SERVICIOS DE SALUD DE NAYARIT TABULADOR DE ...TABULADOR DE SERVICIOS MÉDICOS-ASISTENCIALES EN...

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

1 01-001 CONSULTA GENERAL 5.00 8.00 13.00 20.00 38.00 66.00

2 01-002 CONSULTA ESPECIALIDAD 8.00 14.00 25.00 44.00 80.00 133.00

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 50.00 65.00 84.00 109.00 142.00 185.00

6 01-006 OBSERVACION DE 2 A 12 HRS. 53.00 69.00 89.00 116.00 151.00 197.00

7 01-007 OBSERVACION DE 12 A 23 HRS. 107.00 139.00 180.00 235.00 305.00 397.00

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

9 01-009 HIDRATACION DE MENORES INTRAVENOSA 36.00 46.00 60.00 79.00 102.00 133.00

10 01-010 HOSPITALIZACION DIA CAMA 297.00 297.00 297.00 297.00 297.00 297.00

11 01-011 ALIMENTACION ARTIFICIAL POR DIA 57.00 118.00 165.00 183.00 229.00 343.00

12 01-012 LAVADO GASTRICO 136.00 176.00 229.00 298.00 388.00 504.00

13 01-013 SONDEO VESICAL 116.00 150.00 196.00 254.00 331.00 430.00

14 01-014 VENOCLISIS 136.00 176.00 229.00 297.00 386.00 501.00

15 01-015 APLICACION DE INYECCION INTRAMUSCULAR 0.00 0.00 0.00 0.00 0.00 0.00

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

17 01-017 SANGRIA 52.00 73.00 99.00 183.00 244.00 305.00

18 01-018 CURACIONES 39.00 50.00 65.00 85.00 111.00 144.00

19 01-019 EXANGUINOTRANSFUSION 496.00 644.00 838.00 1,084.00 1,416.00 1,841.00

20 01-020 VENODISECCION 206.00 267.00 348.00 452.00 588.00 764.00

21 01-021 CONSULTA DE CONSULTA DE COLPOSCOPOIA 24.00 37.00 52.00 67.00 121.00 191.00

22 01-022 NEBULIZACIONES 100.00 130.00 169.00 220.00 286.00 371.00

23 01-023 VENDAJE COMPRESIVO 55.00 71.00 92.00 120.00 157.00 204.00

24 01-024 DIA INCUBADORA 35.00 41.00 53.00 69.00 90.00 97.00

25 01-520 VASECTOMÍA 0.00 0.00 0.00 0.00 0.00 0.00

26 02-001 QUISTE CEBACEO QUIRURGICO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

27 02-002 FIMOSIS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

28 02-003 EXTIRPACION GANGLIONAR 384.00 499.00 649.00 844.00 1,097.00 1,426.00

29 02-004 MASTECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

30 02-005 HERNIA UMBILICAL Y PARAUMBILICAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

31 02-006 QUISTE PILONIDAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

32 02-007 EXTRACCION DE UÑAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

Generado el 07/09/2011 a las 15:36:39 1 de 34

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

VERSIÓN 2009


33 02-008 LITOTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

34 02-009 SAFENECTOMIA POR EXTREMIDAD 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

35 02-010 EVENTRACION POSTQUIRURGICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

36 02-011 HISTERECTOMIA, ANTERECTOMIA Y BIOPSIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

37 02-012 EXTIRPACION DE TUMORES DE PIEL MALIGNOS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

38 02-013 EXTIRPACION DE TUMORES DE PIEL BENIGNOS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

39 02-014 FISURAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

40 02-015 TIROIDECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

41 02-016 FRENORRAFIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

42 02-017 COLECISTECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

43 02-018 DIASTASIS DE RECTOS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

44 02-019 SELLO DE AGUA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

45 02-101 LIPOMAS, NUEVOS QUISTES 384.00 499.00 649.00 844.00 1,097.00 1,426.00

46 02-102 HERNIA UMBILICAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

47 02-103 HERNIA INGUINAL (SIMPLE, DOBLE) 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

48 02-104 HERNIA HIATAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

49 02-105 APENDICECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

50 02-106 HERNIOPLASTIA DISFRAGMATICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

51 03-001 CONSULTA Y PLAN DE TRATAMIENTO 17.00 22.00 29.00 37.00 49.00 63.00

52 03-002 APICOFORMACION 110.00 31.00 39.00 48.00 63.00 79.00

53 03-003 CORONA DE ACERO CROMO 308.00 95.00 118.00 142.00 189.00 237.00

54 03-004 MANTENEDORES DE ESPACIO 166.00 221.00 276.00 332.00 332.00 553.00

55 03-005 SEDACION 35.00 41.00 53.00 69.00 90.00 117.00

56 03-101 ATENCION POR CUADRANTE 384.00 499.00 649.00 844.00 1,097.00 1,426.00

57 03-102 OBTURACION CON AMALGAMA DE PLATA 56.00 73.00 95.00 123.00 160.00 208.00

58 03-103 OBTURACION CON RESINA COMPUESTA 86.00 112.00 145.00 189.00 246.00 319.00

59 03-104 OBTURACION CON IRM O CON OXIDO DE ZINC 89.00 116.00 150.00 196.00 254.00 330.00

60 03-105 RESTAURACION CON CORONA DE ACERO DE CROMO 168.00 218.00 284.00 369.00 480.00 624.00

61 03-106 RESTAURACION CON CORONA DE CELULOIDE 152.00 198.00 257.00 334.00 434.00 564.00

62 03-107 CEMENTO INCRUSTACIONES Y CORONA 12.00 16.00 20.00 26.00 34.00 45.00

63 03-108 APLICACION DE FLUOR 12.00 16.00 20.00 26.00 34.00 45.00

64 03-109 EXODONCIA SIMPLE (POR PIEZA) VIA ALVEOLAR 120.00 156.00 203.00 264.00 343.00 446.00



VERSIÓN 2009


65 03-110 EXODONCIA MULTIPLE CON REGULARIZACION 135.00 176.00 228.00 297.00 386.00 501.00

66 03-111 EXODONCIA POR DISECCION 132.00 172.00 223.00 290.00 377.00 490.00

67 03-112 CIRUGIA PREPROTESICA 140.00 182.00 237.00 308.00 400.00 520.00

68 03-113 CIRUGIA PERIAPICAL 149.00 194.00 252.00 327.00 426.00 553.00

69 03-114 CIRUGIA PARODONTAL 135.00 176.00 228.00 297.00 386.00 501.00

70 03-115 CIRUGIA ATM PROTESIS 48.00 62.00 81.00 105.00 137.00 178.00

71 03-116 REDUCCION CERRADA DE FRACTURA MANDIBULAR 152.00 198.00 257.00 334.00 434.00 564.00

72 03-117 REDUCCION ABIERTA DE FRACTURA MANDIBULAR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

73 03-118 MANDIBULA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

74 03-119 MAXILAR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

75 03-120 BIMAXILAR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

76 03-121 PULIDO DE RESTAURACION 18.00 23.00 30.00 40.00 51.00 67.00

77 03-122 CIRUGIA DE LABIO FISURADO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

78 03-123 CIRUGIA DE PALADAR FISURADO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

79 03-124 DRENAJE DE ABCESO EN QUIROFANO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

80 03-125 DRENAJE DE ABSCESO EN CONSULTA EXTERNA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

81 03-126 EXCISION DE NEOPLASTIA BUCAL C/ANEST. LOCAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

82 03-127 EXCISION DE NEOPLASTIA BUCAL C/ANEST. GRAL. 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

83 03-128 EXCISION DE NEOPL. BUCAL R. X. PERIAP. Y OCLUSAL 99.00 129.00 167.00 218.00 283.00 368.00

84 03-129 CURACIONES DENTALES 17.00 22.00 29.00 37.00 49.00 63.00

85 03-130 LIMPIEZA CABITRON 7.00 9.00 12.00 15.00 20.00 26.00

86 03-131 SUTURAS DENTALES 64.00 83.00 108.00 141.00 183.00 238.00

87 03-132 ODONTOXESIS 17.00 22.00 29.00 37.00 49.00 63.00

88 03-133 SILICATO 5.00 7.00 8.00 11.00 14.00 19.00

89 03-134 DIENTES SUPERNUMERARIOS 74.00 96.00 125.00 163.00 211.00 275.00

90 03-135 MÙLTIPLES BAJO ANESTESIA 74.00 96.00 125.00 163.00 211.00 275.00

91 03-136 EXTRACCION TERCER MOLAR 74.00 96.00 125.00 163.00 211.00 275.00

92 03-137 OBTURACION CON IONOMERO DE VIDRIO 29.00 38.00 49.00 64.00 83.00 108.00

93 03-201 RECUBRIMIENTOS PULPARES 16.00 21.00 27.00 35.00 46.00 59.00

94 03-202 PULPOTOMIA PIEZAS POSTERIORES 18.00 23.00 30.00 40.00 51.00 67.00

95 03-203 PULPOTOMIA PIEZAS ANTERIORES 18.00 23.00 30.00 40.00 51.00 67.00

96 03-204 URGENCIA PULPAR 71.00 92.00 120.00 156.00 203.00 264.00



VERSIÓN 2009


97 03-301 TECNICA OCLUSAL 7.00 9.00 12.00 15.00 20.00 26.00

98 03-302 TECNICA PERIAPICAL 7.00 9.00 12.00 15.00 20.00 26.00

99 03-401 PROFILAXIS 24.00 31.00 41.00 53.00 69.00 89.00

100 03-501 FRENIVECTOMIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

101 03-502 OSTEOMIELITIS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

102 03-503 PARODONCIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

103 03-504 GINGIVECTOMIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

104 03-505 PLASTIA LABIAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

105 03-506 ENDODONCIA 23.00 30.00 39.00 51.00 66.00 85.00

106 03-507 DISTRACTOR DACTILAR Y MANDIBULAR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

107 03-601 PORDIFENHIDANTOINA CUADRANTE 384.00 499.00 649.00 844.00 1,097.00 1,426.00

108 03-602 DEBRIDACION Y CANALIZACION DE ABSCESOS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

109 03-603 CORRECCION DE FISTULA ORO-ANGRAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

110 03-604 APICECTOMIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

111 03-605 BLOQUEOS LITICOS A NIVEL TRIGEMINAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

112 03-606 REGULARIZACION DE PROC. ALVEOLARES RESIDUALES 26.00 34.00 44.00 57.00 74.00 97.00

113 03-607 TULVIDINA Y TOMA DE BIOPSIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

114 03-701 REALIZACION DE FERULAS DE YESO 27.00 35.00 49.00 64.00 83.00 108.00

115 03-702 APARATO DE YESO ( COLOCACION) 120.00 156.00 203.00 264.00 343.00 446.00

116 03-703 RETIRO DE YESO 64.00 83.00 108.00 140.00 182.00 237.00

117 03-704 SUTURAS MENORES 384.00 499.00 649.00 844.00 1,097.00 1,426.00

118 03-705 FRACTURA DENTOALVEOLAR FERULA APARTE (MAXILOFACIAL) 384.00 499.00 649.00 844.00 1,097.00 1,426.00

119 03-706 FRACTURA MANDIBULAR ESTABLE (MAXILOFACIAL) 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

120 03-707 FRACTURA MANDIBULAR INESTABLE Y FER. (OSTEO.) (MAXILOFACIAL) 720.00 936.00 1,217.00 1,582.00 2,056.00 3,475.00

