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 2014 - September 2015
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Charge
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$2,798$1,735$727
2560Vaginal Delivery$13,667$8,474$3,553
3720Blood Infection/Septicemia$15,895$9,855$4,133
4302Knee Replacement$44,001$27,281$11,440
5540Cesarean Delivery$18,170$11,265$4,724
6194Heart Failure$12,336$7,648$3,207
7139Pneumonia$13,905$8,621$3,615
8301Hip Replacement$46,040$28,545$11,970
9751Psychoses$10,059$6,237$2,615
10753Bipolar Disorders$7,199$4,463$1,872
11140Chronic Obstructive Pulmonary Disease$9,472$5,873$2,463
12201Heart Abnormal Rhythm and Conduction Disorders$12,413$7,696$3,227
13775Alcohol Abuse/Dependence$7,790$4,830$2,025
14460Renal FailureNRNRNR
15383Cellulitis and Other Bacterial Skin Infections$13,025$8,076$3,387
16045Stroke and Precerebral Occlusion with Infarct$16,677$10,340$4,336
17860Rehabilitation$25,723$15,948$6,688
18221Major Bowel Procedures$47,810$29,642$12,431
19463Kidney/Urinary Tract Infection$20,355$12,620$5,292
20133Pulmonary Edema/Respiratory Failure$73,008$45,265$18,982
21174Angioplasty with Heart Attack$60,481$37,498$15,725
22247Intestinal Obstruction without Surgery$13,192$8,179$3,430
23750Schizophrenia$9,173$5,687$2,385
24282Disorders of Pancreas Except Malignancy$16,329$10,124$4,246
25254Other Digestive System Diagnoses$11,698$7,253$3,041
26420Diabetes$10,594$6,568$2,754
27249Gastroenteritis$20,009$12,406$5,202
28754Depression$6,549$4,060$1,703
29812Poisoning of Medicinal Agents$10,596$6,570$2,755
30137Respiratory Infections and InflammationsNRNRNR
31304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$61,900$38,378$16,094
32053Seizure$13,482$8,359$3,505
33134Pulmonary Embolism$14,208$8,809$3,694
34173Other Vascular Procedures$44,691$27,708$11,620
35308Hip/Thigh Surgery with Trauma Diagnosis$39,121$24,255$10,171
36190Circulatory Disorders with Heart Attack$19,429$12,046$5,052
37263Laparoscopic Cholecystectomy$31,930$19,797$8,302
38244Diverticulitis & Diverticulosis$18,272$11,329$4,751
39425Other Electrolyte Disorders$7,627$4,729$1,983
40175Angioplasty without Heart Attack$66,472$41,213$17,283
41241Peptic Ulcer/Gastritis$18,018$11,171$4,685
42861Signs & Symptoms$15,356$9,521$3,993
43315Shoulder/Upper Arm, Forearm Surgery$35,422$21,962$9,210
44253Other and Unspecified Gastrointestinal Hemorrhage$27,913$17,306$7,257
45347Other Back/Neck Disorders, Fractures, Injuries$15,381$9,536$3,999
46313Other Knee/Lower Leg Surgery$35,588$22,065$9,253
47773Opioid Abuse/Dependence$6,269$3,887$1,630
48351Other Musculoskeletal System and Connective Tissue Diagnoses$28,950$17,949$7,527
49248Major G.I. Bacterial Infections$19,452$12,060$5,058
50710Infectious & parasitic diseases including HIV w O.R. procedure$49,347$30,595$12,830
51663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$18,336$11,368$4,767
52191Cardiac Catheterization without Principal Diagnosis of Ischemic Heart Disease$23,495$14,567$6,109
53466Malfunction, reaction, complic of genitourinary device or proc$7,036$4,362$1,829
54024Extracranial Vascular Procedures$32,373$20,071$8,417
55113Epiglottitis, Ear Infection, URI and Laryngotracheitis$7,038$4,364$1,830
