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 2019 - December 2019
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$4,008$2,084$1,122
2560Vaginal DeliveryNRNRNR
3720Blood Infection/Septicemia$15,754$8,192$4,411
4194Heart Failure$15,934$8,286$4,461
6540Cesarean DeliveryNRNRNR
7301Hip Replacement$46,400$24,128$12,992
8302Knee Replacement$44,342$23,058$12,416
10753Bipolar Disorders$11,270$5,860$3,156
11775Alcohol Abuse/Dependence$11,000$5,720$3,080
12201Heart Abnormal Rhythm and Conduction Disorders$15,745$8,187$4,409
13133Respiratory failureNRNRNR
14045Stroke and Precerebral Occlusion with Infarct$27,075$14,079$7,581
15140Chronic Obstructive Pulmonary Disease$29,263$15,217$8,194
16469Acute Kidney Injury$14,946$7,772$4,185
17463Kidney/Urinary Tract Infection$16,670$8,669$4,668
18383Cellulitis & other skin infections$10,932$5,685$3,061
19174Percutaneous coronary intervention w AMI$56,268$29,259$15,755
22282Disorders of Pancreas Except Malignancy$16,623$8,644$4,654
23247Intestinal Obstruction without Surgery$18,732$9,740$5,245
24308Hip & femur fracture repair$51,035$26,538$14,290
25175Percutaneous coronary intervention w/o AMI$64,740$33,665$18,127
26190Circulatory Disorders with Heart Attack$20,596$10,710$5,767
27231Major large bowel procedures$53,816$27,984$15,069
28304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$85,407$44,411$23,914
29254Other Digestive System Diagnoses$19,481$10,130$5,455
30058Other Disorders of Nervous System$27,322$14,208$7,650
33137Respiratory Infections and Inflammations$16,166$8,407$4,527
34192Cardiac catheterization for other non-coronary conditions$30,976$16,107$8,673
35466Malfunction, reaction, complic of genitourinary device or proc$15,917$8,277$4,457
36134Pulmonary Embolism$16,383$8,519$4,587
37710Infectious & parasitic diseases including HIV w O.R. procedure$35,050$18,226$9,814
38241Peptic Ulcer/Gastritis$18,533$9,637$5,189
39244Diverticulitis & Diverticulosis$19,380$10,077$5,426
40263Laparoscopic Cholecystectomy$42,573$22,138$11,920
41322Shoulder & Elbow Joint Replacement$53,052$27,587$14,854
42249Other gastroenteritis, nausea & vomiting$14,070$7,316$3,940
43773Opioid Abuse/Dependence$15,352$7,983$4,299
44313Other Knee/Lower Leg Surgery$52,077$27,080$14,581
45862Other Factors Influencing Health StatusNRNRNR
46230Major small bowel procedures$42,081$21,882$11,783
47347Other Back/Neck Disorders, Fractures, Injuries$25,405$13,210$7,113
48861Signs & Symptoms$16,925$8,801$4,739
49024Extracranial Vascular Procedures$72,309$37,600$20,246
50253Other and Unspecified Gastrointestinal Hemorrhage$3,095$1,609$866
51426Non-hypovolemic sodium disorders$18,445$9,592$5,165
52351Other Musculoskeletal System and Connective Tissue Diagnoses$20,441$10,629$5,723
53021Craniotomy Except For Trauma$90,202$46,905$25,257
54052Nontraumatic stupor & coma$20,492$10,656$5,738
55248Major G.I. Bacterial Infections$19,350$10,062$5,418
56663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$10,027$5,214$2,808
57181Lower Extremity Arterial Procedures$102,265$53,178$28,634
58055Head trauma w coma >1 hr or hemorrhage$28,018$14,569$7,845
59812Poisoning of Medicinal Agents$14,056$7,309$3,936
60166Coronary bypass w/o AMI or complex PDX$133,486$69,413$37,376