121 03-708 FRACTURA TERCIO MEDIO GIGOMETRICO MALAR (MAXILOFACIAL) 720.00 936.00 1,217.00 1,582.00 2,056.00 3,475.00

122 03-709 SUTURAS MAYORES (10 PUNTOS) 384.00 499.00 649.00 844.00 1,097.00 1,426.00

123 03-801 IMPLANTE NORMAL (POR PIEZA) 63.00 82.00 106.00 138.00 180.00 234.00

124 03-802 IMPLANTE ANORMAL (POR PIEZA) 63.00 82.00 106.00 138.00 180.00 234.00

125 03-803 ORGANOS DENTARIOS RETENIDOS (POR PIEZA) 63.00 82.00 106.00 138.00 180.00 234.00

126 03-901 CUOTA POR SESION 6.00 8.00 10.00 13.00 17.00 22.00

127 04-001 PRUEBAS DE PERSONALIDAD 18.00 25.00 35.00 49.00 69.00 94.00

128 04-002 PRUEBAS VOCACIONALES 0.00 0.00 0.00 0.00 0.00 0.00



VERSIÓN 2009


129 04-003 PRUEBAS PSICOMETRICAS (INDIVIDUAL) 44.00 62.00 86.00 121.00 169.00 237.00

130 04-004 PAQUETE DE PRUEBAS PSICOM. (MAS DE 5 P) C/U 23.00 32.00 45.00 63.00 88.00 124.00

131 04-005 PRUEBAS MMPI 10.00 14.00 20.00 27.00 38.00 54.00

132 04-006 PRUEBAS DE WAIS 10.00 14.00 20.00 27.00 38.00 54.00

133 04-007 PRUEBAS DE TAT 10.00 14.00 20.00 27.00 38.00 54.00

134 04-008 PRUEBAS DE BUCK 8.00 11.00 16.00 22.00 31.00 43.00

135 04-009 PRUEBAS DE BENDER 6.00 8.00 12.00 16.00 23.00 32.00

136 04-010 PRUEBAS DE HABITAT 6.00 8.00 12.00 16.00 23.00 32.00

137 04-011 PRUEBAS DE WIPSI 10.00 14.00 20.00 27.00 38.00 54.00

138 04-012 PRUEBAS DE WISC 10.00 14.00 20.00 27.00 38.00 54.00

139 04-013 TERAPIA CONYUGAL (POR PAREJA DE 1 A 3 SESIONES) 6.00 8.00 12.00 16.00 23.00 32.00

140 04-014 TERAPIA FAMILIAR (FAMILIA DE 1 A 3 SESIONES) 6.00 8.00 12.00 16.00 23.00 32.00

141 04-015 TERAPIA INDIVIDUAL (DE 1 A 3 SESIONES) 5.00 7.00 10.00 14.00 19.00 27.00

142 04-016 TERAPIA DE GRUPO DE 1 A 3 SESIONES POR PERSONA 5.00 7.00 10.00 14.00 19.00 27.00

143 04-017 PRUEBA DE ROSCHARCH 6.00 8.00 12.00 16.00 23.00 32.00

144 04-018 INSCRIPCION A GRUPOS DE ORIENTACION (ANUAL) 14.00 20.00 27.00 38.00 54.00 75.00

145 04-019 GRUPOS DE ORIENTACION (MENSUALIDAD) 14.00 20.00 27.00 38.00 54.00 75.00

146 05-001 BIOPSIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

147 05-002 ELECTRODESECACIÖN 384.00 499.00 649.00 844.00 1,097.00 1,426.00

148 05-003 ELECTROFULGURACION 384.00 499.00 649.00 844.00 1,097.00 1,426.00

149 05-004 EXTIRPACION DE VERRUGAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

150 05-005 EXTIRPACION DE LUNARES 384.00 499.00 649.00 844.00 1,097.00 1,426.00

151 05-007 ESTUDIOS MICOLOGICOS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

152 05-008 RASURADOS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

153 05-009 CRIOCIRUGIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

154 05-011 PEELING QUIMICO SUPERFICIAL O MEDIO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

155 05-012 APLICACION TOPICA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

156 05-013 APLICACION INTRALESIONAR 384.00 499.00 649.00 844.00 1,097.00 1,426.00

157 06-101 ESTUDIO AUDIOFONIATRICO COMPLETO 11.00 19.00 41.00 73.00 123.00 194.00

158 06-102 ESTUDIO AUDIOMETRICO BASICO 8.00 13.00 25.00 43.00 74.00 112.00

159 06-103 ESTUDIO AUDIOMETRICO COMPLEMENTARIO 6.00 10.00 16.00 26.00 48.00 83.00

160 06-104 ESTUDIO FONIATRICO 8.00 13.00 25.00 43.00 74.00 112.00



VERSIÓN 2009


161 06-105 COLOCACION DE AAE 5.00 8.00 14.00 23.00 43.00 66.00

162 06-106 ESTROBOSCOPIA 14.00 29.00 54.00 93.00 158.00 247.00

163 06-201 20 SESIONES AL MES (5 POR SEMANA) 31.00 61.00 120.00 201.00 366.00 597.00


165 06-203 8 SESIONES AL MES(2 POR SEMANA) 19.00 38.00 66.00 123.00 232.00 395.00


167 06-205 1 SESION 6.00 11.00 19.00 35.00 61.00 102.00

168 07-001 SESION DE TERAPIA FISICA 6.00 8.00 16.00 26.00 46.00 68.00

169 07-002 SESION TERAPIA OCUPACIONAL 6.00 10.00 16.00 26.00 49.00 84.00

170 07-003 SESION TERAPIA PSICOLOGICA 5.00 6.00 13.00 20.00 41.00 63.00

171 07-004 DIALISIS PERITONEAL ( CON SOLUCIONES ) 226.00 458.00 641.00 850.00 1,678.00 2,440.00

172 07-005 CARDIOMETRIA POR IMPEDANCIA 13.00 19.00 43.00 75.00 132.00 202.00

173 07-006 VALORACION CARDIACA POR PAQUETE: P/ ESFUERZO 44.00 78.00 148.00 262.00 455.00 703.00

174 07-007 MONITOREO DE CONTROL CARDIACO 18.00 31.00 66.00 120.00 207.00 323.00

175 07-008 TERAPIA DEL LENGUAJE 8.00 10.00 20.00 38.00 66.00 105.00

176 08-001 CONSULTA OBSTETRICA Y MONITOREO FETAL 80.00 107.00 150.00 165.00 220.00 175.00

177 08-002 BARTHOLINECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

178 08-003 CONIFICACION 384.00 499.00 649.00 844.00 1,097.00 1,426.00

179 08-004 RESECCION ALTA O BAJA DE CERVIX 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

180 08-005 DEBRIDACION DE ABSCESO MAMARIO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

181 08-006 COLPOPERINOPLASTIA (CIRUGIA P/CORREC. EST. PELV.) 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

182 08-007 RESECCION DE QUISTES Y TUMORES BENIGNOS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

183 08-008 DRENAJE DE FONDO DE SACO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

184 08-009 REPARACION DE FISTULAS VESICO VAGINALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

185 08-010 EXCERESIS DE NODULO MAMARIO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

186 08-011 EXTIRPACION DE POLIPO CERVICAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

187 08-012 LAPAROSCOPIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

188 08-013 SALPINGOCLASIA 0.00 0.00 0.00 0.00 0.00 0.00

189 08-014 SALPINGO OFERECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

190 08-015 EMBARAZO EXTRAUTERINO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

191 08-016 LEGRADO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

192 08-017 EXTIRPACION DE QUISTE DE OVARIO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00



VERSIÓN 2009


193 08-018 TRAQUELOPLASTIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

194 08-019 CERCLAJE DE CERVIX 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

195 08-020 CONIZACION DE CERVIX 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

196 08-021 CIRUGIA ABDOMINAL NO CLASIFICADA 801.00 1,602.00 3,565.00 5,603.00 7,638.00 10,186.00

197 08-022 MIOMECTOMIA 720.00 936.00 1,782.00 2,801.00 3,822.00 5,092.00

198 08-023 TUMORACIONES ANEXIALES 720.00 936.00 1,782.00 2,801.00 3,822.00 5,092.00

199 08-024 PLASTIA TUBARIA 801.00 1,602.00 3,565.00 5,603.00 7,638.00 10,186.00

200 08-025 BIOPSIA DE GLANDULA MAMARIA 384.00 499.00 891.00 1,399.00 1,910.00 2,456.00

201 08-026 METROPLASTIA 801.00 1,201.00 2,673.00 4,203.00 5,730.00 7,638.00

202 08-027 CIRUGIA MENOR DENTRO DE QUIROFANO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

203 08-028 LAPAROTOMIA EXPLORADORA 801.00 1,041.00 1,353.00 1,759.00 2,287.00 2,976.00

204 08-029 INSEMINACION ARTIFICIAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

205 08-030 ADDAIRE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

206 08-031 CESAREA-HISTERECTOMIA 801.00 1,602.00 3,565.00 5,603.00 7,638.00 10,186.00

207 08-032 COLPOCLISIS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

208 08-033 CUADRANTECTOMIA 384.00 499.00 1,782.00 2,081.00 3,822.00 5,092.00

209 08-034 EXTIRPACION DE LIPOMA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

210 08-035 EXTIRPACION QUISTE GARDNER 384.00 499.00 649.00 844.00 1,097.00 1,426.00

211 08-036 EXTIRPACION POLIPO CERVICAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

212 08-037 HERNIOPLASTIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

213 08-038 HISTEROSCOPIA 1,079.00 1,403.00 1,824.00 2,371.00 3,082.00 4,006.00

214 08-039 HISTEROCTOMIA RADICAL O AMPLIFICADA 1,002.00 2,001.00 4,455.00 7,004.00 9,548.00 12,730.00

215 08-040 MASTECTOMIA RADICAL 801.00 1,602.00 3,565.00 5,603.00 7,638.00 10,186.00

216 08-041 PLASTIA DE PARED 384.00 499.00 649.00 844.00 1,097.00 1,426.00

217 08-042 REPARACION DE FISTULA RECTO-VAGINAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

218 08-043 SALPINGO-OVARIOLISIS Y ADHERENCIOLISIS 400.00 801.00 1,782.00 2,801.00 3,822.00 5,092.00

219 08-044 SALPINGECTOMIA 384.00 499.00 891.00 1,399.00 1,910.00 2,546.00

220 08-045 SUSPENSION DE CUPULA VAGINAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

221 08-046 URETROPEXIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

222 08-047 ASA DIATERMICA 115.00 232.00 520.00 819.00 1,116.00 1,487.00

223 08-048 CONIFICACION CON CRIOTERAPIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

224 08-049 CONIFICACION CON ASA ELECTRICA 384.00 499.00 649.00 844.00 1,097.00 1,426.00



VERSIÓN 2009


225 08-050 ELECTROFULGURACION CERVICALES 384.00 499.00 649.00 844.00 1,097.00 1,426.00

226 08-101 PAQ. TRAQUELOPLASTIA 384.00 623.00 1,305.00 2,158.00 3,301.00 4,778.00

227 08-102 PAQ. BARTHOLINECTOMIA O MARZUPIALIZACION 384.00 499.00 649.00 844.00 1,097.00 1,426.00

228 08-103 PAQ. HIMENECTOMIA O APLICACION DE INTROITO 384.00 499.00 732.00 1,352.00 2,513.00 4,087.00

229 08-104 PAQ. POLIPECTOMIA 384.00 499.00 732.00 1,352.00 2,513.00 4,087.00

230 08-105 PAQ. CONO CERVICAL 720.00 936.00 1,476.00 2,462.00 3,848.00 5,648.00

231 08-106 PAQ. VAPORIZACION DE CERVIX CON LASER 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

