Monroe Clinic
515 22nd Ave
Monroe, WI 53566
608-324-1000
 
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WI Act 146 Top 75 Reports

Charges for 75 Most Common Hospitalizations in Wisconsin:  January 2019 - December 2019
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Charge
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$3,095$1,733$743
2560Vaginal Delivery$10,960$6,137$2,630
3720Blood Infection/Septicemia$20,293$11,364$4,870
4194Heart Failure$16,591$9,291$3,982
5751PsychosesNRNRNR
6540Cesarean Delivery$26,234$14,691$6,296
7301Hip Replacement$41,169$23,055$9,881
8302Knee Replacement$39,888$22,337$9,573
9139Pneumonia$6,887$3,857$1,653
10753Bipolar DisordersNRNRNR
11775Alcohol Abuse/Dependence$39,800$22,288$9,552
12201Heart Abnormal Rhythm and Conduction Disorders$11,527$6,455$2,767
13133Respiratory failureNRNRNR
14045Stroke and Precerebral Occlusion with Infarct$29,540$16,542$7,090
15140Chronic Obstructive Pulmonary Disease$20,971$11,744$5,033
16469Acute Kidney Injury$12,669$7,095$3,041
17463Kidney/Urinary Tract Infection$10,680$5,981$2,563
18383Cellulitis & other skin infections$24,138$13,517$5,793
19174Percutaneous coronary intervention w AMI$59,242$33,176$14,218
20750SchizophreniaNRNRNR
21420Diabetes$11,544$6,465$2,771
22282Disorders of Pancreas Except Malignancy$15,615$8,745$3,748
23247Intestinal Obstruction without Surgery$18,563$10,395$4,455
24308Hip & femur fracture repair$43,493$24,356$10,438
25175Percutaneous coronary intervention w/o AMINRNRNR
26190Circulatory Disorders with Heart Attack$28,562$15,995$6,855
27231Major large bowel procedures$50,618$28,346$12,148
28304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back CurvatureNRNRNR
29254Other Digestive System Diagnoses$17,987$10,073$4,317
30058Other Disorders of Nervous SystemNRNRNR
31754DepressionNRNRNR
32053SeizureNRNRNR
33137Respiratory Infections and Inflammations$11,944$6,689$2,867
34192Cardiac catheterization for other non-coronary conditions$43,958$24,616$10,550
35466Malfunction, reaction, complic of genitourinary device or procNRNRNR
36134Pulmonary Embolism$16,338$9,149$3,921
37710Infectious & parasitic diseases including HIV w O.R. procedureNRNRNR
38241Peptic Ulcer/Gastritis$16,189$9,066$3,885
39244Diverticulitis & Diverticulosis$20,867$11,686$5,008
40263Laparoscopic Cholecystectomy$44,185$24,744$10,604
41322Shoulder & Elbow Joint Replacement$40,386$22,616$9,693
42249Other gastroenteritis, nausea & vomitingNRNRNR
43773Opioid Abuse/DependenceNRNRNR
44313Other Knee/Lower Leg SurgeryNRNRNR
45862Other Factors Influencing Health StatusNRNRNR
46230Major small bowel proceduresNRNRNR
47347Other Back/Neck Disorders, Fractures, Injuries$17,311$9,694$4,155
48861Signs & SymptomsNRNRNR
49024Extracranial Vascular Procedures$36,501$20,441$8,760
50253Other and Unspecified Gastrointestinal Hemorrhage$24,651$13,805$5,916
51426Non-hypovolemic sodium disorders$8,978$5,028$2,155
52351Other Musculoskeletal System and Connective Tissue Diagnoses$30,925$17,318$7,422
53021Craniotomy Except For TraumaNRNRNR
54052Nontraumatic stupor & comaNRNRNR
55248Major G.I. Bacterial Infections$18,682$10,462$4,484
56663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$11,782$6,598$2,828
57181Lower Extremity Arterial Procedures$49,415$27,672$11,860
58055Head trauma w coma >1 hr or hemorrhageNRNRNR
59812Poisoning of Medicinal Agents$10,807$6,052$2,594
