ProHealth Waukesha Memorial Hospital
725 American Avenue
Waukesha, WI 53188
262-928-1000
 
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WI Act 146 Top 75 Reports

Charges for 75 Most Common Hospitalizations in Wisconsin:  July 2018 - June 2019
(Uncomplicated Cases Only)
    Estimated Insurance Payments *
RankAPR- DRGDescriptionMedian  
Charge
Private InsuranceMedicare
1640Normal Newborn, Birthweight 2500g+$4,649$2,696$651
2560Vaginal Delivery$15,308$8,878$2,143
3720Blood Infection/Septicemia$15,701$9,106$2,198
4194Heart Failure$21,323$12,367$2,985
5540Cesarean Delivery$24,130$13,995$3,378
6751Psychoses$12,507$7,254$1,751
7301Hip Replacement$61,763$35,823$8,647
8302Knee Replacement$55,544$32,215$7,776
9139Pneumonia$18,483$10,720$2,588
10753Bipolar Disorders$12,228$7,092$1,712
11775Alcohol Abuse/Dependence$8,101$4,698$1,134
12201Heart Abnormal Rhythm and Conduction Disorders$12,946$7,509$1,812
13133Respiratory failureNRNRNR
14140Chronic Obstructive Pulmonary Disease$14,349$8,322$2,009
15469Acute Kidney InjuryNRNRNR
16045Stroke and Precerebral Occlusion with Infarct$33,050$19,169$4,627
17463Kidney/Urinary Tract Infection$14,566$8,448$2,039
18383Cellulitis & other skin infections$14,063$8,156$1,969
19750Schizophrenia$17,155$9,950$2,402
20174Percutaneous coronary intervention w AMI$57,823$33,537$8,095
21420Diabetes$20,465$11,870$2,865
22282Disorders of Pancreas Except Malignancy$17,743$10,291$2,484
23247Intestinal Obstruction without Surgery$19,680$11,414$2,755
24175Percutaneous coronary intervention w/o AMI$90,932$52,741$12,731
25308Hip & femur fracture repair$54,695$31,723$7,657
26190Circulatory Disorders with Heart Attack$27,462$15,928$3,845
27231Major large bowel procedures$78,940$45,785$11,052
28254Other Digestive System Diagnoses$17,214$9,984$2,410
29053Seizure$38,772$22,488$5,428
30754Depression$9,594$5,564$1,343
31137Respiratory Infections and Inflammations$16,545$9,596$2,316
32304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature$136,159$78,972$19,062
33058Other Disorders of Nervous System$30,342$17,599$4,248
34134Pulmonary Embolism$18,833$10,923$2,637
35192Cardiac catheterization for other non-coronary conditions$29,676$17,212$4,155
36466Malfunction, reaction, complic of genitourinary device or procNRNRNR
37263Laparoscopic Cholecystectomy$51,771$30,027$7,248
38244Diverticulitis & Diverticulosis$19,348$11,222$2,709
39249Other gastroenteritis, nausea & vomiting$18,444$10,698$2,582
40241Peptic Ulcer/Gastritis$21,858$12,678$3,060
41710Infectious & parasitic diseases including HIV w O.R. procedureNRNRNR
42773Opioid Abuse/DependenceNRNRNR
43230Major small bowel procedures$46,628$27,044$6,528
44347Other Back/Neck Disorders, Fractures, Injuries$21,771$12,627$3,048
45322Shoulder & Elbow Joint Replacement$77,309$44,839$10,823
46861Signs & Symptoms$11,266$6,534$1,577
47313Other Knee/Lower Leg Surgery$50,650$29,377$7,091
48024Extracranial Vascular Procedures$48,191$27,951$6,747
49862Other Factors Influencing Health StatusNRNRNR
50253Other and Unspecified Gastrointestinal Hemorrhage$21,227$12,312$2,972
51181Lower Extremity Arterial Procedures$86,473$50,155$12,106
52021Craniotomy Except For Trauma$69,463$40,289$9,725
53351Other Musculoskeletal System and Connective Tissue Diagnoses$16,144$9,364$2,260
54426Non-hypovolemic sodium disorders$16,220$9,408$2,271
55812Poisoning of Medicinal Agents$16,869$9,784$2,362
