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論病例計酬項目DRG參考碼對照表 |
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製表日期:95/04/25 |
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項目 |
支付標準編碼 |
點數 |
上限金額 |
核實率 |
基本率 |
DRG 參考碼 |
起日 |
迄日 |
實施日期 |
|
陰道生產(住院) |
97001K |
36,086 |
36,086 |
100% |
67% |
0373A |
0950101 |
9991231 |
840301 |
|
97002A |
34,286 |
34,286 |
100% |
67% |
|
|
|
||
|
97003B |
32,520 |
32,520 |
100% |
67% |
|
|
|
||
|
97004C |
29,436 |
29,436 |
100% |
67% |
|
|
|
||
|
97005D |
26,704 |
26,704 |
0% |
67% |
|
|
|
||
|
剖腹產(住院) |
97006K |
36,086 |
38,086 |
15% |
75% |
0371A |
0950101 |
9991231 |
840901 |
|
97007A |
34,286 |
36,286 |
10% |
75% |
|
|
|
||
|
97008B |
32,520 |
33,460 |
5% |
75% |
|
|
|
||
|
97009C |
29,436 |
33,460 |
5% |
75% |
|
|
|
||
|
自行要求剖腹產(住院) |
97014C |
15,188 |
- |
0% |
75% |
0373B |
0950501 |
9991231 |
840701 |
|
子宮肌瘤切除術、子宮鏡子宮肌瘤切除術(住院) |
97010K |
40,657 |
45,117 |
15% |
0% |
0359A |
0950101 |
9991231 |
861001 870101 |
|
97011A |
39,019 |
44,869 |
10% |
0% |
|
0950101 |
9991231 |
||
|
97012B |
37,911 |
44,841 |
5% |
0% |
|
|
|
||
|
97013B |
36,975 |
44,475 |
5% |
0% |
|
|
|
||
|
輸卵管外孕手術(住院) |
97015K |
33,997 |
38,427 |
15% |
0% |
0378A |
0950101 |
9991231 |
861001 |
|
97016A |
32,977 |
37,967 |
10% |
0% |
|
|
|
||
|
97017B |
32,217 |
37,717 |
5% |
0% |
|
|
|
||
|
子宮完全切除術(住院) |
97020K |
48,380 |
56,780 |
15% |
0% |
0359B |
0950101 |
9991231 |
861001 |
|
97021A |
46,385 |
56,465 |
10% |
0% |
|
|
|
||
|
97022B |
45,045 |
56,195 |
5% |
0% |
|
|
|
||
|
次全子宮切除術(住院) |
97025K |
43,856 |
54,276 |
15% |
0% |
0359C |
0950101 |
9991231 |
861001 |
|
97026A |
41,819 |
51,799 |
10% |
0% |
|
|
|
||
|
97027B |
40,338 |
51,388 |
5% |
0% |
|
|
|
||
|
卵巢部分(全部)或輸卵管卵巢切除術(住院) |
97030K |
35,953 |
44,653 |
15% |
65% |
0359D |
0950101 |
9991231 |
861101 |
|
97031A |
34,007 |
41,967 |
10% |
65% |
|
|
|
||
|
97032B |
33,100 |
41,790 |
5% |
65% |
|
|
|
||
|
97033B |
31,826 |
41,326 |
5% |
65% |
|
|
|
||
|
腹腔鏡子宮完全切除術 |
97035K |
70,098 |
70,098 |
5% |
0% |
0359E |
0950101 |
9991231 |
870101 |
|
(住院) |
97036A |
68,334 |
68,334 |
5% |
0% |
|
|
|
|
|
|
97037B |
67,050 |
67,050 |
5% |
0% |
|
|
|
|
|
腹腔鏡卵巢部分(全部)或輸卵管卵巢切除術(住院) |
97041K |
56,146 |
56,146 |
5% |
65% |
0359F |
0950101 |
9991231 |
870101 |
|
97042A |
55,756 |
55,756 |
5% |
65% |
|
|
|
||
|
97043B |
54,802 |
54,802 |
5% |
65% |
|
|
|
||
|
97044B |
53,238 |
53,238 |
5% |
65% |
|
|
|
||
|
腹腔鏡子宮外孕手術(住院) |
97045K |
54,407 |
54,407 |
5% |
0% |
0359G |
0950101 |
9991231 |
870101 |
|
97046A |
53,801 |
53,801 |
5% |
0% |
|
