비급여 고시

 병원코드청구코드 상급병실료 
VA011ABZ0100011인실 150,000
확대
 병원코드청구코드 검사 
15501550 수면-위40,000
15511551 수면-위,대장100,000
15521552 수면-대장70,000
C6095C6095인플루엔자바이러스A 150,000
----
CZ241CZ241 당알부민(Glycoalbumin)30,000
CZ246CZ246 허혈성 변형 알부민 검사(IMA)40,000
----
CZ-394CZ394 인플루엔자 A-B 바이러스항원검사[현장검사]30,000

 

CZ434CZ434 Asca검사-Iga[효소면역측정법]100,000
CZ435CZ435Asca검사-Igg[효소면역측정법]100,000
CZ492CZ492Oraquick HCV Teat(간이검사)45,000
CZ983CZ983기타 검사 - 인플루엔자바이러스 A&B [다중역전사중합효소]130,000
TETANUSTETANUS검진Tetanus Ab15,000
MAMMOMAMMO맘모톰-한개 또는 한쪽900,000
MAMMO1MAMMO1맘모톰-2개이상 또는 양쪽1,500,000
JG103JG103종합검진-여자670,000
JG104JG104종합검진-남자570,000
JG13JG13혈액종합검사100,000
JG14-7JG14-7혈액 암표지자/남120,000
JG14-8JG14-8혈액 암표지자/여150,000
JG12-1JG12-1혈액종합+혈액 암표지자/남220,000
JG12-2JG12-2혈액종합+혈액 암표지자/여 250,000
 15531553 수면-S상결장경 40,000 

확대
 병원코드청구코드 초음파 
US12US12초음파 유방+ 갑상선 검사150,000
US19US19초음파 심장170,000
US11AEB443001종검하복부70,000
US25US25초음파 유방 검사100,000
US25AUS25A유방초음파Core Biopsy70,000
US27US27초음파 경동맥 검사100,000
US28US28초음파-thyroid biopsy50,000
US28AUS28A갑상선초음파Core Biopsy50,000
US29US29초음파 갑상선 검사60,000
US37JUS37J초음파 관절 - OS20,000
US55
US55도플러 고환 검사100,000
US57US57Doppler(Varicose exam)편측100,000
US60US60Doppler,both(varicose exam)150,000
US22US22U/S Extremity & other50,000
USNECK-1USNECK-1초음파 목60,000
US41US41초음파 국소한정용30,000
US13-1EB455골반(여성생식기)건강검진  60,000
 EZ985 EZ985수술 중 초음파  30,000
확대
 병원코드청구코드 MRI 
HE135FHE135FBrain MRI+MRA(조영제미사용)550,000
HE235FHE235FBrain MRI+MRA(조영제)650,000
L-MRIL-MRIL-spine MRI300,000
LAK-MRILAK-MRILt.ankle MRI300,000
LEL-MRILEL-MRILt.elbow MRI300,000
LFT-MRILFT-MRILt.foot MRI300,000
LHD-MRILHD-MRILt.hand MRI300,000
LHP-MRILHP-MRILt.hip MRI300,000
LKN-MRILKN-MRILt.knee MRI300,000
LLE-MRILLE-MRILt.lower extremity MRI300,000
LSH-MRILSH-MRILt.shoulder MRI300,000
LUE-MRILUE-MRILt.upper Extremity MRI300,000
LWR-MRILWR-MRILt.wrist MRI300,000
MR-CPMR-CPMR-CP(cholangiopancres)200,000
MRAMRABrain MRA350,000
N-MRIN-MRINeck MRI300,000
P-LMRIP-LMRI[Post OP]L-spine MRI200,000
PE-MRIPE.MRIPelvic MRI300,000
PLKN-MRIPLKN-MRI[Post OP] Lt.knee MRI200,000
PRKN-MRIPRKN-MRI[Post OP] Rt.knee MRI200,000
RAK-MRIRAK-MRIRt.ankle MRI300,000
REL-MRIREL-MRI
Rt.elbow MRI300,000
RFT-MRIRFT-MRIRt.foot MRI300,000
RHD-MRIRHD-MRIRt.hand MRI300,000
RKN-MRIRKN-MRIRt.knee MRI300,000
RLE-MRIRLE-MRIRt.lower extremity MRI300,000
RSH-MRIRSH-MRIRt.shoulder MRI300,000
RUE-MRIRUE-MRIRt.upper extremity MRI300,000
RWR-MRIRWR-MRIRt.wrist MRI300,000
SH-MRIASH-MRIA(MRI)Rt.shoulder coronal view200,000
