St Joseph's Community Hospital of West Bend, Inc
3200 Pleasant Valley Road
West Bend, WI 53095
262-334-5533

Charges for 75 Most Common Hospitalizations in Wisconsin:  October 2015 - September 2016
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Charge
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$4,047$2,792$931
2560Vaginal Delivery$12,898$8,900$2,967
3720Blood Infection/Septicemia$15,723$10,849$3,616
4302Knee Replacement$50,688$34,975$11,658
5540Cesarean Delivery$17,884$12,340$4,113
6194Heart Failure$13,080$9,025$3,008
7301Hip Replacement$50,833$35,075$11,692
8139Pneumonia$15,132$10,441$3,480
9751PsychosesNRNRNR
10753Bipolar DisordersNRNRNR
11775Alcohol Abuse/Dependence$14,811$10,220$3,407
12201Heart Abnormal Rhythm and Conduction Disorders$11,602$8,005$2,668
13140Chronic Obstructive Pulmonary Disease$20,362$14,050$4,683
14383Cellulitis and Other Bacterial Skin Infections$12,052$8,316$2,772
15045Stroke and Precerebral Occlusion with Infarct$18,231$12,579$4,193
16460Renal FailureNRNRNR
17133Pulmonary Edema/Respiratory FailureNRNRNR
18463Kidney/Urinary Tract Infection$12,584$8,683$2,894
19221Major Bowel Procedures$59,207$40,853$13,618
20754DepressionNRNRNR
21174Angioplasty with Heart AttackNRNRNR
22750SchizophreniaNRNRNR
23420DiabetesNRNRNR
24247Intestinal Obstruction without Surgery$20,020$13,814$4,605
25282Disorders of Pancreas Except Malignancy$22,802$15,733$5,244
26812Poisoning of Medicinal Agents$11,547$7,967$2,656
27254Other Digestive System Diagnoses$14,950$10,316$3,439
28710Infectious & parasitic diseases including HIV w O.R. procedure$37,559$25,916$8,639
29304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back CurvatureNRNRNR
30190Circulatory Disorders with Heart Attack$8,120$5,603$1,868
31773Opioid Abuse/Dependence$24,057$16,599$5,533
32173Other Vascular ProceduresNRNRNR
33137Respiratory Infections and Inflammations$30,295$20,904$6,968
34053Seizure$15,962$11,014$3,671
35058Other Disorders of Nervous System$10,660$7,355$2,452
36308Hip/Thigh Surgery with Trauma Diagnosis$41,492$28,629$9,543
37263Laparoscopic Cholecystectomy$37,371$25,786$8,595
38134Pulmonary Embolism$24,090$16,622$5,541
39315Shoulder/Upper Arm, Forearm Surgery$32,340$22,315$7,438
40175Angioplasty without Heart AttackNRNRNR
41249Gastroenteritis$14,553$10,042$3,347
42244Diverticulitis & Diverticulosis$21,731$14,994$4,998
43861Signs & SymptomsNRNRNR
44347Other Back/Neck Disorders, Fractures, Injuries$19,578$13,509$4,503
45253Other and Unspecified Gastrointestinal Hemorrhage$62,163$42,892$14,297
46313Other Knee/Lower Leg Surgery$34,560$23,846$7,949
47862Other Factors Influencing Health StatusNRNRNR
48191Cardiac Catheterization without Principal Diagnosis of Ischemic Heart DiseaseNRNRNR
49351Other Musculoskeletal System and Connective Tissue Diagnoses$10,582$7,302$2,434
50241Peptic Ulcer/Gastritis$12,225$8,435$2,812
51425Other Electrolyte Disorders$11,215$7,738$2,579
52248Major G.I. Bacterial Infections$18,504$12,768$4,256
53663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$15,402$10,627$3,542
54466Malfunction, reaction, complic of genitourinary device or procNRNRNR
55024Extracranial Vascular Procedures$33,828$23,341$7,780
56950Extensive Procedure Unrelated to Principal DiagnosisNRNRNR
57951Moderately Extensive Procedure Unrelated to Diagnosis$15,698$10,832$3,611
58693ChemotherapyNRNRNR
59021Craniotomy Except For TraumaNRNRNR
60566Other Antepartum Diagnoses$10,002$6,901$2,300