232 08-107 PAQ. CERCLAJE 720.00 936.00 1,217.00 1,582.00 2,148.00 3,483.00

233 08-108 PAQ. LEGRADO OBSTETRICO 720.00 936.00 1,217.00 1,582.00 2,745.00 4,398.00

234 08-109 PAQ. SENEQUIOLISIS CON APLICACION DE D.I.U. 720.00 936.00 1,217.00 1,582.00 2,745.00 4,398.00

235 08-110 PAQ. EXTRACCION DE D.I.U. BAJO ANESTESIA 0.00 0.00 0.00 0.00 0.00 0.00

236 08-111 PAQ. LAPAROSCOPIA DIAGNOSTICA 720.00 936.00 1,217.00 1,582.00 2,199.00 3,519.00

237 08-112 PAQ. O.T.B. DE INTERVALO 0.00 0.00 0.00 0.00 0.00 0.00

238 08-113 PAQ. BIOPSIA ABIERTA DE MAMA 384.00 499.00 649.00 994.00 1,803.00 2,903.00

239 08-114 PAQ. BIOPSIA DE PIEL 89.00 116.00 151.00 196.00 255.00 332.00

240 08-115 PAQ. BIOPSIA DE GANGLIOS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

241 08-116 PAQ. RESECCION DE MAMAS SUPERNUMERARIAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

242 08-117 PAQ. EXTIRPACION DE CONDILOMAS VULV. O VAG. 384.00 499.00 649.00 844.00 1,097.00 1,426.00

243 08-118 PAQ. INSEMINACION GIFT-FIVTE 1,002.00 2,001.00 4,455.00 7,004.00 9,548.00 12,730.00

244 08-119 PAQ. PARTO NORMAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

245 08-120 PAQ. PARTO DISTOCICO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

246 08-121 PAQ. CESAREA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

247 08-122 PAQ. HISTERECTOMIA ABDOMINAL 720.00 936.00 1,217.00 1,582.00 2,461.00 3,982.00

248 08-123 PAQ. HISTERECTOMIA VAGINAL 720.00 936.00 1,217.00 1,582.00 2,461.00 3,982.00

249 08-124 PAQ. COLPOPERINEOPLASTIA 720.00 936.00 1,217.00 1,582.00 2,461.00 3,982.00

250 08-125 ESTUDIO COLPOSCOPICO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

251 09-001 PUNCION LUMBAR 384.00 499.00 649.00 844.00 1,097.00 1,426.00

252 09-002 CRANEOTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

253 09-003 CRENIECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

254 09-004 EXPLORACION DE NERVIO PERIFERICO. PLASTIAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

255 09-005 MENINGOPLASTIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

256 09-006 COLOCACION DE VALVULA PUDENS (CON SONDA) 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00



VERSIÓN 2009


257 09-007 TRATAMIENTO QUIRURGICO DE EPILEPSIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

258 09-008 ABORDAJE DE COLUMNA CERVICAL VIA ANTERIOR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

259 09-009 CIRUGIA TRANSFENOIDAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

260 09-010 ELECTROENCEFALOGRAFIA 104.00 135.00 176.00 229.00 298.00 387.00

261 09-011 VELOCIDAD DE CONDUCCION 100.00 130.00 169.00 220.00 286.00 371.00

262 09-012 MAPEO CEREBRAL CON POTENCIALES O BEG. 200.00 260.00 338.00 439.00 571.00 743.00

263 09-013 RESECCION MENINGIONAL FRONTAL 1,002.00 1,155.00 3,232.00 6,117.00 8,656.00 22,545.00

264 09-014 RESECCION TERCER VENTRICULO 1,002.00 1,155.00 3,232.00 6,117.00 8,656.00 22,545.00

265 10-001 PUNCION TRANSTORACICA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

266 10-002 TORACOTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

267 10-003 TORACOTOMIA CON RESECCION 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

268 10-004 TORACTOMIA DE PROCESO MEDIASTINAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

269 10-005 DECORTICACION PULMONAR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

270 10-006 MIOPLASTIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

271 10-007 TORACOPLASTIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

272 10-008 PLEUROTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

273 10-009 MEDIASTINOTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

274 10-010 TRAQUEOSTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

275 10-011 BRONCOSCOPIA CON BROCOSCOPIO RIGIDO DIAGNOST. 384.00 499.00 649.00 844.00 1,097.00 1,426.00

276 10-012 BRONCOSCOPIA CON BROCOSCOPIO LAVADO TERAP. 384.00 499.00 649.00 844.00 1,097.00 1,426.00

277 10-013 FIBROBRONCOSCOPIA CEPILLADO LAVADO BIOPSIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

278 10-014 FIBROBRONCOSCOPIA BIOPSIA TRANSBRONQUIAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

279 10-015 FIBROBRONCOSCOPIA LAVADO BRONCOALVEOLAR 384.00 499.00 649.00 844.00 1,097.00 1,426.00

280 10-016 FIBROBRONCOSCOPIA CEPILLADO SELECTIVO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

281 10-017 FIBROBRONCOSCOPIA BIOPSIA PUNCION TRANSBRON. 384.00 499.00 649.00 844.00 1,097.00 1,426.00

282 10-018 FIBRONCOSCOPIA EXTRACCION DE CUERPO EXTRAÑO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

283 10-019 TORACOSCOPIA TOMA DE BIOPSIA O MUEST. DE LIQ. 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

284 10-020 LARINGOSCOPIA DIRECTA E INDIRECTA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

285 10-021 PRUEBAS FUNCIONALES PULMONARES Y RESPIRATORIAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

286 10-022 PLETISMOGRAFIA 200.00 260.00 338.00 439.00 571.00 743.00

287 11-001 RITIDECTOMIA 384.00 499.00 789.00 994.00 1,251.00 4,052.00

288 11-002 FASIOTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00



VERSIÓN 2009


289 11-003 MAMAS DE REDUCCION 720.00 936.00 1,217.00 1,582.00 2,627.00 4,125.00

290 11-004 MAMAS EN AUMENTO 720.00 936.00 1,217.00 1,642.00 2,399.00 5,957.00

291 11-005 LIPECTOMIA ABDOMINAL 720.00 936.00 1,217.00 1,582.00 2,426.00 3,953.00

292 11-006 BLEFAROPLASTIA 384.00 499.00 1,338.00 2,017.00 3,050.00 6,951.00

293 11-007 OTOPLASTIA 384.00 499.00 649.00 844.00 1,225.00 2,037.00

294 11-008 MENTOPLASTIA 384.00 499.00 917.00 1,274.00 1,769.00 4,894.00

295 11-009 PROGMATISMO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

296 11-010 DERMOABRACION (PEELING) 384.00 499.00 649.00 1,167.00 2,100.00 3,443.00

297 11-011 LIPOSUCCION 720.00 936.00 1,217.00 1,666.00 2,466.00 6,072.00

298 11-012 COLOCACION DE EXPANSORES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

299 11-013 MAXILOFACIAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

300 11-014 COLGAJOS MIOCUTANEOS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

301 11-015 COLGAJOS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

302 11-016 MICROCIRUGIA 384.00 499.00 649.00 844.00 1,211.00 2,019.00

303 11-017 TEMORRAFIAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

304 11-018 NEURORRAFIAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

305 11-019 LABIO LEPORINO Y PALADAR ENDIDO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

306 11-020 MASTOPEXIA 720.00 936.00 1,217.00 1,582.00 2,056.00 3,917.00

307 11-021 PLASTIA UMBILICAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

308 11-022 INJERTOS DE PIEL MENORES 384.00 499.00 649.00 844.00 1,097.00 1,426.00

309 11-023 INJERTOS DE PIEL MAYORES 384.00 499.00 649.00 844.00 1,269.00 2,037.00

310 11-024 CICATRICES DE MANOS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

311 11-025 CICATRICES MAYORES 384.00 499.00 649.00 844.00 1,097.00 1,426.00

312 11-026 PLASTIA LOCAL (CICATRICES MAYORES) 384.00 499.00 649.00 844.00 1,097.00 1,426.00

313 11-027 PROTESIS DE MAMAS 720.00 936.00 1,217.00 1,642.00 2,399.00 5,957.00

314 12-001 APLICACION MARCAPASO TEMPORAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

315 12-002 APLICACION MARCAPASO DEFINITIVO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

316 12-005 TROMBOLOSIS CORONARIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

317 12-006 PLASTIA DE VALV. PULM. AORTICAMITRAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

318 12-007 ESTUDIO ELECTROFISIOLOGICO (AAS DE. HU) 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

319 12-008 APEXCARDIOGRAMA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

320 12-012 ECOCARDIOGRAMA SIMPLE 266.00 346.00 450.00 584.00 760.00 988.00



VERSIÓN 2009


321 12-014 ELECTROCARDIOGRAMA EN REPOSO 139.00 167.00 200.00 240.00 288.00 346.00

322 12-015 ELECTROCARDIOGRAMA DE ESFUERZO 218.00 283.00 368.00 479.00 623.00 809.00

323 12-017 CORAZON ABIERTO 720.00 936.00 1,217.00 1,582.00 2,056.00 4,304.00

324 12-018 CORAZON CERRADO Y GRANDES VASOS 720.00 936.00 1,217.00 1,582.00 2,056.00 3,914.00

325 12-019 AORTA ABDOMINAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

326 12-021 CIRUGIA VASCULAR DE ABDOMEN Y TORAX 720.00 936.00 1,217.00 1,582.00 2,056.00 2,894.00

327 12-022 SIMPATECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

328 12-023 CIRUGIA VASCULAR PERIFERICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

329 12-024 DERIVACION ATRIOVENTRICULAR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

330 12-025 ANILLOS VASCULARES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

331 13-001 CATARATAS 720.00 936.00 1,217.00 1,528.00 2,056.00 2,673.00

332 13-002 ESTRABISMO 720.00 936.00 1,217.00 1,528.00 2,056.00 2,673.00

333 13-003 PTERIGION Y PINGUECULA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

334 13-004 RETINA 720.00 936.00 1,217.00 1,528.00 2,056.00 2,673.00

335 13-005 CHALAZION 384.00 499.00 649.00 844.00 1,097.00 1,426.00

336 13-006 DACRIOSCISTECTOMIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

337 13-007 ENTROPION Y ECTOPRION (Y QUEMADURA) 384.00 499.00 649.00 844.00 1,097.00 1,426.00

338 13-008 EXTRACCION DE CUERPOS EXTRAÑOS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

339 13-009 GLAUCOMA 720.00 936.00 1,217.00 1,528.00 2,056.00 2,673.00

340 13-010 GRADUACION DE LENTES 73.00 98.00 128.00 166.00 217.00 282.00

341 13-011 FOTOCOAGULACION (RAYO LASSER) 850.00 1,105.00 1,436.00 1,867.00 2,427.00 3,155.00

342 13-012 SONDEO 6.00 13.00 20.00 41.00 74.00 128.00

343 13-013 ELECTRONESTACNOGRAFIA 140.00 182.00 237.00 308.00 400.00 520.00

344 13-014 AJUSTES DE ARMAZON DE LENTES 10.00 18.00 38.00 73.00 135.00 219.00

345 13-015 FLUORANGIOGRAFIA 20.00 41.00 79.00 142.00 257.00 424.00

346 13-016 TRASPLANTE DE CORNEA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

347 13-017 RECONSTRUCCION PALPEBRAL 384.00 499.00 649.00 843.00 1,096.00 1,425.00

348 13-018 PROTESIS OCULARES 430.00 559.00 726.00 815.00 1,033.00 1,537.00

349 14-001 EXTRACCION DE CUERPOS EXTRAÑOS EN QUIROFANO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

350 14-002 EXTRACCION DE CUERPOS EXTR. SIN TEC. QUIRURGICAS 6.00 14.00 25.00 44.00 80.00 133.00

351 14-003 PARESENTESIS DEL TIMPANO 11.00 30.00 56.00 104.00 193.00 328.00

352 14-004 COLOCACION DEL TUBO DE VENTILACION 35.00 83.00 125.00 237.00 445.00 770.00



VERSIÓN 2009


353 14-005 TIMPANOTOMIA EXPLORADORA 43.00 84.00 153.00 285.00 530.00 870.00

354 14-006 MIRINGOPLASTIA 65.00 123.00 236.00 411.00 721.00 1,166.00

355 14-007 TIMPANOPLASTIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

356 14-008 MASTOIDECTOMIA SIMPLE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

