Selamat datang di RSUD BAYUNG LENCIR

081380095454 06:00 - 22:00 (Senin-Sabtu)

Operasi

 
Paket Operasi
Kelas
Tarif Operasi
Uff Arch Barr (Cito) Rp. 8.007.500,-
Uff Arch Barr dan suspensi maksila (Cito) Rp. 8.007.500,-
Amputasi jari (phalangs - traumatik) (Cito) Rp. 8.007.500,-
Amputation of digiti single ** (Cito) Rp. 8.007.500,-
Anal fistulectomy (Cito) Rp. 8.007.500,-
Anal fistulotomy (Cito) Rp. 8.007.500,-
Anterior lamellar keratoplasty (Cito) Rp. 8.007.500,-
Appendicostomy (Cito) Rp. 8.007.500,-
Babcock (Cito) Rp. 8.007.500,-
Bilateral excision of ectopic breast tissue (mamma aberans) (Cito) Rp. 8.007.500,-
Bilateral inguinal hernia repair with graft or prosthesis (not otherwise specifi Rp. 8.007.500,-
Bilateral multipel excision of lesion of breast with narcose (Cito) Rp. 8.007.500,-
Bilateral ovariectomy (Cito) Rp. 8.007.500,-
Bilateral repair of direct inguinal hernia (Cito) Rp. 8.007.500,-
Bilateral repair of direct inguinal hernia with graft or prosthetis (Cito) Rp. 8.007.500,-
Bilateral repair of femoral hernia with/without graft of prosthesis (Cito) Rp. 8.007.500,-
Bilateral repair of indirect inguinal hernia (Cito) Rp. 8.007.500,-
Bilateral repair of indirect inguinal hernia with graft or prosthesis (Cito) Rp. 8.007.500,-
Bilateral repair of inguinal hernia, not otherwise specified (Cito) Rp. 8.007.500,-
Bilateral repair of inguinal hernia, one direct and one indirect (Cito) Rp. 8.007.500,-
Bilateral repair of inguinal hernia, one direct and one indirect, with graft or Rp. 8.007.500,-
Biopsi pembuluh darah perifer * (Cito) Rp. 8.007.500,-
Biopsi perikardium * (Cito) Rp. 8.007.500,-
Biopsi terbuka bronkhus * (Cito) Rp. 8.007.500,-
Biopsi terbuka diafragma * (Cito) Rp. 8.007.500,-
Biopsi terbuka mediastinum * (Cito) Rp. 8.007.500,-
Biopsi terbuka paru * (Cito) Rp. 8.007.500,-
Biopsi terbuka pleura * (Cito) Rp. 8.007.500,-
Biopsi terbuka pleura dengan VATS * (Cito) Rp. 8.007.500,-
Biopsi terbuka tumor dinding thoraks * (Cito) Rp. 8.007.500,-
Caecostomy (Cito) Rp. 8.007.500,-
Closure of anal fistula (Cito) Rp. 8.007.500,-
Combustio (luka bakar) * (Cito) Rp. 8.007.500,-
Compartement excision (Cito) Rp. 8.007.500,-
Debridement-nekrotomi luka gangren (Cito) Rp. 8.007.500,-
Deseksi submandibula (Cito) Rp. 8.007.500,-
Disartikulasi sendi ekstremitas (Cito) Rp. 8.007.500,-
Dislokasi bahu * (Cito) Rp. 8.007.500,-
Drainage of appendiceal abscess (Cito) Rp. 8.007.500,-
Drainage of pancreatic cyst by catheter (Cito) Rp. 8.007.500,-
DSAEK (Cito) Rp. 8.007.500,-
ECCE / ICCE / SICS (Cito) Rp. 8.007.500,-
ECCE / SICS dan IOL (Cito) Rp. 8.007.500,-
Eksisi biopsi tumor pembuluh darah (Cito) Rp. 8.007.500,-
Eksisi glandula submandibula (Cito) Rp. 8.007.500,-
Eksisi higroma leher * (Cito) Rp. 8.007.500,-
Eksisi kista tiroglosus (Cito) Rp. 8.007.500,-
Eksisi parsial dan marsupialisasi Ranula (Cito) Rp. 8.007.500,-
Eksisi Pterigium (Cito) Rp. 8.007.500,-
Eksisi tumor dinding dada * (Cito) Rp. 8.007.500,-
Eksisi tumor pembuluh darah perifer (hemangioma) ** (Cito) Rp. 8.007.500,-
Eksisi tumor pembuluh darah perifer ** (Cito) Rp. 8.007.500,-
Ekstirpasi kelainan kornea (Cito) Rp. 8.007.500,-
Ekstraksi corpus alienum segmen anterior (Cito) Rp. 8.007.500,-
Ekstraksi IOL (Cito) Rp. 8.007.500,-
Embolektomi / trombektomi pembuluh darah arteri abdominal (Cito) Rp. 8.007.500,-
Endoskopi - Esofagoskopi BA tanpa penyulit (Cito) Rp. 8.007.500,-
Endoskopi - Esofagoskopi dilatasi (Cito) Rp. 8.007.500,-
Endoskopi - Sialendoskopi diagnostik dan dilatasi (Cito) Rp. 8.007.500,-
Endoskopi - Sialendoskopi diagnostik dan terapeutik (Cito) Rp. 8.007.500,-
Esofago-Gastro-Duodenoscopy (EGD) dan Biopsi (Cito) Rp. 8.007.500,-
Evakuasi hematom di ekstremitas (pasca pungsi HD / traumatik) (Cito) Rp. 8.007.500,-
Evakuasi silicon oil (Cito) Rp. 8.007.500,-
Evakuasi silicon oil dan ECCE (Cito) Rp. 8.007.500,-
Evakuasi silicon oil, Phaco / ECCE dan IOL (Cito) Rp. 8.007.500,-
Exchange IOL (Cito) Rp. 8.007.500,-
Excision of ectopic breast tissue (Cito) Rp. 8.007.500,-
excision of lesion of breast with narcose (Cito) Rp. 8.007.500,-
Excision of thyroglossal duct or trac (Cito) Rp. 8.007.500,-
Exploratory laparotomy (Cito) Rp. 8.007.500,-
Extirpasi kista rongga mulut (Cito) Rp. 8.007.500,-
Extirpasi muoccocele rongga mulut (Cito) Rp. 8.007.500,-
Fasciotomy * (Cito) Rp. 8.007.500,-
Fiksasi interna fraktur maksilofasial 1-2 tempat patahan * (Cito) Rp. 8.007.500,-
Fiksasi interna fraktur nasal (Cito) Rp. 8.007.500,-
Flap konjungtiva amnion graft (Cito) Rp. 8.007.500,-
Fraktur humerus * (Cito) Rp. 8.007.500,-
Gastrostomi * (Cito) Rp. 8.007.500,-
GIN -Ekstirpasi polip (Cito) Rp. 8.007.500,-
Ginekologi - Ekstirpasi Giant Condiloma (Cito) Rp. 8.007.500,-
Ginekologi - Kistektomi (Cito) Rp. 8.007.500,-
Ginekologi - Laparotomi Diagnostik (Cito) Rp. 8.007.500,-
Ginekologi - Ligasi Arteri Hipogastrica / Uterina (Cito) Rp. 8.007.500,-
Ginekologi - Miomektomi (Cito) Rp. 8.007.500,-
Ginekologi - Pemasangan Implan Tableport (Cito) Rp. 8.007.500,-
Ginekologi - Salpingo-ooforektomi (Cito) Rp. 8.007.500,-
Glaukoma - Anterior / posterior sklerotomi (Cito) Rp. 8.007.500,-
Glaukoma - Gonioplasty / goniotomy (Cito) Rp. 8.007.500,-
Glaukoma - Iridektomi perifer (Cito) Rp. 8.007.500,-
Glaukoma - Paracentesis (Cito) Rp. 8.007.500,-
Glaukoma - Reformasi COA (Cito) Rp. 8.007.500,-
Glaukoma - Revisi Bleb (Cito) Rp. 8.007.500,-
Glaukoma - Tindakan cyclodia termi (Cito) Rp. 8.007.500,-
Glaukoma - Trabekulektomi (Cito) Rp. 8.007.500,-
Glaukoma - Trabekulektomi, Phaco dan IOL (Cito) Rp. 8.007.500,-
Glaukoma - Trabekulotomi anak atau bayi (Cito) Rp. 8.007.500,-
Glaukoma - Trabekulotomi dan trabekulektomi anak atau bayi (Cito) Rp. 8.007.500,-
Glaukoma - Transkleral Foto Coagulasi (Cito) Rp. 8.007.500,-
Glaukoma - Tubes implan (Cito) Rp. 8.007.500,-
Hand - Elbow (medical epicondyle), fracture, excision bony fragment (Cito) Rp. 8.007.500,-
Hand - Elbow, tennis elbow, release (Cito) Rp. 8.007.500,-
Hand - Jari, closed fracture or dislocation, reduksi terbuka dan fixation (singl Rp. 8.007.500,-
Hand - Jari, crush injuries (complex) wound debridement (Cito) Rp. 8.007.500,-
Hand - Jari, crush injury (simple), wound debridement (Cito) Rp. 8.007.500,-
Hand - Jari, deep infection, drainage (Cito) Rp. 8.007.500,-
Hand - Jari, deformity, instrinsic muscle extensor relocation (Cito) Rp. 8.007.500,-
Hand - Jari, deformity, instrinsic muscle release (Cito) Rp. 8.007.500,-
Hand - Jari, foreign body (superficial), removal with mobilization of neurovascu Rp. 8.007.500,-
Hand - Jari, injury, debridement (Cito) Rp. 8.007.500,-
Hand - Jari, jaringan lunak tumor, excision (Cito) Rp. 8.007.500,-
Hand - Jari, macrodactyly, debulking (Cito) Rp. 8.007.500,-
Hand - Jari, polydactyly, amputasi with rekonstruksi (Cito) Rp. 8.007.500,-
Hand - Jari, ring construction (single), koreksi (Cito) Rp. 8.007.500,-
Hand - Jari, superficial infection, drainage (Cito) Rp. 8.007.500,-
Hand - Jari, syndactili (single) koreksi (Cito) Rp. 8.007.500,-
Hand - Jari, trauma, terminalisation (multiple) (Cito) Rp. 8.007.500,-
Hand - Jari, trauma, terminalisation (single) (Cito) Rp. 8.007.500,-
Hand - Jari, tumors, excision with dissection of neurovasculer bundle (Cito) Rp. 8.007.500,-
Hand - Jari, various lesions, amputasi (multiple) (Cito) Rp. 8.007.500,-
Hand - Jari, various lesions, Ray amputasi (single) (Cito) Rp. 8.007.500,-
Hand - Jari, wart, com, naevus, excision (Cito) Rp. 8.007.500,-
Hand - Jaringan lunak (palmar space), abscess, drainage (Cito) Rp. 8.007.500,-
Hand - Kulit dan jaringan subkultis, defect (single digit), free full thickness Rp. 8.007.500,-
Hand - Kulit dan jaringan subkus, defect (deep) staged distant flap (division) ( Rp. 8.007.500,-
Hand - Kulit dan jaringan subkutis, defect (multiple digits) staged local flap ( Rp. 8.007.500,-
Hand - Nail bed, Laceration, repair (single) (Cito) Rp. 8.007.500,-
Hand - Nerve various lesions, primary or secondary suture (Cito) Rp. 8.007.500,-
Hand - Nerve, Various Lesions, biopsy (Cito) Rp. 8.007.500,-
Hand - Repair muscle (Cito) Rp. 8.007.500,-
Hand - Sendi (extremitas atas) rush rods / wires / screw removal (Cito) Rp. 8.007.500,-
Hand - Sendi (jari), contracture, capsulectomy (capsulotomy) (Cito) Rp. 8.007.500,-
Hand - Sendi (wrist), various lesions, arthrodesis (Cito) Rp. 8.007.500,-
Hand - Tendon (ekstremitas atas) , contracture, tenotomy (Cito) Rp. 8.007.500,-
Hand - Tendon extensor (extremitas atas) injury, repair (single) (Cito) Rp. 8.007.500,-
Hand - Tendon flexor (ekstremitas atas) adhesion, tenolysis (single) (Cito) Rp. 8.007.500,-
Hand - Tendon flexor (ekstremitas atas), adhesion, tenolysis (multiple) (Cito) Rp. 8.007.500,-
Hand - Tendon sheath (ekstremitas atas), De Quervain's (unilateral), Release (Ci Rp. 8.007.500,-
Hand - Tendon sheath (ekstremitas atas), tenosynovitis (multiple), drainage (Cit Rp. 8.007.500,-
Hand - Tendon sheath (ekstremitas atas), Trigger Jari (multiple), Release (Cito) Rp. 8.007.500,-
Hand - Tendon sheath (extremitas atas) ganglion atau villo nodular synovitis, ex Rp. 8.007.500,-
Hand - Tendon sheath (extremitas atas), tenosynovitis (single), drainage (Cito) Rp. 8.007.500,-
Hand - Tendon sheath (extremitas atas), trigger jari (single) release (Cito) Rp. 8.007.500,-
Hand - Tendon sheath dan jaringan subkutis, ganglion (small bursa), excision (Ci Rp. 8.007.500,-
Hidrokel Testis / Funikuli ** (Cito) Rp. 8.007.500,-
Implantasi iris artifisial (Cito) Rp. 8.007.500,-
Implantasi piggyback IOL (Cito) Rp. 8.007.500,-
Incision of perianal abscess (Cito) Rp. 8.007.500,-
Injeksi intravitreal (Cito) Rp. 8.007.500,-
Insertion of synthetic implant in facial bone (Cito) Rp. 8.007.500,-
Insisi atau Eksisi gingiva (Cito) Rp. 8.007.500,-
Insisi flegmon dasar mulut (Cito) Rp. 8.007.500,-
Internal Fiksasi fraktur condylus mandibula (Cito) Rp. 8.007.500,-
Internal fiksasi fraktur maksilofasial 5 tempat patahan atau lebih (Cito) Rp. 8.007.500,-
Internal Fiksasi fraktur Mandibula segmental (Cito) Rp. 8.007.500,-
Keratoplasty tembus (Cito) Rp. 8.007.500,-
Keratoprosthesis (Cito) Rp. 8.007.500,-
Knee - Open knee debridement (Cito) Rp. 8.007.500,-
Knee - Perypheral nerve ablation (Cito) Rp. 8.007.500,-
Knee - Perypheral nerve lysis (Cito) Rp. 8.007.500,-
Kolonoskopi (Cito) Rp. 8.007.500,-
Labioshisis * (Cito) Rp. 8.007.500,-
Laring dan Faring - Laringofisure (Cito) Rp. 8.007.500,-
Laring dan Faring - Pemasangan T-Tube (Cito) Rp. 8.007.500,-
Left lateral anal sphincterotomy (Cito) Rp. 8.007.500,-
Ligasi vaskular ekstremitas (Cito) Rp. 8.007.500,-
Ligation of hemorrhoids (Cito) Rp. 8.007.500,-
Limbal Relaxing Incision (LRI) (Cito) Rp. 8.007.500,-
Maksilektomi total dan Rekonstruksi * (Cito) Rp. 8.007.500,-
Multipel excision of lesion of breast with narcose (Cito) Rp. 8.007.500,-
Mutilasi digiti ekstremitas (Multiple) (Cito) Rp. 8.007.500,-
Obstetri - Histerorafi (Cito) Rp. 8.007.500,-
Obstetri - Kolporafi anterior (Cito) Rp. 8.007.500,-
Obstetri - Kolporafi posterior (Cito) Rp. 8.007.500,-
Obstetri - Mioma geburt (Cito) Rp. 8.007.500,-
Obstetri - Sectio caesaria tanpa penyulit (Cito) Rp. 8.007.500,-
Odontektomi tingkat I (Cito) Rp. 8.007.500,-
Onkologi - Biopsi tumor hidung, lidah, nasofaring (narkosis) (Cito) Rp. 8.007.500,-
Onkologi - Excision soft tissue tumor < 5 cm (kecil) (Cito) Rp. 8.007.500,-
Onkologi - Limb ablation dengan above atau below knee amputation bone tumor (Cit Rp. 8.007.500,-
Onkologi - Open biopsy bone tumor (Cito) Rp. 8.007.500,-
Onkologi - Open biopsy soft tissue (Cito) Rp. 8.007.500,-
Onkologi - Ray amputation jari (Cito) Rp. 8.007.500,-
Onkologi - Tumor jinak tulang (curettage dan bonegraft) (Cito) Rp. 8.007.500,-
Open biopsi of breast (Cito) Rp. 8.007.500,-
Open biopsy of salivary gland or duct (Cito) Rp. 8.007.500,-
Open reduction of alveolar fracture * (Cito) Rp. 8.007.500,-
Osteotomi eksisi tulang maksilofasial (Cito) Rp. 8.007.500,-
Other appendectomy (elective) * (Cito) Rp. 8.007.500,-
Other bilateral femoral hernioraphy (Cito) Rp. 8.007.500,-
Other hernia repair (Cito) Rp. 8.007.500,-
Other incidental appendectomy * (Cito) Rp. 8.007.500,-
Other incision of anus (Cito) Rp. 8.007.500,-
Other lysis of peritoneal adhesions (Cito) Rp. 8.007.500,-
Other operations on anus (Cito) Rp. 8.007.500,-
Other operations on trachea (Cito) Rp. 8.007.500,-
Other procedures on hemorrhoids (Cito) Rp. 8.007.500,-
Other reconstruction of mandible (Cito) Rp. 8.007.500,-
Other reconstruction of other facial bone (Cito) Rp. 8.007.500,-
Other repair and plastic operation of tongue (Cito) Rp. 8.007.500,-
Other repair of abdominal wall (Cito) Rp. 8.007.500,-
Other umbilical herniorraphy* (Cito) Rp. 8.007.500,-
Other unilateral femoral herniorraphy (Cito) Rp. 8.007.500,-
Otologi - Meatoplasti (Cito) Rp. 8.007.500,-
Otologi - Miringoplasti (Cito) Rp. 8.007.500,-
Otologi - Pemasangan grommet (Cito) Rp. 8.007.500,-
Palatoshisis ** (Cito) Rp. 8.007.500,-
Partial glossectomy (Cito) Rp. 8.007.500,-
Pediatrik - Bony bridge release pada kasus tarsal coalition (Cito) Rp. 8.007.500,-
Pediatrik - Closed reduction dan pemasangan gips fraktur femur anak (Cito) Rp. 8.007.500,-
Pediatrik - Combined Trabeculotomy dan trabeculectomy (Cito) Rp. 8.007.500,-
Pediatrik - Debridement dan soft tissue release pada infeksi sendi (Cito) Rp. 8.007.500,-
Pediatrik - Debridement fraktur terbuka anak (Cito) Rp. 8.007.500,-
Pediatrik - Debridement, nekrotomy dan saucerization pada chronic osteomyelits ( Rp. 8.007.500,-
Pediatrik - Fiksasi cannualted screw pada SCFE (Cito) Rp. 8.007.500,-
Pediatrik - Hemangioma : injeksi intralesi (Cito) Rp. 8.007.500,-
Pediatrik - Injeksi botoks kasus Cerebral Palsy (Cito) Rp. 8.007.500,-
Pediatrik - Katarak (Cito) Rp. 8.007.500,-
Pediatrik - Koreksi curly toe (Cito) Rp. 8.007.500,-
Pediatrik - Koreksi overriding toe polidactili (Cito) Rp. 8.007.500,-
Pediatrik - Koreksi syndactili kaki (Cito) Rp. 8.007.500,-
Pediatrik - Nekrotomy (Cito) Rp. 8.007.500,-
Pediatrik - Open achilles tendon lengthening (Cito) Rp. 8.007.500,-
Pediatrik - Percutaneous tendon tenotomy (Cito) Rp. 8.007.500,-
Pediatrik - Pupilloplasty, membranectomy, anterior vitrectomy, secondary IOL (Ci Rp. 8.007.500,-
Pediatrik - Reposisi tertutup dan gips fraktur anak kecuali fraktur femur (Cito) Rp. 8.007.500,-
Pediatrik - Reposisi tertutup dan percutaneous pinning fraktur seputar sendi sik Rp. 8.007.500,-
Pediatrik - Reposisi tertutup, arthrogram dan hemispica DDH (Cito) Rp. 8.007.500,-
Pediatrik - RetCam and Narkose (Cito) Rp. 8.007.500,-
Pediatrik - Skin graft (Cito) Rp. 8.007.500,-
Pediatrik - Soft tissue release and enhancement kasus habitual dislokasi lutut a Rp. 8.007.500,-
Pediatrik - Soft tissue release kelainan Cerebral Palsy, Arthrogryposis, Spina B Rp. 8.007.500,-
Pediatrik - Synovectomy arthroscopy pada penderita hemofilia (Cito) Rp. 8.007.500,-
Pediatrik - Trabeculotomy pada glaucoma congenital (Cito) Rp. 8.007.500,-
Pembedahan teleangiectasis (Cito) Rp. 8.007.500,-
Pengangkatan encircling silicone band (Cito) Rp. 8.007.500,-
Perikardiektomi * (Cito) Rp. 8.007.500,-
Phaco dan IOL multifokal atau torik (Cito) Rp. 8.007.500,-
Phakik IOL (Cito) Rp. 8.007.500,-
Phototherapeutic keratectomy (PTK) (Cito) Rp. 8.007.500,-
Pionephrosis (Cito) Rp. 8.007.500,-
Plastik Rekionstruksi - Regional flap tidak luas (Cito) Rp. 8.007.500,-
Pleural window (eloeser flap) * (Cito) Rp. 8.007.500,-
Plikasi bulae / bleb emfisematous (Cito) Rp. 8.007.500,-
Pneumatic retinopexy (Cito) Rp. 8.007.500,-
Posterior vitrectomy dan endo laser dengan atau tanpa Silikon Oil / Gas dan inje Rp. 8.007.500,-
Posterior vitrectomy dengaan atau tanpa Sceral buckling (Cito) Rp. 8.007.500,-
Prosedur Sistrunk kista duktus tiroglosus (Cito) Rp. 8.007.500,-
Pulmonary decortication * (Cito) Rp. 8.007.500,-
Rekonstruksi - Cryo/cauter pada trichiasis (Cito) Rp. 8.007.500,-
Rekonstruksi - Eksternal DCR dan silikon tube (Cito) Rp. 8.007.500,-
Rekonstruksi - Ektropion 1 kelopak * (Cito) Rp. 8.007.500,-
Rekonstruksi - Entropion 1 kelopak (Cito) Rp. 8.007.500,-
Rekonstruksi - Eviserasi / enukleasi (Cito) Rp. 8.007.500,-
Rekonstruksi - Eviserasi / enukleasi dan implan (Cito) Rp. 8.007.500,-
Rekonstruksi - Graft Bibir pada Ptisis Bulbi (Cito) Rp. 8.007.500,-
Rekonstruksi - Koreksi Lagoftalmos dengan beban emas (Cito) Rp. 8.007.500,-
Rekonstruksi - Koreksi Ptosis * (Cito) Rp. 8.007.500,-
Rekonstruksi - Koreksi simblefaron (Cito) Rp. 8.007.500,-
Rekonstruksi - Probing (Cito) Rp. 8.007.500,-
Rekonstruksi - Repair Ruptur palpebra (dengan rupture canalis lacrimalis) (Cito) Rp. 8.007.500,-
Rekonstruksi - Repair Ruptur palpebra * (Cito) Rp. 8.007.500,-
Rekonstruksi - Tarsorafi (Cito) Rp. 8.007.500,-
Release kontraktur mandibula (Cito) Rp. 8.007.500,-
Release tortikolis (Cito) Rp. 8.007.500,-
Removal of foreign body from peritoneal cavity (Cito) Rp. 8.007.500,-
Removal of foreign body from retro-peritoneal cavity (Cito) Rp. 8.007.500,-
Repair iridodyalisis (Cito) Rp. 8.007.500,-
Repair of direct inguinal hernia (Cito) Rp. 8.007.500,-
Repair of direct inguinal hernia with graft or prosthesis (Cito) Rp. 8.007.500,-
Repair of indirect inguinal hernia (Cito) Rp. 8.007.500,-
Repair of indirect inguinal hernia with graft or prosthesis (Cito) Rp. 8.007.500,-
Repair of laceration, cornea and or sclera, perforating (Cito) Rp. 8.007.500,-
Repair of laceration, cornea, non perforating (Cito) Rp. 8.007.500,-
Repair of other hernia of anterior abdominal wall (Cito) Rp. 8.007.500,-
Repair of other hernia of anterior abdominal wall with prosthesis (Cito) Rp. 8.007.500,-
Repair of umbilical hernia with prosthesis * (Cito) Rp. 8.007.500,-
Reposisi IOL (Cito) Rp. 8.007.500,-
Reposisi Iris (Cito) Rp. 8.007.500,-
Reposisi tertutup fraktur nasal (Cito) Rp. 8.007.500,-
Reseksi mandibula dengan rekonstruksi graft tulang / K-wire (Cito) Rp. 8.007.500,-
Rinologi - Konkotomi / Konkoplasti (Cito) Rp. 8.007.500,-
Rinologi - Nasoendoskopi Dengan tindakan (Cito) Rp. 8.007.500,-
Rinologi - Sinuskopi / Sinoskopi (Narkosis) (Cito) Rp. 8.007.500,-
Rupture tendon achiles (Cito) Rp. 8.007.500,-
Scleral buckle, cryo dan C3F8 (Cito) Rp. 8.007.500,-
Scleral buckling (Cito) Rp. 8.007.500,-
Sekunder IOL (Cito) Rp. 8.007.500,-
Somnoplasty (Cito) Rp. 8.007.500,-
Spine - Biopsy vertebra (1 level) * (Cito) Rp. 8.007.500,-
Spine - Plaster application of the spine (Cito) Rp. 8.007.500,-
Strabismus 1 otot (Cito) Rp. 8.007.500,-
Strabismus 2 otot (Cito) Rp. 8.007.500,-
Strabismus 3 otot (Cito) Rp. 8.007.500,-
Suture of laceration of large intestine (Cito) Rp. 8.007.500,-
Suture of laceration of small intestine, except duodenum (Cito) Rp. 8.007.500,-
Suture of peritoneum (Cito) Rp. 8.007.500,-
Tatto cornea (Cito) Rp. 8.007.500,-
Torakotomi / sternotomi eksplorasi * (Cito) Rp. 8.007.500,-
Torsio testis ** (Cito) Rp. 8.007.500,-
Trakeostomi temporary ** (Cito) Rp. 8.007.500,-
Trauma - Acute ankle joint dislocation (Cito) Rp. 8.007.500,-
Trauma - Acute elbow joint dislocation (Cito) Rp. 8.007.500,-
Trauma - Acute hip joint dislocation (Cito) Rp. 8.007.500,-
Trauma - Acute knee joint dislocation (Cito) Rp. 8.007.500,-
Trauma - Closed fraktur shaft femur * (Cito) Rp. 8.007.500,-
Trauma - Closed fraktur shaft humerus * (Cito) Rp. 8.007.500,-
Trauma - Closed fraktur shaft radius (Cito) Rp. 8.007.500,-
Trauma - Closed fraktur shaft tibia (Cito) Rp. 8.007.500,-
Trauma - Closed fraktur shaft ulna (Cito) Rp. 8.007.500,-
Trauma - Fraktur tulang panjang dengan MIPO atau ORIF dan implant removal (long Rp. 8.007.500,-
Trauma - Jaringan granulasi dengan STSG (Cito) Rp. 8.007.500,-
Trauma - Kompartemen otot (Cito) Rp. 8.007.500,-
Trauma - Nekrotik tissue > 1 kompartemen dengan debridement (Cito) Rp. 8.007.500,-
Trauma - Nekrotik tissue dengan debridement (Cito) Rp. 8.007.500,-
Trauma - Open fraktur shaft femur grade 1 dan 2 (Cito) Rp. 8.007.500,-
Trauma - Open fraktur shaft humerus grade 1 dan 2 (Cito) Rp. 8.007.500,-
Trauma - Open fraktur shaft radius grade 1 dan 2 (Cito) Rp. 8.007.500,-
Trauma - Open fraktur shaft tibia grade 1 dan 2 (Cito) Rp. 8.007.500,-
Trauma - Open fraktur shaft ulna grade 1 dan 2 (Cito) Rp. 8.007.500,-
Tumor - Biopsi tumor kelopak (Cito) Rp. 8.007.500,-
Tumor - Biopsi tumor orbita (Cito) Rp. 8.007.500,-
Tumor - Eksenterasi (Cito) Rp. 8.007.500,-
Tumor - Eksisi tumor adneksa (Cito) Rp. 8.007.500,-
Tumor - Ekstirpasi Tumor Orbita (Cito) Rp. 8.007.500,-
Tumor - Orbital dekompresi 1 tulang (Cito) Rp. 8.007.500,-
Tumor - Orbital dekompresi 2 tulang (Cito) Rp. 8.007.500,-
Tumor - Orbitotomi anterior (Cito) Rp. 8.007.500,-
Tumor - Orbitotomi lateral (Cito) Rp. 8.007.500,-
Unilateral excision of ectopic breast tissue (mamma aberans) (Cito) Rp. 8.007.500,-
Unilateral repair of femoral atau inguinal hernia with or without graft or prost Rp. 8.007.500,-
Unilateral thyroid lobectomy (Cito) Rp. 8.007.500,-
Wide excision of soft tissue tumor (Cito) Rp. 8.007.500,-
Uff Arch Barr (Cito) Rp. 7.282.400,-
Uff Arch Barr dan suspensi maksila (Cito) Rp. 7.282.400,-
Amputasi jari (phalangs - traumatik) (Cito) Rp. 7.282.400,-
Amputation of digiti single ** (Cito) Rp. 7.282.400,-
Anal fistulectomy (Cito) Rp. 7.282.400,-
Anal fistulotomy (Cito) Rp. 7.282.400,-
Anterior lamellar keratoplasty (Cito) Rp. 7.282.400,-
Appendicostomy (Cito) Rp. 7.282.400,-
Babcock (Cito) Rp. 7.282.400,-
Bilateral excision of ectopic breast tissue (mamma aberans) (Cito) Rp. 7.282.400,-
Bilateral inguinal hernia repair with graft or prosthesis (not otherwise specifi Rp. 7.282.400,-
Bilateral multipel excision of lesion of breast with narcose (Cito) Rp. 7.282.400,-
Bilateral ovariectomy (Cito) Rp. 7.282.400,-
Bilateral repair of direct inguinal hernia (Cito) Rp. 7.282.400,-
Bilateral repair of direct inguinal hernia with graft or prosthetis (Cito) Rp. 7.282.400,-
Bilateral repair of femoral hernia with/without graft of prosthesis (Cito) Rp. 7.282.400,-
Bilateral repair of indirect inguinal hernia (Cito) Rp. 7.282.400,-
Bilateral repair of indirect inguinal hernia with graft or prosthesis (Cito) Rp. 7.282.400,-
Bilateral repair of inguinal hernia, not otherwise specified (Cito) Rp. 7.282.400,-
Bilateral repair of inguinal hernia, one direct and one indirect (Cito) Rp. 7.282.400,-
Bilateral repair of inguinal hernia, one direct and one indirect, with graft or Rp. 7.282.400,-
Biopsi pembuluh darah perifer * (Cito) Rp. 7.282.400,-
Biopsi perikardium * (Cito) Rp. 7.282.400,-
Biopsi terbuka bronkhus * (Cito) Rp. 7.282.400,-
Biopsi terbuka diafragma * (Cito) Rp. 7.282.400,-
Biopsi terbuka mediastinum * (Cito) Rp. 7.282.400,-
Biopsi terbuka paru * (Cito) Rp. 7.282.400,-
Biopsi terbuka pleura * (Cito) Rp. 7.282.400,-
Biopsi terbuka pleura dengan VATS * (Cito) Rp. 7.282.400,-
Biopsi terbuka tumor dinding thoraks * (Cito) Rp. 7.282.400,-
Caecostomy (Cito) Rp. 7.282.400,-
Closure of anal fistula (Cito) Rp. 7.282.400,-
Combustio (luka bakar) * (Cito) Rp. 7.282.400,-
Compartement excision (Cito) Rp. 7.282.400,-
Debridement-nekrotomi luka gangren (Cito) Rp. 7.282.400,-
Deseksi submandibula (Cito) Rp. 7.282.400,-
Disartikulasi sendi ekstremitas (Cito) Rp. 7.282.400,-
Dislokasi bahu * (Cito) Rp. 7.282.400,-
Drainage of appendiceal abscess (Cito) Rp. 7.282.400,-
Drainage of pancreatic cyst by catheter (Cito) Rp. 7.282.400,-
DSAEK (Cito) Rp. 7.282.400,-
ECCE / ICCE / SICS (Cito) Rp. 7.282.400,-
ECCE / SICS dan IOL (Cito) Rp. 7.282.400,-
Eksisi biopsi tumor pembuluh darah (Cito) Rp. 7.282.400,-
Eksisi glandula submandibula (Cito) Rp. 7.282.400,-
Eksisi higroma leher * (Cito) Rp. 7.282.400,-
Eksisi kista tiroglosus (Cito) Rp. 7.282.400,-
Eksisi parsial dan marsupialisasi Ranula (Cito) Rp. 7.282.400,-
Eksisi Pterigium (Cito) Rp. 7.282.400,-
Eksisi tumor dinding dada * (Cito) Rp. 7.282.400,-
Eksisi tumor pembuluh darah perifer (hemangioma) ** (Cito) Rp. 7.282.400,-
Eksisi tumor pembuluh darah perifer ** (Cito) Rp. 7.282.400,-
Ekstirpasi kelainan kornea (Cito) Rp. 7.282.400,-
Ekstraksi corpus alienum segmen anterior (Cito) Rp. 7.282.400,-
Ekstraksi IOL (Cito) Rp. 7.282.400,-
Embolektomi / trombektomi pembuluh darah arteri abdominal (Cito) Rp. 7.282.400,-
Endoskopi - Esofagoskopi BA tanpa penyulit (Cito) Rp. 7.282.400,-
Endoskopi - Esofagoskopi dilatasi (Cito) Rp. 7.282.400,-
Endoskopi - Sialendoskopi diagnostik dan dilatasi (Cito) Rp. 7.282.400,-
Endoskopi - Sialendoskopi diagnostik dan terapeutik (Cito) Rp. 7.282.400,-
Esofago-Gastro-Duodenoscopy (EGD) dan Biopsi (Cito) Rp. 7.282.400,-
Evakuasi hematom di ekstremitas (pasca pungsi HD / traumatik) (Cito) Rp. 7.282.400,-
Evakuasi silicon oil (Cito) Rp. 7.282.400,-
Evakuasi silicon oil dan ECCE (Cito) Rp. 7.282.400,-
