ProHealth Waukesha Memorial Hospital
725 American Avenue
Waukesha, WI 53188
262-928-1000
 
PPS Rule Machine Readable Transparency File Download Hospital Charges

WI Act 146 Top 75 Reports

Charges for 75 Most Common Hospitalizations in Wisconsin:  April 2019 - March 2020
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Charge
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$5,321$3,086$745
2560Vaginal Delivery$15,759$9,140$2,206
3720Blood Infection/Septicemia$20,471$11,873$2,866
4194Heart Failure$20,217$11,726$2,830
5751Psychoses$14,476$8,396$2,027
6540Cesarean Delivery$25,598$14,847$3,584
7301Hip Replacement$60,509$35,095$8,471
8302Knee Replacement$58,952$34,192$8,253
9139Pneumonia$15,196$8,813$2,127
10753Bipolar Disorders$18,212$10,563$2,550
11775Alcohol Abuse/Dependence$9,848$5,712$1,379
12201Heart Abnormal Rhythm and Conduction Disorders$13,150$7,627$1,841
13133Respiratory failureNRNRNR
14045Stroke and Precerebral Occlusion with Infarct$29,699$17,225$4,158
15140Chronic Obstructive Pulmonary Disease$15,975$9,265$2,236
16469Acute Kidney Injury$16,302$9,455$2,282
17463Kidney/Urinary Tract Infection$20,657$11,981$2,892
18383Cellulitis & other skin infections$10,657$6,181$1,492
19174Percutaneous coronary intervention w AMI$57,133$33,137$7,999
20750Schizophrenia$18,573$10,772$2,600
21420Diabetes$13,474$7,815$1,886
22247Intestinal Obstruction without Surgery$20,788$12,057$2,910
23282Disorders of Pancreas Except Malignancy$17,907$10,386$2,507
24308Hip & femur fracture repair$54,103$31,380$7,574
25231Major large bowel procedures$81,308$47,158$11,383
26190Circulatory Disorders with Heart Attack$30,408$17,636$4,257
27175Percutaneous coronary intervention w/o AMI$93,680$54,335$13,115
28058Other Disorders of Nervous System$25,215$14,625$3,530
29304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$143,671$83,329$20,114
30754Depression$12,025$6,975$1,684
31254Other Digestive System Diagnoses$22,126$12,833$3,098
32466Malfunction, reaction, complic of genitourinary device or procNRNRNR
33137Respiratory Infections and Inflammations$21,193$12,292$2,967
34053Seizure$23,040$13,363$3,226
35192Cardiac catheterization for other non-coronary conditions$38,399$22,272$5,376
36134Pulmonary Embolism$19,707$11,430$2,759
37710Infectious & parasitic diseases including HIV w O.R. procedure$27,359$15,868$3,830
38241Peptic Ulcer/Gastritis$17,381$10,081$2,433
39244Diverticulitis & Diverticulosis$19,399$11,251$2,716
40322Shoulder & Elbow Joint Replacement$81,405$47,215$11,397
41263Laparoscopic Cholecystectomy$57,939$33,605$8,111
42249Other gastroenteritis, nausea & vomiting$20,843$12,089$2,918
43773Opioid Abuse/Dependence$11,501$6,670$1,610
44862Other Factors Influencing Health StatusNRNRNR
45230Major small bowel procedures$64,403$37,354$9,016
46313Other Knee/Lower Leg Surgery$57,252$33,206$8,015
47347Other Back/Neck Disorders, Fractures, Injuries$22,617$13,118$3,166
48861Signs & Symptoms$13,440$7,795$1,882
49253Other and Unspecified Gastrointestinal Hemorrhage$16,135$9,359$2,259
50426Non-hypovolemic sodium disorders$25,153$14,589$3,521
51052Nontraumatic stupor & coma$41,766$24,225$5,847
52113Epiglottitis, Ear Infection, URI and Laryngotracheitis$21,062$12,216$2,949
53351Other Musculoskeletal System and Connective Tissue Diagnoses$16,144$9,364$2,260
54248Major G.I. Bacterial Infections$20,556$11,922$2,878
55566Other Antepartum Diagnoses$10,374$6,017$1,452
