UW Hospital and Clinics Authority
600 Highland Avenue
Madison, WI 53792
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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  
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$4,430$2,304$1,240
2560Vaginal DeliveryNRNRNR
3720Blood Infection/Septicemia$22,629$11,767$6,336
4137Respiratory Infections and Inflammations$41,223$21,436$11,542
5194Heart Failure$18,654$9,700$5,223
7540Cesarean Delivery$66,710$34,689$18,679
8753Bipolar Disorders$13,049$6,785$3,654
9775Alcohol Abuse/Dependence$13,314$6,923$3,728
11045Stroke and Precerebral Occlusion with Infarct$29,830$15,512$8,352
12201Heart Abnormal Rhythm and Conduction Disorders$19,500$10,140$5,460
13301Hip Replacement$51,085$26,564$14,304
14133Respiratory failureNRNRNR
15469Acute kidney injury$17,810$9,261$4,987
16302Knee Replacement$39,957$20,778$11,188
17174Percutaneous coronary intervention w AMI$58,063$30,193$16,258
18463Kidney/Urinary Tract Infection$22,302$11,597$6,245
21383Cellulitis & other skin infections$13,711$7,130$3,839
22140Chronic Obstructive Pulmonary Disease$23,559$12,250$6,596
23282Disorders of Pancreas Except Malignancy$22,098$11,491$6,188
24308Hip & femur fracture repair$51,931$27,004$14,541
25247Intestinal Obstruction without Surgery$18,234$9,482$5,105
26710Infectious & parasitic diseases including HIV w O.R. procedure$56,360$29,307$15,781
27231Major large bowel procedures$53,323$27,728$14,930
28058Other Disorders of Nervous System$21,249$11,049$5,950
29466Malfunction, reaction, complic of genitourinary device or procNRNRNR
30190Circulatory Disorders with Heart Attack$28,614$14,879$8,012
31134Pulmonary Embolism$18,873$9,814$5,284
32254Other Digestive System Diagnoses$20,541$10,681$5,751
33241Peptic Ulcer/Gastritis$20,184$10,496$5,652
35304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$85,494$44,457$23,938
37192Cardiac catheterization for other non-coronary conditions$37,656$19,581$10,544
39244Diverticulitis & Diverticulosis$21,103$10,973$5,909
40322Shoulder & elbow joint replacement$47,890$24,903$13,409
41862Other Factors Influencing Health StatusNRNRNR
42175Percutaneous coronary intervention w/o AMI$70,320$36,566$19,690
43426Non-hypovolemic sodium disorders$13,844$7,199$3,876
44230Major small bowel procedures$53,787$27,969$15,060
45773Opioid Abuse/Dependence$8,806$4,579$2,466
46249Other gastroenteritis, nausea & vomiting$17,729$9,219$4,964
47861Signs & Symptoms$14,632$7,609$4,097
48313Other Knee/Lower Leg Surgery$55,232$28,721$15,465
49566Other Antepartum DiagnosesNRNRNR
50539Cesarean delivery with sterlizationNRNRNR
51052Alteration in consciousness$17,142$8,914$4,800
52182Other peripheral vascular procedures$96,656$50,261$27,064
53253Other and Unspecified Gastrointestinal Hemorrhage$16,197$8,423$4,535
54347Other Back/Neck Disorders, Fractures, Injuries$24,487$12,733$6,856
55663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$19,384$10,080$5,428
56055Head trauma w coma >1 hr or hemorrhage$31,123$16,184$8,714
57280Alcoholic Liver Disease$29,426$15,302$8,239
58248Major G.I. Bacterial Infections$26,311$13,682$7,367
59351Other Musculoskeletal System and Connective Tissue Diagnoses$19,847$10,320$5,557
60021Craniotomy Except For Trauma$100,754$52,392$28,211
61183Percutaneous structural cardiac procedures$124,871$64,933$34,964
62721Postoperative and Post-Traumatic Infections$19,148$9,957$5,361
64755Neuroses Other Than Depression$8,295$4,313$2,323
65166Coronary bypass w/o AMI or complex PDX$135,637$70,531$37,978
66425Other non-hypovolemic electrolyte disorders$15,481$8,050$4,335
67326Elective knee joint replacement$35,094$18,249$9,826
68143Other respiratory diagnoses except signs, symptoms & minor diagnoses$15,218$7,913$4,261
69284Disorders of gallbladder & biliary tract$23,258$12,094$6,512
70542Vaginal Delivery with Proc Except SterilizationNRNRNR
71130Respiratory System DX w/ Vent Support 96+ HrsNRNRNR
72171Pacemaker Implant without Heart Attack, Heart Failure or Shock$66,646$34,656$18,661
73042Degenerative nervous system disorders exc mult sclerosis$26,883$13,979$7,527
74321Upper Spinal Fusion$48,873$25,414$13,684
75113Epiglottitis, Ear Infection, URI and Laryngotracheitis$11,083$5,763$3,103
1. These data represent the median charges and payments for the least complicated cases. Individual variations may lead to charges that are greater than the amounts displayed here. Severely ill patients, or patients with additional medical conditions will require greater levels of medical care, and therefore will incur higher charges than reported here.
