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 2021 - December 2021
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$4,100$2,132$1,148
2560Vaginal DeliveryNRNRNR
3720Blood Infection/Septicemia$23,285$12,108$6,520
4137Respiratory Infections and Inflammations$10,596$5,510$2,967
5194Heart Failure$20,694$10,761$5,794
7540Cesarean DeliveryNRNRNR
8775Alcohol Abuse/Dependence$16,316$8,485$4,569
9753Bipolar Disorders$12,169$6,328$3,407
10201Heart Abnormal Rhythm and Conduction Disorders$20,864$10,849$5,842
11045Stroke and Precerebral Occlusion with Infarct$28,563$14,853$7,998
12469Acute Kidney Injury$19,882$10,339$5,567
13133Respiratory failureNRNRNR
15463Kidney/Urinary Tract Infection$20,957$10,897$5,868
16174Percutaneous coronary intervention w AMI$60,177$31,292$16,850
19383Cellulitis & other skin infections$16,039$8,340$4,491
20326Elective knee joint replacement$45,493$23,656$12,738
21282Disorders of Pancreas Except Malignancy$19,834$10,314$5,554
22247Intestinal Obstruction without Surgery$19,762$10,276$5,533
23308Hip & femur fracture repair$60,408$31,412$16,914
24140Chronic Obstructive Pulmonary Disease$24,862$12,928$6,961
25710Infectious & parasitic diseases including HIV w O.R. procedure$37,777$19,644$10,577
26231Major large bowel procedures$60,205$31,307$16,857
27190Circulatory Disorders with Heart Attack$31,516$16,388$8,824
28466Malfunction, reaction, complic of genitourinary device or proc$45,375$23,595$12,705
29058Other Disorders of Nervous System$32,001$16,641$8,960
30304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$92,306$47,999$25,846
32254Other Digestive System Diagnoses$19,857$10,325$5,560
33192Cardiac catheterization for other non-coronary conditions$34,963$18,181$9,790
34134Pulmonary Embolism$17,527$9,114$4,908
36324Elective hip joint replacement$54,102$28,133$15,149
37244Diverticulitis & Diverticulosis$21,560$11,211$6,037
38241Peptic Ulcer/Gastritis$21,646$11,256$6,061
39175Percutaneous coronary intervention w/o AMI$80,646$41,936$22,581
40263Laparoscopic Cholecystectomy$56,063$29,153$15,698
41230Major small bowel procedures$51,234$26,641$14,345
42323Non-elective or complex hip joint replacement$66,696$34,682$18,675
43862Other Factors Influencing Health StatusNRNRNR
44426Non-hypovolemic sodium disorders$19,717$10,253$5,521
45773Opioid Abuse/Dependence$13,082$6,803$3,663
46861Signs & Symptoms$23,314$12,123$6,528
47347Other Back/Neck Disorders, Fractures, Injuries$30,384$15,800$8,508
48253Other and Unspecified Gastrointestinal Hemorrhage$16,982$8,830$4,755
49249Other gastroenteritis, nausea & vomiting$18,301$9,517$5,124
50052Nontraumatic stupor & coma$27,930$14,523$7,820
51566Other Antepartum DiagnosesNRNRNR
52663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$13,697$7,122$3,835
53539Cesarean delivery with sterlizationNRNRNR
54183Percutaneous structural cardiac procedures$117,939$61,328$33,023
55021Craniotomy Except For Trauma$108,315$56,324$30,328
56313Other Knee/Lower Leg Surgery$59,326$30,849$16,611
57055Head trauma w coma >1 hr or hemorrhage$28,643$14,894$8,020
58280Alcoholic Liver Disease$16,061$8,352$4,497
59351Other Musculoskeletal System and Connective Tissue Diagnoses$24,100$12,532$6,748
60403Surgical Procedures for Obesity$42,603$22,153$11,929