60166Coronary bypass w/o AMI or complex PDXNRNRNR
61113Epiglottitis, Ear Infection, URI and Laryngotracheitis$13,924$7,797$3,342
62755Neuroses Other Than DepressionNRNRNR
63566Other Antepartum DiagnosesNRNRNR
64721Postoperative and Post-Traumatic Infections$34,082$19,086$8,180
65143Other respiratory diagnoses except signs, symptoms & minor diagnoses$20,982$11,750$5,036
66171Pacemaker Implant without Heart Attack, Heart Failure or Shock$46,780$26,197$11,227
67280Alcoholic Liver DiseaseNRNRNR
68425Other Electrolyte DisordersNRNRNR
69197Peripheral and Other Vascular Disorders$11,940$6,687$2,866
70321Upper Spinal FusionNRNRNR
71163Cardiac valve procedures w/o AMI or complex PDXNRNRNR
72696Other ChemotherapyNRNRNR
73284Disorders of gallbladder & biliary tract$12,581$7,045$3,019
74042Degenerative nervous system disorders exc mult sclerosis$20,251$11,341$4,860
75756Acute Adjust React Psychosocial DysfunctionNRNRNR

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:  January 2019 - December 2019

 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)$16,576$9,283$3,978$16,978$9,507$4,075
Colonoscopy and Biopsy 45380)$6,005$3,363$1,441$6,503$3,641$1,561
Lesion Removal Colonoscopy by Snare Technique 45385)$6,005$3,363$1,441$6,946$3,890$1,667
Upper GI Endoscopy with Biopsy 43239)$6,425$3,598$1,542$8,212$4,599$1,971
Diagnostic Colonoscopy 45378)$5,124$2,869$1,230$20,133$11,274$4,832
Injection into Lumbar or Sacral Area, Single Level 64483)$2,475$1,386$594$3,551$1,989$852
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)$4,088$2,289$981$6,246$3,498$1,499
Inj/Drainage or Aspiration, Spine/Spinal Cord w/ Img Guidancee 62323)$1,831$1,025$439$3,111$1,742$747
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$4,844$2,712$1,162$8,703$4,874$2,089
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$4,863$2,723$1,167$5,505$3,083$1,321
Carpal Tunnel Surgery 64721)$11,627$6,511$2,791NRNRNR
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)$10,183$5,703$2,444$14,065$7,876$3,376
Uppr GI Endoscopy- Diagnostic 43235)$5,014$2,808$1,203$6,990$3,914$1,678
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$15,973$8,945$3,833$38,170$21,375$9,161
Drain/Inject Major Joint or Bursa 20610)$2,441$1,367$586$3,219$1,803$773
Creation of Eardrum Opening 69436)$10,550$5,908$2,532$22,311$12,494$5,355
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)$2,722$1,525$653NRNRNR
Left Heart Artery/Ventricle Angiography 93458)$18,402$10,305$4,417$21,118$11,826$5,068
Unlisted Dental Surgery Procedure 41899)NRNRNRNRNRNR
Total Knee Arthroscopy 27447)$37,059$20,753$8,894$45,292$25,364$10,870
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)$4,160$2,330$998$3,780$2,117$907
Esophageal Endoscopy with Dilation 43249)$7,156$4,008$1,718$8,792$4,924$2,110
Laparoscopic Cholecystectomy 47562)$25,527$14,295$6,127$31,761$17,786$7,623
Arthroscopic Rotator Cuff Repair 29827)$28,027$15,695$6,726$29,875$16,730$7,170
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)NRNRNRNRNRNR
After Cataract Laser Surgery 66821)NRNRNRNRNRNR
Cataract Surgery- Complex 66982)$16,045$8,985$3,851NRNRNR
Cystourethroscopy with Lithotripsy and Stent 52356)$27,434$15,363$6,584$30,940$17,327$7,426
Hysteroscopy with Biopsy 58558)$16,577$9,283$3,978$23,592$13,211$5,662
Removal of Tonsils And Adenoids - < Age 12 42820)$14,969$8,383$3,593$15,290$8,562$3,670
