servicios de salud de nayarit tabulador … · no. clave descripciÓn nivel 1 nivel 2 nivel 3 nivel...

No. CLAVE DESCRIPCIÓN NIVEL 1 NIVEL 2 NIVEL 3 NIVEL 4 NIVEL 5 NIVEL 6

1 01-001 CONSULTA GENERAL 19.00 15.00 21.00 28.00 51.00 89.00

2 01-002 CONSULTA ESPECIALIDAD 18.00 31.00 43.00 50.00 96.00 133.00

3 01-003 CONSULTA SUBSECUENTE DE ESPECIALIDAD 18.00 31.00 43.00 50.00 96.00 133.00

4 01-004 CONSULTA EXTEMPORANEA 21.00 34.00 48.00 53.00 101.00 141.00

5 01-005 CONSULTA URGENCIAS 19.00 31.00 43.00 50.00 96.00 133.00

6 01-006 OBSERVACION EN URGENCIAS DE 2 A 12 HRS 17.00 27.00 38.00 53.00 76.00 124.00

7 01-007 OBSERVACION EN URGENCIAS DE 12 A 23 HRS 30.00 62.00 87.00 107.00 153.00 250.00

8 01-008 HIDRATACION ORAL 0.00 0.00 0.00 0.00 0.00 0.00

9 01-009 HIDRATACION DE MENORES 5.00 11.00 15.00 20.00 36.00 58.00

10 01-010 HOSPITALIZACION DIA CAMA 30.00 62.00 87.00 116.00 182.00 297.00

11 01-011 DIA ESTANCIA EN TERAPIA INTENSIVA (ADULTOS) 71.00 148.00 207.00 266.00 534.00 915.00

12 01-012 DERECHOS DE USO DE SALA QUIRURGICA 57.00 104.00 146.00 207.00 327.00 726.00

13 01-013 DERECHO DE USO DE LAPAROSCOPIO 169.00 325.00 455.00 607.00 890.00 1,525.00

14 01-014 ANESTESIA (GENERAL O BLOQUEO) 71.00 111.00 155.00 184.00 267.00 382.00

15 01-015 ALIMENTACION ARTIFICIAL POR DIA 57.00 118.00 165.00 183.00 229.00 343.00

16 01-016 CONSULTA OBSTETRICA Y MONITOREO FETAL 80.00 107.00 150.00 165.00 220.00 275.00

17 01-101 DIA ESTANCIA EN CRECIMIENTO Y DESARROLLO 30.00 66.00 92.00 107.00 153.00 305.00

18 01-102 DIA ESTANCIA EN TERAPIA INTERMEDIA 49.00 111.00 144.00 152.00 305.00 534.00

19 01-103 DIA ESTANCIA EN TERAPIA INTENSIVA (NEONATOS) 71.00 148.00 207.00 266.00 534.00 915.00

20 01-104 VENTILACION MECANICA (POR DIA) 42.00 92.00 129.00 158.00 254.00 318.00

21 01-105 NUTRICION PARENTERAL (POR DIA) NEONATOS 28.00 59.00 83.00 91.00 183.00 343.00

22 02-001 LIPOMAS O QUISTE CEBACEO (CIRUGIA MENOR) 31.00 59.00 83.00 108.00 191.00 299.00

23 02-002 LIPOMA O QUISTE CEBACEO (EN QUIROFANO) 45.00 87.00 122.00 158.00 206.00 319.00

24 02-003 EXTIRPACION GANGLIONAR (BIOPSIA) 71.00 98.00 137.00 152.00 217.00 330.00

25 02-004 MASTECTOMIA 136.00 272.00 381.00 481.00 692.00 1,392.00

26 02-005 TIROIDECTOMIA 136.00 276.00 386.00 487.00 842.00 1,319.00

27 02-006 HERNIA UMBILICAL Y PARAUMBILICAL 109.00 215.00 301.00 405.00 745.00 1,195.00

28 02-007 HERNIA INGUINAL 104.00 149.00 209.00 271.00 674.00 1,068.00

29 02-008 HERNIA CRURAL 104.00 149.00 209.00 271.00 674.00 1,068.00

30 02-009 EVENTRACION POSTQUIRURGICA 144.00 241.00 337.00 430.00 745.00 1,176.00

31 02-010 DIASTASIS DE RECTOS 92.00 185.00 259.00 327.00 565.00 890.00

32 02-011 HERNIA HIATAL (OPERACION DE NISSEN) 212.00 369.00 517.00 696.00 1,049.00 1,678.00

Generado el 07/09/2011 a las 15:35:45 1 de 24

SERVICIOS DE SALUD DE NAYARITTABULADOR DE SERVICIOS MÉDICOS-ASISTENCIALES EN VIGENCIA

VERSIÓN 2001


33 02-012 GASTRECTOMIA 212.00 369.00 517.00 759.00 1,080.00 1,652.00

34 02-014 GASTROSTOMIA 118.00 221.00 309.00 380.00 572.00 890.00

35 02-015 PILOROPLASTIA 177.00 369.00 517.00 696.00 1,080.00 1,525.00

36 02-016 COLECISTECTOMIA 177.00 363.00 508.00 722.00 1,189.00 1,271.00

37 02-017 COLECISTECTOMIA POR LAPAROSCOPIA 235.00 535.00 749.00 823.00 1,208.00 1,716.00

38 02-018 COLEDOCORRAFIA 118.00 234.00 328.00 393.00 737.00 954.00

39 02-019 PLASTIA DE VIAS BILIARES 177.00 284.00 398.00 568.00 890.00 1,271.00

40 02-020 APENDICECTOMIA 141.00 308.00 431.00 531.00 905.00 1,398.00

41 02-021 HEMICOLECTOMIAS O COLECTOMIAS 141.00 284.00 398.00 519.00 826.00 1,298.00

42 02-022 TRANSPOSISION DE COLON 177.00 363.00 508.00 607.00 1,016.00 1,588.00

43 02-023 LAPAROTOMIA EXPLORADORA 188.00 333.00 466.00 525.00 991.00 1,525.00

44 02-024 RESECCIONES INTESTINALES 142.00 285.00 399.00 507.00 890.00 1,422.00

45 02-025 COLOSTOMIA O CIERRE 126.00 256.00 358.00 453.00 784.00 1,236.00

46 02-026 COLECTOMIA (RESECCION DE COLON) 142.00 285.00 399.00 507.00 890.00 1,422.00

47 02-027 CIRUGIA DE PANCREAS 142.00 285.00 399.00 507.00 890.00 1,444.00

48 02-028 RESECCION ABDOMINO PERINEAL 142.00 285.00 399.00 507.00 890.00 1,444.00

49 02-029 COLOCACION DE CATETER DE TENKOFF 104.00 149.00 209.00 271.00 446.00 1,068.00

50 02-030 BIOPSIA HEPATICA 82.00 117.00 129.00 133.00 191.00 318.00

51 02-031 FISURAS ANALES (CORRECCION) 89.00 123.00 172.00 216.00 355.00 508.00

52 02-032 QUISTE PINOLIDAL ADULTO 77.00 105.00 116.00 127.00 318.00 508.00

53 02-033 FRENORRAFIA 143.00 289.00 405.00 517.00 904.00 1,442.00

54 02-034 HEMORROIDECTOMIAS 141.00 333.00 466.00 506.00 890.00 1,398.00

55 02-035 EXTIRPACION DE TUMORES BENIGNOS DE ANO O RECTO 118.00 234.00 328.00 405.00 700.00 1,132.00

56 02-036 DEBRIDACION DE ABSCESOS PERIANALES 59.00 123.00 172.00 241.00 471.00 1,132.00

57 02-037 FISTULECTOMIAS 89.00 172.00 241.00 329.00 616.00 1,132.00

58 02-038 PROLAPSO RECTAL 177.00 320.00 448.00 506.00 890.00 1,398.00

59 02-039 CIRUGIA MENOR DE RECTO 59.00 123.00 172.00 216.00 279.00 446.00

60 02-040 ANOPLASTIA PERINEAL 129.00 259.00 363.00 449.00 762.00 1,208.00

61 02-041 RECTONECTOMIA 106.00 215.00 301.00 373.00 636.00 1,011.00

62 02-042 LAPAROSCOPIA DIAGNOSTICA 235.00 535.00 749.00 823.00 1,208.00 1,716.00

63 02-043 TORCOSCOPIA DIAGNOSTICA 235.00 43.00 60.00 823.00 1,208.00 1,716.00

64 02-044 DERIVACION BILIODIGESTIVA 118.00 246.00 344.00 380.00 508.00 700.00



VERSIÓN 2001


65 02-045 ESPLENECTOMIA 89.00 185.00 259.00 317.00 446.00 636.00

66 02-046 ESCLEROSIS DE VARICES POR SESION 94.00 185.00 259.00 348.00 604.00 826.00

67 02-047 DILATACIONES ESOFAGICAS POR SESION 18.00 37.00 52.00 64.00 121.00 191.00

68 02-048 CIRUGIA MENOR DE RECTO 35.00 74.00 104.00 133.00 234.00 382.00

69 02-049 CURACIONES PROCTOLOGICAS 10.00 13.00 18.00 23.00 39.00 70.00

70 02-050 CURACIONES ESOFAGICAS 10.00 13.00 18.00 23.00 39.00 70.00

71 02-051 CUERPOS EXTRAÑOS EN TUBO DIGESTIVO 30.00 62.00 87.00 108.00 191.00 305.00

72 02-052 LARINGOSCOPIA ENDOSCOPICA 24.00 62.00 87.00 152.00 229.00 293.00

73 02-141 RECTOSIGMOIDOSCOPIA 35.00 54.00 59.00 66.00 153.00 318.00

74 02-142 GASTROSCOPIA 71.00 161.00 225.00 297.00 508.00 700.00

75 02-143 PANENDOSCOPIA 71.00 154.00 216.00 285.00 508.00 700.00

76 02-144 COLONOSCOPIA 71.00 154.00 216.00 285.00 508.00 700.00

77 02-145 CIRUGIA MENOR DE ESOFAGO 54.00 98.00 137.00 184.00 337.00 528.00

78 03-001 CONSULTA Y PLAN DE TRATAMIENTO 7.00 16.00 22.00 28.00 44.00 67.00

79 03-101 ATENCION POR CUADRANTE 57.00 118.00 165.00 234.00 458.00 730.00

80 03-102 OBTURACION CON AMALGAMA DE PLATA 6.00 15.00 21.00 25.00 41.00 61.00

81 03-103 OBTURACION CON RESINA COMPUESTA 6.00 15.00 21.00 25.00 41.00 61.00

82 03-104 OBTURACION CON IRM O CON OXIDO DE ZINC 6.00 15.00 21.00 25.00 41.00 61.00

83 03-105 RESTAURACION DE CORONA DE ACERO C 6.00 15.00 21.00 25.00 41.00 61.00

84 03-106 RESTAURACION CON CORONA DE CELOLOID 6.00 15.00 21.00 25.00 41.00 61.00

85 03-107 CEMENTO INCRUSTACIONES Y CORONA 6.00 15.00 21.00 25.00 41.00 61.00

86 03-108 APLICACION DE FLUOR 0.00 0.00 0.00 0.00 0.00 0.00

87 03-109 CIRUGIA PREPOTESICA 40.00 79.00 111.00 144.00 267.00 420.00

88 03-110 CIRUGIA PERIAPICAL 40.00 79.00 111.00 144.00 267.00 420.00

89 03-111 CIRUGIA PARODONTAL 40.00 79.00 111.00 144.00 267.00 420.00

90 03-112 CIRUGIA ATM PROTESIS 78.00 155.00 217.00 296.00 541.00 823.00

