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$1,778$766
2560Vaginal Delivery$12,031$7,820$3,369
3720Blood Infection/Septicemia$12,442$8,087$3,484
4302Knee Replacement$45,577$29,625$12,762
5540Cesarean Delivery$18,104$11,768$5,069
6194Heart Failure$15,494$10,071$4,338
7139Pneumonia$14,329$9,314$4,012
8301Hip Replacement$48,240$31,356$13,507
9751Psychoses$9,373$6,092$2,624
10753Bipolar Disorders$8,844$5,749$2,476
11140Chronic Obstructive Pulmonary Disease$14,358$9,333$4,020
12201Heart Abnormal Rhythm and Conduction Disorders$10,843$7,048$3,036
13775Alcohol Abuse/Dependence$8,742$5,682$2,448
14383Cellulitis and Other Bacterial Skin Infections$12,364$8,037$3,462
15460Renal FailureNRNRNR
16045Stroke and Precerebral Occlusion with Infarct$16,677$10,840$4,670
17463Kidney/Urinary Tract Infection$24,192$15,725$6,774
18860Rehabilitation$29,254$19,015$8,191
19221Major Bowel Procedures$49,827$32,388$13,952
20133Pulmonary Edema/Respiratory Failure$73,008$47,455$20,442
21750Schizophrenia$8,265$5,372$2,314
22174Angioplasty with Heart Attack$52,824$34,336$14,791
23254Other Digestive System Diagnoses$14,544$9,454$4,072
24247Intestinal Obstruction without Surgery$14,899$9,684$4,172
25282Disorders of Pancreas Except Malignancy$18,027$11,718$5,048
26420Diabetes$11,024$7,166$3,087
27249Gastroenteritis$15,880$10,322$4,446
28754Depression$5,425$3,526$1,519
29053Seizure$14,299$9,294$4,004
30304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$62,272$40,477$17,436
31812Poisoning of Medicinal Agents$10,939$7,110$3,063
32137Respiratory Infections and Inflammations$13,730$8,925$3,844
33134Pulmonary Embolism$11,452$7,444$3,207
34190Circulatory Disorders with Heart Attack$19,338$12,570$5,415
35308Hip/Thigh Surgery with Trauma Diagnosis$37,742$24,532$10,568
36173Other Vascular Procedures$44,691$29,049$12,513
37175Angioplasty without Heart Attack$64,190$41,724$17,973
38263Laparoscopic Cholecystectomy$28,713$18,663$8,040
39425Other Electrolyte Disorders$10,445$6,789$2,925
40244Diverticulitis & Diverticulosis$13,919$9,047$3,897
41347Other Back/Neck Disorders, Fractures, Injuries$13,211$8,587$3,699
42861Signs & Symptoms$13,800$8,970$3,864
43241Peptic Ulcer/Gastritis$15,140$9,841$4,239
44315Shoulder/Upper Arm, Forearm SurgeryNRNRNR
45253Other and Unspecified Gastrointestinal Hemorrhage$24,459$15,898$6,849
46313Other Knee/Lower Leg Surgery$29,364$19,087$8,222
47141Asthma$6,022$3,914$1,686
48351Other Musculoskeletal System and Connective Tissue Diagnoses$14,884$9,675$4,168
49663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$14,723$9,570$4,122
50773Opioid Abuse/Dependence$7,719$5,017$2,161
51248Major G.I. Bacterial Infections$19,452$12,644$5,447
52710Infectious & parasitic diseases including HIV w O.R. procedureNRNRNR
53191Cardiac Catheterization without Principal Diagnosis of Ischemic Heart Disease$23,495$15,272$6,579
54693Chemotherapy$35,506$23,079$9,942
55466Malfunction, reaction, complic of genitourinary device or procNRNRNR
56113Epiglottitis, Ear Infection, URI and LaryngotracheitisNRNRNR
57024Extracranial Vascular Procedures$30,885$20,075$8,648
58321Upper Spinal Fusion$41,605$27,043$11,649
59721Postoperative and Post-Traumatic Infections$24,124$15,681$6,755
60144Respiratory System Signs, Symptoms and Minor Diagnoses$26,142$16,992$7,320
61225Appendectomy$28,455$18,496$7,967
62197Peripheral and Other Vascular Disorders$7,067$4,594$1,979
63021Craniotomy Except For TraumaNRNRNR
64192Cardiac Catheterization with Principal Diagnosis of Ischemic Heart Disease$21,077$13,700$5,902
65566Other Antepartum Diagnoses$11,700$7,605$3,276
66163Heart Valve Procedures without Cardiac Catheterization$127,408$82,815$35,674
67204Fainting and Collapse$9,933$6,456$2,781
68143Other respiratory diagnoses except signs, symptoms & minor diagnoses$11,369$7,390$3,183
69052Nontraumatic stupor & coma$13,388$8,702$3,749
70055Head trauma w coma >1 hr or hemorrhage$11,130$7,235$3,116
71755Neuroses Other Than Depression$3,802$2,471$1,065
72310Back/Neck Procedures Except Dorsal and Lumbar Fusion$39,613$25,748$11,092
73660Major hematologic/immunologic diag exc sickle cell crisis & coagul$11,783$7,659$3,299
74198Chest Pain with Angina Pectoris or Coronary Atherosclerosis$9,782$6,358$2,739
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$5,077$2,187$6,778$4,406$1,898
Colonoscopy and Biopsy 45380)$6,181$4,017$1,731$7,203$4,682$2,017
Upper GI Endoscopy with Biopsy 43239)$5,315$3,455$1,488$6,920$4,498$1,938
