ProHealth Oconomowoc Memorial Hospital
791 Summit Avenue
Oconomowoc, WI 53066
262-569-9400
 
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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+$5,245$3,094$892
2560Vaginal Delivery$15,924$9,395$2,707
3720Blood Infection/Septicemia$17,091$10,083$2,905
4194Heart Failure$19,110$11,275$3,249
5751Psychoses$19,193$11,324$3,263
6540Cesarean Delivery$25,088$14,802$4,265
7301Hip Replacement$52,760$31,129$8,969
8302Knee Replacement$61,328$36,184$10,426
9139Pneumonia$11,536$6,806$1,961
10753Bipolar DisordersNRNRNR
11775Alcohol Abuse/Dependence$10,319$6,088$1,754
12201Heart Abnormal Rhythm and Conduction Disorders$16,717$9,863$2,842
13133Respiratory failureNRNRNR
14045Stroke and Precerebral Occlusion with Infarct$28,456$16,789$4,838
15140Chronic Obstructive Pulmonary Disease$15,094$8,905$2,566
16469Acute Kidney Injury$22,504$13,277$3,826
17463Kidney/Urinary Tract Infection$18,644$11,000$3,169
18383Cellulitis & other skin infections$10,148$5,987$1,725
19174Percutaneous coronary intervention w AMI$60,757$35,847$10,329
20750SchizophreniaNRNRNR
21420Diabetes$12,053$7,111$2,049
22247Intestinal Obstruction without Surgery$15,234$8,988$2,590
23282Disorders of Pancreas Except Malignancy$19,900$11,741$3,383
24308Hip & femur fracture repair$54,875$32,376$9,329
25231Major large bowel procedures$55,577$32,790$9,448
26190Circulatory Disorders with Heart Attack$29,113$17,177$4,949
27175Percutaneous coronary intervention w/o AMI$53,042$31,295$9,017
28058Other Disorders of Nervous System$23,999$14,159$4,080
29304Dorsal and Lumbar Fusion Without Principal Diagnosis of Back CurvatureNRNRNR
30754Depression$9,165$5,408$1,558
31254Other Digestive System Diagnoses$19,799$11,681$3,366
32466Malfunction, reaction, complic of genitourinary device or procNRNRNR
33137Respiratory Infections and Inflammations$16,033$9,459$2,726
34053Seizure$28,488$16,808$4,843
35192Cardiac catheterization for other non-coronary conditions$40,597$23,952$6,901
36134Pulmonary Embolism$19,259$11,363$3,274
37710Infectious & parasitic diseases including HIV w O.R. procedureNRNRNR
38241Peptic Ulcer/Gastritis$18,515$10,924$3,147
39244Diverticulitis & Diverticulosis$16,562$9,772$2,816
40322Shoulder & Elbow Joint Replacement$84,429$49,813$14,353
41263Laparoscopic Cholecystectomy$46,056$27,173$7,829
42249Other gastroenteritis, nausea & vomiting$18,040$10,644$3,067
43773Opioid Abuse/DependenceNRNRNR
44862Other Factors Influencing Health StatusNRNRNR
45230Major small bowel proceduresNRNRNR
46313Other Knee/Lower Leg SurgeryNRNRNR
47347Other Back/Neck Disorders, Fractures, Injuries$12,379$7,304$2,104
48861Signs & Symptoms$6,049$3,569$1,028
49253Other and Unspecified Gastrointestinal Hemorrhage$13,899$8,200$2,363
50426Non-hypovolemic sodium disorders$14,100$8,319$2,397
51052Nontraumatic stupor & comaNRNRNR
52113Epiglottitis, Ear Infection, URI and Laryngotracheitis$12,355$7,289$2,100
53351Other Musculoskeletal System and Connective Tissue Diagnoses$16,017$9,450$2,723
54248Major G.I. Bacterial Infections$25,035$14,771$4,256
55566Other Antepartum Diagnoses$16,033$9,460$2,726