56663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$16,681$9,675$2,335
57248Major G.I. Bacterial Infections$17,825$10,339$2,496
58052Nontraumatic stupor & coma$16,507$9,574$2,311
59055Head trauma w coma >1 hr or hemorrhage$13,194$7,652$1,847
60113Epiglottitis, Ear Infection, URI and Laryngotracheitis$15,242$8,840$2,134
61166Coronary bypass w/o AMI or complex PDX$123,039$71,363$17,225
62721Postoperative and Post-Traumatic Infections$17,853$10,355$2,499
63755Neuroses Other Than Depression$8,417$4,882$1,178
64143Other respiratory diagnoses except signs, symptoms & minor diagnoses$14,196$8,234$1,987
65566Other Antepartum Diagnoses$8,804$5,107$1,233
66141Asthma$9,270$5,376$1,298
67696Other ChemotherapyNRNRNR
68199Hypertension$20,131$11,676$2,818
69321Upper Spinal Fusion$84,027$48,736$11,764
70171Pacemaker Implant without Heart Attack, Heart Failure or Shock$49,836$28,905$6,977
71197Peripheral and Other Vascular Disorders$14,964$8,679$2,095
72425Other Electrolyte Disorders$12,908$7,487$1,807
73284Disorders of gallbladder & biliary tract$37,010$21,466$5,181
74163Cardiac valve procedures w/o AMI or complex PDX$184,757$107,159$25,866
75541Vaginal Delivery with Sterilization$27,452$15,922$3,843

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:  July 2018 - June 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)NRNRNRNRNRNR
Colonoscopy and Biopsy 45380)$7,698$4,465$1,078$12,115$7,027$1,696
Lesion Removal Colonoscopy by Snare Technique 45385)$7,914$4,590$1,108$10,612$6,155$1,486
Upper GI Endoscopy with Biopsy 43239)$7,336$4,255$1,027$10,234$5,936$1,433
Diagnostic Colonoscopy 45378)$6,308$3,659$883$10,732$6,225$1,503
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)NRNRNR$7,678$4,453$1,075
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$6,393$3,708$895NRNRNR
Colorectal Cancer Screening ; Colonoscopy, High Risk G0105)$6,380$3,701$893$7,445$4,318$1,042
Carpal Tunnel Surgery 64721)$10,632$6,166$1,488$13,522$7,843$1,893
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)NRNRNRNRNRNR
Uppr GI Endoscopy- Diagnostic 43235)$6,043$3,505$846$8,580$4,977$1,201
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$16,713$9,694$2,340$56,016$32,490$7,842
Drain/Inject Major Joint or Bursa 20610)NRNRNRNRNRNR
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)NRNRNRNRNRNR
Creation of Eardrum Opening 69436)$7,770$4,506$1,088$7,646$4,435$1,071
Left Heart Artery/Ventricle Angiography 93458)$17,416$10,101$2,438$18,827$10,919$2,636
Unlisted Dental Surgery Procedure 41899)$12,006$6,963$1,681NRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)$8,565$4,968$1,199NRNRNR
Laparoscopic Cholecystectomy 47562)$27,150$15,747$3,801$28,967$16,801$4,055
Esophageal Endoscopy with Dilation 43249)$7,877$4,569$1,103$9,403$5,454$1,316
Total Knee Arthroscopy 27447)$53,070$30,781$7,430$52,956$30,715$7,414
After Cataract Laser Surgery 66821)NRNRNRNRNRNR
Arthroscopic Rotator Cuff Repair 29827)NRNRNR$52,128$30,234$7,298
Cataract Surgery- Complex 66982)NRNRNRNRNRNR
Cystourethroscopy with Lithotripsy and Stent 52356)$21,601$12,529$3,024$27,468$15,931$3,846
Hysteroscopy with Biopsy 58558)$18,507$10,734$2,591$20,871$12,105$2,922
Removal of Tonsils And Adenoids - < Age 12 42820)$11,740$6,809$1,644$13,636$7,909$1,909
Uppr GI Endoscopy with Guide Wire 43248)$6,791$3,939$951$8,316$4,824$1,164
