Hawaii Medicaid Reimbursement Rates
What Medicaid pays for medical procedures and services in Hawaii, based on 2024 claims data.
2024 Overview
Procedures
1.4K
Total Claims
7.0M
Total Paid
$608.4M
Popular Services
Procedures
Showing 51–100 of 1,441 procedures, sorted by most claims.
| HCPCS Code | Description | Total Claims | Avg Payment | Min Payment | Max Payment |
|---|---|---|---|---|---|
| S0302 | Completed epsdt | 27,878 | $33.76 | $0.00 | $58.18 |
| S5170 | Homedelivered prepared meal | 27,459 | $93.69 | $15.54 | $646.71 |
| D0140 | Limit oral eval problm focus | 26,944 | $224.01 | $21.71 | $463.04 |
| D0272 | Dental bitewings two images | 26,722 | $21.14 | $12.51 | $27.43 |
| 82565 | Assay of creatinine | 26,546 | $1.76 | $0.00 | $18.36 |
| 92015 | Determine refractive state | 26,477 | $9.64 | $0.00 | $51.00 |
| G9273 | Sys<140 and dia<90 | 26,374 | $0.00 | $0.00 | $0.00 |
| 1000F | Tobacco use assessed | 26,039 | $0.06 | $0.00 | $5.39 |
| S5105 | Centerbased day care perdiem | 25,826 | $61.76 | $20.43 | $245.68 |
| 84520 | Assay of urea nitrogen | 25,815 | $0.75 | $0.00 | $13.93 |
| 71046 | X-ray exam chest 2 views | 25,808 | $18.90 | $0.00 | $193.96 |
| J3490 | Drugs unclassified injection | 25,695 | $305.00 | $0.00 | $6,222.36 |
| G0463 | Hospital outpt clinic visit | 25,619 | $54.64 | $0.00 | $272.42 |
| 97140 | Manual therapy 1/> regions | 25,203 | $28.10 | $0.00 | $224.46 |
| 1126F | Amnt pain noted none prsnt | 24,799 | $0.00 | $0.00 | $0.00 |
| 87635 | Sars-cov-2 covid-19 amp prb | 23,701 | $34.11 | $0.00 | $222.38 |
| 99212 | Office o/p est sf 10 min | 23,527 | $109.79 | $0.00 | $539.55 |
| 96374 | Ther/proph/diag inj iv push | 23,465 | $6.64 | $0.00 | $123.71 |
| 87491 | Chlmyd trach dna amp probe | 23,415 | $93.57 | $0.00 | $336.07 |
| 90832 | Psytx w pt 30 minutes | 23,393 | $254.67 | $0.00 | $531.37 |
| 87591 | N.gonorrhoeae dna amp prob | 23,289 | $25.97 | $0.00 | $42.99 |
| 87502 | Influenza dna amp probe | 23,172 | $60.58 | $0.00 | $330.28 |
| 83540 | Assay of iron | 22,973 | $2.70 | $0.00 | $7.66 |
| 93010 | Electrocardiogram report | 22,891 | $6.61 | $0.00 | $23.08 |
| 1159F | Med list docd in rcrd | 22,535 | $0.00 | $0.00 | $0.00 |
| 1160F | Rvw meds by rx/dr in rcrd | 21,949 | $0.00 | $0.00 | $0.00 |
| A0425 | Ground mileage | 21,670 | $16.83 | $0.00 | $38.40 |
| 90471 | Immunization admin | 21,098 | $20.94 | $0.00 | $67.89 |
| D9999 | Adjunctive procedure | 20,906 | $340.51 | $177.18 | $533.25 |
| 84484 | Assay of troponin quant | 20,583 | $1.38 | $0.00 | $44.00 |
| G0467 | Fqhc visit, estab pt | 20,203 | $90.83 | $0.00 | $405.53 |
| 90833 | Psytx w pt w e/m 30 min | 20,133 | $44.08 | $0.00 | $173.61 |
| 85027 | Complete cbc automated | 20,120 | $7.59 | $0.00 | $80.17 |
| J2405 | Ondansetron hcl injection | 20,043 | $0.02 | $0.00 | $0.32 |
| 80051 | Electrolyte panel | 19,693 | $5.86 | $0.00 | $30.60 |
| 83690 | Assay of lipase | 19,620 | $2.59 | $0.00 | $28.60 |
| 84439 | Assay of free thyroxine | 19,398 | $6.74 | $0.00 | $10.12 |
| 1220F | Pt screened for depression | 19,384 | $0.00 | $0.00 | $0.00 |
| 83735 | Assay of magnesium | 19,268 | $2.11 | $0.00 | $7.72 |
| 99233 | Sbsq hosp ip/obs high 50 | 18,863 | $65.65 | $11.15 | $126.24 |
| 97530 | Therapeutic activities | 18,667 | $56.51 | $0.00 | $156.15 |
| 85610 | Prothrombin time | 18,647 | $2.54 | $0.00 | $19.12 |
| 99282 | Emergency dept visit sf mdm | 18,586 | $436.11 | $0.00 | $796.23 |
| D1110 | Dental prophylaxis adult | 18,520 | $43.79 | $17.61 | $64.00 |
| 99232 | Sbsq hosp ip/obs moderate 35 | 18,484 | $49.58 | $12.58 | $82.14 |
| 1036F | Tobacco non-user | 18,411 | $0.00 | $0.00 | $0.00 |
| 88305 | Tissue exam by pathologist | 18,086 | $89.59 | $0.00 | $1,706.11 |
| 96375 | Tx/pro/dx inj new drug addon | 17,974 | $0.96 | $0.00 | $26.77 |
| Q9967 | Locm 300-399mg/ml iodine,1ml | 17,830 | $0.19 | $0.00 | $20.63 |
| 87186 | Sc std microdil/agar dil | 17,643 | $13.86 | $0.00 | $87.25 |