RUANGAN/ INSTALASI :

NAMA TINDAKAN/ PEMERIKSAAN TARIF LAMA

NO
1 ·   Jahit Luka Kecil 1-5 75,000
·   Jahit Luka Sedang 6-15 120,000
·   Jahit Luka Besar 15-20 200,000
·   Jahit Luka Sangat Besar/ Penyulit > 20 300,000
2 Ekstraksi kuku 120,000
3 Incisi Abses 120,000
4 Angkat Peluru/ Gram 225,000
5 Ekstraksi Corpus Alienum Mata 150,000
6 Ekstraksi Corpus Alienum THT 120,000
7 Debridement Luka Kecil 40,000
8 Debridement Luka Digigit Binatang (Diluar Obat Anti Bisa) 75,000
9 Pemasangan Dower Chateter Urine 75,000
10 Explorasi Luka (Tidak Tembus) 150,000
11 Explorasi Luka Tusuk Paku 75,000
12 Angkat Jaitan 1 –10 Jaitan 40,000
13 Pasang NGT 75,000
14 Pasang IVFD 30,000
15 Bilas Lambung + dengan NGT 165,000
16 Punctie Thorax 150,000
17 Pasang Spalk Jari 75,000
18 Pasang Spalk Tungkai Atas (Tangan) 60,000
19 Pasang Spalk Tungkai Bawah (Kaki) 75,000
20 Pasang Gipsx 300,000
21 Anuscopy 40,000
22 Rectal Toucher/ Vagina Toucher 40,000
23 Nebulizer Inhalation 60,000
24 Resusitasi Jantung Paru Dewasa 150,000
25 Resusitasi Jantung Paru Anak/ Bayi 150,000
26 Luka Bakar 1-9% 60,000
27 Luka Bakar 10-18% 75,000
28 Luka Bakar >20% 120,000
29 Mengurus Mayat 40,000
30 Suction (Isap Lendir/ Darah) 40,000
31 Vena Sectie 300,000
32 Pasang Tampon Hidung/ Epistaksis 90,000
33 Pasang ETT (Endo Tracheal Tube)/ Intubasi 150,000
34 DC Shock 210,000
35 Ganti Perban 40,000
36 Pasang Gudel 40,000
37 ECG Biasa 60,000
38 Monitor Vital Sign 90,000
39 Syringe Pump 75,000
40 Infus Pump 75,000
41 Glukoltest 20,000
42 Doppler 40,000
43 Tracheostomie 300,000
44 Infus Intra Osteus 75,000
45 Infus Intra Umbilical 150,000
46 Spalk Kecil 60,000
47 Spalk Sedang 75,000
48 Spalk Besar 75,000
49 Pasang spalk infus anak 30,000
50 Injeksi 7,500
51 Skin test 15,000
52 Irigasi mata 45,000
53 Perawatan bayi baru lahir di UGD (Perawatan tali pusat) 40,000
54 Incubator 60,000
55 Bebat tekan luka 60,000
56 Pasang elastis perban (untuk pasien fraktur clavikula) 60,000
57 Pasang servival collar 30,000
58 Support Rectal 15,000
59 Pasang elastis perband 60,000
60 Reposisi mandobola 225,000
61 WSD (Chest Tube) 195,000
62 Aspirasi paru/cairan 75,000
63 Pasang stopper 30,000
64 Debridement luas 150,000
65 Pasang Katheter Urine 75,000
66 Fungsi supra pubic 120,000
67 Extubasi 40,000
68 Pemasangan selimut pemanas 450,000
69 Pasang Jackson Reis 75,000
 TARIF BARU

SARANA PELAYANAN TOTAL

35.000 40.000 75,000
40.000 85.000 125,000
50.000 150.000 200,000
60.000 240.000 300,000
40.000 85.000 125,000
20.000 100.000 300,000
25.000 200.000 225,000
20.000 130.000 150,000
15.000 105.000 120,000
15.000 25.000 40,000
15.000 60.000 75,000
35.000 40.000 75,000
40.000 110.000 150,000
20.000 55.000 75,000
15.000 25.000 40,000
30.000 45.000 75,000
15.000 25.000 40,000
55.000 115.000 170,000
45.000 105.000 150,000
18000 57.000 75,000
60.000 25.000 85.000
60.000 25.000 85.000
240.000 160.000 400,000
5.000 35.000 40,000
5.000 35.000 40,000
25.000 50.000 75,000
90.000 60.000 150,000
90.000 60.000 150,000
40000 40.000 80,000
55.000 45000 100,000
75.000 75000 150,000
25.000 25000 50,000
25.000 25000 50,000
280000 120000 400,000
72000 48000 120,000
120000 80000 200,000
168000 112000 280,000
30.000 20000 50,000
30.000 20000 50,000
48000 32000 80,000
44000 66000 110,000
25.000 50.000 75,000
25.000 50.000 75,000
6.000 14.000 20,000
35.033 40.033 40,000
35.034 40.034 300,000
35.035 40.035 75,000
35.036 40.036 150,000
25.000 35.000 60,000
30.000 45.000 75,000
30.000 45.000 75,000
35.040 40.040 30,000
4.000 3.500 7,500
3.500 11.500 15,000
35.043 40.043 45,000
35.044 40.044 40,000
35.045 40.045 60,000
35.046 40.046 60,000
40.000 25.000 65.000
35.048 40.048 30,000
35.049 40.049 15,000
35.050 40.050 60,000
35.051 40.051 225,000
35.052 40.052 195,000
35.053 40.053 75,000
35.054 40.054 30,000
35.055 40.055 150,000
35.056 40.056 75,000
35.057 40.057 120,000
35.058 40.058 40,000
35.059 40.059 450,000
35.060 40.060 75,000