Evakuasi silicon oil, Phaco / ECCE dan IOL (Cito) Rp. 7.282.400,-
Exchange IOL (Cito) Rp. 7.282.400,-
Excision of ectopic breast tissue (Cito) Rp. 7.282.400,-
excision of lesion of breast with narcose (Cito) Rp. 7.282.400,-
Excision of thyroglossal duct or trac (Cito) Rp. 7.282.400,-
Exploratory laparotomy (Cito) Rp. 7.282.400,-
Extirpasi kista rongga mulut (Cito) Rp. 7.282.400,-
Extirpasi muoccocele rongga mulut (Cito) Rp. 7.282.400,-
Fasciotomy * (Cito) Rp. 7.282.400,-
Fiksasi interna fraktur maksilofasial 1-2 tempat patahan * (Cito) Rp. 7.282.400,-
Fiksasi interna fraktur nasal (Cito) Rp. 7.282.400,-
Flap konjungtiva amnion graft (Cito) Rp. 7.282.400,-
Fraktur humerus * (Cito) Rp. 7.282.400,-
Gastrostomi * (Cito) Rp. 7.282.400,-
GIN -Ekstirpasi polip (Cito) Rp. 7.282.400,-
Ginekologi - Ekstirpasi Giant Condiloma (Cito) Rp. 7.282.400,-
Ginekologi - Kistektomi (Cito) Rp. 7.282.400,-
Ginekologi - Laparotomi Diagnostik (Cito) Rp. 7.282.400,-
Ginekologi - Ligasi Arteri Hipogastrica / Uterina (Cito) Rp. 7.282.400,-
Ginekologi - Miomektomi (Cito) Rp. 7.282.400,-
Ginekologi - Pemasangan Implan Tableport (Cito) Rp. 7.282.400,-
Ginekologi - Salpingo-ooforektomi (Cito) Rp. 7.282.400,-
Glaukoma - Anterior / posterior sklerotomi (Cito) Rp. 7.282.400,-
Glaukoma - Gonioplasty / goniotomy (Cito) Rp. 7.282.400,-
Glaukoma - Iridektomi perifer (Cito) Rp. 7.282.400,-
Glaukoma - Paracentesis (Cito) Rp. 7.282.400,-
Glaukoma - Reformasi COA (Cito) Rp. 7.282.400,-
Glaukoma - Revisi Bleb (Cito) Rp. 7.282.400,-
Glaukoma - Tindakan cyclodia termi (Cito) Rp. 7.282.400,-
Glaukoma - Trabekulektomi (Cito) Rp. 7.282.400,-
Glaukoma - Trabekulektomi, Phaco dan IOL (Cito) Rp. 7.282.400,-
Glaukoma - Trabekulotomi anak atau bayi (Cito) Rp. 7.282.400,-
Glaukoma - Trabekulotomi dan trabekulektomi anak atau bayi (Cito) Rp. 7.282.400,-
Glaukoma - Transkleral Foto Coagulasi (Cito) Rp. 7.282.400,-
Glaukoma - Tubes implan (Cito) Rp. 7.282.400,-
Hand - Elbow (medical epicondyle), fracture, excision bony fragment (Cito) Rp. 7.282.400,-
Hand - Elbow, tennis elbow, release (Cito) Rp. 7.282.400,-
Hand - Jari, closed fracture or dislocation, reduksi terbuka dan fixation (singl Rp. 7.282.400,-
Hand - Jari, crush injuries (complex) wound debridement (Cito) Rp. 7.282.400,-
Hand - Jari, crush injury (simple), wound debridement (Cito) Rp. 7.282.400,-
Hand - Jari, deep infection, drainage (Cito) Rp. 7.282.400,-
Hand - Jari, deformity, instrinsic muscle extensor relocation (Cito) Rp. 7.282.400,-
Hand - Jari, deformity, instrinsic muscle release (Cito) Rp. 7.282.400,-
Hand - Jari, foreign body (superficial), removal with mobilization of neurovascu Rp. 7.282.400,-
Hand - Jari, injury, debridement (Cito) Rp. 7.282.400,-
Hand - Jari, jaringan lunak tumor, excision (Cito) Rp. 7.282.400,-
Hand - Jari, macrodactyly, debulking (Cito) Rp. 7.282.400,-
Hand - Jari, polydactyly, amputasi with rekonstruksi (Cito) Rp. 7.282.400,-
Hand - Jari, ring construction (single), koreksi (Cito) Rp. 7.282.400,-
Hand - Jari, superficial infection, drainage (Cito) Rp. 7.282.400,-
Hand - Jari, syndactili (single) koreksi (Cito) Rp. 7.282.400,-
Hand - Jari, trauma, terminalisation (multiple) (Cito) Rp. 7.282.400,-
Hand - Jari, trauma, terminalisation (single) (Cito) Rp. 7.282.400,-
Hand - Jari, tumors, excision with dissection of neurovasculer bundle (Cito) Rp. 7.282.400,-
Hand - Jari, various lesions, amputasi (multiple) (Cito) Rp. 7.282.400,-
Hand - Jari, various lesions, Ray amputasi (single) (Cito) Rp. 7.282.400,-
Hand - Jari, wart, com, naevus, excision (Cito) Rp. 7.282.400,-
Hand - Jaringan lunak (palmar space), abscess, drainage (Cito) Rp. 7.282.400,-
Hand - Kulit dan jaringan subkultis, defect (single digit), free full thickness Rp. 7.282.400,-
Hand - Kulit dan jaringan subkus, defect (deep) staged distant flap (division) ( Rp. 7.282.400,-
Hand - Kulit dan jaringan subkutis, defect (multiple digits) staged local flap ( Rp. 7.282.400,-
Hand - Nail bed, Laceration, repair (single) (Cito) Rp. 7.282.400,-
Hand - Nerve various lesions, primary or secondary suture (Cito) Rp. 7.282.400,-
Hand - Nerve, Various Lesions, biopsy (Cito) Rp. 7.282.400,-
Hand - Repair muscle (Cito) Rp. 7.282.400,-
Hand - Sendi (extremitas atas) rush rods / wires / screw removal (Cito) Rp. 7.282.400,-
Hand - Sendi (jari), contracture, capsulectomy (capsulotomy) (Cito) Rp. 7.282.400,-
Hand - Sendi (wrist), various lesions, arthrodesis (Cito) Rp. 7.282.400,-
Hand - Tendon (ekstremitas atas) , contracture, tenotomy (Cito) Rp. 7.282.400,-
Hand - Tendon extensor (extremitas atas) injury, repair (single) (Cito) Rp. 7.282.400,-
Hand - Tendon flexor (ekstremitas atas) adhesion, tenolysis (single) (Cito) Rp. 7.282.400,-
Hand - Tendon flexor (ekstremitas atas), adhesion, tenolysis (multiple) (Cito) Rp. 7.282.400,-
Hand - Tendon sheath (ekstremitas atas), De Quervain's (unilateral), Release (Ci Rp. 7.282.400,-
Hand - Tendon sheath (ekstremitas atas), tenosynovitis (multiple), drainage (Cit Rp. 7.282.400,-
Hand - Tendon sheath (ekstremitas atas), Trigger Jari (multiple), Release (Cito) Rp. 7.282.400,-
Hand - Tendon sheath (extremitas atas) ganglion atau villo nodular synovitis, ex Rp. 7.282.400,-
Hand - Tendon sheath (extremitas atas), tenosynovitis (single), drainage (Cito) Rp. 7.282.400,-
Hand - Tendon sheath (extremitas atas), trigger jari (single) release (Cito) Rp. 7.282.400,-
Hand - Tendon sheath dan jaringan subkutis, ganglion (small bursa), excision (Ci Rp. 7.282.400,-
Hidrokel Testis / Funikuli ** (Cito) Rp. 7.282.400,-
Implantasi iris artifisial (Cito) Rp. 7.282.400,-
Implantasi piggyback IOL (Cito) Rp. 7.282.400,-
Incision of perianal abscess (Cito) Rp. 7.282.400,-
Injeksi intravitreal (Cito) Rp. 7.282.400,-
Insertion of synthetic implant in facial bone (Cito) Rp. 7.282.400,-
Insisi atau Eksisi gingiva (Cito) Rp. 7.282.400,-
Insisi flegmon dasar mulut (Cito) Rp. 7.282.400,-
Internal Fiksasi fraktur condylus mandibula (Cito) Rp. 7.282.400,-
Internal fiksasi fraktur maksilofasial 5 tempat patahan atau lebih (Cito) Rp. 7.282.400,-
Internal Fiksasi fraktur Mandibula segmental (Cito) Rp. 7.282.400,-
Keratoplasty tembus (Cito) Rp. 7.282.400,-
Keratoprosthesis (Cito) Rp. 7.282.400,-
Knee - Open knee debridement (Cito) Rp. 7.282.400,-
Knee - Perypheral nerve ablation (Cito) Rp. 7.282.400,-
Knee - Perypheral nerve lysis (Cito) Rp. 7.282.400,-
Kolonoskopi (Cito) Rp. 7.282.400,-
Labioshisis * (Cito) Rp. 7.282.400,-
Laring dan Faring - Laringofisure (Cito) Rp. 7.282.400,-
Laring dan Faring - Pemasangan T-Tube (Cito) Rp. 7.282.400,-
Left lateral anal sphincterotomy (Cito) Rp. 7.282.400,-
Ligasi vaskular ekstremitas (Cito) Rp. 7.282.400,-
Ligation of hemorrhoids (Cito) Rp. 7.282.400,-
Limbal Relaxing Incision (LRI) (Cito) Rp. 7.282.400,-
Maksilektomi total dan Rekonstruksi * (Cito) Rp. 7.282.400,-
Multipel excision of lesion of breast with narcose (Cito) Rp. 7.282.400,-
Mutilasi digiti ekstremitas (Multiple) (Cito) Rp. 7.282.400,-
Obstetri - Histerorafi (Cito) Rp. 7.282.400,-
Obstetri - Kolporafi anterior (Cito) Rp. 7.282.400,-
Obstetri - Kolporafi posterior (Cito) Rp. 7.282.400,-
Obstetri - Mioma geburt (Cito) Rp. 7.282.400,-
Obstetri - Sectio caesaria tanpa penyulit (Cito) Rp. 7.282.400,-
Odontektomi tingkat I (Cito) Rp. 7.282.400,-
Onkologi - Biopsi tumor hidung, lidah, nasofaring (narkosis) (Cito) Rp. 7.282.400,-
Onkologi - Excision soft tissue tumor < 5 cm (kecil) (Cito) Rp. 7.282.400,-
Onkologi - Limb ablation dengan above atau below knee amputation bone tumor (Cit Rp. 7.282.400,-
Onkologi - Open biopsy bone tumor (Cito) Rp. 7.282.400,-
Onkologi - Open biopsy soft tissue (Cito) Rp. 7.282.400,-
Onkologi - Ray amputation jari (Cito) Rp. 7.282.400,-
Onkologi - Tumor jinak tulang (curettage dan bonegraft) (Cito) Rp. 7.282.400,-
Open biopsi of breast (Cito) Rp. 7.282.400,-
Open biopsy of salivary gland or duct (Cito) Rp. 7.282.400,-
Open reduction of alveolar fracture * (Cito) Rp. 7.282.400,-
Osteotomi eksisi tulang maksilofasial (Cito) Rp. 7.282.400,-
Other appendectomy (elective) * (Cito) Rp. 7.282.400,-
Other bilateral femoral hernioraphy (Cito) Rp. 7.282.400,-
Other hernia repair (Cito) Rp. 7.282.400,-
Other incidental appendectomy * (Cito) Rp. 7.282.400,-
Other incision of anus (Cito) Rp. 7.282.400,-
Other lysis of peritoneal adhesions (Cito) Rp. 7.282.400,-
Other operations on anus (Cito) Rp. 7.282.400,-
Other operations on trachea (Cito) Rp. 7.282.400,-
Other procedures on hemorrhoids (Cito) Rp. 7.282.400,-
Other reconstruction of mandible (Cito) Rp. 7.282.400,-
Other reconstruction of other facial bone (Cito) Rp. 7.282.400,-
Other repair and plastic operation of tongue (Cito) Rp. 7.282.400,-
Other repair of abdominal wall (Cito) Rp. 7.282.400,-
Other umbilical herniorraphy* (Cito) Rp. 7.282.400,-
Other unilateral femoral herniorraphy (Cito) Rp. 7.282.400,-
Otologi - Meatoplasti (Cito) Rp. 7.282.400,-
Otologi - Miringoplasti (Cito) Rp. 7.282.400,-
Otologi - Pemasangan grommet (Cito) Rp. 7.282.400,-
Palatoshisis ** (Cito) Rp. 7.282.400,-
Partial glossectomy (Cito) Rp. 7.282.400,-
Pediatrik - Bony bridge release pada kasus tarsal coalition (Cito) Rp. 7.282.400,-
Pediatrik - Closed reduction dan pemasangan gips fraktur femur anak (Cito) Rp. 7.282.400,-
Pediatrik - Combined Trabeculotomy dan trabeculectomy (Cito) Rp. 7.282.400,-
Pediatrik - Debridement dan soft tissue release pada infeksi sendi (Cito) Rp. 7.282.400,-
Pediatrik - Debridement fraktur terbuka anak (Cito) Rp. 7.282.400,-
Pediatrik - Debridement, nekrotomy dan saucerization pada chronic osteomyelits ( Rp. 7.282.400,-
Pediatrik - Fiksasi cannualted screw pada SCFE (Cito) Rp. 7.282.400,-
Pediatrik - Hemangioma : injeksi intralesi (Cito) Rp. 7.282.400,-
Pediatrik - Injeksi botoks kasus Cerebral Palsy (Cito) Rp. 7.282.400,-
Pediatrik - Katarak (Cito) Rp. 7.282.400,-
Pediatrik - Koreksi curly toe (Cito) Rp. 7.282.400,-
Pediatrik - Koreksi overriding toe polidactili (Cito) Rp. 7.282.400,-
Pediatrik - Koreksi syndactili kaki (Cito) Rp. 7.282.400,-
Pediatrik - Nekrotomy (Cito) Rp. 7.282.400,-
Pediatrik - Open achilles tendon lengthening (Cito) Rp. 7.282.400,-
Pediatrik - Percutaneous tendon tenotomy (Cito) Rp. 7.282.400,-
Pediatrik - Pupilloplasty, membranectomy, anterior vitrectomy, secondary IOL (Ci Rp. 7.282.400,-
Pediatrik - Reposisi tertutup dan gips fraktur anak kecuali fraktur femur (Cito) Rp. 7.282.400,-
Pediatrik - Reposisi tertutup dan percutaneous pinning fraktur seputar sendi sik Rp. 7.282.400,-
Pediatrik - Reposisi tertutup, arthrogram dan hemispica DDH (Cito) Rp. 7.282.400,-
Pediatrik - RetCam and Narkose (Cito) Rp. 7.282.400,-
Pediatrik - Skin graft (Cito) Rp. 7.282.400,-
Pediatrik - Soft tissue release and enhancement kasus habitual dislokasi lutut a Rp. 7.282.400,-
Pediatrik - Soft tissue release kelainan Cerebral Palsy, Arthrogryposis, Spina B Rp. 7.282.400,-
Pediatrik - Synovectomy arthroscopy pada penderita hemofilia (Cito) Rp. 7.282.400,-
Pediatrik - Trabeculotomy pada glaucoma congenital (Cito) Rp. 7.282.400,-
Pembedahan teleangiectasis (Cito) Rp. 7.282.400,-
Pengangkatan encircling silicone band (Cito) Rp. 7.282.400,-
Perikardiektomi * (Cito) Rp. 7.282.400,-
Phaco dan IOL multifokal atau torik (Cito) Rp. 7.282.400,-
Phakik IOL (Cito) Rp. 7.282.400,-
Phototherapeutic keratectomy (PTK) (Cito) Rp. 7.282.400,-
Pionephrosis (Cito) Rp. 7.282.400,-
Plastik Rekionstruksi - Regional flap tidak luas (Cito) Rp. 7.282.400,-
Pleural window (eloeser flap) * (Cito) Rp. 7.282.400,-
Plikasi bulae / bleb emfisematous (Cito) Rp. 7.282.400,-
Pneumatic retinopexy (Cito) Rp. 7.282.400,-
Posterior vitrectomy dan endo laser dengan atau tanpa Silikon Oil / Gas dan inje Rp. 7.282.400,-
Posterior vitrectomy dengaan atau tanpa Sceral buckling (Cito) Rp. 7.282.400,-
Prosedur Sistrunk kista duktus tiroglosus (Cito) Rp. 7.282.400,-
Pulmonary decortication * (Cito) Rp. 7.282.400,-
Rekonstruksi - Cryo/cauter pada trichiasis (Cito) Rp. 7.282.400,-
Rekonstruksi - Eksternal DCR dan silikon tube (Cito) Rp. 7.282.400,-
Rekonstruksi - Ektropion 1 kelopak * (Cito) Rp. 7.282.400,-
Rekonstruksi - Entropion 1 kelopak (Cito) Rp. 7.282.400,-
Rekonstruksi - Eviserasi / enukleasi (Cito) Rp. 7.282.400,-
Rekonstruksi - Eviserasi / enukleasi dan implan (Cito) Rp. 7.282.400,-
Rekonstruksi - Graft Bibir pada Ptisis Bulbi (Cito) Rp. 7.282.400,-
Rekonstruksi - Koreksi Lagoftalmos dengan beban emas (Cito) Rp. 7.282.400,-
Rekonstruksi - Koreksi Ptosis * (Cito) Rp. 7.282.400,-
Rekonstruksi - Koreksi simblefaron (Cito) Rp. 7.282.400,-
Rekonstruksi - Probing (Cito) Rp. 7.282.400,-
Rekonstruksi - Repair Ruptur palpebra (dengan rupture canalis lacrimalis) (Cito) Rp. 7.282.400,-
Rekonstruksi - Repair Ruptur palpebra * (Cito) Rp. 7.282.400,-
Rekonstruksi - Tarsorafi (Cito) Rp. 7.282.400,-
Release kontraktur mandibula (Cito) Rp. 7.282.400,-
Release tortikolis (Cito) Rp. 7.282.400,-
Removal of foreign body from peritoneal cavity (Cito) Rp. 7.282.400,-
Removal of foreign body from retro-peritoneal cavity (Cito) Rp. 7.282.400,-
Repair iridodyalisis (Cito) Rp. 7.282.400,-
Repair of direct inguinal hernia (Cito) Rp. 7.282.400,-
Repair of direct inguinal hernia with graft or prosthesis (Cito) Rp. 7.282.400,-
Repair of indirect inguinal hernia (Cito) Rp. 7.282.400,-
Repair of indirect inguinal hernia with graft or prosthesis (Cito) Rp. 7.282.400,-
Repair of laceration, cornea and or sclera, perforating (Cito) Rp. 7.282.400,-
Repair of laceration, cornea, non perforating (Cito) Rp. 7.282.400,-
Repair of other hernia of anterior abdominal wall (Cito) Rp. 7.282.400,-
Repair of other hernia of anterior abdominal wall with prosthesis (Cito) Rp. 7.282.400,-
Repair of umbilical hernia with prosthesis * (Cito) Rp. 7.282.400,-
Reposisi IOL (Cito) Rp. 7.282.400,-
Reposisi Iris (Cito) Rp. 7.282.400,-
Reposisi tertutup fraktur nasal (Cito) Rp. 7.282.400,-
Reseksi mandibula dengan rekonstruksi graft tulang / K-wire (Cito) Rp. 7.282.400,-
Rinologi - Konkotomi / Konkoplasti (Cito) Rp. 7.282.400,-
Rinologi - Nasoendoskopi Dengan tindakan (Cito) Rp. 7.282.400,-
Rinologi - Sinuskopi / Sinoskopi (Narkosis) (Cito) Rp. 7.282.400,-
Rupture tendon achiles (Cito) Rp. 7.282.400,-
Scleral buckle, cryo dan C3F8 (Cito) Rp. 7.282.400,-
Scleral buckling (Cito) Rp. 7.282.400,-
Sekunder IOL (Cito) Rp. 7.282.400,-
Somnoplasty (Cito) Rp. 7.282.400,-
Spine - Biopsy vertebra (1 level) * (Cito) Rp. 7.282.400,-
Spine - Plaster application of the spine (Cito) Rp. 7.282.400,-
Strabismus 1 otot (Cito) Rp. 7.282.400,-
Strabismus 2 otot (Cito) Rp. 7.282.400,-
Strabismus 3 otot (Cito) Rp. 7.282.400,-
Suture of laceration of large intestine (Cito) Rp. 7.282.400,-
Suture of laceration of small intestine, except duodenum (Cito) Rp. 7.282.400,-
Suture of peritoneum (Cito) Rp. 7.282.400,-
Tatto cornea (Cito) Rp. 7.282.400,-
Torakotomi / sternotomi eksplorasi * (Cito) Rp. 7.282.400,-
Torsio testis ** (Cito) Rp. 7.282.400,-
Trakeostomi temporary ** (Cito) Rp. 7.282.400,-
Trauma - Acute ankle joint dislocation (Cito) Rp. 7.282.400,-
Trauma - Acute elbow joint dislocation (Cito) Rp. 7.282.400,-
Trauma - Acute hip joint dislocation (Cito) Rp. 7.282.400,-
Trauma - Acute knee joint dislocation (Cito) Rp. 7.282.400,-
Trauma - Closed fraktur shaft femur * (Cito) Rp. 7.282.400,-
Trauma - Closed fraktur shaft humerus * (Cito) Rp. 7.282.400,-
Trauma - Closed fraktur shaft radius (Cito) Rp. 7.282.400,-
Trauma - Closed fraktur shaft tibia (Cito) Rp. 7.282.400,-
Trauma - Closed fraktur shaft ulna (Cito) Rp. 7.282.400,-
Trauma - Fraktur tulang panjang dengan MIPO atau ORIF dan implant removal (long Rp. 7.282.400,-
Trauma - Jaringan granulasi dengan STSG (Cito) Rp. 7.282.400,-
Trauma - Kompartemen otot (Cito) Rp. 7.282.400,-
Trauma - Nekrotik tissue > 1 kompartemen dengan debridement (Cito) Rp. 7.282.400,-
Trauma - Nekrotik tissue dengan debridement (Cito) Rp. 7.282.400,-
Trauma - Open fraktur shaft femur grade 1 dan 2 (Cito) Rp. 7.282.400,-
Trauma - Open fraktur shaft humerus grade 1 dan 2 (Cito) Rp. 7.282.400,-
Trauma - Open fraktur shaft radius grade 1 dan 2 (Cito) Rp. 7.282.400,-
Trauma - Open fraktur shaft tibia grade 1 dan 2 (Cito) Rp. 7.282.400,-
Trauma - Open fraktur shaft ulna grade 1 dan 2 (Cito) Rp. 7.282.400,-
Tumor - Biopsi tumor kelopak (Cito) Rp. 7.282.400,-
Tumor - Biopsi tumor orbita (Cito) Rp. 7.282.400,-
Tumor - Eksenterasi (Cito) Rp. 7.282.400,-
Tumor - Eksisi tumor adneksa (Cito) Rp. 7.282.400,-
Tumor - Ekstirpasi Tumor Orbita (Cito) Rp. 7.282.400,-
Tumor - Orbital dekompresi 1 tulang (Cito) Rp. 7.282.400,-
Tumor - Orbital dekompresi 2 tulang (Cito) Rp. 7.282.400,-
Tumor - Orbitotomi anterior (Cito) Rp. 7.282.400,-
Tumor - Orbitotomi lateral (Cito) Rp. 7.282.400,-
Unilateral excision of ectopic breast tissue (mamma aberans) (Cito) Rp. 7.282.400,-
Unilateral repair of femoral atau inguinal hernia with or without graft or prost Rp. 7.282.400,-
Unilateral thyroid lobectomy (Cito) Rp. 7.282.400,-
Wide excision of soft tissue tumor (Cito) Rp. 7.282.400,-
Uff Arch Barr (Cito) Rp. 6.998.699,-
Bilateral excision of ectopic breast tissue (mamma aberans) (Cito) Rp. 6.998.699,-
Hand - Elbow (medical epicondyle), fracture, excision bony fragment (Cito) Rp. 6.998.699,-
Hand - Elbow, tennis elbow, release (Cito) Rp. 6.998.699,-
Hand - Jari, closed fracture or dislocation, reduksi terbuka dan fixation (singl Rp. 6.998.699,-
Hand - Jari, crush injuries (complex) wound debridement (Cito) Rp. 6.998.699,-
Hand - Jari, crush injury (simple), wound debridement (Cito) Rp. 6.998.699,-
Hand - Jari, deep infection, drainage (Cito) Rp. 6.998.699,-
Hand - Jari, deformity, instrinsic muscle extensor relocation (Cito) Rp. 6.998.699,-
Hand - Jari, deformity, instrinsic muscle release (Cito) Rp. 6.998.699,-
Hand - Jari, foreign body (superficial), removal with mobilization of neurovascu Rp. 6.998.699,-
Hand - Jari, injury, debridement (Cito) Rp. 6.998.699,-
Bilateral inguinal hernia repair with graft or prosthesis (not otherwise specifi Rp. 6.998.699,-
Hand - Jari, jaringan lunak tumor, excision (Cito) Rp. 6.998.699,-
Hand - Jari, macrodactyly, debulking (Cito) Rp. 6.998.699,-
Hand - Jari, polydactyly, amputasi with rekonstruksi (Cito) Rp. 6.998.699,-
Hand - Jari, ring construction (single), koreksi (Cito) Rp. 6.998.699,-
Hand - Jari, superficial infection, drainage (Cito) Rp. 6.998.699,-
Hand - Jari, syndactili (single) koreksi (Cito) Rp. 6.998.699,-
Hand - Jari, trauma, terminalisation (multiple) (Cito) Rp. 6.998.699,-
Hand - Jari, trauma, terminalisation (single) (Cito) Rp. 6.998.699,-
Hand - Jari, tumors, excision with dissection of neurovasculer bundle (Cito) Rp. 6.998.699,-
Hand - Jari, various lesions, amputasi (multiple) (Cito) Rp. 6.998.699,-
Bilateral multipel excision of lesion of breast with narcose (Cito) Rp. 6.998.699,-
Hand - Jari, various lesions, Ray amputasi (single) (Cito) Rp. 6.998.699,-
Hand - Jari, wart, com, naevus, excision (Cito) Rp. 6.998.699,-
Hand - Jaringan lunak (palmar space), abscess, drainage (Cito) Rp. 6.998.699,-
Hand - Kulit dan jaringan subkultis, defect (single digit), free full thickness Rp. 6.998.699,-
Hand - Kulit dan jaringan subkus, defect (deep) staged distant flap (division) ( Rp. 6.998.699,-
Hand - Kulit dan jaringan subkutis, defect (multiple digits) staged local flap ( Rp. 6.998.699,-
Hand - Nail bed, Laceration, repair (single) (Cito) Rp. 6.998.699,-
Hand - Nerve various lesions, primary or secondary suture (Cito) Rp. 6.998.699,-
Hand - Nerve, Various Lesions, biopsy (Cito) Rp. 6.998.699,-
Hand - Repair muscle (Cito) Rp. 6.998.699,-
Bilateral ovariectomy (Cito) Rp. 6.998.699,-
Hand - Sendi (extremitas atas) rush rods / wires / screw removal (Cito) Rp. 6.998.699,-
Hand - Sendi (jari), contracture, capsulectomy (capsulotomy) (Cito) Rp. 6.998.699,-
Hand - Sendi (wrist), various lesions, arthrodesis (Cito) Rp. 6.998.699,-
Hand - Tendon (ekstremitas atas) , contracture, tenotomy (Cito) Rp. 6.998.699,-
Hand - Tendon extensor (extremitas atas) injury, repair (single) (Cito) Rp. 6.998.699,-
Hand - Tendon flexor (ekstremitas atas) adhesion, tenolysis (single) (Cito) Rp. 6.998.699,-
Hand - Tendon flexor (ekstremitas atas), adhesion, tenolysis (multiple) (Cito) Rp. 6.998.699,-
Hand - Tendon sheath (ekstremitas atas), De Quervain's (unilateral), Release (Ci Rp. 6.998.699,-
Hand - Tendon sheath (ekstremitas atas), tenosynovitis (multiple), drainage (Cit Rp. 6.998.699,-
Hand - Tendon sheath (ekstremitas atas), Trigger Jari (multiple), Release (Cito) Rp. 6.998.699,-
Bilateral repair of direct inguinal hernia (Cito) Rp. 6.998.699,-
Hand - Tendon sheath (extremitas atas) ganglion atau villo nodular synovitis, ex Rp. 6.998.699,-
Hand - Tendon sheath (extremitas atas), tenosynovitis (single), drainage (Cito) Rp. 6.998.699,-
Hand - Tendon sheath (extremitas atas), trigger jari (single) release (Cito) Rp. 6.998.699,-
Hand - Tendon sheath dan jaringan subkutis, ganglion (small bursa), excision (Ci Rp. 6.998.699,-
Hidrokel Testis / Funikuli ** (Cito) Rp. 6.998.699,-
Implantasi iris artifisial (Cito) Rp. 6.998.699,-
Implantasi piggyback IOL (Cito) Rp. 6.998.699,-
Incision of perianal abscess (Cito) Rp. 6.998.699,-
Injeksi intravitreal (Cito) Rp. 6.998.699,-
Insertion of synthetic implant in facial bone (Cito) Rp. 6.998.699,-
Bilateral repair of direct inguinal hernia with graft or prosthetis (Cito) Rp. 6.998.699,-
Insisi atau Eksisi gingiva (Cito) Rp. 6.998.699,-
Insisi flegmon dasar mulut (Cito) Rp. 6.998.699,-
Internal Fiksasi fraktur condylus mandibula (Cito) Rp. 6.998.699,-
Internal fiksasi fraktur maksilofasial 5 tempat patahan atau lebih (Cito) Rp. 6.998.699,-
Internal Fiksasi fraktur Mandibula segmental (Cito) Rp. 6.998.699,-
Keratoplasty tembus (Cito) Rp. 6.998.699,-
Keratoprosthesis (Cito) Rp. 6.998.699,-
Knee - Open knee debridement (Cito) Rp. 6.998.699,-
Knee - Perypheral nerve ablation (Cito) Rp. 6.998.699,-
Knee - Perypheral nerve lysis (Cito) Rp. 6.998.699,-
Bilateral repair of femoral hernia with/without graft of prosthesis (Cito) Rp. 6.998.699,-
Kolonoskopi (Cito) Rp. 6.998.699,-
Labioshisis * (Cito) Rp. 6.998.699,-
Laring dan Faring - Laringofisure (Cito) Rp. 6.998.699,-
Laring dan Faring - Pemasangan T-Tube (Cito) Rp. 6.998.699,-
Left lateral anal sphincterotomy (Cito) Rp. 6.998.699,-
Ligasi vaskular ekstremitas (Cito) Rp. 6.998.699,-
Ligation of hemorrhoids (Cito) Rp. 6.998.699,-
Limbal Relaxing Incision (LRI) (Cito) Rp. 6.998.699,-
Maksilektomi total dan Rekonstruksi * (Cito) Rp. 6.998.699,-
Multipel excision of lesion of breast with narcose (Cito) Rp. 6.998.699,-
Bilateral repair of indirect inguinal hernia (Cito) Rp. 6.998.699,-
Mutilasi digiti ekstremitas (Multiple) (Cito) Rp. 6.998.699,-
Obstetri - Histerorafi (Cito) Rp. 6.998.699,-
Obstetri - Kolporafi anterior (Cito) Rp. 6.998.699,-
Obstetri - Kolporafi posterior (Cito) Rp. 6.998.699,-
Obstetri - Mioma geburt (Cito) Rp. 6.998.699,-
Obstetri - Sectio caesaria tanpa penyulit (Cito) Rp. 6.998.699,-
Odontektomi tingkat I (Cito) Rp. 6.998.699,-
Onkologi - Biopsi tumor hidung, lidah, nasofaring (narkosis) (Cito) Rp. 6.998.699,-
Onkologi - Excision soft tissue tumor < 5 cm (kecil) (Cito) Rp. 6.998.699,-
Onkologi - Limb ablation dengan above atau below knee amputation bone tumor (Cit Rp. 6.998.699,-
Bilateral repair of indirect inguinal hernia with graft or prosthesis (Cito) Rp. 6.998.699,-
Onkologi - Open biopsy bone tumor (Cito) Rp. 6.998.699,-
Onkologi - Open biopsy soft tissue (Cito) Rp. 6.998.699,-
Onkologi - Ray amputation jari (Cito) Rp. 6.998.699,-
Onkologi - Tumor jinak tulang (curettage dan bonegraft) (Cito) Rp. 6.998.699,-
Open biopsi of breast (Cito) Rp. 6.998.699,-
Open biopsy of salivary gland or duct (Cito) Rp. 6.998.699,-
Open reduction of alveolar fracture * (Cito) Rp. 6.998.699,-
Osteotomi eksisi tulang maksilofasial (Cito) Rp. 6.998.699,-
Other appendectomy (elective) * (Cito) Rp. 6.998.699,-
Other bilateral femoral hernioraphy (Cito) Rp. 6.998.699,-
Bilateral repair of inguinal hernia, not otherwise specified (Cito) Rp. 6.998.699,-
Other hernia repair (Cito) Rp. 6.998.699,-
Other incidental appendectomy * (Cito) Rp. 6.998.699,-
Other incision of anus (Cito) Rp. 6.998.699,-
Other lysis of peritoneal adhesions (Cito) Rp. 6.998.699,-
Other operations on anus (Cito) Rp. 6.998.699,-
Other operations on trachea (Cito) Rp. 6.998.699,-
Other procedures on hemorrhoids (Cito) Rp. 6.998.699,-
Other reconstruction of mandible (Cito) Rp. 6.998.699,-
Other reconstruction of other facial bone (Cito) Rp. 6.998.699,-
Other repair and plastic operation of tongue (Cito) Rp. 6.998.699,-