61113Epiglottitis, Ear Infection, URI and Laryngotracheitis$12,226$6,358$3,423
62755Neuroses Other Than Depression$9,372$4,873$2,624
63566Other Antepartum Diagnoses$5,951$3,095$1,666
64721Postoperative and Post-Traumatic Infections$16,819$8,746$4,709
65143Other respiratory diagnoses except signs, symptoms & minor diagnoses$17,525$9,113$4,907
66171Pacemaker Implant without Heart Attack, Heart Failure or Shock$63,537$33,039$17,790
67280Alcoholic Liver Disease$10,787$5,609$3,020
68425Other Electrolyte Disorders$10,784$5,608$3,020
69197Peripheral and Other Vascular Disorders$11,717$6,093$3,281
70321Upper Spinal Fusion$41,247$21,449$11,549
71163Cardiac valve procedures w/o AMI or complex PDX$124,040$64,501$34,731
72696Other Chemotherapy$30,793$16,012$8,622
73284Disorders of gallbladder & biliary tract$25,561$13,292$7,157
74042Degenerative nervous system disorders exc mult sclerosis$17,533$9,117$4,909
75756Acute Adjust React Psychosocial Dysfunction$22,149$11,517$6,202
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 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)$9,449$4,914$2,646$18,632$9,689$5,217
Colonoscopy and Biopsy 45380)$4,568$2,375$1,279$8,126$4,226$2,275
Lesion Removal Colonoscopy by Snare Technique 45385)$4,399$2,288$1,232$7,925$4,121$2,219
Upper GI Endoscopy with Biopsy 43239)$3,662$1,904$1,025$9,276$4,823$2,597
Diagnostic Colonoscopy 45378)$3,626$1,885$1,015$6,529$3,395$1,828
Injection into Lumbar or Sacral Area, Single Level 64483)$9,748$5,069$2,730NRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)NRNRNRNRNRNR
Inj/Drainage or Aspiration, Spine/Spinal Cord w/ Img Guidancee 62323)$17,466$9,082$4,890$13,194$6,861$3,694
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$4,000$2,080$1,120$6,769$3,520$1,895
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$3,842$1,998$1,076$7,008$3,644$1,962
Carpal Tunnel Surgery 64721)$4,545$2,363$1,273$4,444$2,311$1,244
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Uppr GI Endoscopy- Diagnostic 43235)$3,137$1,631$878$5,420$2,819$1,518
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$10,158$5,282$2,844$24,857$12,925$6,960
Drain/Inject Major Joint or Bursa 20610)NRNRNR$11,078$5,761$3,102
Creation of Eardrum Opening 69436)$2,601$1,352$728$18,537$9,639$5,190
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)NRNRNRNRNRNR
Left Heart Artery/Ventricle Angiography 93458)$15,426$8,022$4,319$18,275$9,503$5,117
Unlisted Dental Surgery Procedure 41899)$11,781$6,126$3,299$18,947$9,853$5,305
Total Knee Arthroscopy 27447)$34,486$17,933$9,656$41,725$21,697$11,683
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Esophageal Endoscopy with Dilation 43249)$4,564$2,373$1,278$7,335$3,814$2,054
Laparoscopic Cholecystectomy 47562)$17,006$8,843$4,762$27,376$14,236$7,665
Arthroscopic Rotator Cuff Repair 29827)$54,455$28,317$15,247$28,450$14,794$7,966
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)$4,485$2,332$1,256NRNRNR
After Cataract Laser Surgery 66821)NRNRNRNRNRNR
Cataract Surgery- Complex 66982)$14,705$7,647$4,117$22,393$11,644$6,270
Cystourethroscopy with Lithotripsy and Stent 52356)$13,216$6,872$3,701$15,077$7,840$4,221
Hysteroscopy with Biopsy 58558)NRNRNRNRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)$7,836$4,075$2,194$9,596$4,990$2,687