SH-MRIBSH-MRIB(MRI)Lt.shoulder coronal view200,000
SP-MRISP-MRISpine MRI- OP전,후250,000
T-MRIT-MRIT-spine MRI300,000
TL-SPINETL-SPINET-L spine MRI300,000
AB-MRIAB-MRIAbdomen MRI300,000
B-MRIB-MRIBrain MRI300,000
CH-MRICH-MRIChest MRI300,000
C-MRIC-MRIC-spine MRI300,000
XMRIEXMRIEMRI 조영제100,000
BM1301BYBM1301BY
Micro Filter Coil Tube10,000
RHP-MRIRHP-MRIRt.hip MRI300,000
확대
 병원코드청구코드 경구 & 주사
BF0101WCBF0101WC큐블럭(QBLOCK)1,300,000
850659900090스티몰액(STIMOL)10ml/pack4,000
A3180400649803700하이스탈정150
ATPD643900900액티피드정 삼일제약30
CRLF642902060캐롤 애프 정(일동제약)150
DUCLX652001030둘코락스에스장용정(한국베링거인겔하임)100
TRST647802340트레스탄 캅셀(삼진제약)600
FCD5642701050후시딘 크림 20mg/g 10g(동화약품)7,500
ORAMED653400790오라메디연고 10g(동국제약)5,000
6599006565990065모비락스산5,000
2801696300360다케다알보칠콘센트레이트 5ml10,000
4604BM2104JOGuardix-Sp 5g1,600,000
65020105650201050니트로푸라존연고20g2,000
NM23665900010프리베나13 (폐렴예방주사)150,000
NTM644900560뉴타민주 250ml60,000
독감7647400360독감(4가)-일반환자35,000
HBN-I650001800하브릭스주(A형감염백신) - 녹십자90,000
EUVAXB668900920유박스비주 1ml(주)엘지화학(B형간염 예방접종)25,000
702655500900조스타박스주(대상포진생바이러스백신)150,000
TDB643605311파상풍백신(녹십자 티디백신)40,000
말린다653102550말린다주60,000
3002653402041베노스틴주10ml50,000
3004645101151데오에스베리벤에프주2ml7,000
65480225654802250비엠하이디주(콜레칼시페롤)35,000
SUFRAM645101840슈프라민 250ml60,000
66500197665001971네프콤주사액 2ml15,000
ATPS645905980에티피에스주 2ml35,000
67890099678900996워너프 페리주 362mL(단백질아미노산제제)150,000
64360461643604610페라미플루주15mlx260,000
65480227654802270하이디알주100,000
HELCO669906920헬스코스90,000
VITAC670607020혈관기능개선60,000
64510425645104250멀티비타민주사50,000
MRTC-I670600790메리트씨주사 10g/20ml(휴온스)5,000
VITAA670601060면역강화60,000
VITA2653102780바이나민주 + 구치온주50,000
VITAB683200030간기능개선60,000
AMIS669906430기억력향상/치매예방80,000
VITAD653101490숙취황산화미백기능60,000
SPECA670607020스페셜코스1150,000
SPECB670607020스페셜코스2130,000
WEBCO653103140웰빙코스90,000
CARCO653103140케어코스100,000
3006696601891 알타질주(주사용아스피리신90%) 10,000
 3008 알타질주 + NS110mL  20,000
 3010645104391대한멸균생리식염수90mL 10,000 
 3012 67890994위너프페리주502mL180,000 
확대
 병원코드청구코드 경구 & 주사
VITACC1669900590메가비타민C 25g요법60,000
VITACC2669900590메가비타민C 50g요법
80,000
VITACC3669900590메가비타민C 75g요법
100,000
 VITACC4 669900590 메가비타민C 100g요법120,000 
확대
 병원코드청구코드 수술료 & 이화학요법
CIRCUMCIRCUM포경수술
(초등학교6학년 이하)
100,000
CIRCUM1CIRCUM1포경수술
(고등학교3학년 이하)
100,000
CIRCUM2CIRCUM2포경수술-성인120,000
LASERLASERCO2레이저(점)-1개당5,000
LASER2LASER2검버섯3,000
VARICOS1OZ304하지정맥류-레이저(양측)1,800,000
VARICOSEOZ304하지정맥류-레이져(한쪽)1,200,000
SR1SR1흉터제거술(안면부)50,000
SR2SR2흉터제거술(기타부위)30,000
IDET-ASZ083추간판내 고주파 열치료술850,000