Lesion Removal Colonoscopy by Snare Technique 45385)$5,460$3,549$1,529$7,159$4,653$2,004
Diagnostic Colonoscopy 45378)$4,988$3,242$1,397$8,632$5,611$2,417
Injection into Lumbar or Sacral Area, Single Level 64483)$1,709$1,111$479$2,119$1,377$593
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)NRNRNRNRNRNR
Drain/Inject Major Joint or Bursa 20610)NRNRNR$13,493$8,770$3,778
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$5,032$3,271$1,409NRNRNR
Carpal Tunnel Surgery 64721)$6,780$4,407$1,898$6,441$4,187$1,803
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$12,164$7,906$3,406$31,065$20,192$8,698
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$5,274$3,428$1,477NRNRNR
Uppr GI Endoscopy- Diagnostic 43235)$4,539$2,951$1,271$5,971$3,881$1,672
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)$5,671$3,686$1,588$6,402$4,161$1,793
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Left Heart Artery/Ventricle Angiography 93458)$9,775$6,354$2,737$15,354$9,980$4,299
Creation of Eardrum Opening 69436)$7,967$5,179$2,231NRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Laparoscopic Cholecystectomy 47562)$18,617$12,101$5,213$26,824$17,436$7,511
Unlisted Dental Surgery Procedure 41899)NRNRNRNRNRNR
After Cataract Laser Surgery 66821)$1,417$921$397$1,417$921$397
Removal of Tonsils And Adenoids - < Age 12 42820)NRNRNRNRNRNR
Cataract Surgery- Complex 66982)$8,686$5,646$2,432NRNRNR
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNRNRNRNR
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$12,398$8,059$3,472$16,263$10,571$4,554
Arthroscopic Rotator Cuff Repair 29827)NRNRNR$23,707$15,410$6,638
Hysteroscopy with Biopsy 58558)$12,687$8,247$3,552$19,574$12,723$5,481
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Unlisted Cystourethoscopy 52000)$3,952$2,569$1,107$14,499$9,424$4,060
Esophageal Endoscopy with Dilation 43249)$6,204$4,033$1,737$7,110$4,622$1,991
Biopsy Skin and Subcutaneous Tissue; 1 Lesion 11100)$6,114$3,974$1,712NRNRNR
Incision of Finger Tendon Sheath 26055)$4,565$2,967$1,278$7,587$4,931$2,124
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$11,582$7,528$3,243$15,740$10,231$4,407
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$21,271$13,826$5,956$26,070$16,946$7,300
Cystourethroscopy with Lithotripsy and Stent 52356)$17,397$11,308$4,871$19,821$12,884$5,550
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$12,227$7,947$3,424NRNRNR
Laparoscopic Hernia Repair - Initial 49650)$24,258$15,768$6,792$27,692$18,000$7,754
Uppr GI Endoscopy with Guide Wire 43248)$4,443$2,888$1,244NRNRNR
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$13,734$5,916$27,753$18,040$7,771
Cystourethroscopy with Stent 52332)$9,634$6,262$2,697$15,594$10,136$4,366
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Low Back Disk Surgery 63030)$24,096$15,662$6,747$28,283$18,384$7,919
Repair of Nasal Septum 30520)NRNRNRNRNRNR
Fragmenting of Kidney Stone 50590)NRNRNR$15,133$9,836$4,237
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$8,912$3,839$25,094$16,311$7,026
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$29,560$19,214$8,277$28,045$18,230$7,853
Mastectomy, Partial 19301)$12,321$8,009$3,450$25,887$16,826$7,248
Coronary Artery Angio S&I 93454)$11,843$7,698$3,316$10,139$6,591$2,839
Hysteroscopy with Ablation 58563)$14,887$9,677$4,168$24,822$16,134$6,950
Remove Impacted Ear Wax 69210)NRNRNRNRNRNR
Apheresis Plasma 36514)NRNRNRNRNRNR
Laparoscopy - Removal of Adnexal Structures 58661)$23,176$15,064$6,489$27,980$18,187$7,834
Needle Biopsy of Liver 47000)NRNRNRNRNRNR
Debridement Skin/Tissue 11042)NRNRNR$12,023$7,815$3,366
Laparoscopy, Removal of Tubes & Ovaries 58571)$33,253$21,614$9,311$40,531$26,345$11,349
Bone Marrow Biopsy 38221)NRNRNRNRNRNR
Correction of Bunion 28296)$12,090$7,858$3,385$13,978$9,086$3,914
Electro-Uroflowmetry - First 51741)NRNRNRNRNRNR
Aspirate Pleura with Imaging 32555)NRNRNRNRNRNR
Right and Left Heart Artery/Ventricle Angiography 93460)$10,225$6,646$2,863$12,600$8,190$3,528
Diagnostic Laryngoscopy 31575)NRNRNRNRNRNR
Mohs Micrographic Tissue Removal 17311)NRNRNRNRNRNR
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
Shoulder Arthroscopy/Surgery 29824)NRNRNR$19,976$12,984$5,593
Removal of Breast Lesion 19120)$13,901$9,035$3,892$18,848$12,251$5,277
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$4,789$2,063NRNRNR
Colonoscopy with Lesion Removal 45383)$5,096$3,312$1,427$7,146$4,645$2,001
Repair of Hammertoe 28285)NRNRNR$17,592$11,434$4,926
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.