Uff Arch Barr dan suspensi maksila (Cito) Rp. 6.998.699,-
Bilateral repair of inguinal hernia, one direct and one indirect (Cito) Rp. 6.998.699,-
Other repair of abdominal wall (Cito) Rp. 6.998.699,-
Other umbilical herniorraphy* (Cito) Rp. 6.998.699,-
Other unilateral femoral herniorraphy (Cito) Rp. 6.998.699,-
Otologi - Meatoplasti (Cito) Rp. 6.998.699,-
Otologi - Miringoplasti (Cito) Rp. 6.998.699,-
Otologi - Pemasangan grommet (Cito) Rp. 6.998.699,-
Palatoshisis ** (Cito) Rp. 6.998.699,-
Partial glossectomy (Cito) Rp. 6.998.699,-
Pediatrik - Bony bridge release pada kasus tarsal coalition (Cito) Rp. 6.998.699,-
Pediatrik - Closed reduction dan pemasangan gips fraktur femur anak (Cito) Rp. 6.998.699,-
Bilateral repair of inguinal hernia, one direct and one indirect, with graft or Rp. 6.998.699,-
Pediatrik - Combined Trabeculotomy dan trabeculectomy (Cito) Rp. 6.998.699,-
Pediatrik - Debridement dan soft tissue release pada infeksi sendi (Cito) Rp. 6.998.699,-
Pediatrik - Debridement fraktur terbuka anak (Cito) Rp. 6.998.699,-
Pediatrik - Debridement, nekrotomy dan saucerization pada chronic osteomyelits ( Rp. 6.998.699,-
Pediatrik - Fiksasi cannualted screw pada SCFE (Cito) Rp. 6.998.699,-
Pediatrik - Hemangioma : injeksi intralesi (Cito) Rp. 6.998.699,-
Pediatrik - Injeksi botoks kasus Cerebral Palsy (Cito) Rp. 6.998.699,-
Pediatrik - Katarak (Cito) Rp. 6.998.699,-
Pediatrik - Koreksi curly toe (Cito) Rp. 6.998.699,-
Pediatrik - Koreksi overriding toe polidactili (Cito) Rp. 6.998.699,-
Biopsi pembuluh darah perifer * (Cito) Rp. 6.998.699,-
Pediatrik - Koreksi syndactili kaki (Cito) Rp. 6.998.699,-
Pediatrik - Nekrotomy (Cito) Rp. 6.998.699,-
Pediatrik - Open achilles tendon lengthening (Cito) Rp. 6.998.699,-
Pediatrik - Percutaneous tendon tenotomy (Cito) Rp. 6.998.699,-
Pediatrik - Pupilloplasty, membranectomy, anterior vitrectomy, secondary IOL (Ci Rp. 6.998.699,-
Pediatrik - Reposisi tertutup dan gips fraktur anak kecuali fraktur femur (Cito) Rp. 6.998.699,-
Pediatrik - Reposisi tertutup dan percutaneous pinning fraktur seputar sendi sik Rp. 6.998.699,-
Pediatrik - Reposisi tertutup, arthrogram dan hemispica DDH (Cito) Rp. 6.998.699,-
Pediatrik - RetCam and Narkose (Cito) Rp. 6.998.699,-
Pediatrik - Skin graft (Cito) Rp. 6.998.699,-
Biopsi perikardium * (Cito) Rp. 6.998.699,-
Pediatrik - Soft tissue release and enhancement kasus habitual dislokasi lutut a Rp. 6.998.699,-
Pediatrik - Soft tissue release kelainan Cerebral Palsy, Arthrogryposis, Spina B Rp. 6.998.699,-
Pediatrik - Synovectomy arthroscopy pada penderita hemofilia (Cito) Rp. 6.998.699,-
Pediatrik - Trabeculotomy pada glaucoma congenital (Cito) Rp. 6.998.699,-
Pembedahan teleangiectasis (Cito) Rp. 6.998.699,-
Pengangkatan encircling silicone band (Cito) Rp. 6.998.699,-
Perikardiektomi * (Cito) Rp. 6.998.699,-
Phaco dan IOL multifokal atau torik (Cito) Rp. 6.998.699,-
Phakik IOL (Cito) Rp. 6.998.699,-
Phototherapeutic keratectomy (PTK) (Cito) Rp. 6.998.699,-
Biopsi terbuka bronkhus * (Cito) Rp. 6.998.699,-
Pionephrosis (Cito) Rp. 6.998.699,-
Plastik Rekionstruksi - Regional flap tidak luas (Cito) Rp. 6.998.699,-
Pleural window (eloeser flap) * (Cito) Rp. 6.998.699,-
Plikasi bulae / bleb emfisematous (Cito) Rp. 6.998.699,-
Pneumatic retinopexy (Cito) Rp. 6.998.699,-
Posterior vitrectomy dan endo laser dengan atau tanpa Silikon Oil / Gas dan inje Rp. 6.998.699,-
Posterior vitrectomy dengaan atau tanpa Sceral buckling (Cito) Rp. 6.998.699,-
Prosedur Sistrunk kista duktus tiroglosus (Cito) Rp. 6.998.699,-
Pulmonary decortication * (Cito) Rp. 6.998.699,-
Rekonstruksi - Cryo/cauter pada trichiasis (Cito) Rp. 6.998.699,-
Biopsi terbuka diafragma * (Cito) Rp. 6.998.699,-
Rekonstruksi - Eksternal DCR dan silikon tube (Cito) Rp. 6.998.699,-
Rekonstruksi - Ektropion 1 kelopak * (Cito) Rp. 6.998.699,-
Rekonstruksi - Entropion 1 kelopak (Cito) Rp. 6.998.699,-
Rekonstruksi - Eviserasi / enukleasi (Cito) Rp. 6.998.699,-
Rekonstruksi - Eviserasi / enukleasi dan implan (Cito) Rp. 6.998.699,-
Rekonstruksi - Graft Bibir pada Ptisis Bulbi (Cito) Rp. 6.998.699,-
Rekonstruksi - Koreksi Lagoftalmos dengan beban emas (Cito) Rp. 6.998.699,-
Rekonstruksi - Koreksi Ptosis * (Cito) Rp. 6.998.699,-
Rekonstruksi - Koreksi simblefaron (Cito) Rp. 6.998.699,-
Rekonstruksi - Probing (Cito) Rp. 6.998.699,-
Biopsi terbuka mediastinum * (Cito) Rp. 6.998.699,-
Rekonstruksi - Repair Ruptur palpebra (dengan rupture canalis lacrimalis) (Cito) Rp. 6.998.699,-
Rekonstruksi - Repair Ruptur palpebra * (Cito) Rp. 6.998.699,-
Rekonstruksi - Tarsorafi (Cito) Rp. 6.998.699,-
Release kontraktur mandibula (Cito) Rp. 6.998.699,-
Release tortikolis (Cito) Rp. 6.998.699,-
Removal of foreign body from peritoneal cavity (Cito) Rp. 6.998.699,-
Removal of foreign body from retro-peritoneal cavity (Cito) Rp. 6.998.699,-
Repair iridodyalisis (Cito) Rp. 6.998.699,-
Repair of direct inguinal hernia (Cito) Rp. 6.998.699,-
Repair of direct inguinal hernia with graft or prosthesis (Cito) Rp. 6.998.699,-
Biopsi terbuka paru * (Cito) Rp. 6.998.699,-
Repair of indirect inguinal hernia (Cito) Rp. 6.998.699,-
Repair of indirect inguinal hernia with graft or prosthesis (Cito) Rp. 6.998.699,-
Repair of laceration, cornea and or sclera, perforating (Cito) Rp. 6.998.699,-
Repair of laceration, cornea, non perforating (Cito) Rp. 6.998.699,-
Repair of other hernia of anterior abdominal wall (Cito) Rp. 6.998.699,-
Repair of other hernia of anterior abdominal wall with prosthesis (Cito) Rp. 6.998.699,-
Repair of umbilical hernia with prosthesis * (Cito) Rp. 6.998.699,-
Reposisi IOL (Cito) Rp. 6.998.699,-
Reposisi Iris (Cito) Rp. 6.998.699,-
Reposisi tertutup fraktur nasal (Cito) Rp. 6.998.699,-
Biopsi terbuka pleura * (Cito) Rp. 6.998.699,-
Reseksi mandibula dengan rekonstruksi graft tulang / K-wire (Cito) Rp. 6.998.699,-
Rinologi - Konkotomi / Konkoplasti (Cito) Rp. 6.998.699,-
Rinologi - Nasoendoskopi Dengan tindakan (Cito) Rp. 6.998.699,-
Rinologi - Sinuskopi / Sinoskopi (Narkosis) (Cito) Rp. 6.998.699,-
Rupture tendon achiles (Cito) Rp. 6.998.699,-
Scleral buckle, cryo dan C3F8 (Cito) Rp. 6.998.699,-
Scleral buckling (Cito) Rp. 6.998.699,-
Sekunder IOL (Cito) Rp. 6.998.699,-
Somnoplasty (Cito) Rp. 6.998.699,-
Spine - Biopsy vertebra (1 level) * (Cito) Rp. 6.998.699,-
Biopsi terbuka pleura dengan VATS * (Cito) Rp. 6.998.699,-
Spine - Plaster application of the spine (Cito) Rp. 6.998.699,-
Strabismus 1 otot (Cito) Rp. 6.998.699,-
Strabismus 2 otot (Cito) Rp. 6.998.699,-
Strabismus 3 otot (Cito) Rp. 6.998.699,-
Suture of laceration of large intestine (Cito) Rp. 6.998.699,-
Suture of laceration of small intestine, except duodenum (Cito) Rp. 6.998.699,-
Suture of peritoneum (Cito) Rp. 6.998.699,-
Tatto cornea (Cito) Rp. 6.998.699,-
Torakotomi / sternotomi eksplorasi * (Cito) Rp. 6.998.699,-
Torsio testis ** (Cito) Rp. 6.998.699,-
Amputasi jari (phalangs - traumatik) (Cito) Rp. 6.998.699,-
Biopsi terbuka tumor dinding thoraks * (Cito) Rp. 6.998.699,-
Trakeostomi temporary ** (Cito) Rp. 6.998.699,-
Trauma - Acute ankle joint dislocation (Cito) Rp. 6.998.699,-
Trauma - Acute elbow joint dislocation (Cito) Rp. 6.998.699,-
Trauma - Acute hip joint dislocation (Cito) Rp. 6.998.699,-
Trauma - Acute knee joint dislocation (Cito) Rp. 6.998.699,-
Trauma - Closed fraktur shaft femur * (Cito) Rp. 6.998.699,-
Trauma - Closed fraktur shaft humerus * (Cito) Rp. 6.998.699,-
Trauma - Closed fraktur shaft radius (Cito) Rp. 6.998.699,-
Trauma - Closed fraktur shaft tibia (Cito) Rp. 6.998.699,-
Trauma - Closed fraktur shaft ulna (Cito) Rp. 6.998.699,-
Caecostomy (Cito) Rp. 6.998.699,-
Trauma - Fraktur tulang panjang dengan MIPO atau ORIF dan implant removal (long Rp. 6.998.699,-
Trauma - Jaringan granulasi dengan STSG (Cito) Rp. 6.998.699,-
Trauma - Kompartemen otot (Cito) Rp. 6.998.699,-
Trauma - Nekrotik tissue > 1 kompartemen dengan debridement (Cito) Rp. 6.998.699,-
Trauma - Nekrotik tissue dengan debridement (Cito) Rp. 6.998.699,-
Trauma - Open fraktur shaft femur grade 1 dan 2 (Cito) Rp. 6.998.699,-
Trauma - Open fraktur shaft humerus grade 1 dan 2 (Cito) Rp. 6.998.699,-
Trauma - Open fraktur shaft radius grade 1 dan 2 (Cito) Rp. 6.998.699,-
Trauma - Open fraktur shaft tibia grade 1 dan 2 (Cito) Rp. 6.998.699,-
Trauma - Open fraktur shaft ulna grade 1 dan 2 (Cito) Rp. 6.998.699,-
Closure of anal fistula (Cito) Rp. 6.998.699,-
Tumor - Biopsi tumor kelopak (Cito) Rp. 6.998.699,-
Tumor - Biopsi tumor orbita (Cito) Rp. 6.998.699,-
Tumor - Eksenterasi (Cito) Rp. 6.998.699,-
Tumor - Eksisi tumor adneksa (Cito) Rp. 6.998.699,-
Tumor - Ekstirpasi Tumor Orbita (Cito) Rp. 6.998.699,-
Tumor - Orbital dekompresi 1 tulang (Cito) Rp. 6.998.699,-
Tumor - Orbital dekompresi 2 tulang (Cito) Rp. 6.998.699,-
Tumor - Orbitotomi anterior (Cito) Rp. 6.998.699,-
Tumor - Orbitotomi lateral (Cito) Rp. 6.998.699,-
Unilateral excision of ectopic breast tissue (mamma aberans) (Cito) Rp. 6.998.699,-
Combustio (luka bakar) * (Cito) Rp. 6.998.699,-
Unilateral repair of femoral atau inguinal hernia with or without graft or prost Rp. 6.998.699,-
Unilateral thyroid lobectomy (Cito) Rp. 6.998.699,-
Wide excision of soft tissue tumor (Cito) Rp. 6.998.699,-
Compartement excision (Cito) Rp. 6.998.699,-
Debridement-nekrotomi luka gangren (Cito) Rp. 6.998.699,-
Deseksi submandibula (Cito) Rp. 6.998.699,-
Disartikulasi sendi ekstremitas (Cito) Rp. 6.998.699,-
Dislokasi bahu * (Cito) Rp. 6.998.699,-
Drainage of appendiceal abscess (Cito) Rp. 6.998.699,-
Amputation of digiti single ** (Cito) Rp. 6.998.699,-
Drainage of pancreatic cyst by catheter (Cito) Rp. 6.998.699,-
DSAEK (Cito) Rp. 6.998.699,-
ECCE / ICCE / SICS (Cito) Rp. 6.998.699,-
ECCE / SICS dan IOL (Cito) Rp. 6.998.699,-
Eksisi biopsi tumor pembuluh darah (Cito) Rp. 6.998.699,-
Eksisi glandula submandibula (Cito) Rp. 6.998.699,-
Eksisi higroma leher * (Cito) Rp. 6.998.699,-
Eksisi kista tiroglosus (Cito) Rp. 6.998.699,-
Eksisi parsial dan marsupialisasi Ranula (Cito) Rp. 6.998.699,-
Eksisi Pterigium (Cito) Rp. 6.998.699,-
Anal fistulectomy (Cito) Rp. 6.998.699,-
Eksisi tumor dinding dada * (Cito) Rp. 6.998.699,-
Eksisi tumor pembuluh darah perifer (hemangioma) ** (Cito) Rp. 6.998.699,-
Eksisi tumor pembuluh darah perifer ** (Cito) Rp. 6.998.699,-
Ekstirpasi kelainan kornea (Cito) Rp. 6.998.699,-
Ekstraksi corpus alienum segmen anterior (Cito) Rp. 6.998.699,-
Ekstraksi IOL (Cito) Rp. 6.998.699,-
Embolektomi / trombektomi pembuluh darah arteri abdominal (Cito) Rp. 6.998.699,-
Endoskopi - Esofagoskopi BA tanpa penyulit (Cito) Rp. 6.998.699,-
Endoskopi - Esofagoskopi dilatasi (Cito) Rp. 6.998.699,-
Endoskopi - Sialendoskopi diagnostik dan dilatasi (Cito) Rp. 6.998.699,-
Anal fistulotomy (Cito) Rp. 6.998.699,-
Endoskopi - Sialendoskopi diagnostik dan terapeutik (Cito) Rp. 6.998.699,-
Esofago-Gastro-Duodenoscopy (EGD) dan Biopsi (Cito) Rp. 6.998.699,-
Evakuasi hematom di ekstremitas (pasca pungsi HD / traumatik) (Cito) Rp. 6.998.699,-
Evakuasi silicon oil (Cito) Rp. 6.998.699,-
Evakuasi silicon oil dan ECCE (Cito) Rp. 6.998.699,-
Evakuasi silicon oil, Phaco / ECCE dan IOL (Cito) Rp. 6.998.699,-
Exchange IOL (Cito) Rp. 6.998.699,-
Excision of ectopic breast tissue (Cito) Rp. 6.998.699,-
excision of lesion of breast with narcose (Cito) Rp. 6.998.699,-
Excision of thyroglossal duct or trac (Cito) Rp. 6.998.699,-
Anterior lamellar keratoplasty (Cito) Rp. 6.998.699,-
Exploratory laparotomy (Cito) Rp. 6.998.699,-
Extirpasi kista rongga mulut (Cito) Rp. 6.998.699,-
Extirpasi muoccocele rongga mulut (Cito) Rp. 6.998.699,-
Fasciotomy * (Cito) Rp. 6.998.699,-
Fiksasi interna fraktur maksilofasial 1-2 tempat patahan * (Cito) Rp. 6.998.699,-
Fiksasi interna fraktur nasal (Cito) Rp. 6.998.699,-
Flap konjungtiva amnion graft (Cito) Rp. 6.998.699,-
Fraktur humerus * (Cito) Rp. 6.998.699,-
Gastrostomi * (Cito) Rp. 6.998.699,-
GIN -Ekstirpasi polip (Cito) Rp. 6.998.699,-
Appendicostomy (Cito) Rp. 6.998.699,-
Ginekologi - Ekstirpasi Giant Condiloma (Cito) Rp. 6.998.699,-
Ginekologi - Kistektomi (Cito) Rp. 6.998.699,-
Ginekologi - Laparotomi Diagnostik (Cito) Rp. 6.998.699,-
Ginekologi - Ligasi Arteri Hipogastrica / Uterina (Cito) Rp. 6.998.699,-
Ginekologi - Miomektomi (Cito) Rp. 6.998.699,-
Ginekologi - Pemasangan Implan Tableport (Cito) Rp. 6.998.699,-
Ginekologi - Salpingo-ooforektomi (Cito) Rp. 6.998.699,-
Glaukoma - Anterior / posterior sklerotomi (Cito) Rp. 6.998.699,-
Glaukoma - Gonioplasty / goniotomy (Cito) Rp. 6.998.699,-
Glaukoma - Iridektomi perifer (Cito) Rp. 6.998.699,-
Babcock (Cito) Rp. 6.998.699,-
Glaukoma - Paracentesis (Cito) Rp. 6.998.699,-
Glaukoma - Reformasi COA (Cito) Rp. 6.998.699,-
Glaukoma - Revisi Bleb (Cito) Rp. 6.998.699,-
Glaukoma - Tindakan cyclodia termi (Cito) Rp. 6.998.699,-
Glaukoma - Trabekulektomi (Cito) Rp. 6.998.699,-
Glaukoma - Trabekulektomi, Phaco dan IOL (Cito) Rp. 6.998.699,-
Glaukoma - Trabekulotomi anak atau bayi (Cito) Rp. 6.998.699,-
Glaukoma - Trabekulotomi dan trabekulektomi anak atau bayi (Cito) Rp. 6.998.699,-
Glaukoma - Transkleral Foto Coagulasi (Cito) Rp. 6.998.699,-
Glaukoma - Tubes implan (Cito) Rp. 6.998.699,-
Biopsy insisional dengan anastesi lokal (Cito) Rp. 2.295.526,-
Biopsy of anus (Cito) Rp. 2.295.526,-
Biopsy of perianal tissue (Cito) Rp. 2.295.526,-
Eksisi tumor jinak dengan anastesi lokal (Cito) Rp. 2.295.526,-
Ekstraksi fragmen fraktur gigi dengan flap (Cito) Rp. 2.295.526,-
Insisi abses dengan anastesi lokal (Cito) Rp. 2.295.526,-
Other incision of skin and subcutaneous tissue (Cito) Rp. 2.295.526,-
Pungsi hematom / seroma (Cito) Rp. 2.295.526,-
Reposisi dislokasi TMJ tanpa pembiusan (Cito) Rp. 2.295.526,-
RF Dasar Lidah (Cito) Rp. 2.295.526,-
Rinologi - Septoplasti (Cito) Rp. 2.295.526,-
Sirkumsisi *** (Cito) Rp. 2.295.526,-
Biopsy insisional dengan anastesi lokal (Cito) Rp. 2.034.526,-
Biopsy of anus (Cito) Rp. 2.034.526,-
Biopsy of perianal tissue (Cito) Rp. 2.034.526,-
Eksisi tumor jinak dengan anastesi lokal (Cito) Rp. 2.034.526,-
Ekstraksi fragmen fraktur gigi dengan flap (Cito) Rp. 2.034.526,-
Insisi abses dengan anastesi lokal (Cito) Rp. 2.034.526,-
Other incision of skin and subcutaneous tissue (Cito) Rp. 2.034.526,-
Pungsi hematom / seroma (Cito) Rp. 2.034.526,-
Reposisi dislokasi TMJ tanpa pembiusan (Cito) Rp. 2.034.526,-
RF Dasar Lidah (Cito) Rp. 2.034.526,-
Rinologi - Septoplasti (Cito) Rp. 2.034.526,-
Sirkumsisi *** (Cito) Rp. 2.034.526,-
Biopsy insisional dengan anastesi lokal (Cito) Rp. 1.932.426,-
RF Dasar Lidah (Cito) Rp. 1.932.426,-
Rinologi - Septoplasti (Cito) Rp. 1.932.426,-
Sirkumsisi *** (Cito) Rp. 1.932.426,-
Biopsy of anus (Cito) Rp. 1.932.426,-
Biopsy of perianal tissue (Cito) Rp. 1.932.426,-
Eksisi tumor jinak dengan anastesi lokal (Cito) Rp. 1.932.426,-
Ekstraksi fragmen fraktur gigi dengan flap (Cito) Rp. 1.932.426,-
Insisi abses dengan anastesi lokal (Cito) Rp. 1.932.426,-
Other incision of skin and subcutaneous tissue (Cito) Rp. 1.932.426,-
Pungsi hematom / seroma (Cito) Rp. 1.932.426,-
Reposisi dislokasi TMJ tanpa pembiusan (Cito) Rp. 1.932.426,-
Amputasi above knee (Cito) Rp. 10.273.026,-
Amputasi below knee (Cito) Rp. 10.273.026,-
Aneurisma arteri brachialis (Cito) Rp. 10.273.026,-
Aneurisma arteri femoralis (Cito) Rp. 10.273.026,-
Axillary dissection (Cito) Rp. 10.273.026,-
Batu saluran kemih * (Cito) Rp. 10.273.026,-
Bilateral simple mastectomy (Cito) Rp. 10.273.026,-
Cholecystectomy (Cito) Rp. 10.273.026,-
Choledochoplasty (Cito) Rp. 10.273.026,-
Closure of appendiceal fistula (Cito) Rp. 10.273.026,-
Closure of cholecystostomy (Cito) Rp. 10.273.026,-
Closure of fistula of large intestine (Cito) Rp. 10.273.026,-
Closure of fistula of small intestine, except duodenum (Cito) Rp. 10.273.026,-
Closure of intestinal stoma (Cito) Rp. 10.273.026,-
Closure of leceration of liver (Cito) Rp. 10.273.026,-
Colostomy (not otherwise specified) (Cito) Rp. 10.273.026,-
Common duct exploration for removal of calculus (Cito) Rp. 10.273.026,-
Debridement mediastinum (sternotomi) * (Cito) Rp. 10.273.026,-
Diseksi leher radikal / radikal neck dissection * (Cito) Rp. 10.273.026,-
Eksisi luas tumor ganas bibir dengan rekonstruksi flap lokal (Cito) Rp. 10.273.026,-
Eksisi luas tumor ganas kulit tanpa rekonstruksi (Cito) Rp. 10.273.026,-
Eksisi pseudoaneurisma (Cito) Rp. 10.273.026,-
Eksplorasi vaskular (trauma / non trauma) (Cito) Rp. 10.273.026,-
Ekstraksi corpus alienum di regio toraks * (Cito) Rp. 10.273.026,-
Ekstraksi corpus alienum di regio toraks dengan VATS * (Cito) Rp. 10.273.026,-
Embolektomi / trombektomi aorta (Cito) Rp. 10.273.026,-
Embolektomi / trombektomi pembuluh darah arteri ekstremitas bawah * (Cito) Rp. 10.273.026,-
Embolektomi / trombektomi pembuluh darah ekstremitas atas (Cito) Rp. 10.273.026,-
Embolektomi / trombektomi pembuluh darah ekstremitas bawah * (Cito) Rp. 10.273.026,-
Embolektomi / trombektomi pembuluh darah regio servikal (karotis, jugular) * (Ci Rp. 10.273.026,-
Endoscopic polypectomy of rectum (Cito) Rp. 10.273.026,-
Endoscopic thyroidectomy (Cito) Rp. 10.273.026,-
Endoskopi - Bronkoskopi ekstraksi dengan penyulit (Cito) Rp. 10.273.026,-
Endoskopi - Intubasi dengan flexible bronkoskopi (Cito) Rp. 10.273.026,-
Endoskopi - Pan bronkoskopi (Cito) Rp. 10.273.026,-
Endoskopi - Pan esofagoskopi (Cito) Rp. 10.273.026,-
Endoskopi - Sialendoskopi diagnostik (Cito) Rp. 10.273.026,-
Endoskopi - Sleep nasoendoskopi (Cito) Rp. 10.273.026,-
Excision of hemorrhoid (Cito) Rp. 10.273.026,-
Exploration of common duct (Cito) Rp. 10.273.026,-
Exteriorization of large intestine (Cito) Rp. 10.273.026,-
Exteriorization of small intestine (Cito) Rp. 10.273.026,-
Fiksasi sternum (wire, plate) * (Cito) Rp. 10.273.026,-
Fraktur antebrachi (Cito) Rp. 10.273.026,-
Fraktur colles dan pergelangan tangan lainnya (Cito) Rp. 10.273.026,-
Fraktur cruris (Cito) Rp. 10.273.026,-
Fraktur femur * (Cito) Rp. 10.273.026,-
Fraktur klavikula (Cito) Rp. 10.273.026,-
Fraktur olekranon (Cito) Rp. 10.273.026,-
Fraktur patela (Cito) Rp. 10.273.026,-
Fraktur suprakondiler humerus (Cito) Rp. 10.273.026,-
Free skin graft (Cito) Rp. 10.273.026,-
Full-thickness skin graft to hand (Cito) Rp. 10.273.026,-
Full-thickness skin graft to other sites * (Cito) Rp. 10.273.026,-
GIN- Hymenoplasty (Cito) Rp. 10.273.026,-
Ginekologi - Histerektomi (Cito) Rp. 10.273.026,-
Ginekologi - Kehamilan ektopik (Cito) Rp. 10.273.026,-
Ginekologi - Miomektomi (Cito) Rp. 10.273.026,-
Glaukoma - Tubes implan, Phaco dan IOL (Cito) Rp. 10.273.026,-
Groin dissection (Cito) Rp. 10.273.026,-
Hand - Carpus, fracture or dislocation, reduksi terbuka dan fiksasi interna * (C Rp. 10.273.026,-
Hand - Jari, defect or contracture (single) rekonstruksi (Cito) Rp. 10.273.026,-
Hand - Jari, deformities, koreksi (Cito) Rp. 10.273.026,-
Hand - Jari, fracture or dislocation, reduksi terbuka dan fiksasi interna (multi Rp. 10.273.026,-
Hand - Jari, ring constriction (multiple), koreksi (Cito) Rp. 10.273.026,-
Hand - Jari, syndactili (multiple) (Cito) Rp. 10.273.026,-
Hand - Kulit dan Jaringan subkutis, laceration (superficial ) > 7 cm , repair (C Rp. 10.273.026,-
Hand - Nail bed, laceration, Repair (multiple) (Cito) Rp. 10.273.026,-
Hand - Nerve (ekstremitas atas), carpal tunnel syndorme, release (bilateral with Rp. 10.273.026,-
Hand - Nerve (ekstremitas atas), entrapment syndrome (other) decompression (bila Rp. 10.273.026,-
Hand - Nerve (ekstremitas atas), entrapment syndrome (other) decompression with Rp. 10.273.026,-
Hand - Nerve (ekstremitas atas), entrapment syndrome (other), decompression (uni Rp. 10.273.026,-
Hand - Nerve (ekstremitas atas), Guyon's tunnel syndrome, release (bilateral wit Rp. 10.273.026,-
Hand - Nerve (ekstremitas atas), Guyon's Tunnel Syndrome, Release (unilateral) ( Rp. 10.273.026,-
Hand - Tendon Sheath (ekstremitas atas), De Quarvain's (bilateral), release (Cit Rp. 10.273.026,-
Hand - Thumb, deformitas, Koreksi (Cito) Rp. 10.273.026,-
Hemiglosektomi (Cito) Rp. 10.273.026,-
Hip - Arthroscopy (Cito) Rp. 10.273.026,-
Hip - Hemiarthroplasty (Cito) Rp. 10.273.026,-
Hip - ORIF, DHS (Cito) Rp. 10.273.026,-
Hipertropi Prostat Beningna (BPH) * (Cito) Rp. 10.273.026,-
Ileostomy (not otherwise specified) * (Cito) Rp. 10.273.026,-
Incisional hernia repair (Cito) Rp. 10.273.026,-
Incisional hernia repair with prosthesis (Cito) Rp. 10.273.026,-
Internal drainage of pancreatic cyst (Cito) Rp. 10.273.026,-
Knee - Anterior cruciate ligament reconstruction (Cito) Rp. 10.273.026,-
Knee - Arthroscopy debridement knee (Cito) Rp. 10.273.026,-
Knee - Arthroscopy debridement shoulder (Cito) Rp. 10.273.026,-
Knee - Arthroscopy diagnostic (Cito) Rp. 10.273.026,-
Knee - Arthroscopy diagnostic shoulder (Cito) Rp. 10.273.026,-
Knee - Arthroscopy meniscus repair (Cito) Rp. 10.273.026,-
Knee - Arthroscopy minisectomy, arthroscopy synevectomy knee (Cito) Rp. 10.273.026,-
Knee - Arthroscopy remove loose body (Cito) Rp. 10.273.026,-
Knee - Arthroscopy remove loose body shoulder (Cito) Rp. 10.273.026,-
Knee - Fibular osteotomy (Cito) Rp. 10.273.026,-
Knee - Lateral collateral ligament reconstruction (Cito) Rp. 10.273.026,-
Knee - Medial collateral ligament reconstruction (Cito) Rp. 10.273.026,-
Knee - Posterior cruciate ligamnet reconstruction (Cito) Rp. 10.273.026,-
Knee - Recurrent shoulder dislocation repair TUBS and AMBRI (Cito) Rp. 10.273.026,-
Knee - Revisi total knee replacement (Cito) Rp. 10.273.026,-
Knee - Revisi total shoulder replacement (Cito) Rp. 10.273.026,-
Knee - Rotator cuff repair by arthroscopy (Cito) Rp. 10.273.026,-
Knee - Shoulder hemiarthroplasty (Cito) Rp. 10.273.026,-
Knee - Total shoulder replacement (Cito) Rp. 10.273.026,-
Kolonoskopi dan Biopsi (Cito) Rp. 10.273.026,-
Laparoscopic lysis of peritoneal adhesions (Cito) Rp. 10.273.026,-
Laparoskopi/histeroskopi - ovarian drilling (Cito) Rp. 10.273.026,-
Laparskopi / Histereskopi - Histeroskopi diagnostik (Cito) Rp. 10.273.026,-
Laparskopi / Histereskopi - Laparoskopi diagnostik (Cito) Rp. 10.273.026,-
Laparskopi / Histereskopi - Second Look (Cito) Rp. 10.273.026,-
Laparskopi / Histereskopi - Tubektomi (Cito) Rp. 10.273.026,-
Large to large intestinal anastomosis (Cito) Rp. 10.273.026,-
Laring dan Faring - Laringektomi * (Cito) Rp. 10.273.026,-
Laring dan Faring - Laringektomi + RND * (Cito) Rp. 10.273.026,-
Laring dan Faring - Laringoskopi dengan Ekstirpasi (Cito) Rp. 10.273.026,-
Laring dan Faring - RND * (Cito) Rp. 10.273.026,-
Laringectomi * (Cito) Rp. 10.273.026,-
Laringectomi dengan diseksi leher * (Cito) Rp. 10.273.026,-
Lasik 1 (satu) mata (Cito) Rp. 10.273.026,-
Lobektomi parsial (reseksi paru segmental) * (Cito) Rp. 10.273.026,-
Muscle flap graft to breast (Cito) Rp. 10.273.026,-
Muscle flap graft to breast (TRAM flap / LD flap) (Cito) Rp. 10.273.026,-
Obstetri - Histerektomi pervaginam dan kolpoperineoplasti (Cito) Rp. 10.273.026,-
Obstetri - Partus Dengan Bius ELA (Cito) Rp. 10.273.026,-
Obstetri - Partus Dengan Bius ILA (Cito) Rp. 10.273.026,-
Obstetri - Purandare (Cito) Rp. 10.273.026,-
Obstetri - Rekonstruksi vagina (Cito) Rp. 10.273.026,-
Obstetri - Repair fistula (Cito) Rp. 10.273.026,-
Obstetri - Sectio caesaria dan histerektomi obstetri (Cito) Rp. 10.273.026,-
Obstetri - Sectio caesaria dengan penyulit (perlekatan berat, histerorafi) (Cito Rp. 10.273.026,-
Obstetri - Sectio Cesaria (SC) dengan ERACS (Cito) Rp. 10.273.026,-
Obstetri - Vaginoplasti (Cito) Rp. 10.273.026,-
Odontektomi tingkat II (Cito) Rp. 10.273.026,-
Onkologi - Diseksi leher bilateral (Cito) Rp. 10.273.026,-
Onkologi - Diseksi leher modified (Cito) Rp. 10.273.026,-
Onkologi - Ligasi arteri karotis eksterna (Cito) Rp. 10.273.026,-
Onkologi - Limb ablation dengan above atau below knee amputation soft tissue tum Rp. 10.273.026,-
Onkologi - Limb ablation dengan above atau below knee amputation soft tissue tum Rp. 10.273.026,-
Onkologi - Mandibulektomi parsial (Cito) Rp. 10.273.026,-
Onkologi - Panendoskopi (eksplorasi NF, laringoskopi, esofagoskopi, bronkoskopi Rp. 10.273.026,-
Onkologi - Total patellectomy dan rekonstruksi (Cito) Rp. 10.273.026,-
Open biopsy of gallbladder or bile ducts (Cito) Rp. 10.273.026,-
Open biopsy of liver (Cito) Rp. 10.273.026,-
Open biopsy of pancreas (Cito) Rp. 10.273.026,-
Open reduction of malar and zygomatic fracture (Cito) Rp. 10.273.026,-
Open reduction of mandibular fractur (Cito) Rp. 10.273.026,-
Open reduction of maxillary fracture (Cito) Rp. 10.273.026,-
Other destruction of lesion of liver (Cito) Rp. 10.273.026,-
Other laparotomy (Cito) Rp. 10.273.026,-
Other partial excision of large intestine (Cito) Rp. 10.273.026,-