56024Extracranial Vascular ProceduresNRNRNR
57663Red Blood Cell Disorders Except Sickle Cell Anemia Crisis$27,799$16,401$4,726
58021Craniotomy Except For TraumaNRNRNR
59055Head trauma w coma >1 hr or hemorrhage$13,828$8,159$2,351
60755Neuroses Other Than Depression$32,534$19,195$5,531
61166Coronary bypass w/o AMI or complex PDXNRNRNR
62721Postoperative and Post-Traumatic InfectionsNRNRNR
63182Other Peripheral Vascular ProceduresNRNRNR
64812Poisoning of Medicinal Agents$9,829$5,799$1,671
65181Lower Extremity Arterial ProceduresNRNRNR
66143Other respiratory diagnoses except signs, symptoms & minor diagnoses$25,556$15,078$4,345
67171Pacemaker Implant without Heart Attack, Heart Failure or Shock$58,042$34,245$9,867
68280Alcoholic Liver Disease$20,776$12,258$3,532
69321Upper Spinal FusionNRNRNR
70425Other Electrolyte DisordersNRNRNR
71163Cardiac valve procedures w/o AMI or complex PDXNRNRNR
72197Peripheral and Other Vascular Disorders$9,006$5,314$1,531
73284Disorders of gallbladder & biliary tract$19,516$11,514$3,318
74696Other ChemotherapyNRNRNR
75042Degenerative nervous system disorders exc mult sclerosis$25,753$15,195$4,378

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)$12,616$7,443$2,145$21,743$12,828$3,696
Colonoscopy and Biopsy 45380)$7,839$4,625$1,333$12,550$7,405$2,134
Lesion Removal Colonoscopy by Snare Technique 45385)$7,928$4,678$1,348$9,125$5,384$1,551
Upper GI Endoscopy with Biopsy 43239)$7,440$4,390$1,265$10,866$6,411$1,847
Diagnostic Colonoscopy 45378)$6,378$3,763$1,084NRNRNR
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)$6,400$3,776$1,088$10,500$6,195$1,785
Colorectal Cancer Screening; Colonscopy, Not High Risk G0121)$6,568$3,875$1,117NRNRNR
Destruction by Neurolytic Agent w Imaging, Lumbar or Sacral 64635)$9,507$5,609$1,616$8,014$4,728$1,362
Carpal Tunnel Surgery 64721)$10,624$6,268$1,806NRNRNR
Uppr GI Endoscopy- Diagnostic 43235)$5,785$3,413$983$6,871$4,054$1,168
Knee Arthroscopy/Surgery with Medial or Lateral Meniscectomy 29881)$15,374$9,071$2,614NRNRNR
Drain/Inject Major Joint or Bursa 20610)NRNRNRNRNRNR
Left Heart Artery/Ventricle Angiography 93458)$18,741$11,057$3,186$28,271$16,680$4,806
Creation of Eardrum Opening 69436)$8,410$4,962$1,430$9,360$5,523$1,591
Inj/Drainage or Aspiration, Spine/Spinal Cord w/o Img Guidance 62321)NRNRNRNRNRNR
Total Knee Arthroscopy 27447)$56,649$33,423$9,630$60,456$35,669$10,278
Unlisted Dental Surgery Procedure 41899)$18,771$11,075$3,191NRNRNR
Injection into Paravertebral Facet Joint w Image Guidance, Cervical or Thor 64490)NRNRNRNRNRNR
Esophageal Endoscopy with Dilation 43249)$8,607$5,078$1,463$9,610$5,670$1,634
Laparoscopic Cholecystectomy 47562)$23,334$13,767$3,967$22,520$13,287$3,828
Arthroscopic Rotator Cuff Repair 29827)$28,859$17,027$4,906$37,017$21,840$6,293
After Cataract Laser Surgery 66821)NRNRNRNRNRNR
Cystourethroscopy with Lithotripsy and Stent 52356)$22,437$13,238$3,814$25,015$14,759$4,253
Lesion Removal Colonoscopy by Hot Biopsy or Cautery 45384)NRNRNR$10,693$6,309$1,818
Hysteroscopy with Biopsy 58558)$18,436$10,877$3,134$21,043$12,415$3,577
Cataract Surgery- Complex 66982)$14,394$8,492$2,447NRNRNR