|
|
||
|
97047B |
52,949 |
52,949 |
5% |
0% |
|
|
|
||
|
闌尾切除術(住院) |
97201K |
35,416 |
42,836 |
15% |
0% |
0167A |
0941101 |
9991231 |
861001 |
|
97202A |
34,102 |
42,592 |
10% |
0% |
|
|
|
||
|
97203B |
33,401 |
42,401 |
10% |
0% |
|
|
|
||
|
腹腔鏡膽囊切除術(住院) |
97205K |
54,891 |
62,841 |
15% |
65% |
0494A |
0941101 |
9991231 |
861001 |
|
97206A |
54,694 |
62,644 |
15% |
65% |
|
|
|
||
|
97207B |
54,458 |
62,408 |
10% |
65% |
|
|
|
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|
痔瘡或痔瘡併肛門廔管切除術(住院) |
97210K |
24,136 |
29,466 |
10% |
0% |
0158A |
0941101 |
9991231 |
861001 |
|
97211A |
23,402 |
29,292 |
5% |
0% |
|
|
|
||
|
97212B |
22,713 |
29,113 |
5% |
0% |
|
|
|
||
|
股及腹股溝疝氣手術(AGE>1，單側)(住院) |
97215K |
29,118 |
32,568
|
15% |
65% |
0163A |
0861001 |
9991231 |
861001 |
|
97216A |
28,288 |
32,388 |
15% |
65% |
|
|
|
||
|
97217B |
27,525 |
32,115 |
10% |
65% |
|
|
|
||
|
股及腹股溝疝氣手術(AGE>1,單側)(門診) |
97220K |
25,885 |
- |
0% |
0% |
1A |
0861001 |
9991231 |
861001 |
|
97221A |
25,355 |
- |
0% |
0% |
|
|
|
||
|
97222B |
25,133 |
- |
0% |
0% |
|
|
|
||
|
97223C |
24,522 |
- |
0% |
0% |
|
|
|
||
|
股及腹股溝疝氣手術(AGE>1，雙側)(住院) |
97225K |
36,078 |
43,178 |
15% |
65% |
0163B |
0880301 |
9991231 |
880301 |
|
97226A |
35,178 |
41,078 |
15% |
65% |
|
|
|
||
|
97227B |
34,529 |
47,929 |
5% |
65% |
|
|
|
||
|
甲狀腺切除術，無主要合併症或併發症(單側，住院) |
97235K |
37,014 |
55,914 |
5% |
65% |
0290A |
0941101 |
9991231 |
880301 |
|
97236A |
35,898 |
54,198 |
5% |
65% |
|
|
|
||
|
97237B |
33,848 |
46,948 |
5% |
65% |
|
|
|
||
|
甲狀腺切除術，無主要合併症或併發症(雙側，住院) |
97255K |
43,301 |
57,579 |
5% |
65% |
0290B |
0941101 |
9991231 |
930701 |
|
97256A |
41,914 |
55,592 |
5% |
65% |
|
|
|
||
|
97257B |
38,541 |
47,019 |
5% |
65% |
|
|
|
||
|
乳癌全部乳房切除術(單、雙側)，有合併症或併發症(住院) |
97240K |
58,890 |
75,890 |
10% |
65% |
0257A |
0941101 |
9991231 |
880701 |
|
97241A |
58,904 |
75,904 |
10% |
65% |
|
|
|
||
|
97242B |
58,696 |
75,696 |
10% |
65% |
|
|
|
||
|
乳癌全部乳房切除術(單、雙側)，無合併症或併發症(住院) |
97245K |
56,177 |
69,877 |
10% |
65% |
0258A |
0941101 |
9991231 |
880701 |
|
97246A |
56,109 |
69,809 |
10% |
65% |
|
|
|
||
|
97247B |
56,410 |
70,110 |
10% |
65% |
|
|
|
||
|
乳癌部分乳房切除併行腋窩淋巴清除術(單、雙側)
，無主要合併症或併發症(住院) |
97250K |
52,605 |
62,605 |
10% |
65% |
0259A |
0941101 |
9991231 |
880701 |
|
97251A |
52,767 |
62,767 |
5% |
65% |
|
|
|
||
|
97252B |
52,361 |
62,361 |
5% |
65% |
|
|
|
||
|
前列腺切除術(住院) |
97401K |
49,705 |
56,475 |
10% |
0% |
0337A |
0941101 |
9991231 |
861001 |
|
97402A |
49,359 |
56,129 |
10% |
0% |
|
|
|
||
|
97403B |
49,110 |
54,860 |
5% |
0% |
|
|
|