91 03-113 REDUCCION CERRADA DE FRACTURA MANDI 49.00 96.00 134.00 175.00 318.00 518.00

92 03-114 REDUCCION ABIERTA DE FRACTURA MANDI 102.00 207.00 290.00 372.00 640.00 1,014.00

93 03-115 BIMAXILAR 683.00 1,554.00 2,020.00 2,110.00 2,805.00 8,232.00

94 03-116 PULIDO DE RESTAURACION 6.00 12.00 17.00 23.00 41.00 61.00

95 03-117 CIRUGIA DE LABIO FISURADO 57.00 116.00 162.00 202.00 351.00 557.00

96 03-118 CIRUGIA DE PALADAR FISURADO 57.00 116.00 162.00 202.00 351.00 557.00



VERSIÓN 2001


97 03-119 DRENAJE DE ABSCESO EN QUIROFANO 43.00 86.00 120.00 152.00 275.00 435.00

98 03-120 DRENAJE DE ABSCESO EN CONSULTA EXTERNA 20.00 40.00 56.00 74.00 136.00 206.00

99 03-121 EXCISION DE NEOPLASTIA BUCAL C/ANESTESIA LOCAL 78.00 155.00 217.00 296.00 534.00 855.00

100 03-122 EXCISION DE NEOPLASTIA BUCAL C/ANESTESIA GENERAL 98.00 184.00 258.00 349.00 640.00 1,021.00

101 03-123 EXCISION DE NEOPLASTIA BUCAL R.X. PERIAP. Y OC 4.00 7.00 10.00 15.00 28.00 53.00

102 03-124 CURACIONES DENTALES 6.00 15.00 21.00 25.00 44.00 61.00

103 03-125 LIMPIEZA CABITRON 10.00 19.00 27.00 35.00 61.00 107.00

104 03-126 ODONTOXESIS 11.00 25.00 35.00 45.00 84.00 122.00

105 03-127 DIENTES SUPERNUMERARIOS 40.00 81.00 113.00 152.00 275.00 435.00

106 03-128 MULTIPLES BAJO ANESTESIA 40.00 81.00 113.00 152.00 275.00 435.00

107 03-129 EXTRACCION TERCER MOLAR 40.00 86.00 120.00 154.00 275.00 435.00

108 03-130 RESINA FOTOPOLIMERIZABLE 33.00 55.00 77.00 89.00 145.00 242.00

109 03-201 RECUBRIMIENTOS PULPARES 4.00 7.00 10.00 11.00 22.00 31.00

110 03-202 PULPOTOMIA PIEZAS POSTERIORES 4.00 9.00 10.00 11.00 22.00 46.00

111 03-203 PULPOTOMIA PIEZAS ANTERIORES 4.00 9.00 13.00 17.00 28.00 51.00

112 03-301 TECNICA OCLUSAL 4.00 11.00 15.00 22.00 34.00 57.00

113 03-302 TECNICA PERIAPICAL 4.00 9.00 10.00 11.00 21.00 39.00

114 03-400 PATOLOGIA DENTAL 0.00 0.00 0.00 0.00 0.00 0.00

115 03-401 PROFILAXIS 9.00 15.00 21.00 28.00 51.00 92.00

116 03-501 FRENIVECTOMIA 10.00 21.00 29.00 36.00 67.00 107.00

117 03-502 OSTIOMILITIS 7.00 14.00 20.00 25.00 51.00 81.00

118 03-503 PARODONCIA 6.00 14.00 20.00 25.00 45.00 61.00

119 03-504 GINGIVECTOMIA 12.00 22.00 31.00 41.00 70.00 107.00

120 03-505 PLASTIA LABIAL 11.00 22.00 31.00 41.00 70.00 107.00

121 03-506 ENDODONCIA 24.00 54.00 76.00 99.00 160.00 252.00

122 03-507 DISTRACTOR DACTILAR Y MANDIBULAR 113.00 221.00 309.00 584.00 1,525.00 2,287.00

123 03-601 PORDIFENHIDANTOINA CUADRNATE 6.00 14.00 20.00 24.00 46.00 67.00

124 03-602 CEBRIDACION Y CANALIZACION DE ABSCESO 4.00 7.00 10.00 13.00 23.00 44.00

125 03-603 CORRECCION DE FISTULA ORO-ANGRAL 6.00 11.00 15.00 20.00 35.00 67.00

126 03-604 APICECTOMIA 10.00 19.00 27.00 35.00 69.00 107.00

127 03-605 BLOQUEOS LITICOS A NIVEL TRIGEMINAL 4.00 11.00 15.00 20.00 35.00 61.00

128 03-606 REGULARIZACION DE PROC. ALVEOLARES RE 4.00 7.00 10.00 12.00 23.00 45.00



VERSIÓN 2001


129 03-607 TULVIDINA Y TOMA DE BIOPSIA 4.00 7.00 10.00 12.00 24.00 45.00

130 03-700 TRAUMATOLOGIA 0.00 0.00 0.00 0.00 0.00 0.00

131 03-701 FRACTURA DENTOALVEOLAR FERULA APART 14.00 30.00 42.00 56.00 105.00 183.00

132 03-800 EXODONCIA 0.00 0.00 0.00 0.00 0.00 0.00

133 03-801 IMPLANTE NORMAL (POR PIEZA) 7.00 15.00 21.00 28.00 51.00 76.00

134 03-802 IMPLANTE ANORMAL (POR PIEZA) 11.00 21.00 29.00 41.00 74.00 116.00

135 03-803 ORGANOS DENTALES RETENIDOS (POR PIEZA) 14.00 31.00 43.00 61.00 116.00 168.00

136 04-001 PRUEBAS DE PERSONALIDAD 28.00 49.00 69.00 101.00 191.00 318.00

137 04-002 PRUEBAS PSICOMETRICAS (INDIVIDUAL) 61.00 124.00 174.00 222.00 388.00 607.00

138 04-003 PRUEBAS MMPI 16.00 26.00 36.00 51.00 101.00 166.00

139 04-004 PRUEBAS DE WAIS 16.00 26.00 36.00 51.00 101.00 166.00

140 04-005 PRUEBAS DE TAT 16.00 26.00 36.00 51.00 101.00 166.00

141 04-006 PRUEBA INVENTARIO DE PERSONALIDAD (PRF) 16.00 26.00 36.00 51.00 101.00 166.00

142 04-007 PRUEBAS DE DE BENDER 16.00 26.00 36.00 51.00 101.00 166.00

143 04-008 PRUEBA INVENTARIO DE RASGOS TEMPERAMENTALES 16.00 26.00 36.00 51.00 101.00 166.00

144 04-009 PRUEBAS DE WIPSI 16.00 26.00 36.00 51.00 101.00 166.00

145 04-010 PRUEBAS DE WICS 16.00 26.00 36.00 51.00 101.00 166.00

146 04-011 PRUEBA DE RAVEN (ADULTO) 16.00 26.00 36.00 51.00 101.00 166.00

147 04-012 PRUEBA DE RAVEN (NIÑOS) 16.00 26.00 36.00 51.00 101.00 166.00

148 04-013 PRUEBA EVALUACION DE LA PERCEPCION VISUAL 16.00 26.00 36.00 51.00 101.00 166.00

149 04-014 TERAPIA CONYUGAL (POR PAREJA DE 1 A 3 SESIONES) 16.00 30.00 42.00 46.00 83.00 121.00

150 04-015 TERAPIA FAMILIAR (POR FAMILIA DE 1 A 3 SESIONES) 16.00 30.00 42.00 46.00 83.00 121.00

151 04-016 TERAPIA DE GRUPO DE 1 A 3 SESIONES POR PERSONA 7.00 16.00 22.00 28.00 46.00 64.00

152 04-017 SECION TERAPIA PSICOLOGICA (1ª VEZ) 21.00 37.00 52.00 55.00 96.00 153.00

153 04-018 SECION TERAPIA PSICOLOGICA (SUBSECUENTE) 16.00 32.00 45.00 46.00 83.00 121.00

154 05-001 BIOPSIA 16.00 31.00 43.00 64.00 108.00 172.00

155 05-002 ELECTRODESECACION 18.00 37.00 52.00 69.00 128.00 209.00

156 05-003 ELECTROFULGURACION 18.00 37.00 52.00 76.00 133.00 217.00

157 05-004 EXTIRPACION DE VERRUGAS 18.00 31.00 43.00 64.00 116.00 197.00

158 05-005 EXTIRPACION DE LUNARES 24.00 43.00 60.00 76.00 142.00 234.00

159 05-006 ESTUDIOS MICOLOGICOS 10.00 18.00 21.00 25.00 45.00 64.00

160 05-007 RASURADOS 24.00 49.00 69.00 95.00 191.00 274.00



VERSIÓN 2001


161 05-008 PEELING QUIMICO SUPERFICIAL O MEDIO 15.00 32.00 45.00 62.00 117.00 189.00

162 05-009 APLICACION TOPICA 42.00 80.00 112.00 152.00 267.00 420.00

163 05-010 APLICACION INTRALESIONAR DE CORTICOESTEROIDES 24.00 49.00 69.00 89.00 166.00 254.00

164 05-011 EXTIRPACION EN CUNA LECHO UNGUEAL 18.00 37.00 52.00 76.00 153.00 234.00

165 05-012 EXTRIRPACION DE TUMOR BENIGNO 18.00 37.00 52.00 78.00 153.00 234.00

166 06-001 PRUEBA DE ESFUERZO CARDIOLOGICA 85.00 163.00 228.00 288.00 382.00 534.00

167 06-002 MONITOREO CARDIACO (HOLTER) 57.00 86.00 120.00 143.00 229.00 458.00

168 06-003 ELECTROCARDIOGRAMA EN REPOSO 28.00 43.00 47.00 50.00 69.00 116.00

169 06-004 ELECTROENCEFALOGRAFIA 49.00 86.00 120.00 165.00 266.00 484.00

170 07-001 PUNCION LUMBAR 34.00 75.00 105.00 127.00 218.00 305.00

171 07-002 APLICACION MARCAPASO TEMPORAL 141.00 295.00 413.00 531.00 915.00 1,678.00

172 07-003 APLICACION MARCAPASO DEFINITIVO 141.00 295.00 413.00 531.00 915.00 1,678.00

173 07-004 COLOCACION DE CATETER SUBCLAVIO 34.00 65.00 91.00 121.00 206.00 336.00

174 07-005 DIALISIS PERITONEAL (CON SOLICIONES) 226.00 458.00 641.00 850.00 1,678.00 2,440.00

175 07-006 DIALISIS PERITONEAL (SIN SOLICIONES) 169.00 266.00 372.00 638.00 793.00 1,449.00

176 07-007 SELLO DE AGUA 71.00 133.00 186.00 228.00 411.00 686.00

177 07-008 REALIZACION DE FERULAS DE YESO 18.00 27.00 38.00 56.00 64.00 92.00

178 07-009 APARATO DE YESO (COLOCACION) 18.00 35.00 49.00 74.00 117.00 191.00

179 07-010 RETIRO DE YESO 18.00 27.00 38.00 54.00 64.00 92.00

180 07-011 LAVADO GASTRICO 20.00 37.00 52.00 76.00 136.00 229.00

181 07-012 SONDEO VESICAL 18.00 47.00 56.00 61.00 116.00 183.00

182 07-013 VENOCLISIS 20.00 37.00 52.00 76.00 136.00 229.00

183 07-014 APLICACION DE INYECCIONES INTRAMUSCULAR 11.00 18.00 20.00 25.00 33.00 46.00

184 07-015 VENDAJES COMPRESIVOS 11.00 25.00 35.00 43.00 55.00 69.00

185 07-016 SANGRIA 28.00 52.00 73.00 99.00 183.00 244.00

186 07-018 CURACIONES 11.00 19.00 27.00 28.00 39.00 53.00

187 07-019 TROMBOLOSIS CORONARIA 255.00 517.00 724.00 873.00 1,829.00 2,745.00

