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NPI 1114985611 · Kahului, HI · Ambulatory Surgical Clinic/Center
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Aloha Surgical Center LLC is a ambulatory surgical clinic/center provider located in Kahului, Hawaii. This profile covers 17 Medicare and 4 Medicaid CPT/HCPCS procedure codes, with claims volume, average reimbursement, and total revenue by code, benchmarked against other providers billing the same services.
Provider details (source: NPPES NPI Registry)
| Field | Value |
|---|---|
| Entity Type | Organization |
| Organization | Aloha Surgical Center LLC |
| Address | 239 Hoohana St |
| City | Kahului |
| State | HI |
| ZIP | 96732 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | May 3, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $826.3K |
| Medicaid | $247K |
ALOHA SURGICAL CENTER LLC is an ambulatory surgical clinic with a mixed case mix that includes major joint arthroplasty, ophthalmology, and endoscopy services; Medicare claims are led by 27447 (knee replacement), 27130 (hip replacement), and 66984 (cataract extraction with lens insertion), indicating the center performs both orthopedic joint replacements and high-volume ophthalmic procedures alongside GI and ENT endoscopic work. The presence of both high-revenue joint arthroplasty codes and numerous endoscopy codes suggests a multi-specialty ambulatory surgery model rather than a single-procedure niche.
Revenue concentration on Medicare is pronounced: the precomputed top 3 Medicare codes account for 61.2% of the provider's total Medicare revenue, showing reliance on a small set of high-value procedures (notably 27447 and 27130) to generate the majority of Medicare receipts. For Medicaid the concentration is even stronger: the top 3 Medicaid codes represent 98.7% of total Medicaid revenue, indicating that a very small group of procedures (primarily colonoscopy and upper endoscopy biopsies) dominates the provider's Medicaid billing.
Scale and payer mix are skewed toward Medicare: lifetime Medicare revenue is $826.3K compared with $247K in Medicaid, so Medicare comprises the larger share of billed public-payer revenue. This gap implies the center’s patient population and case-mix generate substantially more Medicare-paid dollar volume than Medicaid, though Medicaid still supports sizable endoscopy volume on the inpatient/outpatient side.
Competitive standing on key Medicare codes is generally modest to typical nationally: 27447 ranks #6832 of 12089 providers (42nd percentile) and 27130 ranks #5215 of 8062 providers (32nd percentile), both characterized as typical, unremarkable volume nationally, so the center is not a dominant national provider for major joint arthroplasty. By contrast some endoscopy codes show higher national percentile positions (for example, 45380 ranks in the 90th percentile), indicating above-typical Medicare colonoscopy activity relative to peers.
Within the state Medicaid market the provider occupies a middle-to-upper position for GI procedures: 45380 ranks #9 of 20 in-state (58th percentile) and 43239 ranks #8 of 31 in-state (77th percentile), which signals competitive, above-typical in-state volume for upper endoscopy and colon biopsy services. However, for other Medicaid procedures such as 45378 the provider ranks lower in-state (29th percentile), showing variability in competitiveness across specific GI service lines.
Tenure is long-standing: the NPI was enumerated on 2006-05-03 (approximately 20 years ago), indicating enduring market presence in KAHULUI, HI which supports the likelihood of established referral and operational workflows for the mix of orthopedics, ophthalmology, and endoscopy services documented.
Procedure-level outliers and pay-rate context provide additional nuance: Medicare payments for 27447 and 27130 are high on a per-claim basis ($7803 and $8117 avg paid/claim respectively) and together with 66984 ($928 avg) drive a large share of Medicare revenue, so the site’s financial performance depends on relatively few high-dollar surgical episodes. On Medicaid, 45380 and 43239 together account for the vast majority of Medicaid revenue ($130.1K and $89K respectively), reinforcing that Medicaid volume is concentrated in endoscopic diagnostic and biopsy work.
