PETUNJUK TEKNIS PERDA TARIP NOMOR 39 TAHUN 2002

TENTANG
PAKET TARIF TINDAKAN OPERASI & ANESTESI (Belum termasuk Bhn./Alat Dan Obat )
F. PAKET TARIF TINDAKAN OPERASI & ANESTESI (Belum termasuk Bhn./Alat Dan Obat )
KOMPONEN
ELEKTIF
CYTO
NO
BIAYA
JM
JRS
JM
KLS/GOL
1
PAVILIUN
Jasa Rs
829,800
Khusus
Dr. Operator
1,008,000
1,176,000
411,600
Dr. Anestesi
352,800
126,000
Perawat OK
100,800
126,000
Perawat Anestesi
100,800
307,980
Jasa Pelayanan
264,600
Jumlah Sub
1,827,000
829,800
2,147,580
Total Paket Tarip
2,656,800
Besar
Jasa Rs
680,400
Dr. Operator
840,000
1,092,000
382,200
Dr. Anestesi
294,000
117,600
Perawat OK
84,000
117,600
Perawat Anestesi
84,000
282,780
Jasa Pelayanan
217,140
Jumlah Sub
1,519,140
680,400
1,992,180
Total Paket Tarip
2,199,540
Sedang
Jasa Rs
626,400
Dr. Operator
756,000
966,000
338,100
Dr. Anestesi
264,600
100,800
Perawat OK
75,600
100,800
Perawat Anestesi
75,600
250,620
Jasa Pelayanan
197,100
Jumlah Sub
1,368,900
626,400
1,756,320
Total Paket Tarip
1,995,300
Kecil
Jasa Rs
324,000
Dr. Operator
420,000
504,000
176,400
Dr. Anestesi
147,000
42,000
Perawat OK
33,600
42,000
Perawat Anestesi
33,600
126,000
Jasa Pelayanan
102,300
Jumlah Sub
736,500
324,000
890,400
Total Paket Tarip
1,060,500
2
VIP
Jasa Rs
691,500
Khusus
Dr. Operator
840,000
980,000
343,000
Dr. Anestesi
294,000
105,000
Perawat OK
84,000
105,000
Perawat Anestesi
84,000
256,650
Jasa Pelayanan
220,500
Jumlah Sub
1,522,500
691,500
1,789,650
Total Paket Tarip
2,214,000
Besar
Jasa Rs
567,000
Dr. Operator
700,000
910,000
318,500
Dr. Anestesi
245,000
98,000
Perawat OK
70,000
98,000
Perawat Anestesi
70,000
235,650
Jasa Pelayanan
180,950
Jumlah Sub
1,265,950
567,000
1,660,150
Total Paket Tarip
1,832,950
Sedang
Jasa Rs
522,000
Dr. Operator
630,000
805,000
281,750
Dr. Anestesi
220,500
84,000
Perawat OK
63,000
84,000
Perawat Anestesi
63,000
208,850
Jasa Pelayanan
164,250
Jumlah Sub
1,140,750
522,000
1,463,600
Total Paket Tarip
1,662,750
Kecil
Jasa Rs
270,000
Dr. Operator
350,000
420,000
147,000
Dr. Anestesi
122,500
35,000
Perawat OK
28,000
35,000
Perawat Anestesi
28,000
105,000
Jasa Pelayanan
85,250
Jumlah Sub
613,750
270,000
742,000
Total Paket Tarip
883,750
3
KELAS I
Jasa Rs
468,500
Khusus
Dr. Operator
560,000
630,000
220,500
Dr. Anestesi
196,000
77,000
Perawat OK
70,000
77,000
Perawat Anestesi
70,000
168,000
Jasa Pelayanan
149,250
Jumlah Sub
1,045,250
468,500
1,172,500
Total Paket Tarip
1,699,500
1,513,750
Besar
Jasa Rs
406,500
Dr. Operator
490,000
595,000
208,250
Dr. Anestesi
171,500
70,000
Perawat OK
56,000
70,000
Perawat Anestesi
56,000
157,500
Jasa Pelayanan
129,500
Jumlah Sub
903,000
406,500
1,100,750
Total Paket Tarip
1,594,750
1,309,500
Sedang
Jasa Rs
348,000
Dr. Operator
420,000
525,000
183,750
Dr. Anestesi
147,000
56,000
Perawat OK
49,000

JRS
966,000

966,000
3,113,580
886,800

886,800
2,878,980
786,000

786,000
2,542,320
410,400

410,400
1,300,800
805,000

805,000
2,594,650
739,000

739,000
2,399,150
655,000

655,000
2,118,600
342,000

342,000
1,084,000
527,000

527,000
494,000

494,000
432,000

Kecil

KELAS II
Khusus

Besar

Sedang

Kecil

Perawat Anestesi
Jasa Pelayanan
Jumlah Sub
Total Paket Tarip
Jasa Rs
Dr. Operator
Dr. Anestesi
Perawat OK
Perawat Anestesi
Jasa Pelayanan
Jumlah Sub
Total Paket Tarip
Jasa Rs
Dr. Operator
Dr. Anestesi
Perawat OK
Perawat Anestesi
Jasa Pelayanan
Jumlah Sub
Total Paket Tarip
Jasa Rs
Dr. Operator
Dr. Anestesi
Perawat OK
Perawat Anestesi
Jasa Pelayanan
Jumlah Sub
Total Paket Tarip
Jasa Rs
Dr. Operator
Dr. Anestesi
Perawat OK
Perawat Anestesi
Jasa Pelayanan
Jumlah
Total Paket Tarip
Jasa Rs
Dr. Operator
Dr. Anestesi
Perawat OK
Perawat Anestesi
Jasa Pelayanan
Jumlah Sub
Total Paket Tarip

CATATAN
Bila kegiatan Operasi tidak disertai oleh
Dokter Anestesi, maka Komponen Tarip
Penata Anestesi hanya dipungut 55 %
dari Tarip Komponen Dokter Anestesi.

49,000
110,500
775,500
1,123,500

348,000

56,000
137,650
958,400
1,390,400

225,000
280,000
98,000
28,000
28,000
72,250
506,250
731,250

225,000

277,000
350,000
122,500
42,000
42,000
92,250
648,750
925,750

351,500
480,000
168,000
64,000
64,000
128,000
904,000
1,255,500

351,500

289,000

201,500

113,500

344,000
238,000

320,000
112,000
40,000
40,000
86,500
598,500
836,500

113,500
160,000
56,000
16,000
16,000
41,250
289,250
402,750

414,000
344,000

480,000
168,000
56,000
56,000
125,250
885,250
1,229,250

201,500
280,000
98,000
32,000
32,000
73,250
515,250
716,750

277,000
414,000

560,000
196,000
72,000
72,000
150,500
1,050,500
1,464,500

289,000
400,000
140,000
48,000
48,000
105,250
741,250
1,030,250

432,000

238,000
143,000

200,000
70,000
24,000
24,000
52,000
370,000
513,000

143,000