Why are Medicare and Medicaid shown separately instead of combined?

They come from two different CMS data sources with no shared claim identifier, so they can't be reconciled into one number without double-counting or guessing. Every table and chart on this page keeps them fully separate.

Why is there no private/commercial revenue figure?

Private and commercial payer data comes from Transparency in Coverage files, which only publish negotiated rates — not claims or utilization volume. Without a volume figure, no revenue number can be computed for any provider from that data.

What does "Rank" mean in the Competitive Analysis & Benchmarks tables?

For a given CPT/HCPCS code, it's this provider's position by claims volume among all providers billing that same code at that geography level (State, National, or Hawaii for Medicaid) — rank 1 means the highest claims volume for that code.

Why is the Medicaid comparison limited to Hawaii only?

Medicaid is administered per-state with no single national fee schedule, so a state or national comparison the way Medicare has one isn't available. Hawaii (this provider's own state) is the only grouping that's conceptually meaningful.

Why are the numbers rounded to the nearest 10?

To avoid implying more precision than the underlying data supports at a single-provider level. Ratios are kept precise since they're a relative comparison, not a volume or dollar figure.

How current is this data?

The Medicare and Medicaid tables are both single current snapshots, not refreshed on a recurring schedule yet.

Kapiolani Medical Center For Women & Children (NPI 1043263080)

Field	Value
Entity Type	Organization
Organization	Kapiolani Medical Center For Women & Children
Address	1319 Punahou St
City	Honolulu
State	HI
ZIP	96826
Taxonomy	Children's Hospital
NPI Enumerated	May 19, 2006

Payer Source	Total Paid
Medicaid	$102.4M
Medicare	$0

Key Findings

KAPIOLANI MEDICAL CENTER FOR WOMEN & CHILDREN is effectively a single‑payer Medicaid provider in the available data: there is no Medicare billing on file and reported Medicaid revenue totals $102.4M. The absence of Medicare revenue suggests payer exposure and strategic positioning are concentrated in Medicaid-managed care and state programs rather than dual Medicare/Medicaid mixes common at other hospital types.

Revenue concentration is high: the top three Medicaid codes (99283, 99284, 99282) account for 71.6% of this provider’s total Medicaid revenue. Individually, 99283 generates $42.2M (43.4% of Medicaid revenue) and 99284 and 99282 add $17.5M (18.0%) and $9.9M (10.2%) respectively, indicating the hospital’s finances are heavily dependent on a narrow set of ED evaluation-and-management services.

The code mix strongly reflects an emergency department and acute pediatric care operational profile. The dominant codes are ED E/M visits (99283, 99284, 99282, and 99285), and additional activity such as observation hours (G0378: $5.1M, 5.3%) and IV rehydration (96361) support a pattern of short-term acute care and ED-to-observation throughput rather than elective inpatient or outpatient specialty procedures.

KAPIOLANI is a statewide leader on multiple high-volume pediatric and perinatal service codes. It ranks #2 of 45 for 99283 (98th percentile; notably above typical state volume) and #2 of 31 for 99282 (97th percentile; notably above typical state volume), signaling dominant ED volume for these acuity tiers relative to in-state peers.

Several specialty service lines show unusually high state market share consistent with a women’s and children’s hospital. Fetal and obstetric ultrasound codes (76811, 76815, 76805, 76816, 76813) repeatedly rank #1 in-state and reach the 100th percentile for volume in multiple categories, and MRI brain (70553) and screening mammography (77067) also appear among the top Medicaid-revenue codes, reflecting a broad maternal/child imaging footprint.

There are multiple statistical outliers and sole-state reporters among the top codes. A0424 (extra ambulance attendant) is reported as #1 of 1 providers in-state with no peer comparison; several speech, hearing, and therapy codes (92507, 92579, 92523, 97530) rank at or near the top in-state (many at the 100th percentile), indicating unusually large pediatric rehabilitative and developmental services volume relative to peers.

Competitive standing is mixed by code: for core ED codes KAPIOLANI ranks in the top percentiles statewide and is a major player in emergency pediatric care, while for imaging and some advanced diagnostics it is a high-volume but more typical participant (for example, 74177 and 74176 are mid-to-upper percentile ranks around the 48th–60th percentiles). This suggests regional dominance in ED and perinatal services, with more conventional market share in certain imaging categories.

The provider has established tenure in the data: its NPI was enumerated on 2006-05-19 (~20 years ago) and the taxonomy is listed as Children’s Hospital. That long-standing enrollment together with concentrated Medicaid revenue and high in-state ranks for pediatric and perinatal services supports a strategic identity focused on women’s and children’s acute and specialty care within the Hawaii Medicaid market.

Medicaid: Complete Services Breakdown

Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.

