Top 75 Reports

	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 *
Rank	APR- DRG	Description	Median Charge	Private Insurance	Medicare
1	640	Normal Newborn, Birthweight 2500g+	$4,649	$2,696	$651
2	560	Vaginal Delivery	$15,308	$8,878	$2,143
3	720	Blood Infection/Septicemia	$15,701	$9,106	$2,198
4	194	Heart Failure	$21,323	$12,367	$2,985
5	540	Cesarean Delivery	$24,130	$13,995	$3,378
6	751	Psychoses	$12,507	$7,254	$1,751
7	301	Hip Replacement	$61,763	$35,823	$8,647
8	302	Knee Replacement	$55,544	$32,215	$7,776
9	139	Pneumonia	$18,483	$10,720	$2,588
10	753	Bipolar Disorders	$12,228	$7,092	$1,712
11	775	Alcohol Abuse/Dependence	$8,101	$4,698	$1,134
12	201	Heart Abnormal Rhythm and Conduction Disorders	$12,946	$7,509	$1,812
13	133	Respiratory failure	NR	NR	NR
14	140	Chronic Obstructive Pulmonary Disease	$14,349	$8,322	$2,009
15	469	Acute Kidney Injury	NR	NR	NR
16	045	Stroke and Precerebral Occlusion with Infarct	$33,050	$19,169	$4,627
17	463	Kidney/Urinary Tract Infection	$14,566	$8,448	$2,039
18	383	Cellulitis & other skin infections	$14,063	$8,156	$1,969
19	750	Schizophrenia	$17,155	$9,950	$2,402
20	174	Percutaneous coronary intervention w AMI	$57,823	$33,537	$8,095
21	420	Diabetes	$20,465	$11,870	$2,865
22	282	Disorders of Pancreas Except Malignancy	$17,743	$10,291	$2,484
23	247	Intestinal Obstruction without Surgery	$19,680	$11,414	$2,755
24	175	Percutaneous coronary intervention w/o AMI	$90,932	$52,741	$12,731
25	308	Hip & femur fracture repair	$54,695	$31,723	$7,657
26	190	Circulatory Disorders with Heart Attack	$27,462	$15,928	$3,845
27	231	Major large bowel procedures	$78,940	$45,785	$11,052
28	254	Other Digestive System Diagnoses	$17,214	$9,984	$2,410
29	053	Seizure	$38,772	$22,488	$5,428
30	754	Depression	$9,594	$5,564	$1,343
31	137	Respiratory Infections and Inflammations	$16,545	$9,596	$2,316
32	304	Dorsal and Lumbar Fusion Without Principal Diagnosis of Back Curvature	$136,159	$78,972	$19,062
33	058	Other Disorders of Nervous System	$30,342	$17,599	$4,248
34	134	Pulmonary Embolism	$18,833	$10,923	$2,637
35	192	Cardiac catheterization for other non-coronary conditions	$29,676	$17,212	$4,155
36	466	Malfunction, reaction, complic of genitourinary device or proc	NR	NR	NR
37	263	Laparoscopic Cholecystectomy	$51,771	$30,027	$7,248
38	244	Diverticulitis & Diverticulosis	$19,348	$11,222	$2,709
39	249	Other gastroenteritis, nausea & vomiting	$18,444	$10,698	$2,582
40	241	Peptic Ulcer/Gastritis	$21,858	$12,678	$3,060
41	710	Infectious & parasitic diseases including HIV w O.R. procedure	NR	NR	NR
42	773	Opioid Abuse/Dependence	NR	NR	NR
43	230	Major small bowel procedures	$46,628	$27,044	$6,528
44	347	Other Back/Neck Disorders, Fractures, Injuries	$21,771	$12,627	$3,048
45	322	Shoulder & Elbow Joint Replacement	$77,309	$44,839	$10,823
46	861	Signs & Symptoms	$11,266	$6,534	$1,577
47	313	Other Knee/Lower Leg Surgery	$50,650	$29,377	$7,091
48	024	Extracranial Vascular Procedures	$48,191	$27,951	$6,747
49	862	Other Factors Influencing Health Status	NR	NR	NR
50	253	Other and Unspecified Gastrointestinal Hemorrhage	$21,227	$12,312	$2,972
51	181	Lower Extremity Arterial Procedures	$86,473	$50,155	$12,106
52	021	Craniotomy Except For Trauma	$69,463	$40,289	$9,725
53	351	Other Musculoskeletal System and Connective Tissue Diagnoses	$16,144	$9,364	$2,260
54	426	Non-hypovolemic sodium disorders	$16,220	$9,408	$2,271
55	812	Poisoning of Medicinal Agents	$16,869	$9,784	$2,362
56	663	Red Blood Cell Disorders Except Sickle Cell Anemia Crisis	$16,681	$9,675	$2,335