357 14-009 MASTOIDECTOMIA CON TIMPANOPLASTIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

358 14-010 TRATAMIENTO QUIRURGICO DE PARALISIS FACIAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

359 14-011 MASTOIDECTOMIA RADICAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

360 14-013 LABERINTECTOMIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

361 14-014 ESTAPEDECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

362 14-015 TRATAMIENTO QUIRURGICO DE TUMORES B.DE OIDO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

363 14-016 TRATAMIENTO QUIRURGICO DE ABSCESO OTOGENO ENDOCRANEANO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

364 14-017 TRATAMIENTO QUIRURGICO ESTENOSIS DEL CONDUCT. AUDITIV. EXT. 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

365 14-018 TRATAMIENTO QUIRURGICO MALFORMACIONES CONGENITAS DE OIDO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

366 14-019 CIRUGIA DE POLIPOS NASALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

367 14-020 LIGADURA TRANS-ANTRAL DE LA ARTERIA MAX. INT. 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

368 14-021 LIGADURA DE CAROTIDA EXTERNA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

369 14-022 DEBRIDACION DE HEMATOMA Y/O ABSCESO SEP. NASAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

370 14-023 TRATAMIENTO QUIRURGICO DE SEQUIAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

371 14-024 TRATAMIENTO DE FRACTURA NASAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

372 14-025 TRATAMIENTO QUIRURGICO ATRESIA COANAL 721.00 937.00 1,218.00 1,584.00 2,059.00 2,677.00

373 14-026 CORRECCION QUIRURGICO SEPTUM NASAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

374 14-027 RINOPLASTIA 720.00 936.00 1,217.00 1,847.00 2,955.00 7,134.00

375 14-028 RINOSEPTUMPLASTIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

376 14-029 TRATAMIENTO QUIRURGICO DE PERFORACIONES DENT. 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

377 14-030 EXTIRPACION DE TUMORES BENIGNOS EN FOSAS NASALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

378 14-031 TRATAMIENTO QUIRURGICO DE ANGIOFIBROMA NASFAR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

379 14-032 TRATAMIENTO QUIRURGICO DE SINUSITIS FRONT.Y/O ET. 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

380 14-033 TRATAMIENTO QUIRURGICO DE SINUSITIS MAXILAR (CALDWELL LUC) 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

381 14-034 TRATAMIENTO QUIRURGICO DEL LABERINTO ETMOIDAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

382 14-035 AMIGDALECTOMIA CON O SIN ADENOIDECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

383 14-036 DEBRIDACION DE ABSCESOS FARINGOAMIGDALINOS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

384 14-037 TRATAMIENTO QUIRURGICO DE RANULA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00



VERSIÓN 2009


385 14-038 EXTIRPACION DE GLANDULA SUBMAXILAR 384.00 499.00 649.00 844.00 1,097.00 1,426.00

386 14-039 OCLUSION DE FISTULA OROANTRAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

387 14-040 TAPONAMIENTO NASAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

388 14-041 LARINGOFISURA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

389 14-042 TRATAMIENTO QUIRURGICO DE LA PARALISIS DE LOS ABD. LARINGE 384.00 499.00 649.00 844.00 1,097.00 1,426.00

390 14-043 LARINGOSTOMIA (RESOLUCIONES DE LAS EST.LAR.) 384.00 499.00 649.00 844.00 1,097.00 1,426.00

391 14-044 LARINGECTOMIA TOTAL 720.00 936.00 1,217.00 1,829.00 2,589.00 3,452.00

392 14-045 LARINGECTOMIAS PARCIALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

393 14-046 PROCEDIMIENTOS RECONSTRUCTIVOS (COLGAJOS LAR) 721.00 937.00 1,218.00 1,584.00 2,059.00 2,677.00

394 14-047 TRATAMIENTO QUIRURGICO DE REMANENTES EMBRIONARIOS DEL CUE. 384.00 499.00 649.00 844.00 1,097.00 1,426.00

395 14-048 LARINGOSCOPIA DIR. EXPL. MICROSCOPIA DE LARINGE 384.00 499.00 649.00 844.00 1,097.00 1,426.00

396 14-049 OBTURADORES POR MAXILECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

397 14-050 RINECTOMIA PROTESIS NASAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

398 14-051 TRATAMIENTO QUIRURGICO DE TUMORES M. DE OIDO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

399 14-101 EXTRACCION DE C/EXTRAÑO NASAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

400 14-102 CIRUGIA POLIPOS NASALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

401 14-103 TRATAMIENTO DE FRACTURA NASAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

402 14-104 C. QX. SEPTUM NASAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

403 14-105 RINOSEPTUMPLASTIA 720.00 936.00 1,217.00 1,582.00 2,050.00 3,330.00

404 14-106 SINUSITIS MAXILAR CADWEL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

405 14-107 AMIGDALECTOMIA CON O SIN ADENOIDECTOMIA. 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

406 15-001 NEFRECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

407 15-002 PIELILOTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

408 15-003 CISTOSTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

409 15-004 PROSTATECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

410 15-005 CORRECCION DE REFLUJO VESICOURETRAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

411 15-006 DILATACION URETRAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

412 15-007 PUNCION DE ABSCESO PROSTATICO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

413 15-008 ORQUIECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

414 15-009 MEATOTOMIAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

415 15-010 DIALISIS PERITONEAL (CON EQUIPO) 110.00 223.00 425.00 772.00 1,408.00 2,281.00

416 15-011 DIALISIS PERITONEAL (SIN EQUIPO) 84.00 163.00 317.00 577.00 1,041.00 1,690.00



VERSIÓN 2009


417 15-012 HEMODIALISIS (CON EQUIPO) 54.00 98.00 189.00 357.00 665.00 1,107.00

418 15-013 HEMODIALISIS 6.00 13.00 20.00 41.00 79.00 139.00

419 15-014 EXTIRPACION DE TUMORES RETROPERITONEALES 720.00 936.00 1,217.00 1,582.00 2,614.00 3,486.00

420 15-015 EXTIRPACION DE TUMORES RENALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

421 15-016 BIOPSIA RENAL PERCUTANEA 384.00 499.00 632.00 1,196.00 1,693.00 2,257.00

422 15-019 CISTOSCOPIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

423 15-117 PROSTACTECTOMIA 720.00 936.00 1,217.00 1,995.00 3,677.00 6,154.00

424 15-118 PROSTACTECTOMIA POR RESECCION TRASSURETRAL (RTU) 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

425 16-001 BRAZO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

426 16-002 ANTEBRAZO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

427 16-003 MUSLO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

428 16-004 PIERNA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

429 16-005 MANO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

430 16-006 PIE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

431 16-007 DEDO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

432 16-008 ORTEJO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

433 16-101 HOMBRO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

434 16-102 COLUMNA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

435 16-103 CADERA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

436 16-104 ARTRONEUMOGRAFIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

437 16-105 ARTRODESIS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

438 16-201 TOTAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

439 16-202 PARCIAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

440 16-301 ARTROPLASTIA TOTAL 720.00 936.00 1,217.00 1,837.00 2,600.00 3,467.00

441 16-302 ARTROPLASTIA PARCIAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

442 16-303 OSTEOSINTESIS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

443 16-304 ELONGACION OSEA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

444 16-305 EXTIRPACION DISCAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

445 16-306 LAMINECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

446 16-401 UNILATERAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

447 16-402 BILATERAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

448 16-501 MIEMBRO TORAXICO REDUCCION MANUAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00



VERSIÓN 2009


449 16-502 MIEMBRO TORAXICO REDUCCION QUIRURGICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

450 16-503 RADIOCARPIANA REDUCCION MANUAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

451 16-504 RADIOCARPIANA REDUCCION QUIRURGICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

452 16-505 DEDOS REDUCCION MANUAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

453 16-506 DEDOS REDUCCION QUIRURGICA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

454 16-507 MIEMBRO PELVICO REDUCCION MANUAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

455 16-508 MIEMBRO PELVICO REDUCCION QUIRURGICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

456 16-509 RODILLA REDUCCION MANUAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

457 16-510 TOBILLO REDUCCION MANUAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

458 16-511 TOBILLO REDUCCION QUIRURGICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

459 16-512 PIE REDUCCION MANUAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

460 16-513 PIE REDUCCION QUIRURGICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

461 16-514 COLUMNA REDUCCION MANUAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

462 16-515 COLUMNA REDUCCION QUIRURGICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

463 16-516 REALIZACION DE FERULAS DE YESO 120.00 156.00 203.00 264.00 343.00 446.00

464 16-601 HUMERO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

465 16-602 CODO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

466 16-603 ANTEBRAZO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

467 16-604 MANO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

468 16-605 DEDO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

469 16-606 CADERA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

470 16-607 FEMUR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

471 16-608 RODILLA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

472 16-609 TIBIA Y/O PERONE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

473 16-610 TOBILLO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

474 16-611 PIE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

475 16-612 COLUMNA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

476 16-701 HUMERO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

477 16-702 CODO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

478 16-703 ANTEBRAZO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

479 16-704 MANO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

480 16-705 DEDO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00



VERSIÓN 2009


481 16-706 CADERA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

482 16-707 FEMUR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

483 16-708 RODILLA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

484 16-709 MENISECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

485 16-710 TIBIA Y/O PERONE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

486 16-711 TOBILLO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

487 16-712 PIE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

488 16-713 COLUMNA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

489 16-714 MENISCOTOMIA Y COLOCACION DE PROTESIS ORTOPEDICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

490 16-715 LIBERACION DE CANAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

491 16-801 HUMERO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

492 16-802 CODO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

493 16-803 ANTEBRAZO 720.00 936.00 1,217.00 1,755.00 2,484.00 3,311.00

494 16-804 MANO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

495 16-805 COLUMNA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

496 16-806 PROTESIS DACTILAR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

497 16-901 HUMERO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

498 16-902 CODO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

499 16-903 ANTEBRAZO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

500 16-904 MANO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

501 16-905 DEDO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

502 16-906 CADERA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

503 16-907 FEMUR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

504 16-908 RODILLA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

505 16-909 TIBIA Y/O PERONE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

506 16-910 PIE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

507 16-911 COLUMNA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

508 16-912 VENDAS DE YESO C/U (REPOSICION) 29.00 38.00 49.00 64.00 83.00 108.00

509 16-913 TOBILLO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

510 17-101 HERNIOPLASTIA INGUINAL SIMPLE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

511 17-102 HERNIOPLASTIA INGUINAL DOBLE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

512 17-103 HERNIOPLASTIA UMBILICAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00



VERSIÓN 2009


513 17-104 HERNIOPLASTIA DIAFRAGMATICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

514 17-105 PILOROTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

515 17-106 DESINVAGINACION DEL INTESTINO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

516 17-107 INTERVENCION DEL INTESTINO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

517 17-108 INTERVENCIONES ESPLENICAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

518 17-109 INTERVENCIONES HEPATICAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

519 17-110 INTERVENCIONES BILIARES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

520 17-111 ATRESIAS DE INTESTINO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

521 17-112 ESPLENECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

522 17-113 ANASTOMOSIS DE HIGADO. RIÑON Y T. DIGESTIVO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

523 17-114 ATRESIA DE ESOFAGO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

524 17-115 TUMORECTOMIAS ABDOMINALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

525 17-116 ATRESIA RECTAL ALTA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

526 17-117 ATRESIA RECTAL BAJA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

527 17-118 COLOSTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

528 17-119 DESCENSO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

529 17-120 ANO CUBIERTO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

530 17-121 ANO HUMEDO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

531 17-122 OCLUSION INTESTINAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

532 17-123 QUISTE IDEOPATICO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