----
----
PEN-ASZ634A-경피적 경막외강 신경성형술500,000
PEN-CSZ631C-내시경적 경막외강 신경성형술1,900,000
TELASZ631내시경적 경막외강 신경근성형술2,100,000
SZ641SZ641경피적 풍선확장 경막외강 신경성형술800,000
BMSBMS줄기세포이식술1,200,000
SZ084SZ084체외충격파치료[근골격계질환]30,000
MX122-1MX122도수치료 1단계100,000
MX122-2MX122도수치료 2단계100,000
MX122-3MX122도수치료 3단계150,000
MX122-4MX122도수치료 4단계200,000
MX122-5MX122도수치료 5단계200,000
MX122-6MX122도수치료 6단계250,000
MX122-7MX122도수치료 7단계300,000
MY142MT142증식치료Prolotherapy30,000
확대
 병원코드청구코드 수술재료
ART-NART-N인공손톱20,000
BC0101ABC0101ATDMB 5cc-서울본메디텍1,734,600
BC0101ATBC0101ATDbx Cortical Bone 1cc800,000
BC0101BUBC0101BURafugen DBM Gel Human Dbm+Porcine Collagen800,000
BC0101KJBC0101KJDemios Dbm+Poloxamer+Sterile Water800,000
BC0101KVBC0101KVallomatrix 1cc800,000
BC0102ATBC0102ATDbx Mix Cortico -Cancellous+Naha-Pbs800,000
BC0102BUBC0102BUBio-Paste Human Dbm 30%+Procine Collagen 70%800,000
BC0103BUBC103BURafugen Dbm Gel pro Human Dbm + Glycerol800,000
BC0103E3BC0103EDSurefuse-Tm Dbm + Cmc / 3cc2,000,000
BC0103EDBC0103EDSurefuse-Tm Dbm + Cmc / 1cc500,000
BC0103K1BC0103KZDBM 3CC1,980,000
BC0103K2BC0103K2Grafton DBM Putty 5CC - 휴먼메디칼1,900,000
BC0103KZBC0103KZGrafton DBM Putty 1CC - 휴먼메디칼800,000
BC0105EDBC0105EDXgen Graft Dbm 및 뼈 분말, Cmc800,000
BC0106BUBC0106BUDb Stik Dbm+Cmc+Glycerol+Starch880,000
BC0106EDBC0106EDPenoss Dbm+Cmc+Hydroxyapatite880,000
BC0108BUBC0108BUBio-paste Ii Injectable Human Dbm+Glycerol700,000
BC0301KJBC0301KJNovosis Dent Rhbmp-2, Hydroxyapatite 등1,500,000
BC4001HPBC4001HP흡수성 골절 고정용 핀(PIN 1520~2050)
200,000
BC5301HPBC5301HP흡수성 골절 고정용 핀Plate(Ankle)(FRF 1050~1055)554,000
BC5302-ABC5302HPINION Distal Radius Plate Small - CS Medi770,000
BC5302HPBC5302HPINION Distal Radius Plate Large (FRF 1060,1)
770,000
BC5303HPBC5303HPINION Mini Plate(Hand) FRF-1005390,000
BC5401HPBC5401HPFreedom plate800,000
BC6001HPBC6001HP흡수성 screw FRF-1232~1262248,000
BC6002HPBC6002HPObservable Screw 4.5mm (FRF-1272~1275)389,000
BC6003HPBC6003HPOTPS MESH SCREW (3.1mm이하)248,000
BC6004HPBC6004HPOTPS MESH SCREW  (4.5mm)389,000
BF0002ATBF0002ATPlivios Chronos Peek(cage)1,300,000
BF0003ATBF0003ATCervios Chronos Peek1,800,000
BF0003GZBF0003GZBaguera C Ti-6al-4v Eli/ Uhmwpe4,600,000
BF0101PGBF0101PGOxiplex Sodium Carboxymethyl Cellouse 등 FZIOMED950,000
BF0201OBBF0201OBLDISQ(재료)2,100,000
BF0201DABF0201DALDISQ(재료)1,650,000
BF0201OBBF0201OB일회용발조절식전기수술기용전극 Stainless Steel 등2,100,000
BF0201VCBF0201VCInto-C BIo Stainless Steel 등1,650,000
BF0201VLBF0201VCInto-L Bio Statinless Steel 등1,650,000