57	248	Major G.I. Bacterial Infections	$17,825	$10,339	$2,496
58	052	Nontraumatic stupor & coma	$16,507	$9,574	$2,311
59	055	Head trauma w coma >1 hr or hemorrhage	$13,194	$7,652	$1,847
60	113	Epiglottitis, Ear Infection, URI and Laryngotracheitis	$15,242	$8,840	$2,134
61	166	Coronary bypass w/o AMI or complex PDX	$123,039	$71,363	$17,225
62	721	Postoperative and Post-Traumatic Infections	$17,853	$10,355	$2,499
63	755	Neuroses Other Than Depression	$8,417	$4,882	$1,178
64	143	Other respiratory diagnoses except signs, symptoms & minor diagnoses	$14,196	$8,234	$1,987
65	566	Other Antepartum Diagnoses	$8,804	$5,107	$1,233
66	141	Asthma	$9,270	$5,376	$1,298
67	696	Other Chemotherapy	NR	NR	NR
68	199	Hypertension	$20,131	$11,676	$2,818
69	321	Upper Spinal Fusion	$84,027	$48,736	$11,764
70	171	Pacemaker Implant without Heart Attack, Heart Failure or Shock	$49,836	$28,905	$6,977
71	197	Peripheral and Other Vascular Disorders	$14,964	$8,679	$2,095
72	425	Other Electrolyte Disorders	$12,908	$7,487	$1,807
73	284	Disorders of gallbladder & biliary tract	$37,010	$21,466	$5,181
74	163	Cardiac valve procedures w/o AMI or complex PDX	$184,757	$107,159	$25,866
75	541	Vaginal 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 Procedures			With 1 or More Additional Procedures
Principal Procedure	Median Charge	Average Commercial Insurance Payment	Average Medicare Insurance Payment*	Median Charge	Average Commercial Insurance Payment	Average Medicare Insurance Payment*
Cataract Surgery with Intraocular Lens - Stage 1 66984)	NR	NR	NR	NR	NR	NR
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)	NR	NR	NR	NR	NR	NR
Inj/Drainage or Aspiration, Spine/Spinal Cord w/ Img Guidancee 62323)	NR	NR	NR	NR	NR	NR
Injection into Paravertebral Facet Joint w Image Guidance, Lumbar or Sacral 64493)	NR	NR	NR	$7,678	$4,453	$1,075
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)	$6,393	$3,708	$895	NR	NR	NR
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)	NR	NR	NR	NR	NR	NR
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)	NR	NR	NR	NR	NR	NR
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)	NR	NR	NR	NR	NR	NR
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	$1,681	NR	NR	NR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)	NR	NR	NR	NR	NR	NR
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)	$8,565	$4,968	$1,199	NR	NR	NR
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)	NR	NR	NR	NR	NR	NR
Arthroscopic Rotator Cuff Repair 29827)	NR	NR	NR	$52,128	$30,234	$7,298
Cataract Surgery- Complex 66982)	NR	NR	NR	NR	NR	NR
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)	NR	NR	NR	NR	NR	NR
Biopsy, Breast w/Ultrasound Image; 1 Lesion 19083)	NR	NR	NR	NR	NR	NR
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)	NR	NR	NR	NR	NR	NR
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)	NR	NR	NR	NR	NR	NR
Coronary Artery Angio S&I 93454)	$17,650	$10,237	$2,471	$20,914	$12,130	$2,928
Wrist Endoscopy/Surgery 29848)	NR	NR	NR	NR	NR	NR
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	$5,001	NR	NR	NR
Biopsy breast w/stereotactic image; 1 lesion 19081)	NR	NR	NR	$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)	NR	NR	NR	$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)	NR	NR	NR	NR	NR	NR
Implant Neuroelectrodes 63650)	NR	NR	NR	NR	NR	NR
Repair of wrist joints 25447)	NR	NR	NR	$23,989	$13,914	$3,358
Repair of upper eyelid with excessive skin 15823)	NR	NR	NR	NR	NR	NR
ESOPHAGUS MOTILITY STUDY 91010)	NR	NR	NR	NR	NR	NR
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.