OBSTETRIC OPERATIVE PROCEDURE

AMNIOTOMY TO INDUCED LABOUR 73.01

ASSISTED SPONTANEUS DELIVERY 73.59
EKSPLORASI UTERI 75.7
EKSTRAKSI IUD 97.71
EPISIOTOMY 73.6
HISTECTOMY 65.61
HYSTERECTOMY SUPRACERVICAL 68.39
Induksi 73.4
INSERSI IUD 69.7
JAHIT PERINEUM 75.69
KURETASE 69.09
KURETASE POST HAMIL 69.02
Low cervical cesarean 74.1
MANUAL PLASENTA 75.4
MOW 66.39
Other breech extraction 72.54
Other obstetric operation 75.99
PARTUS SPONTAN 73.59
REPAIR PERINEUM POST PARTUS 75.69
SC 74.1
USG HAMIL 88.78
VE 72.79
VE WITH EPISIOTOMY 72.71

UROLOGIC OPERATIVE PROCEDURE

 Laparotomy
Medikasi
Cystography 87.77 Adhesiolysis (Lysis Adhesion Perioneal)
Blader Neck Insicion 57.91 Amputation Bellow Knee
BNO 88.79 Appendectomy
Cytoscopy 57.32 Appendictomy Laparoscopi
Evakuasi Blood Clot 57.19 Biopsi Breast
Insertion Stent Uretral/ Pasang DJ Stent 59.8 Biopsi Tumor Paru/ Ttna (Transthoracic Neddle Aspirasion)
IVP 87.73 Biopsy Lymph
Lithotripsy Ureter 57.0 Biopsy Nasopharing
Pasang DC 57.94 Biopsy Stt
Pyelolithotomy 55.11 Bmp (Bone Marrow Punction)
Removal DJ Stent 97.62
RPG (Retrograde Pyelogram) 87.74 Chemotheraphy
Sachse (Urethrotomy Interna) 58.5 Chemotheraphy
Sectio Alta (Cystolithotomy) 57.19 Cil/ Colon In Loop
Sirkumsisi 64.0 Circumsisi
TURBT (Transurethral Resection Bladder Tumor) 57.49 Colonoscopy
TURP (Transurethral Resection Of Prostate) 60.29 Colonoscopy With Biopsi
TUUBT(Transuretero Ureterostomy Blader Tumor) 56.75 Cystography
Urethrography 87.73 Cystotomy Terbuka
Uretricystography 87.76 Cystotomy Tertutup
URS/ Urethro Renosystoscopi 56.99 Ear Piercing
USG Upper Lower Abd 88.76 Eksisi Debridement
USG Urologi 88.75 Eksisi Fam/ Tumor Mamae
Ureteroplasty 56.89 Eksisi Ganglion
Repair Of Hypospadia Or Epispadias 58.45 Eksisi Ganglion (Hand)
Release Of Chordee 64.42 Eksisi Lesion Of Soft Tissue
Businasi 58.6 Eksisi Lesion/ Eksisi Keloid
Eksisi Lipoma/Eksisi Tumor Nos
Eksisi Local Lesion/ Skin
Eksisi Luas/ Wide Excision
Eksisi Nail
Eksisi Parotid/ Salivary Gland Lesion
Eksisi Stt
Eksisi Stt Hand
Eksisi Wide/ Wide Eksisi
Fess/Functional Endoscopic Sinus Surgery
OPTIC OPERATIVE PROCEDURE Fistulectomy Perianal
Ftsg/ Fill Thickness Skin Graft
Direct Ophthalmuscopy 16.21 Fungsi Ascites/ Parasentesis
Ecce 13.19 Gastroscopy
Ecce + Iol 13.71 Gastroscopy With Biopsy
Eksisi Pterigium 11.39 Hemorrhoidectomy
Eksisi Pterigium Corneal Graft 11.32 Hernia Repair
Eksisi Xanthalasma 08.20 Hernio Inguinal Repair
Ekstraksi Katarak 13.19 Hernio Repair
Epilasi Bulu Mata 08.93 High Ligation Of Spermatic Vein/Varicocele&Hydrocele
Funduscopy 95.11 Incision And Drainage Abdominal Wall
Incici Hordeolom` 08.09 Incision Hematom/ Pungsi Hematume/ Incision Skin Without Drainage
Incision Hordeolum 8.09 Incision Of Brain
Irrigasi Eye/Spooling 96.51 Incision With Drainage Skin/ Absces
Kir Tbw 95.06 Jahit Luka
Koreksi Kacamata 95.01 Laminectomy
Medikasi Mata 86.28 Laparotomy Eksplorasi
Other Eye Procedure 16.99 Laparotomy Eksplorasi
Removal Corpal Eye 98.21 Lepas Catheter
Slit Lamp 95.02 Lepas Dj Stent
Tonography (Pengukuran Tekanan Intra Occular) 95.26 Lepas Jahitan
Trabekulectomi 12.64 Lithotripsy Ureter
Enukleasi/ Removal Lession Di Eyelid 08.20 Lithotripsy Urethra
Mastectomy NOS
Mrm (Modified Radical Mastectomy)
Necrotomi
Ngt
Omentectomy
Pasang Et (Endotracheal Tube)
Polypectomy Colon
Rawat Luka/ Debridement/ Medikasi
Rectal Thaucher
Removal Corpal Di Kaki
Removal Foreign Body
Scan Nasopharing Non Contras/ Neck
Stricturace
Stsg (Split Thickness Skin Graft)
Tonsilectomy
 Tutup Defect/ Homograft To Skin
VP shunt
ORTHOPEDIC OPERATIVE PROCEDURE