188 07-020 ESANGUINOTRANSFUSION 49.00 185.00 259.00 342.00 496.00 686.00

189 07-021 VENODISECCION 34.00 65.00 91.00 121.00 206.00 336.00

190 07-022 COLOCACION DE CATETER DE ONFALOCLISIS 34.00 65.00 91.00 121.00 206.00 336.00

191 08-001 HISTERECTOMIA ABDOMINAL 177.00 257.00 360.00 443.00 666.00 1,089.00

192 08-002 HISTERECTOMIA VAGINAL 177.00 215.00 301.00 443.00 826.00 1,144.00



VERSIÓN 2001


193 08-003 HISTERECTOMIA OBSTETRICA 177.00 259.00 363.00 531.00 968.00 1,452.00

194 08-004 HISTERECTOMIA CON LINFADENECTOMIA 195.00 394.00 552.00 708.00 1,220.00 1,906.00

195 08-005 BARTHOLINECTOMIA 71.00 92.00 129.00 165.00 305.00 508.00

196 08-006 MARZUPIALIZACION DE GLANDULA BARTHOLINO 71.00 92.00 129.00 165.00 305.00 508.00

197 08-007 CONIFICACION (EN QUIROFANO) 71.00 98.00 137.00 190.00 330.00 636.00

198 08-008 RESECCION ALTA O BAJA DE CERVIX 71.00 98.00 137.00 190.00 330.00 636.00

199 08-009 DEBRIDACION DE ABSCESO MAMARIO 42.00 62.00 87.00 127.00 217.00 318.00

200 08-010 COLPOPERINORRAFIA (PLASTIA VAGINAL) 177.00 246.00 344.00 380.00 636.00 1,271.00

201 08-011 RESECCION DE QUISTES Y TUMORES BENIGNOS 148.00 221.00 309.00 405.00 762.00 1,208.00

202 08-012 DRENAJE DE FONDO DE SACO 47.00 87.00 122.00 152.00 267.00 508.00

203 08-013 REPARACION DE FISTULAS VESICO VAGINAL 118.00 215.00 301.00 253.00 762.00 1,208.00

204 08-014 REPARACION DE FISTULAS RECTO VAGINAL 118.00 215.00 301.00 253.00 762.00 1,208.00

205 08-015 EXCERESIS DE NODULO MAMARIO 43.00 83.00 116.00 152.00 270.00 426.00

206 08-016 MASTECTOMIA SIMPLE 118.00 215.00 301.00 443.00 636.00 1,208.00

207 08-017 CERCLAJE CERVICO UTERINO 118.00 215.00 301.00 443.00 636.00 1,208.00

208 08-018 ESTIRPACION DE POLIO CERVICAL 47.00 98.00 137.00 190.00 330.00 572.00

209 08-019 LAPAROSCOPIA 118.00 215.00 301.00 443.00 572.00 1,080.00

210 08-020 SALPINGOCLASIA 0.00 0.00 0.00 0.00 0.00 0.00

211 08-021 SALPINGO OFERECTOMIA 118.00 215.00 301.00 443.00 636.00 1,080.00

212 08-022 MIOMECTOMIA 118.00 215.00 301.00 443.00 636.00 1,080.00

213 08-023 PLASTIA TUBARIA 118.00 215.00 301.00 443.00 636.00 1,080.00

214 08-024 PLASTIA UTERINA 118.00 215.00 301.00 443.00 636.00 1,080.00

215 08-025 EXTIRPACION DE TUMORES VULVARES O VAGINALES 118.00 215.00 301.00 443.00 636.00 1,080.00

216 08-026 VULVECTOMIA SIMPLE 141.00 259.00 363.00 481.00 864.00 1,398.00

217 08-027 OPERACION DE BURCH 141.00 284.00 398.00 506.00 890.00 1,398.00

218 08-028 OPERACION DE PEREYNA 141.00 284.00 398.00 506.00 890.00 1,398.00

219 08-029 ESTIRPACION DE QUISTE DE OVARIO 141.00 185.00 259.00 443.00 636.00 1,080.00

220 08-030 PARTO DISTOCICO 94.00 221.00 309.00 354.00 649.00 1,016.00

221 08-031 EMBARAZO EXTRAUTERINO 94.00 185.00 259.00 278.00 508.00 1,080.00

222 08-032 PARTO NORMAL 89.00 185.00 259.00 348.00 636.00 1,080.00

223 08-033 CESAREA 141.00 271.00 379.00 506.00 890.00 1,398.00

224 08-034 LEGRADO 89.00 185.00 259.00 317.00 572.00 890.00



VERSIÓN 2001


225 08-035 REPARACION DE DESGARRO UTERINO 118.00 215.00 301.00 443.00 636.00 1,080.00

226 08-101 CONSULTA CON COLPOSCOPIA 24.00 37.00 52.00 57.00 121.00 191.00

227 08-102 CONIFICACION CON CRIOTERAPIA 54.00 102.00 143.00 185.00 330.00 540.00

228 08-103 CONIFICACION CON ASA ELECTRICA 54.00 102.00 143.00 185.00 330.00 540.00

229 08-104 ELECTROFULGORACIONES CERVICALES 37.00 75.00 105.00 142.00 262.00 438.00

230 08-105 BIOPSIA DE ENDOMETRIO 37.00 75.00 105.00 142.00 262.00 438.00

231 09-001 CRANEOTOMIA 271.00 495.00 693.00 1,265.00 3,416.00 3,795.00

232 09-002 CRENIECTOMIA 271.00 495.00 693.00 946.00 1,594.00 2,391.00

233 09-003 EXPLORACION DE NERVIO PERIFERICO, PLA 136.00 227.00 318.00 437.00 691.00 1,263.00

234 09-004 MENINGOPLASTIA 163.00 339.00 475.00 582.00 930.00 1,594.00

235 09-005 COLOCACION DE VALVULA PUDENS 163.00 495.00 693.00 949.00 1,645.00 2,391.00

236 09-006 LAMINECTOMIA ADULTO 271.00 495.00 693.00 949.00 1,594.00 2,391.00

237 09-007 DISCECTOMIA LUMBAR 474.00 779.00 896.00 946.00 1,461.00 1,992.00

238 09-008 ARTRODESIS EN COLUMNA 474.00 779.00 896.00 946.00 1,461.00 1,992.00

239 09-009 RESECCION DE TUMOR CEREBRAL 271.00 495.00 693.00 1,238.00 3,188.00 3,719.00

240 09-010 RESECCION DE TUMOR EXTRACEREBRAL 271.00 495.00 693.00 1,238.00 3,188.00 3,719.00

241 09-011 DRENAJE DE HEMATOMA INTRACRANEANO 271.00 495.00 693.00 1,238.00 3,188.00 3,719.00

242 09-012 PLASTIA CRANEAL ADULTO 163.00 339.00 475.00 582.00 930.00 1,594.00

243 09-101 QUISTE PILONIDAL PEDIATRIA 102.00 205.00 287.00 364.00 558.00 864.00

244 09-102 LAMINECTOMIA PEDIATRIA 271.00 495.00 693.00 946.00 1,594.00 2,391.00

245 09-103 PLASTIA DE MENINGOCELE 170.00 274.00 346.00 349.00 465.00 798.00

246 09-104 PLASTIA DE MENINGOCELE CRANEANO 170.00 247.00 346.00 349.00 531.00 864.00

247 09-105 MURCELACION 95.00 198.00 277.00 364.00 531.00 798.00

248 09-106 CRANEOPLASTIA 95.00 198.00 277.00 364.00 531.00 798.00

249 09-107 DERIVACION DE LIQUIDO CEFALORRAQUIDEO 163.00 495.00 693.00 946.00 1,594.00 2,391.00

250 11-002 FASIOTOMIA 124.00 248.00 344.00 418.00 686.00 1,055.00

251 11-006 BLEFAROPLASTIA 589.00 1,199.00 1,679.00 1,847.00 2,820.00 6,353.00

252 11-007 OTOPLASTIA 165.00 326.00 456.00 620.00 1,132.00 1,894.00

253 11-008 MENTOPLASTIA 407.00 825.00 1,155.00 1,181.00 1,652.00 4,447.00

254 11-010 DERMOABRACION (PEELING) 294.00 584.00 818.00 1,076.00 1,945.00 3,177.00

255 11-012 COLOCACION DE EXPANSORES 165.00 326.00 456.00 620.00 1,144.00 1,906.00

256 11-013 MAXILOFACIAL 224.00 449.00 629.00 823.00 1,493.00 2,415.00



VERSIÓN 2001


257 11-014 COLGAJOS MIOCUTANEOS 148.00 295.00 413.00 563.00 1,080.00 1,855.00

258 11-015 COLGAJOS 89.00 172.00 241.00 342.00 649.00 1,067.00

259 11-016 MICROCIRUGIA 165.00 333.00 466.00 620.00 1,132.00 1,868.00

260 11-017 TENORRAFIAS 94.00 148.00 207.00 317.00 476.00 762.00

261 11-018 NEURORRAFIAS 94.00 148.00 207.00 317.00 476.00 762.00

262 11-019 PROCESOS COMBINADOS 141.00 295.00 413.00 443.00 826.00 1,652.00

263 11-020 LABIO LEPORINO Y PALADAR ENDIDO 89.00 148.00 207.00 228.00 471.00 572.00

264 11-021 MASTOPEXIA 324.00 640.00 832.00 860.00 1,080.00 3,685.00

265 11-022 PLASTIA UMBILICAL 89.00 148.00 207.00 228.00 446.00 604.00

266 11-023 INJERTOS DE PIEL MENORES 89.00 148.00 207.00 278.00 521.00 890.00

267 11-024 INJERTOS DE PIEL MAYORES 177.00 369.00 517.00 658.00 1,184.00 1,906.00

268 11-025 CICATRICES DE MANOS 89.00 148.00 207.00 228.00 446.00 604.00

269 11-026 CICATRICES MAYORES 89.00 148.00 207.00 228.00 446.00 700.00

270 11-027 PLASTIA LOCAL (CICATRICES MAYORES) 89.00 148.00 207.00 241.00 446.00 700.00

271 11-028 EXTIRPACION DE TUMORES DE PIEL MALIGNOS 59.00 123.00 172.00 216.00 382.00 604.00

272 11-029 EXTIRPACION DE TUMORES DE PIEL BENIGNOS 54.00 92.00 129.00 165.00 286.00 463.00

273 11-030 RINOPLASTIA 930.00 1,785.00 2,321.00 2,366.00 2,669.00 3,837.00

274 11-031 MASTOPLASTIA DE AUMENTO 1,683.00 2,000.00 2,300.00 2,422.00 3,125.00 4,409.00

275 11-032 LIPECTOMIA 1,513.00 2,332.00 3,265.00 3,340.00 4,028.00 5,718.00

276 11-033 RITIDOPLASTIA 2,354.00 3,692.00 4,800.00 5,060.00 5,718.00 6,353.00

277 12-001 CIRUGIA DE AORTA ABDOMINAL 177.00 375.00 525.00 715.00 1,210.00 1,906.00

278 12-002 CIRUGIA VASCULAR DE ABDOMEN Y TORAX 242.00 486.00 680.00 911.00 1,626.00 2,669.00

279 12-012 SIMPATECTOMIA 118.00 240.00 336.00 449.00 813.00 1,271.00

