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Most Common Procedure Case Rates

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Most Common Procedure Case Rates LUNG CENTER OF THE PHILIPPINES PHILHEALTH CASE RATES MOST COMMON PROCEDURE CASE RATES RVS CODE DESCRIPTION CASE RATE PROF. FEE HCI FEE 19100 Biopsy of breast; needle core 3,640 840 2,800 19101 Biopsy of breast; incisional 5,560 1,260 4,300 19120 Excision of cyst,fibroadenoma or 8,020 2,520 5,500 other benign breast tissue 1 or more lesion 19160 Mastectomy,partial 22,000 8,800 13,200 19180 Mastectomy,simple,complete 22,000 8,800 13,200 19200 Mastectomy, radical 22,000 8,800 13,200 19240 Mastectomy, modified radical 22,000 8,800 13,200 27125 Partial Hip replacement 37,180 18,480 18,700 27130 Total Hip replacement 53,400 29,400 24,000 31600 Tracheostomy,planned 12,120 6,720 5,400 31601 Tracheostomy,planned;under 2 years 12,540 7,140 5,400 31603 Tracheostomy,emergency procedure 7,140 4,760 2,380 31622 Bronchoscopy,diagnostic, w/ or w/o 10,960 5,460 5,500 cell washing or brushing 31625 Bronchoscopy, w/ biopsy 10,960 5,460 5,500 31635 Bronchoscopy; w/ removal of foreign 18,000 8,400 9,600 body 31640 Bronchoscopy; w/ excision of tumor 30,300 16,800 13,500 32000 Thoracentesis 1,260 840 420 32005 Chemical Pleurodesis 10,540 5,040 5,500 32020 Tube Thoracotomy 7,980 5,320 2,660 32100 Thoracotomy,major 37,800 21,000 16,800 32220 Decortication,pulmonary;total 38,440 19,740 18,700 32225 Decortication,pulmonary;partial 30,300 16,800 13,500 32310 Pleurectomy,parietal 37,800 21,000 16,800 32320 Decortication & parietal pleurectomy 37,800 21,000 16,800 32400 Biopsy of pleura 5,560 1,260 4,300 32402 Biopsy,pleura;open 37,180 18,480 18,700 32405 Biopsy, lung or mediastinum 8,440 2,940 5,500 32440 Removal of lung,total pneumonectomy 46,500 25,200 21,300 32480 Removal of lung,other than total 41,160 24,360 16,800 pneumonectomy;single lobe (lobectomy) 32482 Removal of lung,other than total 46,500 25,200 21,300 Pneumonectomy; 2 lobes (bilobectomy ) 32500 Removal of lung,other than total 40,320 23,520 16,800 pneumonectomy;wedge resection 32601 Thoracoscopy,lungs & pleura w/o biopsy 11,980 5,880 6,100 32602 Thoracoscopy,lung & pleura w/ biopsy 12,900 6,300 6,600 32605 Thoracoscopy,mediastinal space w/o biopsy 12,120 6,720 5,400 32606 Thoracoscopy,mediastinal space w/ biopsy 12,120 6,720 5,400 32650 Thoracoscopy; w/ pleurodesis 12,120 6,720 5,400 32651 Thoracoscopy,w/ partial pulmonary 12,120 6,720 5,400 decortication 32652 Thoracoscopy; w/ total pulmonary decortication 12,120 6,720 5,400 32655 Thoracoscopy; w/ excision-plication of bullae 41,160 24,360 16,800 including any pleural procedure 32656 Thoracoscopy, w/ parietal pleurectomy 38,640 21,840 16,800 32659 Thoracoscopy, w/ creation of pericardial 38,640 21,840 16,800 window or partial resection of pericardial sac 32660 Thoracoscopy, w/ total pericardiectomy 41,160 24,360 16,800 32661 Thoracoscopy, w/ excision of pericardial cyst, 41,160 24,360 16,800 tumor or mass 32662 Thoracoscopy, w/ excision of mediastinal cyst, 41,160 24,360 16,800 tumor or mass 32663 Thoracoscopy, w/ lobectomy,total or segmental 46,500 25,200 21,300 33010 Pericardiocentesis 8,020 2,520 5,500 33015 Tube pericardiostomy 9,700 4,200 5,500 36430 Outpatient