61425Other Electrolyte Disorders$29,619$15,402$8,293
62721Postoperative and Post-Traumatic Infections$21,932$11,405$6,141
63166Coronary bypass w/o AMI or complex PDX$142,844$74,279$39,996
64248Major G.I. Bacterial Infections$22,576$11,739$6,321
66755Neuroses Other Than Depression$11,424$5,940$3,199
67130Respiratory System DX w/ Vent Support 96+ HrsNRNRNR
68171Pacemaker Implant without Heart Attack, Heart Failure or Shock$67,057$34,870$18,776
69182Other Peripheral Vascular Procedures$86,200$44,824$24,136
70143Other respiratory diagnoses except signs, symptoms & minor diagnoses$15,224$7,917$4,263
71284Disorders of gallbladder & biliary tract$27,052$14,067$7,575
72163Cardiac valve procedures w/o AMI or complex PDX$145,706$75,767$40,798
73542Vaginal Delivery with Proc Except SterilizationNRNRNR
74042Degenerative nervous system disorders exc mult sclerosis$27,726$14,418$7,763
75197Peripheral and Other Vascular Disorders$22,058$11,470$6,176
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 2021 - December 2021

 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*
Lesion Removal Colonoscopy by Snare Technique 45385)$5,638$2,932$1,579$9,995$5,198$2,799
Cataract Surgery with Intraocular Lens - Stage 1 66984)$10,204$5,306$2,857$22,055$11,468$6,175
Colonoscopy and Biopsy 45380)$5,390$2,803$1,509$9,295$4,833$2,603
Upper GI Endoscopy with Biopsy 43239)$4,723$2,456$1,323$11,243$5,846$3,148
Diagnostic Colonoscopy 45378)$4,722$2,456$1,322$8,590$4,467$2,405
Injection into Lumbar or Sacral Area, Single Level 64483)NRNRNR$3,402$1,769$953
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$4,284$2,228$1,200$7,848$4,081$2,197
Inj/Drainage or Aspiration, Spine/Spinal Cord w/ Img Guidancee 62323)$10,015$5,208$2,804$5,841$3,037$1,635
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$4,126$2,146$1,155$7,812$4,062$2,187
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)NRNRNRNRNRNR
Total Knee Arthroscopy 27447)$37,273$19,382$10,436$49,113$25,539$13,752
Carpal Tunnel Surgery 64721)$4,517$2,349$1,265$17,222$8,955$4,822
Uppr GI Endoscopy- Diagnostic 43235)$3,537$1,839$990$5,719$2,974$1,601
TOTAL HIP ARTHROPLASTY 27130)$47,531$24,716$13,309$58,529$30,435$16,388
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$11,166$5,807$3,127$28,360$14,747$7,941
Left Heart Artery/Ventricle Angiography 93458)$19,317$10,045$5,409$26,919$13,998$7,537
Drain/Inject Major Joint or Bursa 20610)NRNRNR$35,228$18,319$9,864
Unlisted Dental Surgery Procedure 41899)$13,995$7,277$3,918$20,284$10,548$5,680
Esophageal Endoscopy with Dilation 43249)$6,011$3,126$1,683$9,489$4,934$2,657
Cystourethroscopy with Lithotripsy and Stent 52356)$15,068$7,836$4,219$18,991$9,875$5,317
Arthroscopic Rotator Cuff Repair 29827)$29,644$15,415$8,300$33,908$17,632$9,494
Laparoscopic Cholecystectomy 47562)$24,566$12,774$6,879$33,909$17,633$9,495
Hysteroscopy with Biopsy 58558)NRNRNRNRNRNR
Cataract Surgery- Complex 66982)$12,977$6,748$3,634$27,765$14,438$7,774
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)NRNRNRNRNRNR
Laparoscopic Hernia Repair - Initial 49650)$18,553$9,648$5,195$23,282$12,107$6,519
Uppr GI Endoscopy with Guide Wire 43248)$5,241$2,725$1,468$8,457$4,398$2,368
After Cataract Laser Surgery 66821)NRNRNR$13,229$6,879$3,704
