38.5 | $61.99 |
| Knee X-ray 1-2 views | CPT | 73560 | 5 | $348 | $226.2 | $17.04 | $37.81 | $64.03 |
| Ankle X-ray 3 views | CPT | 73610 | 5 | $381 | $247.65 | $17.34 | $38.5 | $64.03 |
| CT abdomen without contrast | CPT | 74150 | 5 | $1,514.67 | $984.54 | $186.48 | $255.57 | $494.35 |
| CT abdomen with contrast | CPT | 74160 | 5 | $1,425 | $926.25 | $225.48 | $476.77 | $628.34 |
| CT abdomen with and without contrast | CPT | 74170 | 5 | $1,578 | $1,025.7 | $279.37 | $548.46 | $805.52 |
| CT abdomen and pelvis without contrast | CPT | 74176 | 4 | $2,600 | $1,690 | $94.66 | $305.97 | $841.23 |
| CT abdomen and pelvis with contrast | CPT | 74177 | 4 | $3,350 | $2,177.5 | $180.62 | $523.64 | $996.6 |
| CT abdomen and pelvis with and without contrast | CPT | 74178 | 4 | $3,500 | $2,275 | $238.75 | $663.51 | $1,233.65 |
| Abdominal ultrasound complete | CPT | 76700 | 5 | $722 | $469.3 | $64.94 | $145.93 | $237.12 |
| Abdominal ultrasound limited | CPT | 76705 | 5 | $649 | $421.85 | $46.98 | $109.94 | $177.71 |
| Retroperitoneal ultrasound complete | CPT | 76770 | 5 | $722 | $469.3 | $64.94 | $144.61 | $219.7 |
| Obstetric ultrasound first trimester | CPT | 76801 | 5 | $722 | $469.3 | $55.49 | $131.39 | $211.51 |
| Obstetric ultrasound after first trimester | CPT | 76805 | 5 | $725 | $471.25 | $61.23 | $153.11 | $263.76 |
| Transvaginal ultrasound | CPT | 76830 | 5 | $722 | $469.3 | $50.35 | $125.68 | $251.46 |
| Pelvic ultrasound complete | CPT | 76856 | 5 | $772 | $501.8 | $50.35 | $126.3 | $217.66 |
| Scrotal ultrasound | CPT | 76870 | 5 | $725 | $471.25 | $50.35 | $101.94 | $170.14 |
| Diagnostic mammography unilateral | CPT | 77065 | 3 | $789 | $512.85 | $64.13 | $90.59 | $202.69 |
| Diagnostic mammography bilateral | CPT | 77066 | 3 | $974 | $633.1 | $77.83 | $113.15 | $259.39 |
| Screening mammography bilateral | CPT | 77067 | 3 | $789 | $512.85 | $80.77 | $106.74 | $214.17 |
| EKG tracing only | CPT | 93005 | 3 | $256 | $166.4 | $15.16 | $31.7 | $36.14 |
| Transthoracic echocardiogram complete | CPT | 93306 | 2 | $2,895 | $1,881.75 | $132.88 | $357 | $2,230 |
| inpatient | ||||||||
| Respiratory infections & inflammations w MCC | MS-DRG | 177 | 1 | — | — | $43,147 | $43,147 | $43,147 |
| COPD w MCC | MS-DRG | 190 | 1 | — | — | $18,927 | $18,927 | $18,927 |
| COPD w CC | MS-DRG | 191 | 1 | — | — | $18,927 | $18,927 | $18,927 |
| COPD w/o CC/MCC | MS-DRG | 192 | 1 | — | — | $18,927 | $18,927 | $18,927 |
| Simple pneumonia & pleurisy w CC | MS-DRG | 194 | 1 | — | — | $24,357 | $24,357 | $24,357 |
| Simple pneumonia & pleurisy w/o CC/MCC | MS-DRG | 195 | 1 | — | — | $19,388 | $19,388 | $19,388 |
| AMI discharged alive w MCC | MS-DRG | 280 | 1 | — | — | $34,260 | $34,260 | $34,260 |
| AMI discharged alive w CC | MS-DRG | 281 | 1 | — | — | $29,621 | $29,621 | $29,621 |
| AMI discharged alive w/o CC/MCC | MS-DRG | 282 | 1 | — | — | $25,940 | $25,940 | $25,940 |
| Heart failure & shock w MCC | MS-DRG | 291 | 1 | — | — | $29,197 | $29,197 | $29,197 |
