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
----
COVIDD6620 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
US62US62초음파 하복부70,000
US25US25초음파 유방 검사100,000
US25AUS25A유방초음파Core Biopsy150,000
US27US27초음파 경동맥 검사100,000
US28US28초음파-thyroid biopsy70,000
US28AUS28A갑상선초음파Core Biopsy160,000
US29US29초음파 갑상선 검사60,000
US37JUS37J초음파 관절 - OS30,000
US55
US55도플러 고환 검사100,000
US57US57Doppler(Varicose exam)편측100,000
US60US60Doppler,both(varicose exam)150,000
US22US22U/S Extremity & other50,000
USNECK-1USNECK-1초음파 목(갑상선제외)60,000
US41US41초음파 국소한정용30,000
US13-1EB455골반(여성생식기)건강검진  60,000
 EZ985 EZ985수술 중 초음파  100,000
 usneckusneck  초음파 목(갑상선포함)100,000 
 us61us61  초음파 상복부 100,000
 US40US40  초음파 전립선 70,000
    
    
확대
 병원코드청구코드 경구 & 주사
BF0101WCBF0101WC큐블럭(QBLOCK)1,500,000
850659900090스티몰액(STIMOL)10ml/pack4,000
A3180400649803700하이스탈정150
ATPD643900900액티피드정 삼일제약30
CRLF642902060캐롤 애프 정(일동제약)150
PLK 642401650 푸라콩정  15
확대
 병원코드청구코드 경구 & 주사
706650003220싱그릭스(대상포진)250,000
66590018665900181아박심(A형간염백심)90,000
64590667645906671파노펜주100ml15,000
3019
 
645104631 판비콤프주  5,000
65990034  659900341아큐판주사액  15,000
 66980484 669804841 네포펜주15,000 
확대
 병원코드청구코드 경구 & 주사
VITACC1669900590메가비타민C 25g요법60,000
VITACC2669900590메가비타민C 50g요법
80,000
VITACC3669900590메가비타민C 75g요법
100,000
 VITACC4 669900590 메가비타민C 100g요법120,000 
 라이넥 681100026라이넥주2ml 20,000 
 기력보충기력보충 기력보충  80,000
 68110024 681100241메가그린주20ml  5,000
 64590667 645906671 파노펜주100ml15,000 
MPERI645103850  멀티플렉스페리주 550ml80,000 
 3020645104441 멀티서플라이5주 10ml  20,000
    
확대
 병원코드청구코드 수술료 & 이화학요법
CIRCUMCIRCUM포경수술
(초등학교6학년 이하)
150,000
CIRCUM1CIRCUM1포경수술
(고등학교3학년 이하)
150,000
CIRCUM2CIRCUM2포경수술-성인150,000
LASERLASERCO2레이저(점)-1개당5,000
LASER2LASER2검버섯3,000
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]100,000
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-1쌍20,000
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 
확대
 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
확대