56693ChemotherapyNRNRNR
57141Asthma$9,186$5,695$2,388
58321Upper Spinal Fusion$42,951$26,630$11,167
59721Postoperative and Post-Traumatic InfectionsNRNRNR
60197Peripheral and Other Vascular Disorders$12,080$7,490$3,141
61021Craniotomy Except For TraumaNRNRNR
62225Appendectomy$29,139$18,066$7,576
63144Respiratory System Signs, Symptoms and Minor Diagnoses$18,616$11,542$4,840
64566Other Antepartum Diagnoses$11,834$7,337$3,077
65163Heart Valve Procedures without Cardiac Catheterization$150,763$93,473$39,198
66143Other respiratory diagnoses except signs, symptoms & minor diagnoses$10,045$6,228$2,612
67192Cardiac Catheterization with Principal Diagnosis of Ischemic Heart Disease$17,854$11,069$4,642
68055Head trauma w coma >1 hr or hemorrhage$10,809$6,702$2,810
69052Nontraumatic stupor & coma$13,388$8,301$3,481
70755Neuroses Other Than Depression$5,820$3,608$1,513
71204Fainting and Collapse$11,358$7,042$2,953
72310Back/Neck Procedures Except Dorsal and Lumbar Fusion$42,382$26,277$11,019
73660Major hematologic/immunologic diag exc sickle cell crisis & coagulNRNRNR
74284Disorders of gallbladder & biliary tract$20,983$13,009$5,456
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:  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)$7,948$4,928$2,067$9,304$5,769$2,419
Colonoscopy and Biopsy 45380)$6,253$3,877$1,626$7,656$4,747$1,991
Upper GI Endoscopy with Biopsy 43239)$5,328$3,304$1,385$7,152$4,434$1,859
Lesion Removal Colonoscopy by Snare Technique 45385)$5,983$3,709$1,556$7,159$4,438$1,861
Diagnostic Colonoscopy 45378)$5,300$3,286$1,378$8,485$5,261$2,206
Injection into Lumbar or Sacral Area, Single Level 64483)$1,679$1,041$436$1,976$1,225$514
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)NRNRNRNRNRNR
Drain/Inject Major Joint or Bursa 20610)NRNRNR$12,734$7,895$3,311
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$5,081$3,150$1,321NRNRNR
Carpal Tunnel Surgery 64721)$6,701$4,155$1,742$7,153$4,435$1,860
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$5,424$3,363$1,410NRNRNR
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$12,425$7,703$3,230$27,649$17,142$7,189
Uppr GI Endoscopy- Diagnostic 43235)$4,876$3,023$1,268$6,734$4,175$1,751
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)$5,747$3,563$1,494$6,362$3,944$1,654
Left Heart Artery/Ventricle Angiography 93458)$10,572$6,555$2,749$15,944$9,886$4,146
Creation of Eardrum Opening 69436)$7,967$4,940$2,071NRNRNR
Unlisted Dental Surgery Procedure 41899)NRNRNRNRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Laparoscopic Cholecystectomy 47562)$18,733$11,614$4,871$22,529$13,968$5,857
After Cataract Laser Surgery 66821)$1,417$879$368$1,417$879$368
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNR$26,148$16,212$6,798
Cataract Surgery- Complex 66982)$8,862$5,494$2,304NRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)NRNRNRNRNRNR
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Arthroscopic Rotator Cuff Repair 29827)NRNRNR$23,715$14,703$6,166
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$13,639$8,456$3,546$16,263$10,083$4,228
Hysteroscopy with Biopsy 58558)$13,145$8,150$3,418$24,486$15,181$6,366
Biopsy Skin and Subcutaneous Tissue; 1 Lesion 11100)$6,470$4,012$1,682NRNRNR
