Community Memorial Hospital of Menomonee Falls, Inc
W180 N8085 Town Hall Road
Menomonee Falls, WI 53051
262-251-1000

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+$3,100$1,860$651
2560Vaginal Delivery$14,231$8,539$2,989
3720Blood Infection/Septicemia$14,227$8,536$2,988
4302Knee Replacement$43,265$25,959$9,086
5540Cesarean Delivery$19,016$11,410$3,993
6194Heart Failure$12,230$7,338$2,568
7301Hip Replacement$44,326$26,596$9,308
8139Pneumonia$12,756$7,654$2,679
9751Psychoses$8,834$5,300$1,855
10753Bipolar Disorders$7,093$4,256$1,490
11775Alcohol Abuse/Dependence$6,772$4,063$1,422
12201Heart Abnormal Rhythm and Conduction Disorders$13,298$7,979$2,793
13140Chronic Obstructive Pulmonary Disease$13,066$7,840$2,744
14383Cellulitis and Other Bacterial Skin Infections$10,926$6,556$2,294
15045Stroke and Precerebral Occlusion with Infarct$17,844$10,706$3,747
16460Renal FailureNRNRNR
17133Pulmonary Edema/Respiratory FailureNRNRNR
18463Kidney/Urinary Tract Infection$11,912$7,147$2,502
19221Major Bowel Procedures$51,338$30,803$10,781
20754Depression$7,165$4,299$1,505
21174Angioplasty with Heart Attack$72,005$43,203$15,121
22750Schizophrenia$11,342$6,805$2,382
23420Diabetes$9,785$5,871$2,055
24247Intestinal Obstruction without Surgery$17,869$10,721$3,752
25282Disorders of Pancreas Except Malignancy$22,790$13,674$4,786
26812Poisoning of Medicinal Agents$5,911$3,547$1,241
27254Other Digestive System Diagnoses$14,702$8,821$3,087
28710Infectious & parasitic diseases including HIV w O.R. procedure$34,159$20,495$7,173
29304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$56,832$34,099$11,935
30190Circulatory Disorders with Heart Attack$19,437$11,662$4,082
31773Opioid Abuse/Dependence$9,931$5,959$2,086
32173Other Vascular Procedures$41,849$25,109$8,788
33137Respiratory Infections and InflammationsNRNRNR
34053Seizure$17,480$10,488$3,671
35058Other Disorders of Nervous System$35,793$21,476$7,517
36308Hip/Thigh Surgery with Trauma Diagnosis$39,638$23,783$8,324
37263Laparoscopic Cholecystectomy$32,596$19,558$6,845
38134Pulmonary Embolism$11,280$6,768$2,369
39315Shoulder/Upper Arm, Forearm Surgery$34,848$20,909$7,318
40175Angioplasty without Heart Attack$70,689$42,413$14,845
41249Gastroenteritis$21,352$12,811$4,484
42244Diverticulitis & Diverticulosis$15,105$9,063$3,172
43861Signs & Symptoms$9,649$5,789$2,026
44347Other Back/Neck Disorders, Fractures, Injuries$17,970$10,782$3,774
45253Other and Unspecified Gastrointestinal Hemorrhage$17,621$10,573$3,700
46313Other Knee/Lower Leg Surgery$30,550$18,330$6,416
47862Other Factors Influencing Health Status$24,558$14,735$5,157
48191Cardiac Catheterization without Principal Diagnosis of Ischemic Heart Disease$22,373$13,424$4,698
49351Other Musculoskeletal System and Connective Tissue Diagnoses$14,016$8,410$2,943
50241Peptic Ulcer/Gastritis$18,769$11,261$3,941
51425Other Electrolyte Disorders$34,717$20,830$7,291
52248Major G.I. Bacterial Infections$18,507$11,104$3,886
53663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$15,198$9,119$3,192
54466Malfunction, reaction, complic of genitourinary device or procNRNRNR
55024Extracranial Vascular Procedures$35,174$21,104$7,387
56950Extensive Procedure Unrelated to Principal DiagnosisNRNRNR
57951Moderately Extensive Procedure Unrelated to Diagnosis$19,444$11,666$4,083
58693ChemotherapyNRNRNR
59021Craniotomy Except For TraumaNRNRNR
60566Other Antepartum Diagnoses$10,087$6,052$2,118
61197Peripheral and Other Vascular DisordersNRNRNR
62220Major Stomach/Esophagus/Duodenum Procedures$57,095$34,257$11,990
63422Hypovolemia$23,944$14,366$5,028
64225Appendectomy$30,701$18,421$6,447
65052Nontraumatic stupor & coma$12,664$7,598$2,659
66321Upper Spinal Fusion$56,913$34,148$11,952
67141Asthma$7,656$4,594$1,608
68755Neuroses Other Than Depression$4,434$2,660$931
69192Cardiac Catheterization with Principal Diagnosis of Ischemic Heart Disease$18,958$11,375$3,981
70055Head trauma w coma >1 hr or hemorrhage$14,721$8,833$3,091
71721Postoperative and Post-Traumatic InfectionsNRNRNR
72163Heart Valve Procedures without Cardiac Catheterization$167,195$100,317$35,111
73204Fainting and CollapseNRNRNR
74639Neonate Birthwt >2499g with Other Significant Condition$6,012$3,607$1,263
75756Acute Adjust React Psychosocial Dysfunction$9,816$5,890$2,061

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)$8,447$5,068$1,774$10,725$6,435$2,252
Colonoscopy and Biopsy 45380)$6,540$3,924$1,373$7,582$4,549$1,592
Lesion Removal Colonoscopy by Snare Technique 45385)$8,807$5,284$1,849$7,151$4,291$1,502
Upper GI Endoscopy with Biopsy 43239)$5,858$3,515$1,230$7,556$4,534$1,587