AMPUTATION PASANG GIPS

Finger 84.01 PEDICLE FLAB GRAFT
Thumb 84.02 RELEASE TRIGER THUMB
Toe 84.11 REMOVAL IMPLANT
Amp / austin moore prostesis 81.52
ARTHROPLASTY 81.96
BNP/ bone marow punction(biopsi) 41.31
BONE GRAFT 78.00
Cabut k-wire (kirschner wire) 97.88
Close reduction dislocasi 79.7--
Collar neck 93.52
DEBRIDEMENT FRAKTUR 79.6-
Diskectomy 80.51
EKSISI POLIDAKTILI 86.26
Ganti gip kaki 97.12
Ganti gip tangan 97.11
Ganti gips 97.13
Hemiarthoplasty femur 81.52
Injeksi knee/ function sendi 81.92
LAMINECTOMY 03.09 Repair/reconstruction pcl/acl
Lepas gips 97.88 REPAIR TENDON
Menisectomy 80.6 REPAIRTENDON HAND
REVISI SKOLIOSIS
STSG (SPLIT THICKNESS SKIN GRAFT)
ORIF 79.39 Sural flap
HUMERUS 79.31 THR/ total hip replasment
CARPAL, METACARPAL 79.33 TKR/ Total knee replasment
FEMUR 79.35
FIBULA 79.36
HUMERUS 79.31
CRURIS 79.36
MANDIBULA 76.76
MAXILLA 76.74
NASAL 21.72
PATELLA 79.36
PHALANX FOOT 79.38
PHALANX HAND 79.34
RADIUS 79.32
TARSAL,METATRSAL 79.37
TIBIA 79.36
ULNA 79.32
VERTEBRA, SPINAL 03.53
FOOT 79.37

