Tarif Tindakan Medis Operasi Orthopedi

Tindakan Kecil: Rp. 1.400.000Tindakan Sedang: Rp. 4.200.000Tindakan Besar : Rp. 9.100.000Tindakan Khusus: 12.600.000
Amputasi / repair stump satu jari tangan / kakiEksisi tumor jaringan lunak ukuran kecil (marginal margin aksisi)Total patelletomyWid excision/radical excision tumor ektremitas atas
Debridement / reapir satu tendon jari tangan / kakiClose reduksi + pemasangan gipsCorrective osteotomy surgeryLateral colateral ligament reconttuction, medial collateral ligament
Ekstirpasi ganglion pergelangan tangan / kakiDebridement fraktur terbuka pada anakWide excision tumor jinakRecontruction, shouldr hemiarthroplasty
Angkat wire exposed tanpa narkoseNeukrotomycurretage + bonegraffDebridement and anterior fusion in tb spine
Pasang gyps back slab atau sirkuler pada lenganInjeksi botoka pada kasus crebral palsyArthroscopy remove loose bodyOpen reduction of spinal fractur
Pasang skin / skeletal traksiSkin graftArthroscopy debridement shoulderPosterolateral fusion/alar transverse fusion
Perawatan luka yang jelek dengan back up anethesiPercutaneous tendon tenotomyDiscograph ( 1 level)Micro endoscopic disscetion ( 1level )
Release stiffness sendi jari / wrist / elbow / shoulder / ankle / knee / hipOpen achiles tendon lengtheningfacet block multilevelMicroscopic dissectomy ( 1 level)
Angkat jahitan dalam narkoseNeukrotik tissueforaminal block multilevelLaminectomy ( 1 level ) pada simple spine stenosis
Debridement gangrene jari tangan / kakiDebridementfraktur + internal/ekternal fiksasiOpen disectomy multilevel
Kompartement ototbony bridge release pada kasus tarsal coalitionIdet multilevel
Limb ablasi 1 jari (toe)reposisi tertutup & gips pada fraktur anak (kecuali fraktur femur)Ctev (soft tissue prosedur)
Arthroscopy diagnosticfraktur tulang panjang –MIPO/ORIP & implant removal (long bone )Open reduction dislokasi panggul tanpa acetabuloplasty
Open kne debridementReposisi dislokasi sendi alineumTendon transfer aktremitas bawah pada kasus neuromuscular pada anak
Mayor deglovingEkplorasi corpus alineumReposisi terbuka & fiksasi interna kasus fraktur intra artikular pada anak
Wound debrodement of the spinebone graftNeclegted fractur supracondyler humeis
Plaster application of extremity & spinetendon – ektensor (ektremitas atas ) injury, repair (single)Orif fraktur supracondylar humerus
Jaringan granulasi – SSTtendon sheath (ektremitas atas) tenosynovitis (single) drainageFraktur acetabulum 1 collumn-orif
Release de guervainjari, injury debridementPercutsneous pinning collum humeri
Trigger hayerjari supervicial infection, drainageFractura pelvis simple – fiksasi eksterna pelvic & c-clamp orif fractur – pelvis simple
Ray amputationjari, wart/corn/naevus,excisionFracture artikuler –mpo/orif artikular
Bonegraf onlyjari, various,amputasi (single)Nerve,various lesions,biopsy
Bone open biopsyjari, deep infection, drainageKulit dan jaringan subkutis, defect (single digit ),free full thickness graft
Marginal margin excisejari, ektra digit,amputasiJari,various lesions, ray amputasi (single)
Soft tisuejari,crush injury (simple) wound debridementNerve (ektremitas atas),entrapment syndrome (others),decompresion (unilateral)
Arthroscopy debridement knetendon sheath (ektremitas atas) ganglion/villo nodular sinovitis,excisionNerve (ektremitas atas),guyon’s tunnel syndrome,release (unilateral)
Arthroscopy debridement shouldertendon sheath (ektremitas atas),triger jari (single) releaseTendon seath (ektremitas atas),trigger jari (multiple),release