533 17-124 PERFORACION DE INTESTINO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

534 17-125 ADHERENCIAS INTESTINALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

535 17-126 ABSCESO RESIDUAL DE PARED ABDOMINAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

536 17-127 QUISTE TIROGLOSO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

537 17-128 MIECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

538 17-129 EVENTRACIONES. BRIDAS. RESECCION 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

539 17-130 EXONFALOS SIMPLES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

540 17-131 EXONFALOS EN DOS TIEMPOS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

541 17-132 ESTENOSIS URETERO PIELICA UNILATERAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

542 17-133 ESTENOSIS URETERO PIELICA BILATERAL: PLASTIA BILATERAL 720.00 936.00 1,453.00 1,744.00 2,326.00 1,906.00

543 17-134 FISTULA BRANQUIAL (RESECCION DE FISTULA) 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

544 17-135 FRENILLO LINGUAL CORTO: FRENILECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00



VERSIÓN 2009


545 17-136 HIPOSPADIAS: PLASTIA DE URETRA PENEANA 384.00 499.00 649.00 1,422.00 1,896.00 2,370.00

546 17-137 DESINVAGINACION POR TAXIS 384.00 499.00 649.00 1,137.00 1,517.00 1,896.00

547 17-138 FISTULA RECTO URINARIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

548 17-201 CIERRE DE C.I.V. 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

549 17-202 CORRECCION TRANSPOSICION DE GRANDES VASOS TGV 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

550 17-227 CORRECCION TOTAL DEL CANAL A.V. 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

551 17-403 PLASTIA DE MENINGOCELE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

552 17-404 PLASTIA DE MENINGOCELE CRANEANO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

553 17-405 MURCELACION 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

554 17-406 CRANEOPLASTIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

555 17-407 CRENEOTOMIA O CRANIECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

556 17-408 DERIVACION DE LIQUIDO CEFALORRAQUIDEO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

557 17-409 COLOCACION DE RESERVORIO DE OMAYA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

558 17-410 COLOCACION DE DERIV VENTRICULAR PERITON 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

559 17-501 DIALISIS PERITONEAL CON EQUIPO 458.00 641.00 850.00 1,678.00 2,440.00 3,202.00

560 17-502 DIALISIS PERITONEAL SIN EQUIPO 266.00 372.00 638.00 793.00 1,449.00 2,105.00

561 17-503 HEMODIALIS CON EQUIPO 458.00 641.00 850.00 1,678.00 2,440.00 3,202.00

562 17-504 HEMODIALIS SIN EQUIPO 266.00 372.00 638.00 793.00 1,449.00 2,105.00

563 17-505 BIOPSIA RENAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

564 17-506 TRASPLANTE DE RIÑON-RECEPTOR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

565 17-507 TRASPLANTE DE RIÑON-DONADOR 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

566 17-508 ORQUIDOPEXIA UNILATERAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

567 17-509 ORQUIDOPEXIA BILATERAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

568 17-510 CIRCUNCISION CON PLASTIBEL Y ANESTESIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

569 17-511 CICATRIZ FIBROSA DEL PREPUCIO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

570 17-512 CORRECCION DE HIPOSPADIAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

571 17-513 REFLUJO VESICOURETRAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

572 17-514 REIMPLANTE DE URETEROS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

573 17-515 VALVAS POSTERIORES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

574 17-516 TUMORES DE VEJIGA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

575 17-601 CIRCUNCISION 384.00 499.00 649.00 844.00 1,270.00 2,069.00

576 17-701 DIA INCUBADORA 35.00 41.00 53.00 69.00 90.00 97.00



VERSIÓN 2009


577 17-702 HOSPITALIZACION DIA ESTANCIA EN TERAPIA INTENSIVA 534.00 694.00 902.00 1,173.00 1,525.00 1,982.00

578 17-703 DIA ESTANCIA EN CRECIMIENTO Y DESARROLLO 153.00 198.00 258.00 336.00 436.00 568.00

579 17-704 DIA ESTANCIA EN TERAPIA INTERMEDIA 305.00 396.00 515.00 670.00 871.00 1,132.00

580 17-705 DIA ESTANCIA EN TERAPIA INTENSIVA( NEONATOS) 534.00 694.00 902.00 1,173.00 1,525.00 1,982.00

581 17-706 VENTILACION MECANICA (POR DIA) 254.00 330.00 429.00 558.00 725.00 943.00

582 17-707 NUTRICION PARENTERAL POR DIA,NEONATOS 183.00 237.00 309.00 402.00 522.00 679.00

583 17-708 ASPIRACION DE SECRECIONES 95.00 95.00 95.00 95.00 95.00 95.00

584 17-709 FOTOTERAPIA POR DIA 48.00 48.00 48.00 48.00 48.00 48.00

585 17-710 FOTOTERAPIA POR 1 HORA 10.00 10.00 10.00 10.00 10.00 10.00

586 17-711 INTUBACION 63.00 63.00 63.00 63.00 63.00 63.00

587 17-712 USO MONITOR APNEA POR DIA 31.00 31.00 31.00 31.00 31.00 31.00

588 17-713 USO DE MONITOR NEONATAL 79.00 79.00 79.00 79.00 79.00 79.00

589 17-714 COLOCACION DE CATETER DE ONFALOCLISIS 206.00 267.00 348.00 452.00 518.00 764.00

590 17-715 PREPARACION ALIMENTACION PARENTERAL 48.00 48.00 48.00 48.00 48.00 48.00

591 18-001 HEMORROIDECTOMIAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

592 18-002 EXTIRPACION DE TUMORES BENIGNOS DE ANO O RECTO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

593 18-003 PROLAPSO RECTAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00


595 18-005 COLECISTECTOMIA CON CANALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

596 18-006 GASTRECTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

597 18-007 HERNIAS DIAFRAGMATICAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

598 18-008 GASTROTOMIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

599 18-009 HEMICOLECTOMIAS O COLECTOMIAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

600 18-010 RESECCION ABDOMINO PERINEAL 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

601 18-011 TRANSPOSICION DE COLON 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

602 18-012 LAPAROTOMIA EXPLORADORA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

603 18-013 RESECCIONES INTESTINALES 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

604 18-014 COLOSTOMIA O CIERRE 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

605 18-015 BIOPSIA HEPATICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

606 18-016 RECTOSIGMOIDOSCOPIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

607 18-017 GASTROSCOPIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

608 18-018 PANENDOSCOPIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00



VERSIÓN 2009


609 18-019 COLONOSCOPIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

610 18-020 CIRUGIA MENOR DE ESOFAGO 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

611 18-021 ESCLEROSIS DE VARICES POR SESION 384.00 499.00 649.00 844.00 1,097.00 1,426.00

612 18-022 DILATACIONES ESOFAGICAS POR SESION 384.00 499.00 649.00 844.00 1,097.00 1,426.00

613 18-023 CIRUGIA MENOR DE RECTO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

614 18-024 CURACIONES PROCTOLOGICAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

615 18-025 CURACIONES ESOFAGICAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

616 18-026 PERITONEOSCOPIAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

617 18-027 CUERPOS EXTRAÑOS EN ESOFAGO Y RECTO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

618 18-028 PERFIL RECTAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

619 18-029 CIRUGIA DE PANCREAS 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

620 18-030 ABDOMEN AGUDO POR PERFORACION DE VISCERA HUECA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

621 18-031 ENDOSCOPIA 700.00 910.00 1,183.00 1,538.00 1,999.00 2,599.00

622 18-032 PILOROPLASTIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

623 18-033 ANOPLASTIA PERINEAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

624 18-034 RECTONECTOMIA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

625 18-035 PLASTIA LOCAL COLESISTECTOMIA LAPAROSCOPICA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

626 18-036 COLECTOMIA (RESECCION DE COLON) 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

627 18-037 APENDICECTOMIA POR LAPAROSCOPIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00

