PETUNJUK TEKNIS PERDA TARIP NOMOR 39 TAHUN 2002T E N T A N G

PAKET TARIF TINDAKAN OPERASI & ANESTESI (Belum termasuk Bhn./Alat Dan Obat )F. PAKET TARIF TINDAKAN OPERASI & ANESTESI (Belum termasuk Bhn./Alat Dan Obat )

NO KLS/GOLKOMPONEN ELEKTIF CYTO

BIAYA JM JRS JM JRS1 PAVILIUN Jasa Rs 829,800 966,000

Khusus Dr. Operator 1,008,000 1,176,000 Dr. Anestesi 352,800 411,600 Perawat OK 100,800 126,000 Perawat Anestesi 100,800 126,000 Jasa Pelayanan 264,600 307,980 Jumlah Sub 1,827,000 829,800 2,147,580 966,000Total Paket Tarip 2,656,800 3,113,580

Besar Jasa Rs 680,400 886,800 Dr. Operator 840,000 1,092,000 Dr. Anestesi 294,000 382,200 Perawat OK 84,000 117,600 Perawat Anestesi 84,000 117,600 Jasa Pelayanan 217,140 282,780 Jumlah Sub 1,519,140 680,400 1,992,180 886,800Total Paket Tarip 2,199,540 2,878,980

Sedang Jasa Rs 626,400 786,000 Dr. Operator 756,000 966,000 Dr. Anestesi 264,600 338,100 Perawat OK 75,600 100,800 Perawat Anestesi 75,600 100,800 Jasa Pelayanan 197,100 250,620 Jumlah Sub 1,368,900 626,400 1,756,320 786,000Total Paket Tarip 1,995,300 2,542,320

Kecil Jasa Rs 324,000 410,400 Dr. Operator 420,000 504,000 Dr. Anestesi 147,000 176,400 Perawat OK 33,600 42,000 Perawat Anestesi 33,600 42,000 Jasa Pelayanan 102,300 126,000 Jumlah Sub 736,500 324,000 890,400 410,400Total Paket Tarip 1,060,500 1,300,800

2 VIP Jasa Rs 691,500 805,000 Khusus Dr. Operator 840,000 980,000

Dr. Anestesi 294,000 343,000 Perawat OK 84,000 105,000 Perawat Anestesi 84,000 105,000 Jasa Pelayanan 220,500 256,650 Jumlah Sub 1,522,500 691,500 1,789,650 805,000Total Paket Tarip 2,214,000 2,594,650

Besar Jasa Rs 567,000 739,000 Dr. Operator 700,000 910,000 Dr. Anestesi 245,000 318,500 Perawat OK 70,000 98,000 Perawat Anestesi 70,000 98,000 Jasa Pelayanan 180,950 235,650 Jumlah Sub 1,265,950 567,000 1,660,150 739,000Total Paket Tarip 1,832,950 2,399,150

Sedang Jasa Rs 522,000 655,000 Dr. Operator 630,000 805,000 Dr. Anestesi 220,500 281,750 Perawat OK 63,000 84,000 Perawat Anestesi 63,000 84,000 Jasa Pelayanan 164,250 208,850 Jumlah Sub 1,140,750 522,000 1,463,600 655,000Total Paket Tarip 1,662,750 2,118,600

Kecil Jasa Rs 270,000 342,000 Dr. Operator 350,000 420,000 Dr. Anestesi 122,500 147,000 Perawat OK 28,000 35,000 Perawat Anestesi 28,000 35,000 Jasa Pelayanan 85,250 105,000 Jumlah Sub 613,750 270,000 742,000 342,000Total Paket Tarip 883,750 1,084,000

3 KELAS I Jasa Rs 468,500 527,000 Khusus Dr. Operator 560,000 630,000

Dr. Anestesi 196,000 220,500 Perawat OK 70,000 77,000 Perawat Anestesi 70,000 77,000 Jasa Pelayanan 149,250 168,000 Jumlah Sub 1,045,250 468,500 1,172,500 527,000Total Paket Tarip 1,513,750 1,699,500

Besar Jasa Rs 406,500 494,000 Dr. Operator 490,000 595,000 Dr. Anestesi 171,500 208,250 Perawat OK 56,000 70,000 Perawat Anestesi 56,000 70,000 Jasa Pelayanan 129,500 157,500 Jumlah Sub 903,000 406,500 1,100,750 494,000Total Paket Tarip 1,309,500 1,594,750

Sedang Jasa Rs 348,000 432,000 Dr. Operator 420,000 525,000 Dr. Anestesi 147,000 183,750 Perawat OK 49,000 56,000

Perawat Anestesi 49,000 56,000 Jasa Pelayanan 110,500 137,650 Jumlah Sub 775,500 348,000 958,400 432,000Total Paket Tarip 1,123,500 1,390,400

Kecil Jasa Rs 225,000 277,000 Dr. Operator 280,000 350,000 Dr. Anestesi 98,000 122,500 Perawat OK 28,000 42,000 Perawat Anestesi 28,000 42,000 Jasa Pelayanan 72,250 92,250 Jumlah Sub 506,250 225,000 648,750 277,000Total Paket Tarip 731,250 925,750

4 KELAS II Jasa Rs 351,500 414,000Khusus Dr. Operator 480,000 560,000

Dr. Anestesi 168,000 196,000 Perawat OK 64,000 72,000Perawat Anestesi 64,000 72,000Jasa Pelayanan 128,000 150,500Jumlah Sub 904,000 351,500 1,050,500 414,000Total Paket Tarip 1,255,500 1,464,500

Besar Jasa Rs 289,000 344,000Dr. Operator 400,000 480,000Dr. Anestesi 140,000 168,000 Perawat OK 48,000 56,000Perawat Anestesi 48,000 56,000Jasa Pelayanan 105,250 125,250Jumlah Sub 741,250 289,000 885,250 344,000Total Paket Tarip 1,030,250 1,229,250

Sedang Jasa Rs 201,500 238,000Dr. Operator 280,000 320,000Dr. Anestesi 98,000 112,000 Perawat OK 32,000 40,000Perawat Anestesi 32,000 40,000Jasa Pelayanan 73,250 86,500Jumlah 515,250 201,500 598,500 238,000Total Paket Tarip 716,750 836,500

Kecil Jasa Rs 113,500 143,000Dr. Operator 160,000 200,000Dr. Anestesi 56,000 70,000 Perawat OK 16,000 24,000Perawat Anestesi 16,000 24,000Jasa Pelayanan 41,250 52,000Jumlah Sub 289,250 113,500 370,000 143,000Total Paket Tarip 402,750 513,000

CATATANBila kegiatan Operasi tidak disertai olehDokter Anestesi, maka Komponen TaripPenata Anestesi hanya dipungut 55 %dari Tarip Komponen Dokter Anestesi.

OPERASI