||
|
尿路結石體外震波碎石術(門診) |
97405K |
29,022 |
- |
0% |
65% |
2A |
0870101 |
9991231 |
870101 |
|
97406A |
29,022 |
- |
0% |
65% |
2A |
0870101 |
9991231 |
870101 |
|
|
97420B |
29,022 |
- |
0% |
65% |
2A |
0930701 |
9991231 |
930701 |
|
|
97407K |
51,284 |
- |
0% |
65% |
2B |
0870101 |
9991231 |
870101 |
|
|
97408A |
51,284 |
- |
0% |
65% |
2B |
0870101 |
9991231 |
870101 |
|
|
97421B |
51,284 |
- |
0% |
65% |
2B |
0930701 |
9991231 |
930701 |
|
|
97409K |
22,972 |
- |
0% |
65% |
2C |
0870101 |
9991231 |
870101 |
|
|
97410A |
22,972 |
- |
0% |
65% |
2C |
0870101 |
9991231 |
870101 |
|
|
97422B |
22,972 |
- |
0% |
65% |
2C |
0930701 |
9991231 |
930701 |
|
|
97411K |
45,234 |
- |
0% |
65% |
2D |
0870101 |
9991231 |
870101 |
|
|
97412A |
45,234 |
- |
0% |
65% |
2D |
0870101 |
9991231 |
870101 |
|
|
|
97423B |
45,234 |
- |
0% |
65% |
2D |
0930701 |
9991231 |
930701 |
|
腎臟移植(住院) |
97416K |
355,000 |
460,000 |
5% |
65% |
0302A |
0940501 |
9991231 |
880701 |
|
97417A |
355,000 |
460,000 |
5% |
65% |
|
0940501 |
9991231 |
880701 |
|
|
|
97418B |
355,000 |
460,000 |
5% |
65% |
|
0940501 |
9991231 |
930701 |
|
全股關節置換手術(單側)(住院) |
97801K |
123,973 |
146,103 |
10% |
65% |
0209A |
0861101 |
9991231 |
861101 |
|
97802A |
123,623 |
145,753 |
5% |
65% |
|
|
|
||
|
97803B |
123,223 |
145,353 |
5% |
65% |
|
|
|
||
|
全膝關節置換手術(單側)(住院) |
97805K |
133,368 |
188,798 |
5% |
65% |
0209B |
0861101 |
9991231 |
861101 |
|
97806A |
133,018 |
188,448 |
5% |
65% |
|
|
|
||
|
97807B |
132,618 |
188,048 |
5% |
65% |
|
|
|
||
|
全股關節置換術(雙側)(住院) |
97811K |
211,391 |
244,491 |
10% |
65% |
0471A |
0880701 |
9991231 |
880701 |
|
97812A |
210,921 |
244,021 |
5% |
65% |
|
|
|
||
|
97813B |
210,398 |
243,498 |
5% |
65% |
|
|
|
||
|
跗骨、蹠骨、趾骨閉鎖性骨折開放性復位術，無主要合併症或併發症(住院) |
97816K |
29,739 |
40,839 |
5% |
0% |
0225A |
0880701 |
9991231 |
880701 |
|
97817A |
28,689 |
39,589 |
5% |
0% |
|
|
|
||
|
97818B |
27,498 |
37,998 |
5% |
0% |
|
|
|
||
|
腕骨、掌骨、指骨閉鎖性骨折開放性復位術，無合併症或併發症(住院) |
97821K |
23,169 |
31,969 |
5% |
0% |
0229A |
0880701 |
9991231 |
880701 |
|
97822A |
22,519 |
31,119 |
5% |
0% |
|
|
|
||
|
97823B |
21,725 |
30,125 |
5% |
0% |
|
|
|
||
|
橈骨、尺骨閉鎖性骨折開放性復位術，無合併症或併發症(住院) |
97826K |
31,452 |
42,152 |
5% |
0% |
0224A |
0880701 |
9991231 |
880701 |
|
97827A |
30,652 |
41,152 |
5% |
0% |
|
|
|
||
|
97828B |
29,725 |
39,925 |
5% |
0% |
|
|
|
||
|
肱骨閉鎖性骨折開放性復位術(AGE >17)，無合併症或併發症(住院) |
97831K |
39,508 |
54,408 |
5% |
0% |
0219A |
0880701 |
9991231 |
880701 |
|
97832A |
38,378 |
52,878 |
5% |
0% |
|
|
|
||
|
97833B |
36,952 |
51,152 |
5% |
0% |