Service-line implication for operations: the mix of high-revenue joint replacement codes and high-volume endoscopy codes implies the facility must maintain both sterile surgical capabilities and endoscopy suites with pathology coordination. Staffing, equipment, and scheduling models are therefore likely configured to support episodic, resource-intensive orthopedic cases alongside many shorter-duration endoscopic procedures, affecting throughput and case-mix economics.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
17 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 27447 | In this procedure, the provider replaces the damaged weight bearing surfaces of both the medial and lateral compartments in the knee joint using implants of metal or other strong materials. The… | 30 | $7,800 | $210.7K |
| 27130 | In this procedure, the provider surgically replaces the hip joint by prosthesis, or artificial hip joint. He replaces both the femoral and acetabular components with or without using an autograft or… | 20 | $8,120 | $154.2K |
| 66984 | The provider inserts an artificial lens after removing an extracapsular cataract by aspiration or use of ultrasonic waves. This procedure is done without the use of an endoscopic laser probe to… | 150 | $930 | $141.1K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 160 | $420 | $68.1K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 180 | $210 | $37.4K |
| G0105 | Colorectal cancer screening; colonoscopy on individual at high risk | 80 | $450 | $36.5K |
| 31276 | In this procedure, the provider inserts an endoscope into the frontal sinus to explore it for abnormalities. The provider may also remove bone, scar tissue, polyps, or other tissue from the frontal… | 20 | $1,250 | $28.8K |
| 31267 | In this procedure, the provider inserts an endoscope into the nasal cavity. She then gains access to the maxillary sinus through a cut in the uncinate process. The provider opens the maxillary sinus… | 20 | $1,040 | $25.1K |
| 45385 | The provider examines the colon and rectum using a colonoscope, a long, thin flexible tubular instrument with a light source and camera. He removes one or more tumors, polyps, or other lesions with a… | 50 | $460 | $22.3K |
| 43249 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum and dilates (widens) the esophagus with a balloon less than 30 mm in diameter. | 40 | $620 | $21.6K |
Showing 1–10 of 17
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 17 CPT/HCPCS codes.
View: State1 / 2
Full comparison — all codes billed, vs. state median
17 rows
| CPT/HCPCS Code | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|
| 66984 | 19 | 70 | 60 | $640 | $88.9K |
| 27447 | 11 | 20 | 30 | $1,970 | $66.9K |
| 27130 | 11 | 10 | 30 | $2,140 | $64.2K |
| 31276 | 1 | 10 | 20 | $1,250 | $28.8K |
| 66982 | 14 | 20 | 30 | $770 | $25.5K |
| 45385 | 21 | 50 | 40 | $320 | $23.5K |
| 45380 | 9 | 60 | 50 | $210 | $16.1K |
| 45384 | 9 | 10 | 80 | $210 | $14.9K |
| 43249 | 1 | 10 | 30 | $430 | $11.5K |
| 31267 | 1 | 10 | 10 | $620 | $10.5K |
Showing 1–10 of 17
Medicaid revenue breakdown by year and by CPT/HCPCS procedure code, including monthly billing trends and the top codes driving revenue.
View: By Year1 / 3
Every CPT/HCPCS code this provider has billed to Medicaid, with claims volume, average payment, and total revenue.
4 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 270 | $490 | $130.1K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 340 | $260 | $89K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 40 | $590 | $24.6K |
| L8699 | Prosthetic implant, not otherwise specified | 40 | $80 | $3.1K |
How this provider's Medicaid billing volume and revenue compare to other Hawaii providers billing the same CPT/HCPCS codes.
Full comparison — all codes billed, vs. Hawaii median
4 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| L8699 | Prosthetic implant, not otherwise specified | 6 | 10 | 600 | $650 | $472.4K |
| 45380 | The provider examines the rectum and colon using a flexible colonoscope, a tubular instrument with a light source and camera, to look for the cause of a patient's symptoms, which may include… | 9 | 20 | 190 | $340 | $177.3K |
| 43239 | The provider inserts a flexible endoscope through the mouth and down into the esophagus, stomach, and duodenum where he removes one or more tissue biopsy specimens for diagnostic analysis. | 8 | 30 | 100 | $280 | $111.1K |
| 45378 | The provider examines the colon and rectum using a colonoscope, a flexible tube with a camera at its inserted end. If he sees any areas of abnormal mucosa or tissue, he takes samples using a brush… | 6 | 10 | 90 | $450 | $45.5K |
Other providers in the same ZIP code as Aloha Surgical Center LLC, ranked by combined Medicare and Medicaid revenue.
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