Diagnostic Colonoscopy 45378)$5,874$3,524$1,234$12,310$7,386$2,585
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)NRNRNR$16,655$9,993$3,498
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$5,531$3,319$1,161NRNRNR
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$5,576$3,346$1,171$8,257$4,954$1,734
Carpal Tunnel Surgery 64721)$6,861$4,116$1,441$7,237$4,342$1,520
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$13,494$8,096$2,834$25,705$15,423$5,398
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Uppr GI Endoscopy- Diagnostic 43235)$4,520$2,712$949$6,677$4,006$1,402
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)$7,057$4,234$1,482$7,919$4,751$1,663
Creation of Eardrum Opening 69436)NRNRNR$10,512$6,307$2,207
Left Heart Artery/Ventricle Angiography 93458)$11,354$6,812$2,384$50,713$30,428$10,650
Unlisted Dental Surgery Procedure 41899)NRNRNRNRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
After Cataract Laser Surgery 66821)$2,015$1,209$423$2,015$1,209$423
Laparoscopic Cholecystectomy 47562)$19,731$11,839$4,143$27,936$16,761$5,866
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNRNRNRNR
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)NRNRNRNRNRNR
Cataract Surgery- Complex 66982)$9,320$5,592$1,957NRNRNR
Esophageal Endoscopy with Dilation 43249)$5,497$3,298$1,154$6,532$3,919$1,372
Arthroscopic Rotator Cuff Repair 29827)NRNRNR$23,679$14,207$4,973
Hysteroscopy with Biopsy 58558)$13,190$7,914$2,770$14,594$8,756$3,065
Biopsy Skin and Subcutaneous Tissue; 1 Lesion 11100)NRNRNR$12,323$7,394$2,588
Cystourethroscopy with Lithotripsy and Stent 52356)$20,346$12,208$4,273$25,603$15,362$5,377
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$14,364$8,618$3,016$21,031$12,618$4,416
Incision of Finger Tendon Sheath 26055)$6,567$3,940$1,379$6,809$4,085$1,430
Laparoscopic Hernia Repair - Initial 49650)$27,717$16,630$5,820$28,316$16,990$5,946
Unlisted Cystourethoscopy 52000)$8,181$4,909$1,718$11,494$6,897$2,414
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$22,194$13,316$4,661$23,032$13,819$4,837
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$12,657$7,594$2,658$21,399$12,839$4,494
Uppr GI Endoscopy with Guide Wire 43248)NRNRNRNRNRNR
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)$13,296$7,978$2,792$38,828$23,297$8,154
Laparoscopic Appendectomy 44970)$21,711$13,027$4,559$29,852$17,911$6,269
Destruction of Benign Lesions up to 14 Lesions 17110)NRNRNRNRNRNR
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Cystourethroscopy with Stent 52332)$10,268$6,161$2,156$14,285$8,571$3,000
Removal of Tonsils 42826)NRNRNRNRNRNR
Laparoscopy - Removal of Adnexal Structures 58661)$23,647$14,188$4,966$25,923$15,554$5,444
Injections; Single or Multiple Trigger Points, 1 or 2 Muscles 20552)NRNRNRNRNRNR
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$11,809$7,085$2,480$26,692$16,015$5,605
Mastectomy, Partial 19301)$17,638$10,583$3,704$26,945$16,167$5,658
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$29,688$17,813$6,235$31,340$18,804$6,581
Low Back Disk Surgery 63030)$27,719$16,632$5,821$31,442$18,865$6,603
Repair of Nasal Septum 30520)NRNRNR$14,896$8,938$3,128
Fragmenting of Kidney Stone 50590)NRNRNR$15,161$9,097$3,184
Laparoscopy, Removal of Tubes & Ovaries 58571)$35,228$21,137$7,398$38,330$22,998$8,049
Needle Biopsy of Liver 47000)NRNRNRNRNRNR
Aspirate Pleura with Imaging 32555)NRNRNRNRNRNR
Coronary Artery Angio S&I 93454)$11,209$6,725$2,354$49,048$29,429$10,300
Debridement Skin/Tissue 11042)$6,664$3,998$1,399$16,051$9,630$3,371
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
Hysteroscopy with Ablation 58563)$14,575$8,745$3,061$22,183$13,310$4,658
Transluminal balloon angioplasty, percutaneous, venous 35476)NRNRNRNRNRNR
Bone Marrow Biopsy 38221)NRNRNRNRNRNR
Diagnostic Laryngoscopy 31575)NRNRNRNRNRNR
Correction of Bunion 28296)NRNRNRNRNRNR
Remove Impacted Ear Wax 69210)NRNRNRNRNRNR
Shoulder Arthroscopy/Surgery 29824)NRNRNR$19,943$11,966$4,188
Apheresis Plasma 36514)NRNRNRNRNRNR
Right and Left Heart Artery/Ventricle Angiography 93460)$12,334$7,401$2,590$39,321$23,593$8,257
Biopsy of lung or mediastinum, percutaneous w/needle 32405)NRNRNRNRNRNR
Removal of Adenoids 42830)NRNRNRNRNRNR
Electro-Uroflowmetry - First 51741)NRNRNRNRNRNR
Removal of Central Venous Device w Port or Pump 36590)$10,771$6,463$2,262NRNRNR
Ablation therapy of first vein of extremity 36475)NRNRNRNRNRNR
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 Community Memorial Hospital of Menomonee Falls, Inc may be found at http://www.wicheckpoint.org
* Estimated Insurance Payments based on average percent of billed charges collected.