| No | Nama Layanan | Tarif | Jenis Pemeriksaan |
|---|---|---|---|
| 2081 | Amputasi Jari | Rp4.726.000 | Prosedur Non Bedah |
| 2082 | Amputasi Transmedular (Bedah Orthopedi Sedang) | Rp4.000.000 | Prosedur Non Bedah |
| 2083 | Angkat Pen / Screw | Rp4.570.000 | Prosedur Non Bedah |
| 2084 | Atrhrotomy / Synovectomi | Rp4.506.000 | Prosedur Non Bedah |
| 2085 | Biopsi Dalam Narkose | Rp4.682.000 | Prosedur Non Bedah |
| 2086 | Biopsi Saraf Kutaneus/Otot (Bedah Orthopedi) | Rp4.509.000 | Prosedur Non Bedah |
| 2087 | Biopsy Vetebra (1 Level) | Rp4.000.000 | Prosedur Non Bedah |
| 2088 | Blok Saraf Tepi (Bedah Saraf) | Rp15.200.000 | Prosedur Non Bedah |
| 2089 | Closed Fraktur intercondylar femur | Rp4.000.000 | Prosedur Non Bedah |
| 2090 | Closed Fraktur proksimal tibia involve intraatikular | Rp4.000.000 | Prosedur Non Bedah |