BF0202DABF0202DALdisq-C Stainless Steel1,650,000
BF0202RABF0202RAAbro-C Stainless Steel 등1,650,000
BF0202XPBF0202XPRf-Curer Stainless Steel 등2,100,000
BF0203RABF0203RAABRO1,650,000
BF0301HBF0301HOWave two turn rod - 에이치원케어900,000
BF0301HOBF0301HOWX poly pedicle screw - 에이치원케어400,000
BF0401HOBF0401HOINTERSPINOUS OMEGA FIXATION SYSTEM2,300,000
BJ4801GVBJ4801GVEden Epidural Catheter Polyamide, Stainless Ste550,000
BJ4801OJBJ4801OJPCM Polyurethane 등750,000
BJ4801WQBJ4801WQIndigo Abs, Sus304 등700,000
BJ4801YBBJ4801YBIdolphin-S Polyurethane 등2,100,000
확대
 병원코드청구코드 수술재료
BJ4802RABJ4802RASt Cox Stainless Steel 등800,000
BJ4802RBBJ4802RASt.cox Stainless Steel(Cervical)800,000
BJ4803RABJ4803RAST.REED PLUS1,000,000
BJ4803XUBJ4803XUNeedleview Ch Polycarbonate, Stainless Steel 등1,850,000
BJ4804UNBJ4804UNSpinaut-H Polyurethane 등1,700,000
BJ4805RABJ4805RAFora-B Thermoplastic Polyurethane 등1,500,000
BM2101QTBM2101QTMEDICLORE200,000
BM2601OPBM2601OPCollashield Type I 콜라겐 등300,000
BTS01114BTS01114Allocover Had Acellular Dermis1,400,000
CATISTEM622900010[비급여] CATISTEM(카티스템)-1 Vial당8,000,000
NEEDLE VBJ4803XUNeedle View CH1,850,000
TTA01101TTA01101Achilles Tendon W/Bb W/Sheath Achilles Tendon1,480,940
X-STICKBC0108EDX-STICK880,000
4601BC4100ASMulti-Fix Artbendpin400,000
4602BJ4805OJCave Finder800,000
TEMPUS한시적 비급여 TEMPUS 900,000
BF0100AJBF0100AJ Cover Seal  300,000
확대
 병원코드청구코드 치료재료 및 보조재료
4002681800010박티그라 10x10cm3,000
5001BC1217UZ손가락보호대(Thumb)15,000
5002BC1215UZ손목보호대20,000
5003BC1215UZ손목보호대(Wrap)15,000
5004BC1217UZ손가락보호대(finger)15,000
5005BC1211GM팔꿈치보호대18,000
5007BC1001UZMCL brace50,000
5008BC1001UZKnee Immobilizer(무릎고정)90,000
5009BC1001UZ동사MCL80,000
5010BC1001UZ무릎밴드(Patella Cut Out)40,000
5011BC1216UZ발목보호대(Thunder brace)60,000
5012BC1216UZAnkle Support30,000
5013BC1216UZ족저근막보호대(Planta Fasciitis Support)30,000
5015BC1101VP리바운드 에어워커270,000
5018BC1104VP메쉬톱 수술화60,000
816-1BC1201KZ필라델피아칼라(Philadelpia)21,000
ANKLE-BBC1216UZAnkle Brace30,000
ARM-SVM061팔걸이(arm sling)5,000
BB3000LQBB3000LQLiquiband Surgical S N-Butyl Cyanoacrylate, 2-120,000
BB3001CDBB3001CD피부봉합용 접착테이프 Skinlink 7mm x 6mm150,000
4005BC1301UJSTIRING220,000
BJ1005COBJ1005COIV DOSI(ACELOCK PLUS,IV)8,000
BK7101RTBK7101RTCold Bandage10,000
BM1301BLBM1301BLBANDGOLD FILTER SYRINGE1,650
BM1302P1BM1302PWINFU-GREEN PLUS(FILTER)9,000
BM1302PWBM1302PWINFU-GREEN PLUS(FILTER)Y자5,850
BM5000SQBM5000SQSurgicon 3g Acetylhexapeptide- 49 등150,000
