Oconomowoc Memorial Hospital
791 Summit Avenue
Oconomowoc, WI 53066
262-569-9400

Charges for 75 Most Common Hospitalizations in Wisconsin:  April 2016 - March 2017
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Charge
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$4,024$2,294$885
2560Vaginal Delivery$13,300$7,581$2,926
3720Blood Infection/Septicemia$14,938$8,515$3,286
4302Knee Replacement$57,514$32,783$12,653
5540Cesarean Delivery$21,183$12,074$4,660
6194Heart Failure$16,469$9,387$3,623
7301Hip Replacement$50,648$28,869$11,143
8751PsychosesNRNRNR
9139Pneumonia$13,602$7,753$2,992
10140Chronic Obstructive Pulmonary Disease$11,664$6,648$2,566
11753Bipolar DisordersNRNRNR
12775Alcohol Abuse/Dependence$7,950$4,532$1,749
13201Heart Abnormal Rhythm and Conduction Disorders$11,343$6,466$2,495
14383Cellulitis & other skin infections$8,471$4,828$1,864
15045Stroke and Precerebral Occlusion with Infarct$26,902$15,334$5,918
16133Respiratory failureNRNRNR
17463Kidney/Urinary Tract Infection$9,045$5,156$1,990
18221Major Bowel Procedures$47,674$27,174$10,488
19174Percutaneous coronary intervention w AMI$51,078$29,114$11,237
20750SchizophreniaNRNRNR
21754DepressionNRNRNR
22420Diabetes$14,300$8,151$3,146
23282Disorders of Pancreas Except Malignancy$21,772$12,410$4,790
24247Intestinal Obstruction without Surgery$13,489$7,689$2,968
25254Other Digestive System Diagnoses$15,186$8,656$3,341
26812Poisoning of Medicinal Agents$14,566$8,303$3,205
27710Infectious & parasitic diseases including HIV w O.R. procedure$32,486$18,517$7,147
28773Opioid Abuse/DependenceNRNRNR
29308Hip & femur fracture repair$36,123$20,590$7,947
30304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back CurvatureNRNRNR
31190Circulatory Disorders with Heart Attack$22,764$12,975$5,008
32053Seizure$4,484$2,556$986
33137Respiratory Infections and InflammationsNRNRNR
34058Other Disorders of Nervous System$12,398$7,067$2,728
35175Percutaneous coronary intervention w/o AMI$55,996$31,918$12,319
36249Other gastroenteritis, nausea & vomiting$39,527$22,530$8,696
37460Renal FailureNRNRNR
38134Pulmonary Embolism$18,843$10,741$4,145
39263Laparoscopic Cholecystectomy$54,916$31,302$12,082
40244Diverticulitis & Diverticulosis$16,840$9,599$3,705
41469Acute Kidney InjuryNRNRNR
42861Signs & Symptoms$16,287$9,284$3,583
43347Other Back/Neck Disorders, Fractures, Injuries$17,650$10,061$3,883
44315Shoulder, upper arm & forearm procedures except joint replacementNRNRNR
45253Other and Unspecified Gastrointestinal Hemorrhage$9,058$5,163$1,993
46241Peptic Ulcer/Gastritis$19,035$10,850$4,188
47313Other Knee/Lower Leg Surgery$41,869$23,865$9,211
48466Malfunction, reaction, complic of genitourinary device or procNRNRNR
49192Cardiac catheterization for other non-coronary conditions$21,587$12,305$4,749
50351Other Musculoskeletal System and Connective Tissue Diagnoses$8,828$5,032$1,942
51425Other Electrolyte Disorders$12,111$6,903$2,664
52248Major G.I. Bacterial Infections$16,149$9,205$3,553
53951Moderately Extensive Procedure Unrelated to Diagnosis$11,690$6,663$2,572
54663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$24,585$14,013$5,409
55862Other Factors Influencing Health StatusNRNRNR
56024Extracranial Vascular Procedures$34,070$19,420$7,495
57021Craniotomy Except For TraumaNRNRNR