Laparoscopic Hernia Repair - Initial 49650)$27,544$15,425$6,611NRNRNR
Uppr GI Endoscopy with Guide Wire 43248)NRNRNRNRNRNR
Incision of Finger Tendon Sheath 26055)$10,828$6,064$2,599$11,746$6,578$2,819
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)$5,007$2,804$1,202$12,757$7,144$3,062
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$16,434$9,203$3,944$21,995$12,317$5,279
ABD Paracentesis w/Imaging 49083)$4,101$2,297$984$8,614$4,824$2,067
Laparoscopy - Removal of Adnexal Structures 58661)$27,178$15,220$6,523$29,385$16,455$7,052
Laparoscopy, Removal of Tubes & Ovaries 58571)$36,784$20,599$8,828$41,796$23,406$10,031
Unlisted Cystourethoscopy 52000)$13,614$7,624$3,267$13,371$7,488$3,209
Laparoscopic Appendectomy 44970)$28,047$15,706$6,731$34,961$19,578$8,391
Cystourethroscopy with Stent 52332)$17,141$9,599$4,114$25,214$14,120$6,051
Mastectomy, Partial 19301)$20,712$11,599$4,971$28,295$15,845$6,791
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$20,395$11,421$4,895$25,080$14,045$6,019
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$28,168$15,774$6,760$39,129$21,912$9,391
Coronary Artery Angio S&I 93454)$17,048$9,547$4,091$23,678$13,260$5,683
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$16,461$9,218$3,951NRNRNR
Angioplasty - peripheral segment of the dialysis circuit 36902)$18,859$10,561$4,526$33,541$18,783$8,050
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
FNA BX W/US GDN 1ST LES 10005)$2,380$1,333$571$2,172$1,216$521
Removal of Tonsils 42826)$16,492$9,236$3,958NRNRNR
Debridement Skin/Tissue 11042)$17,293$9,684$4,150$14,012$7,847$3,363
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$18,215$10,200$4,372NRNRNR
Low Back Disk Surgery 63030)NRNRNRNRNRNR
Fragmenting of Kidney Stone 50590)$37,007$20,724$8,882NRNRNR
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$34,720$19,443$8,333NRNRNR
Biopsy breast w/stereotactic image; 1 lesion 19081)$6,234$3,491$1,496NRNRNR
Repair of Nasal Septum 30520)NRNRNR$23,906$13,388$5,738
Decompression of Ulnar Nerve at Elbow 64718)$17,318$9,698$4,156$17,464$9,780$4,191
Right and Left Heart Artery/Ventricle Angiography 93460)$23,456$13,136$5,630$25,343$14,192$6,082
Removal of Adenoids 42830)$13,792$7,723$3,310$15,914$8,912$3,819
DX BONE MARROW BX & ASPIR 38222)NRNRNRNRNRNR
SHOULDER ARTHROSCOPY/SURGERY 29823)$21,263$11,907$5,103$31,583$17,686$7,580
ESOPHAGUS MOTILITY STUDY 91010)NRNRNRNRNRNR
Hysteroscopy with Ablation 58563)$19,185$10,744$4,604$27,348$15,315$6,563
Repair of wrist joints 25447)NRNRNR$22,393$12,540$5,374
Implant Neuroelectrodes 63650)NRNRNRNRNRNR
Repair of upper eyelid with excessive skin 15823)$15,142$8,480$3,634NRNRNR
Upper GI Endoscopy w Removal of Foreign Body 43247)NRNRNR$8,551$4,789$2,052
Laparoscopy- Excision of Lesions of Ovary or Pelvic Area 58662)$25,134$14,075$6,032NRNRNR
Repair of Hammertoe 28285)$7,477$4,187$1,795$15,197$8,510$3,647
REMOVAL OF SPINAL LAMINA 63047)NRNRNRNRNRNR
Excision Breast Lesion with Preoperative Placement Radiological Marker 19125)$21,768$12,190$5,224$28,218$15,802$6,772
REMOVAL OF TURBINATE BONES 30140)$17,834$9,987$4,280$20,200$11,312$4,848
INSERT ANT SEGMENT DRAIN INT 0191T)NRNRNR$21,049$11,788$5,052
Information about quality and safety of care for Monroe Clinic may be found at http://www.wicheckpoint.org
* Estimated Insurance Payments based on average percent of billed charges collected.