INTERNA OPERATIVE PROCEDURE

Funduscopy 95.11
av shunt for dialysis ren 39.27
RKP (RESUSITASI JANTUNG PARU) 99.60.
COLON IN LOOP 87.69
COLONOSCOPY 45.23
COLONOSCOPY WITH BIOPSY 45.25
CPAP (CONTINUOUS POSITIVE AIRWAY PRESSURE) 93.90
CT SCAN 87.03
DEBRIDEMENT 86.28
EKG 89.52
eksisi inguinal canal 54.3
GASTROSCOPY 44.13
GASTROSCOPY+BIOPSY 44.14
GIT BLEEDING (NEONATAL) P54.3
HD 39.95
INTUBASI LAMBUNG 96.07
ISTHMOLOBECTOMY 06.2
NGT / SUCTION 96.04
NST (NON STRESS TEST) 75.35
O2 93.96
OMD 87.65
PERAWATAN CC >4HR 96.72
PHOTOTHERAPY 99.83
PUNGTIE PLEURA (THORACENTESIS) 34.91
RECLOSING 54.61
REPAIR ABDOMINAL WALL 54.72
REPAIR DINDING ABDOMEN 54.72
RESUSITASI 93.93
RO BABYGRAM 88.31
RO THORAX 87.44
STERILISASI 66.39
TRANSFUSI 99.03
TREADMILL 89.41
VAKSIN HEPATITIS 99.59
VENTILATOR 96.7
VERSI EKSTRASI 73.22
Infus NOS 99.29
Insulin injection 99.17
urethrocystography 87.76
cateter vein for renal dyalisis 38.95
HD 39.95
ventilator < 96jam 96.71
ventilator > 96 jam 96.72

RADIOLOGY DIAGNOSTIC PROCEDURE

BNO- blass nier Oversich/ KUB-Kidney 87.79
contras brain 87.02
IVP-intra venous pyelogram 87.73
RO Abdomen 88.19
RO Elbow, forearm 88.22
RO Foot, ankle 88.28
RO Gigi 87.12
RO hand, wrist 88.23
RO Hip, pelvis 88.26
RO Intestine 87.65
RO Kepala (noncontras) 87.09
RO Leg, Knee, thigh 88.27
RO Lumbal/ VLS 87.24
RO Nose/ facial bones-mandible,maxila 67.16
RO Oesopagus/ other disgestive track 87.69
RO Rib, Clavicle, 87.43
RO sholder,upper arm 88.21
RO Thorax 87.44
Ro cervical 87.22
scan v thorax/ c.a.t scan thorax 87.41

REHAB MEDIK PROCEDURE

Akupuntur 99.92
Diathermi/ SWD 93.34
ECT/ EST 94.27
Infra Red 93.35
IR 93.35
Latihan 93.19
Okupasi Theraphy/ OT 93.83
Psycotheraphy 94.39
Shock Therapy 94.24
Speech Theraphy 93.75
SWD 93.34
TENS 99.86
Terapi Individu 94.39
Terapi Wicara 93.75
Test IQ 94.01
Theraphy behavior 94.33
Theraphy Family 94.42
Theraphy Group 94.44
Therapy Perkembangan 99.92
Traksi/ manual traksi 93.21
PARU PROCEDURE
WSD (INTERCOSTAL CATHETER WATER SEAL) 34.04
nebulizer 96.05
thoraxocentesis/ pungsi pleura 34.91.
Pasang Collar/ collapse of lung 33.39
GYNECOLOGYCAL OPERATIVE PROCEDURE

Cauterization cervix 67.32

Cauterization vagina 70.33
Colporraphy 70.51
HISTECTOMY 65.61
HSG / HYSTEROSALPHINGOGRAPHY 87.82
KURETASE DX 69.09
LE FORT ( colpocleisis) 70.8
Lepas iud 97.71
MARSUPIALISASI BARTHOLINI 71.23
Marsupialisasi kista cervix 67.31
MIOMECTOMY 68.29
Mow 66.39
Other local excision or destruction of ovary 65.29
PANHYSTERECTOMY 68.49
PAPSMER 91.91
PEMERIKSAAN GYN 89.26
Pemuntiran servix 67.39
Salphinectomy partial bilateral 66.63
Salphingectomy w/ removal of tubal 66.62
SALPHINGO-OOPHORECTOMY 65.49
SALPHINGO-OOPHORosTOMY 66.72
TAH (TOTAL ABDOMINAL HYSTERECTOMY) 68.4
TLH (TAH LAPAROSCOPY) 68.41
TVH (total vagina hysterectomi) 68.59
USG UTERUS NON OBS 88.79
VAGINAL TOUCHER 89.26