58113Epiglottitis, Ear Infection, URI and Laryngotracheitis$22,075$12,583$4,857
59321Upper Spinal FusionNRNRNR
60566Other Antepartum Diagnoses$8,591$4,897$1,890
61197Peripheral and Other Vascular Disorders$12,532$7,143$2,757
62422HypovolemiaNRNRNR
63055Head trauma w coma >1 hr or hemorrhageNRNRNR
64173Other Vascular Procedures$27,447$15,645$6,038
65052Nontraumatic stupor & coma$24,734$14,098$5,441
66225Appendectomy$21,306$12,144$4,687
67141Asthma$4,723$2,692$1,039
68166Coronary bypass w/o AMI or complex PDXNRNRNR
69721Postoperative and Post-Traumatic InfectionsNRNRNR
70755Neuroses Other Than DepressionNRNRNR
71191Cardiac catheterization for coronary artery disease$23,618$13,462$5,196
72220Major Stomach/Esophagus/Duodenum ProceduresNRNRNR
73143Other respiratory diagnoses except signs, symptoms & minor diagnoses$19,596$11,170$4,311
74163Cardiac valve procedures w/o AMI or complex PDXNRNRNR
75950Extensive Procedure Unrelated to Principal Diagnosis$50,623$28,855$11,137

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 2016 - March 2017
 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)$11,098$6,326$2,442NRNRNR
Colonoscopy and Biopsy 45380)$6,963$3,969$1,532$10,903$6,214$2,399
Lesion Removal Colonoscopy by Snare Technique 45385)$6,968$3,971$1,533$8,698$4,958$1,914
Upper GI Endoscopy with Biopsy 43239)$6,597$3,760$1,451$7,984$4,551$1,756
Diagnostic Colonoscopy 45378)$5,595$3,189$1,231$9,178$5,231$2,019
Injection into Lumbar or Sacral Area, Single Level 64483)$2,278$1,299$501$2,747$1,566$604
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)$5,242$2,988$1,153$6,367$3,629$1,401
Drain/Inject Major Joint or Bursa 20610)$1,161$662$255$1,017$580$224
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$5,567$3,173$1,225NRNRNR
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$5,505$3,138$1,211NRNRNR
Carpal Tunnel Surgery 64721)$9,048$5,157$1,990$14,045$8,006$3,090
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$13,680$7,797$3,010NRNRNR
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)$6,348$3,618$1,396$5,529$3,151$1,216
Uppr GI Endoscopy- Diagnostic 43235)$5,213$2,972$1,147$8,848$5,043$1,947
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)$7,263$4,140$1,598NRNRNR
Creation of Eardrum Opening 69436)$6,424$3,662$1,413$7,594$4,328$1,671
Left Heart Artery/Ventricle Angiography 93458)$19,347$11,028$4,256$22,239$12,676$4,893
Unlisted Dental Surgery Procedure 41899)$18,013$10,268$3,963$35,123$20,020$7,727
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)$2,895$1,650$637$3,715$2,118$817
After Cataract Laser Surgery 66821)NRNRNRNRNRNR
Laparoscopic Cholecystectomy 47562)$20,279$11,559$4,461$37,046$21,116$8,150
ABD Paracentesis w/Imaging 49083)$3,393$1,934$747$4,803$2,737$1,057
Inj/Drainage or Aspiration, Spine/Spinal Cord w/ Img Guidancee 62323)$3,235$1,844$712NRNRNR
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)$6,613$3,770$1,455$10,747$6,126$2,364
Esophageal Endoscopy with Dilation 43249)$4,801$2,737$1,056$9,120$5,198$2,006
Arthroscopic Rotator Cuff Repair 29827)NRNRNRNRNRNR
Biopsy Skin and Subcutaneous Tissue; 1 Lesion 11100)NRNRNRNRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)$10,403$5,930$2,289$12,543$7,150$2,760
Hysteroscopy with Biopsy 58558)$15,216$8,673$3,348$15,898$9,062$3,498
Cataract Surgery- Complex 66982)$11,432$6,516$2,515NRNRNR