2. In most cases, Medicare payments are less than UW Hospital's cost of providing the care.
3. The charge information is for hospital services only. It does not include your doctor's fees.
4. It is important to understand that due to variations in individual physician practice patterns as well as individual patient differences, and the potential for unforeseen complications, this information should not be considered a price quote, but only an estimate. We encourage you to call our PriceLine staff at 608-263-1507 for more customized information regarding your specific case, and any other financial counseling we can provide. These staff can also provide you with estimates of physician fees for services at UW Hospital.
5. For comparative information on the quality of care at UW Hospital and Clinics, please see the Wisconsin Collaborative for Healthcare Quality's website at www.wchq.org.

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)$9,886$5,141$2,768$21,094$10,969$5,906
Lesion Removal Colonoscopy by Snare Technique 45385)$5,225$2,717$1,463$9,777$5,084$2,738
Colonoscopy and Biopsy 45380)$5,071$2,637$1,420$8,534$4,437$2,389
Upper GI Endoscopy with Biopsy 43239)$4,334$2,254$1,213$10,631$5,528$2,977
Diagnostic Colonoscopy 45378)$4,454$2,316$1,247$7,817$4,065$2,189
Injection into Lumbar or Sacral Area, Single Level 64483)$9,602$4,993$2,688$3,505$1,823$981
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)$4,193$2,180$1,174$7,660$3,983$2,145
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$3,997$2,078$1,119$7,295$3,793$2,042
Carpal Tunnel Surgery 64721)$4,646$2,416$1,301$7,770$4,040$2,176
Total Knee Arthroscopy 27447)$33,849$17,601$9,478$43,470$22,605$12,172
Uppr GI Endoscopy- Diagnostic 43235)$3,340$1,737$935$5,895$3,065$1,651
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$10,698$5,563$2,995$24,864$12,929$6,962
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Left Heart Artery/Ventricle Angiography 93458)$19,328$10,051$5,412$24,626$12,806$6,895
Drain/Inject Major Joint or Bursa 20610)NRNRNR$31,632$16,449$8,857
Cystourethroscopy with Lithotripsy and Stent 52356)$14,705$7,647$4,117$21,833$11,353$6,113
Unlisted Dental Surgery Procedure 41899)$13,162$6,844$3,685$17,894$9,305$5,010
Arthroscopic Rotator Cuff Repair 29827)$31,571$16,417$8,840$30,774$16,003$8,617
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)NRNRNRNRNRNR
TOTAL HIP ARTHROPLASTY 27130)$45,241$23,526$12,668$55,327$28,770$15,491
Esophageal Endoscopy with Dilation 43249)$5,255$2,733$1,471$8,697$4,522$2,435
Laparoscopic Cholecystectomy 47562)$19,105$9,935$5,349$26,043$13,542$7,292
Hysteroscopy with Biopsy 58558)NRNRNRNRNRNR
Laparoscopic Hernia Repair - Initial 49650)$17,637$9,171$4,938$19,573$10,178$5,480
Cataract Surgery- Complex 66982)$13,020$6,771$3,646$22,630$11,768$6,336
After Cataract Laser Surgery 66821)NRNRNRNRNRNR
Creation of Eardrum Opening 69436)$3,060$1,591$857$16,942$8,810$4,744
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Uppr GI Endoscopy with Guide Wire 43248)$4,940$2,569$1,383$7,503$3,901$2,101
Incision of Finger Tendon Sheath 26055)$4,413$2,295$1,236$6,338$3,296$1,775