280 12-014 CIRUGIA VASCULAR PERIFERICA 177.00 320.00 448.00 545.00 903.00 1,398.00

281 12-019 TROMBECTOMIA 177.00 320.00 448.00 545.00 903.00 1,398.00

282 12-021 ENDARTERECTOMIA 129.00 268.00 375.00 484.00 847.00 1,271.00

283 12-022 SAFENECTOMIA POR EXTREMIDAD 129.00 268.00 375.00 484.00 847.00 1,271.00

284 12-023 BRAZO AMPUTACION 94.00 185.00 259.00 317.00 540.00 851.00

285 12-024 ANTEBRAZO AMPUTACION 106.00 221.00 309.00 367.00 629.00 997.00

286 12-025 MUSLO AMPUTACION 136.00 264.00 370.00 469.00 794.00 1,271.00

287 12-026 MANO AMPUTACION 82.00 166.00 232.00 278.00 458.00 700.00

288 12-027 PIE AMPUTACION 101.00 203.00 284.00 342.00 572.00 915.00



VERSIÓN 2001


289 12-028 DEDO (PIE O MANO) AMPUTACION O DESARTICULACION 101.00 203.00 284.00 342.00 572.00 915.00

290 13-001 CATARATAS 101.00 200.00 280.00 349.00 591.00 1,208.00

291 13-002 ESTRABISMO 148.00 246.00 320.00 443.00 757.00 1,208.00

292 13-003 PTERIGION Y PINGUECULA 71.00 136.00 190.00 260.00 483.00 801.00

293 13-004 RETINA 136.00 277.00 388.00 487.00 846.00 1,398.00

294 13-005 CHALAZION 42.00 87.00 122.00 158.00 286.00 471.00

295 13-006 DACRIOSCISTECTOMIA 82.00 154.00 216.00 298.00 547.00 890.00

296 13-007 ENTROPION Y ECTOPRION (Y QUEMADURA) 82.00 154.00 216.00 298.00 547.00 890.00

297 13-008 EXTRACCION DE CUERPOS EXTRAÑOS 24.00 49.00 69.00 95.00 172.00 274.00

298 13-009 GLAUCOMA 118.00 240.00 336.00 424.00 730.00 1,163.00

299 13-010 GRADUACION DE LENTES 11.00 21.00 29.00 39.00 76.00 128.00

300 13-011 SONDEO VESICAL 12.00 19.00 27.00 39.00 70.00 191.00

301 13-012 FOTOCOAGULACION (RAYO LASER) 30.00 64.00 90.00 121.00 242.00 572.00

302 13-014 FLUORANGIOGRAFIA 35.00 75.00 105.00 143.00 266.00 636.00

303 13-015 RECONSTRUCCION PALPEBRAL 82.00 161.00 225.00 304.00 559.00 954.00

304 14-001 EXTRACCION DE CUERPOS EXTRAÑOS EN Q 89.00 148.00 207.00 278.00 496.00 826.00

305 14-002 EXTRACCION DE CUERPOS EXTRAÑOS SIN TEC. Q 42.00 56.00 62.00 69.00 96.00 121.00

306 14-005 PARENTESIS DEL TIMPANO 42.00 56.00 78.00 95.00 184.00 305.00

307 14-006 COLOCACION DEL TUBO DE VENTILACION 77.00 128.00 179.00 231.00 424.00 712.00

308 14-007 TIMPANOTOMIA EXPLORADORA 77.00 136.00 190.00 266.00 496.00 826.00

309 14-008 MIRINGOPLASTIA 106.00 221.00 309.00 380.00 667.00 1,080.00

310 14-009 TIMPANOPLASTIA 106.00 221.00 309.00 443.00 667.00 1,080.00

311 14-010 TRATAMIENTO QUIRURGICO DE TUMORES MALIGNOS 141.00 271.00 379.00 487.00 928.00 1,588.00

312 14-011 TRATAMIENTO QUIRURGICO DE TUMORES BENIGNOS 94.00 185.00 259.00 348.00 661.00 1,132.00

313 14-012 TRATAMIENTO QUIRURGICO DE ABSCESO OTOGENO ENDO 112.00 228.00 319.00 455.00 890.00 1,557.00

314 14-013 TRAT. QUIR. ESTENOSIS DEL CONDUCT. AUDITIVO 112.00 228.00 319.00 380.00 700.00 1,132.00

315 14-014 TRAT. QUIR. MALFORMACIONES CONGENITAS 112.00 228.00 319.00 380.00 700.00 1,132.00

316 14-015 CIRUGIA DE POLIPOS NASALES 112.00 228.00 319.00 380.00 700.00 826.00

317 14-016 LIGADURA TRANS-ANTRAL DE LA ARTERIA M. 112.00 228.00 319.00 380.00 700.00 890.00

318 14-017 LIGADURA DE CAROTIDA EXTERNA 112.00 228.00 319.00 380.00 700.00 954.00

319 14-018 DEBRIDACION DE HEMATOMA Y/O ABSCESO 112.00 228.00 319.00 380.00 700.00 890.00

320 14-019 TRATAMIENTO QUIRURGICO DE SEQUIAS 112.00 228.00 319.00 380.00 700.00 826.00



VERSIÓN 2001


321 14-020 TRATAMIENTO DE FRACTURA NASAL 112.00 228.00 319.00 380.00 700.00 826.00

322 14-021 TRATAMIENTO QUIRURGICO ATRESIA COAN 112.00 228.00 319.00 380.00 700.00 1,132.00

323 14-022 CORRECCION QUIRUGICO SEPTUM NASAL 141.00 271.00 379.00 487.00 928.00 1,588.00

324 14-023 RINOSEPTUMPLASTIA 677.00 1,009.00 1,160.00 1,202.00 1,843.00 2,859.00

325 14-024 TRATAMIENTO QUIRURGICO DE PERFORACI 141.00 271.00 379.00 487.00 928.00 1,588.00

326 14-025 EXTIRPACION DE TUMORES BENIGNOS EN F 112.00 228.00 319.00 380.00 700.00 890.00

327 14-026 TRATAMIENTO QUIRURGICO DE ANGIOFIBRO 141.00 271.00 379.00 487.00 928.00 1,588.00

328 14-027 TRATAMIENTO QUIRUR. DE SINUSITIS MAXILAR (CALDWEL) 141.00 271.00 379.00 487.00 928.00 1,588.00

329 14-028 AMIGDALECTOMIA CON O SIN ADENOIDECTO 89.00 148.00 207.00 317.00 471.00 762.00

330 14-029 CEBRIDACION DE ABSCESOS FARINGOAMIG 89.00 148.00 207.00 317.00 471.00 762.00

331 14-030 TRATAMIENTO QUIRURGICO DE RANULA 106.00 197.00 276.00 373.00 700.00 1,144.00

332 14-031 EXTIRPACION DE GLANDULA SUBMAXILAR 118.00 234.00 328.00 443.00 813.00 1,334.00

333 14-032 OCLUCION DE FISTULA OROANTRAL 141.00 271.00 379.00 487.00 928.00 1,588.00

334 14-033 TAPONAMIENTO NASAL 54.00 62.00 87.00 158.00 222.00 254.00

335 14-034 LARINGOFISURA 65.00 136.00 190.00 253.00 446.00 712.00

336 14-035 TRAQUEOSTOMIA 65.00 123.00 172.00 253.00 446.00 712.00

337 14-036 LARINGOSCPIA DIRECTA E INDIRECTA 54.00 67.00 77.00 83.00 141.00 222.00

338 15-001 NEFRECTOMIA 188.00 369.00 517.00 671.00 1,183.00 1,906.00

339 15-002 PIELILOTOMIA 188.00 369.00 517.00 671.00 1,183.00 1,906.00

340 15-003 CSTOSTOMIA 106.00 215.00 301.00 506.00 826.00 1,398.00

341 15-004 PROSTATECTOMIA 188.00 320.00 448.00 595.00 1,080.00 1,779.00

342 15-005 CORRECCION DE REFLUJO VESICOURETRAL 141.00 277.00 388.00 506.00 870.00 1,398.00

343 15-006 DILATACION URETRAL 54.00 111.00 155.00 221.00 413.00 700.00

344 15-007 PUNCION DE ABSCESO PROSTATICO 54.00 111.00 155.00 221.00 413.00 572.00

345 15-008 ORQUIECTOMIA 177.00 246.00 344.00 380.00 661.00 1,080.00

346 15-009 MEATOTOMIAS 54.00 105.00 147.00 209.00 446.00 674.00

347 15-010 EXTIRPACION DE TUMORES RETROPERITONEALES 188.00 369.00 517.00 671.00 1,183.00 1,906.00

348 15-011 EXTIRPACION DE TUMORES RENALES 188.00 369.00 517.00 671.00 1,183.00 1,906.00

349 15-012 EXCERESIS DE QUISTE DE EPIDIDIMO 54.00 111.00 155.00 221.00 413.00 700.00

350 15-013 CIRCUNCICION (FIMOSIS) 89.00 185.00 259.00 317.00 446.00 667.00

351 15-014 PROSTATECTOMIA POR RESECCION TRASURETRAL (RTU) 509.00 748.00 1,047.00 1,145.00 1,520.00 2,329.00

352 15-015 CISTOSCOPIA 71.00 161.00 225.00 297.00 508.00 700.00



VERSIÓN 2001


353 16-001 HOMBRO ARTRODESIS 141.00 308.00 431.00 506.00 890.00 1,525.00

354 16-002 COLUMNA ARTRODESIS 148.00 308.00 431.00 531.00 921.00 1,525.00

355 16-003 CADERA ARTRODESIS 171.00 308.00 431.00 538.00 954.00 1,588.00

356 16-005 ARTRONEUMOGRAFIA 54.00 98.00 137.00 196.00 382.00 636.00

357 16-101 PROTESIS TOTAL 207.00 308.00 431.00 570.00 921.00 1,525.00

358 16-102 PROTESIS PARCIAL 207.00 308.00 431.00 570.00 921.00 1,525.00

359 16-201 ARTOPLASTIA TOTAL 207.00 310.00 434.00 605.00 968.00 1,525.00

360 16-202 ARTOPLASTIA PARCIAL 207.00 310.00 434.00 605.00 968.00 1,525.00

361 16-203 ELONGACION OSEA 54.00 107.00 150.00 220.00 424.00 636.00

362 16-204 EXTIRPACION DISCAL 235.00 461.00 645.00 696.00 1,080.00 1,906.00

363 16-205 LAMINECTOMIA ADULTO 235.00 482.00 675.00 715.00 1,113.00 1,906.00

364 16-301 UNILATERAL 89.00 148.00 207.00 253.00 458.00 1,016.00

365 16-302 BILATERAL 112.00 221.00 309.00 380.00 604.00 1,398.00

366 16-401 MIEMBRO TORACICO ( REDUCCION MANUAL) 89.00 148.00 192.00 202.00 446.00 572.00

367 16-402 MIEMBRO TORACICO ( REDUCCION QUIRURGICA) 159.00 221.00 309.00 405.00 717.00 1,137.00

368 16-403 MIEMBRO PELVICO (REDUCCION MANUAL) 89.00 148.00 192.00 202.00 446.00 572.00

369 16-404 MIEMBRO PELVICO (REDUCCION QUIRURGICA) 177.00 295.00 413.00 531.00 954.00 1,525.00

370 16-405 COLUMNA (REDUCCION MANUAL) 89.00 148.00 192.00 202.00 448.00 584.00

