Wisconsin / Thedacare Regional Medical Center - Appleton Inc
CMS certification 520160 · Appleton, WI
Thedacare Regional Medical Center - Appleton Inc: charges and Medicare payments
Thedacare Regional Medical Center - Appleton Inc reported 794 Medicare inpatient stays across 34 DRGs in 2024. Across them it charged 2.6 times what it was paid — among the lower ratios in Wisconsin, number 46 of 55 hospitals with at least 100 stays (state median 3.47×, national 4.15×). Its most frequent stay was DRG 871, Septicemia or Severe Sepsis without MV >96 Hours with MCC: 124 stays at an average charge of $34,356, 62% below the national average. It also billed 1,972 outpatient services, charging 4.44 times what Medicare paid.
- 1Medicare inpatient stays 794
- 2Charge ÷ paid, inpatient 2.6×
- 3Rank in WI (highest ratio = 1) 46 of 55
- 4CMS price-transparency actions 0
Inpatient stays
For the 34 DRGs that can be compared with the national average, Thedacare Regional Medical Center - Appleton Inc charged more than the national average in 0 (0%). Payments follow Medicare's rates, so they usually vary far less than charges.
| DRG | Stays | Avg charge | vs US | Avg paid |
|---|---|---|---|---|
| 871 Septicemia or Severe Sepsis without MV >96 Hours with MCC | 124 | $34,356 | -62% | $14,707 |
| 291 Heart Failure and Shock with MCC | 61 | $26,609 | -53% | $10,248 |
| 470 Major Hip and Knee Joint Replacement or Reattachment of... | 40 | $40,101 | -57% | $14,438 |
| 280 Acute Myocardial Infarction, Discharged Alive with MCC | 35 | $38,571 | -49% | $12,665 |
| 853 Infectious and Parasitic Diseases with O.R. Procedures with... | 32 | $62,750 | -73% | $31,573 |
| 872 Septicemia or Severe Sepsis without MV >96 Hours without MCC | 31 | $21,197 | -57% | $8,522 |
| 177 Respiratory Infections and Inflammations with MCC | 26 | $31,977 | -55% | $14,202 |
| 253 Other Vascular Procedures with CC | 26 | $67,574 | -49% | $19,992 |
| 189 Pulmonary Edema and Respiratory Failure | 25 | $21,297 | -63% | $9,451 |
| 322 Percutaneous Cardiovascular Procedures with Intraluminal... | 24 | $65,284 | -43% | $16,453 |
| 698 Other Kidney and Urinary Tract Diagnoses with MCC | 24 | $28,902 | -61% | $12,680 |
| 193 Simple Pneumonia and Pleurisy with MCC | 22 | $27,450 | -54% | $11,082 |
| 640 Miscellaneous Disorders of Nutrition, Metabolism, Fluids and... | 21 | $26,816 | -56% | $10,147 |
| 682 Renal Failure with MCC | 21 | $30,970 | -53% | $11,541 |
| 175 Pulmonary Embolism with MCC or Acute Cor Pulmonale | 19 | $26,788 | -59% | $12,325 |
| 309 Cardiac Arrhythmia and Conduction Disorders with CC | 19 | $11,474 | -68% | $6,225 |
| 378 Gastrointestinal Hemorrhage with CC | 18 | $23,359 | -52% | $8,345 |
| 264 Other Circulatory System O.R. Procedures | 17 | $33,499 | -78% | $22,548 |
| 690 Kidney and Urinary Tract Infections without MCC | 17 | $18,389 | -51% | $6,675 |
| 321 Percutaneous Cardiovascular Procedures with Intraluminal... | 16 | $87,901 | -46% | $24,899 |
| 281 Acute Myocardial Infarction, Discharged Alive with CC | 15 | $20,030 | -60% | $8,158 |
| 329 Major Small and Large Bowel Procedures with MCC | 14 | $100,038 | -53% | $34,390 |
| 377 Gastrointestinal Hemorrhage with MCC | 14 | $30,752 | -64% | $14,455 |
| 392 Esophagitis, Gastroenteritis and Miscellaneous Digestive... | 14 | $20,227 | -50% | $6,556 |
| 208 Respiratory System Diagnosis with Ventilator Support <=96... | 13 | $55,374 | -59% | $22,325 |
| 274 Percutaneous and Other Intracardiac Procedures without MCC | 13 | $84,877 | -46% | $23,330 |
| 689 Kidney and Urinary Tract Infections with MCC | 13 | $23,140 | -55% | $8,568 |
| 252 Other Vascular Procedures with MCC | 12 | $72,475 | -58% | $24,741 |
| 271 Other Major Cardiovascular Procedures with CC | 12 | $55,696 | -68% | $29,476 |
| 522 Hip Replacement with Principal Diagnosis of Hip Fracture... | 12 | $49,069 | -52% | $16,646 |
| 038 Extracranial Procedures with CC | 11 | $51,120 | -42% | $13,644 |
| 286 Circulatory Disorders except AMI, with Cardiac... | 11 | $33,460 | -70% | $16,390 |
| 330 Major Small and Large Bowel Procedures with CC | 11 | $61,740 | -48% | $24,822 |
| 683 Renal Failure with CC | 11 | $21,976 | -46% | $7,455 |
Outpatient services
Against the Wisconsin average
For Septicemia or Severe Sepsis without MV >96 Hours with MCC (DRG 871), Thedacare Regional Medical Center - Appleton Inc charged $34,356 on average, 42% less than the Wisconsin average of $59,481, and was paid $14,707 against a state average of $16,719. For Heart Failure and Shock with MCC (DRG 291), Thedacare Regional Medical Center - Appleton Inc charged $26,609 on average, 33% less than the Wisconsin average of $39,564, and was paid $10,248 against a state average of $10,862. For Major Hip and Knee Joint Replacement or Reattachment of Lower Extremity without MCC (DRG 470), Thedacare Regional Medical Center - Appleton Inc charged $40,101 on average, 41% less than the Wisconsin average of $68,121, and was paid $14,438 against a state average of $14,934. For Acute Myocardial Infarction, Discharged Alive with MCC (DRG 280), Thedacare Regional Medical Center - Appleton Inc charged $38,571 on average, 25% less than the Wisconsin average of $51,375, and was paid $12,665 against a state average of $13,995. For Level 5 Musculoskeletal Procedures (outpatient APC 5115), its average charge of $24,979 was 50% below the state average of $50,282. For Level 3 Vascular Procedures (outpatient APC 5183), its average charge of $11,504 was 29% below the state average of $16,152. For Level 1 Nerve Procedures (outpatient APC 5431), its average charge of $8,883 was 5% below the state average of $9,348. For Level 4 Musculoskeletal Procedures (outpatient APC 5114), its average charge of $28,092 was 14% below the state average of $32,813.
Price-transparency record
No action in CMS's price-transparency enforcement list (July 2026) matches this hospital's exact name, city and state. That can mean CMS has not reviewed it, or that it is listed under a different name.
Charges are the hospital's list prices averaged over its 2024 Medicare cases; payments are what those cases actually brought in. Neither is what you will pay. For a planned procedure, ask the hospital for its price estimate or, if you are uninsured or self-paying, a good-faith estimate.
Sources: CMS Medicare Inpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Medicare Outpatient Hospitals — by Provider and Service / by Geography and Service, data year 2024; CMS Hospital Price Transparency Enforcement Activities and Outcomes, July 2026. Checked 2026-10-24. Methodology.