Acuan Jasa Medis Dokter Spesialis 1

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  TARIF JASA MEDIS TINDAKAN PEMBED NONAMA TINDAKAN 1Aff Arch Barr 2Aff Arch Barr dan suspensi maksila3Amputasi Above Knee4Amputasi Below Knee5Amputasi Jari (halan!s #raumatik$%Amputation of di!iti sin!le &&'Anal fistulectom)Anal fistulotom*Aneurisma A+ Brachialis (diluar !raft$1,Aneurisma A+ -emoralis (diluar !raft$11Appendicostom12Arterial pun!si. kanulasi. sectie13Arteriovenous shunt (A/ 0hunt$ brakiosefalika14Arteriovenous shunt (A/ 0hunt$ radiosefalika15A/  0hunt (okal Anestesi$1%Aillar dissection1'Babcock 1)Batu 0aluran Kemih &1*Bilateral ecision of ectopic breast tissue (mamma aberans$2,21Bilateral multipel ecision of lesion of breast with narcose22Bilateral variectom23Bilateral radical mastectom24Bilateral repair of direct in!uinal herniaBilateral in!uinal hernia repair with !raft or prosthesis. nototherwise specified  252%Bilateral repair of femoral hernia withwithout !raft of  prosthesis2'Bilateral repair of indirect in!uinal hernia NONAMA TINDAKAN 2)2*Bilateral repair of in!uinal hernia. not otherwise specified3,3132Bilateral simple mastectom33Biopsi pembuluh darah (perifer$ &34Biopsi erikardium &35Biopsi terbuka bronkhus &3%Biopsi terbuka diafra!ma &3'Biopsi terbuka mediastinum &3)Biopsi terbuka paru &3*Biopsi terbuka pleura &4,Biopsi terbuka pleura den!an /A#0 &41Biopsi terbuka tumor dindin! thoraks &42Biops insisional den!an anastesi lokal43Biops of anus44Biops of perianal tissue456aecostom4%6holecstectom4'6holedochoplast4)6lippin! 6ostae (diluar plate$4*6losed reduction of temporomandibular dislocation5,6losure of anal fistula516losure of appendiceal fistula526losure of cholecstostom536losure of fistula of lar!e intestine546losure of fistula of small intestine. ecept duodenum556losure of intestinal stoma5%6losure of leceration of liver 5'6olostom. not otherwise specified NONAMA TINDAKAN 5)6ombustio (uka Bakar$ &Bilateral repair of direct in!uinal hernia with !raft or  prosthetisBilateral repair of indirect in!uinal hernia with !raft or  prosthesisBilateral repair of in!uinal hernia. one direct and oneindirectBilateral repair of in!uinal hernia. one direct and oneindirect. with !raft or prosthesis  5*6ommon duct eploration for removal of calculus%,6ompartement ecision%1complete !lossectom%26omplete throidectom%36ontrol of hemorrha!e of anus%47ebridement mediastinum (0ternotomi$ &%57ebridement nekrotomi luka !an!ren%%7eseksi submandibula%'7isartikulasi sendi ekstremitas%)7iseksi leher radikal  radikal neck dissection &%*7islokasi bahu &',7raina!e of appediceal abscess'17raina!e of pancreatic cst b catheter '28ksisi Biopsi #umor pembuluh darah'38ksisi !ld submandibula'48ksisi hi!roma leher &'58ksisi kista tiro!losus'%8ksisi luas tumor !anas bibir den!an rekonstruksi flap lokal''8ksisi luas tumor !anas den!an rekonstruksi flap 9auh')8ksisi luas tumor !anas kulit tanpa rekonstruksi'*),8ksisi pada bronkhus)18ksisi parsial:marsupialisasi ;anula)28ksisi seudoaneurisma)38ksisi #umor 7indin! dada &)48ksisi tumor !anas kulit den!an flap local atau !raft kulit)58ksisi tumor 9inak den!an anastesi lokal)%8ksisi #umor embuluh 7arah erifer &&)'8ksisi tumor pembuluh darah perifer (heman!ioma$ &&))8kskokleasi epulis NONAMA TINDAKAN )*8kskokleasi kista folikuler *,8kskokleasi kista radikuler *18ksplorasi vaskular (#rauma <on #rauma$*2*38kstirpasi kista dermoid &*48kstraksi 6orpus Alienum di ;e!io #oraks &*58kstraksi 6orpus Alienum di ;e!io #oraks den!an /A#0 &*%8mbolektomi (diluar alat$8ksisi luas tumor !anas ron!!a mulut den!an rekonstruksiflap lokal8kstirpasi  eksisi tumor 9inak 9arin!an lunak ukuran =2cm&&  *'8mbolektomitrombektomi aorta*)**1,,1,11,21,38ndoscopic polpectom of rectum1,48ndoscopic throidectom1,58vakuasi >ematom (pasca pun!si$1,%1,'8cision of ectopic breast tissue1,)8cision of hemorrhoids1,*ecision of lesion of breast with narcose11,8cision of other bile duct1118cision of perianal skin ta!s1128cision of thro!lossal duct or trac1138ploration of common duct1148plorator laparotom1158teriori?ation of lar!e intestine11%8teriori?ation of small intestine11'-asciotom &11)-iksasi interna fraktur maksilofasial 1 2 tempat patahan & NONAMA TINDAKAN 11*-iksasi interna fraktur nasal12,-iksasi interna -raktur anfacial121-iksasi 0ternum (@ire. late$ (diluar wireplate$ &122-raktur Antebrachi123-raktur 6olles  er!elan!an tan!an lainna124-raktur 6ruris125-raktur -emur &12%-raktur >umerus &12'-raktur klavikula12)-raktur lekranon12*-raktur atela8mbolektomitrombektomi pembuluh darah arteriekstremitas bawah &8mbolektomitrombektomi pembuluh darah arteriabdominal * 8mbolektomitrombektomi pembuluh darah ekstremitas atas(diluar alat$ * 8mbolektomitrombektomi pembuluh darah ekstremitas bawah (diluar alat$ &8mbolektomitrombektomi pembuluh darah re!io servikal(karotis.9u!ular$( diluar alat$ &8vakuasi hematom di ekstremitas (pasca pun!si>7traumatik$
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