BM5001GABM5001GA지혈밴드 Secuex2,000
BM5026H1BM5026HF쎄텍패드 Setect Pad(10x10)26,000
BM5026H2BM5026HF쎼텍패드 Setect Pad(10x20)35,000
CLBANDVM0628자붕대10,000
COBANBK7101EA코반붕대 1인치(20cm당)2,250
COBAN1BK7101EA코반붕대 1인치 1개3,000
COBAN2BK7101EA코반붕대 2인치(20cm당)3,750
COBAN5BK7101EA코반붕대 2인치 1개4,000
CRUTCH20330목발-1쌍15,000
EXOFORMBC1210VPEXOFORM WRIST60,000
FILTER NBM1301UO일회용여과기부착침 Stainless Steel, Pp 등15,000
FIXR10BM5101LX픽스롤 10cm*10M(기본 30cm당 500원)500
FIXR5BM5101LX픽스롤 5cm*10M300
INNOBM0303BXINNOFUSER10,000
MALLET MALLETmallet finger(고무형)5,000
POLYTHEBM5001SB폴리텍 실리콘겔 15g(1개)50,000
S-STRIPBM5003EM스테리 스트립 1541 15421,500
SFIXR10BM5103SO하이퍼스킨10cm*10cm5,000
SFIXR5BM5103SO하이퍼스킨5cm*10cm3,000
SHOESVM070캐스트슈즈 (신)8,000
SOFT-CBC1203YF소프트칼라10,000
SPGSTNW01380011스폰고스탄 아날 20*8*3cm (존슨앤드존슨)8,800
확대
 병원코드청구코드 치료재료 및 보조재료
STRIPEBM5003EMsteri strip1,500
SOSO남자소변기5,000
SO1SO1여자소변기10,000
VELPEAUVM062벨포붕대15,000
WRIST-BBC1211UZWrist Brace7,000
좌욕기좌욕기좌욕기10,000
코르셋1BC1213UZ코르셋(외래)50,000
코르셋2BC1213UZ코르셋(입원)100,000
PLIO6BK7000GSPlio 6인치(1회용멸균스타키넷/상지)40,000
PLIO8BK7000GSPlio 8인치(1회용멸균스타키넷/하지)45,000
4003BM5302VT젠타큐(Genta Q)200,000
4004BM2601OP콜라쉴드0.5(Collashield)150,000
M000M000사후처치20,000
4010BJ1000IP  Gm Sution Fix 부직포, 벨크로, 이형지15,000 
 4011 BJ1001ZC PIL(배액관 고정용판)10,000 
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 병원코드청구코드 제증명
CD-CPDZ110004진료기록영상 복사(CD)10,000
JG100JG100총포 건강진단5,000
JG102PDE010001영문 일반진단서20,000
JG110PDZ010004채용신체검사40,000
K29-2PDZ110101검사결과지1,000
K30PDZ010000진단서(일반,질병)20,000
K30-1PDZ160000제증명 사본(재발행)-추가당1,000
K31PDZ090004입퇴원확인서(입원사실증명서)3,000
K32PDZ090004수술확인서3,000
K34-1PDZ010003채용신체검사서(공무원)40,000
K35PDZ070001장애진단서(신체적장애)15,000
K35-1PDZ090007진료확인서3,000
K36PDZ080000병무용 진단서20,000
K37PDZ070003후유장해진단서(AMA,맥브라이드)100,000
K38PDZ020001상해진단서(3주 미만)100,000
K38-1PDZ020002상해진단서(3주 이상)150,000
K38-2PDZ160000상해진단서 추가 사본1,000
K40PDZ110101진료기록사본복사(1~5매까지) 장당1,000
K40-1PDZ110102진료기록사본 (6매 이상) 장당100
K41PDZ030000사망진단서10,000
K41-1PDZ160000사망진단서(재발행)1,000
K42PDZ040000시체검안서30,000
K43PDZ140001향후치료비추정서(천만원 미만)50,000
K43-1PDZ140002향후치료비추정서(천만원 이상)100,000
K43-2PDZ160000향후치료비추정서 재발급1,000
K45PDZ090007상급병실 사용확인서3,000
K46PDZ160000제증명서 사본(재발행)-추가당1,000
K49PDZ100000국민연금 장애심사용 진단서15,000
K51PDZ010001건강진단서20,000
K53PDZ090004통원확인서3,000
K54PDZ090007수술확인서3,000
K55PDZ110101수술기록지(장당)1,000
K56PDZ010002근로능력평가용 진단서10,000
K57K57보험회사용 확인서50,000
NRD3NRD3공기 밥 추가1,000
NRDFNRDF보호자 일반식5,000
환의환의환의-상,하20,000
K42-1PDZ160000시체검안서-추가당1,000
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