371 16-406 COLUMNA (REDUCCION QUIRURGICA) 207.00 295.00 413.00 519.00 941.00 1,525.00

372 16-501 HUMERO OSTEOPLASTIA 141.00 271.00 379.00 481.00 826.00 1,398.00

373 16-502 CODO OSTEOPLASTIA 141.00 308.00 431.00 506.00 895.00 1,525.00

374 16-503 ANTEBRAZO OSTEOPLASTIA 141.00 308.00 431.00 469.00 826.00 1,525.00

375 16-504 MANO OSTEOPLASTIA 148.00 308.00 431.00 519.00 895.00 1,525.00

376 16-505 DEDO OSTEOPLASTIA 141.00 221.00 309.00 418.00 737.00 1,169.00

377 16-506 CADERA OSTEOPLASTIA 148.00 308.00 431.00 531.00 928.00 1,525.00

378 16-507 FEMUR OSTEOPLASTIA 141.00 259.00 363.00 455.00 788.00 1,239.00

379 16-508 RODILLA OSTEOPLASTIA 141.00 259.00 363.00 455.00 788.00 1,239.00

380 16-509 TIBIA Y/O PERONE OSTEOPLASTIA 141.00 259.00 363.00 455.00 788.00 1,239.00

381 16-510 TOBILLO OSTEOPLASTIA 141.00 284.00 398.00 506.00 890.00 1,525.00

382 16-511 PIE OSTEOPLASTIA 141.00 284.00 398.00 506.00 890.00 1,525.00

383 16-512 COLUMNA OSTEOPLASTIA 153.00 308.00 431.00 570.00 1,016.00 1,678.00

384 16-513 ARTROPLASTIA TOTAL DE RODILLA OSTEOPLASTIA 207.00 308.00 431.00 601.00 954.00 1,652.00



VERSIÓN 2001


385 16-514 ARTROPLASTIA TOTAL DE HOMBRO OSTEOPLASTIA 207.00 308.00 431.00 601.00 954.00 1,652.00

386 16-515 ARTROTOMIA OSTEOPLASTIA 207.00 308.00 431.00 601.00 954.00 1,652.00

387 16-601 HUMERO OSTEOSINTESIS 207.00 308.00 431.00 601.00 954.00 1,652.00

388 16-602 ANTEBRAZO (CUBITO O RADIO) OSTEOSINTESIS 207.00 308.00 431.00 601.00 954.00 1,652.00

389 16-603 MANO OSTEOSINTESIS 106.00 215.00 301.00 380.00 661.00 1,016.00

390 16-604 DEDO OSTEOSINTESIS 106.00 215.00 301.00 380.00 661.00 1,016.00

391 16-605 CADERA OSTEOSINTESIS 207.00 308.00 431.00 570.00 921.00 1,652.00

392 16-606 FEMUR OSTEOSINTESIS 207.00 308.00 431.00 570.00 921.00 1,652.00

393 16-607 RODILLA OSTEOSINTESIS 106.00 215.00 301.00 380.00 661.00 1,016.00

394 16-608 MENISECTOMIA OSTEOSINTESIS 106.00 215.00 301.00 380.00 661.00 1,016.00

395 16-609 TIBIA Y/O PERONE OSTEOSINTESIS 207.00 308.00 431.00 570.00 921.00 1,652.00

396 16-610 TOBILLO (BIMALEOLAR) OSTEOSINTESIS 207.00 308.00 431.00 570.00 921.00 1,652.00

397 16-611 PIE OSTEOSINTESIS 141.00 221.00 309.00 443.00 661.00 1,080.00

398 16-612 COLUMNA OSTEOSINTESIS 412.00 677.00 779.00 823.00 1,398.00 1,906.00

399 16-613 MENISCOTOMIA Y COLOCACION DE PROTESIS ORTOPEDICA 207.00 321.00 449.00 570.00 921.00 1,652.00

400 16-614 LIBERACION DE CANAL OSTEOSINTESIS 207.00 321.00 449.00 570.00 921.00 1,652.00

401 16-615 RETIRO DE MATERIAL DE OSTEOSINTESIS 148.00 321.00 449.00 506.00 954.00 1,525.00

402 16-701 HUMERO OSTIOTOMIA 141.00 221.00 309.00 405.00 692.00 1,080.00

403 16-702 CODO OSTIOTOMIA 141.00 221.00 309.00 405.00 692.00 1,080.00

404 16-703 ANTEBRAZO OSTIOTOMIA 141.00 221.00 309.00 405.00 692.00 1,080.00

405 16-704 MANO OSTIOTOMIA 141.00 221.00 309.00 405.00 692.00 1,080.00

406 16-705 DEDO OSTIOTOMIA 141.00 221.00 309.00 405.00 692.00 1,080.00

407 16-706 CADERA OSTIOTOMIA 207.00 308.00 431.00 531.00 890.00 1,398.00

408 16-707 FEMUR OSTIOTOMIA 207.00 308.00 431.00 531.00 890.00 1,398.00

409 16-708 RODILLA OSTIOTOMIA 141.00 221.00 309.00 405.00 692.00 1,080.00

410 16-709 TIBIA Y/O PERONE OSTIOTOMIA 141.00 221.00 309.00 405.00 692.00 1,080.00

411 16-710 TOBILLO OSTIOTOMIA 141.00 221.00 309.00 405.00 692.00 1,080.00

412 16-711 PIE OSTIOTOMIA 141.00 221.00 309.00 405.00 692.00 1,080.00

413 16-712 COLUMNA OSTIOTOMIA 207.00 308.00 431.00 531.00 954.00 1,525.00

414 16-713 PROTESIS DACTILAR OSTIOTOMIA 141.00 308.00 311.00 317.00 540.00 954.00

415 16-714 RESECCION DE COXIS OSTIOTOMIA 141.00 221.00 309.00 443.00 762.00 1,208.00

416 16-715 RETIRO DE MATERIAL DE OSTIOTOMIA 148.00 308.00 431.00 506.00 954.00 1,525.00



VERSIÓN 2001


417 16-801 HUMERO 141.00 221.00 309.00 443.00 762.00 1,208.00

418 16-802 CODO 141.00 221.00 309.00 443.00 762.00 1,208.00

419 16-803 ANTEBRAZO 141.00 221.00 309.00 443.00 762.00 1,208.00

420 16-804 MANO 118.00 215.00 301.00 380.00 636.00 1,016.00

421 16-805 DEDO 118.00 215.00 301.00 380.00 636.00 1,016.00

422 16-806 FEMUR 141.00 221.00 309.00 443.00 762.00 1,208.00

423 16-807 RODILLA 141.00 221.00 309.00 443.00 762.00 1,208.00

424 16-808 TIBIA Y/O PERONE 141.00 221.00 309.00 443.00 762.00 1,208.00

425 16-809 PIE 141.00 221.00 309.00 443.00 762.00 1,208.00

426 16-810 COLUMNA 141.00 271.00 379.00 506.00 826.00 1,271.00

427 16-811 TOBILLO 141.00 221.00 309.00 443.00 762.00 1,208.00

428 16-812 DEBRIDACION DE ABSCESO OSEO 141.00 221.00 309.00 443.00 762.00 1,208.00

429 16-813 BIOPSIA DE HUESO 141.00 197.00 276.00 342.00 572.00 890.00

430 16-814 CADERAS 141.00 221.00 309.00 443.00 762.00 1,208.00

431 17-101 HERNIOPLASTIA INGUINAL SIMPLE 141.00 215.00 301.00 304.00 572.00 953.00

432 17-102 HERNIOPLASTIA INGUINAL DOBLE 235.00 357.00 464.00 475.00 826.00 1,398.00

433 17-103 HERNIOPLASTIA UMBILICAL 141.00 215.00 301.00 304.00 572.00 954.00

434 17-104 HERNIOPLASTIA DIAFRAGMATICA 141.00 225.00 315.00 495.00 847.00 1,573.00

435 17-106 PILOROTOMIA 207.00 278.00 389.00 443.00 726.00 1,210.00

436 17-107 DESINVAGINACION DEL INTESTINO 207.00 271.00 379.00 445.00 826.00 1,525.00

437 17-108 INTERVENCION DEL INTESTINO 207.00 271.00 379.00 474.00 826.00 1,525.00

438 17-109 INTERVENCIONES ESPLENICAS 207.00 271.00 379.00 474.00 954.00 1,588.00

439 17-110 INTERVENCIONES HEPATICAS 207.00 382.00 535.00 683.00 1,239.00 1,970.00

440 17-111 INTERVENCIONES BILIARES 207.00 382.00 535.00 683.00 1,239.00 1,970.00

441 17-112 ATRESIAS DE INTESTINO 207.00 308.00 431.00 570.00 991.00 1,588.00

442 17-113 ESPLENECTOMIA 207.00 308.00 431.00 443.00 991.00 1,525.00

443 17-114 ANASTOMOSIS DE HIGADO, RIÑON Y T. DIGES. 207.00 382.00 535.00 683.00 1,239.00 1,970.00

444 17-115 ATRESIA DE ESOFAGO 159.00 338.00 473.00 570.00 991.00 1,970.00

445 17-116 TUMORECTOMIAS ABDOMINALES 207.00 338.00 473.00 570.00 991.00 1,970.00

446 17-117 ATRESIA RECTAL ALTA 207.00 308.00 431.00 570.00 1,016.00 1,652.00

447 17-118 ATRESIA RECTAL BAJA 207.00 308.00 431.00 570.00 1,016.00 1,652.00

448 17-119 COLOSTOMIA 177.00 246.00 344.00 380.00 661.00 1,080.00



VERSIÓN 2001


449 17-120 DESCENSO 207.00 394.00 552.00 715.00 1,271.00 2,033.00

450 17-122 ANO CUBIERTO 177.00 295.00 413.00 531.00 921.00 1,525.00

451 17-123 ANO HUMEDO 177.00 295.00 413.00 531.00 921.00 1,525.00

452 17-125 OCLUCION INTESTINAL 177.00 320.00 448.00 570.00 991.00 1,588.00

453 17-126 FISTULA RECTO URINARIA 177.00 320.00 448.00 570.00 1,004.00 1,652.00

454 17-127 QUISTE IDEOPATICO 177.00 320.00 448.00 582.00 1,042.00 1,683.00

455 17-128 PERFORACION DE INTESTINO 177.00 295.00 413.00 506.00 890.00 1,525.00

456 17-129 ADHERENCIAS INTESTINALES 177.00 338.00 473.00 614.00 1,087.00 1,753.00

457 17-130 ABSCESO RESIDUAL DE PARED ABDOMINAL 89.00 123.00 172.00 285.00 446.00 636.00

458 17-131 QUISTE TIROGLOSO 89.00 185.00 259.00 336.00 667.00 1,144.00

459 17-132 MIECTOMIA 118.00 234.00 328.00 449.00 858.00 1,429.00

460 17-133 EVENTRACIONES, BRIDAS, RESECCION 177.00 246.00 344.00 405.00 700.00 1,144.00

461 17-134 EXOFALOS SIMPLES 177.00 271.00 379.00 455.00 788.00 1,271.00

462 17-135 EXOFALOS EN 2 TIEMPOS 177.00 308.00 431.00 563.00 1,016.00 1,588.00

463 17-200 CIRUGIA CARDIOVASCULAR PEDIATRICA 0.00 0.00 0.00 0.00 0.00 0.00

464 17-201 SECCION Y SUTURA DE CONDUCTO P.C.A. 235.00 492.00 689.00 911.00 1,716.00 2,795.00