Laparoscopic Hernia Repair - Initial 49650)$30,860$17,899$4,320$36,581$21,217$5,121
Incision of Finger Tendon Sheath 26055)$10,016$5,810$1,402$13,498$7,829$1,890
Removal of Support Implant (barred wire, pin, screw, metal band, nail, rod) 20680)$13,496$7,828$1,890$17,420$10,104$2,439
Destruction by neurolytic agent w imaging, cervical or thoracic 64633)NRNRNRNRNRNR
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)NRNRNRNRNRNR
Laparoscopy - Removal of Adnexal Structures 58661)$24,448$14,180$3,423$32,417$18,802$4,538
Laparoscopy, Removal of Tubes & Ovaries 58571)$38,050$22,069$5,327$56,743$32,911$7,944
ABD Paracentesis w/Imaging 49083)NRNRNRNRNRNR
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$29,229$16,953$4,092$39,457$22,885$5,524
Mastectomy, Partial 19301)$16,048$9,308$2,247$24,279$14,082$3,399
Cystourethroscopy with Stent 52332)$11,899$6,901$1,666$13,945$8,088$1,952
Laparoscopic Appendectomy 44970)$30,582$17,737$4,281$33,710$19,552$4,719
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$27,039$15,683$3,785$33,233$19,275$4,653
Unlisted Cystourethoscopy 52000)$6,124$3,552$857$7,676$4,452$1,075
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$15,434$8,952$2,161$16,777$9,730$2,349
Angioplasty - peripheral segment of the dialysis circuit 36902)NRNRNRNRNRNR
Coronary Artery Angio S&I 93454)$17,650$10,237$2,471$20,914$12,130$2,928
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
Removal of Tonsils 42826)$13,280$7,703$1,859$23,124$13,412$3,237
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$14,992$8,695$2,099$24,828$14,400$3,476
Fragmenting of Kidney Stone 50590)$17,447$10,119$2,443$21,194$12,292$2,967
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)$28,312$16,421$3,964$47,802$27,725$6,692
Low Back Disk Surgery 63030)$31,290$18,148$4,381$42,188$24,469$5,906
Debridement Skin/Tissue 11042)$35,720$20,718$5,001NRNRNR
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNR$18,163$10,534$2,543
Repair of Nasal Septum 30520)$15,484$8,981$2,168$19,373$11,236$2,712
Right and Left Heart Artery/Ventricle Angiography 93460)$20,526$11,905$2,874$22,721$13,178$3,181
Decompression of Ulnar Nerve at Elbow 64718)$21,379$12,400$2,993$19,718$11,437$2,761
SHOULDER ARTHROSCOPY/SURGERY 29823)NRNRNR$30,224$17,530$4,231
Removal of Adenoids 42830)$9,269$5,376$1,298$10,622$6,161$1,487
Hysteroscopy with Ablation 58563)$21,124$12,252$2,957$27,389$15,886$3,834
DX BONE MARROW BX & ASPIR 38222)NRNRNRNRNRNR
Implant Neuroelectrodes 63650)NRNRNRNRNRNR
Repair of wrist joints 25447)NRNRNR$23,989$13,914$3,358
Repair of upper eyelid with excessive skin 15823)NRNRNRNRNRNR
ESOPHAGUS MOTILITY STUDY 91010)NRNRNRNRNRNR
Laparoscopy- Excision of Lesions of Ovary or Pelvic Area 58662)$24,352$14,124$3,409$30,672$17,790$4,294
Upper GI Endoscopy w Removal of Foreign Body 43247)$7,687$4,459$1,076$10,044$5,825$1,406
Repair of Hammertoe 28285)$13,866$8,042$1,941$13,290$7,708$1,861
REMOVAL OF SPINAL LAMINA 63047)$30,287$17,566$4,240$37,957$22,015$5,314
Excision Breast Lesion with Preoperative Placement Radiological Marker 19125)$15,709$9,111$2,199$18,077$10,484$2,531
OPEN TX OF DISTAL RADIAL FX W INT FIX 3+ FRAG 25609)$45,310$26,280$6,343$43,783$25,394$6,130
REMOVAL OF TURBINATE BONES 30140)$12,828$7,440$1,796$14,060$8,155$1,968
REDUCTION OF LARGE BREAST 19318)$36,368$21,094$5,092$38,089$22,092$5,332
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.