Page 13 - TARIF BPJS (Update Nov 2017)

Biaya belum termasuk Obat-obatan dan Medical Supply

BEDAH UMUM
I TINDAKAN Jasa Medis Biaya Sarana Total Tarif
1 Debridement :
Debridement Luka Bakar 1 s/d 10 Grade II 65,520 116,480 182,000
Debridement Luka Bakar 11 s/d 20% Grade II 75,600 134,400 210,000
Debridement Luka Lain II 75,600 134,400 210,000
Debridement Luka Lain I 63,000 112,000 175,000
2 Insisi / Eksisi 100,800 179,200 280,000
3 Kauterisasi 105,840 188,160 294,000
4 Rozer plastik per kuku 105,840 188,160 294,000
5 Sirkumsisi 239,400 425,600 665,000
6 Extirpasi 195,300 347,200 542,500
7 Anuscopi 100,800 179,200 280,000
8 Dilatasi Preputium 83,160 147,840 231,000
9 Insisi Larva 63,000 112,000 175,000
10 Lobulo Plasty 81,900 145,600 227,500
11 Ring Cutting 44,100 78,400 122,500

Catatan :
Biaya belum termasuk Obat-obatan dan Medical Supply

UROLOGY
I TINDAKAN Jasa Medis Biaya Sarana Total Tarif
1 Businasi 117,000 208,000 325,000
2 Instilasi Intra Vesika 105,300 187,200 292,500
3 Instilasi kemoterapi via catheter 81,000 144,000 225,000
4 USG Tractus Urinarius 72,000 128,000 200,000
5 Nefrostomy per kutan 140,400 249,600 390,000
Catatan :
Biaya belum termasuk Obat-obatan dan Medical Supply
ORTHOPEDI

I TINDAKAN Jasa Medis Biaya Sarana Total Tarif
1 Buka Gips 94,500 168,000 262,500
2 Extraksi Fixasi External 94,500 168,000 262,500
3 Extraksi K-Wire Simple 100,800 179,200 280,000
4 Pasang Back Slab Fore Arm 100,800 179,200 280,000
5 Pasang Back Slab Fore Leg 88,200 156,800 245,000
6 Pasang Elastis Verband / Mitela 37,800 67,200 105,000
7 Pasang Gips AEC / U - slab 138,600 246,400 385,000
8 Pasang Gips Boot Cast 88,200 156,800 245,000
9 Pasang Gips Kocher 126,000 224,000 350,000
10 Pasang Gips LLC / PTB 138,600 246,400 385,000
11 Pasang External Fixasi CTEV 59,018 104,922 163,940
12 Pasang Ransel Verband 75,600 134,400 210,000
13 Pasang Spalk / Bidai 56,700 100,800 157,500
14 Pasang YoGips / Body Jacket 176,400 313,600 490,000
15 Drainase Cairan Sendi 75,600 134,400 210,000
16 Reposisi Sendi 151,200 268,800 420,000
17 Revisi Gips AEC / LLC 63,000 112,000 175,000
18 Revisi Gips Body Jacket 100,800 179,200 280,000
19 Revisi Gips Boot Cast 63,000 112,000 175,000
20 Skin Traction 88,200 156,800 245,000
Catatan :
Biaya belum termasuk Obat-obatan dan Medical Supply