Laparoscopic Hernia Repair - Initial 49650)$16,423$8,540$4,598$20,228$10,518$5,664
Uppr GI Endoscopy with Guide Wire 43248)$4,376$2,275$1,225$6,873$3,574$1,924
Incision of Finger Tendon Sheath 26055)$4,047$2,104$1,133$5,482$2,851$1,535
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNRNRNRNR
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$11,360$5,907$3,181$25,529$13,275$7,148
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Laparoscopy - Removal of Adnexal Structures 58661)$24,668$12,827$6,907$26,215$13,632$7,340
Laparoscopy, Removal of Tubes & Ovaries 58571)$36,583$19,023$10,243$36,488$18,974$10,217
Unlisted Cystourethoscopy 52000)$6,837$3,555$1,914$8,964$4,661$2,510
Laparoscopic Appendectomy 44970)$31,157$16,202$8,724$31,670$16,469$8,868
Cystourethroscopy with Stent 52332)$8,798$4,575$2,464$14,176$7,372$3,969
Mastectomy, Partial 19301)$9,691$5,039$2,713$24,225$12,597$6,783
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$17,201$8,945$4,816$13,996$7,278$3,919
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$15,702$8,165$4,396$55,641$28,933$15,580
Coronary Artery Angio S&I 93454)NRNRNR$20,683$10,755$5,791
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$10,730$5,580$3,004$24,784$12,887$6,939
Angioplasty - peripheral segment of the dialysis circuit 36902)$41,163$21,405$11,526NRNRNR
Wrist Endoscopy/Surgery 29848)$3,593$1,868$1,006$7,818$4,065$2,189
Removal of Tonsils 42826)$10,700$5,564$2,996NRNRNR
Debridement Skin/Tissue 11042)$9,525$4,953$2,667$15,916$8,276$4,457
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$9,386$4,881$2,628$18,760$9,755$5,253
Low Back Disk Surgery 63030)$17,862$9,288$5,001$24,018$12,490$6,725
Fragmenting of Kidney Stone 50590)NRNRNRNRNRNR
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$20,855$10,844$5,839$23,776$12,363$6,657
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Repair of Nasal Septum 30520)$15,781$8,206$4,419$28,245$14,687$7,909
Decompression of Ulnar Nerve at Elbow 64718)$11,884$6,180$3,328$13,013$6,767$3,644
Right and Left Heart Artery/Ventricle Angiography 93460)NRNRNR$22,990$11,955$6,437
Removal of Adenoids 42830)$5,873$3,054$1,644$5,762$2,996$1,613
DX BONE MARROW BX & ASPIR 38222)$8,298$4,315$2,324$14,689$7,638$4,113
SHOULDER ARTHROSCOPY/SURGERY 29823)$16,493$8,576$4,618$16,376$8,515$4,585
ESOPHAGUS MOTILITY STUDY 91010)$1,490$775$417$2,953$1,536$827
Hysteroscopy with Ablation 58563)NRNRNRNRNRNR
Repair of wrist joints 25447)$13,627$7,086$3,815$11,575$6,019$3,241
Implant Neuroelectrodes 63650)$17,476$9,087$4,893$48,670$25,308$13,628
Repair of upper eyelid with excessive skin 15823)$6,455$3,357$1,807$8,898$4,627$2,491
Upper GI Endoscopy w Removal of Foreign Body 43247)$6,939$3,608$1,943$9,639$5,012$2,699
Laparoscopy- Excision of Lesions of Ovary or Pelvic Area 58662)$36,368$18,912$10,183$29,164$15,165$8,166
Repair of Hammertoe 28285)$8,729$4,539$2,444$14,103$7,334$3,949
REMOVAL OF SPINAL LAMINA 63047)$23,307$12,120$6,526$31,119$16,182$8,713
Excision Breast Lesion with Preoperative Placement Radiological Marker 19125)$9,247$4,808$2,589$11,191$5,819$3,134
REMOVAL OF TURBINATE BONES 30140)$15,055$7,829$4,216$20,649$10,737$5,782
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.