| Heart failure & shock w CC | MS-DRG | 292 | 1 | — | — | $29,197 | $29,197 | $29,197 |
| Heart failure & shock w/o CC/MCC | MS-DRG | 293 | 1 | — | — | $29,197 | $29,197 | $29,197 |
| Cardiac arrhythmia w MCC | MS-DRG | 308 | 1 | — | — | $21,618 | $21,618 | $21,618 |
| Cardiac arrhythmia w CC | MS-DRG | 309 | 1 | — | — | $20,288 | $20,288 | $20,288 |
| Cardiac arrhythmia w/o CC/MCC | MS-DRG | 310 | 1 | — | — | $15,550 | $15,550 | $15,550 |
| GI hemorrhage w CC | MS-DRG | 378 | 1 | — | — | $21,866 | $21,866 | $21,866 |
| GI hemorrhage w/o CC/MCC | MS-DRG | 379 | 1 | — | — | $16,768 | $16,768 | $16,768 |
| Esophagitis/gastroenteritis w/o MCC | MS-DRG | 392 | 1 | — | — | $14,904 | $14,904 | $14,904 |
| Fractures of femur w/o MCC | MS-DRG | 533 | 1 | — | — | $12,485 | $12,485 | $12,485 |
| Kidney/UTI w MCC | MS-DRG | 689 | 1 | — | — | $17,959 | $17,959 | $17,959 |
| Kidney/UTI w/o MCC | MS-DRG | 690 | 1 | — | — | $15,333 | $15,333 | $15,333 |
| Septicemia or severe sepsis w MV 96+ hrs | MS-DRG | 871 | 1 | — | — | $41,796 | $41,796 | $41,796 |
| Septicemia or severe sepsis w/o MV 96+ hrs | MS-DRG | 872 | 1 | — | — | $41,773 | $41,773 | $41,773 |
| lab | ||||||||
| Basic metabolic panel (BMP) | CPT | 80048 | 5 | $107 | $69.55 | $11.7 | $20.08 | $23.9 |
| Electrolyte panel | CPT | 80051 | 5 | $74 | $48.1 | $9.69 | $16.64 | $19.8 |
| Comprehensive metabolic panel | CPT | 80053 | 5 | $133 | $86.45 | $14.61 | $25.1 | $29.84 |
| Lipid panel | CPT | 80061 | 5 | $143 | $92.95 | $18.51 | $31.76 | $37.81 |
| Renal function panel | CPT | 80069 | 5 | $103 | $66.95 | $12 | $20.63 | $24.5 |
| Hepatic function panel | CPT | 80076 | 5 | $110 | $71.5 | $11.29 | $19.39 | $23.07 |
| Urinalysis automated | CPT | 81003 | 5 | $30 | $19.5 | $3.1 | $5.36 | $6.34 |
| Glucose quantitative | CPT | 82947 | 5 | $42 | $27.3 | $5.42 | $9.29 | $11.07 |
| Hemoglobin A1c | CPT | 83036 | 5 | $116 | $75.4 | $13.42 | $23.04 | $27.39 |
| Thyroid stimulating hormone (TSH) | CPT | 84443 | 5 | $223 | $144.95 | $23.21 | $39.88 | $47.41 |
| Complete blood count with automated differential | CPT | 85025 | 5 | $104 | $67.6 | $10.74 | $18.43 | $21.94 |
| Complete blood count without differential | CPT | 85027 | 5 | $79 | $51.35 | $8.95 | $15.34 | $18.26 |
| Urine culture bacterial | CPT | 87086 | 5 | $89 | $57.85 | $11.16 | $19.19 | $22.79 |
| Urine culture identification | CPT | 87088 | 5 | $92 | $59.8 | $10.55 | $18.15 | $21.55 |
| Tissue exam by pathologist level IV | CPT | 88305 | 4 | $365.75 | $237.74 | $40.64 | $75.75 | $144.69 |
| maternity | ||||||||
| Fetal non-stress test | CPT | 59025 | 3 | $681 | $442.65 | $8.21 | $10.04 | $42.26 |
| office | ||||||||
| Office visit, established patient, 5 min | CPT | 99211 | 1 | $264 | $171.6 | $9.17 | $9.17 | $9.17 |
| Office visit, established patient, 10-19 min | CPT | 99212 | 1 | $322 | $209.3 | $24.13 | $24.13 | $24.13 |