Esophageal Endoscopy with Dilation 43249)$7,263$4,503$1,888$7,472$4,632$1,943
Unlisted Cystourethoscopy 52000)$14,913$9,246$3,877$33,397$20,706$8,683
Incision of Finger Tendon Sheath 26055)$6,182$3,833$1,607$9,842$6,102$2,559
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$11,582$7,181$3,011$27,127$16,819$7,053
Cystourethroscopy with Lithotripsy and Stent 52356)$17,832$11,056$4,636$19,761$12,252$5,138
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$21,151$13,114$5,499$24,010$14,886$6,243
Laparoscopic Hernia Repair - Initial 49650)$23,855$14,790$6,202$29,509$18,296$7,672
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$12,650$7,843$3,289$22,986$14,251$5,976
Destruction of Premalignant Lesion 17000)NRNRNRNRNRNR
Uppr GI Endoscopy with Guide Wire 43248)NRNRNRNRNRNR
Destruction of Benign Lesions up to 14 Lesions 17110)NRNRNRNRNRNR
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Laparoscopic Appendectomy 44970)$20,585$12,763$5,352$27,575$17,096$7,169
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Cystourethroscopy with Stent 52332)$9,345$5,794$2,430$16,002$9,922$4,161
Injections; Single or Multiple Trigger Points, 1 or 2 Muscles 20552)NRNRNRNRNRNR
Removal of Tonsils 42826)NRNRNRNRNRNR
Repair of Nasal Septum 30520)NRNRNRNRNRNR
Low Back Disk Surgery 63030)$24,511$15,197$6,373NRNRNR
Fragmenting of Kidney Stone 50590)NRNRNR$14,841$9,201$3,859
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$29,119$18,054$7,571$28,967$17,959$7,531
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$13,789$8,549$3,585$28,677$17,780$7,456
Mastectomy, Partial 19301)$11,504$7,133$2,991$26,816$16,626$6,972
Coronary Artery Angio S&I 93454)$11,160$6,919$2,902$33,173$20,567$8,625
Laparoscopy - Removal of Adnexal Structures 58661)$20,752$12,866$5,395$26,255$16,278$6,826
Debridement Skin/Tissue 11042)$10,156$6,297$2,641$14,030$8,698$3,648
Needle Biopsy of Liver 47000)NRNRNRNRNRNR
Remove Impacted Ear Wax 69210)NRNRNRNRNRNR
Hysteroscopy with Ablation 58563)$16,450$10,199$4,277$24,349$15,097$6,331
Laparoscopy, Removal of Tubes & Ovaries 58571)$31,740$19,679$8,252$39,393$24,424$10,242
Apheresis Plasma 36514)NRNRNRNRNRNR
Aspirate Pleura with Imaging 32555)NRNRNRNRNRNR
Diagnostic Laryngoscopy 31575)NRNRNRNRNRNR
Right and Left Heart Artery/Ventricle Angiography 93460)$11,230$6,963$2,920$13,820$8,568$3,593
Debridement, Open Wound <= 20 Square Centimeters 97597)NRNRNRNRNRNR
Correction of Bunion 28296)$14,669$9,095$3,814$15,368$9,528$3,996
Bone Marrow Biopsy 38221)NRNRNRNRNRNR
Transluminal balloon angioplasty, percutaneous, venous 35476)NRNRNRNRNRNR
Shoulder Arthroscopy/Surgery 29824)NRNRNR$18,672$11,576$4,855
Electro-Uroflowmetry - First 51741)NRNRNRNRNRNR
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
Removal of Adenoids 42830)$8,999$5,579$2,340$10,160$6,299$2,642
Electronic analysis of implantable pump spine w/reprogram/refill 62369)NRNRNRNRNRNR
Removal of Central Venous Device w Port or Pump 36590)$7,321$4,539$1,904NRNRNR
Insertion of Central Venous Catheter >= 5 years 36569)NRNRNRNRNRNR
Removal of Breast Lesion 19120)$12,773$7,919$3,321$17,607$10,916$4,578
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.