Other repair of anal sphincter (Cito) Rp. 10.273.026,-
Other repair of intestine (Cito) Rp. 10.273.026,-
Other repair of mesentery (Cito) Rp. 10.273.026,-
Other skin graft to hand (Cito) Rp. 10.273.026,-
Other skin graft to other sites (Cito) Rp. 10.273.026,-
Other small to large intestinal anastomosis (Cito) Rp. 10.273.026,-
Other suture of abdominal wall (Cito) Rp. 10.273.026,-
Otologi - Dekompresi nervus fasialis (Cito) Rp. 10.273.026,-
Otologi - Kanaloplasti / kanalomeatoplasty (Cito) Rp. 10.273.026,-
Otologi - Mastoidektomi radikal (Cito) Rp. 10.273.026,-
Otologi - Mastoidektomi sederhana (Cito) Rp. 10.273.026,-
Otologi - Stapedektomi (Cito) Rp. 10.273.026,-
Parotidektomi superfisial * (Cito) Rp. 10.273.026,-
Partial splenectomy (Cito) Rp. 10.273.026,-
Pediatrik - Open reduction dislokasi panggul dengan Acetabuloplasty dan Femoral Rp. 10.273.026,-
Pediatrik - Operasi rekonstruksi ibu jari kaki pada Hallux Valgus (Cito) Rp. 10.273.026,-
Pediatrik - Reposisi terbuka dan fiksasi interna fraktur tulang panjang pada ana Rp. 10.273.026,-
Pediatrik - Reposisi terbuka dan fiksasi interna kasus fraktur intra artikular a Rp. 10.273.026,-
Pediatrik - Reposisi terbuka dan fiksasi Interna pada kasus fraktur Salter Harri Rp. 10.273.026,-
Pediatrik - Tendon transfer ekstremitas bawah kasus neuromuskular anak (Cito) Rp. 10.273.026,-
Pedicle or flaps graft (not otherwise specified) (Cito) Rp. 10.273.026,-
Pemasangan Peritoneal Dialysis (PD) Catheter (Cito) Rp. 10.273.026,-
Pembuatan thoracic window (Cito) Rp. 10.273.026,-
Perikardiotomi / pericardial window * (Cito) Rp. 10.273.026,-
Permanent colostomy (Cito) Rp. 10.273.026,-
Permanent ileostomy (Cito) Rp. 10.273.026,-
Phaco (Cito) Rp. 10.273.026,-
Phaco dan IOL (Cito) Rp. 10.273.026,-
Plastik Rekionstruksi - Faringeal flap (Cito) Rp. 10.273.026,-
Plastik Rekionstruksi - Forehead flap (Cito) Rp. 10.273.026,-
Plastik Rekionstruksi - Otoplasty * (Cito) Rp. 10.273.026,-
Plastik Rekionstruksi - Revisi parut (Cito) Rp. 10.273.026,-
Plastik Rekionstruksi - Rinoplasty * (Cito) Rp. 10.273.026,-
Plastik Rekionstruksi - Rinoplasty dengan augmentasi tulang rawan (Cito) Rp. 10.273.026,-
Pleurektomi * (Cito) Rp. 10.273.026,-
Plikasi diafragma * (Cito) Rp. 10.273.026,-
Pneumonectomy * (Cito) Rp. 10.273.026,-
Posterior vitektomi, SB, Endo laser, Silikon Oil / Gas, Phaco dan IOL (Cito) Rp. 10.273.026,-
Posterior vitrectomy, Phaco dan IOL (Cito) Rp. 10.273.026,-
Radical excision of skin lesion (Cito) Rp. 10.273.026,-
Reclosure of postoperative disruption of abdominal wall (Cito) Rp. 10.273.026,-
Rectosigmoidoskopi (Cito) Rp. 10.273.026,-
Reduction of anal prolapse (Cito) Rp. 10.273.026,-
Rekonstruksi - Blefaroplasty 2 kelopak (Cito) Rp. 10.273.026,-
Rekonstruksi - Ekstirpasi Tumor Adneksa (Cito) Rp. 10.273.026,-
Rekonstruksi - Endoskopi DCR dan silikon tube (Cito) Rp. 10.273.026,-
Rekonstruksi - Fraktur dasar orbita (Cito) Rp. 10.273.026,-
Rekonstruksi - Fraktur Multiple (Cito) Rp. 10.273.026,-
Rekonstruksi - Palpebra dengan Graft * (Cito) Rp. 10.273.026,-
Rekonstruksi - Soket kontraktur (Cito) Rp. 10.273.026,-
Rekonstruksi - Soket landai (Cito) Rp. 10.273.026,-
Reopening of recent laparotomy site (Cito) Rp. 10.273.026,-
Repair arteri poplitea dan femoralis (Cito) Rp. 10.273.026,-
Repair of diaphragmatic hernia, abdominal approach (Cito) Rp. 10.273.026,-
Repair of laceration of gallbladder (Cito) Rp. 10.273.026,-
Repair pembuluh darah regio servikal (karotis, jugular) * (Cito) Rp. 10.273.026,-
Resection of transverse colon (Cito) Rp. 10.273.026,-
Reseksi maksila infrastuktural (Cito) Rp. 10.273.026,-
Reseksi mandibula tanpa rekonstruksi (Cito) Rp. 10.273.026,-
Revision of anastomosis of large intestine (Cito) Rp. 10.273.026,-
Revision of anastomosis of small intestine (Cito) Rp. 10.273.026,-
Revision of stoma of large intestine (Cito) Rp. 10.273.026,-
Revision of stoma of small intestine (Cito) Rp. 10.273.026,-
Revision of tracheostomy (Cito) Rp. 10.273.026,-
Right hemicolectomy (Cito) Rp. 10.273.026,-
Rinologi - BSEF / FESS 1 : Mini (Cito) Rp. 10.273.026,-
Rinologi - BSEF / FESS 2 : Mini dan Maksila / etmoid (Cito) Rp. 10.273.026,-
Rinologi - BSEF / FESS 3 : Mini dan frontal / sfenoid (Cito) Rp. 10.273.026,-
Rupture buli-buli * (Cito) Rp. 10.273.026,-
Scleral buckling, phaco dan IOL (Cito) Rp. 10.273.026,-
Sigmoidectomy (Cito) Rp. 10.273.026,-
Simple suture of common bile duct (Cito) Rp. 10.273.026,-
Small to small intestinal anastomosis (Cito) Rp. 10.273.026,-
Spine - Discograph (1 level) * (Cito) Rp. 10.273.026,-
Spine - Discograph (1 level) * (Cito) Rp. 10.273.026,-
Spine - Discograph multilevel * (Cito) Rp. 10.273.026,-
Spine - Facet block (1 level) (Cito) Rp. 10.273.026,-
Spine - Facet block multilevel (Cito) Rp. 10.273.026,-
Spine - Foraminal block (1 level) (Cito) Rp. 10.273.026,-
Spine - Foraminal block multilevel (Cito) Rp. 10.273.026,-
Spine - Manipulation, reduction of simple fracture and dislocation with general Rp. 10.273.026,-
Spine - Removal of implants (Plate, Nail, Screw) * (Cito) Rp. 10.273.026,-
Strabismus 4 otot (Cito) Rp. 10.273.026,-
Stripping varises ekstremitas inferior (Cito) Rp. 10.273.026,-
Subtotal mastectomy (Cito) Rp. 10.273.026,-
Temporary colostomy (Cito) Rp. 10.273.026,-
Temporary ileostomy * (Cito) Rp. 10.273.026,-
Thoracal symphatectomy dengan Video Assissted Thoracoscopic Surgery (VATS) (Cito Rp. 10.273.026,-
Tiroidektomi subtotal / total nodul tiroid ** (Cito) Rp. 10.273.026,-
Total splenectomy * (Cito) Rp. 10.273.026,-
Trauma - Closed fraktur distal tibia (Cito) Rp. 10.273.026,-
Trauma - Closed fraktur intercondylar femur (Cito) Rp. 10.273.026,-
Trauma - Closed fraktur proksimal tibia involve intraartikular (Cito) Rp. 10.273.026,-
Trauma - Closed fraktur supracondylar femur (Cito) Rp. 10.273.026,-
Trauma - Fracture acetabulum 1 collum dengan ORIF (Cito) Rp. 10.273.026,-
Trauma - Fracture artikuler dengan MIPO atau ORIF Artikuler (Cito) Rp. 10.273.026,-
Trauma - Fracture pelvis simple dengan fiksasi eksterna pelvic (ORIF) (Cito) Rp. 10.273.026,-
Trauma - Fraktur acetabulum dan pelvic dengan ORIF (Cito) Rp. 10.273.026,-
Trauma - Fraktur collum femur pada orang tua (Cito) Rp. 10.273.026,-
Trauma - Fraktur collum femur pada usia < 60 tahun (Cito) Rp. 10.273.026,-
Trauma - Fraktur galeazi (Cito) Rp. 10.273.026,-
Trauma - Fraktur intertrochanter femur pada orang tua (Cito) Rp. 10.273.026,-
Trauma - Fraktur intertrochanter femur pada usia < 60 tahun (Cito) Rp. 10.273.026,-
Trauma - Fraktur montegia (Cito) Rp. 10.273.026,-
Trauma - Fraktur neck humerus pada usia < 60 tahun (Cito) Rp. 10.273.026,-
Trauma - Fraktur neck humerus pada usia > 60 tahun (Cito) Rp. 10.273.026,-
Trauma - Fraktur subtrochanter femur pada usia < 60 tahun (Cito) Rp. 10.273.026,-
Trauma - Fraktur subtrochanter femur pada usia > 60 tahun (Cito) Rp. 10.273.026,-
Trauma - Instability joint infection (Cito) Rp. 10.273.026,-
Trauma - Joint stiffness dengan liberation (Cito) Rp. 10.273.026,-
Trauma - Multiple fracture tulang panjang dengan MIPO atau ORIF dan removal impl Rp. 10.273.026,-
Trauma - Non union dengan bone graft (Cito) Rp. 10.273.026,-
Trauma - Open fraktur shaft femur grade 3 (Cito) Rp. 10.273.026,-
Trauma - Open fraktur shaft humerus grade 3 (Cito) Rp. 10.273.026,-
Trauma - Open fraktur shaft radius grade 3 (Cito) Rp. 10.273.026,-
Trauma - Open fraktur shaft tibia grade 3 (Cito) Rp. 10.273.026,-
Trauma - Open fraktur shaft ulna grade 3 (Cito) Rp. 10.273.026,-
Trauma - Osteomyelitis (Cito) Rp. 10.273.026,-
Tumor - Extended Eksenterasi (Cito) Rp. 10.273.026,-
Tumor - Orbital dekompresi 3 tulang (Cito) Rp. 10.273.026,-
Tumor - Orbitotomi lateral and superior (medial) (Cito) Rp. 10.273.026,-
Unilateral radical mastectomy (Cito) Rp. 10.273.026,-
Unilateral simple mastectomy (Cito) Rp. 10.273.026,-
Upper Endoskopi (Cito) Rp. 10.273.026,-
Upper Endoskopi dan biopsi (Cito) Rp. 10.273.026,-
Upper Endoskopi dan ekstraksi carpal (Cito) Rp. 10.273.026,-
Upper Endoskopi dan ligasi (Cito) Rp. 10.273.026,-
Amputasi above knee (Cito) Rp. 9.402.825,-
Amputasi below knee (Cito) Rp. 9.402.825,-
Aneurisma arteri brachialis (Cito) Rp. 9.402.825,-
Aneurisma arteri femoralis (Cito) Rp. 9.402.825,-
Axillary dissection (Cito) Rp. 9.402.825,-
Batu saluran kemih * (Cito) Rp. 9.402.825,-
Bilateral simple mastectomy (Cito) Rp. 9.402.825,-
Cholecystectomy (Cito) Rp. 9.402.825,-
Choledochoplasty (Cito) Rp. 9.402.825,-
Closure of appendiceal fistula (Cito) Rp. 9.402.825,-
Closure of cholecystostomy (Cito) Rp. 9.402.825,-
Closure of fistula of large intestine (Cito) Rp. 9.402.825,-
Closure of fistula of small intestine, except duodenum (Cito) Rp. 9.402.825,-
Closure of intestinal stoma (Cito) Rp. 9.402.825,-
Closure of leceration of liver (Cito) Rp. 9.402.825,-
Colostomy (not otherwise specified) (Cito) Rp. 9.402.825,-
Common duct exploration for removal of calculus (Cito) Rp. 9.402.825,-
Debridement mediastinum (sternotomi) * (Cito) Rp. 9.402.825,-
Diseksi leher radikal / radikal neck dissection * (Cito) Rp. 9.402.825,-
Eksisi luas tumor ganas bibir dengan rekonstruksi flap lokal (Cito) Rp. 9.402.825,-
Eksisi luas tumor ganas kulit tanpa rekonstruksi (Cito) Rp. 9.402.825,-
Eksisi pseudoaneurisma (Cito) Rp. 9.402.825,-
Eksplorasi vaskular (trauma / non trauma) (Cito) Rp. 9.402.825,-
Ekstraksi corpus alienum di regio toraks * (Cito) Rp. 9.402.825,-
Ekstraksi corpus alienum di regio toraks dengan VATS * (Cito) Rp. 9.402.825,-
Embolektomi / trombektomi aorta (Cito) Rp. 9.402.825,-
Embolektomi / trombektomi pembuluh darah arteri ekstremitas bawah * (Cito) Rp. 9.402.825,-
Embolektomi / trombektomi pembuluh darah ekstremitas atas (Cito) Rp. 9.402.825,-
Embolektomi / trombektomi pembuluh darah ekstremitas bawah * (Cito) Rp. 9.402.825,-
Embolektomi / trombektomi pembuluh darah regio servikal (karotis, jugular) * (Ci Rp. 9.402.825,-
Endoscopic polypectomy of rectum (Cito) Rp. 9.402.825,-
Endoscopic thyroidectomy (Cito) Rp. 9.402.825,-
Endoskopi - Bronkoskopi ekstraksi dengan penyulit (Cito) Rp. 9.402.825,-
Endoskopi - Intubasi dengan flexible bronkoskopi (Cito) Rp. 9.402.825,-
Endoskopi - Pan bronkoskopi (Cito) Rp. 9.402.825,-
Endoskopi - Pan esofagoskopi (Cito) Rp. 9.402.825,-
Endoskopi - Sialendoskopi diagnostik (Cito) Rp. 9.402.825,-
Endoskopi - Sleep nasoendoskopi (Cito) Rp. 9.402.825,-
Excision of hemorrhoid (Cito) Rp. 9.402.825,-
Exploration of common duct (Cito) Rp. 9.402.825,-
Exteriorization of large intestine (Cito) Rp. 9.402.825,-
Exteriorization of small intestine (Cito) Rp. 9.402.825,-
Fiksasi sternum (wire, plate) * (Cito) Rp. 9.402.825,-
Fraktur antebrachi (Cito) Rp. 9.402.825,-
Fraktur colles dan pergelangan tangan lainnya (Cito) Rp. 9.402.825,-
Fraktur cruris (Cito) Rp. 9.402.825,-
Fraktur femur * (Cito) Rp. 9.402.825,-
Fraktur klavikula (Cito) Rp. 9.402.825,-
Fraktur olekranon (Cito) Rp. 9.402.825,-
Fraktur patela (Cito) Rp. 9.402.825,-
Fraktur suprakondiler humerus (Cito) Rp. 9.402.825,-
Free skin graft (Cito) Rp. 9.402.825,-
Full-thickness skin graft to hand (Cito) Rp. 9.402.825,-
Full-thickness skin graft to other sites * (Cito) Rp. 9.402.825,-
GIN- Hymenoplasty (Cito) Rp. 9.402.825,-
Ginekologi - Histerektomi (Cito) Rp. 9.402.825,-
Ginekologi - Kehamilan ektopik (Cito) Rp. 9.402.825,-
Ginekologi - Miomektomi (Cito) Rp. 9.402.825,-
Glaukoma - Tubes implan, Phaco dan IOL (Cito) Rp. 9.402.825,-
Groin dissection (Cito) Rp. 9.402.825,-
Hand - Carpus, fracture or dislocation, reduksi terbuka dan fiksasi interna * (C Rp. 9.402.825,-
Hand - Jari, defect or contracture (single) rekonstruksi (Cito) Rp. 9.402.825,-
Hand - Jari, deformities, koreksi (Cito) Rp. 9.402.825,-
Hand - Jari, fracture or dislocation, reduksi terbuka dan fiksasi interna (multi Rp. 9.402.825,-
Hand - Jari, ring constriction (multiple), koreksi (Cito) Rp. 9.402.825,-
Hand - Jari, syndactili (multiple) (Cito) Rp. 9.402.825,-
Hand - Kulit dan Jaringan subkutis, laceration (superficial ) > 7 cm , repair (C Rp. 9.402.825,-
Hand - Nail bed, laceration, Repair (multiple) (Cito) Rp. 9.402.825,-
Hand - Nerve (ekstremitas atas), carpal tunnel syndorme, release (bilateral with Rp. 9.402.825,-
Hand - Nerve (ekstremitas atas), entrapment syndrome (other) decompression (bila Rp. 9.402.825,-
Hand - Nerve (ekstremitas atas), entrapment syndrome (other) decompression with Rp. 9.402.825,-
Hand - Nerve (ekstremitas atas), entrapment syndrome (other), decompression (uni Rp. 9.402.825,-
Hand - Nerve (ekstremitas atas), Guyon's tunnel syndrome, release (bilateral wit Rp. 9.402.825,-
Hand - Nerve (ekstremitas atas), Guyon's Tunnel Syndrome, Release (unilateral) ( Rp. 9.402.825,-
Hand - Tendon Sheath (ekstremitas atas), De Quarvain's (bilateral), release (Cit Rp. 9.402.825,-
Hand - Thumb, deformitas, Koreksi (Cito) Rp. 9.402.825,-
Hemiglosektomi (Cito) Rp. 9.402.825,-
Hip - Arthroscopy (Cito) Rp. 9.402.825,-
Hip - Hemiarthroplasty (Cito) Rp. 9.402.825,-
Hip - ORIF, DHS (Cito) Rp. 9.402.825,-
Hipertropi Prostat Beningna (BPH) * (Cito) Rp. 9.402.825,-
Ileostomy (not otherwise specified) * (Cito) Rp. 9.402.825,-
Incisional hernia repair (Cito) Rp. 9.402.825,-
Incisional hernia repair with prosthesis (Cito) Rp. 9.402.825,-
Internal drainage of pancreatic cyst (Cito) Rp. 9.402.825,-
Knee - Anterior cruciate ligament reconstruction (Cito) Rp. 9.402.825,-
Knee - Arthroscopy debridement knee (Cito) Rp. 9.402.825,-
Knee - Arthroscopy debridement shoulder (Cito) Rp. 9.402.825,-
Knee - Arthroscopy diagnostic (Cito) Rp. 9.402.825,-
Knee - Arthroscopy diagnostic shoulder (Cito) Rp. 9.402.825,-
Knee - Arthroscopy meniscus repair (Cito) Rp. 9.402.825,-
Knee - Arthroscopy minisectomy, arthroscopy synevectomy knee (Cito) Rp. 9.402.825,-
Knee - Arthroscopy remove loose body (Cito) Rp. 9.402.825,-
Knee - Arthroscopy remove loose body shoulder (Cito) Rp. 9.402.825,-
Knee - Fibular osteotomy (Cito) Rp. 9.402.825,-
Knee - Lateral collateral ligament reconstruction (Cito) Rp. 9.402.825,-
Knee - Medial collateral ligament reconstruction (Cito) Rp. 9.402.825,-
Knee - Posterior cruciate ligamnet reconstruction (Cito) Rp. 9.402.825,-
Knee - Recurrent shoulder dislocation repair TUBS and AMBRI (Cito) Rp. 9.402.825,-
Knee - Revisi total knee replacement (Cito) Rp. 9.402.825,-
Knee - Revisi total shoulder replacement (Cito) Rp. 9.402.825,-
Knee - Rotator cuff repair by arthroscopy (Cito) Rp. 9.402.825,-
Knee - Shoulder hemiarthroplasty (Cito) Rp. 9.402.825,-
Knee - Total shoulder replacement (Cito) Rp. 9.402.825,-
Kolonoskopi dan Biopsi (Cito) Rp. 9.402.825,-
Laparoscopic lysis of peritoneal adhesions (Cito) Rp. 9.402.825,-
Laparoskopi/histeroskopi - ovarian drilling (Cito) Rp. 9.402.825,-
Laparskopi / Histereskopi - Histeroskopi diagnostik (Cito) Rp. 9.402.825,-
Laparskopi / Histereskopi - Laparoskopi diagnostik (Cito) Rp. 9.402.825,-
Laparskopi / Histereskopi - Second Look (Cito) Rp. 9.402.825,-
Laparskopi / Histereskopi - Tubektomi (Cito) Rp. 9.402.825,-
Large to large intestinal anastomosis (Cito) Rp. 9.402.825,-
Laring dan Faring - Laringektomi * (Cito) Rp. 9.402.825,-
Laring dan Faring - Laringektomi + RND * (Cito) Rp. 9.402.825,-
Laring dan Faring - Laringoskopi dengan Ekstirpasi (Cito) Rp. 9.402.825,-
Laring dan Faring - RND * (Cito) Rp. 9.402.825,-
Laringectomi * (Cito) Rp. 9.402.825,-
Laringectomi dengan diseksi leher * (Cito) Rp. 9.402.825,-
Lasik 1 (satu) mata (Cito) Rp. 9.402.825,-
Lobektomi parsial (reseksi paru segmental) * (Cito) Rp. 9.402.825,-
Muscle flap graft to breast (Cito) Rp. 9.402.825,-
Muscle flap graft to breast (TRAM flap / LD flap) (Cito) Rp. 9.402.825,-
Obstetri - Histerektomi pervaginam dan kolpoperineoplasti (Cito) Rp. 9.402.825,-
Obstetri - Partus Dengan Bius ELA (Cito) Rp. 9.402.825,-
Obstetri - Partus Dengan Bius ILA (Cito) Rp. 9.402.825,-
Obstetri - Purandare (Cito) Rp. 9.402.825,-
Obstetri - Rekonstruksi vagina (Cito) Rp. 9.402.825,-
Obstetri - Repair fistula (Cito) Rp. 9.402.825,-
Obstetri - Sectio caesaria dan histerektomi obstetri (Cito) Rp. 9.402.825,-
Obstetri - Sectio caesaria dengan penyulit (perlekatan berat, histerorafi) (Cito Rp. 9.402.825,-
Obstetri - Sectio Cesaria (SC) dengan ERACS (Cito) Rp. 9.402.825,-
Obstetri - Vaginoplasti (Cito) Rp. 9.402.825,-
Odontektomi tingkat II (Cito) Rp. 9.402.825,-
Onkologi - Diseksi leher bilateral (Cito) Rp. 9.402.825,-
Onkologi - Diseksi leher modified (Cito) Rp. 9.402.825,-
Onkologi - Ligasi arteri karotis eksterna (Cito) Rp. 9.402.825,-
Onkologi - Limb ablation dengan above atau below knee amputation soft tissue tum Rp. 9.402.825,-
Onkologi - Limb ablation dengan above atau below knee amputation soft tissue tum Rp. 9.402.825,-
Onkologi - Mandibulektomi parsial (Cito) Rp. 9.402.825,-
Onkologi - Panendoskopi (eksplorasi NF, laringoskopi, esofagoskopi, bronkoskopi Rp. 9.402.825,-
Onkologi - Total patellectomy dan rekonstruksi (Cito) Rp. 9.402.825,-
Open biopsy of gallbladder or bile ducts (Cito) Rp. 9.402.825,-
Open biopsy of liver (Cito) Rp. 9.402.825,-
Open biopsy of pancreas (Cito) Rp. 9.402.825,-
Open reduction of malar and zygomatic fracture (Cito) Rp. 9.402.825,-
Open reduction of mandibular fractur (Cito) Rp. 9.402.825,-
Open reduction of maxillary fracture (Cito) Rp. 9.402.825,-
Other destruction of lesion of liver (Cito) Rp. 9.402.825,-
Other laparotomy (Cito) Rp. 9.402.825,-
Other partial excision of large intestine (Cito) Rp. 9.402.825,-
Other repair of anal sphincter (Cito) Rp. 9.402.825,-
Other repair of intestine (Cito) Rp. 9.402.825,-
Other repair of mesentery (Cito) Rp. 9.402.825,-
Other skin graft to hand (Cito) Rp. 9.402.825,-
Other skin graft to other sites (Cito) Rp. 9.402.825,-
Other small to large intestinal anastomosis (Cito) Rp. 9.402.825,-
Other suture of abdominal wall (Cito) Rp. 9.402.825,-
Otologi - Dekompresi nervus fasialis (Cito) Rp. 9.402.825,-
Otologi - Kanaloplasti / kanalomeatoplasty (Cito) Rp. 9.402.825,-
Otologi - Mastoidektomi radikal (Cito) Rp. 9.402.825,-
Otologi - Mastoidektomi sederhana (Cito) Rp. 9.402.825,-
Otologi - Stapedektomi (Cito) Rp. 9.402.825,-
Parotidektomi superfisial * (Cito) Rp. 9.402.825,-
Partial splenectomy (Cito) Rp. 9.402.825,-
Pediatrik - Open reduction dislokasi panggul dengan Acetabuloplasty dan Femoral Rp. 9.402.825,-
Pediatrik - Operasi rekonstruksi ibu jari kaki pada Hallux Valgus (Cito) Rp. 9.402.825,-
Pediatrik - Reposisi terbuka dan fiksasi interna fraktur tulang panjang pada ana Rp. 9.402.825,-
Pediatrik - Reposisi terbuka dan fiksasi interna kasus fraktur intra artikular a Rp. 9.402.825,-
Pediatrik - Reposisi terbuka dan fiksasi Interna pada kasus fraktur Salter Harri Rp. 9.402.825,-
Pediatrik - Tendon transfer ekstremitas bawah kasus neuromuskular anak (Cito) Rp. 9.402.825,-
Pedicle or flaps graft (not otherwise specified) (Cito) Rp. 9.402.825,-
Pemasangan Peritoneal Dialysis (PD) Catheter (Cito) Rp. 9.402.825,-
Pembuatan thoracic window (Cito) Rp. 9.402.825,-
Perikardiotomi / pericardial window * (Cito) Rp. 9.402.825,-
Permanent colostomy (Cito) Rp. 9.402.825,-
Permanent ileostomy (Cito) Rp. 9.402.825,-
Phaco (Cito) Rp. 9.402.825,-
Phaco dan IOL (Cito) Rp. 9.402.825,-
Plastik Rekionstruksi - Faringeal flap (Cito) Rp. 9.402.825,-
Plastik Rekionstruksi - Forehead flap (Cito) Rp. 9.402.825,-
Plastik Rekionstruksi - Otoplasty * (Cito) Rp. 9.402.825,-
Plastik Rekionstruksi - Revisi parut (Cito) Rp. 9.402.825,-
Plastik Rekionstruksi - Rinoplasty * (Cito) Rp. 9.402.825,-
Plastik Rekionstruksi - Rinoplasty dengan augmentasi tulang rawan (Cito) Rp. 9.402.825,-
Pleurektomi * (Cito) Rp. 9.402.825,-
Plikasi diafragma * (Cito) Rp. 9.402.825,-
Pneumonectomy * (Cito) Rp. 9.402.825,-
Posterior vitektomi, SB, Endo laser, Silikon Oil / Gas, Phaco dan IOL (Cito) Rp. 9.402.825,-
Posterior vitrectomy, Phaco dan IOL (Cito) Rp. 9.402.825,-
Radical excision of skin lesion (Cito) Rp. 9.402.825,-
Reclosure of postoperative disruption of abdominal wall (Cito) Rp. 9.402.825,-
Rectosigmoidoskopi (Cito) Rp. 9.402.825,-
Reduction of anal prolapse (Cito) Rp. 9.402.825,-
Rekonstruksi - Blefaroplasty 2 kelopak (Cito) Rp. 9.402.825,-
Rekonstruksi - Ekstirpasi Tumor Adneksa (Cito) Rp. 9.402.825,-
Rekonstruksi - Endoskopi DCR dan silikon tube (Cito) Rp. 9.402.825,-
Rekonstruksi - Fraktur dasar orbita (Cito) Rp. 9.402.825,-
Rekonstruksi - Fraktur Multiple (Cito) Rp. 9.402.825,-
Rekonstruksi - Palpebra dengan Graft * (Cito) Rp. 9.402.825,-
Rekonstruksi - Soket kontraktur (Cito) Rp. 9.402.825,-
Rekonstruksi - Soket landai (Cito) Rp. 9.402.825,-
Reopening of recent laparotomy site (Cito) Rp. 9.402.825,-
Repair arteri poplitea dan femoralis (Cito) Rp. 9.402.825,-
Repair of diaphragmatic hernia, abdominal approach (Cito) Rp. 9.402.825,-
Repair of laceration of gallbladder (Cito) Rp. 9.402.825,-
Repair pembuluh darah regio servikal (karotis, jugular) * (Cito) Rp. 9.402.825,-
Resection of transverse colon (Cito) Rp. 9.402.825,-
Reseksi maksila infrastuktural (Cito) Rp. 9.402.825,-
Reseksi mandibula tanpa rekonstruksi (Cito) Rp. 9.402.825,-
Revision of anastomosis of large intestine (Cito) Rp. 9.402.825,-
Revision of anastomosis of small intestine (Cito) Rp. 9.402.825,-
Revision of stoma of large intestine (Cito) Rp. 9.402.825,-
Revision of stoma of small intestine (Cito) Rp. 9.402.825,-
Revision of tracheostomy (Cito) Rp. 9.402.825,-
Right hemicolectomy (Cito) Rp. 9.402.825,-
Rinologi - BSEF / FESS 1 : Mini (Cito) Rp. 9.402.825,-
Rinologi - BSEF / FESS 2 : Mini dan Maksila / etmoid (Cito) Rp. 9.402.825,-
Rinologi - BSEF / FESS 3 : Mini dan frontal / sfenoid (Cito) Rp. 9.402.825,-
Rupture buli-buli * (Cito) Rp. 9.402.825,-
Scleral buckling, phaco dan IOL (Cito) Rp. 9.402.825,-
Sigmoidectomy (Cito) Rp. 9.402.825,-
Simple suture of common bile duct (Cito) Rp. 9.402.825,-
Small to small intestinal anastomosis (Cito) Rp. 9.402.825,-
Spine - Discograph (1 level) * (Cito) Rp. 9.402.825,-
Spine - Discograph (1 level) * (Cito) Rp. 9.402.825,-
Spine - Discograph multilevel * (Cito) Rp. 9.402.825,-
Spine - Facet block (1 level) (Cito) Rp. 9.402.825,-
Spine - Facet block multilevel (Cito) Rp. 9.402.825,-
Spine - Foraminal block (1 level) (Cito) Rp. 9.402.825,-
Spine - Foraminal block multilevel (Cito) Rp. 9.402.825,-
Spine - Manipulation, reduction of simple fracture and dislocation with general Rp. 9.402.825,-
Spine - Removal of implants (Plate, Nail, Screw) * (Cito) Rp. 9.402.825,-
Strabismus 4 otot (Cito) Rp. 9.402.825,-
Stripping varises ekstremitas inferior (Cito) Rp. 9.402.825,-
Subtotal mastectomy (Cito) Rp. 9.402.825,-
Temporary colostomy (Cito) Rp. 9.402.825,-
Temporary ileostomy * (Cito) Rp. 9.402.825,-
Thoracal symphatectomy dengan Video Assissted Thoracoscopic Surgery (VATS) (Cito Rp. 9.402.825,-
Tiroidektomi subtotal / total nodul tiroid ** (Cito) Rp. 9.402.825,-
Total splenectomy * (Cito) Rp. 9.402.825,-
Trauma - Closed fraktur distal tibia (Cito) Rp. 9.402.825,-
Trauma - Closed fraktur intercondylar femur (Cito) Rp. 9.402.825,-
Trauma - Closed fraktur proksimal tibia involve intraartikular (Cito) Rp. 9.402.825,-
Trauma - Closed fraktur supracondylar femur (Cito) Rp. 9.402.825,-
Trauma - Fracture acetabulum 1 collum dengan ORIF (Cito) Rp. 9.402.825,-
Trauma - Fracture artikuler dengan MIPO atau ORIF Artikuler (Cito) Rp. 9.402.825,-
Trauma - Fracture pelvis simple dengan fiksasi eksterna pelvic (ORIF) (Cito) Rp. 9.402.825,-
Trauma - Fraktur acetabulum dan pelvic dengan ORIF (Cito) Rp. 9.402.825,-
Trauma - Fraktur collum femur pada orang tua (Cito) Rp. 9.402.825,-
Trauma - Fraktur collum femur pada usia < 60 tahun (Cito) Rp. 9.402.825,-
Trauma - Fraktur galeazi (Cito) Rp. 9.402.825,-
Trauma - Fraktur intertrochanter femur pada orang tua (Cito) Rp. 9.402.825,-
Trauma - Fraktur intertrochanter femur pada usia < 60 tahun (Cito) Rp. 9.402.825,-
Trauma - Fraktur montegia (Cito) Rp. 9.402.825,-
Trauma - Fraktur neck humerus pada usia < 60 tahun (Cito) Rp. 9.402.825,-
Trauma - Fraktur neck humerus pada usia > 60 tahun (Cito) Rp. 9.402.825,-
Trauma - Fraktur subtrochanter femur pada usia < 60 tahun (Cito) Rp. 9.402.825,-
Trauma - Fraktur subtrochanter femur pada usia > 60 tahun (Cito) Rp. 9.402.825,-
Trauma - Instability joint infection (Cito) Rp. 9.402.825,-
Trauma - Joint stiffness dengan liberation (Cito) Rp. 9.402.825,-
Trauma - Multiple fracture tulang panjang dengan MIPO atau ORIF dan removal impl Rp. 9.402.825,-
Trauma - Non union dengan bone graft (Cito) Rp. 9.402.825,-
Trauma - Open fraktur shaft femur grade 3 (Cito) Rp. 9.402.825,-
Trauma - Open fraktur shaft humerus grade 3 (Cito) Rp. 9.402.825,-