465 17-209 ORTOQUIDOPEXIA UNILATERAL 106.00 197.00 276.00 380.00 700.00 1,118.00

466 17-210 ORTOQUIDOPEXIA BILATERAL 165.00 320.00 448.00 570.00 991.00 1,588.00

467 17-211 CIRCUNCISION 89.00 123.00 172.00 221.00 446.00 661.00

468 17-212 CICATRIZ FIBROSA DEL PREPUCIO 89.00 123.00 172.00 221.00 446.00 661.00

469 17-213 CORRECCION DE HIPOSPADIAS 177.00 246.00 295.00 317.00 476.00 762.00

470 17-214 REFLUJO VESICOURETRAL 177.00 246.00 344.00 380.00 661.00 1,042.00

471 17-216 REIMPLANTE DE UTEROS 177.00 246.00 344.00 380.00 661.00 1,042.00

472 17-217 VALVAS POSTERIORES 177.00 215.00 301.00 348.00 636.00 1,016.00

473 17-218 TUMORES DE VEJIGA 177.00 215.00 301.00 348.00 636.00 1,016.00

474 19-101 BACTERIOLOGIA EN FRESCO 5.00 9.00 13.00 18.00 25.00 43.00

475 19-102 BACTERIOLOGIA FROTIS Y TINCION 5.00 9.00 13.00 18.00 25.00 43.00

476 19-103 SEROTIPIFICACIONES 13.00 17.00 20.00 23.00 25.00 43.00

477 19-104 INVESTIGACION DE PLASMODIUM 10.00 16.00 22.00 32.00 62.00 108.00

478 19-105 UROCULTIVO 26.00 48.00 67.00 99.00 133.00 212.00

479 19-111 CULTIVOS DE LIQUIDOS 26.00 48.00 67.00 99.00 133.00 212.00

480 19-112 CULTIVO DE HERIDA 26.00 48.00 67.00 99.00 133.00 212.00



VERSIÓN 2001


481 19-201 ESTUDIO DE L.C.R. 13.00 26.00 36.00 50.00 88.00 160.00

482 19-202 ESTUDIO DE L. ASCITIS 13.00 26.00 36.00 43.00 80.00 145.00

483 19-203 ESTUDIO DE L. PERITONIAL 13.00 26.00 36.00 43.00 88.00 145.00

484 19-204 ESTUDIO DE L.SINOVIAL 13.00 26.00 36.00 43.00 88.00 145.00

485 19-205 REACCIONES FEBRILES EN PLACA 15.00 26.00 30.00 35.00 46.00 73.00

486 19-206 V.D.R.L. CUANTITATIVO VDRL 11.00 21.00 24.00 28.00 52.00 67.00

487 19-207 VDRL CUALITATIVO 0.00 0.00 0.00 0.00 0.00 0.00

488 19-208 EOSINOFILOS EN MOCO NASAL 9.00 11.00 15.00 26.00 52.00 67.00

489 19-209 EOSINOFILOS EN ESPUTO 9.00 11.00 15.00 26.00 52.00 67.00

490 19-210 ANTIESTREPTOLISINAS 16.00 26.00 29.00 33.00 46.00 59.00

491 19-211 PROTEINAS C-REACTIVAS 16.00 26.00 29.00 33.00 46.00 59.00

492 19-212 FACTOR REUMATOIDE (P. LATEX R.F.) FR 16.00 26.00 29.00 33.00 46.00 59.00

493 19-231 COOMS DIRECTA 7.00 11.00 15.00 18.00 34.00 53.00

494 19-232 COOMS INDIRECTA 7.00 11.00 15.00 18.00 34.00 53.00

495 19-301 GLUCOSA (GLICEMIA) 9.00 11.00 12.00 13.00 24.00 36.00

496 19-302 GLUCOSA PRE Y POSTPANDRIAL 16.00 20.00 23.00 26.00 46.00 61.00

497 19-303 CURVA DE TOLERANCIA A LA GLUCOSA 3 HORAS 21.00 27.00 38.00 52.00 67.00 113.00

498 19-304 UREA 8.00 11.00 15.00 14.00 24.00 36.00

499 19-305 N. UREA (BUM) 8.00 11.00 15.00 14.00 24.00 36.00

500 19-306 CREATININA CREA 8.00 11.00 15.00 14.00 24.00 36.00

501 19-307 AC. URICO SERICO (AU) 11.00 16.00 19.00 22.00 33.00 46.00

502 19-308 BILIRRUBINAS (DIRECTA E INDIRECTA) 11.00 16.00 22.00 24.00 37.00 63.00

503 19-309 PROTEINAS TOTALES P. SERICAS 8.00 11.00 13.00 14.00 24.00 36.00

504 19-310 ALBUMINA 8.00 11.00 13.00 14.00 24.00 36.00

505 19-311 GLOBULINAS 8.00 11.00 13.00 14.00 24.00 36.00

506 19-312 COLESTEROL TOTAL CT 8.00 11.00 13.00 14.00 24.00 36.00

507 19-313 CAPACIDAD DE FIJACION DE HIERRO 8.00 11.00 15.00 22.00 26.00 36.00

508 19-314 HIERRO SERICO 8.00 11.00 13.00 14.00 24.00 36.00

509 19-315 DEP. DE CREATININA ENDOGENA 16.00 24.00 28.00 33.00 46.00 61.00

510 19-401 TGO 11.00 16.00 22.00 24.00 39.00 62.00

511 19-402 TGP 11.00 16.00 22.00 24.00 39.00 62.00

512 19-403 F. ALCALINA FA 11.00 16.00 22.00 24.00 40.00 62.00



VERSIÓN 2001


513 19-405 F. ACIDA 11.00 16.00 22.00 24.00 40.00 62.00

514 19-406 DHL 11.00 16.00 22.00 24.00 40.00 62.00

515 19-407 AMILASA SERICA O URINARIA 16.00 21.00 29.00 30.00 40.00 67.00

516 19-408 LIPASA 16.00 21.00 29.00 30.00 40.00 67.00

517 19-409 CPK 16.00 21.00 29.00 30.00 40.00 67.00

518 19-410 CPL (FRACCION MB) 47.00 54.00 62.00 66.00 109.00 140.00

519 19-411 F. ACIDA (FRACCION PROSTATICA) 16.00 21.00 29.00 30.00 61.00 97.00

520 19-601 ELECTROLITOS SERICOS (SODIO, POTASIO, CLORO) 12.00 19.00 27.00 32.00 46.00 133.00

521 19-602 GASOMETRIA (ARTERIAL O VENOSA) 16.00 28.00 39.00 46.00 67.00 133.00

522 19-603 MAGNESIO MG 8.00 12.00 17.00 24.00 40.00 55.00

523 19-604 FOSFORO PO 8.00 12.00 17.00 24.00 40.00 55.00

524 19-605 CALSIO CA 8.00 12.00 17.00 24.00 40.00 55.00

525 19-701 COLESTEROL TOTAL 8.00 13.00 18.00 24.00 46.00 61.00

526 19-702 TRIGLICERIDOS TG 8.00 13.00 18.00 24.00 46.00 61.00

527 19-704 COLESTEROL HDL 8.00 13.00 18.00 24.00 46.00 61.00

528 19-901 CUANTIFICACION DE PROTEINAS 9.00 16.00 22.00 28.00 61.00 97.00

529 19-903 EXAMEN GENERAL DE ORINA (EGO) 10.00 16.00 22.00 24.00 46.00 61.00

530 19-905 PRUEBA DE EMBARAZO (GRAVINDEX, PIE) 15.00 28.00 39.00 48.00 74.00 128.00

531 20-001 EX. COPROPARASITOSCOPICO EN SERIE COPRO 8.00 10.00 14.00 24.00 46.00 61.00

532 20-002 INVESTIGACION ENTEROBIOS 8.00 10.00 14.00 24.00 46.00 61.00

533 20-003 INVESTIGACION TROFOZOITOS 14.00 21.00 29.00 30.00 47.00 63.00

534 20-004 SANGRE OCULTA EN HECES 8.00 10.00 14.00 24.00 46.00 61.00

535 20-006 EXAMEN COPROLOGICO 8.00 10.00 14.00 24.00 46.00 68.00

536 20-007 AMIBA EN FRESCO 15.00 24.00 28.00 31.00 46.00 53.00

537 20-008 INVESTIGACION HEMATOZOARIOS 7.00 12.00 17.00 24.00 34.00 53.00

538 20-009 FROTIS DE MOCO FECAL 7.00 11.00 15.00 24.00 34.00 53.00

539 20-101 BIOMETRIA HEMATICA (BH CON PLAQUETAS) 18.00 24.00 34.00 52.00 65.00 103.00

540 20-102 RECUENTO DE PLAQUETAS 18.00 24.00 34.00 52.00 65.00 103.00

541 20-103 RECUENTO DE RETICULOCITOS RETIS 8.00 12.00 17.00 24.00 35.00 53.00

542 20-104 VELOCIDAD SEDIMENTACION GLOBULAR (VES) 8.00 12.00 17.00 24.00 35.00 53.00

543 20-105 PRUEBAS CRUZADAS (PC) 15.00 20.00 28.00 32.00 46.00 61.00

544 20-106 DETERMINACION DE GRUPO SANGUINEO (GPO Y RH) 12.00 16.00 22.00 24.00 36.00 55.00



VERSIÓN 2001


545 20-107 TIEMPOS DE COAGULACION (TP Y TPT) 21.00 32.00 45.00 48.00 68.00 94.00

546 20-108 TIEMPO DE TROMBO PLASTINA PARCIAL ACT. 10.00 16.00 22.00 24.00 35.00 57.00

547 20-109 TIEMPO DE SANGRADO 10.00 16.00 22.00 24.00 35.00 57.00

548 20-110 TIEMPO DE COAGULACION (TC) 10.00 16.00 22.00 24.00 35.00 57.00

549 20-111 TIEMPO DE COAGULACION DE PLASMA RECALCI 10.00 16.00 22.00 24.00 35.00 57.00

550 20-112 TIEMPO DE PROTOMBINA 10.00 16.00 22.00 24.00 35.00 57.00

551 20-113 TIEMPO PARCIAL DE TROMBOPLASTINA 10.00 16.00 22.00 24.00 35.00 57.00

552 20-114 TIEMPO DE TROMBINA 10.00 16.00 22.00 24.00 35.00 57.00

553 20-115 CONSUMO DE PROTOMBINA 10.00 16.00 22.00 24.00 35.00 57.00

554 20-116 RETRACCION DEL COAGULO 10.00 16.00 22.00 24.00 35.00 57.00

555 20-117 FIBRINOGENO 10.00 16.00 22.00 24.00 35.00 57.00

556 20-201 QUIMICA SANGUINEA III (GLUCOSA, UREA, CREATININA) 24.00 32.00 45.00 73.00 118.00 140.00

557 20-202 PERFIL DE LIPIDOS I (PL) 24.00 36.00 50.00 73.00 118.00 140.00

558 20-203 ESTUDIO DE UNIDAD DE SANGRE 80.00 107.00 123.00 138.00 212.00 273.00

559 20-204 PERFIL HEPATICO PFH 41.00 60.00 84.00 160.00 303.00 363.00

560 20-205 PERFIL QUIRURGICO (BH, GRUPO SANGUINEO, TP Y TPT) 47.00 63.00 88.00 160.00 237.00 321.00

561 20-206 PERFIL PRENATAL (BH, QUIMICA SANGUINEA, VDRL, GRUP) 41.00 67.00 94.00 99.00 184.00 220.00

562 20-207 PAQUETE DE GASOMETRIA NEONATOLOGICA (POR DIA) 82.00 118.00 165.00 212.00 303.00 436.00

563 30-201 B.TORAX P. A. RX 26.00 48.00 67.00 88.00 145.00 244.00

564 30-202 COSTILLAS O ESTERNON (TORAX OSEO) RX 26.00 44.00 62.00 84.00 145.00 244.00

565 30-203 COLUMNA VERTEBRAL CERVICAL RX 22.00 35.00 49.00 74.00 130.00 206.00