56024Extracranial Vascular Procedures$54,056$31,352$7,568
57663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$19,495$11,307$2,729
58021Craniotomy Except For Trauma$74,350$43,123$10,409
59055Head trauma w coma >1 hr or hemorrhage$17,748$10,294$2,485
60755Neuroses Other Than Depression$6,958$4,036$974
61166Coronary bypass w/o AMI or complex PDX$182,065$105,598$25,489
62721Postoperative and Post-Traumatic Infections$16,299$9,453$2,282
63182Other Peripheral Vascular Procedures$75,773$43,948$10,608
64812Poisoning of Medicinal Agents$13,332$7,732$1,866
65181Lower Extremity Arterial Procedures$88,026$51,055$12,324
66143Other respiratory diagnoses except signs, symptoms & minor diagnoses$28,794$16,701$4,031
67171Pacemaker Implant without Heart Attack, Heart Failure or Shock$53,572$31,072$7,500
68280Alcoholic Liver DiseaseNRNRNR
69321Upper Spinal Fusion$94,764$54,963$13,267
70425Other Electrolyte Disorders$24,052$13,950$3,367
71163Cardiac valve procedures w/o AMI or complex PDX$255,160$147,993$35,722
72197Peripheral and Other Vascular Disorders$32,930$19,100$4,610
73284Disorders of gallbladder & biliary tract$30,031$17,418$4,204
74696Other ChemotherapyNRNRNR
75042Degenerative nervous system disorders exc mult sclerosis$21,336$12,375$2,987

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:  April 2019 - March 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)NRNRNRNRNRNR
Colonoscopy and Biopsy 45380)$7,868$4,564$1,102$12,498$7,249$1,750
Lesion Removal Colonoscopy by Snare Technique 45385)$8,109$4,703$1,135$11,313$6,562$1,584
Upper GI Endoscopy with Biopsy 43239)$7,624$4,422$1,067$10,505$6,093$1,471
Diagnostic Colonoscopy 45378)$6,387$3,704$894$10,446$6,059$1,462
Injection into Lumbar or Sacral Area, Single Level 64483)NRNRNRNRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)NRNRNRNRNRNR
Inj/Drainage or Aspiration, Spine/Spinal Cord w/ Img Guidancee 62323)NRNRNRNRNRNR
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$6,519$3,781$913$9,110$5,284$1,275
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$6,485$3,761$908NRNRNR
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Carpal Tunnel Surgery 64721)$10,414$6,040$1,458$12,370$7,175$1,732
Uppr GI Endoscopy- Diagnostic 43235)$6,119$3,549$857$8,504$4,933$1,191
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$16,625$9,643$2,328$51,423$29,826$7,199
Drain/Inject Major Joint or Bursa 20610)NRNRNRNRNRNR
Left Heart Artery/Ventricle Angiography 93458)$18,222$10,569$2,551$19,121$11,090$2,677
Creation of Eardrum Opening 69436)$8,028$4,656$1,124$7,924$4,596$1,109
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)NRNRNRNRNRNR
Total Knee Arthroscopy 27447)$54,540$31,633$7,636$54,594$31,664$7,643
Unlisted Dental Surgery Procedure 41899)$13,033$7,559$1,825NRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Esophageal Endoscopy with Dilation 43249)$8,095$4,695$1,133$9,974$5,785$1,396
Laparoscopic Cholecystectomy 47562)$25,578$14,835$3,581$27,082$15,708$3,792
Arthroscopic Rotator Cuff Repair 29827)NRNRNR$53,281$30,903$7,459
After Cataract Laser Surgery 66821)NRNRNRNRNRNR
Cystourethroscopy with Lithotripsy and Stent 52356)$22,665$13,146$3,173$31,135$18,058$4,359
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)$8,197$4,754$1,148$11,522$6,683$1,613
Hysteroscopy with Biopsy 58558)$18,614$10,796$2,606$22,504$13,052$3,151
Cataract Surgery- Complex 66982)NRNRNRNRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)$12,905$7,485$1,807$13,636$7,909$1,909