Trauma - Open fraktur shaft radius grade 3 (Cito) Rp. 9.402.825,-
Trauma - Open fraktur shaft tibia grade 3 (Cito) Rp. 9.402.825,-
Trauma - Open fraktur shaft ulna grade 3 (Cito) Rp. 9.402.825,-
Trauma - Osteomyelitis (Cito) Rp. 9.402.825,-
Tumor - Extended Eksenterasi (Cito) Rp. 9.402.825,-
Tumor - Orbital dekompresi 3 tulang (Cito) Rp. 9.402.825,-
Tumor - Orbitotomi lateral and superior (medial) (Cito) Rp. 9.402.825,-
Unilateral radical mastectomy (Cito) Rp. 9.402.825,-
Unilateral simple mastectomy (Cito) Rp. 9.402.825,-
Upper Endoskopi (Cito) Rp. 9.402.825,-
Upper Endoskopi dan biopsi (Cito) Rp. 9.402.825,-
Upper Endoskopi dan ekstraksi carpal (Cito) Rp. 9.402.825,-
Upper Endoskopi dan ligasi (Cito) Rp. 9.402.825,-
Amputasi above knee (Cito) Rp. 9.062.526,-
Closure of appendiceal fistula (Cito) Rp. 9.062.526,-
Knee - Revisi total knee replacement (Cito) Rp. 9.062.526,-
Knee - Revisi total shoulder replacement (Cito) Rp. 9.062.526,-
Knee - Rotator cuff repair by arthroscopy (Cito) Rp. 9.062.526,-
Knee - Shoulder hemiarthroplasty (Cito) Rp. 9.062.526,-
Knee - Total shoulder replacement (Cito) Rp. 9.062.526,-
Kolonoskopi dan Biopsi (Cito) Rp. 9.062.526,-
Laparoscopic lysis of peritoneal adhesions (Cito) Rp. 9.062.526,-
Laparoskopi/histeroskopi - ovarian drilling (Cito) Rp. 9.062.526,-
Laparskopi / Histereskopi - Histeroskopi diagnostik (Cito) Rp. 9.062.526,-
Laparskopi / Histereskopi - Laparoskopi diagnostik (Cito) Rp. 9.062.526,-
Closure of cholecystostomy (Cito) Rp. 9.062.526,-
Laparskopi / Histereskopi - Second Look (Cito) Rp. 9.062.526,-
Laparskopi / Histereskopi - Tubektomi (Cito) Rp. 9.062.526,-
Large to large intestinal anastomosis (Cito) Rp. 9.062.526,-
Laring dan Faring - Laringektomi * (Cito) Rp. 9.062.526,-
Laring dan Faring - Laringektomi + RND * (Cito) Rp. 9.062.526,-
Laring dan Faring - Laringoskopi dengan Ekstirpasi (Cito) Rp. 9.062.526,-
Laring dan Faring - RND * (Cito) Rp. 9.062.526,-
Laringectomi * (Cito) Rp. 9.062.526,-
Laringectomi dengan diseksi leher * (Cito) Rp. 9.062.526,-
Lasik 1 (satu) mata (Cito) Rp. 9.062.526,-
Closure of fistula of large intestine (Cito) Rp. 9.062.526,-
Lobektomi parsial (reseksi paru segmental) * (Cito) Rp. 9.062.526,-
Muscle flap graft to breast (Cito) Rp. 9.062.526,-
Muscle flap graft to breast (TRAM flap / LD flap) (Cito) Rp. 9.062.526,-
Obstetri - Histerektomi pervaginam dan kolpoperineoplasti (Cito) Rp. 9.062.526,-
Obstetri - Partus Dengan Bius ELA (Cito) Rp. 9.062.526,-
Obstetri - Partus Dengan Bius ILA (Cito) Rp. 9.062.526,-
Obstetri - Purandare (Cito) Rp. 9.062.526,-
Obstetri - Rekonstruksi vagina (Cito) Rp. 9.062.526,-
Obstetri - Repair fistula (Cito) Rp. 9.062.526,-
Obstetri - Sectio caesaria dan histerektomi obstetri (Cito) Rp. 9.062.526,-
Closure of fistula of small intestine, except duodenum (Cito) Rp. 9.062.526,-
Obstetri - Sectio caesaria dengan penyulit (perlekatan berat, histerorafi) (Cito Rp. 9.062.526,-
Obstetri - Sectio Cesaria (SC) dengan ERACS (Cito) Rp. 9.062.526,-
Obstetri - Vaginoplasti (Cito) Rp. 9.062.526,-
Odontektomi tingkat II (Cito) Rp. 9.062.526,-
Onkologi - Diseksi leher bilateral (Cito) Rp. 9.062.526,-
Onkologi - Diseksi leher modified (Cito) Rp. 9.062.526,-
Onkologi - Ligasi arteri karotis eksterna (Cito) Rp. 9.062.526,-
Onkologi - Limb ablation dengan above atau below knee amputation soft tissue tum Rp. 9.062.526,-
Onkologi - Limb ablation dengan above atau below knee amputation soft tissue tum Rp. 9.062.526,-
Onkologi - Mandibulektomi parsial (Cito) Rp. 9.062.526,-
Closure of intestinal stoma (Cito) Rp. 9.062.526,-
Onkologi - Panendoskopi (eksplorasi NF, laringoskopi, esofagoskopi, bronkoskopi Rp. 9.062.526,-
Onkologi - Total patellectomy dan rekonstruksi (Cito) Rp. 9.062.526,-
Open biopsy of gallbladder or bile ducts (Cito) Rp. 9.062.526,-
Open biopsy of liver (Cito) Rp. 9.062.526,-
Open biopsy of pancreas (Cito) Rp. 9.062.526,-
Open reduction of malar and zygomatic fracture (Cito) Rp. 9.062.526,-
Open reduction of mandibular fractur (Cito) Rp. 9.062.526,-
Open reduction of maxillary fracture (Cito) Rp. 9.062.526,-
Other destruction of lesion of liver (Cito) Rp. 9.062.526,-
Other laparotomy (Cito) Rp. 9.062.526,-
Closure of leceration of liver (Cito) Rp. 9.062.526,-
Other partial excision of large intestine (Cito) Rp. 9.062.526,-
Other repair of anal sphincter (Cito) Rp. 9.062.526,-
Other repair of intestine (Cito) Rp. 9.062.526,-
Other repair of mesentery (Cito) Rp. 9.062.526,-
Other skin graft to hand (Cito) Rp. 9.062.526,-
Other skin graft to other sites (Cito) Rp. 9.062.526,-
Other small to large intestinal anastomosis (Cito) Rp. 9.062.526,-
Other suture of abdominal wall (Cito) Rp. 9.062.526,-
Otologi - Dekompresi nervus fasialis (Cito) Rp. 9.062.526,-
Otologi - Kanaloplasti / kanalomeatoplasty (Cito) Rp. 9.062.526,-
Colostomy (not otherwise specified) (Cito) Rp. 9.062.526,-
Otologi - Mastoidektomi radikal (Cito) Rp. 9.062.526,-
Otologi - Mastoidektomi sederhana (Cito) Rp. 9.062.526,-
Otologi - Stapedektomi (Cito) Rp. 9.062.526,-
Parotidektomi superfisial * (Cito) Rp. 9.062.526,-
Partial splenectomy (Cito) Rp. 9.062.526,-
Pediatrik - Open reduction dislokasi panggul dengan Acetabuloplasty dan Femoral Rp. 9.062.526,-
Pediatrik - Operasi rekonstruksi ibu jari kaki pada Hallux Valgus (Cito) Rp. 9.062.526,-
Pediatrik - Reposisi terbuka dan fiksasi interna fraktur tulang panjang pada ana Rp. 9.062.526,-
Pediatrik - Reposisi terbuka dan fiksasi interna kasus fraktur intra artikular a Rp. 9.062.526,-
Pediatrik - Reposisi terbuka dan fiksasi Interna pada kasus fraktur Salter Harri Rp. 9.062.526,-
Common duct exploration for removal of calculus (Cito) Rp. 9.062.526,-
Pediatrik - Tendon transfer ekstremitas bawah kasus neuromuskular anak (Cito) Rp. 9.062.526,-
Pedicle or flaps graft (not otherwise specified) (Cito) Rp. 9.062.526,-
Pemasangan Peritoneal Dialysis (PD) Catheter (Cito) Rp. 9.062.526,-
Pembuatan thoracic window (Cito) Rp. 9.062.526,-
Perikardiotomi / pericardial window * (Cito) Rp. 9.062.526,-
Permanent colostomy (Cito) Rp. 9.062.526,-
Permanent ileostomy (Cito) Rp. 9.062.526,-
Phaco (Cito) Rp. 9.062.526,-
Phaco dan IOL (Cito) Rp. 9.062.526,-
Plastik Rekionstruksi - Faringeal flap (Cito) Rp. 9.062.526,-
Debridement mediastinum (sternotomi) * (Cito) Rp. 9.062.526,-
Plastik Rekionstruksi - Forehead flap (Cito) Rp. 9.062.526,-
Plastik Rekionstruksi - Otoplasty * (Cito) Rp. 9.062.526,-
Plastik Rekionstruksi - Revisi parut (Cito) Rp. 9.062.526,-
Plastik Rekionstruksi - Rinoplasty * (Cito) Rp. 9.062.526,-
Plastik Rekionstruksi - Rinoplasty dengan augmentasi tulang rawan (Cito) Rp. 9.062.526,-
Pleurektomi * (Cito) Rp. 9.062.526,-
Plikasi diafragma * (Cito) Rp. 9.062.526,-
Pneumonectomy * (Cito) Rp. 9.062.526,-
Posterior vitektomi, SB, Endo laser, Silikon Oil / Gas, Phaco dan IOL (Cito) Rp. 9.062.526,-
Posterior vitrectomy, Phaco dan IOL (Cito) Rp. 9.062.526,-
Diseksi leher radikal / radikal neck dissection * (Cito) Rp. 9.062.526,-
Radical excision of skin lesion (Cito) Rp. 9.062.526,-
Reclosure of postoperative disruption of abdominal wall (Cito) Rp. 9.062.526,-
Rectosigmoidoskopi (Cito) Rp. 9.062.526,-
Reduction of anal prolapse (Cito) Rp. 9.062.526,-
Rekonstruksi - Blefaroplasty 2 kelopak (Cito) Rp. 9.062.526,-
Rekonstruksi - Ekstirpasi Tumor Adneksa (Cito) Rp. 9.062.526,-
Rekonstruksi - Endoskopi DCR dan silikon tube (Cito) Rp. 9.062.526,-
Rekonstruksi - Fraktur dasar orbita (Cito) Rp. 9.062.526,-
Rekonstruksi - Fraktur Multiple (Cito) Rp. 9.062.526,-
Rekonstruksi - Palpebra dengan Graft * (Cito) Rp. 9.062.526,-
Amputasi below knee (Cito) Rp. 9.062.526,-
Eksisi luas tumor ganas bibir dengan rekonstruksi flap lokal (Cito) Rp. 9.062.526,-
Rekonstruksi - Soket kontraktur (Cito) Rp. 9.062.526,-
Rekonstruksi - Soket landai (Cito) Rp. 9.062.526,-
Reopening of recent laparotomy site (Cito) Rp. 9.062.526,-
Repair arteri poplitea dan femoralis (Cito) Rp. 9.062.526,-
Repair of diaphragmatic hernia, abdominal approach (Cito) Rp. 9.062.526,-
Repair of laceration of gallbladder (Cito) Rp. 9.062.526,-
Repair pembuluh darah regio servikal (karotis, jugular) * (Cito) Rp. 9.062.526,-
Resection of transverse colon (Cito) Rp. 9.062.526,-
Reseksi maksila infrastuktural (Cito) Rp. 9.062.526,-
Reseksi mandibula tanpa rekonstruksi (Cito) Rp. 9.062.526,-
Eksisi luas tumor ganas kulit tanpa rekonstruksi (Cito) Rp. 9.062.526,-
Revision of anastomosis of large intestine (Cito) Rp. 9.062.526,-
Revision of anastomosis of small intestine (Cito) Rp. 9.062.526,-
Revision of stoma of large intestine (Cito) Rp. 9.062.526,-
Revision of stoma of small intestine (Cito) Rp. 9.062.526,-
Revision of tracheostomy (Cito) Rp. 9.062.526,-
Right hemicolectomy (Cito) Rp. 9.062.526,-
Rinologi - BSEF / FESS 1 : Mini (Cito) Rp. 9.062.526,-
Rinologi - BSEF / FESS 2 : Mini dan Maksila / etmoid (Cito) Rp. 9.062.526,-
Rinologi - BSEF / FESS 3 : Mini dan frontal / sfenoid (Cito) Rp. 9.062.526,-
Rupture buli-buli * (Cito) Rp. 9.062.526,-
Eksisi pseudoaneurisma (Cito) Rp. 9.062.526,-
Scleral buckling, phaco dan IOL (Cito) Rp. 9.062.526,-
Sigmoidectomy (Cito) Rp. 9.062.526,-
Simple suture of common bile duct (Cito) Rp. 9.062.526,-
Small to small intestinal anastomosis (Cito) Rp. 9.062.526,-
Spine - Discograph (1 level) * (Cito) Rp. 9.062.526,-
Spine - Discograph (1 level) * (Cito) Rp. 9.062.526,-
Spine - Discograph multilevel * (Cito) Rp. 9.062.526,-
Spine - Facet block (1 level) (Cito) Rp. 9.062.526,-
Spine - Facet block multilevel (Cito) Rp. 9.062.526,-
Spine - Foraminal block (1 level) (Cito) Rp. 9.062.526,-
Eksplorasi vaskular (trauma / non trauma) (Cito) Rp. 9.062.526,-
Spine - Foraminal block multilevel (Cito) Rp. 9.062.526,-
Spine - Manipulation, reduction of simple fracture and dislocation with general Rp. 9.062.526,-
Spine - Removal of implants (Plate, Nail, Screw) * (Cito) Rp. 9.062.526,-
Strabismus 4 otot (Cito) Rp. 9.062.526,-
Stripping varises ekstremitas inferior (Cito) Rp. 9.062.526,-
Subtotal mastectomy (Cito) Rp. 9.062.526,-
Temporary colostomy (Cito) Rp. 9.062.526,-
Temporary ileostomy * (Cito) Rp. 9.062.526,-
Thoracal symphatectomy dengan Video Assissted Thoracoscopic Surgery (VATS) (Cito Rp. 9.062.526,-
Tiroidektomi subtotal / total nodul tiroid ** (Cito) Rp. 9.062.526,-
Ekstraksi corpus alienum di regio toraks * (Cito) Rp. 9.062.526,-
Total splenectomy * (Cito) Rp. 9.062.526,-
Trauma - Closed fraktur distal tibia (Cito) Rp. 9.062.526,-
Trauma - Closed fraktur intercondylar femur (Cito) Rp. 9.062.526,-
Trauma - Closed fraktur proksimal tibia involve intraartikular (Cito) Rp. 9.062.526,-
Trauma - Closed fraktur supracondylar femur (Cito) Rp. 9.062.526,-
Trauma - Fracture acetabulum 1 collum dengan ORIF (Cito) Rp. 9.062.526,-
Trauma - Fracture artikuler dengan MIPO atau ORIF Artikuler (Cito) Rp. 9.062.526,-
Trauma - Fracture pelvis simple dengan fiksasi eksterna pelvic (ORIF) (Cito) Rp. 9.062.526,-
Trauma - Fraktur acetabulum dan pelvic dengan ORIF (Cito) Rp. 9.062.526,-
Trauma - Fraktur collum femur pada orang tua (Cito) Rp. 9.062.526,-
Ekstraksi corpus alienum di regio toraks dengan VATS * (Cito) Rp. 9.062.526,-
Trauma - Fraktur collum femur pada usia < 60 tahun (Cito) Rp. 9.062.526,-
Trauma - Fraktur galeazi (Cito) Rp. 9.062.526,-
Trauma - Fraktur intertrochanter femur pada orang tua (Cito) Rp. 9.062.526,-
Trauma - Fraktur intertrochanter femur pada usia < 60 tahun (Cito) Rp. 9.062.526,-
Trauma - Fraktur montegia (Cito) Rp. 9.062.526,-
Trauma - Fraktur neck humerus pada usia < 60 tahun (Cito) Rp. 9.062.526,-
Trauma - Fraktur neck humerus pada usia > 60 tahun (Cito) Rp. 9.062.526,-
Trauma - Fraktur subtrochanter femur pada usia < 60 tahun (Cito) Rp. 9.062.526,-
Trauma - Fraktur subtrochanter femur pada usia > 60 tahun (Cito) Rp. 9.062.526,-
Trauma - Instability joint infection (Cito) Rp. 9.062.526,-
Embolektomi / trombektomi aorta (Cito) Rp. 9.062.526,-
Trauma - Joint stiffness dengan liberation (Cito) Rp. 9.062.526,-
Trauma - Multiple fracture tulang panjang dengan MIPO atau ORIF dan removal impl Rp. 9.062.526,-
Trauma - Non union dengan bone graft (Cito) Rp. 9.062.526,-
Trauma - Open fraktur shaft femur grade 3 (Cito) Rp. 9.062.526,-
Trauma - Open fraktur shaft humerus grade 3 (Cito) Rp. 9.062.526,-
Trauma - Open fraktur shaft radius grade 3 (Cito) Rp. 9.062.526,-
Trauma - Open fraktur shaft tibia grade 3 (Cito) Rp. 9.062.526,-
Trauma - Open fraktur shaft ulna grade 3 (Cito) Rp. 9.062.526,-
Trauma - Osteomyelitis (Cito) Rp. 9.062.526,-
Tumor - Extended Eksenterasi (Cito) Rp. 9.062.526,-
Embolektomi / trombektomi pembuluh darah arteri ekstremitas bawah * (Cito) Rp. 9.062.526,-
Tumor - Orbital dekompresi 3 tulang (Cito) Rp. 9.062.526,-
Tumor - Orbitotomi lateral and superior (medial) (Cito) Rp. 9.062.526,-
Unilateral radical mastectomy (Cito) Rp. 9.062.526,-
Unilateral simple mastectomy (Cito) Rp. 9.062.526,-
Upper Endoskopi (Cito) Rp. 9.062.526,-
Upper Endoskopi dan biopsi (Cito) Rp. 9.062.526,-
Upper Endoskopi dan ekstraksi carpal (Cito) Rp. 9.062.526,-
Upper Endoskopi dan ligasi (Cito) Rp. 9.062.526,-
Embolektomi / trombektomi pembuluh darah ekstremitas atas (Cito) Rp. 9.062.526,-
Embolektomi / trombektomi pembuluh darah ekstremitas bawah * (Cito) Rp. 9.062.526,-
Aneurisma arteri brachialis (Cito) Rp. 9.062.526,-
Embolektomi / trombektomi pembuluh darah regio servikal (karotis, jugular) * (Ci Rp. 9.062.526,-
Endoscopic polypectomy of rectum (Cito) Rp. 9.062.526,-
Endoscopic thyroidectomy (Cito) Rp. 9.062.526,-
Endoskopi - Bronkoskopi ekstraksi dengan penyulit (Cito) Rp. 9.062.526,-
Endoskopi - Intubasi dengan flexible bronkoskopi (Cito) Rp. 9.062.526,-
Endoskopi - Pan bronkoskopi (Cito) Rp. 9.062.526,-
Endoskopi - Pan esofagoskopi (Cito) Rp. 9.062.526,-
Endoskopi - Sialendoskopi diagnostik (Cito) Rp. 9.062.526,-
Endoskopi - Sleep nasoendoskopi (Cito) Rp. 9.062.526,-
Excision of hemorrhoid (Cito) Rp. 9.062.526,-
Aneurisma arteri femoralis (Cito) Rp. 9.062.526,-
Exploration of common duct (Cito) Rp. 9.062.526,-
Exteriorization of large intestine (Cito) Rp. 9.062.526,-
Exteriorization of small intestine (Cito) Rp. 9.062.526,-
Fiksasi sternum (wire, plate) * (Cito) Rp. 9.062.526,-
Fraktur antebrachi (Cito) Rp. 9.062.526,-
Fraktur colles dan pergelangan tangan lainnya (Cito) Rp. 9.062.526,-
Fraktur cruris (Cito) Rp. 9.062.526,-
Fraktur femur * (Cito) Rp. 9.062.526,-
Fraktur klavikula (Cito) Rp. 9.062.526,-
Fraktur olekranon (Cito) Rp. 9.062.526,-
Axillary dissection (Cito) Rp. 9.062.526,-
Fraktur patela (Cito) Rp. 9.062.526,-
Fraktur suprakondiler humerus (Cito) Rp. 9.062.526,-
Free skin graft (Cito) Rp. 9.062.526,-
Full-thickness skin graft to hand (Cito) Rp. 9.062.526,-
Full-thickness skin graft to other sites * (Cito) Rp. 9.062.526,-
GIN- Hymenoplasty (Cito) Rp. 9.062.526,-
Ginekologi - Histerektomi (Cito) Rp. 9.062.526,-
Ginekologi - Kehamilan ektopik (Cito) Rp. 9.062.526,-
Ginekologi - Miomektomi (Cito) Rp. 9.062.526,-
Glaukoma - Tubes implan, Phaco dan IOL (Cito) Rp. 9.062.526,-
Batu saluran kemih * (Cito) Rp. 9.062.526,-
Groin dissection (Cito) Rp. 9.062.526,-
Hand - Carpus, fracture or dislocation, reduksi terbuka dan fiksasi interna * (C Rp. 9.062.526,-
Hand - Jari, defect or contracture (single) rekonstruksi (Cito) Rp. 9.062.526,-
Hand - Jari, deformities, koreksi (Cito) Rp. 9.062.526,-
Hand - Jari, fracture or dislocation, reduksi terbuka dan fiksasi interna (multi Rp. 9.062.526,-
Hand - Jari, ring constriction (multiple), koreksi (Cito) Rp. 9.062.526,-
Hand - Jari, syndactili (multiple) (Cito) Rp. 9.062.526,-
Hand - Kulit dan Jaringan subkutis, laceration (superficial ) > 7 cm , repair (C Rp. 9.062.526,-
Hand - Nail bed, laceration, Repair (multiple) (Cito) Rp. 9.062.526,-
Hand - Nerve (ekstremitas atas), carpal tunnel syndorme, release (bilateral with Rp. 9.062.526,-
Bilateral simple mastectomy (Cito) Rp. 9.062.526,-
Hand - Nerve (ekstremitas atas), entrapment syndrome (other) decompression (bila Rp. 9.062.526,-
Hand - Nerve (ekstremitas atas), entrapment syndrome (other) decompression with Rp. 9.062.526,-
Hand - Nerve (ekstremitas atas), entrapment syndrome (other), decompression (uni Rp. 9.062.526,-
Hand - Nerve (ekstremitas atas), Guyon's tunnel syndrome, release (bilateral wit Rp. 9.062.526,-
Hand - Nerve (ekstremitas atas), Guyon's Tunnel Syndrome, Release (unilateral) ( Rp. 9.062.526,-
Hand - Tendon Sheath (ekstremitas atas), De Quarvain's (bilateral), release (Cit Rp. 9.062.526,-
Hand - Thumb, deformitas, Koreksi (Cito) Rp. 9.062.526,-
Hemiglosektomi (Cito) Rp. 9.062.526,-
Hip - Arthroscopy (Cito) Rp. 9.062.526,-
Hip - Hemiarthroplasty (Cito) Rp. 9.062.526,-
Cholecystectomy (Cito) Rp. 9.062.526,-
Hip - ORIF, DHS (Cito) Rp. 9.062.526,-
Hipertropi Prostat Beningna (BPH) * (Cito) Rp. 9.062.526,-
Ileostomy (not otherwise specified) * (Cito) Rp. 9.062.526,-
Incisional hernia repair (Cito) Rp. 9.062.526,-
Incisional hernia repair with prosthesis (Cito) Rp. 9.062.526,-
Internal drainage of pancreatic cyst (Cito) Rp. 9.062.526,-
Knee - Anterior cruciate ligament reconstruction (Cito) Rp. 9.062.526,-
Knee - Arthroscopy debridement knee (Cito) Rp. 9.062.526,-
Knee - Arthroscopy debridement shoulder (Cito) Rp. 9.062.526,-
Knee - Arthroscopy diagnostic (Cito) Rp. 9.062.526,-
Choledochoplasty (Cito) Rp. 9.062.526,-
Knee - Arthroscopy diagnostic shoulder (Cito) Rp. 9.062.526,-
Knee - Arthroscopy meniscus repair (Cito) Rp. 9.062.526,-
Knee - Arthroscopy minisectomy, arthroscopy synevectomy knee (Cito) Rp. 9.062.526,-
Knee - Arthroscopy remove loose body (Cito) Rp. 9.062.526,-
Knee - Arthroscopy remove loose body shoulder (Cito) Rp. 9.062.526,-
Knee - Fibular osteotomy (Cito) Rp. 9.062.526,-
Knee - Lateral collateral ligament reconstruction (Cito) Rp. 9.062.526,-
Knee - Medial collateral ligament reconstruction (Cito) Rp. 9.062.526,-
Knee - Posterior cruciate ligamnet reconstruction (Cito) Rp. 9.062.526,-
Knee - Recurrent shoulder dislocation repair TUBS and AMBRI (Cito) Rp. 9.062.526,-
Clipping costa (Cito) Rp. 13.379.676,-
Complete thyroidectomy (Cito) Rp. 13.379.676,-
Eksisi luas tumor ganas dengan rekonstruksi flap jauh (Cito) Rp. 13.379.676,-
Eksisi luas tumor ganas rongga mulut dengan rekonstruksi flap lokal (Cito) Rp. 13.379.676,-
Eksisi pada bronkhus (Cito) Rp. 13.379.676,-
Eksisi tumor ganas kulit dengan flap local atau graft kulit (Cito) Rp. 13.379.676,-
Endoskopi - Bronkoskopi diagnostik (Cito) Rp. 13.379.676,-
Endoskopi - Bronkoskopi ekstraksi tanpa penyulit (Cito) Rp. 13.379.676,-
Endoskopi - Esofagoskopi BA dengan penyulit (Cito) Rp. 13.379.676,-
Endoskopi - Esofagoskopi diagnostik (Cito) Rp. 13.379.676,-
Excision of other bile duct (Cito) Rp. 13.379.676,-
Ginekologi - Adhesiolisis perlekatan berat pelvik (Cito) Rp. 13.379.676,-
Ginekologi - Infeksi panggul/PUS dengan perlekatan (Cito) Rp. 13.379.676,-
Ginekologi - Repair tuba (tubaplasti) (Cito) Rp. 13.379.676,-
Ginekologi - Reseksi adenomiosis (Cito) Rp. 13.379.676,-
Ginekologi - Transposisi Ovarium (Cito) Rp. 13.379.676,-
Hand - Artery, large, injury, repair with grafting (Cito) Rp. 13.379.676,-
Hand - Carpus, delayed (non union), rekonstruksi (Cito) Rp. 13.379.676,-
Hand - Jari (digit), stump, revision (Cito) Rp. 13.379.676,-
Hand - Jari, defect or contracture (multiple) rekonstruksi (Cito) Rp. 13.379.676,-
Hand - Jari, deformities, major reconstruction procedure (Cito) Rp. 13.379.676,-
Hand - Jari, deformities, osteotomy (Cito) Rp. 13.379.676,-
Hand - Jari, deformity, instrinsic muscle transfer (Cito) Rp. 13.379.676,-
Hand - Jari, scar, revision osteotomy (Cito) Rp. 13.379.676,-
Hand - Nerve (ekstremitas atas), major, injury, microsurgical, repair (single) ( Rp. 13.379.676,-
Hand - Nerve defect, peripheral graft (Cito) Rp. 13.379.676,-
Hand - Nerve digital, Injury, microsurgical (single) (Cito) Rp. 13.379.676,-
Hand - Nerve digital, injury, primary repair (Cito) Rp. 13.379.676,-
Hand - Nerve ulnar, entrapment, transposition (Cito) Rp. 13.379.676,-
Hand - Sendi (jari), various lesions, replacement arthoplasty (Cito) Rp. 13.379.676,-
Hand - Tendon (ekstremitas atas), bowstringing (entrapment), pulley rekonstruksi Rp. 13.379.676,-
Hand - Tendon extensor (ekstremitas atas) injury, repair (multiple) (Cito) Rp. 13.379.676,-
Hand - Tendon flexor (ekstremitas atas) injury, tendon graft (Cito) Rp. 13.379.676,-
Hand - Tendon flexor (ekstremitas atas), defect grafting (single) (Cito) Rp. 13.379.676,-
Hand - Thumb, paralysis, oppnens plasty (Cito) Rp. 13.379.676,-
Hip - Total hip replacement (Cito) Rp. 13.379.676,-
Intra-abdominal manipulation of intestine (not otherwise specified) (Cito) Rp. 13.379.676,-
Intra-abdominal manipulation of large intestine (Cito) Rp. 13.379.676,-
Intra-abdominal manipulation of small intestine (Cito) Rp. 13.379.676,-
Knee - Total knee replacement (Cito) Rp. 13.379.676,-
Knee - Uni compartment arthroplasty (Cito) Rp. 13.379.676,-
Laparoscopic appendectomy (Cito) Rp. 13.379.676,-
Laparoscopic appendectomy (elective) (Cito) Rp. 13.379.676,-
Laparoscopic cholecystectomy (Cito) Rp. 13.379.676,-
Laparoscopic incidental appendectomy (Cito) Rp. 13.379.676,-
Laparoscopy (Cito) Rp. 13.379.676,-
Laparskopi / Histereskopi - Adhesiolisis Perlekatan Ringan (Cito) Rp. 13.379.676,-
Laparskopi / Histereskopi - Eksplorasi dan ektraksi IUD translokasi. (Cito) Rp. 13.379.676,-
Laparskopi / Histereskopi - Kasus dengan penyulit (Cito) Rp. 13.379.676,-
Laparskopi / Histereskopi - Kistektomi (Cito) Rp. 13.379.676,-
Laparskopi / Histereskopi - Ooforektomi/salpingektomi (Cito) Rp. 13.379.676,-
Laparskopi / Histereskopi - Ovareksi (Cito) Rp. 13.379.676,-
Laparskopi / Histereskopi - Salpingoooforektomi (Cito) Rp. 13.379.676,-
Laparskopi / Histereskopi - Transposisi Ovarium (Cito) Rp. 13.379.676,-
Laring dan Faring - TA/T dengan Coblation Laser (Cito) Rp. 13.379.676,-
Laring dan Faring - Tiroidektomi Subtotal ** (Cito) Rp. 13.379.676,-
Laring dan Faring - Tiroidektomi Total (Cito) Rp. 13.379.676,-
Laring dan Faring - UPPP (Uvulo Palatopharyngo Plasty) (Cito) Rp. 13.379.676,-
Left hemicolectomy (Cito) Rp. 13.379.676,-
Mediastinostomy (Cito) Rp. 13.379.676,-
Obstetri - Operasi plasenta akreta (Cito) Rp. 13.379.676,-
Odontektomi tingkat III (Cito) Rp. 13.379.676,-
Onkologi - Belloque tampon dengan narkosis (Cito) Rp. 13.379.676,-
Onkologi - Diseksi leher radikal * (Cito) Rp. 13.379.676,-
Onkologi - Eksplorasi nasofaring (Cito) Rp. 13.379.676,-
Onkologi - Ekstirpasi tumor jinak kel liur (Cito) Rp. 13.379.676,-
Onkologi - Ekstirpasi tumor jinak sinonasal, oral cavity (Cito) Rp. 13.379.676,-
Onkologi - Hemiartroplasty pada metastatic bone disease (Cito) Rp. 13.379.676,-
Onkologi - Hemiglosektomi (Cito) Rp. 13.379.676,-
Onkologi - Maksilektomi parsial (Cito) Rp. 13.379.676,-
Onkologi - Maksilektomi total (radikal) (Cito) Rp. 13.379.676,-
Onkologi - ORIF MBD (Cito) Rp. 13.379.676,-
Onkologi - Parotidektomi * (Cito) Rp. 13.379.676,-
Onkologi - Wide excision soft tisue sarcoma (Cito) Rp. 13.379.676,-
Other operations on intestines (Cito) Rp. 13.379.676,-
Other operations on the breast (reconstruction of the breast) (Cito) Rp. 13.379.676,-
Other partial thyroidectomy (Cito) Rp. 13.379.676,-
Parathyroidectomy subtotal (Cito) Rp. 13.379.676,-
Parathyroidectomy total (Cito) Rp. 13.379.676,-
partial mandibulectomy hemimandibulectomy (Cito) Rp. 13.379.676,-
Pediatrik - Posteromedial soft tissue release CTEV (Cito) Rp. 13.379.676,-
Pilar Implant (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Labioplasti Bilateral (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Labioplasti unilateral (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Pembukaan lubang hidung (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Rekonstruksi fraktur rahang (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Rekonstruksi hidung dengan defek (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Rekonstruksi mandibula ** (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Rekonstruksi telinga (mirotia) tahap 1 (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Rekonstruksi telinga (mirotia) tahap 2 (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Reseksi septum (Cito) Rp. 13.379.676,-
Plastik Rekionstruksi - Septorinoplasty (Cito) Rp. 13.379.676,-
Redo torakotomi * (Cito) Rp. 13.379.676,-
Reduction Neglected Dislocation (Cito) Rp. 13.379.676,-
Rekonstruksi vaskular ekstremitas inferior (arteri femoralis dan poplitea) (Cito Rp. 13.379.676,-
Rekonstruksi vaskular ekstremitas superior (arteri brakialis, radialis dan ulnar Rp. 13.379.676,-
Repair laserasi diafragma * (Cito) Rp. 13.379.676,-
Reposisi dislokasi rahang (Cito) Rp. 13.379.676,-