61197Peripheral and Other Vascular DisordersNRNRNR
62220Major Stomach/Esophagus/Duodenum Procedures$26,209$18,084$6,028
63422HypovolemiaNRNRNR
64225Appendectomy$34,381$23,723$7,908
65052Nontraumatic stupor & coma$19,243$13,278$4,426
66321Upper Spinal FusionNRNRNR
67141Asthma$14,306$9,871$3,290
68755Neuroses Other Than DepressionNRNRNR
69192Cardiac Catheterization with Principal Diagnosis of Ischemic Heart DiseaseNRNRNR
70055Head trauma w coma >1 hr or hemorrhageNRNRNR
71721Postoperative and Post-Traumatic Infections$8,916$6,152$2,051
72163Heart Valve Procedures without Cardiac CatheterizationNRNRNR
73204Fainting and Collapse$9,010$6,217$2,072
74639Neonate Birthwt >2499g with Other Significant Condition$17,953$12,388$4,129
75756Acute Adjust React Psychosocial Dysfunction$24,716$17,054$5,685

NR = No Cases Reported

This report was produced in part by using computer software created, owned and licensed by the 3M Company. All copyrights in and to the 3M™ APR DRG Software, and to the 3M™ APR DRG Classification System(s) (including the selection, coordination and arrangement of all codes) are owned by 3M. All rights reserved.
Charges for 75 Most Common Types of Outpatient Surgical Procedures in Wisconsin:  October 2015 - September 2016
 With No Other ProceduresWith 1 or More Additional Procedures
Principal ProcedureMedian ChargeAverage Commercial Insurance PaymentAverage Medicare Insurance Payment*Median ChargeAverage Commercial Insurance PaymentAverage Medicare Insurance Payment*
Cataract Surgery with Intraocular Lens - Stage 1 66984)$8,150$5,624$1,875$11,354$7,834$2,611
Colonoscopy and Biopsy 45380)$5,419$3,739$1,246$6,363$4,391$1,464
Lesion Removal Colonoscopy by Snare Technique 45385)$5,285$3,646$1,215$6,609$4,560$1,520
Upper GI Endoscopy with Biopsy 43239)$4,905$3,384$1,128$6,112$4,217$1,406
Diagnostic Colonoscopy 45378)$4,720$3,257$1,086$6,223$4,294$1,431
Injection into Lumbar or Sacral Area, Single Level 64483)NRNRNRNRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)NRNRNRNRNRNR
Drain/Inject Major Joint or Bursa 20610)$5,678$3,918$1,306NRNRNR
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$4,644$3,205$1,068NRNRNR
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$4,756$3,282$1,094NRNRNR
Carpal Tunnel Surgery 64721)$8,725$6,020$2,007$10,024$6,917$2,306
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$15,159$10,460$3,487$16,575$11,437$3,812
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Uppr GI Endoscopy- Diagnostic 43235)$4,519$3,118$1,039$4,916$3,392$1,131
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)NRNRNRNRNRNR
Creation of Eardrum Opening 69436)$7,587$5,235$1,745$12,038$8,306$2,769
Left Heart Artery/Ventricle Angiography 93458)NRNRNRNRNRNR
Unlisted Dental Surgery Procedure 41899)$11,627$8,023$2,674$12,961$8,943$2,981
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
After Cataract Laser Surgery 66821)NRNRNRNRNRNR
Laparoscopic Cholecystectomy 47562)$19,193$13,243$4,414$26,104$18,012$6,004
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNRNRNRNR
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)$12,444$8,586$2,862$12,373$8,537$2,846
Cataract Surgery- Complex 66982)$8,798$6,071$2,024NRNRNR
Esophageal Endoscopy with Dilation 43249)$5,392$3,721$1,240$5,814$4,012$1,337
Arthroscopic Rotator Cuff Repair 29827)NRNRNR$28,324$19,544$6,515
Hysteroscopy with Biopsy 58558)$13,415$9,257$3,086$16,893$11,656$3,885