SURGE OPERATIVE PROCEDURE

54.19
93.57
54.59
84.15
47.09
47.01
85.12
33.26
40.11
29.12
83.21
41.31

99.25
99.25
87.69
64.0
45.23
45.25
87.77
57.18
57.17
18.01
86.22
85.21
83.31
82.21
83.49
86.3
86.3
86.3
86.4
86.23
26.29
83.49
82.39
86.4
22.19
48.93
86.63
54.91
44.13
44.14
49.46
53.9
53.00
53.04
63.1
54.0
86.09
01.39
86.04
86.59
03.09
54.11
54.11
97.55
97.69
86.99
56.0
57.0
85.41
85.43
86.22
96.07
54.4
96.04
45.42
86.28
48.23
98.28
98.20
8709
48.35
86.69
28.2
 86.66
02.34

93.53
86.71
82.01
78.60
CARPAL, METACARPAL 78.64
CLAVICULA 78.61
FEMUR 78.65
FIBULA 78.67
HUMERUS 78.62
PATELLA 78.66
PELVIC 78.69
PHALANX FOOT/HAND 78.69
RADIUS 78.63
SCAPULA 78.61
TARSAL, METATARSAL 78.68
THORAX 78.61
TIBIA 78.67
ULNA 78.63
VERTEBRA 78.69
81.45
83.73
82.53
84.68
86.69
86.74
81.51
81.54
BM OPERATIVE PROCEDURE

AFF ARCH BARS 24.8

Aff Wire 97.33
Alveolectomy 24.5
Biopsi mouth 27.24
Cabut/ Extraction 23.09
wsd 24.91
Fixation Mandibula 76.75
Gingivectomy 24.31
IDW/ inter dental wiring 76.77
IDW-IMW 76.75
IMW/ inter mandibular wiring 76.75
ODONTECTOMY 23.19
Odontectomy 23.19
OPG 87.11
Prophylaxis 96.54
PSA 23.2
open reduction fr maksila 76.74
REMOVAL PLAQUE 96.54
Removal/ cabut residural root 23.11
Reposisi Mandibula 76.93
RO Mandible 87.16
RO Gigi 87.12
Scalling/ debridement dental 96.54
tambal gigi/ PSA 23.2
spooling 86.28
defitalisasi pulpa 23.7
insicion of mouth 27.92
other excision of mouth 27.49
excision cys jaw 76.2

OTHER DIAGNOSTIC PROCEDURE

AJH MAMAE 90.49
AJH NOS 90.19
Babygram 88.31
CT Scan Abd 88.01
CT Scan Kepala 87.03
CT Scan Nasopharing 88.38
CT Scan NOS 88.38
CT SCAN THORAX 87.41
Cystography 87.77
EEG 89.14
EKG 89.52
Pasang monitor 89.19
SITOLOGI 91.99
USG Abdomen Abdomen 88.76
USG Jantung 88.72
USG Mamae 88.73
USG Thorax 88.73
USG Thyroid 88.71
USG Urologi 88.75
USG Uterus 88.79
RKP 99.6 0
USG ekstrimitas pro AV Shunt 88.77

SKIN PROCEDURE
Injeksi keloid 99.23
SKIN TES 91.6
cauter skin 86.3
bedah kimia 86.24

THT PROCEDURE
AUDIOMETRI 95.41
REMOVAL CERUMEN 96.52
EXCISI TELINGA LUAR 18.29
TAMPON TELINGA 93.57
TONSILECTOMY 28.2
tes alergy 89.12
removal foreign body nose without incicion 98.12
removal foreign body ear 98.11
FESS/ Functional Endoscopic Sinus Surgeri 22.19

ANAK PROCEDURE
IMUNISASI POLIO 99.41
IMUNISASI BCG 99.33
IMUNISASI TT 99.38
Phototeraphy newborn 99.83