Reseksi maksila suprastuktural (Cito) Rp. 13.379.676,-
Rinologi - Caldwell Luc (Cito) Rp. 13.379.676,-
Rinologi - Ekstraksi Benda Asing (Narkosis) (Cito) Rp. 13.379.676,-
Rinologi - Septum Reseksi / SMR (Cito) Rp. 13.379.676,-
Rinologi - Sinuskopi / Sinoskopi Dengan Tindakan (Cito) Rp. 13.379.676,-
Spine - Alar transverse fusion * (Cito) Rp. 13.379.676,-
Spine - Anterior cervcal discetomy dan Fusion (ACDF) * (Cito) Rp. 13.379.676,-
Spine - Anterior cervical corpectomy dan Fusion (ACCF) * (Cito) Rp. 13.379.676,-
Spine - Debridement and anterior fusion in TB Spine * (Cito) Rp. 13.379.676,-
Spine - Decompression laminectomy for HNP with stabilization * (Cito) Rp. 13.379.676,-
Spine - Decompression laminectomy for spondilolisthesis stabilization * (Cito) Rp. 13.379.676,-
Spine - Decompression laminectomy for tumor and spinal stenosis with stabilizati Rp. 13.379.676,-
Spine - Laminectomy (1 Level) pada simple spine stenosis * (Cito) Rp. 13.379.676,-
Spine - Mayor desloughing and wound debridement of the spine * (Cito) Rp. 13.379.676,-
Spine - Micro endoscopic disectomy (1 level) * (Cito) Rp. 13.379.676,-
Spine - Microscopic disectomy (1 Level) (Cito) Rp. 13.379.676,-
Spine - Open disectomy multilevel * (Cito) Rp. 13.379.676,-
Spine - Open disestomy (1 Level) * (Cito) Rp. 13.379.676,-
Spine - Open reduction and stabilisation of spinal fracture * (Cito) Rp. 13.379.676,-
Spine - Posterior cervical fusion * (Cito) Rp. 13.379.676,-
Spine - Posterior lumbar interbody fusion (FLIF) dan posterior stabilisation * ( Rp. 13.379.676,-
Spine - Posterolateral fusion * (Cito) Rp. 13.379.676,-
Spine - Total disc replacement (multilevel) * (Cito) Rp. 13.379.676,-
Split thickness graft to breast (Cito) Rp. 13.379.676,-
Terapi Slem Cell (Cito) Rp. 13.379.676,-
Thymectomy dengan VATS (Cito) Rp. 13.379.676,-
Tiroidektomi total dengan berry picking (Cito) Rp. 13.379.676,-
Tiroidektomi total dengan diseksi leher fungsional (Cito) Rp. 13.379.676,-
Trakeostomi dengan penyulit tumor pada akses trakea *** (Cito) Rp. 13.379.676,-
Trauma - Joint kompleks destruction / OA post trauma (total joint arthroplasty) Rp. 13.379.676,-
Trauma - Limb leg inequality dengan bone lengthening transport (Cito) Rp. 13.379.676,-
Turbinoplasty (Cito) Rp. 13.379.676,-
Clipping costa (Cito) Rp. 12.364.475,-
Complete thyroidectomy (Cito) Rp. 12.364.475,-
Eksisi luas tumor ganas dengan rekonstruksi flap jauh (Cito) Rp. 12.364.475,-
Eksisi luas tumor ganas rongga mulut dengan rekonstruksi flap lokal (Cito) Rp. 12.364.475,-
Eksisi pada bronkhus (Cito) Rp. 12.364.475,-
Eksisi tumor ganas kulit dengan flap local atau graft kulit (Cito) Rp. 12.364.475,-
Endoskopi - Bronkoskopi diagnostik (Cito) Rp. 12.364.475,-
Endoskopi - Bronkoskopi ekstraksi tanpa penyulit (Cito) Rp. 12.364.475,-
Endoskopi - Esofagoskopi BA dengan penyulit (Cito) Rp. 12.364.475,-
Endoskopi - Esofagoskopi diagnostik (Cito) Rp. 12.364.475,-
Excision of other bile duct (Cito) Rp. 12.364.475,-
Ginekologi - Adhesiolisis perlekatan berat pelvik (Cito) Rp. 12.364.475,-
Ginekologi - Infeksi panggul/PUS dengan perlekatan (Cito) Rp. 12.364.475,-
Ginekologi - Repair tuba (tubaplasti) (Cito) Rp. 12.364.475,-
Ginekologi - Reseksi adenomiosis (Cito) Rp. 12.364.475,-
Ginekologi - Transposisi Ovarium (Cito) Rp. 12.364.475,-
Hand - Artery, large, injury, repair with grafting (Cito) Rp. 12.364.475,-
Hand - Carpus, delayed (non union), rekonstruksi (Cito) Rp. 12.364.475,-
Hand - Jari (digit), stump, revision (Cito) Rp. 12.364.475,-
Hand - Jari, defect or contracture (multiple) rekonstruksi (Cito) Rp. 12.364.475,-
Hand - Jari, deformities, major reconstruction procedure (Cito) Rp. 12.364.475,-
Hand - Jari, deformities, osteotomy (Cito) Rp. 12.364.475,-
Hand - Jari, deformity, instrinsic muscle transfer (Cito) Rp. 12.364.475,-
Hand - Jari, scar, revision osteotomy (Cito) Rp. 12.364.475,-
Hand - Nerve (ekstremitas atas), major, injury, microsurgical, repair (single) ( Rp. 12.364.475,-
Hand - Nerve defect, peripheral graft (Cito) Rp. 12.364.475,-
Hand - Nerve digital, Injury, microsurgical (single) (Cito) Rp. 12.364.475,-
Hand - Nerve digital, injury, primary repair (Cito) Rp. 12.364.475,-
Hand - Nerve ulnar, entrapment, transposition (Cito) Rp. 12.364.475,-
Hand - Sendi (jari), various lesions, replacement arthoplasty (Cito) Rp. 12.364.475,-
Hand - Tendon (ekstremitas atas), bowstringing (entrapment), pulley rekonstruksi Rp. 12.364.475,-
Hand - Tendon extensor (ekstremitas atas) injury, repair (multiple) (Cito) Rp. 12.364.475,-
Hand - Tendon flexor (ekstremitas atas) injury, tendon graft (Cito) Rp. 12.364.475,-
Hand - Tendon flexor (ekstremitas atas), defect grafting (single) (Cito) Rp. 12.364.475,-
Hand - Thumb, paralysis, oppnens plasty (Cito) Rp. 12.364.475,-
Hip - Total hip replacement (Cito) Rp. 12.364.475,-
Intra-abdominal manipulation of intestine (not otherwise specified) (Cito) Rp. 12.364.475,-
Intra-abdominal manipulation of large intestine (Cito) Rp. 12.364.475,-
Intra-abdominal manipulation of small intestine (Cito) Rp. 12.364.475,-
Knee - Total knee replacement (Cito) Rp. 12.364.475,-
Knee - Uni compartment arthroplasty (Cito) Rp. 12.364.475,-
Laparoscopic appendectomy (Cito) Rp. 12.364.475,-
Laparoscopic appendectomy (elective) (Cito) Rp. 12.364.475,-
Laparoscopic cholecystectomy (Cito) Rp. 12.364.475,-
Laparoscopic incidental appendectomy (Cito) Rp. 12.364.475,-
Laparoscopy (Cito) Rp. 12.364.475,-
Laparskopi / Histereskopi - Adhesiolisis Perlekatan Ringan (Cito) Rp. 12.364.475,-
Laparskopi / Histereskopi - Eksplorasi dan ektraksi IUD translokasi. (Cito) Rp. 12.364.475,-
Laparskopi / Histereskopi - Kasus dengan penyulit (Cito) Rp. 12.364.475,-
Laparskopi / Histereskopi - Kistektomi (Cito) Rp. 12.364.475,-
Laparskopi / Histereskopi - Ooforektomi/salpingektomi (Cito) Rp. 12.364.475,-
Laparskopi / Histereskopi - Ovareksi (Cito) Rp. 12.364.475,-
Laparskopi / Histereskopi - Salpingoooforektomi (Cito) Rp. 12.364.475,-
Laparskopi / Histereskopi - Transposisi Ovarium (Cito) Rp. 12.364.475,-
Laring dan Faring - TA/T dengan Coblation Laser (Cito) Rp. 12.364.475,-
Laring dan Faring - Tiroidektomi Subtotal ** (Cito) Rp. 12.364.475,-
Laring dan Faring - Tiroidektomi Total (Cito) Rp. 12.364.475,-
Laring dan Faring - UPPP (Uvulo Palatopharyngo Plasty) (Cito) Rp. 12.364.475,-
Left hemicolectomy (Cito) Rp. 12.364.475,-
Mediastinostomy (Cito) Rp. 12.364.475,-
Obstetri - Operasi plasenta akreta (Cito) Rp. 12.364.475,-
Odontektomi tingkat III (Cito) Rp. 12.364.475,-
Onkologi - Belloque tampon dengan narkosis (Cito) Rp. 12.364.475,-
Onkologi - Diseksi leher radikal * (Cito) Rp. 12.364.475,-
Onkologi - Eksplorasi nasofaring (Cito) Rp. 12.364.475,-
Onkologi - Ekstirpasi tumor jinak kel liur (Cito) Rp. 12.364.475,-
Onkologi - Ekstirpasi tumor jinak sinonasal, oral cavity (Cito) Rp. 12.364.475,-
Onkologi - Hemiartroplasty pada metastatic bone disease (Cito) Rp. 12.364.475,-
Onkologi - Hemiglosektomi (Cito) Rp. 12.364.475,-
Onkologi - Maksilektomi parsial (Cito) Rp. 12.364.475,-
Onkologi - Maksilektomi total (radikal) (Cito) Rp. 12.364.475,-
Onkologi - ORIF MBD (Cito) Rp. 12.364.475,-
Onkologi - Parotidektomi * (Cito) Rp. 12.364.475,-
Onkologi - Wide excision soft tisue sarcoma (Cito) Rp. 12.364.475,-
Other operations on intestines (Cito) Rp. 12.364.475,-
Other operations on the breast (reconstruction of the breast) (Cito) Rp. 12.364.475,-
Other partial thyroidectomy (Cito) Rp. 12.364.475,-
Parathyroidectomy subtotal (Cito) Rp. 12.364.475,-
Parathyroidectomy total (Cito) Rp. 12.364.475,-
partial mandibulectomy hemimandibulectomy (Cito) Rp. 12.364.475,-
Pediatrik - Posteromedial soft tissue release CTEV (Cito) Rp. 12.364.475,-
Pilar Implant (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Labioplasti Bilateral (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Labioplasti unilateral (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Pembukaan lubang hidung (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Rekonstruksi fraktur rahang (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Rekonstruksi hidung dengan defek (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Rekonstruksi mandibula ** (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Rekonstruksi telinga (mirotia) tahap 1 (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Rekonstruksi telinga (mirotia) tahap 2 (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Reseksi septum (Cito) Rp. 12.364.475,-
Plastik Rekionstruksi - Septorinoplasty (Cito) Rp. 12.364.475,-
Redo torakotomi * (Cito) Rp. 12.364.475,-
Reduction Neglected Dislocation (Cito) Rp. 12.364.475,-
Rekonstruksi vaskular ekstremitas inferior (arteri femoralis dan poplitea) (Cito Rp. 12.364.475,-
Rekonstruksi vaskular ekstremitas superior (arteri brakialis, radialis dan ulnar Rp. 12.364.475,-
Repair laserasi diafragma * (Cito) Rp. 12.364.475,-
Reposisi dislokasi rahang (Cito) Rp. 12.364.475,-
Reseksi maksila suprastuktural (Cito) Rp. 12.364.475,-
Rinologi - Caldwell Luc (Cito) Rp. 12.364.475,-
Rinologi - Ekstraksi Benda Asing (Narkosis) (Cito) Rp. 12.364.475,-
Rinologi - Septum Reseksi / SMR (Cito) Rp. 12.364.475,-
Rinologi - Sinuskopi / Sinoskopi Dengan Tindakan (Cito) Rp. 12.364.475,-
Spine - Alar transverse fusion * (Cito) Rp. 12.364.475,-
Spine - Anterior cervcal discetomy dan Fusion (ACDF) * (Cito) Rp. 12.364.475,-
Spine - Anterior cervical corpectomy dan Fusion (ACCF) * (Cito) Rp. 12.364.475,-
Spine - Debridement and anterior fusion in TB Spine * (Cito) Rp. 12.364.475,-
Spine - Decompression laminectomy for HNP with stabilization * (Cito) Rp. 12.364.475,-
Spine - Decompression laminectomy for spondilolisthesis stabilization * (Cito) Rp. 12.364.475,-
Spine - Decompression laminectomy for tumor and spinal stenosis with stabilizati Rp. 12.364.475,-
Spine - Laminectomy (1 Level) pada simple spine stenosis * (Cito) Rp. 12.364.475,-
Spine - Mayor desloughing and wound debridement of the spine * (Cito) Rp. 12.364.475,-
Spine - Micro endoscopic disectomy (1 level) * (Cito) Rp. 12.364.475,-
Spine - Microscopic disectomy (1 Level) (Cito) Rp. 12.364.475,-
Spine - Open disectomy multilevel * (Cito) Rp. 12.364.475,-
Spine - Open disestomy (1 Level) * (Cito) Rp. 12.364.475,-
Spine - Open reduction and stabilisation of spinal fracture * (Cito) Rp. 12.364.475,-
Spine - Posterior cervical fusion * (Cito) Rp. 12.364.475,-
Spine - Posterior lumbar interbody fusion (FLIF) dan posterior stabilisation * ( Rp. 12.364.475,-
Spine - Posterolateral fusion * (Cito) Rp. 12.364.475,-
Spine - Total disc replacement (multilevel) * (Cito) Rp. 12.364.475,-
Split thickness graft to breast (Cito) Rp. 12.364.475,-
Terapi Slem Cell (Cito) Rp. 12.364.475,-
Thymectomy dengan VATS (Cito) Rp. 12.364.475,-
Tiroidektomi total dengan berry picking (Cito) Rp. 12.364.475,-
Tiroidektomi total dengan diseksi leher fungsional (Cito) Rp. 12.364.475,-
Trakeostomi dengan penyulit tumor pada akses trakea *** (Cito) Rp. 12.364.475,-
Trauma - Joint kompleks destruction / OA post trauma (total joint arthroplasty) Rp. 12.364.475,-
Trauma - Limb leg inequality dengan bone lengthening transport (Cito) Rp. 12.364.475,-
Turbinoplasty (Cito) Rp. 12.364.475,-
Clipping costa (Cito) Rp. 11.967.376,-
Endoskopi - Esofagoskopi diagnostik (Cito) Rp. 11.967.376,-
Rinologi - Caldwell Luc (Cito) Rp. 11.967.376,-
Rinologi - Ekstraksi Benda Asing (Narkosis) (Cito) Rp. 11.967.376,-
Rinologi - Septum Reseksi / SMR (Cito) Rp. 11.967.376,-
Rinologi - Sinuskopi / Sinoskopi Dengan Tindakan (Cito) Rp. 11.967.376,-
Spine - Alar transverse fusion * (Cito) Rp. 11.967.376,-
Spine - Anterior cervcal discetomy dan Fusion (ACDF) * (Cito) Rp. 11.967.376,-
Spine - Anterior cervical corpectomy dan Fusion (ACCF) * (Cito) Rp. 11.967.376,-
Spine - Debridement and anterior fusion in TB Spine * (Cito) Rp. 11.967.376,-
Spine - Decompression laminectomy for HNP with stabilization * (Cito) Rp. 11.967.376,-
Spine - Decompression laminectomy for spondilolisthesis stabilization * (Cito) Rp. 11.967.376,-
Excision of other bile duct (Cito) Rp. 11.967.376,-
Spine - Decompression laminectomy for tumor and spinal stenosis with stabilizati Rp. 11.967.376,-
Spine - Laminectomy (1 Level) pada simple spine stenosis * (Cito) Rp. 11.967.376,-
Spine - Mayor desloughing and wound debridement of the spine * (Cito) Rp. 11.967.376,-
Spine - Micro endoscopic disectomy (1 level) * (Cito) Rp. 11.967.376,-
Spine - Microscopic disectomy (1 Level) (Cito) Rp. 11.967.376,-
Spine - Open disectomy multilevel * (Cito) Rp. 11.967.376,-
Spine - Open disestomy (1 Level) * (Cito) Rp. 11.967.376,-
Spine - Open reduction and stabilisation of spinal fracture * (Cito) Rp. 11.967.376,-
Spine - Posterior cervical fusion * (Cito) Rp. 11.967.376,-
Spine - Posterior lumbar interbody fusion (FLIF) dan posterior stabilisation * ( Rp. 11.967.376,-
Ginekologi - Adhesiolisis perlekatan berat pelvik (Cito) Rp. 11.967.376,-
Spine - Posterolateral fusion * (Cito) Rp. 11.967.376,-
Spine - Total disc replacement (multilevel) * (Cito) Rp. 11.967.376,-
Split thickness graft to breast (Cito) Rp. 11.967.376,-
Terapi Slem Cell (Cito) Rp. 11.967.376,-
Thymectomy dengan VATS (Cito) Rp. 11.967.376,-
Tiroidektomi total dengan berry picking (Cito) Rp. 11.967.376,-
Tiroidektomi total dengan diseksi leher fungsional (Cito) Rp. 11.967.376,-
Trakeostomi dengan penyulit tumor pada akses trakea *** (Cito) Rp. 11.967.376,-
Trauma - Joint kompleks destruction / OA post trauma (total joint arthroplasty) Rp. 11.967.376,-
Trauma - Limb leg inequality dengan bone lengthening transport (Cito) Rp. 11.967.376,-
Ginekologi - Infeksi panggul/PUS dengan perlekatan (Cito) Rp. 11.967.376,-
Turbinoplasty (Cito) Rp. 11.967.376,-
Ginekologi - Repair tuba (tubaplasti) (Cito) Rp. 11.967.376,-
Ginekologi - Reseksi adenomiosis (Cito) Rp. 11.967.376,-
Ginekologi - Transposisi Ovarium (Cito) Rp. 11.967.376,-
Hand - Artery, large, injury, repair with grafting (Cito) Rp. 11.967.376,-
Hand - Carpus, delayed (non union), rekonstruksi (Cito) Rp. 11.967.376,-
Hand - Jari (digit), stump, revision (Cito) Rp. 11.967.376,-
Complete thyroidectomy (Cito) Rp. 11.967.376,-
Hand - Jari, defect or contracture (multiple) rekonstruksi (Cito) Rp. 11.967.376,-
Hand - Jari, deformities, major reconstruction procedure (Cito) Rp. 11.967.376,-
Hand - Jari, deformities, osteotomy (Cito) Rp. 11.967.376,-
Hand - Jari, deformity, instrinsic muscle transfer (Cito) Rp. 11.967.376,-
Hand - Jari, scar, revision osteotomy (Cito) Rp. 11.967.376,-
Hand - Nerve (ekstremitas atas), major, injury, microsurgical, repair (single) ( Rp. 11.967.376,-
Hand - Nerve defect, peripheral graft (Cito) Rp. 11.967.376,-
Hand - Nerve digital, Injury, microsurgical (single) (Cito) Rp. 11.967.376,-
Hand - Nerve digital, injury, primary repair (Cito) Rp. 11.967.376,-
Hand - Nerve ulnar, entrapment, transposition (Cito) Rp. 11.967.376,-
Eksisi luas tumor ganas dengan rekonstruksi flap jauh (Cito) Rp. 11.967.376,-
Hand - Sendi (jari), various lesions, replacement arthoplasty (Cito) Rp. 11.967.376,-
Hand - Tendon (ekstremitas atas), bowstringing (entrapment), pulley rekonstruksi Rp. 11.967.376,-
Hand - Tendon extensor (ekstremitas atas) injury, repair (multiple) (Cito) Rp. 11.967.376,-
Hand - Tendon flexor (ekstremitas atas) injury, tendon graft (Cito) Rp. 11.967.376,-
Hand - Tendon flexor (ekstremitas atas), defect grafting (single) (Cito) Rp. 11.967.376,-
Hand - Thumb, paralysis, oppnens plasty (Cito) Rp. 11.967.376,-
Hip - Total hip replacement (Cito) Rp. 11.967.376,-
Intra-abdominal manipulation of intestine (not otherwise specified) (Cito) Rp. 11.967.376,-
Intra-abdominal manipulation of large intestine (Cito) Rp. 11.967.376,-
Intra-abdominal manipulation of small intestine (Cito) Rp. 11.967.376,-
Eksisi luas tumor ganas rongga mulut dengan rekonstruksi flap lokal (Cito) Rp. 11.967.376,-
Knee - Total knee replacement (Cito) Rp. 11.967.376,-
Knee - Uni compartment arthroplasty (Cito) Rp. 11.967.376,-
Laparoscopic appendectomy (Cito) Rp. 11.967.376,-
Laparoscopic appendectomy (elective) (Cito) Rp. 11.967.376,-
Laparoscopic cholecystectomy (Cito) Rp. 11.967.376,-
Laparoscopic incidental appendectomy (Cito) Rp. 11.967.376,-
Laparoscopy (Cito) Rp. 11.967.376,-
Laparskopi / Histereskopi - Adhesiolisis Perlekatan Ringan (Cito) Rp. 11.967.376,-
Laparskopi / Histereskopi - Eksplorasi dan ektraksi IUD translokasi. (Cito) Rp. 11.967.376,-
Laparskopi / Histereskopi - Kasus dengan penyulit (Cito) Rp. 11.967.376,-
Eksisi pada bronkhus (Cito) Rp. 11.967.376,-
Laparskopi / Histereskopi - Kistektomi (Cito) Rp. 11.967.376,-
Laparskopi / Histereskopi - Ooforektomi/salpingektomi (Cito) Rp. 11.967.376,-
Laparskopi / Histereskopi - Ovareksi (Cito) Rp. 11.967.376,-
Laparskopi / Histereskopi - Salpingoooforektomi (Cito) Rp. 11.967.376,-
Laparskopi / Histereskopi - Transposisi Ovarium (Cito) Rp. 11.967.376,-
Laring dan Faring - TA/T dengan Coblation Laser (Cito) Rp. 11.967.376,-
Laring dan Faring - Tiroidektomi Subtotal ** (Cito) Rp. 11.967.376,-
Laring dan Faring - Tiroidektomi Total (Cito) Rp. 11.967.376,-
Laring dan Faring - UPPP (Uvulo Palatopharyngo Plasty) (Cito) Rp. 11.967.376,-
Left hemicolectomy (Cito) Rp. 11.967.376,-
Eksisi tumor ganas kulit dengan flap local atau graft kulit (Cito) Rp. 11.967.376,-
Mediastinostomy (Cito) Rp. 11.967.376,-
Obstetri - Operasi plasenta akreta (Cito) Rp. 11.967.376,-
Odontektomi tingkat III (Cito) Rp. 11.967.376,-
Onkologi - Belloque tampon dengan narkosis (Cito) Rp. 11.967.376,-
Onkologi - Diseksi leher radikal * (Cito) Rp. 11.967.376,-
Onkologi - Eksplorasi nasofaring (Cito) Rp. 11.967.376,-
Onkologi - Ekstirpasi tumor jinak kel liur (Cito) Rp. 11.967.376,-
Onkologi - Ekstirpasi tumor jinak sinonasal, oral cavity (Cito) Rp. 11.967.376,-
Onkologi - Hemiartroplasty pada metastatic bone disease (Cito) Rp. 11.967.376,-
Onkologi - Hemiglosektomi (Cito) Rp. 11.967.376,-
Endoskopi - Bronkoskopi diagnostik (Cito) Rp. 11.967.376,-
Onkologi - Maksilektomi parsial (Cito) Rp. 11.967.376,-
Onkologi - Maksilektomi total (radikal) (Cito) Rp. 11.967.376,-
Onkologi - ORIF MBD (Cito) Rp. 11.967.376,-
Onkologi - Parotidektomi * (Cito) Rp. 11.967.376,-
Onkologi - Wide excision soft tisue sarcoma (Cito) Rp. 11.967.376,-
Other operations on intestines (Cito) Rp. 11.967.376,-
Other operations on the breast (reconstruction of the breast) (Cito) Rp. 11.967.376,-
Other partial thyroidectomy (Cito) Rp. 11.967.376,-
Parathyroidectomy subtotal (Cito) Rp. 11.967.376,-
Parathyroidectomy total (Cito) Rp. 11.967.376,-
Endoskopi - Bronkoskopi ekstraksi tanpa penyulit (Cito) Rp. 11.967.376,-
partial mandibulectomy hemimandibulectomy (Cito) Rp. 11.967.376,-
Pediatrik - Posteromedial soft tissue release CTEV (Cito) Rp. 11.967.376,-
Pilar Implant (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Labioplasti Bilateral (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Labioplasti unilateral (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Pembukaan lubang hidung (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Rekonstruksi fraktur rahang (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Rekonstruksi hidung dengan defek (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Rekonstruksi mandibula ** (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Rekonstruksi telinga (mirotia) tahap 1 (Cito) Rp. 11.967.376,-
Endoskopi - Esofagoskopi BA dengan penyulit (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Rekonstruksi telinga (mirotia) tahap 2 (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Reseksi septum (Cito) Rp. 11.967.376,-
Plastik Rekionstruksi - Septorinoplasty (Cito) Rp. 11.967.376,-
Redo torakotomi * (Cito) Rp. 11.967.376,-
Reduction Neglected Dislocation (Cito) Rp. 11.967.376,-
Rekonstruksi vaskular ekstremitas inferior (arteri femoralis dan poplitea) (Cito Rp. 11.967.376,-
Rekonstruksi vaskular ekstremitas superior (arteri brakialis, radialis dan ulnar Rp. 11.967.376,-
Repair laserasi diafragma * (Cito) Rp. 11.967.376,-
Reposisi dislokasi rahang (Cito) Rp. 11.967.376,-
Reseksi maksila suprastuktural (Cito) Rp. 11.967.376,-
Bilateral radical mastectomy (Cito) Rp. 19.009.699,-
complete glossectomy (Cito) Rp. 19.009.699,-
Fiksasi interna fraktur panfacial (Cito) Rp. 19.009.699,-
Ginekologi - Debulking Kanker Ovarium Lanjut (Cito) Rp. 19.009.699,-
Ginekologi - Eksenterasi (Anterior Posterior) (Cito) Rp. 19.009.699,-
Ginekologi - Histerektomi radikal (Cito) Rp. 19.009.699,-
Ginekologi - Operasi Frozen Pelvic (Cito) Rp. 19.009.699,-
Ginekologi - Relaparatomi high risk complication (Cito) Rp. 19.009.699,-
Ginekologi - Staging Laparatomi (Cito) Rp. 19.009.699,-
Ginekologi - Trachelectomy Radical Servix (Cito) Rp. 19.009.699,-
Ginekologi - Ultra Radikal Histerektomi (Cito) Rp. 19.009.699,-
Ginekologi - Vulvektomi radikal (Cito) Rp. 19.009.699,-
Hand - Jari, swan neck or boutonniere deformity (single), koreksi (Cito) Rp. 19.009.699,-
Hand - Nerve-digital, injury, microsurgical repair (multiple) (Cito) Rp. 19.009.699,-
Hand - Replantasi (Cito) Rp. 19.009.699,-
Hip - Revisi THR (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Adhesiolisis Perlekatan berat (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Histerektomi (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Histeroskopi operatif (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Kistektomi / Adesiolisis Berat (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Laparaskopi histerektomi radikal (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Miomektomi (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Onkologi (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Rekanalisasi tuba (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Reseksi adenomiosis (Cito) Rp. 19.009.699,-
Laparskopi / Histereskopi - Reseksi endometriosis (Cito) Rp. 19.009.699,-
Laring dan Faring - Eksplorasi Asbes Multiple (Cito) Rp. 19.009.699,-
Laring dan Faring - Eksplorasi Asbes Parafaring (Cito) Rp. 19.009.699,-
Laring dan Faring - Eksplorasi Asbes Submandibula (Cito) Rp. 19.009.699,-
Laring dan Faring - Ekstirpasi Kista Bronchialis (Cito) Rp. 19.009.699,-
Laring dan Faring - Ekstirpasi Papiloma Laring (Cito) Rp. 19.009.699,-
Laring dan Faring - Ekstsisi Ca Laring dengan Laser (Cito) Rp. 19.009.699,-
Laring dan Faring - Laringoskopi Diagnostik (Cito) Rp. 19.009.699,-
Laring dan Faring - TA/T (Cito) Rp. 19.009.699,-
Laring dan Faring - Trakeostomi ** (Cito) Rp. 19.009.699,-
Laring dan Faring - Trakeostomi dengan penyulit *** (Cito) Rp. 19.009.699,-
Modifikasi RND / functional neck dissection (Cito) Rp. 19.009.699,-
Onkologi - Ekstirpasi angiofibroma (Cito) Rp. 19.009.699,-
Onkologi - Forequarter amputation (Cito) Rp. 19.009.699,-
Onkologi - Hemipelvectomy (Cito) Rp. 19.009.699,-
Onkologi - Hemoglosektomi dan diseksi leher (Cito) Rp. 19.009.699,-
Onkologi - Limb salvage surgery dan rekonstruksi dengan artrodesis (Cito) Rp. 19.009.699,-
Onkologi - Limb salvage surgery dengan resection dan rekonstruksi dengan fibular Rp. 19.009.699,-
Onkologi - Limb salvage surgery dengan scapular reconstruction (Cito) Rp. 19.009.699,-
Onkologi - Limb salvage surgery dengan tumor resection only (Cito) Rp. 19.009.699,-
Onkologi - Limb salvage surgery tahap 1 (Cito) Rp. 19.009.699,-
Onkologi - Limb salvage surgery tahap 2 (Cito) Rp. 19.009.699,-
Onkologi - Marginal margine excision soft tissue tumor (Cito) Rp. 19.009.699,-
Onkologi - Tiroidektomi subtotal ** (Cito) Rp. 19.009.699,-
Onkologi - Tiroidektomi total (Cito) Rp. 19.009.699,-
Onkologi - Wide eksisi tumor tonsil, orofaring (Cito) Rp. 19.009.699,-
Operasi Commando (Cito) Rp. 19.009.699,-
Other operations on pancreas (Cito) Rp. 19.009.699,-
Other pancreatotomy (Cito) Rp. 19.009.699,-
Otologi - Implantasi koklea (Cito) Rp. 19.009.699,-
Otologi - Mastoidektomi radikal dengan penyulit (Cito) Rp. 19.009.699,-
Otologi - Temporal bone ressection (Cito) Rp. 19.009.699,-
Otologi - Timpanoplasti (Cito) Rp. 19.009.699,-
Parotidektomi total (Cito) Rp. 19.009.699,-
Partial gastrectomy (Cito) Rp. 19.009.699,-
Partial hepatectomy (Cito) Rp. 19.009.699,-
Pediatrik - Acetabuloplasty (salter innominate, pemberton, dega) pada panggul (C Rp. 19.009.699,-
Pediatrik - Arthrodesis sendi (panggul, wrist, ankle , triple arthrodesis) (Cito Rp. 19.009.699,-
Pediatrik - Bony reconstruction ekstremitas atas anak (malunion fraktur supracon Rp. 19.009.699,-
Pediatrik - Bony reconstruction ekstremitas bawah anak (CTEV, Blount disease, ke Rp. 19.009.699,-
Pediatrik - Double osteotomy pelvis pada exstrophy bladder (Cito) Rp. 19.009.699,-
