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NPI 1891759601 · Hilo, HI · Ambulatory Surgical Clinic/Center
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Punahele Associates, LLC is a ambulatory surgical clinic/center provider located in Hilo, Hawaii. This profile covers 3 Medicare and 8 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 | Punahele Associates, LLC |
| Address | 82 Puuhonu Place |
| City | Hilo |
| State | HI |
| ZIP | 96720 |
| Taxonomy | Ambulatory Surgical Clinic/Center |
| NPI Enumerated | April 17, 2006 |
Lifetime revenue by payer source (source: CMS Medicare & Medicaid claims data)
| Payer Source | Total Paid |
|---|---|
| Medicare | $338.6K |
| Medicaid | $163.5K |
This ambulatory surgical clinic’s Medicare billing is overwhelmingly driven by cataract surgery: code 66984 accounts for $274.9K (81.2% of this provider's total Medicare revenue), with 66982 contributing $47.2K (13.9%) and 58558 adding $16.4K (4.8%). Precomputed concentration shows the top three Medicare codes account for 100.0% of the provider’s Medicare revenue, indicating the facility’s Medicare business is effectively limited to a very small set of procedures rather than a broad mix of services.
On the Medicaid side the revenue mix is even more concentrated around a single procedure: 66984 generates $154.5K (94.4% of this provider's total Medicaid revenue), and the precomputed top-three share is 99.2% of Medicaid revenue. This pattern indicates the provider’s Medicaid activity is functionally focused on the same cataract service line that dominates Medicare billing.
Comparing payers, lifetime Medicare revenue ($338.6K) exceeds lifetime Medicaid revenue ($163.5K), so Medicare represents the larger share of reported public-payer activity for this entity. Both payers show strong dependence on the same ophthalmic procedure 66984, but Medicare produces roughly the larger absolute dollar amount as reported.
National and specialty competitive standing for the clinic’s primary Medicare codes is broadly “typical, unremarkable”: 66984 ranks #4159 of 15965 providers nationally (74th percentile) and 66982 ranks #1085 of 4580 providers nationally (76th percentile), suggesting the provider delivers cataract surgery at volumes consistent with many peers rather than as a dominant national center. By contrast, code 58558 sits at a lower relative standing for Medicare (rank #269 of 456; 28th percentile), indicating modest activity in hysteroscopic endometrial work compared with specialty peers.
Within-state Medicaid ranks indicate the clinic is a mid-to-upper participant for its dominant cataract code: 66984 ranks #6 of 16 providers in-state (67th percentile; typical, unremarkable volume). Other Medicaid codes show sparse in-state peer sets (for example 59841 ranks #1 of 2 providers in-state with a notation of no state peer volume comparison available), which limits conclusions about competitive dominance for non-ophthalmic services.
Medicaid claim lines include a substantial number of items with little or no payment value, signalling administrative or quality-reporting claims that do not materially drive revenue: S9999 appears in 1.3K claims with $0 revenue, G8907 appears in 58 claims with $0 revenue, G8918 appears in 24 claims with $0 revenue, and anesthesia code 00142 is present in 23 claims with $0 revenue. These patterns suggest the facility submits numerous ancillary or non-reimbursed lines alongside the small set of revenue-driving surgical codes.
The presence of non-ophthalmic billed procedures—58558 on Medicare ($16.4K, 4.8% of Medicare revenue) and 59841 on Medicaid ($5.5K, 3.3% of Medicaid revenue)—indicates some procedural diversity (hysteroscopic uterine procedures and second-trimester terminations) in addition to dominant cataract work. However, the dollar amounts and share figures show these services are secondary to the center’s core ophthalmic operations.
This provider has an established presence, with its NPI enumerated on 2006-04-17 (~20 years ago), and lifetime public-payer revenues reported at $338.6K (Medicare) and $163.5K (Medicaid). Taken together, the data portray a long-tenured, modest-scale ambulatory surgical clinic whose public-payer business is highly concentrated on cataract extraction and intraocular lens implantation procedures.
Medicare revenue breakdown by CPT/HCPCS procedure code.
View: Bar Chart1 / 2
The CPT/HCPCS codes generating the most Medicare revenue for this provider.
3 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 290 | $960 | $274.9K |
| 66982 | The provider inserts an intraocular lens prosthesis after extracapsular cataract extraction using complex techniques and devices. He may perform this by means of an iris expansion device, providing… | 50 | $960 | $47.2K |
| 58558 | The provider either biopsies the lining of the uterus (endometrium) or removes polyps, or both, through a hysteroscope ; he may or may not perform a dilation and curettage (D&C). He sends all samples… | 10 | $1,260 | $16.4K |
How this provider's Medicare billing volume and revenue compare to other providers nationally and within its state, across 3 CPT/HCPCS codes.
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.
8 rows
| CPT/HCPCS Code | Description | Claims | Avg Paid | Revenue |
|---|---|---|---|---|
| 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… | 160 | $950 | $154.5K |
| 59841 | In this procedure, the provider deliberately terminates a pregnancy for elective or therapeutic reasons. He removes the fetus and products of conception by dilating the cervix and then evacuating the… | 10 | $460 | $5.5K |
| L8699 | Prosthetic implant, not otherwise specified | 10 | $190 | $2.3K |
| V2632 | Posterior chamber intraocular lens | 230 | $10 | $1.4K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 20 | $0 | $0 |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 60 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 20 | $0 | $0 |
| S9999 | Sales tax | 1,260 | $0 | $0 |
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
8 rows
| CPT/HCPCS Code | Description | Rank | Provider Count | Median Claims | Avg Paid | Average Revenue |
|---|---|---|---|---|---|---|
| L8699 | Prosthetic implant, not otherwise specified | 8 | 10 | 600 | $650 | $472.4K |
| 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… | 6 | 20 | 80 | $590 | $129.1K |
| 00142 | The provider performs anesthesia services for a patient undergoing an eye lens procedure. | 6 | 10 | 30 | $70 | $7.3K |
| V2632 | Posterior chamber intraocular lens | 4 | 10 | 130 | $20 | $5.8K |
| 59841 | In this procedure, the provider deliberately terminates a pregnancy for elective or therapeutic reasons. He removes the fetus and products of conception by dilating the cervix and then evacuating the… | 1 | 10 | 10 | $340 | $4.1K |
| S9999 | Sales tax | 44 | 240 | 200 | $1 | $820 |
| G8907 | Patient documented not to have experienced any of the following events: a burn prior to discharge; a fall within the facility; wrong site/side/patient/procedure/implant event; or a hospital transfer… | 2 | 10 | 50 | $0 | $0 |
| G8918 | Patient without preoperative order for iv antibiotic surgical site infection (ssi) prophylaxis | 1 | 10 | 20 | $0 | $0 |
Other providers in the same ZIP code as Punahele Associates, LLC, ranked by combined Medicare and Medicaid revenue.
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