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:  April 2014 - March 2015
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Charge
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$2,735$1,696$711
2560Vaginal Delivery$12,031$7,459$3,128
3720Blood Infection/Septicemia$12,442$7,714$3,235
4302Knee Replacement$45,577$28,258$11,850
5540Cesarean Delivery$18,104$11,224$4,707
6194Heart Failure$15,494$9,606$4,028
7139Pneumonia$14,329$8,884$3,726
8301Hip Replacement$48,240$29,909$12,542
9751Psychoses$9,373$5,811$2,437
10753Bipolar Disorders$8,844$5,483$2,299
11140Chronic Obstructive Pulmonary Disease$14,358$8,902$3,733
12201Heart Abnormal Rhythm and Conduction Disorders$10,843$6,723$2,819
13775Alcohol Abuse/Dependence$8,742$5,420$2,273
14383Cellulitis and Other Bacterial Skin Infections$12,364$7,666$3,215
15460Renal FailureNRNRNR
16045Stroke and Precerebral Occlusion with Infarct$16,677$10,340$4,336
17463Kidney/Urinary Tract Infection$24,192$14,999$6,290
18860Rehabilitation$29,254$18,137$7,606
19221Major Bowel Procedures$49,827$30,893$12,955
20133Pulmonary Edema/Respiratory Failure$73,008$45,265$18,982
21750Schizophrenia$8,265$5,124$2,149
22174Angioplasty with Heart Attack$52,824$32,751$13,734
23254Other Digestive System Diagnoses$14,544$9,017$3,781
24247Intestinal Obstruction without Surgery$14,899$9,237$3,874
25282Disorders of Pancreas Except Malignancy$18,027$11,177$4,687
26420Diabetes$11,024$6,835$2,866
27249Gastroenteritis$15,880$9,846$4,129
28754Depression$5,425$3,364$1,411
29053Seizure$14,299$8,865$3,718
30304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$62,272$38,609$16,191
31812Poisoning of Medicinal Agents$10,939$6,782$2,844
32137Respiratory Infections and Inflammations$13,730$8,513$3,570
33134Pulmonary Embolism$11,452$7,100$2,978
34190Circulatory Disorders with Heart Attack$19,338$11,990$5,028
35308Hip/Thigh Surgery with Trauma Diagnosis$37,742$23,400$9,813
36173Other Vascular Procedures$44,691$27,708$11,620
37175Angioplasty without Heart Attack$64,190$39,798$16,689
38263Laparoscopic Cholecystectomy$28,713$17,802$7,465
39425Other Electrolyte Disorders$10,445$6,476$2,716
40244Diverticulitis & Diverticulosis$13,919$8,630$3,619
41347Other Back/Neck Disorders, Fractures, Injuries$13,211$8,191$3,435
42861Signs & Symptoms$13,800$8,556$3,588
43241Peptic Ulcer/Gastritis$15,140$9,387$3,936
44315Shoulder/Upper Arm, Forearm SurgeryNRNRNR
45253Other and Unspecified Gastrointestinal Hemorrhage$24,459$15,165$6,359
46313Other Knee/Lower Leg Surgery$29,364$18,206$7,635
47141Asthma$6,022$3,734$1,566
48351Other Musculoskeletal System and Connective Tissue Diagnoses$14,884$9,228$3,870
49663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$14,723$9,128$3,828
50773Opioid Abuse/Dependence$7,719$4,786$2,007
51248Major G.I. Bacterial Infections$19,452$12,060$5,058
52710Infectious & parasitic diseases including HIV w O.R. procedureNRNRNR
53191Cardiac Catheterization without Principal Diagnosis of Ischemic Heart Disease$23,495$14,567$6,109
54693Chemotherapy$35,506$22,014$9,232
55466Malfunction, reaction, complic of genitourinary device or procNRNRNR
56113Epiglottitis, Ear Infection, URI and LaryngotracheitisNRNRNR
57024Extracranial Vascular Procedures$30,885$19,149$8,030