transfusion of blood or blood products;1 or more 3,640 840 2,800 36488 Placement of central venous catheter (jugular or 9,700 4,200 5,500 other vein) (e.g.,hemodialysis,chemotherapy); percutaneous cutdown 36825 Creation of atriovenous fistula 12,900 6,300 6,600 38220 Bone marrow aspiration or biopsy 10,880 3,780 7,100 38500 Biopsy or excision or lymph nodes 5,680 1,680 4,000 38505 Biopsy or excision or lumph nodes; by needle, 5,680 1,680 4,000 Superficial ( e.g., cervical,inguinal,axilliary) 38510 Biopsy or excision or lymph nodes; deep cervical 8,260 3,360 4,900 39000 Mediastinotomy 18,000 8,400 9,600 39200 Excision of mediastinal cyst 37,800 21,000 16,800 39220 Excision of mediastinal tumor 41,160 24,360 16,800 39400 Mediastinoscopy 14,960 7,560 7,400 43020 Esophagotomy, cervical approach, w/ removal of foreign body 12,120 6,720 5,400 43045 Esophagotomy, thoracic approach, w/ removal of foreign body 37,800 21,000 16,800 43107 Total or near esophagectomy, w/o thoracotomy; w/ 55,000 33,600 21,400 pharyngogastrostomy or cervical esophagogastrotomy, w/ or w/o pyloroplasty 43108 Total or near esophagectomy, w/o thoracotomy; w/ colon 58,800 37,800 21,000 interposition or small bowel reconstruction, including bowel mobilization, preparation & anastomosis 43112 Total or near total esophagectomy, w/ thoracotomy; w/ 59,640 38,640 21,000 pharyngogastrostomy or cervical esophagogastrotomy, w/ or w/o pyloroplasty 43113 Total or near esophagectomy, w/ thoracotomy; w/ colon 63,000 42,000 21,000 interposition or small bowel reconstruction, including bowel mobilization,preparation & anastomosis 43116 Partial esophagectomy, cervical w/ free intestinal graft, 55,000 33,600 21,400 including microvascular anastomosis, obtaining the graft & intestinal reconstruction 43117 Partial esophagectomy,distal two-thirds, w/ thoracotomy & 55,000 33,600 21,400 separate abdominal incision, w/ or w/o proximal gastrectomy w/ thoracic esophagostrotomy, w/ or w/o pyloroplasty 43118 Partial esophagectomy, distal two-thirds; w/ thoracotomy & 58,800 37,800 21,000 separate abdominal incision, w/ or w/o proximal gastrectomy w/ colon interposition or small bowel reconstruction,including bowel mobilization,preparation & anastomosis 43121 Partial esophagectomy,distal two-thirds, w/ thoracotomy only 55,000 33,600 21,400 w/ or w/o proximal gastrectomy, w/ thoracic esophagogastrotomy w/ or w/o pyloroplasty 43122 Partial esophagectomy,thoracoabdominal or abdominal approach, 55,000 33,600 21,400 w/ or w/o proximal gastrectomy, w/ thoracic esophagogastrotomy w/ or w/o pyloroplasty 43123 Partial esophagectomy, thoracoabdominal or abdominal approach 58,800 37,800 21,000 w/ or w/o proximal gastrectomy; w/ colon interposition or small bowel reconstruction,including bowel mobilization,preparation & anastomosis 43124 Total or partial esophagectomy,w/o reconstruction w/ cervical 46,500 25,200 21,300 esophagostomy 43200 Esophagoscopy, rigid or flexible; diagnostic; w/ or w/o collection 10,540 5,040 5,500 of specimen by brushing or washing 43202 Esophagoscopy, rigid or flexible; w/ biopsy, single or multiple 10,540 5,040 5,500 43204 Esophagoscopy, rigid or flexible; w/ injectable sclerosis of 14,960 7,560 7,400 esophageal varices 43205 Esophagoscopy, rigid or flexible; w/ band ligation of esophageal 14,960 7,560 7,400 varices 43215 Esophagoscopy, rigid or flexible; w/ removal of foreign body 14,960 7,560 7,400 43216 Esophagoscopy, rigid or flexible; w/ removal of tumors,polyps or 11,980 5,880 6,100 other lesion by hot biopsy forceps or bipolar cautery 43217 Esophagoscopy, rigid or flexible; w/ removal of tumors,polyps or 12,120 6,720 5,400 other lesion by snare technique 43219 Esophagoscopy, rigid or flexible; w/ insertion of plastic tube 18,000 8,400 9,600 43220 Esophagoscopy, rigid or flexible; w/ balloon dilation 18,000 8,400 9,600 43226 Esophagoscopy, rigid or flexible; w/ insertion of guide wire 18,000 8,400 9,600 43227 Esophagoscopy, rigid or flexible; w/ ablation of tumor,polyps or 18,000 8,400 9,600 other lesion not amenable to removal by hot biopsy forceps, bipolar cautery or snare technique 43620 Gastrectomy, total; w/ esophagoenterostomy 63,000 42,000 21,000 43621 Gastrectomy, total; w/ Roux-en-Y reconstruction 67,200 46,200 21,000 43622 Gastrectomy, total; w/ formation of intestinal pouch 67,200 46,200 21,000 43631 Gastrectomy, partial, distal; w/ gastroduodenostomy 55,000 33,600 21,400 43632 Gastrectomy, partial, distal; w/ gastrojejunostomy 5,500 33,600 21,400 43633 Gastrectomy, partial, distal; w/ Roux-en-Y reconstruction 63,000 42,000 21,000 43634 Gastrectomy, partial, distal; w/ formation of intestinal pouch 63,000 42,000 21,000 43638 Gastrectomy, partial, proximal, thoracic or abdominal approach 63,000 42,000 21,000 including esophagogostrostomy, w/ vagotomy 43639 Gastrectomy, partial, proximal, thoracic or abdominal approach 67,200 46,200 21,000 including esophagogastrostomy, w/ vagotomy; w/ pyloroplasty 43750 Percutaneous placement of gastrostomy tube 8,020 2,520 5,500 43760 Change of gastrostomy tube 5,560 1,260 4,300 43800 Pyloroplasty 37,800 21,000 16,800 43810 Gastroduodenostomy 63,000 42,000 21,000 43820 Gastrojejunostomy, w/o vagotomy 46,500 25,200 21,300 43825 Gastrojejunostomy, w/ vagotomy 53,400 29,400 24,000 43830 Gastrostomy, temporary (tube,rubber or plastic) 37,800 21,000 16,800 43832 Gastrostomy, permanent, w/ construction of gastric tube 37,800 21,000 16,800 44140 Colectomy, partial; w/ anastomosis 58,800 37,800 21,000 44141 Colectomy, partial; w/ skin level cecostomy or colostomy 58,800 37,800 21,000 44143 Colectomy, partial; w/ end colostomy & closure of distal segment 58,800 37,800 21,000 44144 Colectomy, partial; w/ resection; w/ colostomy or ileostomy & 58,800 37,800 21,000 creation of ,mucofistula 44145 Colectomy, partial; w/ coloproctostomy 56,680 35,280 21,400 44146 Colectomy, partial; w/ coloproctostomy, w/ colostomy 58,800 37,800 21,000 44147 Colectomy, partial; abdominal & transanal apparoach 63,000 42,000 21,000 44150 Colectomy, total, abdominal, w/o protectomy, w/ ileostomy or 63,000 42,000 21,000 ileoproctostomy 44151 Colectomy, total, abdominal, w/o protectomy, w/ continent ileostomy 63,000 42,000 21,000 44152 Colectomy, total, abdominal, w/o protectomy, w/ rectal mucosectomy 67,200 46,200 21,000 ileoanal anastomosis, w/ or w/o loop ileostomy 44153 Colectomy, total, abdominal, w/o protectomy, w/ rectal mucosectomy 67,200 46,200 21,000 ileoanal anastomosis, creation of ileal reservoir,
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