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 2014 - September 2015
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Charge
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$3,810$2,553$876
2560Vaginal Delivery$10,775$7,219$2,478
3720Blood Infection/Septicemia$22,457$15,046$5,165
4302Knee Replacement$51,132$34,258$11,760
5540Cesarean Delivery$16,839$11,282$3,873
6194Heart Failure$13,617$9,123$3,132
7139Pneumonia$15,371$10,299$3,535
8301Hip Replacement$50,363$33,743$11,583
9751PsychosesNRNRNR
10753Bipolar DisordersNRNRNR
11140Chronic Obstructive Pulmonary Disease$15,213$10,193$3,499
12201Heart Abnormal Rhythm and Conduction Disorders$8,473$5,677$1,949
13775Alcohol Abuse/Dependence$16,078$10,772$3,698
14460Renal FailureNRNRNR
15383Cellulitis and Other Bacterial Skin Infections$10,734$7,192$2,469
16045Stroke and Precerebral Occlusion with Infarct$16,252$10,889$3,738
17860RehabilitationNRNRNR
18221Major Bowel Procedures$55,729$37,338$12,818
19463Kidney/Urinary Tract Infection$17,440$11,685$4,011
20133Pulmonary Edema/Respiratory FailureNRNRNR
21174Angioplasty with Heart AttackNRNRNR
22247Intestinal Obstruction without Surgery$13,010$8,717$2,992
23750SchizophreniaNRNRNR
24282Disorders of Pancreas Except Malignancy$18,592$12,457$4,276
25254Other Digestive System Diagnoses$15,260$10,224$3,510
26420Diabetes$13,192$8,839$3,034
27249Gastroenteritis$22,333$14,963$5,137
28754DepressionNRNRNR
29812Poisoning of Medicinal Agents$9,775$6,549$2,248
30137Respiratory Infections and Inflammations$12,232$8,195$2,813
31304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$83,880$56,200$19,292
32053SeizureNRNRNR
33134Pulmonary Embolism$11,555$7,742$2,658
34173Other Vascular Procedures$33,103$22,179$7,614
35308Hip/Thigh Surgery with Trauma Diagnosis$39,370$26,378$9,055
36190Circulatory Disorders with Heart Attack$8,540$5,722$1,964
37263Laparoscopic Cholecystectomy$40,985$27,460$9,427
38244Diverticulitis & Diverticulosis$19,596$13,129$4,507
39425Other Electrolyte Disorders$9,030$6,050$2,077
40175Angioplasty without Heart AttackNRNRNR
41241Peptic Ulcer/Gastritis$14,271$9,562$3,282
42861Signs & SymptomsNRNRNR
43315Shoulder/Upper Arm, Forearm SurgeryNRNRNR
44253Other and Unspecified Gastrointestinal HemorrhageNRNRNR
45347Other Back/Neck Disorders, Fractures, Injuries$10,974$7,353$2,524
46313Other Knee/Lower Leg Surgery$30,548$20,467$7,026
47773Opioid Abuse/DependenceNRNRNR
48351Other Musculoskeletal System and Connective Tissue Diagnoses$11,948$8,005$2,748
49248Major G.I. Bacterial Infections$20,988$14,062$4,827
50710Infectious & parasitic diseases including HIV w O.R. procedureNRNRNR
51663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$25,733$17,241$5,919
52191Cardiac Catheterization without Principal Diagnosis of Ischemic Heart DiseaseNRNRNR
53466Malfunction, reaction, complic of genitourinary device or procNRNRNR
54024Extracranial Vascular Procedures$33,173$22,226$7,630
55113Epiglottitis, Ear Infection, URI and Laryngotracheitis$9,616$6,443$2,212
56693ChemotherapyNRNRNR
57141Asthma$8,607$5,767$1,980
58321Upper Spinal Fusion$47,561$31,866$10,939
59721Postoperative and Post-Traumatic InfectionsNRNRNR
60197Peripheral and Other Vascular Disorders$7,016$4,701$1,614
61021Craniotomy Except For TraumaNRNRNR
62225Appendectomy$35,115$23,527$8,076
63144Respiratory System Signs, Symptoms and Minor Diagnoses$36,436$24,412$8,380
64566Other Antepartum Diagnoses$6,781$4,543$1,560
65163Heart Valve Procedures without Cardiac CatheterizationNRNRNR
66143Other respiratory diagnoses except signs, symptoms & minor diagnoses$13,180$8,831$3,031
67192Cardiac Catheterization with Principal Diagnosis of Ischemic Heart DiseaseNRNRNR
68055Head trauma w coma >1 hr or hemorrhageNRNRNR
69052Nontraumatic stupor & comaNRNRNR
70755Neuroses Other Than DepressionNRNRNR
71204Fainting and Collapse$14,035$9,403$3,228
72310Back/Neck Procedures Except Dorsal and Lumbar Fusion$29,431$19,719$6,769
73660Major hematologic/immunologic diag exc sickle cell crisis & coagul$11,076$7,421$2,547
74284Disorders of gallbladder & biliary tract$26,573$17,804$6,112
75422Hypovolemia$9,132$6,118$2,100

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 2014 - September 2015
 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)$7,739$5,185$1,780$10,181$6,821$2,342
Colonoscopy and Biopsy 45380)$5,192$3,479$1,194$6,686$4,480$1,538
Upper GI Endoscopy with Biopsy 43239)$4,516$3,026$1,039$5,794$3,882$1,333
Lesion Removal Colonoscopy by Snare Technique 45385)$5,337$3,576$1,227$6,546$4,386$1,506