347 rows

CPT/HCPCS Code	Description	Claims	Avg Paid	Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	69,970	$600	$42.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	24,660	$710	$17.5M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	20,290	$490	$9.9M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	8,170	$920	$7.5M
G0378	Hospital observation service, per hour	17,800	$290	$5.1M
99281	The provider sees a patient for the lowest level emergency department visit.	4,420	$450	$2M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	1,660	$1,090	$1.8M
A0424	Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)	1,170	$1,120	$1.3M
76811	The provider performs an ultrasound study using a transabdominal approach to examine the fetus and mother, along with additional examination of the fetal anatomy, such as the heart rate, amniotic…	6,750	$180	$1.2M
70553	In this procedure, the provider performs a magnetic resonance imaging, or MRI, study of the brain including the brain stem. He performs this procedure without using contrast material. He then follows…	960	$1,260	$1.2M

Showing 1–10 of 347

Medicaid: Competitive Analysis & Benchmarks

How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.

Claims Volume vs. Hawaii Distribution

Kapiolani Medical Center For Women & Children — 11 of 25 codes billed far more than typical (above p95)

p5–p95 (all providers)p25–p75MedianThis providerOutlier

Rank Distribution — Hawaii

Full comparison — all codes billed, vs. Hawaii median

347 rows

CPT/HCPCS Code	Description	Rank	Provider Count	Median Claims	Avg Paid	Average Revenue
99283	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a low level of medical decision making.	2	50	8,590	$340	$5.2M
99284	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a moderate level of medical decision making.	7	50	3,740	$290	$3.8M
99285	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a high level of medical decision making.	12	40	3,820	$330	$3.3M
G0378	Hospital observation service, per hour	2	10	3,250	$480	$2.3M
99282	The provider sees a patient for an emergency department visit involving evaluation and management (E/M). The visit involves a straightforward level of medical decision making.	2	30	2,660	$330	$1.5M
A0424	Extra ambulance attendant, ground (als or bls) or air (fixed or rotary winged); (requires medical review)	1	10	1,170	$1,120	$1.3M
74177	The provider performs computed tomography of the abdomen and pelvis with contrast material to diagnose the cause of abdominal or pelvic pain or other abnormalities of the internal organs.	15	40	1,050	$510	$1.3M
J3490	Unclassified drugs	3	50	160	$200	$740.3K
99281	The provider sees a patient for the lowest level emergency department visit.	4	20	950	$220	$651.2K
87389	The lab analyst performs a test to screen for human immunodeficiency virus, called HIV. The test screens for antigens of the HIV 1 virus and antibodies to the HIV 1 and HIV 2 viruses using an…	7	10	2,090	$60	$613.6K

Showing 1–10 of 347

Related Providers

Other providers that share a Tax Identification Number (TIN) with Kapiolani Medical Center For Women & Children, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Straub Clinic & Hospital	HI	General Acute Care Hospital	$0	$45.6M
Straub Clinic & Hospital	HI	Multi-Specialty Clinic/Center	$0	$8.2M
Kapiolani Medical Center For Women & Children	HI	Multi-Specialty Clinic/Center	$0	$3.3M
Straub Clinic & Hospital	HI	Community/Retail Pharmacy	$0	$984.9K
Devy Setyono	HI	Rheumatology Physician	$712.5K	$0
Manas Jain	WA	Urology Physician	$489.2K	$0
Arnold Kop	HI	Internal Medicine Physician	$392.9K	$0
Boyuan Cao	HI	Internal Medicine Physician	$81.1K	$288.1K
Sian Yik Lim	HI	Rheumatology Physician	$316.7K	$0
Cass Nakasone	HI	Orthopaedic Surgery Physician	$233K	$0

Nearby Providers

Other providers in the same ZIP code as Kapiolani Medical Center For Women & Children, ranked by combined Medicare and Medicaid revenue.

Provider	State	Taxonomy	Medicare Revenue	Medicaid Revenue
Emergency Medicine Physicians Of Honolulu Kapiolani, LLC	HI	Emergency Medicine Physician	$0	$7.9M
Usrc Beretania, LLC	HI	End-Stage Renal Disease (ESRD) Treatment Clinic/Center	$0	$7.3M
Kapiolani Medical Specialists	HI	Multi-Specialty Clinic/Center	$0	$5.1M
Hawaii Anesthesia Group Inc	HI	Anesthesiology Physician	$0	$3.6M
Waikiki Health	HI	Federally Qualified Health Center (FQHC)	$0	$3.5M
Shriners Hospitals For Children	HI	Children's Hospital	$0	$2.8M
Pediatric Ophthalmology Associates Of Hawaii Inc	HI	Ophthalmology Physician	$0	$1.7M
Dentistry For Children Inc.	HI	Pediatric Dentistry	$0	$1.5M
Peggy Liao	HI	Ophthalmology Physician	$3.3K	$968K
Infectious Disease Consultants Of Hawaii LLC	HI	Infectious Disease Physician	$0	$837.2K

Kapiolani Medical Center For Women & Children — Billing Profile & Reimbursement Data

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Kapiolani Medical Center For Women & Children — Billing Profile & Reimbursement Data

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Key Findings

Medicaid: Total Revenue Breakdown by CPT/HCPCS Code

Medicaid: Complete Services Breakdown

Medicaid: Competitive Analysis & Benchmarks

Related Providers

Nearby Providers

Frequently Asked Questions

References