|
|
|
||
|
股骨幹、股骨頸閉鎖性骨折放性復位術(AGE >17)，無合併症或併發症(住院) |
97836K |
64,210 |
81,910 |
5% |
0% |
0211A |
0880701 |
9991231 |
880701 |
|
97837A |
62,630 |
80,030 |
5% |
0% |
|
|
|
||
|
97838B |
60,667 |
77,667 |
5% |
0% |
|
|
|
||
|
脛腓骨閉鎖性骨折開放性復位術(AGE >17)，無合併症或併發症(住院) |
97841K |
54,170 |
71,070 |
5% |
0% |
0219B |
0880701 |
9991231 |
880701 |
|
97842A |
52,590 |
69,190 |
5% |
0% |
|
|
|
||
|
97843B |
50,758 |
66,858 |
5% |
0% |
|
|
|
||
|
水晶體囊內(外)摘除術及人工水晶體置入術(單側)(住院) |
97601K |
24,815 |
35,395 |
5% |
65% |
0039A |
0870101 |
9991231 |
870101 |
|
97602A |
24,725 |
34,705 |
5% |
65% |
|
|
|
||
|
97603B |
24,623 |
- |
0% |
65% |
|
|
|
||
|
水晶體囊內(外)摘除術及人工水晶體置入術(單側)(門診) |
97605K |
20,658 |
- |
0% |
65% |
3A |
0870101 |
9991231 |
870101 |
|
97606A |
20,658 |
- |
0% |
65% |
|
|
|
||
|
97607B |
20,656 |
- |
0% |
65% |
|
|
|
||
|
97608C |
20,665 |
- |
0% |
65% |
|
|
|
||
|
顎、咽扁桃摘出術，無主要合併症或併發症(住院) |
97701K |
27,645 |
41,945 |
5% |
65% |
0059A |
0941101 |
9991231 |
880301 |
|
97702A |
25,934 |
38,834 |
5% |
65% |
|
|
|
||
|
97703B |
22,167 |
33,467 |
5% |
65% |
|
|
|
||
|
鼻中膈鼻道成形術(單、雙側)，無主要合併症或併發症(住院) |
97706K |
26,536 |
- |
0% |
65% |
0055A |
0941101 |
9991231 |
880301 |
|
97707A |
26,502 |
- |
0% |
65% |
|
|
|
||
|
97708B |
26,144 |
- |
0% |
65% |
|
|
|
||
|
喉直達鏡並做聲帶或會厭軟骨腫瘤切除或剝去，無主要合併症或併發症(住院) |
97711K |
22,814 |
- |
0% |
65% |
0055B |
0941101 |
9991231 |
880701 |
|
97712A |
22,549 |
- |
0% |
65% |
|
|
|
||
|
97713B |
22,544 |
- |
0% |
65% |
|
|
|
||
|
喉直達鏡並做聲帶或會厭軟骨腫瘤切除或剝去，無主要合併症或併發症(門診) |
97716K |
15,432 |
- |
0% |
65% |
4A |
0941101 |
9991231 |
880701 |
|
97717A |
15,299 |
- |
0% |
65% |
|
|
|
||
|
97718B |
15,421 |
- |
0% |
65% |
|
|
|
||
|
心導管檢查(一、二側，含冠狀動脈攝影，有複雜診斷)(住院) |
97501K |
44,874 |
66,574 |
15% |
65% |
0124A |
0880701 |
9991231 |
880701 |
|
97502A |
43,184 |
66,384 |
10% |
65% |
|
0880701 |
9991231 |
880701 |
|
|
97503B |
42,066 |
65,266 |
10% |
65% |
|
0930701 |
9991231 |
930701 |
|
|
心導管檢查(一、二側，含冠狀動脈攝影，無複雜診斷)(住院) |
97506K |
35,796 |
53,196 |
10% |
65% |
0125A |
0880701 |
9991231 |
880701 |
|
97507A |
35,676 |
53,076 |
5% |
65% |
|
0880701 |
9991231 |
880701 |
|
|
97508B |
34,931 |
52,331 |
5% |
65% |
|
0930701 |
9991231 |
930701 |
|
|
經皮冠狀動脈擴張術（一條血管，未裝血管支架，做心導管)，無主要合併症或併發症(住院) |
97511K |
136,105 |
228,205 |
5% |
65% |
0112A |
0880701 |
9991231 |
880701 |
|
97512A |
131,385 |
207,485 |
5% |
65% |
|
0880701 |
9991231 |
880701 |
|
|
97513B |
130,081 |
206,181 |
5% |
65% |
|
0930701 |
9991231 |
930701 |
|
|
|
|
|
|
|
|
|
|
|
|
|
經皮冠狀動脈擴張術（一條血管，未裝血管支架，未做心導管)，無主要合併症或併發症(住院) |
97516K |
&n | |||||||