Stoughton Hospital Association
900 Ridge Street
Stoughton, WI 53589
608-873-6611
 
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WI Act 146 Top 75 Reports

Charges for 75 Most Common Hospitalizations in Wisconsin:  January 2020 - December 2020
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Charge		Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+NRNRNR
2560Vaginal DeliveryNRNRNR
3720Blood Infection/Septicemia$3,683$2,100$1,326
4137Respiratory Infections and Inflammations$26,610$15,168$9,580
5194Heart Failure$15,082$8,597$5,430
6751PsychosesNRNRNR
7540Cesarean DeliveryNRNRNR
8753Bipolar DisordersNRNRNR
9775Alcohol Abuse/Dependence$8,092$4,613$2,913
10139Pneumonia$10,639$6,064$3,830
11045Stroke and Precerebral Occlusion with Infarct$16,275$9,277$5,859
12201Heart Abnormal Rhythm and Conduction Disorders$12,077$6,884$4,348
13301Hip Replacement$38,817$22,126$13,974
14133Respiratory failureNRNRNR
15469Acute kidney injuryNRNRNR
16302Knee Replacement$36,593$20,858$13,173
17174Percutaneous coronary intervention w AMINRNRNR
18463Kidney/Urinary Tract InfectionNRNRNR
19420Diabetes$8,294$4,728$2,986
20750SchizophreniaNRNRNR
21383Cellulitis & other skin infections$8,602$4,903$3,097
22140Chronic Obstructive Pulmonary Disease$9,898$5,642$3,563
23282Disorders of Pancreas Except Malignancy$6,975$3,976$2,511
24308Hip & femur fracture repair$33,100$18,867$11,916
25247Intestinal Obstruction without Surgery$5,248$2,991$1,889
26710Infectious & parasitic diseases including HIV w O.R. procedureNRNRNR
27231Major large bowel procedures$31,435$17,918$11,317
28058Other Disorders of Nervous System$13,367$7,619$4,812
29466Malfunction, reaction, complic of genitourinary device or procNRNRNR
30190Circulatory Disorders with Heart AttackNRNRNR
31134Pulmonary Embolism$7,095$4,044$2,554
32254Other Digestive System Diagnoses$12,870$7,336$4,633
33241Peptic Ulcer/Gastritis$11,686$6,661$4,207
34754DepressionNRNRNR
35304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back CurvatureNRNRNR
36053SeizureNRNRNR
37192Cardiac catheterization for other non-coronary conditionsNRNRNR
38263Cholecystectomy$19,609$11,177$7,059
39244Diverticulitis & Diverticulosis$11,841$6,749$4,263
40322Shoulder & elbow joint replacement$41,612$23,719$14,980
41862Other Factors Influencing Health Status$14,017$7,990$5,046
42175Percutaneous coronary intervention w/o AMINRNRNR
43426Non-hypovolemic sodium disorders$14,921$8,505$5,371
44230Major small bowel proceduresNRNRNR
45773Opioid Abuse/DependenceNRNRNR
46249Other gastroenteritis, nausea & vomiting$6,832$3,894$2,460
47861Signs & SymptomsNRNRNR
48313Other Knee/Lower Leg Surgery$33,202$18,925$11,953
49566Other Antepartum DiagnosesNRNRNR
50539Cesarean delivery with sterlizationNRNRNR
51052Alteration in consciousness$2,955$1,684$1,064
52182Other peripheral vascular proceduresNRNRNR
53253Other and Unspecified Gastrointestinal HemorrhageNRNRNR
54347Other Back/Neck Disorders, Fractures, Injuries$5,880$3,352$2,117
55663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$15,122$8,619$5,444
56055Head trauma w coma >1 hr or hemorrhageNRNRNR
57280Alcoholic Liver Disease$18,051$10,289$6,499
58248Major G.I. Bacterial InfectionsNRNRNR
59351Other Musculoskeletal System and Connective Tissue Diagnoses$5,850$3,334$2,106
60021Craniotomy Except For TraumaNRNRNR
61183Percutaneous structural cardiac proceduresNRNRNR
62721Postoperative and Post-Traumatic InfectionsNRNRNR
63817Overdose$2,905$1,656$1,046
64755Neuroses Other Than DepressionNRNRNR
65166Coronary bypass w/o AMI or complex PDXNRNRNR
66425Other non-hypovolemic electrolyte disordersNRNRNR
67326Elective knee joint replacement$38,667$22,040$13,920
68143Other respiratory diagnoses except signs, symptoms & minor diagnoses$13,602$7,753$4,897
69284Disorders of gallbladder & biliary tractNRNRNR
70542Vaginal Delivery with Proc Except SterilizationNRNRNR
71130Respiratory System DX w/ Vent Support 96+ HrsNRNRNR
72171Pacemaker Implant without Heart Attack, Heart Failure or ShockNRNRNR
73042Degenerative nervous system disorders exc mult sclerosis$23,716$13,518$8,538
74321Upper Spinal FusionNRNRNR
75113Epiglottitis, Ear Infection, URI and LaryngotracheitisNRNRNR