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)NRNRNRNRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)$9,100$4,732$2,548$9,066$4,714$2,539
Laparoscopic Appendectomy 44970)$34,798$18,095$9,743$40,538$21,080$11,351
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Laparoscopy, Removal of Tubes & Ovaries 58571)$35,857$18,646$10,040$28,933$15,045$8,101
Laparoscopy - Removal of Adnexal Structures 58661)$28,762$14,956$8,053$30,431$15,824$8,521
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$12,100$6,292$3,388$24,283$12,627$6,799
Cystourethroscopy with Stent 52332)$10,367$5,391$2,903$16,314$8,483$4,568
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNRNRNRNR
Mastectomy, Partial 19301)$11,176$5,811$3,129$25,980$13,510$7,275
Angioplasty - peripheral segment of the dialysis circuit 36902)NRNRNRNRNRNR
Unlisted Cystourethoscopy 52000)$9,130$4,747$2,556$12,402$6,449$3,473
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$27,423$14,260$7,678NRNRNR
Wrist Endoscopy/Surgery 29848)$5,608$2,916$1,570$5,885$3,060$1,648
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$18,238$9,484$5,107$24,608$12,796$6,890
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$11,584$6,024$3,244$26,079$13,561$7,302
Coronary Artery Angio S&I 93454)NRNRNR$21,606$11,235$6,050
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Removal of Tonsils 42826)$10,245$5,327$2,869$8,676$4,512$2,429
Low Back Disk Surgery 63030)$18,596$9,670$5,207$25,050$13,026$7,014
Fragmenting of Kidney Stone 50590)NRNRNR$11,271$5,861$3,156
Debridement Skin/Tissue 11042)$8,923$4,640$2,498$14,970$7,784$4,191
DX BONE MARROW BX & ASPIR 38222)$11,507$5,984$3,222$16,268$8,460$4,555
Decompression of Ulnar Nerve at Elbow 64718)$13,723$7,136$3,842$13,590$7,067$3,805
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$21,164$11,005$5,926$26,985$14,032$7,556
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$10,779$5,605$3,018$20,964$10,901$5,870
Right and Left Heart Artery/Ventricle Angiography 93460)$22,743$11,827$6,368$29,818$15,505$8,349
Repair of Nasal Septum 30520)$14,815$7,704$4,148$34,610$17,997$9,691
SHOULDER ARTHROSCOPY/SURGERY 29823)$16,551$8,607$4,634$18,953$9,856$5,307
Repair of wrist joints 25447)$12,888$6,702$3,609$11,810$6,141$3,307
Upper GI Endoscopy w Removal of Foreign Body 43247)$7,869$4,092$2,203$10,188$5,298$2,853
REMOVAL OF SPINAL LAMINA 63047)$23,952$12,455$6,707$34,415$17,896$9,636
OPEN TX OF DISTAL RADIAL FX W INT FIX 3+ FRAG 25609)$20,363$10,589$5,702$28,864$15,009$8,082
ESOPHAGUS MOTILITY STUDY 91010)$1,856$965$520$3,685$1,916$1,032
REDUCTION OF LARGE BREAST 19318)$29,746$15,468$8,329$28,879$15,017$8,086
TX ATRIAL FIB PULM VEIN ISOL 93656)NRNRNR$93,042$48,382$26,052
REPAIR DETACHED RETINA 67108)$16,412$8,534$4,595$19,808$10,300$5,546
Hysteroscopy with Ablation 58563)NRNRNRNRNRNR
Laparoscopy- Excision of Lesions of Ovary or Pelvic Area 58662)$31,162$16,204$8,725$45,855$23,844$12,839
CYSTOURETHROSCOPY W/FULG; MEDIUM TUMOR 52235)$14,371$7,473$4,024$18,950$9,854$5,306
Information about quality and safety of care for UW Hospital and Clinics Authority may be found at http://www.wicheckpoint.org
* Estimated Insurance Payments based on average percent of billed charges collected.