Diagnostic Colonoscopy 45378)$4,764$3,192$1,096$5,990$4,013$1,378
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)NRNRNRNRNRNR
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$4,502$3,016$1,035NRNRNR
Carpal Tunnel Surgery 64721)$8,103$5,429$1,864$9,363$6,273$2,154
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$4,310$2,888$991NRNRNR
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$13,979$9,366$3,215$15,016$10,061$3,454
Uppr GI Endoscopy- Diagnostic 43235)$4,281$2,868$985$6,851$4,590$1,576
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)NRNRNRNRNRNR
Left Heart Artery/Ventricle Angiography 93458)NRNRNRNRNRNR
Creation of Eardrum Opening 69436)NRNRNR$12,133$8,129$2,790
Unlisted Dental Surgery Procedure 41899)$10,477$7,020$2,410NRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Laparoscopic Cholecystectomy 47562)$18,567$12,440$4,270$22,310$14,948$5,131
After Cataract Laser Surgery 66821)$2,178$1,459$501NRNRNR
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNRNRNRNR
Cataract Surgery- Complex 66982)$8,475$5,678$1,949NRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)NRNRNRNRNRNR
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Arthroscopic Rotator Cuff Repair 29827)NRNRNR$26,771$17,937$6,157
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$14,022$9,395$3,225$16,359$10,960$3,762
Hysteroscopy with Biopsy 58558)$10,867$7,281$2,499$20,194$13,530$4,645
Biopsy Skin and Subcutaneous Tissue; 1 Lesion 11100)NRNRNRNRNRNR
Esophageal Endoscopy with Dilation 43249)$5,317$3,562$1,223$5,968$3,998$1,373
Unlisted Cystourethoscopy 52000)$6,098$4,086$1,403$6,347$4,252$1,460
Incision of Finger Tendon Sheath 26055)$6,382$4,276$1,468NRNRNR
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$12,108$8,112$2,785NRNRNR
Cystourethroscopy with Lithotripsy and Stent 52356)$20,661$13,843$4,752$22,351$14,975$5,141
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$21,187$14,195$4,873$25,599$17,151$5,888
Laparoscopic Hernia Repair - Initial 49650)$18,997$12,728$4,369$30,065$20,144$6,915
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$15,158$10,156$3,486NRNRNR
Destruction of Premalignant Lesion 17000)NRNRNRNRNRNR
Uppr GI Endoscopy with Guide Wire 43248)$4,461$2,989$1,026NRNRNR
Destruction of Benign Lesions up to 14 Lesions 17110)NRNRNRNRNRNR
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Laparoscopic Appendectomy 44970)$20,618$13,814$4,742$26,983$18,079$6,206
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Cystourethroscopy with Stent 52332)$8,466$5,672$1,947$16,811$11,264$3,867
Injections; Single or Multiple Trigger Points, 1 or 2 Muscles 20552)NRNRNRNRNRNR
Removal of Tonsils 42826)$12,111$8,114$2,786$16,336$10,945$3,757
Repair of Nasal Septum 30520)$13,820$9,260$3,179$15,009$10,056$3,452
Low Back Disk Surgery 63030)$19,563$13,107$4,499NRNRNR
Fragmenting of Kidney Stone 50590)$12,984$8,699$2,986$14,871$9,964$3,420
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)NRNRNR$27,984$18,749$6,436
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$15,784$10,575$3,630$22,526$15,092$5,181
Mastectomy, Partial 19301)$16,988$11,382$3,907$32,529$21,795$7,482
Coronary Artery Angio S&I 93454)NRNRNRNRNRNR
Laparoscopy - Removal of Adnexal Structures 58661)$20,364$13,644$4,684$20,347$13,632$4,680
Debridement Skin/Tissue 11042)$13,376$8,962$3,076$10,078$6,752$2,318
Needle Biopsy of Liver 47000)NRNRNRNRNRNR
Remove Impacted Ear Wax 69210)$7,225$4,840$1,662$10,934$7,326$2,515
Hysteroscopy with Ablation 58563)$14,939$10,009$3,436$20,142$13,495$4,633
Laparoscopy, Removal of Tubes & Ovaries 58571)NRNRNR$30,802$20,637$7,085
Apheresis Plasma 36514)NRNRNRNRNRNR
Aspirate Pleura with Imaging 32555)NRNRNRNRNRNR
Diagnostic Laryngoscopy 31575)NRNRNRNRNRNR
Right and Left Heart Artery/Ventricle Angiography 93460)NRNRNRNRNRNR
Debridement, Open Wound <= 20 Square Centimeters 97597)NRNRNRNRNRNR
Correction of Bunion 28296)NRNRNRNRNRNR
Bone Marrow Biopsy 38221)NRNRNRNRNRNR
Transluminal balloon angioplasty, percutaneous, venous 35476)NRNRNRNRNRNR
Shoulder Arthroscopy/Surgery 29824)NRNRNR$20,427$13,686$4,698
Electro-Uroflowmetry - First 51741)NRNRNRNRNRNR
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
Removal of Adenoids 42830)NRNRNRNRNRNR
Electronic analysis of implantable pump spine w/reprogram/refill 62369)NRNRNRNRNRNR
Removal of Central Venous Device w Port or Pump 36590)$7,189$4,817$1,654NRNRNR
Insertion of Central Venous Catheter >= 5 years 36569)NRNRNRNRNRNR
Removal of Breast Lesion 19120)$10,966$7,347$2,522NRNRNR
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.