Biopsi vertebrata (1 level )Marginal margin excisi-bone tumor, open biopsy tumor di spineTendon seath (ektremitas atas), de quervain’s (unilateral),release
Manipulation & reuction of simple fracture & dislocation with general anestesiArthroscopy menisectomyJari, defect/contracture (single) rekontruksi
Faset block ( 1 level )arthroscopy synevectomy kneeJari,trauma,terminalisation (single)
Foramiral block ( 1 level )Arthroscopy remove loose body shoulderJari,closed fracture/dislocation,reduksi terbuka dan fiksation (single)
Body castremoval of implantJaringan lunak (palmar space) absces, drainage
Neukrotik tissue > 1 kompartemeb – debridementdiscografh multilevelJari,defect/contracture (multiple) rekontruksi
Implant removal – wireReposisi tertutup, arthogram dan hemispica pada DDHJari ring contruction (single),koreksi
Reposisi frakturFiksasi cannualted screw pada SCFEJari, trauma, terminalisation (single)
Angkat k – wire tanpa anestesi/regionalClose reduction & pemasangan hemispica fraktur femur pada anakJari, deformities, osteotomy
Tendon sheath & jaringan subkutis,ganglion/small bursa,excisionClose reduction & pemasangan gips fraktur salter Harris I & IITendon – flexor (ektremitas atas) injury, tendon graft
Sendi (ektremitas atas) rush rods/wires/srews removalReposisi tertutup & percutaneous pinning pada fraktur sepular,sendi siku pada anak (misallnya supracondylar, lateral condyle)Tendon flexor (ektremitas atas) adhesion,tenolisys (multiple)
Nail bed, laceration, repair singleJoint stiffnes – liberation,amputasi lengan, crushed injury nekrosis antebrahiNerve (ektremitas atas), carpal tuner syndrome, release (bilateral with endoneurolisys)
Jari, scar, revision osteotomyNerve (ektremitas atas), entrpment syndrome (others),decompresion (billateral)
Jari/digit,stump, revisionNerve (ektremitas atas), entrapment syndrome (others), decompresion with nerve tranposition/endoneurolisys
Nail bed, laceration, repair (multiple)Tendon seath (ektremitas atas), de quarvain’s (billateral),release
Jari, foreign body (superficial), removal with mobilazation of neuravascular bundleNerve (ektremitas atas), guyon’s tunnel syndrome, release (billateral with endoneurolisys)
Jari, jaringan lunak tumor, excisionThumb,deformities,koreksi
Tendon sheath (ektremitas atas ) bowstringing/entrapment,pulley recontrucsiJari,tumors,excision with disecction of neurovascular bundle
Tendon sheath (ektremitas atas ), tenosynovitis (multiple) drainageCarpus,delayed/non union, rekontruksi
Carpus, fracture/dislocation, reduksi terebuka & fiksasi internaJari,ring constriction (multiple),koreksi
Jari, crush injury (complex) wound debridementJari,syndactily (multiple)
Limb ablation:above/below knee & ektremitas atas,synovectomyTendon-flexor (ektremitas atas),adhesion,thenolisys (multiple)
Athroscopy meniscus repair,microfakturTendon-flexor (ektremitas atas),defect grafting (single)
Idet 1 ( 1 level )Hemiarthoplaety, arthroscopy hip
Open distectomy multilevelHip disarticulation, shoulder disarticulation, hemiarthoplarty
Soft tissue release pada kelainan cerebral palsy, arthrogryposis, spinabifidaAnterior /posterior cruciate ligament recontruction
Debridement, necrotomy dan sauzeration pada chronic osteomyelitisRecurent cruciate ligament recontruction
Debridement dan soft tissue release pada infeksi sendiTotal knee replacement
Reposisi terbuka dan fiksasi interna pada kasus faktur salter harris III & IVTotal shoulder replacement
Soft tissue release & enhancement pada kasus fraktur habitual dislokasi lutut pada anakAutogenus condrocythe implantiont
