N

Diagnosa

Kode
ICD
10

Deskripsi

Tumor Telinga

D14.
0

Middle ear, nasal

cavity and
accessory
sinuses

Kode
ICD
9

Deskripsi Tindakan

Kode
Grup
INA
CBGs

Deskripsi

Estimasi biaya kelas

3

28.0

Incision and drainage of

tonsil and peritonsilair
structure
Excision of lesion of
maxillary sinus with
Caldwell-Luc approach
Simple mastoidectomy

U-1-15-I

Prosedur Tonsil dan Adenoid

Ringan

2.301.463

U-1-12-I

Prosedur Mastoid dan Sinus

Ringan

4.834.076

U-1-12-I

4.834.076

Radical mastoidectomy

U-1-12-I

Biopsy of tonsils and

adenoids
Excision of lesion of
tonsil and adenoid
Biopsy of tonsils and
adenoids

U-1-15-I

Prosedur Mastoid dan Sinus

Ringan
Prosedur Mastoid dan Sinus
Ringan
Prosedur Tonsil dan Adenoid
Ringan

Prosedur Tonsil dan Adenoid

Ringan

2.301.463

Cartilage of nose

D22.
2

C30.
1

Melanocytic naevi
of ear and
external auricular
canal
Malignant
neoplasm of inner
ear and middle
ear
Malignant
neoplasm of nasal
cavity
Peritonsilair
abscess

Tumor Cavum
Nasi

C30.
0

Tonsil abses/
peritonsil abses

J36

Sinusitis
maksilaris
kronis
Mastoiditis
Kronis
Mastoiditis
Kronis
Tumor tonsil

J32.0

Chronic maxillary
sinusitis

22.6
1

H70.
1
H70.
1
D10.
4

Chronic
mastoiditis
Chronic
mastoiditis
Benign neoplasm
of tonsil

C09.
9

Malignant
neoplasm of
tonsil, unspecifed

20.4
1
20.4
2
28.1
1
28.9
2
28.1
1
28.9
2

Tumor cavum

Excision of lesion of
tonsil and adenoid

U-1-15-I

4.834.076
2.301.463

nasi