628 18-038 COLESISTECTOMIA POR LAPAROSCOPIA 720.00 936.00 1,217.00 1,582.00 2,056.00 2,673.00


630 18-102 LAPARATOMIA EXPLORADORA 720.00 936.00 1,217.00 1,609.00 2,919.00 4,833.00

631 19-101 BACTERIOLOGIA EN FRESCO 15.00 20.00 25.00 33.00 43.00 56.00

632 19-102 BACTERIOLOGIA FROTIS Y TINCION 15.00 20.00 25.00 33.00 43.00 56.00

633 19-103 SEROTIPIFICACIONES 15.00 20.00 25.00 33.00 43.00 56.00

634 19-104 INVESTIGACION DE PLASMODIUM 15.00 20.00 25.00 33.00 43.00 56.00

635 19-105 CULTIVOS EN GENERAL 120.00 130.00 140.00 150.00 160.00 170.00

636 19-106 CULTIVOS DE LIQUIDOS 120.00 130.00 140.00 150.00 160.00 170.00

637 19-201 ESTUDIO DE L.C.R. 80.00 104.00 135.00 176.00 228.00 297.00

638 19-202 ESTUDIO DE L. ASCITIS 80.00 104.00 135.00 176.00 228.00 297.00

639 19-203 ESTUDIO DE L.PERITONEAL 80.00 104.00 135.00 176.00 228.00 297.00

640 19-204 ESTUDIO DE L. SINOVIAL 80.00 104.00 135.00 176.00 228.00 297.00



VERSIÓN 2009


641 19-205 REACCIONES FEBRILES EN PLACA 20.00 26.00 34.00 44.00 57.00 74.00

642 19-206 V.D.R.L. CUANTITATIVO 30.00 39.00 51.00 66.00 86.00 111.00

643 19-207 V.D.R.L. CUALITATIVO (NO SE COBRA, PROGRAMAS DE SSN) 15.00 20.00 25.00 33.00 43.00 56.00

644 19-208 EOSINOFILOS EN MOCO NASAL 12.00 16.00 20.00 26.00 34.00 45.00

645 19-209 EOSINOFILOS EN ESPUTO 12.00 16.00 20.00 26.00 34.00 45.00

646 19-210 ANTIESTREPTOLISINAS 35.00 46.00 59.00 77.00 100.00 130.00

647 19-211 PROTEINAS C-REACTIVAS 35.00 46.00 59.00 77.00 100.00 130.00

648 19-212 FACTOR REUMATOIDE (P. LATEX R.F.) 35.00 46.00 59.00 77.00 100.00 130.00

649 19-213 COOMBS DIRECTO 20.00 26.00 34.00 44.00 57.00 74.00

650 19-214 COOMBS INDIRECTO 20.00 26.00 34.00 44.00 57.00 74.00

651 19-301 GLUCOSA 15.00 20.00 25.00 33.00 43.00 56.00

652 19-302 GLUCOSA PRE Y POSTPANDRIAL 25.00 33.00 42.00 55.00 71.00 93.00

653 19-303 CURVA DE TOLERANCIA A LA GLUCOSA 3 HORAS 60.00 78.00 101.00 132.00 171.00 223.00

654 19-304 UREA 15.00 20.00 25.00 33.00 43.00 56.00

655 19-305 NITROGENO UREA 15.00 20.00 25.00 33.00 43.00 56.00

656 19-306 CREATININA 15.00 20.00 25.00 33.00 43.00 56.00

657 19-307 AC. URICO SERICO 15.00 20.00 25.00 33.00 43.00 56.00

658 19-308 BILIRRUBINAS (DIRECTA E INDIRECTA) 30.00 39.00 51.00 66.00 86.00 111.00

659 19-309 PROTEINAS TOTALES 15.00 20.00 25.00 33.00 43.00 56.00

660 19-310 ALBUMINA 15.00 20.00 25.00 33.00 43.00 56.00

661 19-311 GLOBULINAS 15.00 20.00 25.00 33.00 43.00 56.00

662 19-312 COLESTEROL TOTAL 15.00 20.00 25.00 33.00 43.00 56.00

663 19-313 DEP. CREATININA ENDOGENA 55.00 72.00 93.00 121.00 157.00 204.00

664 19-401 T.G.O. 23.00 30.00 39.00 51.00 66.00 85.00

665 19-402 T.G.P. 23.00 30.00 39.00 51.00 66.00 85.00

666 19-403 F. ALCALINA FA 23.00 30.00 39.00 51.00 66.00 85.00

667 19-404 F.ACIDA 0.00 0.00 0.00 0.00 0.00 0.00

668 19-405 D.H.L. 20.00 26.00 34.00 44.00 57.00 74.00

669 19-406 AMILASA SERICA O URINARIA 20.00 26.00 34.00 44.00 57.00 74.00

670 19-407 LIPASA 20.00 26.00 34.00 44.00 57.00 74.00

671 19-408 C.P.K. 20.00 26.00 34.00 44.00 57.00 74.00

672 19-409 DETERMINACION DE CREATINA CINASA FRACCION MB CPK MB 20.00 26.00 34.00 44.00 57.00 74.00



VERSIÓN 2009


673 19-410 F. AC. FRACCION PROSTATICA 0.00 0.00 0.00 0.00 0.00 0.00

674 19-601 ELECTROLITOS SERICOS (SODIO,POTACIO,CLORO) 15.00 20.00 25.00 33.00 43.00 56.00

675 19-602 GASOMETRIA (ARTERIAL O VENOSA) 70.00 91.00 118.00 154.00 200.00 260.00

676 19-603 MAGNESIO 20.00 26.00 34.00 44.00 57.00 74.00

677 19-604 FOSFORO 20.00 26.00 34.00 44.00 57.00 74.00

678 19-605 CALCIO 20.00 26.00 34.00 44.00 57.00 74.00

679 19-701 COLESTEROL TOTAL 15.00 20.00 25.00 33.00 43.00 56.00

680 19-702 TRIGLICERIDOS 15.00 20.00 25.00 33.00 43.00 56.00

681 19-703 H.D.L.COLESTEROL(ALFA, BETA Y PREBETA LIPOPR.) 20.00 26.00 34.00 44.00 57.00 74.00

682 19-801 FRACCION B GONADOTROPINA 18.00 23.00 30.00 40.00 51.00 67.00

683 19-901 PROTEINAS 20.00 26.00 34.00 44.00 57.00 74.00

684 19-902 GENERAL DE ORINA 13.00 17.00 22.00 29.00 37.00 48.00

685 19-903 PRUEBA DE EMBARAZO (GRAVINDEX, PIE) 25.00 33.00 42.00 55.00 71.00 93.00

686 20-001 EX. COPROPARASITOSCOPICO EN SERIE 20.00 26.00 34.00 44.00 57.00 74.00

687 20-002 INVESTIGACION ENTEROBIOS 10.00 13.00 17.00 22.00 29.00 37.00

688 20-003 INVESTIGACION TROFOZOITOS 10.00 13.00 17.00 22.00 29.00 37.00

689 20-004 SANGRE OCULTA EN HECES 30.00 39.00 51.00 66.00 86.00 111.00

690 20-005 EXAMEN COPROLOGICO 40.00 52.00 68.00 88.00 114.00 149.00

691 20-006 AMEBA EN FRESCO 10.00 13.00 17.00 22.00 29.00 37.00

692 20-007 INVESTIGACION DE HEMATOZOARIOS 10.00 13.00 17.00 22.00 29.00 37.00

693 20-008 FROTIS DE MOCO FECAL 10.00 13.00 17.00 22.00 29.00 37.00

694 20-101 BIOMETRIA HEMATICA (BH CON PLAQUETAS) 20.00 26.00 34.00 44.00 57.00 74.00

695 20-102 RECUENTO DE PLAQUETAS 20.00 26.00 34.00 44.00 57.00 74.00

696 20-103 RECUENTO DE RETICULOCITOS RETIS 20.00 26.00 34.00 44.00 57.00 74.00

697 20-104 VELOCIDAD SEDIMENTACION GLOBULAR (VSG) 25.00 33.00 42.00 55.00 71.00 93.00

698 20-105 PRUEBAS CRUZADAS 20.00 26.00 34.00 44.00 57.00 74.00

699 20-106 DETERMINACION DE GRUPO SANGUINEO Y FACTOR RH 20.00 26.00 34.00 44.00 57.00 74.00

700 20-107 TIEMPOS DE COAGULACION (TP Y TPT) 40.00 52.00 68.00 88.00 114.00 149.00

701 20-108 TIEMPO DE TROMBOPLASTINA PARCIAL ACT. (TIPA) 25.00 33.00 42.00 55.00 71.00 93.00

702 20-109 TIEMPO DE SANGRADO 20.00 26.00 34.00 44.00 57.00 74.00

703 20-110 TIEMPOS DE COAGULACION (TC) 20.00 26.00 34.00 44.00 57.00 74.00

704 20-111 TIEMPOS DE COAGULACION PLASMA RECALCI 20.00 26.00 34.00 44.00 57.00 74.00



VERSIÓN 2009


705 20-112 TIEMPO DE PROTOMBINA 25.00 33.00 42.00 55.00 71.00 93.00

706 20-113 TIEMPO PARCIAL DE TROMBOPLASTINA 25.00 33.00 42.00 55.00 71.00 93.00

707 20-114 TIEMPO DE TROMBINA 25.00 33.00 42.00 55.00 71.00 93.00

708 20-115 CONSUMO DE PROTOMBINA 25.00 33.00 42.00 55.00 71.00 93.00

709 20-116 REACCION DEL COAGULO 20.00 26.00 34.00 44.00 57.00 74.00

710 20-117 FIBRINOGENO 30.00 39.00 51.00 66.00 86.00 111.00

711 20-201 QUIMICA SANGUINEA III (GLUCOSA, UREA, CREATININA) 45.00 59.00 76.00 99.00 129.00 167.00

712 20-202 PERFIL DE LIPIDOS (PL) 60.00 78.00 101.00 132.00 171.00 223.00

713 20-203 ESTUDIO UNIDAD DE SANGRE 100.00 130.00 169.00 220.00 286.00 371.00

714 20-204 PERFIL HEPATICO 100.00 130.00 169.00 220.00 286.00 371.00

715 20-205 PERFIL QUIRURGICO (BH,GPO. SANGUINEO, TP Y TPT) 100.00 130.00 169.00 220.00 286.00 371.00

716 20-206 PERFIL PRENATAL (BH, QS, VDRL, GPO) 100.00 130.00 169.00 220.00 286.00 371.00

717 20-207 PAQUETE GASOMETRIA NEONATAL (X DIA) 100.00 130.00 169.00 220.00 286.00 371.00

718 20-208 MOICROPROTEINAS EN LIQUIDOS 20.00 26.00 34.00 44.00 57.00 74.00

719 20-209 HEMOGLOBINA GLICOSILADA 100.00 130.00 169.00 220.00 286.00 371.00

720 20-210 PERFIL DE DROGAS DE ABUSO EN ORINA (6 DET) 200.00 260.00 338.00 439.00 571.00 743.00

721 20-211 ANTIGENOS CAPSULARES EN LCR 350.00 455.00 592.00 769.00 1,000.00 1,300.00

722 20-212 ANTIGENOS PROSTATICOS (PSA) 100.00 130.00 169.00 220.00 286.00 371.00

723 20-213 T.3 TRIYODOTIRONINA TOTAL 70.00 91.00 118.00 154.00 200.00 260.00

724 20-214 T.3 LIBRE 70.00 91.00 118.00 154.00 200.00 260.00

725 20-215 T.4 TIROXINA TOTAL 70.00 91.00 118.00 154.00 200.00 260.00

726 20-216 T.4 LIBRE 70.00 91.00 118.00 154.00 200.00 260.00

727 20-217 TU CAPCION 70.00 91.00 118.00 154.00 200.00 260.00

728 20-218 TSH (HORMONA ESTIMULANTE DE TIROIDES) 70.00 91.00 118.00 154.00 200.00 260.00

729 20-219 HGC (SUB UNIDAD ßHGC CUANTITATIVA) 80.00 104.00 135.00 176.00 228.00 297.00

730 20-220 PERFIL TIROIDEO 200.00 260.00 338.00 439.00 571.00 743.00

731 20-221 HEMOCULTIVO 150.00 195.00 254.00 330.00 428.00 557.00

732 30-001 TELETERAPIA ACELERADOR LINEAL POR SESION 44.00 84.00 163.00 287.00 510.00 806.00

733 30-002 SIMULACION Y LOCALIZACION CON TAC ERA. D 132.00 255.00 450.00 873.00 1,555.00 2,444.00

734 30-003 MARCACION DEL GTV Y ORGANOS DE RIESGOS 500.00 1,250.00 2,000.00 2,500.00 3,000.00 3,500.00

735 30-004 PLANEACION SOBRE TAC EN 3 D POR EL DEPARTAMENTO DE FISICA 500.00 1,250.00 2,000.00 2,500.00 3,000.00 3,500.00

736 30-005 BRAQUITERAPIA MANUAL (HOSP.72-120 HRS) 485.00 930.00 1,805.00 2,365.00 3,098.00 8,967.00



VERSIÓN 2009


737 30-006 BRAQUITERAPIA CON SELECTRON (2-4 HRS) 485.00 930.00 1,805.00 2,365.00 3,098.00 8,967.00

738 30-007 TERAPIA SUPERFICIAL 33.00 65.00 125.00 221.00 394.00 627.00

739 30-008 MOLDE DE RADIOTERAPIA POR REGION 71.00 141.00 353.00 748.00 1,059.00 1,200.00

740 30-009 COLOCACION DE SONDA DE BRAQUITERAPIA (COLPOSTATO) 2.00 5.00 10.00 26.00 37.00 42.00

741 30-010 QUIMIOTERAPIA (INTRAVENOSA O INTRA-ARTERIAL) 25.00 46.00 90.00 159.00 283.00 448.00

742 30-011 ADIESTRAMIENTO PARA USUARIO DE CATETER 11.00 31.00 56.00 118.00 167.00 189.00

743 30-012 RETIRO DE CATETER 10.00 29.00 51.00 108.00 153.00 173.00