Cystourethroscopy with Lithotripsy and Stent 52356)$17,035$9,710$3,748$26,506$15,109$5,831
Incision of Finger Tendon Sheath 26055)$7,958$4,536$1,751NRNRNR
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$15,993$9,116$3,518$22,119$12,608$4,866
Laparoscopic Hernia Repair - Initial 49650)$24,752$14,109$5,445$28,393$16,184$6,246
Unlisted Cystourethoscopy 52000)$9,286$5,293$2,043$4,066$2,318$894
Uppr GI Endoscopy with Guide Wire 43248)$5,350$3,049$1,177$7,269$4,143$1,599
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)$4,319$2,462$950$4,968$2,832$1,093
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$7,743$4,414$1,703NRNRNR
Destruction of Premalignant Lesion 17000)NRNRNRNRNRNR
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$24,812$14,143$5,459$33,111$18,873$7,284
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$14,264$8,130$3,138NRNRNR
Destruction of Benign Lesions up to 14 Lesions 17110)$1,769$1,008$389NRNRNR
Cystourethroscopy with Stent 52332)$10,881$6,202$2,394$12,245$6,980$2,694
Biopsy breast w/stereotactic image; 1 lesion 19081)$9,186$5,236$2,021$15,727$8,964$3,460
Laparoscopy - Removal of Adnexal Structures 58661)$22,767$12,977$5,009$20,159$11,491$4,435
Mastectomy, Partial 19301)NRNRNR$21,130$12,044$4,649
Laparoscopic Appendectomy 44970)$25,175$14,350$5,538$20,705$11,802$4,555
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$14,955$8,525$3,290$15,847$9,033$3,486
Removal of Tonsils 42826)$13,719$7,820$3,018NRNRNR
Laparoscopy, Removal of Tubes & Ovaries 58571)NRNRNRNRNRNR
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)NRNRNRNRNRNR
Injections; Single or Multiple Trigger Points, 1 or 2 Muscles 20552)$812$463$179$2,316$1,320$510
Low Back Disk Surgery 63030)NRNRNRNRNRNR
Repair of Nasal Septum 30520)NRNRNR$18,390$10,482$4,046
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)$3,245$1,850$714NRNRNR
Needle Biopsy of Liver 47000)$5,919$3,374$1,302$5,028$2,866$1,106
Debridement Skin/Tissue 11042)$6,420$3,660$1,412NRNRNR
Fragmenting of Kidney Stone 50590)$16,148$9,205$3,553$20,233$11,533$4,451
Coronary Artery Angio S&I 93454)NRNRNR$47,964$27,339$10,552
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
Aspirate Pleura with Imaging 32555)$2,168$1,236$477$5,349$3,049$1,177
Bone Marrow Biopsy 38221)$2,882$1,643$634$5,031$2,867$1,107
Diagnostic Laryngoscopy 31575)NRNRNRNRNRNR
Correction of Bunion 28296)$18,254$10,405$4,016$30,037$17,121$6,608
Hysteroscopy with Ablation 58563)$18,876$10,759$4,153$25,202$14,365$5,544
Remove Impacted Ear Wax 69210)NRNRNRNRNRNR
Shoulder Arthroscopy/Surgery 29824)NRNRNR$25,739$14,671$5,663
Removal of Adenoids 42830)NRNRNRNRNRNR
Right and Left Heart Artery/Ventricle Angiography 93460)$22,217$12,664$4,888$27,627$15,747$6,078
Injection of chemical agent into muscles near face/neck 64615)NRNRNRNRNRNR
Biopsy of lung or mediastinum, percutaneous w/needle 32405)NRNRNRNRNRNR
Removal of Central Venous Device w Port or Pump 36590)$2,155$1,228$474NRNRNR
Electro-Uroflowmetry - First 51741)$784$447$173NRNRNR
Apheresis Plasma 36514)NRNRNRNRNRNR
Repair of wrist joints 25447)NRNRNRNRNRNR
Information about quality and safety of care for Oconomowoc Memorial Hospital may be found at http://www.wicheckpoint.org
* Estimated Insurance Payments based on average percent of billed charges collected.