566 30-204 COLUMNA VERTEBRAL DORZAL RX 26.00 42.00 59.00 96.00 183.00 244.00

567 30-205 COLUMNA VERTEBRAL LUMBOSACRA RX 26.00 43.00 60.00 99.00 194.00 244.00

568 30-206 COLUMNA VERTEBRAL ESTUDIO DINAMICO RX 71.00 163.00 228.00 334.00 549.00 733.00

569 30-207 PELVIS A.P. RX 26.00 44.00 62.00 64.00 84.00 99.00

570 30-208 CRANEO (LATERAL AP) 26.00 48.00 62.00 66.00 91.00 145.00

571 30-209 CRANEO (LATERAL, AP Y TOWNE) 34.00 62.00 68.00 78.00 122.00 183.00

572 30-210 MACIZO FACIAL RX 26.00 44.00 62.00 64.00 84.00 99.00

573 30-211 HUESOS PROPIOS DE LA NARIZ PERFILOGRAMA RX 26.00 44.00 62.00 64.00 84.00 99.00

574 30-212 ORBITAS PORPLACA RX 26.00 44.00 62.00 64.00 84.00 99.00

575 30-213 SENOS PARANASALES RX 34.00 62.00 68.00 78.00 136.00 206.00

576 30-214 ARTICULACIONES TEMPOROMANDIBULARES RX 21.00 39.00 55.00 76.00 136.00 213.00



VERSIÓN 2001


577 30-215 SILLA TURCA RX 26.00 44.00 62.00 64.00 84.00 130.00

578 30-216 OIDOS SCHULLER RX 26.00 44.00 62.00 64.00 84.00 99.00

579 30-217 MASTOIDES CONVENCIONAL RX 26.00 44.00 62.00 64.00 84.00 99.00

580 30-218 CONDUCTOS AUDITIVOS RX 26.00 44.00 62.00 64.00 84.00 122.00

581 30-219 MANDIBULA DOS POSICIONES RX 26.00 44.00 62.00 64.00 84.00 122.00

582 30-220 LATERAL DE CUELLO RX 26.00 44.00 62.00 64.00 84.00 122.00

583 30-221 LARINGE RX 26.00 44.00 62.00 64.00 84.00 116.00

584 30-222 CUELLO A.P Y LATERAL PARTES BLANDAS RX 34.00 62.00 68.00 79.00 136.00 206.00

585 30-223 MANO RX 17.00 35.00 49.00 50.00 84.00 122.00

586 30-224 MANOS COMPARATIVAS RX 34.00 62.00 87.00 96.00 168.00 305.00

587 30-225 MUÑECA, ESCAFOIDES Y CARPO RX 17.00 35.00 40.00 48.00 84.00 122.00

588 30-226 ANTEBRAZO ADULTO RX 17.00 35.00 40.00 48.00 84.00 160.00

589 30-227 CODO RX 17.00 35.00 40.00 48.00 84.00 122.00

590 30-228 CODO COMPARATIVO RX 34.00 62.00 87.00 96.00 168.00 305.00

591 30-229 HUMERO RX 17.00 35.00 40.00 48.00 84.00 160.00

592 30-230 HUMEROS COMPARATIVOS RX 34.00 62.00 87.00 96.00 168.00 305.00

593 30-231 HOMBROS RX 17.00 35.00 40.00 48.00 84.00 160.00

594 30-232 HOMBROS COMPARATIVOS RX 34.00 62.00 87.00 96.00 168.00 305.00

595 30-233 CLAVICULA RX 17.00 35.00 40.00 48.00 84.00 160.00

596 30-234 CLAVICULA COMPARADA RX 34.00 62.00 87.00 96.00 168.00 305.00

597 30-235 OMOPLATO RX 17.00 35.00 40.00 48.00 84.00 160.00

598 30-236 OMOPLATO COMPARATIVO RX 34.00 62.00 87.00 96.00 168.00 305.00

599 30-237 PIE RX 17.00 35.00 40.00 48.00 84.00 160.00

600 30-238 TOBILLO RX 17.00 35.00 40.00 48.00 84.00 160.00

601 30-239 TOBILLO COMPARATIVO RX 34.00 72.00 86.00 97.00 168.00 305.00

602 30-240 PIERNA RX 22.00 42.00 59.00 61.00 116.00 206.00

603 30-241 RODILLA RX 17.00 35.00 40.00 48.00 84.00 160.00

604 30-242 ROTULA RX 17.00 35.00 40.00 48.00 84.00 160.00

605 30-243 RODILLAS COMPARATIVAS RX 34.00 62.00 87.00 96.00 168.00 305.00

606 30-244 FEMUR A.P RX 22.00 43.00 60.00 66.00 121.00 206.00

607 30-245 FEMUR A.P Y LATERAL RX 34.00 59.00 83.00 83.00 152.00 343.00

608 30-246 FEMUR COMPARATIVO RX 45.00 86.00 120.00 138.00 254.00 382.00



VERSIÓN 2001


609 30-247 EDAD OSEA 17.00 35.00 40.00 48.00 84.00 160.00

610 30-248 ABDOMEN SIMPLE (AP) RX 28.00 54.00 76.00 99.00 152.00 206.00

611 30-249 CEFALO PELVIMETRIA 43.00 67.00 94.00 114.00 160.00 282.00

612 30-250 MAMOGRAFIA 71.00 148.00 178.00 198.00 328.00 411.00

613 30-251 MARCAJE 642.00 856.00 984.00 1,100.00 1,650.00 2,200.00

614 30-301 UROGRAFIA EXCRETORA ADULTO (S/CONTRASTE) 79.00 163.00 228.00 304.00 564.00 661.00

615 30-302 UROGRAFIA EXCRETORA INFANTIL (S/CONTRASTE) 61.00 118.00 165.00 190.00 435.00 534.00

616 30-303 UROGRAFIA EXCRETORA CRONOMETRADA (S/CONTRASTE) 79.00 185.00 259.00 334.00 640.00 661.00

617 30-304 UROGRAFIA EXCRETORA POR PERFUSION A (S/CONTRASTE) 106.00 221.00 309.00 395.00 640.00 915.00

618 30-305 URETROSISTOGRAFIA (S/CONTRASTE) 50.00 104.00 146.00 190.00 351.00 446.00

619 30-306 SIALOGRAFIA 34.00 62.00 87.00 114.00 213.00 254.00

620 30-307 FISTULOGRAFIA (S/CONTRASTE) 43.00 81.00 113.00 152.00 244.00 279.00

621 30-308 MIELOGRAFIA LUMBAR, DORSAL, CERVICAL (S/CONTRASTE) 155.00 318.00 445.00 607.00 1,098.00 1,398.00

622 30-309 FLEBOGRAFIA BILATERAL (S/CONTRASTE) 78.00 148.00 207.00 281.00 518.00 661.00

623 30-310 COLECISTOGRAFIA (ORAL) 54.00 133.00 186.00 251.00 458.00 355.00

624 30-311 COLANGIOGRAFIA POR PERFUSION 64.00 111.00 155.00 197.00 336.00 355.00

625 30-312 COLANGIOGRAFIA POR SONDA EN T (S/CONTRASTE) 64.00 111.00 155.00 197.00 336.00 355.00

626 30-313 COLANGIOGRAFIA PERCUTANEA 106.00 207.00 290.00 334.00 640.00 762.00

627 30-314 COLON POR ENEMA (S/CONTRASTE) 106.00 207.00 290.00 334.00 640.00 661.00

628 30-315 SERIE ESOFAGO GASTRODUDENAL (S/CONTRASTE) 78.00 148.00 207.00 281.00 510.00 661.00

629 30-316 TRANSITO INTESTINAL (S/COMTRASTE) 78.00 148.00 207.00 281.00 510.00 661.00

630 30-317 TRANSITO INTESTINAL CON SERIE ESOF. GAS (S/CONTRASTE) 141.00 259.00 363.00 486.00 884.00 1,080.00

631 30-318 SERIE CARDIACA 59.00 118.00 165.00 190.00 305.00 286.00

632 30-319 HISTEROSALPINGOGRAFIA 71.00 141.00 197.00 266.00 488.00 628.00

633 30-320 UROGRAFIA EXCRETORA ADULTO (C/CONTRASTE) 169.00 253.00 318.00 394.00 654.00 751.00

634 30-321 UROGRAFIA EXCRETORA INFANTIL (C/CONTRASTE) 151.00 208.00 255.00 280.00 525.00 624.00

635 30-322 UROGRAFIA EXCRETORA CRONOMETRADA (C/CONTRASTE) 169.00 275.00 349.00 424.00 730.00 751.00

636 30-323 UROGRAFIA EXCRETORA POR PERFUSION A (C/CONTRASTE) 296.00 411.00 499.00 585.00 830.00 1,105.00

637 30-324 URETROCISTOGRAFIA (C/CONTRASTE) 240.00 294.00 336.00 380.00 541.00 636.00

638 30-325 FISTULOGRAFIA (C/CONTRASTE) 133.00 171.00 203.00 242.00 334.00 369.00

639 30-326 MIELOGRAFIA LUMBAR, DORSAL, CERVICAL (C/CONTRASTE) 465.00 628.00 755.00 917.00 1,408.00 1,708.00

640 30-327 FLEBOGRAFIA BILATERAL (C/CONTRASTE) 268.00 338.00 397.00 471.00 708.00 851.00



VERSIÓN 2001


641 30-328 COLANGIOGRAFIA POR SONDA EN T (C/CONTRASTE) 154.00 201.00 245.00 287.00 426.00 445.00

642 30-329 COLON POR ENEMA (C/CONTRASTE) 296.00 397.00 480.00 524.00 830.00 851.00

643 30-330 SERIE ESOFAGO GASTRODUDENAL (C/CONTRASTE) 483.00 553.00 612.00 686.00 915.00 1,066.00

644 30-331 TRANSITO INTESTINAL (C/COMTRASTE) 483.00 553.00 612.00 686.00 915.00 1,066.00

645 30-332 TRANSITO INTESTINAL CON SERIE ESOF. GAS (C/CONTRASTE) 546.00 664.00 768.00 891.00 1,289.00 1,485.00

646 30-601 ULTRASONIDO OBSTETRICO 43.00 86.00 120.00 154.00 206.00 275.00

647 30-602 ULTRASONIDO MAMARIO 43.00 86.00 120.00 154.00 206.00 275.00

648 30-603 ULTRASONIDO HIGADO Y VIAS BILIARES 43.00 86.00 120.00 154.00 206.00 275.00

649 30-604 ULTRASONIDO TIROIDEO 43.00 81.00 113.00 154.00 198.00 275.00

650 30-605 ULTRASONIDO GINECOLOGICO 43.00 86.00 120.00 154.00 206.00 275.00

651 30-606 ULTRASONIDO ABDOMEN SUPERIOR 57.00 118.00 165.00 212.00 267.00 343.00

652 30-607 ULTRASONIDO GINECOLOGICO (SONDA VAGINAL) 57.00 118.00 165.00 212.00 267.00 343.00

653 30-608 ULTRASONIDO PROSTATICO (SONDA RECTAL) 57.00 118.00 165.00 212.00 267.00 343.00

654 30-609 ULTRASONIDO CARDIACO 57.00 118.00 165.00 212.00 267.00 343.00

655 31-001 APENDICE CECAL 16.00 32.00 45.00 58.00 101.00 153.00

656 31-002 VESICULA BILIAR 16.00 32.00 45.00 58.00 101.00 153.00

657 31-003 TUMORES PEQUEÑOS DE MAMA 12.00 22.00 31.00 41.00 69.00 128.00

658 31-004 TUMORES BENIGNOS DE MAMA (PIEZA MAYOR) 30.00 62.00 87.00 114.00 158.00 254.00