744 30-013 CURACION PARA PERMEABILIZAR CATETER OBSTRUIDO 4.00 8.00 18.00 37.00 47.00 53.00

745 30-014 APLICACION DE HEPARINA A CATETER CENTRAL 4.00 8.00 18.00 37.00 47.00 53.00

746 30-015 PREPARACION DE INFUSOR 4.00 7.00 17.00 36.00 50.00 57.00

747 30-016 QUIMIOTERAPIA(INTRAVENOSAOINTRA-ARTERIAL) 46.00 90.00 159.00 283.00 448.00 672.00

748 30-017 APLICACION QUIMIOTERAPIA INTRATECAL EN RESERVORIO 79.00 167.00 236.00 268.00 315.00 394.00

749 30-018 ADIESTRAMIENTO PARA USUARIO DE CATETER 31.00 56.00 118.00 167.00 189.00 278.00

750 30-019 RETIRO DE CATETER 29.00 51.00 108.00 153.00 173.00 255.00

751 30-020 CURACION PARA PERMEABILIZAR CATETER OBSTRUIDO 8.00 18.00 37.00 47.00 53.00 75.00

752 30-021 APLICACION DE HEPARINA A CATETER CENTRAL 8.00 18.00 37.00 47.00 53.00 75.00

753 30-022 PREPARACION DE INFUSOR 7.00 17.00 36.00 50.00 57.00 84.00

754 30-023 ESTUDIO CLINICO PREVENTIVO 97.00 187.00 362.00 642.00 1,132.00 1,793.00

755 30-101 TODOS LOS GAMAGRAMAS 25.00 49.00 95.00 168.00 298.00 470.00

756 30-102 PERFIL TIROIDEO 125.00 237.00 460.00 814.00 1,442.00 2,286.00

757 30-103 PERFIL GINECOLOGICO 125.00 237.00 460.00 814.00 1,442.00 2,286.00

758 30-104 PERFIL PARATIROIDEO 93.00 177.00 342.00 606.00 1,073.00 1,705.00

759 30-105 PERFIL SUPRARENAL 93.00 177.00 342.00 606.00 1,073.00 1,705.00

760 30-106 PERFIL ONCOLOGICO 89.00 168.00 326.00 577.00 1,019.00 1,612.00

761 30-107 OSEO 95.00 178.00 362.00 642.00 1,132.00 1,793.00

762 30-108 PANCREAS 174.00 335.00 649.00 1,150.00 2,036.00 3,229.00

763 30-109 PULMON 169.00 327.00 631.00 1,118.00 1,978.00 3,137.00

764 30-110 UTERO 97.00 187.00 362.00 642.00 1,132.00 1,793.00

765 30-111 VENOSO 97.00 187.00 362.00 642.00 1,132.00 1,793.00

766 30-112 RASTREO 147.00 285.00 548.00 977.00 1,737.00 2,728.00

767 30-113 TRATAMIENTO 204.00 391.00 759.00 1,342.00 2,375.00 3,766.00

768 30-114 MIELOGRAMA 16.00 31.00 60.00 108.00 193.00 308.00



VERSIÓN 2009


769 30-115 ESPLENOGRAMA 8.00 14.00 25.00 44.00 80.00 133.00

770 30-116 ADENOGRAMA 5.00 6.00 10.00 18.00 29.00 46.00

771 30-117 ASPIRADO E INTERPRETACION DE MEDULA OSEA 8.00 14.00 25.00 44.00 80.00 133.00

772 30-118 ESOFAGOGRAFIA 59.00 115.00 223.00 402.00 723.00 1,153.00

773 30-119 NEUMOPERITONEO 43.00 79.00 154.00 278.00 499.00 791.00

774 30-201 B. TORAX P.A. 100.00 120.00 144.00 173.00 207.00 249.00

775 30-202 COSTILLAS O ESTERNON (TORAX OSEO) 90.00 117.00 152.00 198.00 257.00 334.00

776 30-203 COLUMNA VERTEBRAL CERVICAL 80.00 104.00 135.00 176.00 228.00 297.00

777 30-204 COLUMNA VERTEBRAL DORSAL 100.00 130.00 169.00 220.00 286.00 371.00

778 30-205 COLUMNA VERTEBRAL LUMBOSACRA 100.00 130.00 169.00 220.00 286.00 371.00

779 30-206 COLUMNA VERTEBRAL ESTUDIO DINAMICO 350.00 455.00 592.00 769.00 1,000.00 1,300.00

780 30-207 PELVIS A.P. 100.00 120.00 144.00 173.00 207.00 249.00

781 30-208 CRANEO (LATERAL AP) 100.00 130.00 169.00 220.00 286.00 371.00

782 30-209 CRANEO (AP Y TOWNE) 100.00 130.00 169.00 220.00 286.00 371.00

783 30-210 MACIZO FACIAL 80.00 104.00 135.00 176.00 228.00 297.00

784 30-211 HUESOS PROPIOS DE LA NARIZ PERFILOGRAMA 80.00 104.00 135.00 176.00 228.00 297.00

785 30-212 ORBITAS POR PLACA 80.00 104.00 135.00 176.00 228.00 297.00

786 30-213 SENOS PARANASALES 110.00 143.00 186.00 242.00 314.00 408.00

787 30-214 ARTICULACIONES TEMPOROMANDIBULARES 100.00 130.00 169.00 220.00 286.00 371.00

788 30-215 SILLA TURCA 80.00 104.00 135.00 176.00 228.00 297.00

789 30-216 OIDOS SCHULLER 80.00 104.00 135.00 176.00 228.00 297.00

790 30-217 MASTOIDES CONVENCIONAL 80.00 104.00 135.00 176.00 228.00 297.00

791 30-218 CONDUCTOS AUDITIVOS 80.00 104.00 135.00 176.00 228.00 297.00

792 30-219 MANDIBULA DOS POSICIONES 80.00 104.00 135.00 176.00 228.00 297.00

793 30-220 LATERAL DE CUELLO 80.00 104.00 135.00 176.00 228.00 297.00

794 30-221 LARINGE 80.00 104.00 135.00 176.00 228.00 297.00

795 30-222 CUELLO A.P. Y LATERAL PARTES BLANDAS 110.00 143.00 186.00 242.00 314.00 408.00

796 30-223 MANO 70.00 84.00 101.00 121.00 145.00 174.00

797 30-224 MANOS COMPARATIVAS 120.00 156.00 203.00 264.00 343.00 446.00

798 30-225 MUÑECA, ESCAFOIDES Y CARPO 70.00 91.00 118.00 154.00 200.00 260.00

799 30-226 CODO 70.00 91.00 118.00 154.00 200.00 260.00

800 30-227 CODO COMPARATIVO 130.00 169.00 220.00 286.00 371.00 483.00



VERSIÓN 2009


801 30-228 HUMERO 70.00 91.00 118.00 154.00 200.00 260.00

802 30-229 HUMEROS COMPARATIVOS 130.00 169.00 220.00 286.00 371.00 483.00

803 30-230 HOMBRO 70.00 91.00 118.00 154.00 200.00 260.00

804 30-231 HOMBROS COMPARATIVOS 130.00 169.00 220.00 286.00 371.00 483.00

805 30-232 CLAVICULA 70.00 91.00 118.00 154.00 200.00 260.00

806 30-233 CLAVICULA COMPARADA 130.00 169.00 220.00 286.00 371.00 483.00

807 30-234 OMOPLATO 70.00 91.00 118.00 154.00 200.00 260.00

808 30-235 OMOPLATO COMPARATIVO 130.00 169.00 220.00 286.00 371.00 483.00

809 30-236 PIE 70.00 91.00 118.00 154.00 200.00 260.00

810 30-237 TOBILLO 70.00 91.00 118.00 154.00 200.00 260.00

811 30-238 TOBILLO COMPARATIVO 130.00 169.00 220.00 286.00 371.00 483.00

812 30-239 PIERNA 90.00 117.00 152.00 198.00 257.00 334.00

813 30-240 RODILLA 70.00 91.00 118.00 154.00 200.00 260.00

814 30-241 ROTULA 70.00 91.00 118.00 154.00 200.00 260.00

815 30-242 RODILLAS COMPARATIVAS 130.00 169.00 220.00 286.00 371.00 483.00

816 30-243 FEMUR A.P. 90.00 117.00 152.00 198.00 257.00 334.00

817 30-244 FEMUR A.P. V.L. 150.00 195.00 254.00 330.00 428.00 557.00

818 30-245 FEMUR COMPARATIVO 150.00 195.00 254.00 330.00 428.00 557.00

819 30-246 EDAD OSEA 150.00 195.00 254.00 330.00 428.00 557.00

820 30-247 ABDOMEN SIMPLE 100.00 130.00 169.00 220.00 286.00 371.00

821 30-248 CEFALO PELVIMETRIA 120.00 156.00 203.00 264.00 343.00 446.00

822 30-301 MAMOGRAFIA 200.00 225.00 250.00 275.00 300.00 350.00

823 30-302 UROGRAFIA EXCRETORA ADULTO SIN CONTRASTE 200.00 260.00 338.00 439.00 571.00 743.00

824 30-303 UROGRAFIA EXCRETORA INFANTIL SIN CONTRASTE 200.00 260.00 338.00 439.00 571.00 743.00

825 30-304 COLANGIO POR SONDA 300.00 390.00 507.00 659.00 857.00 1,114.00

826 30-305 COLON POR ENEMA SIN CONTRASTE 300.00 390.00 507.00 659.00 857.00 1,114.00

827 30-306 SERIE ESOFAGO GASTRODUODENAL SIN CONTRASTE 300.00 390.00 507.00 659.00 857.00 1,114.00

828 30-307 TRANSITO INTESTINAL 670.00 871.00 1,132.00 1,472.00 1,914.00 2,488.00

829 30-308 TRANSITO INTESTINAL CON SERIE ESOF. GASTRODUOD 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

830 30-309 SERIE CARDIACA 200.00 68.00 133.00 242.00 444.00 680.00

831 30-310 MARCAJE 400.00 650.00 800.00 1,000.00 1,300.00 2,000.00

832 30-311 MAMMOTOME 1,100.00 1,210.00 1,331.00 1,464.00 1,611.00 1,772.00



VERSIÓN 2009


833 30-312 BAFF 1,100.00 1,210.00 1,331.00 1,464.00 1,611.00 1,772.00

834 30-313 TRU-CUT 1,100.00 1,210.00 1,331.00 1,464.00 1,611.00 1,772.00

835 30-314 FLUROSCOPIA 400.00 440.00 484.00 532.00 586.00 644.00

836 30-315 ARCO EN C 150.00 250.00 500.00 1,000.00 1,500.00 2,500.00

837 30-501 ULTRASONIDO MAMARIO 150.00 200.00 225.00 275.00 300.00 350.00

838 30-502 SONOGRAFIA DOPLER 300.00 360.00 430.00 520.00 620.00 750.00

839 30-503 SONOGRAMA MUSCULAR 200.00 225.00 300.00 400.00 475.00 525.00

840 30-504 SONOGRAMA CON TRANSDUCTOR INTRACAVITARIO 250.00 300.00 350.00 425.00 475.00 525.00

841 30-505 TOMOGRAFIA DE CRANEO SIMPLE Y CON CONTRASTE 975.00 1,070.00 1,180.00 1,300.00 1,500.00 1,750.00

842 30-506 TOMOGRAFIA CRANEO FACIAL 3D 1,450.00 1,700.00 1,900.00 2,200.00 2,450.00 2,700.00

843 30-507 TOMOGRAFIAS CORPORALES DE UNA REGION 1,150.00 1,250.00 1,350.00 1,450.00 1,550.00 1,750.00

844 30-508 TOMOGRAFIA CORPORAL DOS REGIONES 1,500.00 1,700.00 1,900.00 2,100.00 2,300.00 2,500.00

845 30-509 TOMOGRAFIA CORPORAL DE TRES REGIONES 1,900.00 2,100.00 2,250.00 2,450.00 2,650.00 3,000.00

846 30-510 TOMOGRAFIA ESPECIALES (ANGIO TC-3D-COLON TC, ETC) 3,000.00 3,500.00 4,000.00 5,000.00 5,500.00 6,000.00

847 30-511 SENOS PARANASALES CON TOMOGRAFIA 0.00 0.00 0.00 0.00 0.00 0.00

848 31-001 APENDICE CECCOL. VESICULA BILIAR 120.00 156.00 203.00 264.00 343.00 446.00

849 31-002 TUMORES BENIGNOS DE MAMA (PIEZA MAYOR) 200.00 260.00 338.00 439.00 571.00 743.00

850 31-003 RESECCIONES INTESTINALES SIN TUMOR 300.00 390.00 507.00 659.00 857.00 1,114.00

851 31-004 RESECCIONES INTESTINALES CON TUMOR 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

852 31-005 TUMORES DE GLANDULAS SALIVALES S/DISECCION 350.00 455.00 592.00 769.00 1,000.00 1,300.00

853 31-006 TUMORES DE GLANDULAS SALIVALES C/DISECCION 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

854 31-007 ESTOMAGO SIN TUMOR PARCIAL 300.00 390.00 507.00 659.00 857.00 1,114.00

855 31-008 ESTOMAGO CON TUMOR 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

856 31-009 SEGMENTOS O LOBULOS PULMONARES POR TUMOR 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