Pediatrik - Limb lengthening (operasi rekonstruksi pada anak dengan alat khusus) Rp. 19.009.699,-
Pediatrik - Open reduction dislokasi panggul tanpa acetabuloplasty (Cito) Rp. 19.009.699,-
Plastik Rekionstruksi - Ekstirpasi preaurikuler fistel (Cito) Rp. 19.009.699,-
Plastik Rekionstruksi - Palatoplasty * (Cito) Rp. 19.009.699,-
Plastik Rekionstruksi - Rekonstruksi fraktur muka dengan plate screw (Cito) Rp. 19.009.699,-
Plastik Rekionstruksi - Septoplasty e.c trauma hidung (Cito) Rp. 19.009.699,-
Plastik Rekionstruksi - Skingrafting tidak luas (Cito) Rp. 19.009.699,-
Rekonstruksi arteri ekstremitas dengan by-pass graft synthetic (Cito) Rp. 19.009.699,-
Rekonstruksi fraktur blow-out (Cito) Rp. 19.009.699,-
Rekonstruksi menggunakan flap bebas (Cito) Rp. 19.009.699,-
Rekonstruksi sternum dan dinding dada (Cito) Rp. 19.009.699,-
Repair aneurisma aorta abdominalis * (Cito) Rp. 19.009.699,-
Repair of gastroschisis (Cito) Rp. 19.009.699,-
Repair of other bile ducts (Cito) Rp. 19.009.699,-
Rinologi - BSEF / FESS 4 : Mini dan maksila / etmoid dan frontal / sfenoid (Cito Rp. 19.009.699,-
Rinologi - BSEF / FESS Lanjut : Ekstirpasi Tumor, penutupan defek intrakranial ( Rp. 19.009.699,-
Spine - Anterior dan posterior surgery in deformity with stabilization (Instrume Rp. 19.009.699,-
Spine - Anterior dan posterior surgery in spinal disease with stabilization (ins Rp. 19.009.699,-
Spine - Scoliosis < 70 derajat corrective surgery * (Cito) Rp. 19.009.699,-
Spine - Scoliosis kurva > 70 derajat corrective surgery * (Cito) Rp. 19.009.699,-
Spine - Spinal osteotomy for ankylossing spondylitis dengan forward gaze kurang Rp. 19.009.699,-
Spine - Spinal osteotomy for Ankylossing Spondylitis* (Cito) Rp. 19.009.699,-
Total gastrectomy (Cito) Rp. 19.009.699,-
Trauma - Neglected case dengan bone reconstruction (Cito) Rp. 19.009.699,-
Vascular shunting (splenorenal shunt, de palma shunt) (Cito) Rp. 19.009.699,-
Whipple procedure (Cito) Rp. 19.009.699,-
Arteriovenous shunt (AV Shunt) brakiosefalika (Cito) Rp. 19.009.699,-
Arteriovenous shunt (AV Shunt) radiosefalika (Cito) Rp. 19.009.699,-
AV - Shunt dengan lokal anesthesi (Cito) Rp. 19.009.699,-
Pasang double lumen hemodialysis (HD) (Cito) Rp. 19.009.699,-
Pemasangan Central Venous Catheter (CVC) (Cito) Rp. 19.009.699,-
Revisi arteriovenous shunt * (Cito) Rp. 19.009.699,-
Skleroterapi vena (varises, hemangioma) * (Cito) Rp. 19.009.699,-
Bilateral radical mastectomy (Cito) Rp. 17.849.400,-
complete glossectomy (Cito) Rp. 17.849.400,-
Fiksasi interna fraktur panfacial (Cito) Rp. 17.849.400,-
Ginekologi - Debulking Kanker Ovarium Lanjut (Cito) Rp. 17.849.400,-
Ginekologi - Eksenterasi (Anterior Posterior) (Cito) Rp. 17.849.400,-
Ginekologi - Histerektomi radikal (Cito) Rp. 17.849.400,-
Ginekologi - Operasi Frozen Pelvic (Cito) Rp. 17.849.400,-
Ginekologi - Relaparatomi high risk complication (Cito) Rp. 17.849.400,-
Ginekologi - Staging Laparatomi (Cito) Rp. 17.849.400,-
Ginekologi - Trachelectomy Radical Servix (Cito) Rp. 17.849.400,-
Ginekologi - Ultra Radikal Histerektomi (Cito) Rp. 17.849.400,-
Ginekologi - Vulvektomi radikal (Cito) Rp. 17.849.400,-
Hand - Jari, swan neck or boutonniere deformity (single), koreksi (Cito) Rp. 17.849.400,-
Hand - Nerve-digital, injury, microsurgical repair (multiple) (Cito) Rp. 17.849.400,-
Hand - Replantasi (Cito) Rp. 17.849.400,-
Hip - Revisi THR (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Adhesiolisis Perlekatan berat (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Histerektomi (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Histeroskopi operatif (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Kistektomi / Adesiolisis Berat (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Laparaskopi histerektomi radikal (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Miomektomi (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Onkologi (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Rekanalisasi tuba (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Reseksi adenomiosis (Cito) Rp. 17.849.400,-
Laparskopi / Histereskopi - Reseksi endometriosis (Cito) Rp. 17.849.400,-
Laring dan Faring - Eksplorasi Asbes Multiple (Cito) Rp. 17.849.400,-
Laring dan Faring - Eksplorasi Asbes Parafaring (Cito) Rp. 17.849.400,-
Laring dan Faring - Eksplorasi Asbes Submandibula (Cito) Rp. 17.849.400,-
Laring dan Faring - Ekstirpasi Kista Bronchialis (Cito) Rp. 17.849.400,-
Laring dan Faring - Ekstirpasi Papiloma Laring (Cito) Rp. 17.849.400,-
Laring dan Faring - Ekstsisi Ca Laring dengan Laser (Cito) Rp. 17.849.400,-
Laring dan Faring - Laringoskopi Diagnostik (Cito) Rp. 17.849.400,-
Laring dan Faring - TA/T (Cito) Rp. 17.849.400,-
Laring dan Faring - Trakeostomi ** (Cito) Rp. 17.849.400,-
Laring dan Faring - Trakeostomi dengan penyulit *** (Cito) Rp. 17.849.400,-
Modifikasi RND / functional neck dissection (Cito) Rp. 17.849.400,-
Onkologi - Ekstirpasi angiofibroma (Cito) Rp. 17.849.400,-
Onkologi - Forequarter amputation (Cito) Rp. 17.849.400,-
Onkologi - Hemipelvectomy (Cito) Rp. 17.849.400,-
Onkologi - Hemoglosektomi dan diseksi leher (Cito) Rp. 17.849.400,-
Onkologi - Limb salvage surgery dan rekonstruksi dengan artrodesis (Cito) Rp. 17.849.400,-
Onkologi - Limb salvage surgery dengan resection dan rekonstruksi dengan fibular Rp. 17.849.400,-
Onkologi - Limb salvage surgery dengan scapular reconstruction (Cito) Rp. 17.849.400,-
Onkologi - Limb salvage surgery dengan tumor resection only (Cito) Rp. 17.849.400,-
Onkologi - Limb salvage surgery tahap 1 (Cito) Rp. 17.849.400,-
Onkologi - Limb salvage surgery tahap 2 (Cito) Rp. 17.849.400,-
Onkologi - Marginal margine excision soft tissue tumor (Cito) Rp. 17.849.400,-
Onkologi - Tiroidektomi subtotal ** (Cito) Rp. 17.849.400,-
Onkologi - Tiroidektomi total (Cito) Rp. 17.849.400,-
Onkologi - Wide eksisi tumor tonsil, orofaring (Cito) Rp. 17.849.400,-
Operasi Commando (Cito) Rp. 17.849.400,-
Other operations on pancreas (Cito) Rp. 17.849.400,-
Other pancreatotomy (Cito) Rp. 17.849.400,-
Otologi - Implantasi koklea (Cito) Rp. 17.849.400,-
Otologi - Mastoidektomi radikal dengan penyulit (Cito) Rp. 17.849.400,-
Otologi - Temporal bone ressection (Cito) Rp. 17.849.400,-
Otologi - Timpanoplasti (Cito) Rp. 17.849.400,-
Parotidektomi total (Cito) Rp. 17.849.400,-
Partial gastrectomy (Cito) Rp. 17.849.400,-
Partial hepatectomy (Cito) Rp. 17.849.400,-
Pediatrik - Acetabuloplasty (salter innominate, pemberton, dega) pada panggul (C Rp. 17.849.400,-
Pediatrik - Arthrodesis sendi (panggul, wrist, ankle , triple arthrodesis) (Cito Rp. 17.849.400,-
Pediatrik - Bony reconstruction ekstremitas atas anak (malunion fraktur supracon Rp. 17.849.400,-
Pediatrik - Bony reconstruction ekstremitas bawah anak (CTEV, Blount disease, ke Rp. 17.849.400,-
Pediatrik - Double osteotomy pelvis pada exstrophy bladder (Cito) Rp. 17.849.400,-
Pediatrik - Limb lengthening (operasi rekonstruksi pada anak dengan alat khusus) Rp. 17.849.400,-
Pediatrik - Open reduction dislokasi panggul tanpa acetabuloplasty (Cito) Rp. 17.849.400,-
Plastik Rekionstruksi - Ekstirpasi preaurikuler fistel (Cito) Rp. 17.849.400,-
Plastik Rekionstruksi - Palatoplasty * (Cito) Rp. 17.849.400,-
Plastik Rekionstruksi - Rekonstruksi fraktur muka dengan plate screw (Cito) Rp. 17.849.400,-
Plastik Rekionstruksi - Septoplasty e.c trauma hidung (Cito) Rp. 17.849.400,-
Plastik Rekionstruksi - Skingrafting tidak luas (Cito) Rp. 17.849.400,-
Rekonstruksi arteri ekstremitas dengan by-pass graft synthetic (Cito) Rp. 17.849.400,-
Rekonstruksi fraktur blow-out (Cito) Rp. 17.849.400,-
Rekonstruksi menggunakan flap bebas (Cito) Rp. 17.849.400,-
Rekonstruksi sternum dan dinding dada (Cito) Rp. 17.849.400,-
Repair aneurisma aorta abdominalis * (Cito) Rp. 17.849.400,-
Repair of gastroschisis (Cito) Rp. 17.849.400,-
Repair of other bile ducts (Cito) Rp. 17.849.400,-
Rinologi - BSEF / FESS 4 : Mini dan maksila / etmoid dan frontal / sfenoid (Cito Rp. 17.849.400,-
Rinologi - BSEF / FESS Lanjut : Ekstirpasi Tumor, penutupan defek intrakranial ( Rp. 17.849.400,-
Spine - Anterior dan posterior surgery in deformity with stabilization (Instrume Rp. 17.849.400,-
Spine - Anterior dan posterior surgery in spinal disease with stabilization (ins Rp. 17.849.400,-
Spine - Scoliosis < 70 derajat corrective surgery * (Cito) Rp. 17.849.400,-
Spine - Scoliosis kurva > 70 derajat corrective surgery * (Cito) Rp. 17.849.400,-
Spine - Spinal osteotomy for ankylossing spondylitis dengan forward gaze kurang Rp. 17.849.400,-
Spine - Spinal osteotomy for Ankylossing Spondylitis* (Cito) Rp. 17.849.400,-
Total gastrectomy (Cito) Rp. 17.849.400,-
Trauma - Neglected case dengan bone reconstruction (Cito) Rp. 17.849.400,-
Vascular shunting (splenorenal shunt, de palma shunt) (Cito) Rp. 17.849.400,-
Whipple procedure (Cito) Rp. 17.849.400,-
Arteriovenous shunt (AV Shunt) brakiosefalika (Cito) Rp. 17.849.400,-
Arteriovenous shunt (AV Shunt) radiosefalika (Cito) Rp. 17.849.400,-
AV - Shunt dengan lokal anesthesi (Cito) Rp. 17.849.400,-
Pasang double lumen hemodialysis (HD) (Cito) Rp. 17.849.400,-
Pemasangan Central Venous Catheter (CVC) (Cito) Rp. 17.849.400,-
Revisi arteriovenous shunt * (Cito) Rp. 17.849.400,-
Skleroterapi vena (varises, hemangioma) * (Cito) Rp. 17.849.400,-
Bilateral radical mastectomy (Cito) Rp. 17.395.600,-
Ginekologi - Trachelectomy Radical Servix (Cito) Rp. 17.395.600,-
Ginekologi - Ultra Radikal Histerektomi (Cito) Rp. 17.395.600,-
Ginekologi - Vulvektomi radikal (Cito) Rp. 17.395.600,-
Hand - Jari, swan neck or boutonniere deformity (single), koreksi (Cito) Rp. 17.395.600,-
Hand - Nerve-digital, injury, microsurgical repair (multiple) (Cito) Rp. 17.395.600,-
Hand - Replantasi (Cito) Rp. 17.395.600,-
Hip - Revisi THR (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Adhesiolisis Perlekatan berat (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Histerektomi (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Histeroskopi operatif (Cito) Rp. 17.395.600,-
complete glossectomy (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Kistektomi / Adesiolisis Berat (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Laparaskopi histerektomi radikal (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Miomektomi (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Onkologi (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Rekanalisasi tuba (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Reseksi adenomiosis (Cito) Rp. 17.395.600,-
Laparskopi / Histereskopi - Reseksi endometriosis (Cito) Rp. 17.395.600,-
Laring dan Faring - Eksplorasi Asbes Multiple (Cito) Rp. 17.395.600,-
Laring dan Faring - Eksplorasi Asbes Parafaring (Cito) Rp. 17.395.600,-
Laring dan Faring - Eksplorasi Asbes Submandibula (Cito) Rp. 17.395.600,-
Fiksasi interna fraktur panfacial (Cito) Rp. 17.395.600,-
Laring dan Faring - Ekstirpasi Kista Bronchialis (Cito) Rp. 17.395.600,-
Laring dan Faring - Ekstirpasi Papiloma Laring (Cito) Rp. 17.395.600,-
Laring dan Faring - Ekstsisi Ca Laring dengan Laser (Cito) Rp. 17.395.600,-
Laring dan Faring - Laringoskopi Diagnostik (Cito) Rp. 17.395.600,-
Laring dan Faring - TA/T (Cito) Rp. 17.395.600,-
Laring dan Faring - Trakeostomi ** (Cito) Rp. 17.395.600,-
Laring dan Faring - Trakeostomi dengan penyulit *** (Cito) Rp. 17.395.600,-
Modifikasi RND / functional neck dissection (Cito) Rp. 17.395.600,-
Onkologi - Ekstirpasi angiofibroma (Cito) Rp. 17.395.600,-
Onkologi - Forequarter amputation (Cito) Rp. 17.395.600,-
Ginekologi - Debulking Kanker Ovarium Lanjut (Cito) Rp. 17.395.600,-
Onkologi - Hemipelvectomy (Cito) Rp. 17.395.600,-
Onkologi - Hemoglosektomi dan diseksi leher (Cito) Rp. 17.395.600,-
Onkologi - Limb salvage surgery dan rekonstruksi dengan artrodesis (Cito) Rp. 17.395.600,-
Onkologi - Limb salvage surgery dengan resection dan rekonstruksi dengan fibular Rp. 17.395.600,-
Onkologi - Limb salvage surgery dengan scapular reconstruction (Cito) Rp. 17.395.600,-
Onkologi - Limb salvage surgery dengan tumor resection only (Cito) Rp. 17.395.600,-
Onkologi - Limb salvage surgery tahap 1 (Cito) Rp. 17.395.600,-
Onkologi - Limb salvage surgery tahap 2 (Cito) Rp. 17.395.600,-
Onkologi - Marginal margine excision soft tissue tumor (Cito) Rp. 17.395.600,-
Onkologi - Tiroidektomi subtotal ** (Cito) Rp. 17.395.600,-
Ginekologi - Eksenterasi (Anterior Posterior) (Cito) Rp. 17.395.600,-
Onkologi - Tiroidektomi total (Cito) Rp. 17.395.600,-
Onkologi - Wide eksisi tumor tonsil, orofaring (Cito) Rp. 17.395.600,-
Operasi Commando (Cito) Rp. 17.395.600,-
Other operations on pancreas (Cito) Rp. 17.395.600,-
Other pancreatotomy (Cito) Rp. 17.395.600,-
Otologi - Implantasi koklea (Cito) Rp. 17.395.600,-
Otologi - Mastoidektomi radikal dengan penyulit (Cito) Rp. 17.395.600,-
Otologi - Temporal bone ressection (Cito) Rp. 17.395.600,-
Otologi - Timpanoplasti (Cito) Rp. 17.395.600,-
Parotidektomi total (Cito) Rp. 17.395.600,-
Ginekologi - Histerektomi radikal (Cito) Rp. 17.395.600,-
Partial gastrectomy (Cito) Rp. 17.395.600,-
Partial hepatectomy (Cito) Rp. 17.395.600,-
Pediatrik - Acetabuloplasty (salter innominate, pemberton, dega) pada panggul (C Rp. 17.395.600,-
Pediatrik - Arthrodesis sendi (panggul, wrist, ankle , triple arthrodesis) (Cito Rp. 17.395.600,-
Pediatrik - Bony reconstruction ekstremitas atas anak (malunion fraktur supracon Rp. 17.395.600,-
Pediatrik - Bony reconstruction ekstremitas bawah anak (CTEV, Blount disease, ke Rp. 17.395.600,-
Pediatrik - Double osteotomy pelvis pada exstrophy bladder (Cito) Rp. 17.395.600,-
Pediatrik - Limb lengthening (operasi rekonstruksi pada anak dengan alat khusus) Rp. 17.395.600,-
Pediatrik - Open reduction dislokasi panggul tanpa acetabuloplasty (Cito) Rp. 17.395.600,-
Plastik Rekionstruksi - Ekstirpasi preaurikuler fistel (Cito) Rp. 17.395.600,-
Ginekologi - Operasi Frozen Pelvic (Cito) Rp. 17.395.600,-
Plastik Rekionstruksi - Palatoplasty * (Cito) Rp. 17.395.600,-
Plastik Rekionstruksi - Rekonstruksi fraktur muka dengan plate screw (Cito) Rp. 17.395.600,-
Plastik Rekionstruksi - Septoplasty e.c trauma hidung (Cito) Rp. 17.395.600,-
Plastik Rekionstruksi - Skingrafting tidak luas (Cito) Rp. 17.395.600,-
Rekonstruksi arteri ekstremitas dengan by-pass graft synthetic (Cito) Rp. 17.395.600,-
Rekonstruksi fraktur blow-out (Cito) Rp. 17.395.600,-
Rekonstruksi menggunakan flap bebas (Cito) Rp. 17.395.600,-
Rekonstruksi sternum dan dinding dada (Cito) Rp. 17.395.600,-
Repair aneurisma aorta abdominalis * (Cito) Rp. 17.395.600,-
Repair of gastroschisis (Cito) Rp. 17.395.600,-
Ginekologi - Relaparatomi high risk complication (Cito) Rp. 17.395.600,-
Repair of other bile ducts (Cito) Rp. 17.395.600,-
Rinologi - BSEF / FESS 4 : Mini dan maksila / etmoid dan frontal / sfenoid (Cito Rp. 17.395.600,-
Rinologi - BSEF / FESS Lanjut : Ekstirpasi Tumor, penutupan defek intrakranial ( Rp. 17.395.600,-
Spine - Anterior dan posterior surgery in deformity with stabilization (Instrume Rp. 17.395.600,-
Spine - Anterior dan posterior surgery in spinal disease with stabilization (ins Rp. 17.395.600,-
Spine - Scoliosis < 70 derajat corrective surgery * (Cito) Rp. 17.395.600,-
Spine - Scoliosis kurva > 70 derajat corrective surgery * (Cito) Rp. 17.395.600,-
Spine - Spinal osteotomy for ankylossing spondylitis dengan forward gaze kurang Rp. 17.395.600,-
Spine - Spinal osteotomy for Ankylossing Spondylitis* (Cito) Rp. 17.395.600,-
Total gastrectomy (Cito) Rp. 17.395.600,-
Ginekologi - Staging Laparatomi (Cito) Rp. 17.395.600,-
Trauma - Neglected case dengan bone reconstruction (Cito) Rp. 17.395.600,-
Vascular shunting (splenorenal shunt, de palma shunt) (Cito) Rp. 17.395.600,-
Whipple procedure (Cito) Rp. 17.395.600,-
Arteriovenous shunt (AV Shunt) brakiosefalika (Cito) Rp. 17.395.600,-
Arteriovenous shunt (AV Shunt) radiosefalika (Cito) Rp. 17.395.600,-
AV - Shunt dengan lokal anesthesi (Cito) Rp. 17.395.600,-
Pasang double lumen hemodialysis (HD) (Cito) Rp. 17.395.600,-
Pemasangan Central Venous Catheter (CVC) (Cito) Rp. 17.395.600,-
Revisi arteriovenous shunt * (Cito) Rp. 17.395.600,-
Skleroterapi vena (varises, hemangioma) * (Cito) Rp. 17.395.600,-
Alveolektomi ( Cito ) Rp. 5.520.725,-
Angkat jahitan Kornea ( Cito ) Rp. 5.520.725,-
Arterial pungsi - kanulasi - sectie ( Cito ) Rp. 5.520.725,-
Aspirasi / irigasi / reformasi COA ( Cito ) Rp. 5.520.725,-
Closed reduction of temporomandibular dislocation ( Cito ) Rp. 5.520.725,-
Control of hemorrhage of anus ( Cito ) Rp. 5.520.725,-
Ekskokleasi epulis ( Cito ) Rp. 5.520.725,-
Ekskokleasi kista folikuler ( Cito ) Rp. 5.520.725,-
Ekskokleasi kista radikuler ( Cito ) Rp. 5.520.725,-
Ekstirpasi / eksisi tumor jinak jaringan lunak ukuran < 2 cm ( Cito ) Rp. 5.520.725,-
Ekstirpasi kista dermoid * ( Cito ) Rp. 5.520.725,-
Ekstraksi corpus alienum cornea ( Cito ) Rp. 5.520.725,-
Ekstraksi epithelial downgrowth ( Cito ) Rp. 5.520.725,-
Embolektomi (diluar alat) ( Cito ) Rp. 5.520.725,-
Esofago-Gastro-Duodenoscopy (EGD) ( Cito ) Rp. 5.520.725,-
Evakuasi hematom (pasca pungsi) ( Cito ) Rp. 5.520.725,-
Excision of perianal skin tags ( Cito ) Rp. 5.520.725,-
GIN - Insisi Septum Vagina ( Cito ) Rp. 5.520.725,-
GIN - kromotubasi ( Cito ) Rp. 5.520.725,-
GIN- Himenectomy ( Cito ) Rp. 5.520.725,-
GIN- Insisi Drainage ( Cito ) Rp. 5.520.725,-
GIN- Marsupialisasi ( Cito ) Rp. 5.520.725,-
Ginekologi - Tubektomi ( Cito ) Rp. 5.520.725,-
GIN-Kuretase-biopsi PA ( Cito ) Rp. 5.520.725,-
Glaukoma - Cyclo cryo ( Cito ) Rp. 5.520.725,-
Hand - Angkat K-Wire with anestesia regional ( Cito ) Rp. 5.520.725,-
Hand - Jari, extra digit, amputasi ( Cito ) Rp. 5.520.725,-
Hand - Jari, various, amputation (single) ** ( Cito ) Rp. 5.520.725,-
Injeksi botox pada strabismus ( Cito ) Rp. 5.520.725,-
Ligasi Varices Esofgaus (VE) ( Cito ) Rp. 5.520.725,-
Local excision of lesion of breast ( Cito ) Rp. 5.520.725,-
Local excision of rectal lesion or tissue ( Cito ) Rp. 5.520.725,-
Obstetri - Drainase abses ( Cito ) Rp. 5.520.725,-
Obstetri - Ekstirpasi ( Cito ) Rp. 5.520.725,-
Obstetri - Ekstraksi IUD dengan anestesi ( Cito ) Rp. 5.520.725,-
Obstetri - Hematoma (ruptur) ( Cito ) Rp. 5.520.725,-
Obstetri - Kauterisasi kondiloma akuminata ( Cito ) Rp. 5.520.725,-
Obstetri - Kista bartholin (kista gartner) ( Cito ) Rp. 5.520.725,-
Obstetri - Kolpotomi pada abses cavum douglas ( Cito ) Rp. 5.520.725,-
Obstetri - Konisasi ( Cito ) Rp. 5.520.725,-
Obstetri - Kuretase abortus ( Cito ) Rp. 5.520.725,-
Obstetri - Kuretase pasca persalinan ( Cito ) Rp. 5.520.725,-
Obstetri - Penjahitan laserasi ringan ( Cito ) Rp. 5.520.725,-
Obstetri - Polip serviks ( Cito ) Rp. 5.520.725,-
Obstetri - Robekan serviks (forniks) ( Cito ) Rp. 5.520.725,-
Obstetri - Shirodkar ( Cito ) Rp. 5.520.725,-
Obstetri - Sistoskopi LEETZ ( Cito ) Rp. 5.520.725,-
Onkologi - Insisional biopsi kelenjar leher ( Cito ) Rp. 5.520.725,-
Open biopsy of rectum ( Cito ) Rp. 5.520.725,-
Operkulektomi ( Cito ) Rp. 5.520.725,-
Other diagnostic procedures of abdominal region ( Cito ) Rp. 5.520.725,-
Other excision of perianal tissue ( Cito ) Rp. 5.520.725,-
Other local excision or destruction of lesion or tissue of skin and subcutaneous Rp. 5.520.725,-
Otologi - Biopsi ( Cito ) Rp. 5.520.725,-
Otologi - Ekstraksi benda asing ( Cito ) Rp. 5.520.725,-
Pasang implantable central venous access * ( Cito ) Rp. 5.520.725,-
Pasang thoraks drain (WSD) * ( Cito ) Rp. 5.520.725,-
Pelepasan plat dan skrup maksilofasial 3 tempat atau lebih ( Cito ) Rp. 5.520.725,-
Pelepasan plat dan skrup tulang maksilofasial 1-2 tempat ( Cito ) Rp. 5.520.725,-
Pemasangan interdental wiring / arch bar ( Cito ) Rp. 5.520.725,-
Pericardiocentesis * ( Cito ) Rp. 5.520.725,-
Pleurodesis (pleurosklerosis) * ( Cito ) Rp. 5.520.725,-
Rekonstruksi - Eksisi tumor kecil kelopak ( Cito ) Rp. 5.520.725,-
Rekonstruksi - Oklusi punctum lakrimal ( Cito ) Rp. 5.520.725,-
Release tongue tie * ( Cito ) Rp. 5.520.725,-
Reposisi dislokasi sendi rahang dengan pembiusan (TMJ) * ( Cito ) Rp. 5.520.725,-
Reposisi tertutup fraktur condilus mandibula ( Cito ) Rp. 5.520.725,-
Revisi thoraks drain/ Water Sealed Drainage (WSD) ( Cito ) Rp. 5.520.725,-
Rinologi - Irigasi Sinus / DAWO ( Cito ) Rp. 5.520.725,-
Scleroterapi dan atau ligasi hemangioma ( Cito ) Rp. 5.520.725,-
Suture of laceration of anus ( Cito ) Rp. 5.520.725,-
Thoracocentesis * ( Cito ) Rp. 5.520.725,-
Trauma - Acute glenohumeral joint dislocation * ( Cito ) Rp. 5.520.725,-
Tumor jinak kulit dan tumor non neoplastik kulit * ( Cito ) Rp. 5.520.725,-
Vena punctie - kanulasi - sectie * ( Cito ) Rp. 5.520.725,-
Glaukoma - Cyclo cryo ( Cito ) Rp. 4.940.626,-
Hand - Angkat K-Wire with anestesia regional ( Cito ) Rp. 4.940.626,-
Hand - Jari, extra digit, amputasi ( Cito ) Rp. 4.940.626,-
Hand - Jari, various, amputation (single) ** ( Cito ) Rp. 4.940.626,-
Injeksi botox pada strabismus ( Cito ) Rp. 4.940.626,-
Ligasi Varices Esofgaus (VE) ( Cito ) Rp. 4.940.626,-
Local excision of lesion of breast ( Cito ) Rp. 4.940.626,-
Local excision of rectal lesion or tissue ( Cito ) Rp. 4.940.626,-
Obstetri - Drainase abses ( Cito ) Rp. 4.940.626,-
Obstetri - Ekstirpasi ( Cito ) Rp. 4.940.626,-
Obstetri - Ekstraksi IUD dengan anestesi ( Cito ) Rp. 4.940.626,-
Obstetri - Hematoma (ruptur) ( Cito ) Rp. 4.940.626,-
Obstetri - Kauterisasi kondiloma akuminata ( Cito ) Rp. 4.940.626,-
Obstetri - Kista bartholin (kista gartner) ( Cito ) Rp. 4.940.626,-
Obstetri - Kolpotomi pada abses cavum douglas ( Cito ) Rp. 4.940.626,-
Obstetri - Konisasi ( Cito ) Rp. 4.940.626,-
Obstetri - Kuretase abortus ( Cito ) Rp. 4.940.626,-
Obstetri - Kuretase pasca persalinan ( Cito ) Rp. 4.940.626,-
Obstetri - Penjahitan laserasi ringan ( Cito ) Rp. 4.940.626,-
Obstetri - Polip serviks ( Cito ) Rp. 4.940.626,-
Obstetri - Robekan serviks (forniks) ( Cito ) Rp. 4.940.626,-
Obstetri - Shirodkar ( Cito ) Rp. 4.940.626,-
Obstetri - Sistoskopi LEETZ ( Cito ) Rp. 4.940.626,-
Onkologi - Insisional biopsi kelenjar leher ( Cito ) Rp. 4.940.626,-
Open biopsy of rectum ( Cito ) Rp. 4.940.626,-
Operkulektomi ( Cito ) Rp. 4.940.626,-
Other diagnostic procedures of abdominal region ( Cito ) Rp. 4.940.626,-
Other excision of perianal tissue ( Cito ) Rp. 4.940.626,-
Other local excision or destruction of lesion or tissue of skin and subcutaneous Rp. 4.940.626,-
Otologi - Biopsi ( Cito ) Rp. 4.940.626,-
Otologi - Ekstraksi benda asing ( Cito ) Rp. 4.940.626,-
Pasang implantable central venous access * ( Cito ) Rp. 4.940.626,-
Pasang thoraks drain (WSD) * ( Cito ) Rp. 4.940.626,-
Pelepasan plat dan skrup maksilofasial 3 tempat atau lebih ( Cito ) Rp. 4.940.626,-
Pelepasan plat dan skrup tulang maksilofasial 1-2 tempat ( Cito ) Rp. 4.940.626,-
Pemasangan interdental wiring / arch bar ( Cito ) Rp. 4.940.626,-
Pericardiocentesis * ( Cito ) Rp. 4.940.626,-
Pleurodesis (pleurosklerosis) * ( Cito ) Rp. 4.940.626,-
Rekonstruksi - Eksisi tumor kecil kelopak ( Cito ) Rp. 4.940.626,-
Rekonstruksi - Oklusi punctum lakrimal ( Cito ) Rp. 4.940.626,-
Release tongue tie * ( Cito ) Rp. 4.940.626,-
Reposisi dislokasi sendi rahang dengan pembiusan (TMJ) * ( Cito ) Rp. 4.940.626,-
Reposisi tertutup fraktur condilus mandibula ( Cito ) Rp. 4.940.626,-
Revisi thoraks drain/ Water Sealed Drainage (WSD) ( Cito ) Rp. 4.940.626,-
Rinologi - Irigasi Sinus / DAWO ( Cito ) Rp. 4.940.626,-
Scleroterapi dan atau ligasi hemangioma ( Cito ) Rp. 4.940.626,-
Suture of laceration of anus ( Cito ) Rp. 4.940.626,-
Thoracocentesis * ( Cito ) Rp. 4.940.626,-
Trauma - Acute glenohumeral joint dislocation * ( Cito ) Rp. 4.940.626,-
Tumor jinak kulit dan tumor non neoplastik kulit * ( Cito ) Rp. 4.940.626,-
Vena punctie - kanulasi - sectie * ( Cito ) Rp. 4.940.626,-
Alveolektomi ( Cito ) Rp. 4.940.626,-
Angkat jahitan Kornea ( Cito ) Rp. 4.940.626,-
Arterial pungsi - kanulasi - sectie ( Cito ) Rp. 4.940.626,-
Aspirasi / irigasi / reformasi COA ( Cito ) Rp. 4.940.626,-
Closed reduction of temporomandibular dislocation ( Cito ) Rp. 4.940.626,-
Control of hemorrhage of anus ( Cito ) Rp. 4.940.626,-
Ekskokleasi epulis ( Cito ) Rp. 4.940.626,-
Ekskokleasi kista folikuler ( Cito ) Rp. 4.940.626,-
Ekskokleasi kista radikuler ( Cito ) Rp. 4.940.626,-
Ekstirpasi / eksisi tumor jinak jaringan lunak ukuran < 2 cm ( Cito ) Rp. 4.940.626,-
Ekstirpasi kista dermoid * ( Cito ) Rp. 4.940.626,-
Ekstraksi corpus alienum cornea ( Cito ) Rp. 4.940.626,-
Ekstraksi epithelial downgrowth ( Cito ) Rp. 4.940.626,-
Embolektomi (diluar alat) ( Cito ) Rp. 4.940.626,-