| Office visit, established patient, 20-29 minutes | CPT | 99213 | 1 | $372 | $241.8 | $36.31 | $36.31 | $36.31 |
| Office visit, established patient, 30-39 minutes | CPT | 99214 | 1 | $456 | $296.4 | $56.46 | $56.46 | $56.46 |
| Office visit, established patient, 40-54 min | CPT | 99215 | 1 | $542 | $352.3 | $83.57 | $83.57 | $83.57 |
| preventive | ||||||||
| Upper GI endoscopy diagnostic | CPT | 43235 | 7 | — | — | $340.18 | $1,896 | $3,104 |
| Upper GI endoscopy with biopsy | CPT | 43239 | 7 | — | — | $456.03 | $2,837 | $5,280 |
| Sigmoidoscopy diagnostic | CPT | 45330 | 2 | — | — | $357 | $1,311.13 | $3,104 |
| Sigmoidoscopy with biopsy | CPT | 45331 | 7 | — | — | $357 | $1,896 | $3,104 |
| Colonoscopy diagnostic | CPT | 45378 | 7 | — | — | $456.03 | $2,837 | $5,280 |
| Colonoscopy with biopsy | CPT | 45380 | 7 | — | — | $456.03 | $2,837 | $5,280 |
| Colonoscopy with polyp removal | CPT | 45385 | 7 | — | — | $456.03 | $2,837 | $5,280 |
| surgery | ||||||||
| Total shoulder arthroplasty | CPT | 23472 | 2 | — | — | $676 | $9,068.17 | $19,500 |
| Hip hemiarthroplasty | CPT | 27125 | 1 | — | — | $676 | $2,021.33 | $16,115 |
| Total hip replacement | CPT | 27130 | 2 | — | — | $676 | $9,068.17 | $19,500 |
| Total knee replacement | CPT | 27447 | 2 | — | — | $676 | $7,010.6 | $19,500 |
| Knee revision arthroplasty single component | CPT | 27486 | 1 | — | — | $676 | $1,829.2 | $12,192 |
| Knee revision arthroplasty all components | CPT | 27487 | 2 | — | — | $676 | $7,010.6 | $19,500 |
| Shoulder arthroscopy with decompression | CPT | 29826 | 5 | — | — | $521.33 | $2,837 | $4,664 |
| Shoulder arthroscopy with rotator cuff repair | CPT | 29827 | 7 | — | — | $644.55 | $2,837 | $12,192 |
| Knee arthroscopy with meniscectomy | CPT | 29881 | 7 | — | — | $547 | $2,837 | $9,497.44 |
| ACL reconstruction | CPT | 29888 | 7 | — | — | $521.33 | $2,837 | $12,192 |
| Major small/large bowel procedures w MCC | MS-DRG | 329 | 1 | — | — | $82,490 | $82,490 | $82,490 |
| Major small/large bowel procedures w CC | MS-DRG | 330 | 1 | — | — | $66,778 | $66,778 | $66,778 |
| Major small/large bowel procedures w/o CC/MCC | MS-DRG | 331 | 1 | — | — | $37,403 | $37,403 | $37,403 |
| Laparoscopic cholecystectomy w/o CDE w MCC | MS-DRG | 418 | 1 | — | — | $27,630 | $27,630 | $27,630 |
| Laparoscopic cholecystectomy w/o CDE w CC | MS-DRG | 419 | 1 | — | — | $17,874 | $17,874 | $17,874 |
| Laparoscopic cholecystectomy w/o CDE w/o CC/MCC | MS-DRG | 420 | 1 | — | — | $67,031 | $67,031 | $67,031 |
| Open appendectomy | CPT | 44950 | 1 | — | — | $676 | $1,110.05 | $10,382 |
| Laparoscopic appendectomy | CPT | 44970 | 2 | — | — | $676 | $7,010.6 | $19,500 |
| Spinal fusion (non-cervical) w MCC | MS-DRG | 459 | 1 | — | — | $86,263 | $86,263 | $86,263 |
| Spinal fusion (non-cervical) w/o MCC | MS-DRG | 460 | 1 | — | — | $81,172 | $81,172 | $81,172 |
| Major joint replacement w MCC | MS-DRG | 469 | 1 | — | — | $41,938 | $41,938 | $41,938 |