Removal of Tonsils And Adenoids - < Age 12 42820)$15,684$9,254$2,666$17,570$10,367$2,987
Laparoscopic Hernia Repair - Initial 49650)$28,670$16,915$4,874$33,146$19,556$5,635
Uppr GI Endoscopy with Guide Wire 43248)$6,962$4,107$1,183$9,704$5,726$1,650
Incision of Finger Tendon Sheath 26055)NRNRNRNRNRNR
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)$17,591$10,379$2,990NRNRNR
Laparoscopy - Removal of Adnexal Structures 58661)$23,938$14,124$4,070$27,205$16,051$4,625
Laparoscopy, Removal of Tubes & Ovaries 58571)NRNRNR$37,818$22,313$6,429
Laparoscopic Appendectomy 44970)$33,132$19,548$5,632$29,664$17,502$5,043
Unlisted Cystourethoscopy 52000)$9,622$5,677$1,636$13,151$7,759$2,236
Mastectomy, Partial 19301)$18,269$10,779$3,106$24,580$14,502$4,179
Cystourethroscopy with Stent 52332)$12,754$7,525$2,168$14,766$8,712$2,510
Repair Initial Ingunial Hernia, > = 5 years, Reducible 49505)$20,789$12,265$3,534$21,128$12,466$3,592
Coronary Artery Angio S&I 93454)NRNRNR$17,765$10,481$3,020
Angioplasty - peripheral segment of the dialysis circuit 36902)NRNRNRNRNRNR
Knee Arthroscopy/Surgery w Medical and Lateral Meniscectomy 29880)$16,090$9,493$2,735NRNRNR
Laparoscopic Cholecystectomy w X-ray of Liver and Bile Duct 47563)$31,559$18,620$5,365$31,795$18,759$5,405
Wrist Endoscopy/Surgery 29848)NRNRNRNRNRNR
FNA BX W/US GDN 1ST LES 10005)NRNRNRNRNRNR
Debridement Skin/Tissue 11042)$30,675$18,098$5,215$14,549$8,584$2,473
Removal of Tonsils 42826)$13,949$8,230$2,371$19,242$11,353$3,271
Biopsy breast w/stereotactic image; 1 lesion 19081)NRNRNRNRNRNR
Low Back Disk Surgery 63030)NRNRNRNRNRNR
Knee Arthroscopy/Surgery with Anterior Cruciate Ligament Repair 29888)NRNRNRNRNRNR
Fragmenting of Kidney Stone 50590)$19,030$11,228$3,235$23,612$13,931$4,014
Repair Umbilical Hernia, > = 5 Yrs - Reducible 49585)$16,122$9,512$2,741$17,260$10,184$2,934
Repair of Nasal Septum 30520)NRNRNRNRNRNR
Decompression of Ulnar Nerve at Elbow 64718)NRNRNRNRNRNR
Removal of Adenoids 42830)NRNRNR$10,766$6,352$1,830
Right and Left Heart Artery/Ventricle Angiography 93460)$23,203$13,690$3,945NRNRNR
DX BONE MARROW BX & ASPIR 38222)NRNRNRNRNRNR
TOTAL HIP ARTHROPLASTY 27130)$49,576$29,250$8,428NRNRNR
SHOULDER ARTHROSCOPY/SURGERY 29823)NRNRNRNRNRNR
ESOPHAGUS MOTILITY STUDY 91010)NRNRNRNRNRNR
Hysteroscopy with Ablation 58563)$21,688$12,796$3,687$31,147$18,377$5,295
Repair of wrist joints 25447)NRNRNRNRNRNR
Implant Neuroelectrodes 63650)$121,483$71,675$20,652$118,647$70,002$20,170
Repair of upper eyelid with excessive skin 15823)NRNRNRNRNRNR
Upper GI Endoscopy w Removal of Foreign Body 43247)$9,051$5,340$1,539$11,483$6,775$1,952
INSERT ANT SEGMENT DRAIN INT 0191T)NRNRNR$21,969$12,962$3,735
TX ATRIAL FIB PULM VEIN ISOL 93656)NRNRNRNRNRNR
REMOVAL OF SPINAL LAMINA 63047)NRNRNRNRNRNR
REMOVAL OF TURBINATE BONES 30140)NRNRNRNRNRNR
Excision Breast Lesion with Preoperative Placement Radiological Marker 19125)$18,549$10,944$3,153$20,867$12,311$3,547
Information about quality and safety of care for ProHealth Oconomowoc Memorial Hospital may be found at http://www.wicheckpoint.org
* Estimated Insurance Payments based on average percent of billed charges collected.