Laparoscopic Hernia Repair - Initial 49650)$34,110$19,784$4,775$32,887$19,075$4,604
Uppr GI Endoscopy with Guide Wire 43248)$7,070$4,100$990$8,397$4,870$1,176
Incision of Finger Tendon Sheath 26055)$11,123$6,451$1,557$11,392$6,607$1,595
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
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)$12,726$7,381$1,782$14,805$8,587$2,073
Laparoscopy - Removal of Adnexal Structures 58661)$23,961$13,898$3,355$33,566$19,469$4,699
Laparoscopy, Removal of Tubes & Ovaries 58571)$38,205$22,159$5,349$56,623$32,841$7,927
Laparoscopic Appendectomy 44970)$31,657$18,361$4,432$36,186$20,988$5,066
Unlisted Cystourethoscopy 52000)$6,640$3,851$930$10,811$6,270$1,514
Mastectomy, Partial 19301)$16,095$9,335$2,253$25,786$14,956$3,610
Cystourethroscopy with Stent 52332)$12,420$7,203$1,739$15,983$9,270$2,238
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$28,534$16,550$3,995$27,307$15,838$3,823
Coronary Artery Angio S&I 93454)$18,428$10,688$2,580$23,828$13,820$3,336
Angioplasty - peripheral segment of the dialysis circuit 36902)NRNRNRNRNRNR
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$18,135$10,518$2,539NRNRNR
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$28,275$16,400$3,959$37,369$21,674$5,232
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
FNA BX W/US GDN 1ST LES 10005)NRNRNRNRNRNR
Debridement Skin/Tissue 11042)$13,249$7,684$1,855$35,378$20,519$4,953
Removal of Tonsils 42826)$14,035$8,140$1,965$15,937$9,243$2,231
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Low Back Disk Surgery 63030)$31,153$18,069$4,361$47,338$27,456$6,627
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$60,446$35,059$8,462$46,615$27,037$6,526
Fragmenting of Kidney Stone 50590)$18,643$10,813$2,610$20,586$11,940$2,882
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$17,661$10,244$2,473$24,828$14,400$3,476
Repair of Nasal Septum 30520)$16,585$9,619$2,322$21,682$12,576$3,036
Decompression of Ulnar Nerve at Elbow 64718)$18,631$10,806$2,608$17,531$10,168$2,454
Removal of Adenoids 42830)NRNRNR$10,155$5,890$1,422
Right and Left Heart Artery/Ventricle Angiography 93460)$22,355$12,966$3,130$23,270$13,496$3,258
DX BONE MARROW BX & ASPIR 38222)$14,033$8,139$1,965NRNRNR
TOTAL HIP ARTHROPLASTY 27130)$53,607$31,092$7,505NRNRNR
SHOULDER ARTHROSCOPY/SURGERY 29823)$25,581$14,837$3,581$36,116$20,947$5,056
ESOPHAGUS MOTILITY STUDY 91010)NRNRNRNRNRNR
Hysteroscopy with Ablation 58563)$21,862$12,680$3,061$28,931$16,780$4,050
Repair of wrist joints 25447)NRNRNR$25,235$14,637$3,533
Implant Neuroelectrodes 63650)$136,178$78,983$19,065NRNRNR
Repair of upper eyelid with excessive skin 15823)NRNRNRNRNRNR
Upper GI Endoscopy w Removal of Foreign Body 43247)$8,597$4,986$1,204$9,863$5,721$1,381
INSERT ANT SEGMENT DRAIN INT 0191T)NRNRNRNRNRNR
TX ATRIAL FIB PULM VEIN ISOL 93656)NRNRNR$103,507$60,034$14,491
REMOVAL OF SPINAL LAMINA 63047)$31,453$18,243$4,403$50,593$29,344$7,083
REMOVAL OF TURBINATE BONES 30140)$13,856$8,036$1,940$14,697$8,524$2,058
Excision Breast Lesion with Preoperative Placement Radiological Marker 19125)$15,699$9,106$2,198$18,844$10,930$2,638
Information about quality and safety of care for ProHealth Waukesha Memorial Hospital may be found at http://www.wicheckpoint.org
* Estimated Insurance Payments based on average percent of billed charges collected.