659 31-005 RESECCIONES INTESTINALES SIN TUMOR 16.00 32.00 45.00 61.00 101.00 153.00

660 31-007 RESECCIONES INTESTINALES CON TUMOR 21.00 40.00 56.00 76.00 128.00 191.00

661 31-008 TUMORES DE GLANDULAS SALIVALES C/DISE 30.00 62.00 87.00 111.00 191.00 293.00

662 31-009 ESTOMAGO SIN TUMOR 16.00 32.00 42.00 45.00 76.00 128.00

663 31-010 ESTOMAGO CON TUMOR 30.00 62.00 87.00 114.00 158.00 254.00

664 31-011 SEGMENTOS O LOBULOS PULMONARES 16.00 32.00 45.00 61.00 101.00 153.00

665 31-012 PROSTATA 16.00 32.00 45.00 61.00 101.00 153.00

666 31-013 RIÑON SIN TUMOR 16.00 32.00 45.00 61.00 101.00 153.00

667 31-014 RIÑON CON TUMOR 21.00 40.00 56.00 76.00 128.00 191.00

668 31-015 TESTICULOS SIN TUMOR 16.00 27.00 38.00 51.00 89.00 191.00

669 31-016 TESTICULOS CON TUMOR 21.00 40.00 56.00 70.00 128.00 191.00

670 31-017 EXTREMIDADES CON GANGRENA O INFECCI. 24.00 47.00 66.00 89.00 153.00 242.00

671 31-018 TUMORES RETROPERITONEALES 24.00 47.00 66.00 89.00 172.00 242.00

672 31-019 AMIGDALAS 16.00 22.00 31.00 41.00 70.00 116.00



VERSIÓN 2001


673 31-020 GANGLIO LINFATICO 14.00 31.00 43.00 58.00 101.00 153.00

674 31-021 MEDULA OSEA 24.00 47.00 66.00 89.00 153.00 242.00

675 31-022 BAZO 21.00 40.00 56.00 76.00 128.00 191.00

676 31-023 LARINGE SIN DISECCION DE CUELLO 26.00 49.00 69.00 89.00 153.00 254.00

677 31-024 LARINGE CON DISECCION DE CUELLO 31.00 62.00 87.00 108.00 191.00 299.00

678 31-025 TIROIDES SIN DISECCION DE CUELLO 21.00 42.00 59.00 76.00 130.00 204.00

679 31-026 TIROIDES CON DISECCION DE CUELLO 28.00 57.00 80.00 101.00 184.00 299.00

680 31-027 OVARIOS SIN TUMOR 14.00 27.00 38.00 48.00 81.00 128.00

681 31-028 OVARIOS CON TUMOR 14.00 27.00 38.00 45.00 81.00 128.00

682 31-029 UTERO SIN ANEXOS 16.00 34.00 48.00 64.00 108.00 166.00

683 31-030 UTERO CON ANEXOS 21.00 37.00 52.00 69.00 128.00 191.00

684 31-031 CONO CERVICAL 31.00 62.00 87.00 108.00 191.00 299.00

685 31-032 EXENTERACION ANTERIOR Y POSTERIOR 35.00 62.00 87.00 114.00 197.00 305.00

686 31-033 FETOS HASTA 4 1/2 MESES 19.00 42.00 59.00 76.00 128.00 197.00

687 31-034 PLACENTA 14.00 22.00 31.00 41.00 70.00 116.00

688 31-035 REVISION DE LAMINILLAS 14.00 22.00 31.00 41.00 70.00 116.00

689 31-037 LAMINILLAS PARA OTRA INSTITUCION 14.00 22.00 31.00 41.00 70.00 116.00

690 31-038 BIOPSIA DE PIEL 14.00 22.00 31.00 41.00 70.00 116.00

691 31-039 BIOPSIA GASTRICA (OBTENIDA POR ENDOSCOPIA) 14.00 22.00 31.00 41.00 70.00 116.00

692 31-040 BIOPSIA QUIRURGICA 14.00 22.00 31.00 41.00 70.00 116.00

693 31-041 BIOPSIA DE CERVIX 14.00 22.00 31.00 41.00 70.00 116.00

694 31-101 ESPECTORACION EN SERIE 33.00 62.00 87.00 114.00 191.00 318.00

695 31-102 CEPILLADO Y LAVADO 14.00 22.00 31.00 41.00 70.00 116.00

696 31-103 ASCITIS LIQUIDO PLEURAL Y LIQUIDO CEFAL 14.00 22.00 31.00 41.00 70.00 116.00

697 31-104 ORINA EN SERIE 19.00 40.00 56.00 70.00 128.00 191.00

698 31-105 PULMON GLANDULA MAMARIA, TIROIDES GAN 14.00 22.00 31.00 41.00 70.00 116.00

699 31-106 CITOLOGIA GASTRICA 14.00 22.00 31.00 41.00 70.00 116.00

700 31-107 PROSTATA TEJIDO BLANDO HUESOS 14.00 22.00 31.00 41.00 70.00 116.00

701 34-001 BLOQUEO RAMA TRIGEMINAL 14.00 24.00 29.00 33.00 67.00 101.00

702 34-002 BLOQUEO GANGLIO GASER 14.00 24.00 34.00 44.00 79.00 121.00

703 34-003 BLOQUEO DE RAMAS TRIGEMINALES TERMIN 14.00 22.00 31.00 33.00 46.00 64.00

704 34-004 BLOQUEO DE NERVIO LINGUAL 14.00 22.00 31.00 33.00 64.00 108.00



VERSIÓN 2001


705 34-005 BLOQUEO DE NERVIO GLOSO FARINGEO 14.00 24.00 34.00 44.00 85.00 121.00

706 34-006 BLOQUEO DE GANGLIO ESFENOPALATINO 14.00 24.00 34.00 39.00 73.00 108.00

707 34-007 BLOQUEO DE NERVIO OCCIPITAL 14.00 24.00 34.00 39.00 48.00 70.00

708 34-008 BLOQUEO DE RAIZ CERVICAL PROFUNDA 14.00 24.00 34.00 39.00 48.00 70.00

709 34-009 BLOQUEO DE PLEXO CERVICAL SUPERFICIAL 14.00 24.00 34.00 44.00 48.00 70.00

710 34-010 BLOQUEO DE NERVIO FARINGEO 14.00 24.00 34.00 44.00 48.00 70.00

711 34-011 BLOQUEO DE NERVIO FRENICO 14.00 24.00 34.00 44.00 48.00 70.00

712 34-012 BLOQUEO DE NERVIO SUPRAESCAPULAR 14.00 24.00 34.00 44.00 48.00 70.00

713 34-013 BLOQUEO SIMPATICO CERVICODORSAL C/C 14.00 30.00 42.00 55.00 109.00 166.00

714 34-014 BLOQUEO SIMPATICO CERVICODORSAL S/CO 14.00 24.00 34.00 44.00 85.00 121.00

715 34-015 BLOQUEO PERIDUAL ANTI-INFLAMAT. SIN ME 14.00 24.00 34.00 39.00 73.00 108.00

716 34-016 BLOQUEO PERIDUAL LITICO 14.00 24.00 34.00 55.00 48.00 70.00

717 34-017 BLOQUEO SUBARAGNOIDEO LITICO 14.00 43.00 60.00 77.00 145.00 234.00

718 34-018 BLOQUEO PARAVERTEBRAL 14.00 24.00 34.00 44.00 48.00 70.00

719 34-019 BLOQUEO DE NERVIOS INTERCOSTALES 14.00 24.00 34.00 44.00 48.00 70.00

720 34-020 BLOQUEO DE NERVIO ABDOMINOGENITAL 14.00 24.00 34.00 44.00 48.00 70.00

721 34-021 BLOQUEO DE NERVIO CRURAL 14.00 24.00 34.00 44.00 48.00 70.00

722 34-022 BLOQUEO DE NERVIO FERMOROCUTANEO 14.00 24.00 34.00 44.00 48.00 70.00

723 34-023 BLOQUEO DE NERVIO OBTURADOR 14.00 24.00 34.00 44.00 48.00 70.00

724 34-024 BLOQUEO DE NERVIO CIATICO 14.00 24.00 34.00 44.00 48.00 70.00

725 34-025 BLOQUEO DE ARTICULACION SACRO-ILIACA 14.00 24.00 34.00 44.00 48.00 70.00

726 34-026 BLOQUEO DE ARTICULACION COXO-FEMORA 14.00 24.00 34.00 44.00 48.00 70.00

727 34-027 BLOQUEO DE NERVIO SAFENO 14.00 24.00 34.00 44.00 48.00 70.00

728 34-028 BLOQUEO TRANS-SACRO 14.00 24.00 34.00 44.00 48.00 70.00

729 34-029 BLOQUEO DE RAMAS TERMINALES DE MIEMB. 14.00 24.00 34.00 44.00 48.00 70.00

730 34-030 BLOQUEO DE ARTICULACION DE RODILLAS 14.00 24.00 34.00 44.00 48.00 70.00

731 34-031 BLOQUEO CAUDAL 14.00 24.00 34.00 44.00 48.00 70.00

732 34-032 BLOQUEO DE BURSA ANTERIOR DE HOMBRO 14.00 24.00 34.00 44.00 48.00 70.00

733 34-033 BLOQUEO DE PLEXO BRONQUIAL 14.00 24.00 34.00 44.00 48.00 70.00

734 34-034 BLOQUEO PERIFERICOS DE MIEMBROS SU 14.00 24.00 34.00 44.00 48.00 70.00

735 34-035 BLOQUEO DE GANGLIO SIMPATICO LUM. CO 28.00 59.00 83.00 110.00 194.00 318.00

736 34-036 BLOQUEO DE GANGLIO ESPLACICO CELIACO 28.00 59.00 83.00 110.00 194.00 318.00



VERSIÓN 2001


737 34-037 BLOQUEO DE CAPSULA DE HOMBRO 14.00 24.00 34.00 44.00 48.00 70.00

738 34-038 BLOQUEO PERIVASCULAR DE ARTERIA TEMP. 14.00 24.00 34.00 44.00 48.00 70.00

739 34-039 ESTIMULACION ELECTRICA CUTANEA 14.00 24.00 29.00 33.00 43.00 57.00

740 37-001 SERV DE AMBULANCIA P/ TRASL. DE ENF. (KM) 1.00 1.00 1.00 2.00 6.00 10.00

741 37-002 FOTOCOPIA 1.00 1.00 1.00 1.00 1.00 1.00

742 37-003 EXPEDICION DE CREDENCIA 19.00 25.00 25.00 25.00 25.00 25.00

743 37-004 REPOSICION DE CARNET 7.00 13.00 14.00 15.00 19.00 21.00

744 37-005 CERTIFICADO PRENUPCIAL (SIN EXAMENES) 10.00 15.00 21.00 28.00 51.00 89.00

745 37-006 CERTIFICADO MEDICO (SIN EXAMENES) 9.00 15.00 21.00 28.00 51.00 89.00

746 37-007 CERTIFICADO INTERNACIONAL DE VACUNACION 35.00 73.00 88.00 92.00 118.00 149.00

747 37-008 EXPEDICION DE CERTIFICADO 5.00 11.00 11.00 11.00 17.00 17.00

748 39-001 AUDIOMETRIA COMPLETA 96.00 0.00 96.00 144.00 192.00 0.00

749 39-002 IMPEDANCIOMETRIA 50.00 0.00 50.00 64.00 106.00 0.00

750 39-003 REFLEJO ESTAPEDIAL 50.00 0.00 50.00 64.00 106.00 0.00

751 39-004 POTENCIALES AUDITIVOS EVOCADOS 158.00 0.00 158.00 237.00 316.00 0.00

752 39-005 POTENCIALES DE ESTADO ESTABLE 158.00 0.00 158.00 237.00 316.00 0.00

753 39-006 OTONEUROLOGICO (V.N.G.) 158.00 0.00 158.00 237.00 316.00 0.00



VERSIÓN 2001

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