58321Upper Spinal Fusion$41,605$25,795$10,817
59721Postoperative and Post-Traumatic Infections$24,124$14,957$6,272
60144Respiratory System Signs, Symptoms and Minor Diagnoses$26,142$16,208$6,797
61225Appendectomy$28,455$17,642$7,398
62197Peripheral and Other Vascular Disorders$7,067$4,382$1,837
63021Craniotomy Except For TraumaNRNRNR
64192Cardiac Catheterization with Principal Diagnosis of Ischemic Heart Disease$21,077$13,068$5,480
65566Other Antepartum Diagnoses$11,700$7,254$3,042
66163Heart Valve Procedures without Cardiac Catheterization$127,408$78,993$33,126
67204Fainting and Collapse$9,933$6,158$2,583
68143Other respiratory diagnoses except signs, symptoms & minor diagnoses$11,369$7,049$2,956
69052Nontraumatic stupor & coma$13,388$8,301$3,481
70055Head trauma w coma >1 hr or hemorrhage$11,130$6,901$2,894
71755Neuroses Other Than Depression$3,802$2,357$989
72310Back/Neck Procedures Except Dorsal and Lumbar Fusion$39,613$24,560$10,299
73660Major hematologic/immunologic diag exc sickle cell crisis & coagul$11,783$7,305$3,064
74198Chest Pain with Angina Pectoris or Coronary Atherosclerosis$9,782$6,065$2,543
75422HypovolemiaNRNRNR

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:  April 2014 - March 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)$7,811$4,843$2,031$6,778$4,202$1,762
Colonoscopy and Biopsy 45380)$6,181$3,832$1,607$7,203$4,466$1,873
Upper GI Endoscopy with Biopsy 43239)$5,315$3,296$1,382$6,920$4,290$1,799
Lesion Removal Colonoscopy by Snare Technique 45385)$5,460$3,385$1,420$7,159$4,438$1,861
Diagnostic Colonoscopy 45378)$4,988$3,093$1,297$8,632$5,352$2,244
Injection into Lumbar or Sacral Area, Single Level 64483)$1,709$1,060$444$2,119$1,314$551
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)NRNRNRNRNRNR
Drain/Inject Major Joint or Bursa 20610)NRNRNR$13,493$8,365$3,508
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$5,032$3,120$1,308NRNRNR
Carpal Tunnel Surgery 64721)$6,780$4,204$1,763$6,441$3,993$1,675
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$12,164$7,541$3,163$31,065$19,260$8,077
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$5,274$3,270$1,371NRNRNR
Uppr GI Endoscopy- Diagnostic 43235)$4,539$2,814$1,180$5,971$3,702$1,552
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)$5,671$3,516$1,475$6,402$3,969$1,664
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Left Heart Artery/Ventricle Angiography 93458)$9,775$6,061$2,542$15,354$9,519$3,992
Creation of Eardrum Opening 69436)$7,967$4,940$2,071NRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Laparoscopic Cholecystectomy 47562)$18,617$11,542$4,840$26,824$16,631$6,974
Unlisted Dental Surgery Procedure 41899)NRNRNRNRNRNR
After Cataract Laser Surgery 66821)$1,417$879$368$1,417$879$368
Removal of Tonsils And Adenoids - < Age 12 42820)NRNRNRNRNRNR
Cataract Surgery- Complex 66982)$8,686$5,385$2,258NRNRNR
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNRNRNRNR
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$12,398$7,687$3,224$16,263$10,083$4,228
Arthroscopic Rotator Cuff Repair 29827)NRNRNR$23,707$14,698$6,164
Hysteroscopy with Biopsy 58558)$12,687$7,866$3,299$19,574$12,136$5,089
