Page 6 - TARIF BPJS (Update Nov 2017)

II TINDAKAN RAWAT INAP KELAS I Jasa Medis Biaya Sarana Total Tarif
1 Endoskopi :
- Oesofagoskopi 259,200 460,800 720,000
- Laringoskopi 216,000 384,000 600,000
- Gastroskopi / Duodenoskopi 352,800 627,200 980,000
2 Biopsi Perendoscopi 172,800 307,200 480,000
3 Colonoskopi 390,600 694,400 1,085,000
4 Sigmoidoskopi 345,600 614,400 960,000
5 Ligasi Haemoroid 302,400 537,600 840,000
6 STE Haemoroid 220,500 392,000 612,500
7 Ligasi Varices Oesofagus 302,400 537,600 840,000
8 STE Oesofagus 220,500 392,000 612,500
9 Anuscopy 163,800 291,200 455,000
10 Punksi Ascites 187,200 332,800 520,000
III TINDAKAN RAWAT INAP KELAS II Jasa Medis Biaya Sarana Total Tarif

1 Endoskopi :
- Oesofagoskopi 230,400 409,600 640,000
- Laringoskopi 201,600 358,400 560,000
- Gastroskopi / Duodenoskopi 302,400 537,600 840,000
2 Biopsi Perendoscopi 151,200 268,800 420,000
3 Colonoskopi 352,800 627,200 980,000
4 Sigmoidoskopi 302,400 537,600 840,000
5 Ligasi Haemoroid 252,000 448,000 700,000
6 STE Haemoroid 189,000 336,000 525,000
7 Ligasi Varices Oesofagus 252,000 448,000 700,000
8 STE Oesofagus 189,000 336,000 525,000
9 Anuscopy 144,900 257,600 402,500
10 Punksi Ascites 136,800 243,200 380,000
Catatan :
Biaya belum termasuk Obat-obatan dan Medical Supply

TINDAKAN INTERNIS DENGAN GENERAL ANESTESI DI KAMAR BEDAH
Jasa Medis Jasa Medis
I TINDAKAN RAWAT INAP KELAS I Biaya Sarana Total Tarif
Operator Anastesi
1 Endoskopi :
- Oesofagoskopi 618,156 185,447 913,497 1,717,100
- Laringoskopi 573,930 172,179 848,141 1,594,250
- Gastroskopi / Duodenoskopi 765,576 229,673 1,131,351 2,126,600
2 Biopsi Perendoscopi 529,704 158,911 782,785 1,471,400
3 Colonoskopi 809,802 242,941 1,196,707 2,249,450
4 Sigmoidoskopi 706,608 211,982 1,044,210 1,962,800
5 Ligasi Haemoroid 667,296 200,189 986,115 1,853,600
6 STE Haemoroid 627,984 188,395 928,021 1,744,400
7 Ligasi Varices Oesofagus 667,296 200,189 986,115 1,853,600
8 STE Oesofagus 627,984 188,395 928,021 1,744,400
9 Anuscopy 549,360 164,808 811,832 1,526,000
10 Punksi Ascites 549,360 164,808 811,832 1,526,000
Jasa Medis Jasa Medis
II TINDAKAN RAWAT INAP KELAS II Biaya Sarana Total Tarif
Operator Anastesi
1 Endoskopi :
- Oesofagoskopi 450,072 135,021.60 665,106 1,250,200
- Laringoskopi 420,588 126,176.40 621,536 1,168,300
- Gastroskopi / Duodenoskopi 568,008 170,402.40 839,390 1,577,800
2 Biopsi Perendoscopi 371,448 111,434.40 548,918 1,031,800
3 Colonoskopi 626,976 188,092.80 926,531 1,741,600
4 Sigmoidoskopi 528,696 158,608.80 781,295 1,468,600
5 Ligasi Haemoroid 479,556 143,866.80 708,677 1,332,100