| Major joint replacement w/o MCC | MS-DRG | 470 | 1 | — | — | $28,473 | $28,473 | $28,473 |
| Laparoscopic cholecystectomy | CPT | 47562 | 2 | — | — | $676 | $7,010.6 | $18,300 |
| Lap cholecystectomy with cholangiography | CPT | 47563 | 2 | — | — | $676 | $7,010.6 | $18,300 |
| Hip & femur procedures except major joint w MCC | MS-DRG | 480 | 1 | — | — | $50,946 | $50,946 | $50,946 |
| Hip & femur procedures except major joint w CC | MS-DRG | 481 | 1 | — | — | $49,684 | $49,684 | $49,684 |
| Hip & femur procedures except major joint w/o CC/MCC | MS-DRG | 482 | 1 | — | — | $35,803 | $35,803 | $35,803 |
| Open umbilical hernia repair | CPT | 49560 | 2 | — | — | $547 | $3,715.78 | $9,497.44 |
| Umbilical hernia repair age 5+ | CPT | 49585 | 2 | — | — | $547 | $3,715.78 | $9,497.44 |
| Lap inguinal hernia repair | CPT | 49650 | 7 | — | — | $644.55 | $2,837 | $10,382 |
| Lap incisional hernia repair | CPT | 49652 | 1 | — | — | $547 | $816.55 | $6,615 |
| Total abdominal hysterectomy | CPT | 58150 | 1 | — | — | $676 | $1,829.2 | $12,192 |
| Vaginal hysterectomy | CPT | 58260 | 1 | — | — | $676 | $1,829.2 | $12,192 |
| Lap-assisted vaginal hysterectomy | CPT | 58550 | 4 | — | — | $676 | $7,613 | $19,500 |
| Lap-assisted vaginal hysterectomy >250g | CPT | 58552 | 2 | — | — | $676 | $7,010.6 | $19,500 |
| Lap salpingo-oophorectomy | CPT | 58661 | 7 | — | — | $644.55 | $2,837 | $12,192 |
| OR procedure for obesity w MCC | MS-DRG | 619 | 1 | — | — | $52,956 | $52,956 | $52,956 |
| OR procedure for obesity w CC | MS-DRG | 620 | 1 | — | — | $52,956 | $52,956 | $52,956 |
| OR procedure for obesity w/o CC/MCC | MS-DRG | 621 | 1 | — | — | $52,725 | $52,725 | $52,725 |
| Complex cataract surgery | CPT | 66982 | 7 | — | — | $547 | $2,837 | $11,224 |
| Cataract surgery with lens implant | CPT | 66984 | 7 | — | — | $547 | $2,837 | $11,224 |
| Intravitreal injection | CPT | 67028 | 1 | — | — | $3,104 | $3,104 | $3,104 |
| Vitrectomy mechanical | CPT | 67042 | 2 | — | — | $676 | $6,032.16 | $12,192 |
| Uterine & adnexa procedures w CC/MCC | MS-DRG | 743 | 1 | — | — | $20,505 | $20,505 | $20,505 |
| Uterine & adnexa procedures w/o CC/MCC | MS-DRG | 744 | 1 | — | — | $16,023 | $16,023 | $16,023 |
| PCI single major coronary artery | CPT | 92920 | 1 | — | — | $676 | $2,021.33 | $16,115 |
| PCI with drug-eluting stent | CPT | 92928 | 2 | — | — | $676 | $9,068.17 | $19,500 |
| PCI bypass graft | CPT | 92937 | 1 | — | — | $676 | $2,021.33 | $16,115 |
| Left heart catheterization | CPT | 93452 | 1 | — | — | $676 | $1,829.2 | $12,192 |
| Coronary angiography with cath | CPT | 93455 | 1 | — | — | $676 | $1,829.2 | $12,192 |
| Coronary angiography with bypass cath | CPT | 93458 | 2 | — | — | $676 | $7,010.6 | $19,500 |
Payer mix (top 7)
| Payer | Codes covered | Median rate |
|---|---|---|
| hmsa | 142 | $479 |
| uha | 82 | $396.53 |
| UnitedHealthcare | 75 | $64.94 |
| hma | 61 | $263.76 |
| hmaa | 61 | $197.23 |
| alohacare | 20 | $570.38 |
| Kaiser Permanente | 20 | $2,837 |