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Incision of Finger Tendon Sheath 26055)$4,074$2,118$1,141$6,115$3,180$1,712
Laparoscopy, Removal of Tubes & Ovaries 58571)$39,787$20,689$11,140$78,349$40,742$21,938
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)NRNRNRNRNRNR
Creation of Eardrum Opening 69436)$3,833$1,993$1,073$9,755$5,073$2,731
Laparoscopic Appendectomy 44970)$35,619$18,522$9,973$34,227$17,798$9,584
Laparoscopy - Removal of Adnexal Structures 58661)$30,389$15,802$8,509$40,628$21,127$11,376
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$13,750$7,150$3,850$23,872$12,414$6,684
Mastectomy, Partial 19301)$13,197$6,863$3,695$29,408$15,292$8,234
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNRNRNRNR
Cystourethroscopy with Stent 52332)$12,166$6,327$3,407$18,619$9,682$5,213
Unlisted Cystourethoscopy 52000)$8,142$4,234$2,280$14,979$7,789$4,194
Coronary Artery Angio S&I 93454)NRNRNR$23,719$12,334$6,641
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$33,072$17,197$9,260$104,801$54,496$29,344
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$18,475$9,607$5,173$19,394$10,085$5,430
Wrist Endoscopy/Surgery 29848)$5,594$2,909$1,566$8,991$4,675$2,518
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$11,757$6,114$3,292$28,150$14,638$7,882
FNA BX W/US GDN 1ST LES 10005)NRNRNR$22,130$11,508$6,196
Removal of Tonsils And Adenoids - < Age 12 42820)$9,862$5,128$2,761$11,453$5,956$3,207
Angioplasty - peripheral segment of the dialysis circuit 36902)$45,350$23,582$12,698NRNRNR
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Removal of Tonsils 42826)$11,430$5,944$3,201NRNRNR
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$24,245$12,608$6,789$26,246$13,648$7,349
RECONSTRUCT SHOULDER JOINT 23472)$68,215$35,472$19,100$60,905$31,671$17,053
Decompression of Ulnar Nerve at Elbow 64718)$9,769$5,080$2,735$13,344$6,939$3,736
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$11,411$5,934$3,195$19,675$10,231$5,509
Repair of Nasal Septum 30520)$13,149$6,837$3,682$36,027$18,734$10,088
Low Back Disk Surgery 63030)$20,224$10,516$5,663$26,658$13,862$7,464
Right and Left Heart Artery/Ventricle Angiography 93460)$23,274$12,102$6,517$31,076$16,160$8,701
Fragmenting of Kidney Stone 50590)NRNRNRNRNRNR
REDUCTION OF LARGE BREAST 19318)$29,382$15,279$8,227$36,590$19,027$10,245
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
DX BONE MARROW BX & ASPIR 38222)$11,962$6,220$3,349$21,025$10,933$5,887
Debridement Skin/Tissue 11042)$12,233$6,361$3,425$12,445$6,471$3,485
TX ATRIAL FIB PULM VEIN ISOL 93656)$43,190$22,459$12,093$100,892$52,464$28,250
Mohs Micrographic Tissue Removal 17311)NRNRNRNRNRNR
Repair of wrist joints 25447)$15,210$7,909$4,259$15,369$7,992$4,303
ESOPHAGUS MOTILITY STUDY 91010)$1,897$986$531$3,694$1,921$1,034
REMOVAL OF SPINAL LAMINA 63047)$25,505$13,263$7,142$34,716$18,052$9,720
REMOVAL OF TURBINATE BONES 30140)$12,272$6,382$3,436$22,479$11,689$6,294
Repair of upper eyelid with excessive skin 15823)$6,543$3,403$1,832$10,249$5,330$2,870
Upper GI Endoscopy w Removal of Foreign Body 43247)$9,795$5,093$2,743$13,976$7,268$3,913
Injection of chemical agent into muscles near face/neck 64615)NRNRNRNRNRNR
Hysteroscopy with Ablation 58563)NRNRNRNRNRNR
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.