Esofago-Gastro-Duodenoscopy (EGD) ( Cito ) Rp. 4.940.626,-
Evakuasi hematom (pasca pungsi) ( Cito ) Rp. 4.940.626,-
Excision of perianal skin tags ( Cito ) Rp. 4.940.626,-
GIN - Insisi Septum Vagina ( Cito ) Rp. 4.940.626,-
GIN - kromotubasi ( Cito ) Rp. 4.940.626,-
GIN- Himenectomy ( Cito ) Rp. 4.940.626,-
GIN- Insisi Drainage ( Cito ) Rp. 4.940.626,-
GIN- Marsupialisasi ( Cito ) Rp. 4.940.626,-
Ginekologi - Tubektomi ( Cito ) Rp. 4.940.626,-
GIN-Kuretase-biopsi PA ( Cito ) Rp. 4.940.626,-
Alveolektomi ( Cito ) Rp. 4.713.725,-
Ekstirpasi / eksisi tumor jinak jaringan lunak ukuran < 2 cm ( Cito ) Rp. 4.713.725,-
Ekstirpasi kista dermoid * ( Cito ) Rp. 4.713.725,-
Ekstraksi corpus alienum cornea ( Cito ) Rp. 4.713.725,-
Ekstraksi epithelial downgrowth ( Cito ) Rp. 4.713.725,-
Embolektomi (diluar alat) ( Cito ) Rp. 4.713.725,-
Esofago-Gastro-Duodenoscopy (EGD) ( Cito ) Rp. 4.713.725,-
Evakuasi hematom (pasca pungsi) ( Cito ) Rp. 4.713.725,-
Excision of perianal skin tags ( Cito ) Rp. 4.713.725,-
GIN - Insisi Septum Vagina ( Cito ) Rp. 4.713.725,-
GIN - kromotubasi ( Cito ) Rp. 4.713.725,-
Angkat jahitan Kornea ( Cito ) Rp. 4.713.725,-
GIN- Himenectomy ( Cito ) Rp. 4.713.725,-
GIN- Insisi Drainage ( Cito ) Rp. 4.713.725,-
GIN- Marsupialisasi ( Cito ) Rp. 4.713.725,-
Ginekologi - Tubektomi ( Cito ) Rp. 4.713.725,-
GIN-Kuretase-biopsi PA ( Cito ) Rp. 4.713.725,-
Glaukoma - Cyclo cryo ( Cito ) Rp. 4.713.725,-
Hand - Angkat K-Wire with anestesia regional ( Cito ) Rp. 4.713.725,-
Hand - Jari, extra digit, amputasi ( Cito ) Rp. 4.713.725,-
Hand - Jari, various, amputation (single) ** ( Cito ) Rp. 4.713.725,-
Injeksi botox pada strabismus ( Cito ) Rp. 4.713.725,-
Arterial pungsi - kanulasi - sectie ( Cito ) Rp. 4.713.725,-
Ligasi Varices Esofgaus (VE) ( Cito ) Rp. 4.713.725,-
Local excision of lesion of breast ( Cito ) Rp. 4.713.725,-
Local excision of rectal lesion or tissue ( Cito ) Rp. 4.713.725,-
Obstetri - Drainase abses ( Cito ) Rp. 4.713.725,-
Obstetri - Ekstirpasi ( Cito ) Rp. 4.713.725,-
Obstetri - Ekstraksi IUD dengan anestesi ( Cito ) Rp. 4.713.725,-
Obstetri - Hematoma (ruptur) ( Cito ) Rp. 4.713.725,-
Obstetri - Kauterisasi kondiloma akuminata ( Cito ) Rp. 4.713.725,-
Obstetri - Kista bartholin (kista gartner) ( Cito ) Rp. 4.713.725,-
Obstetri - Kolpotomi pada abses cavum douglas ( Cito ) Rp. 4.713.725,-
Aspirasi / irigasi / reformasi COA ( Cito ) Rp. 4.713.725,-
Obstetri - Konisasi ( Cito ) Rp. 4.713.725,-
Obstetri - Kuretase abortus ( Cito ) Rp. 4.713.725,-
Obstetri - Kuretase pasca persalinan ( Cito ) Rp. 4.713.725,-
Obstetri - Penjahitan laserasi ringan ( Cito ) Rp. 4.713.725,-
Obstetri - Polip serviks ( Cito ) Rp. 4.713.725,-
Obstetri - Robekan serviks (forniks) ( Cito ) Rp. 4.713.725,-
Obstetri - Shirodkar ( Cito ) Rp. 4.713.725,-
Obstetri - Sistoskopi LEETZ ( Cito ) Rp. 4.713.725,-
Onkologi - Insisional biopsi kelenjar leher ( Cito ) Rp. 4.713.725,-
Open biopsy of rectum ( Cito ) Rp. 4.713.725,-
Closed reduction of temporomandibular dislocation ( Cito ) Rp. 4.713.725,-
Operkulektomi ( Cito ) Rp. 4.713.725,-
Other diagnostic procedures of abdominal region ( Cito ) Rp. 4.713.725,-
Other excision of perianal tissue ( Cito ) Rp. 4.713.725,-
Other local excision or destruction of lesion or tissue of skin and subcutaneous Rp. 4.713.725,-
Otologi - Biopsi ( Cito ) Rp. 4.713.725,-
Otologi - Ekstraksi benda asing ( Cito ) Rp. 4.713.725,-
Pasang implantable central venous access * ( Cito ) Rp. 4.713.725,-
Pasang thoraks drain (WSD) * ( Cito ) Rp. 4.713.725,-
Pelepasan plat dan skrup maksilofasial 3 tempat atau lebih ( Cito ) Rp. 4.713.725,-
Pelepasan plat dan skrup tulang maksilofasial 1-2 tempat ( Cito ) Rp. 4.713.725,-
Control of hemorrhage of anus ( Cito ) Rp. 4.713.725,-
Pemasangan interdental wiring / arch bar ( Cito ) Rp. 4.713.725,-
Pericardiocentesis * ( Cito ) Rp. 4.713.725,-
Pleurodesis (pleurosklerosis) * ( Cito ) Rp. 4.713.725,-
Rekonstruksi - Eksisi tumor kecil kelopak ( Cito ) Rp. 4.713.725,-
Rekonstruksi - Oklusi punctum lakrimal ( Cito ) Rp. 4.713.725,-
Release tongue tie * ( Cito ) Rp. 4.713.725,-
Reposisi dislokasi sendi rahang dengan pembiusan (TMJ) * ( Cito ) Rp. 4.713.725,-
Reposisi tertutup fraktur condilus mandibula ( Cito ) Rp. 4.713.725,-
Revisi thoraks drain/ Water Sealed Drainage (WSD) ( Cito ) Rp. 4.713.725,-
Rinologi - Irigasi Sinus / DAWO ( Cito ) Rp. 4.713.725,-
Ekskokleasi epulis ( Cito ) Rp. 4.713.725,-
Scleroterapi dan atau ligasi hemangioma ( Cito ) Rp. 4.713.725,-
Suture of laceration of anus ( Cito ) Rp. 4.713.725,-
Thoracocentesis * ( Cito ) Rp. 4.713.725,-
Trauma - Acute glenohumeral joint dislocation * ( Cito ) Rp. 4.713.725,-
Tumor jinak kulit dan tumor non neoplastik kulit * ( Cito ) Rp. 4.713.725,-
Vena punctie - kanulasi - sectie * ( Cito ) Rp. 4.713.725,-
Ekskokleasi kista folikuler ( Cito ) Rp. 4.713.725,-
Ekskokleasi kista radikuler ( Cito ) Rp. 4.713.725,-
Biopsy insisional dengan anastesi lokal (Elektif) Rp. 2.022.500,-
Biopsy of anus (Elektif) Rp. 2.022.500,-
Biopsy of perianal tissue (Elektif) Rp. 2.022.500,-
Eksisi tumor jinak dengan anastesi lokal (Elektif) Rp. 2.022.500,-
Ekstraksi fragmen fraktur gigi dengan flap (Elektif) Rp. 2.022.500,-
Insisi abses dengan anastesi lokal (Elektif) Rp. 2.022.500,-
Other incision of skin and subcutaneous tissue (Elektif) Rp. 2.022.500,-
Pungsi hematom / seroma (Elektif) Rp. 2.022.500,-
Reposisi dislokasi TMJ tanpa pembiusan (Elektif) Rp. 2.022.500,-
RF Dasar Lidah (Elektif) Rp. 2.022.500,-
Rinologi - Septoplasti (Elektif) Rp. 2.022.500,-
Sirkumsisi *** (Elektif) Rp. 2.022.500,-
Biopsy insisional dengan anastesi lokal (Elektif) Rp. 1.761.500,-
Biopsy of anus (Elektif) Rp. 1.761.500,-
Biopsy of perianal tissue (Elektif) Rp. 1.761.500,-
Eksisi tumor jinak dengan anastesi lokal (Elektif) Rp. 1.761.500,-
Ekstraksi fragmen fraktur gigi dengan flap (Elektif) Rp. 1.761.500,-
Insisi abses dengan anastesi lokal (Elektif) Rp. 1.761.500,-
Other incision of skin and subcutaneous tissue (Elektif) Rp. 1.761.500,-
Pungsi hematom / seroma (Elektif) Rp. 1.761.500,-
Reposisi dislokasi TMJ tanpa pembiusan (Elektif) Rp. 1.761.500,-
RF Dasar Lidah (Elektif) Rp. 1.761.500,-
Rinologi - Septoplasti (Elektif) Rp. 1.761.500,-
Sirkumsisi *** (Elektif) Rp. 1.761.500,-
Biopsy insisional dengan anastesi lokal (Elektif) Rp. 1.659.400,-
Biopsy of anus (Elektif) Rp. 1.659.400,-
Biopsy of perianal tissue (Elektif) Rp. 1.659.400,-
Eksisi tumor jinak dengan anastesi lokal (Elektif) Rp. 1.659.400,-
Ekstraksi fragmen fraktur gigi dengan flap (Elektif) Rp. 1.659.400,-
Insisi abses dengan anastesi lokal (Elektif) Rp. 1.659.400,-
Other incision of skin and subcutaneous tissue (Elektif) Rp. 1.659.400,-
Pungsi hematom / seroma (Elektif) Rp. 1.659.400,-
Reposisi dislokasi TMJ tanpa pembiusan (Elektif) Rp. 1.659.400,-
RF Dasar Lidah (Elektif) Rp. 1.659.400,-
Rinologi - Septoplasti (Elektif) Rp. 1.659.400,-
Sirkumsisi *** (Elektif) Rp. 1.659.400,-
Robekan Himen + Laserasi Dinding Vagina (Kolporeksis) (cito) - Rp. 9.062.526,-
Rekonstruksi Penis - Urologi - Rp. 1.910.500,-
Asuhan pra-anestesi - Rp. 45.000,-
Asuhan intra-anestesi - Rp. 90.000,-
Asuhan pasca-anestesi - Rp. 45.000,-
Asuhan Keperawatan Kamar Operasi - Rp. 45.000,-
Persalinan Normal - Rp. 2.091.100,-
Persalinan Dengan Penyulit - Rp. 3.326.300,-
Hecting Perineum - Rp. 1.182.500,-
Manual Plasenta - Rp. 313.800,-
Induksi Persalinan - Rp. 522.800,-
ERACS - Rp. 10.654.100,-
Vena Seksi - Rp. 2.962.400,-
Koreksi Jar/Ring Construction (Single/Multilevel) / Deformitas - Orthopedy - Rp. 2.962.400,-
Laparotomy pada perforasi Usus pada Anak - Anak - Rp. 2.962.400,-
Maksilektomi Partialis - THT - Rp. 2.962.400,-
Myringoplasty - THT - Rp. 2.962.400,-
Operasi Rekontruksi Ibu Jari Kaki pada Hallux Valgus - Orthopedy - Rp. 2.962.400,-
Orkhidektomi Extended - Urologi - Rp. 2.962.400,-
Parotidektomi Partialis - THT - Rp. 2.962.400,-
Reconstruction Anterior Cruciate Ligament (Anterior/Posterior/ Lateral/ Medial) - Rp. 2.962.400,-
Release (bilateral with endoneusrolysis) Nerve (extremitas atas) - Orthopedy - Rp. 2.962.400,-
Remove Wire - Orthopedy - Rp. 2.962.400,-
Reposisi Terbuka & Fiksasi Interna pada Kasus Fraktur Salter Haris III-IV - Orto - Rp. 2.962.400,-
Scrotoplasty pada Hyspopadia - Anak - Rp. 2.962.400,-
Tenotomy Tendon (ekstremitas atas), contracture - Orthopedy - Rp. 2.962.400,-
Ureterolithotomi - Urologi - Rp. 2.962.400,-
Synovectomy Biasa - Orthopedy - Rp. 2.962.400,-
Operasi katarak metode SICS - Rp. 1.845.699,-
Phaceomulsifikasi Mata - Rp. 1.910.500,-
Uff Arch Barr (Elektif) Kelas 1 Rp. 6.922.900,-
Uff Arch Barr dan suspensi maksila (Elektif) Kelas 1 Rp. 6.922.900,-
Amputasi jari (phalangs - traumatik) (Elektif) Kelas 1 Rp. 6.922.900,-
Amputation of digiti single ** (Elektif) Kelas 1 Rp. 6.922.900,-
Anal fistulectomy (Elektif) Kelas 1 Rp. 6.922.900,-
Anal fistulotomy (Elektif) Kelas 1 Rp. 6.922.900,-
Anterior lamellar keratoplasty (Elektif) Kelas 1 Rp. 6.922.900,-
Appendicostomy (Elektif) Kelas 1 Rp. 6.922.900,-
Babcock (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral excision of ectopic breast tissue (mamma aberans) (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral inguinal hernia repair with graft or prosthesis (not otherwise specifi Kelas 1 Rp. 6.922.900,-
Bilateral multipel excision of lesion of breast with narcose (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral ovariectomy (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral repair of direct inguinal hernia (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral repair of direct inguinal hernia with graft or prosthetis (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral repair of femoral hernia with/without graft of prosthesis (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral repair of indirect inguinal hernia (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral repair of indirect inguinal hernia with graft or prosthesis (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral repair of inguinal hernia, not otherwise specified (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral repair of inguinal hernia, one direct and one indirect (Elektif) Kelas 1 Rp. 6.922.900,-
Bilateral repair of inguinal hernia, one direct and one indirect, with graft or Kelas 1 Rp. 6.922.900,-
Biopsi pembuluh darah perifer * (Elektif) Kelas 1 Rp. 6.922.900,-
Biopsi perikardium * (Elektif) Kelas 1 Rp. 6.922.900,-
Biopsi terbuka bronkhus * (Elektif) Kelas 1 Rp. 6.922.900,-
Biopsi terbuka diafragma * (Elektif) Kelas 1 Rp. 6.922.900,-
Biopsi terbuka mediastinum * (Elektif) Kelas 1 Rp. 6.922.900,-
Biopsi terbuka paru * (Elektif) Kelas 1 Rp. 6.922.900,-
Biopsi terbuka pleura * (Elektif) Kelas 1 Rp. 6.922.900,-
Biopsi terbuka pleura dengan VATS * (Elektif) Kelas 1 Rp. 6.922.900,-
Biopsi terbuka tumor dinding thoraks * (Elektif) Kelas 1 Rp. 6.922.900,-
Caecostomy (Elektif) Kelas 1 Rp. 6.922.900,-
Closure of anal fistula (Elektif) Kelas 1 Rp. 6.922.900,-
Combustio (luka bakar) * (Elektif) Kelas 1 Rp. 6.922.900,-
Compartement excision (Elektif) Kelas 1 Rp. 6.922.900,-
Debridement-nekrotomi luka gangren (Elektif) Kelas 1 Rp. 6.922.900,-
Deseksi submandibula (Elektif) Kelas 1 Rp. 6.922.900,-
Disartikulasi sendi ekstremitas (Elektif) Kelas 1 Rp. 6.922.900,-
Dislokasi bahu * (Elektif) Kelas 1 Rp. 6.922.900,-
Drainage of appendiceal abscess (Elektif) Kelas 1 Rp. 6.922.900,-
Drainage of pancreatic cyst by catheter (Elektif) Kelas 1 Rp. 6.922.900,-
DSAEK (Elektif) Kelas 1 Rp. 6.922.900,-
ECCE / ICCE / SICS (Elektif) Kelas 1 Rp. 6.922.900,-
ECCE / SICS dan IOL (Elektif) Kelas 1 Rp. 6.922.900,-
Eksisi biopsi tumor pembuluh darah (Elektif) Kelas 1 Rp. 6.922.900,-
Eksisi glandula submandibula (Elektif) Kelas 1 Rp. 6.922.900,-
Eksisi higroma leher * (Elektif) Kelas 1 Rp. 6.922.900,-
Eksisi kista tiroglosus (Elektif) Kelas 1 Rp. 6.922.900,-
Eksisi parsial dan marsupialisasi Ranula (Elektif) Kelas 1 Rp. 6.922.900,-
Eksisi Pterigium (Elektif) Kelas 1 Rp. 6.922.900,-
Eksisi tumor dinding dada * (Elektif) Kelas 1 Rp. 6.922.900,-
Eksisi tumor pembuluh darah perifer (hemangioma) ** (Elektif) Kelas 1 Rp. 6.922.900,-
Eksisi tumor pembuluh darah perifer ** (Elektif) Kelas 1 Rp. 6.922.900,-
Ekstirpasi kelainan kornea (Elektif) Kelas 1 Rp. 6.922.900,-
Ekstraksi corpus alienum segmen anterior (Elektif) Kelas 1 Rp. 6.922.900,-
Ekstraksi IOL (Elektif) Kelas 1 Rp. 6.922.900,-
Embolektomi / trombektomi pembuluh darah arteri abdominal (Elektif) Kelas 1 Rp. 6.922.900,-
Endoskopi - Esofagoskopi BA tanpa penyulit (Elektif) Kelas 1 Rp. 6.922.900,-
Endoskopi - Esofagoskopi dilatasi (Elektif) Kelas 1 Rp. 6.922.900,-
Endoskopi - Sialendoskopi diagnostik dan dilatasi (Elektif) Kelas 1 Rp. 6.922.900,-
Endoskopi - Sialendoskopi diagnostik dan terapeutik (Elektif) Kelas 1 Rp. 6.922.900,-
Esofago-Gastro-Duodenoscopy (EGD) dan Biopsi (Elektif) Kelas 1 Rp. 6.922.900,-
Evakuasi hematom di ekstremitas (pasca pungsi HD / traumatik) (Elektif) Kelas 1 Rp. 6.922.900,-
Evakuasi silicon oil (Elektif) Kelas 1 Rp. 6.922.900,-
Evakuasi silicon oil dan ECCE (Elektif) Kelas 1 Rp. 6.922.900,-
Evakuasi silicon oil, Phaco / ECCE dan IOL (Elektif) Kelas 1 Rp. 6.922.900,-
Exchange IOL (Elektif) Kelas 1 Rp. 6.922.900,-
Excision of ectopic breast tissue (Elektif) Kelas 1 Rp. 6.922.900,-
excision of lesion of breast with narcose (Elektif) Kelas 1 Rp. 6.922.900,-
Excision of thyroglossal duct or trac (Elektif) Kelas 1 Rp. 6.922.900,-
Exploratory laparotomy (Elektif) Kelas 1 Rp. 6.922.900,-
Extirpasi kista rongga mulut (Elektif) Kelas 1 Rp. 6.922.900,-
Extirpasi muoccocele rongga mulut (Elektif) Kelas 1 Rp. 6.922.900,-
Fasciotomy * (Elektif) Kelas 1 Rp. 6.922.900,-
Fiksasi interna fraktur maksilofasial 1-2 tempat patahan * (Elektif) Kelas 1 Rp. 6.922.900,-
Fiksasi interna fraktur nasal (Elektif) Kelas 1 Rp. 6.922.900,-
Flap konjungtiva amnion graft (Elektif) Kelas 1 Rp. 6.922.900,-
Fraktur humerus * (Elektif) Kelas 1 Rp. 6.922.900,-
Gastrostomi * (Elektif) Kelas 1 Rp. 6.922.900,-
GIN -Ekstirpasi polip (Elektif) Kelas 1 Rp. 6.922.900,-
Ginekologi - Ekstirpasi Giant Condiloma (Elektif) Kelas 1 Rp. 6.922.900,-
Ginekologi - Kistektomi (Elektif) Kelas 1 Rp. 6.922.900,-
Ginekologi - Laparotomi Diagnostik (Elektif) Kelas 1 Rp. 6.922.900,-
Ginekologi - Ligasi Arteri Hipogastrica / Uterina (Elektif) Kelas 1 Rp. 6.922.900,-
Ginekologi - Miomektomi (Elektif) Kelas 1 Rp. 6.922.900,-
Ginekologi - Pemasangan Implan Tableport (Elektif) Kelas 1 Rp. 6.922.900,-
Ginekologi - Salpingo-ooforektomi (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Anterior / posterior sklerotomi (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Gonioplasty / goniotomy (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Iridektomi perifer (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Paracentesis (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Reformasi COA (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Revisi Bleb (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Tindakan cyclodia termi (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Trabekulektomi (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Trabekulektomi, Phaco dan IOL (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Trabekulotomi anak atau bayi (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Trabekulotomi dan trabekulektomi anak atau bayi (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Transkleral Foto Coagulasi (Elektif) Kelas 1 Rp. 6.922.900,-
Glaukoma - Tubes implan (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Elbow (medical epicondyle), fracture, excision bony fragment (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Elbow, tennis elbow, release (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, closed fracture or dislocation, reduksi terbuka dan fixation (singl Kelas 1 Rp. 6.922.900,-
Hand - Jari, crush injuries (complex) wound debridement (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, crush injury (simple), wound debridement (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, deep infection, drainage (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, deformity, instrinsic muscle extensor relocation (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, deformity, instrinsic muscle release (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, foreign body (superficial), removal with mobilization of neurovascu Kelas 1 Rp. 6.922.900,-
Hand - Jari, injury, debridement (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, jaringan lunak tumor, excision (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, macrodactyly, debulking (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, polydactyly, amputasi with rekonstruksi (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, ring construction (single), koreksi (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, superficial infection, drainage (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, syndactili (single) koreksi (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, trauma, terminalisation (multiple) (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, trauma, terminalisation (single) (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, tumors, excision with dissection of neurovasculer bundle (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, various lesions, amputasi (multiple) (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, various lesions, Ray amputasi (single) (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jari, wart, com, naevus, excision (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Jaringan lunak (palmar space), abscess, drainage (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Kulit dan jaringan subkultis, defect (single digit), free full thickness Kelas 1 Rp. 6.922.900,-
Hand - Kulit dan jaringan subkus, defect (deep) staged distant flap (division) ( Kelas 1 Rp. 6.922.900,-
Hand - Kulit dan jaringan subkutis, defect (multiple digits) staged local flap ( Kelas 1 Rp. 6.922.900,-
Hand - Nail bed, Laceration, repair (single) (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Nerve various lesions, primary or secondary suture (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Nerve, Various Lesions, biopsy (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Repair muscle (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Sendi (extremitas atas) rush rods / wires / screw removal (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Sendi (jari), contracture, capsulectomy (capsulotomy) (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Sendi (wrist), various lesions, arthrodesis (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Tendon (ekstremitas atas) , contracture, tenotomy (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Tendon extensor (extremitas atas) injury, repair (single) (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Tendon flexor (ekstremitas atas) adhesion, tenolysis (single) (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Tendon flexor (ekstremitas atas), adhesion, tenolysis (multiple) (Elektif Kelas 1 Rp. 6.922.900,-
Hand - Tendon sheath (ekstremitas atas), De Quervain's (unilateral), Release (El Kelas 1 Rp. 6.922.900,-
Hand - Tendon sheath (ekstremitas atas), tenosynovitis (multiple), drainage (Ele Kelas 1 Rp. 6.922.900,-
Hand - Tendon sheath (ekstremitas atas), Trigger Jari (multiple), Release (Elekt Kelas 1 Rp. 6.922.900,-
Hand - Tendon sheath (extremitas atas) ganglion atau villo nodular synovitis, ex Kelas 1 Rp. 6.922.900,-
Hand - Tendon sheath (extremitas atas), tenosynovitis (single), drainage (Elekti Kelas 1 Rp. 6.922.900,-
Hand - Tendon sheath (extremitas atas), trigger jari (single) release (Elektif) Kelas 1 Rp. 6.922.900,-
Hand - Tendon sheath dan jaringan subkutis, ganglion (small bursa), excision (El Kelas 1 Rp. 6.922.900,-
Hidrokel Testis / Funikuli ** (Elektif) Kelas 1 Rp. 6.922.900,-
Implantasi iris artifisial (Elektif) Kelas 1 Rp. 6.922.900,-
Implantasi piggyback IOL (Elektif) Kelas 1 Rp. 6.922.900,-
Incision of perianal abscess (Elektif) Kelas 1 Rp. 6.922.900,-
Injeksi intravitreal (Elektif) Kelas 1 Rp. 6.922.900,-
Insertion of synthetic implant in facial bone (Elektif) Kelas 1 Rp. 6.922.900,-
Insisi atau Eksisi gingiva (Elektif) Kelas 1 Rp. 6.922.900,-
Insisi flegmon dasar mulut (Elektif) Kelas 1 Rp. 6.922.900,-
Internal Fiksasi fraktur condylus mandibula (Elektif) Kelas 1 Rp. 6.922.900,-
Internal fiksasi fraktur maksilofasial 5 tempat patahan atau lebih (Elektif) Kelas 1 Rp. 6.922.900,-
Internal Fiksasi fraktur Mandibula segmental (Elektif) Kelas 1 Rp. 6.922.900,-
Keratoplasty tembus (Elektif) Kelas 1 Rp. 6.922.900,-
Keratoprosthesis (Elektif) Kelas 1 Rp. 6.922.900,-
Knee - Open knee debridement (Elektif) Kelas 1 Rp. 6.922.900,-
Knee - Perypheral nerve ablation (Elektif) Kelas 1 Rp. 6.922.900,-
Knee - Perypheral nerve lysis (Elektif) Kelas 1 Rp. 6.922.900,-
Kolonoskopi (Elektif) Kelas 1 Rp. 6.922.900,-
Labioshisis * (Elektif) Kelas 1 Rp. 6.922.900,-
Laring dan Faring - Laringofisure (Elektif) Kelas 1 Rp. 6.922.900,-
Laring dan Faring - Pemasangan T-Tube (Elektif) Kelas 1 Rp. 6.922.900,-
Left lateral anal sphincterotomy (Elektif) Kelas 1 Rp. 6.922.900,-
Ligasi vaskular ekstremitas (Elektif) Kelas 1 Rp. 6.922.900,-
Ligation of hemorrhoids (Elektif) Kelas 1 Rp. 6.922.900,-
Limbal Relaxing Incision (LRI) (Elektif) Kelas 1 Rp. 6.922.900,-
Maksilektomi total dan Rekonstruksi * (Elektif) Kelas 1 Rp. 6.922.900,-
Multipel excision of lesion of breast with narcose (Elektif) Kelas 1 Rp. 6.922.900,-
Mutilasi digiti ekstremitas (Multiple) (Elektif) Kelas 1 Rp. 6.922.900,-
Obstetri - Histerorafi (Elektif) Kelas 1 Rp. 6.922.900,-
Obstetri - Kolporafi anterior (Elektif) Kelas 1 Rp. 6.922.900,-
Obstetri - Kolporafi posterior (Elektif) Kelas 1 Rp. 6.922.900,-
Obstetri - Mioma geburt (Elektif) Kelas 1 Rp. 6.922.900,-
Obstetri - Sectio caesaria tanpa penyulit (Elektif) Kelas 1 Rp. 6.922.900,-
Odontektomi tingkat I (Elektif) Kelas 1 Rp. 6.922.900,-
Onkologi - Biopsi tumor hidung, lidah, nasofaring (narkosis) (Elektif) Kelas 1 Rp. 6.922.900,-
Onkologi - Excision soft tissue tumor < 5 cm (kecil) (Elektif) Kelas 1 Rp. 6.922.900,-
Onkologi - Limb ablation dengan above atau below knee amputation bone tumor (Ele Kelas 1 Rp. 6.922.900,-
Onkologi - Open biopsy bone tumor (Elektif) Kelas 1 Rp. 6.922.900,-
Onkologi - Open biopsy soft tissue (Elektif) Kelas 1 Rp. 6.922.900,-
Onkologi - Ray amputation jari (Elektif) Kelas 1 Rp. 6.922.900,-
Onkologi - Tumor jinak tulang (curettage dan bonegraft) (Elektif) Kelas 1 Rp. 6.922.900,-
Open biopsi of breast (Elektif) Kelas 1 Rp. 6.922.900,-
Open biopsy of salivary gland or duct (Elektif) Kelas 1 Rp. 6.922.900,-
Open reduction of alveolar fracture * (Elektif) Kelas 1 Rp. 6.922.900,-
Osteotomi eksisi tulang maksilofasial (Elektif) Kelas 1 Rp. 6.922.900,-
Other appendectomy (elective) * (Elektif) Kelas 1 Rp. 6.922.900,-
Other bilateral femoral hernioraphy (Elektif) Kelas 1 Rp. 6.922.900,-
Other hernia repair (Elektif) Kelas 1 Rp. 6.922.900,-
Other incidental appendectomy * (Elektif) Kelas 1 Rp. 6.922.900,-
Other incision of anus (Elektif) Kelas 1 Rp. 6.922.900,-
Other lysis of peritoneal adhesions (Elektif) Kelas 1 Rp. 6.922.900,-
Other operations on anus (Elektif) Kelas 1 Rp. 6.922.900,-
Other operations on trachea (Elektif) Kelas 1 Rp. 6.922.900,-
Other procedures on hemorrhoids (Elektif) Kelas 1 Rp. 6.922.900,-
Other reconstruction of mandible (Elektif) Kelas 1 Rp. 6.922.900,-
Other reconstruction of other facial bone (Elektif) Kelas 1 Rp. 6.922.900,-
Other repair and plastic operation of tongue (Elektif) Kelas 1 Rp. 6.922.900,-
Other repair of abdominal wall (Elektif) Kelas 1 Rp. 6.922.900,-
Other umbilical herniorraphy* (Elektif) Kelas 1 Rp. 6.922.900,-
Other unilateral femoral herniorraphy (Elektif) Kelas 1 Rp. 6.922.900,-
Otologi - Meatoplasti (Elektif) Kelas 1 Rp. 6.922.900,-
Otologi - Miringoplasti (Elektif) Kelas 1 Rp. 6.922.900,-
Otologi - Pemasangan grommet (Elektif) Kelas 1 Rp. 6.922.900,-
Palatoshisis ** (Elektif) Kelas 1 Rp. 6.922.900,-
Partial glossectomy (Elektif) Kelas 1 Rp. 6.922.900,-
Pediatrik - Bony bridge release pada kasus tarsal coalition (Elektif) Kelas 1 Rp. 6.922.900,-
Pediatrik - Closed reduction dan pemasangan gips fraktur femur anak (Elektif) Kelas 1 Rp. 6.922.900,-
Pediatrik - Combined Trabeculotomy dan trabeculectomy (Elektif) Kelas 1 Rp. 6.922.900,-
Pediatrik - Debridement dan soft tissue release pada infeksi sendi (Elektif) Kelas 1 Rp. 6.922.900,-