Biopsy Skin and Subcutaneous Tissue; 1 Lesion 11100)NRNRNRNRNRNR
Cystourethroscopy with Lithotripsy and Stent 52356)$21,831$15,063$5,021$23,919$16,504$5,501
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$15,233$10,511$3,504$21,920$15,125$5,042
Incision of Finger Tendon Sheath 26055)$9,277$6,401$2,134$10,019$6,913$2,304
Laparoscopic Hernia Repair - Initial 49650)$22,007$15,185$5,062$27,410$18,913$6,304
Unlisted Cystourethoscopy 52000)$6,373$4,398$1,466$14,842$10,241$3,414
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$21,952$15,147$5,049$20,314$14,017$4,672
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$12,070$8,328$2,776$16,471$11,365$3,788
Uppr GI Endoscopy with Guide Wire 43248)$4,701$3,243$1,081$5,566$3,840$1,280
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Destruction of Premalignant Lesion 17000)NRNRNRNRNRNR
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$15,234$10,512$3,504$21,377$14,750$4,917
Laparoscopic Appendectomy 44970)$25,041$17,278$5,759$29,663$20,467$6,822
Destruction of Benign Lesions up to 14 Lesions 17110)NRNRNRNRNRNR
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Cystourethroscopy with Stent 52332)$9,451$6,521$2,174$11,994$8,276$2,759
Removal of Tonsils 42826)$11,232$7,750$2,583$12,059$8,321$2,774
Laparoscopy - Removal of Adnexal Structures 58661)$21,182$14,616$4,872$24,074$16,611$5,537
Injections; Single or Multiple Trigger Points, 1 or 2 Muscles 20552)NRNRNRNRNRNR
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$15,020$10,364$3,455$31,810$21,949$7,316
Mastectomy, Partial 19301)$18,546$12,797$4,266$27,228$18,787$6,262
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)NRNRNR$31,671$21,853$7,284
Low Back Disk Surgery 63030)NRNRNRNRNRNR
Repair of Nasal Septum 30520)NRNRNR$17,525$12,093$4,031
Fragmenting of Kidney Stone 50590)$6,165$4,254$1,418NRNRNR
Laparoscopy, Removal of Tubes & Ovaries 58571)$35,041$24,179$8,060NRNRNR
Needle Biopsy of Liver 47000)NRNRNR$26,796$18,489$6,163
Aspirate Pleura with Imaging 32555)NRNRNRNRNRNR
Coronary Artery Angio S&I 93454)NRNRNRNRNRNR
Debridement Skin/Tissue 11042)$12,862$8,875$2,958NRNRNR
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
Hysteroscopy with Ablation 58563)$16,133$11,132$3,711$16,786$11,582$3,861
Transluminal balloon angioplasty, percutaneous, venous 35476)NRNRNRNRNRNR
Bone Marrow Biopsy 38221)NRNRNRNRNRNR
Diagnostic Laryngoscopy 31575)NRNRNRNRNRNR
Correction of Bunion 28296)NRNRNR$23,049$15,904$5,301
Remove Impacted Ear Wax 69210)NRNRNRNRNRNR
Shoulder Arthroscopy/Surgery 29824)NRNRNR$18,997$13,108$4,369
Apheresis Plasma 36514)NRNRNRNRNRNR
Right and Left Heart Artery/Ventricle Angiography 93460)NRNRNRNRNRNR
Biopsy of lung or mediastinum, percutaneous w/needle 32405)NRNRNRNRNRNR
Removal of Adenoids 42830)$11,764$8,117$2,706$12,811$8,840$2,947
Electro-Uroflowmetry - First 51741)NRNRNRNRNRNR
Removal of Central Venous Device w Port or Pump 36590)$8,480$5,851$1,950NRNRNR
Ablation therapy of first vein of extremity 36475)$18,173$12,539$4,180$23,758$16,393$5,464
Injection of chemical agent into muscles near face/neck 64615)NRNRNRNRNRNR
Debridement, Open Wound <= 20 Square Centimeters 97597)NRNRNRNRNRNR
Information about quality and safety of care for St Joseph's Community Hospital of West Bend, Inc may be found at http://www.wicheckpoint.org
* Estimated Insurance Payments based on average percent of billed charges collected.