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 2020 - December 2020

 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)$11,373$6,483$4,094$18,506$10,548$6,662
Lesion Removal Colonoscopy by Snare Technique 45385)$4,949$2,821$1,782$5,258$2,997$1,893
Colonoscopy and Biopsy 45380)$4,989$2,844$1,796$5,006$2,854$1,802
Upper GI Endoscopy with Biopsy 43239)$5,201$2,964$1,872$6,742$3,843$2,427
Diagnostic Colonoscopy 45378)$3,161$1,802$1,138NRNRNR
Injection into Lumbar or Sacral Area, Single Level 64483)NRNRNRNRNRNR
Inj/Drainage or Aspiration, Spine/Spinal Cord w/ Img Guidancee 62323)NRNRNRNRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)NRNRNRNRNRNR
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$3,040$1,733$1,094NRNRNR
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$3,231$1,842$1,163NRNRNR
Carpal Tunnel Surgery 64721)$5,043$2,875$1,816NRNRNR
Total Knee Arthroscopy 27447)$33,382$19,028$12,018$32,154$18,328$11,576
Uppr GI Endoscopy- Diagnostic 43235)$4,884$2,784$1,758$6,901$3,934$2,484
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$9,522$5,428$3,428$21,406$12,201$7,706
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Left Heart Artery/Ventricle Angiography 93458)NRNRNRNRNRNR
Drain/Inject Major Joint or Bursa 20610)NRNRNRNRNRNR
Cystourethroscopy with Lithotripsy and Stent 52356)NRNRNRNRNRNR
Unlisted Dental Surgery Procedure 41899)$7,753$4,419$2,791$12,708$7,243$4,575
Arthroscopic Rotator Cuff Repair 29827)$23,266$13,262$8,376$18,642$10,626$6,711
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)NRNRNRNRNRNR
TOTAL HIP ARTHROPLASTY 27130)$37,812$21,553$13,612$35,982$20,510$12,954
Esophageal Endoscopy with Dilation 43249)$4,981$2,839$1,793$7,508$4,280$2,703
Laparoscopic Cholecystectomy 47562)$14,588$8,315$5,252NRNRNR
Hysteroscopy with Biopsy 58558)$9,705$5,532$3,494NRNRNR
Laparoscopic Hernia Repair - Initial 49650)$15,509$8,840$5,583$16,389$9,342$5,900
Cataract Surgery- Complex 66982)$11,950$6,812$4,302NRNRNR
After Cataract Laser Surgery 66821)NRNRNRNRNRNR
Creation of Eardrum Opening 69436)$5,914$3,371$2,129NRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Uppr GI Endoscopy with Guide Wire 43248)$3,857$2,198$1,389NRNRNR
Incision of Finger Tendon Sheath 26055)$5,006$2,853$1,802NRNRNR
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)$4,445$2,534$1,600NRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)$7,235$4,124$2,605NRNRNR
Laparoscopic Appendectomy 44970)$25,974$14,805$9,351$19,728$11,245$7,102
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Laparoscopy, Removal of Tubes & Ovaries 58571)NRNRNRNRNRNR
Laparoscopy - Removal of Adnexal Structures 58661)NRNRNRNRNRNR
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$7,284$4,152$2,622$36,010$20,525$12,963
Cystourethroscopy with Stent 52332)NRNRNRNRNRNR
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)$4,477$2,552$1,612NRNRNR
Mastectomy, Partial 19301)$7,666$4,369$2,760$22,741$12,962$8,187
Angioplasty - peripheral segment of the dialysis circuit 36902)NRNRNRNRNRNR
Unlisted Cystourethoscopy 52000)NRNRNRNRNRNR
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$16,482$9,395$5,934NRNRNR
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)NRNRNRNRNRNR
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$10,217$5,824$3,678NRNRNR
Coronary Artery Angio S&I 93454)NRNRNRNRNRNR
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
FNA BX W/US GDN 1ST LES 10005)NRNRNRNRNRNR
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Removal of Tonsils 42826)$8,396$4,786$3,023$12,249$6,982$4,409
Low Back Disk Surgery 63030)NRNRNRNRNRNR
Fragmenting of Kidney Stone 50590)$8,467$4,826$3,048NRNRNR
Debridement Skin/Tissue 11042)NRNRNR$10,564$6,022$3,803
DX BONE MARROW BX & ASPIR 38222)NRNRNRNRNRNR
Decompression of Ulnar Nerve at Elbow 64718)NRNRNRNRNRNR
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$22,268$12,693$8,017NRNRNR
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$8,037$4,581$2,893$19,437$11,079$6,997
Right and Left Heart Artery/Ventricle Angiography 93460)NRNRNRNRNRNR
Repair of Nasal Septum 30520)$10,885$6,204$3,919$13,537$7,716$4,873
SHOULDER ARTHROSCOPY/SURGERY 29823)$13,915$7,932$5,009$18,596$10,600$6,695
Repair of wrist joints 25447)NRNRNRNRNRNR
Upper GI Endoscopy w Removal of Foreign Body 43247)NRNRNRNRNRNR
REMOVAL OF SPINAL LAMINA 63047)NRNRNRNRNRNR
OPEN TX OF DISTAL RADIAL FX W INT FIX 3+ FRAG 25609)NRNRNRNRNRNR
ESOPHAGUS MOTILITY STUDY 91010)NRNRNRNRNRNR
REDUCTION OF LARGE BREAST 19318)NRNRNRNRNRNR
TX ATRIAL FIB PULM VEIN ISOL 93656)NRNRNRNRNRNR
REPAIR DETACHED RETINA 67108)NRNRNRNRNRNR
INSERT ANT SEGMENT DRAIN INT 0191T)NRNRNRNRNRNR
Hysteroscopy with Ablation 58563)NRNRNRNRNRNR
Laparoscopy- Excision of Lesions of Ovary or Pelvic Area 58662)NRNRNRNRNRNR
CYSTOURETHROSCOPY W/FULG; MEDIUM TUMOR 52235)NRNRNRNRNRNR
Information about quality and safety of care for Stoughton Hospital Association may be found at http://www.wicheckpoint.org
* Estimated Insurance Payments based on average percent of billed charges collected.