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Unlisted Cystourethoscopy 52000)$3,952$2,450$1,028$14,499$8,989$3,770
Esophageal Endoscopy with Dilation 43249)$6,204$3,846$1,613$7,110$4,408$1,849
Biopsy Skin and Subcutaneous Tissue; 1 Lesion 11100)$6,114$3,791$1,590NRNRNR
Incision of Finger Tendon Sheath 26055)$4,565$2,830$1,187$7,587$4,704$1,973
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$11,582$7,181$3,011$15,740$9,759$4,092
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$21,271$13,188$5,530$26,070$16,164$6,778
Cystourethroscopy with Lithotripsy and Stent 52356)$17,397$10,786$4,523$19,821$12,289$5,154
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$12,227$7,581$3,179NRNRNR
Laparoscopic Hernia Repair - Initial 49650)$24,258$15,040$6,307$27,692$17,169$7,200
Uppr GI Endoscopy with Guide Wire 43248)$4,443$2,755$1,155NRNRNR
Destruction of Benign Lesions up to 14 Lesions 17110)NRNRNRNRNRNR
Destruction of Premalignant Lesion 17000)NRNRNRNRNRNR
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Laparoscopic Appendectomy 44970)$21,129$13,100$5,494$27,753$17,207$7,216
Cystourethroscopy with Stent 52332)$9,634$5,973$2,505$15,594$9,669$4,055
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Low Back Disk Surgery 63030)$24,096$14,939$6,265$28,283$17,535$7,353
Repair of Nasal Septum 30520)NRNRNRNRNRNR
Fragmenting of Kidney Stone 50590)NRNRNR$15,133$9,382$3,935
Injections; Single or Multiple Trigger Points, 1 or 2 Muscles 20552)NRNRNRNRNRNR
Removal of Tonsils 42826)NRNRNRNRNRNR
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$13,710$8,500$3,565$25,094$15,558$6,524
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$29,560$18,327$7,686$28,045$17,388$7,292
Mastectomy, Partial 19301)$12,321$7,639$3,203$25,887$16,050$6,731
Coronary Artery Angio S&I 93454)$11,843$7,343$3,079$10,139$6,286$2,636
Hysteroscopy with Ablation 58563)$14,887$9,230$3,871$24,822$15,390$6,454
Remove Impacted Ear Wax 69210)NRNRNRNRNRNR
Apheresis Plasma 36514)NRNRNRNRNRNR
Laparoscopy - Removal of Adnexal Structures 58661)$23,176$14,369$6,026$27,980$17,347$7,275
Needle Biopsy of Liver 47000)NRNRNRNRNRNR
Debridement Skin/Tissue 11042)NRNRNR$12,023$7,454$3,126
Laparoscopy, Removal of Tubes & Ovaries 58571)$33,253$20,617$8,646$40,531$25,129$10,538
Bone Marrow Biopsy 38221)NRNRNRNRNRNR
Correction of Bunion 28296)$12,090$7,495$3,143$13,978$8,666$3,634
Electro-Uroflowmetry - First 51741)NRNRNRNRNRNR
Aspirate Pleura with Imaging 32555)NRNRNRNRNRNR
Right and Left Heart Artery/Ventricle Angiography 93460)$10,225$6,339$2,658$12,600$7,812$3,276
Diagnostic Laryngoscopy 31575)NRNRNRNRNRNR
Mohs Micrographic Tissue Removal 17311)NRNRNRNRNRNR
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
Shoulder Arthroscopy/Surgery 29824)NRNRNR$19,976$12,385$5,194
Removal of Breast Lesion 19120)$13,901$8,618$3,614$18,848$11,686$4,900
Transluminal balloon angioplasty, percutaneous, venous 35476)NRNRNRNRNRNR
Electronic analysis of implantable pump spine w/reprogram/refill 62369)NRNRNRNRNRNR
Removal of Central Venous Device w Port or Pump 36590)$7,367$4,568$1,915NRNRNR
Colonoscopy with Lesion Removal 45383)$5,096$3,160$1,325$7,146$4,431$1,858
Repair of Hammertoe 28285)NRNRNR$17,592$10,907$4,574
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.