Operasi rekontruksi ibu jari kaki pada allux valgusDebridement end enterior fusion in tb spine + stabilization
reposisi terbuka & fiksasi interna fraktur tulang panjang pada anakOpen reduction of spinal fracture + stabilization
Multiple fraktur tulang panjang – MIPO/ORIP & removal implat > 1Posteroalateral fusion/alar transverse fusion + stabilization
Instability,joint infection- Arthrodesis, amputasi tungkaiAnterior disectomy for correction of scoliosis
Crashed necrosisOpen door laminoplasty
Tendon (ektremitas atas) contracture, tenotomyDecompresion laminectomy for hnp, tumor and spinal stenosis
Kulit dan jaringan subkutis, laceration (superficial ) of more then 7 cm, repairPosterior lumbal interbody fusion (plif)
Sendi (jari) various lesions, biopsiTotal disc replacement ( 1 level)
ORIF,DHSCdh
Osteotomy (bowing, pseudo arthrosis)
Cp correction
Acetabuloplasty (salter innomunate, pemberton, dega) pada kasus-kasus panggul
Rekontruksi panggul ; ada blader eksthrophy
Posteromedial soft tissue release ctev
Fractur acetabulum pelvis –orif acetabulum & pelvis
Terapi slem celle
Percutaneous pinning acetabular
Joint komplek destruction /oa post trauma – total joint
Arthtoplasty
Reduction neglected dislocation
Bristow precedure
Open reduction
Open bankard repair
Open rotator repair
Nerve digital,injury,microsurgical (single)
Nerve unlar,entrapment,transposition
Elbow,tennis elbow, release
Elbow (medial epicondyle), fracture,excision bony fagment
Jari,various lesions, amputasi (multiple)
Artery,large,injury, repair with grafting
Sendi (wrist),various lesions, arhtrodesis
Nerve – digital, injury, microsurgical repair (multiple)
Nerve (ektremitas atas), major,injury,microsurgical,repair (single)
Thumb, paralisys, oppones plasty
Jari,deformity,instrinsic muscle release/transfer/extensor relocation
Jari, deformities, major reconstructive procedure
Jari, fracture/dislocation, reduksi terbuka & fiksasi interna (multiple)
Head – face, trauma, craniofacial approach reductiont & fiksation
Sendi (jari), various llesions, replacement arthroplasty
Total hip replacement (thr)
Limb salvage procedure, hemipelvectomy,for quarter amputation
Rotator cuf repair by arthroscopy,revisi tkr
Total shoulder replacement
Anterior and posterior surgery in spinal disease/deformity with stabilization/instrumentation
Scoliosis correction surgery
Decompresion laminectomy for hnp, tumor and spinal stenosis spondilolisthesis + stabilization
Spinal osteostomy for ankylosing spondylitis
Posterior lumbal interbody fusion (plif) + posterior /anterior stabilization
Total disc replacement
Limb lengthening atau operasi rekontruksi pada anak yang menggunakan alat khusus
Limb leg inequality – bone lengthening transport
Necleted case – bone reconstruction
Kulit dan jaringan subkutis, defect (deep) staged distant flap (division)
Kulit dan jaringan subkutis, defect (multiple digits) staged local flap (division)
Nerve defect, peripheral graft
Nerve various lesions, primary/scondary suture
Jari, swan neck/boutoniere deformity (single), koreksi
Jari, deformities, koreksi
Jari, syndactily (single) koreksi
Jari, polydactily, amputasi with rekontruksi
Sendi (jari), contracture, capsulectomy/capsulotomy
Nerve digital, injury, primary repair
Jari, macrodactily, debulking
Revisi thr

Keterangan :

  1. Tarif pelayanan belum termasuk tarif pelayanan penunjang medik dan obat-obatan
  2. Tarif operasi TIDAK termasuk bahan dan alat habis pakai di kamar operasi; dan
  3. Tarif operasi cito dikenakan tarif operasi ditambah 25% dari tarif normal