857 31-010 PROSTATA TRANSRECTAL 120.00 156.00 203.00 264.00 343.00 446.00

858 31-011 PROSTATA RTU 250.00 325.00 423.00 549.00 714.00 928.00

859 31-012 PROSTATECTOMIA 300.00 390.00 507.00 659.00 857.00 1,114.00

860 31-013 PROSTATECTOMIA RADICAL 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

861 31-014 RIÑON SIN TUMOR 300.00 390.00 507.00 659.00 857.00 1,114.00

862 31-015 RIÑON CON TUMOR 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

863 31-016 TESTICULOS SIN TUMOR 300.00 390.00 507.00 659.00 857.00 1,114.00

864 31-017 TESTICULOS CON TUMOR 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00



VERSIÓN 2009


865 31-018 TUMORES RETROPERITONEALES 300.00 390.00 507.00 659.00 857.00 1,114.00

866 31-019 EXTREMIDADES POR TUMOR 400.00 520.00 676.00 879.00 1,142.00 1,485.00

867 31-020 AMIGDALAS 200.00 260.00 338.00 439.00 571.00 743.00

868 31-021 GANGLIO LINFATICO 200.00 260.00 338.00 439.00 571.00 743.00

869 31-022 MEDULA OSEA 200.00 260.00 338.00 439.00 571.00 743.00

870 31-023 BAZO 200.00 260.00 338.00 439.00 571.00 743.00

871 31-024 LARINGE SIN DISECCION DE CUELLO 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

872 31-025 LARINGE CON DISECCION DE CUELLO 650.00 845.00 1,099.00 1,428.00 1,856.00 2,413.00

873 31-026 TIROIDES SIN DISECCION DE CUELLO 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

874 31-027 TIROIDES CON DISECCION DE CUELLO 650.00 845.00 1,099.00 1,428.00 1,856.00 2,413.00

875 31-028 REVISION DE LAMINILLAS DE 1 A 3, MAS $30.00 POR LAMINILLA EXTRA 200.00 260.00 338.00 439.00 571.00 743.00

876 31-029 BIOPSIA POR SACA-BOCADO DE PIEL (PUNCH) 120.00 156.00 203.00 264.00 343.00 446.00

877 31-030 BIOPSIA INCISIONAL DE PIEL 150.00 195.00 254.00 330.00 428.00 557.00

878 31-031 BIOPSIA PARA RASURADO DE PIEL 120.00 156.00 203.00 264.00 343.00 446.00

879 31-032 BIOPSIA POR CORETAJE DE PIEL 120.00 156.00 203.00 264.00 343.00 446.00

880 31-033 PIEZA QUIRURGICA DE PIEL 300.00 390.00 507.00 659.00 857.00 1,114.00

881 31-034 ESPECTORACION DE 1 SERIE 100.00 130.00 169.00 220.00 286.00 371.00

882 31-035 ESPECTORACION DE 3 SERIE 150.00 195.00 254.00 330.00 428.00 557.00

883 31-036 ESPECTORACION DE 5 SERIES 250.00 325.00 423.00 549.00 714.00 928.00

884 31-037 CEPILLADO Y/O LAVADO DE 1 SERIE 100.00 130.00 169.00 220.00 286.00 371.00

885 31-038 CEPILLADO Y/O LAVADO DE 3 SERIE 150.00 195.00 254.00 330.00 428.00 557.00

886 31-039 CEPILLADO Y/O LAVADO 5 SERIES 250.00 325.00 423.00 549.00 714.00 928.00

887 31-040 ASCITIS LIQUIDO PLEURAL Y LIQUIDO CEFALORAQ. 110.00 143.00 186.00 242.00 314.00 408.00

888 31-041 ORINA DE 1 SERIE 100.00 130.00 169.00 220.00 286.00 371.00

889 31-042 ORINA DE 3 SERIE 150.00 195.00 254.00 330.00 428.00 557.00

890 31-043 ORINA DE 5 SERIES 250.00 325.00 423.00 549.00 714.00 928.00

891 31-044 GLANDULA MAMARIA 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

892 31-045 CITOLOGIA GASTRICA DE 1 A 3, MAS $30.00 POR LAMINILLA EXTRA 110.00 143.00 186.00 242.00 314.00 408.00

893 31-046 BIOPSIAS PEQ. CERVIX ENDOM. ESTOM. ESOF. INTEST. 120.00 156.00 203.00 264.00 343.00 446.00

894 31-047 OVARIOS SIN TUMOR DE 1 A 5 CM. 200.00 260.00 338.00 439.00 571.00 743.00

895 31-048 OVARIOS SIN TUMOR DE 6 CM. O MAS 350.00 455.00 592.00 769.00 1,000.00 1,300.00

896 31-049 UTERO SIN ANEXOS SIN CANCER 200.00 260.00 338.00 439.00 571.00 743.00



VERSIÓN 2009


897 31-050 OVARIOS CON TUMOR 300.00 390.00 507.00 659.00 857.00 1,114.00

898 31-051 UTERO CON ANEXOS 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

899 31-052 EXENTERACION ANTERIOR Y POSTERIOR 600.00 780.00 1,014.00 1,318.00 1,714.00 2,228.00

900 31-053 EXENTERACION TOTAL 700.00 910.00 1,183.00 1,538.00 1,999.00 2,599.00

901 31-054 LEGRADO UTERINO (RESTOS PLACENTARIOS) 120.00 156.00 203.00 264.00 343.00 446.00

902 31-055 FETOS HASTA 3 MESES HASTA OBITO (DESCRIPCION) 200.00 260.00 338.00 439.00 571.00 743.00

903 31-056 PLACENTA 300.00 390.00 507.00 659.00 857.00 1,114.00

904 31-057 BIOPSIA DE HIGADO Y RIÑON 300.00 390.00 507.00 659.00 857.00 1,114.00

905 31-058 CONO CERVICAL 250.00 325.00 423.00 549.00 714.00 928.00

906 31-059 BIOPSIA GASTRICA 120.00 156.00 203.00 264.00 343.00 446.00

907 31-060 BIOPSIA QUIRURGICA SIN TUMOR 200.00 260.00 338.00 439.00 571.00 743.00

908 31-061 BIOPSIA QUIRURGICA CON TUMOR 550.00 715.00 930.00 1,208.00 1,571.00 2,042.00

909 31-062 AUTOPCIA DE FETO 3,000.00 3,900.00 5,070.00 6,591.00 8,568.00 11,139.00

910 31-063 AUTOPCIA DE NIÑO 3,500.00 4,550.00 5,915.00 7,690.00 9,996.00 12,995.00

911 31-064 AUTOPCIA DE ADULTO 4,500.00 5,850.00 7,605.00 9,887.00 12,852.00 16,708.00

912 34-001 BLOQUEO RAMA TRIGEMINAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

913 34-002 BLOQUEO GANGLIO GASER 384.00 499.00 649.00 844.00 1,097.00 1,426.00

914 34-003 BLOQUEO DE RAMAS TRIGEMINALES TERMINALES 384.00 499.00 649.00 844.00 1,097.00 1,426.00

915 34-004 BLOQUEO DE NERVIO LINGUAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

916 34-005 BLOQUEO DE NERVIO GLOSO FARINGEO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

917 34-006 BLOQUE DE GANGLIO ESFENOPALATINO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

918 34-007 BLOQUEO DE NERVIO OCCIPITAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

919 34-008 BLOQUEO DE RAIZ CERVICAL PROFUNDA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

920 34-009 BLOQUEO DE PLEXO CERVICAL SUPERFICIAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

921 34-010 BLOQUEO DE NERVIO FARINGEO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

922 34-011 BLOQUEO DE NERVIO SUPRAESCAPULAR 384.00 499.00 649.00 844.00 1,097.00 1,426.00

923 34-012 BLOQUEO SIMPATICO SERVICODORSAL C/CONTR. R. X 384.00 499.00 649.00 844.00 1,097.00 1,426.00

924 34-013 BLOQUEO SIMPATICO SERVICODORSAL S/CONTR. R. X 384.00 499.00 649.00 844.00 1,097.00 1,426.00

925 34-014 BLOQUEO PERIDUAL ANTI-INFLAMAT. SIN MEDICAMENTO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

926 34-015 BLOQUEO PERIDUAL LITICO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

927 34-016 BLOQUEO SUBARAGNOIDEO LITICO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

928 34-017 BLOQUEO PARAVERTEBRAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00



VERSIÓN 2009


929 34-018 BLOQUEO DE NERVIOS INTERCOSTALES 384.00 499.00 649.00 844.00 1,097.00 1,426.00

930 34-019 BLOQUEO DE NERVIO ABDOMINOGENITAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

931 34-020 BLOQUEO DE NERVIO CRURAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

932 34-021 BLOQUEO DE NERVIO FERMOROCUTANEO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

933 34-022 BLOQUEO DE NERVIO OBTURADOR 384.00 499.00 649.00 844.00 1,097.00 1,426.00

934 34-023 BLOQUEO DE NERVIO CIATICO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

935 34-024 BLOQUEO DE ARTICULACION SACRO-ILIACA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

936 34-025 BLOQUEO DE ARTICULACION COXO-FEMORAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

937 34-026 BLOQUEO DE NERVIO SAFENO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

938 34-027 BLOQUEO TRANS-SACRO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

939 34-028 BLOQUEO DE RAMAS TERMINALES DE MIEMBROS PELV. 384.00 499.00 649.00 844.00 1,097.00 1,426.00

940 34-029 BLOQUEO DE RAMAS TERMINALES DE MIEMBROS PELV. 384.00 499.00 649.00 844.00 1,097.00 1,426.00

941 34-030 BLOQUEO DE ARTICULACION DE RODILLAS 384.00 499.00 649.00 844.00 1,097.00 1,426.00

942 34-031 BLOQUE CAUDAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

943 34-032 BLOQUEO DE BURSA ANTERIOR DE HOMBRO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

944 34-033 BLOQUEO DE PLEXO BRONQUIAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

945 34-034 BLOQUEOS PERIFERICOS DE MIEMBROS SUPERIORES 384.00 499.00 649.00 844.00 1,097.00 1,426.00

946 34-035 BLOQUEO DE GANGLIO SIMPATICO LUMB. CONTR. R. X 384.00 499.00 649.00 844.00 1,097.00 1,426.00

947 34-036 BLOQUEO DE GANGLIO ESPLACICO CELIACO C/R.X 384.00 499.00 649.00 844.00 1,097.00 1,426.00

948 34-037 BLOQUEO DE CAPSULA DE HOMBRO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

949 34-038 BLOQUEO PERIVASCULAR DE ARTERIA TEMPORAL 384.00 499.00 649.00 844.00 1,097.00 1,426.00

950 34-039 ESTIMULACION ELECTRICA CUTANEA 384.00 499.00 649.00 844.00 1,097.00 1,426.00

951 34-040 BLOQUENIO DE NERVIO FRENICO 384.00 499.00 649.00 844.00 1,097.00 1,426.00

952 34-101 ABORDAJE DEL SISTEMA SIMPATICO LUMBAR 120.00 240.00 601.00 1,274.00 1,802.00 2,043.00

953 34-102 APLICACION DE ANALGESICO DE URGENCIA ( RESCATE ) 8.00 15.00 39.00 82.00 116.00 131.00

954 34-103 APLICACION DE BOMBA NEUMATICA 165.00 331.00 827.00 1,753.00 2,480.00 2,811.00

955 34-104 ASISTENCIA TRANSINTERVENCIONISMO (PERMEABILIZAR VENA Y SEDACION ) 44.00 88.00 219.00 464.00 657.00 745.00

956 34-105 ATENCION EN FASE TERMINAL 3.00 6.00 14.00 30.00 42.00 48.00

957 34-106 BLOQUE NEUROLITICO DE NERVIOS SOMATICOS 34.00 68.00 170.00 360.00 510.00 578.00

958 34-107BLOQUEO ANTI-INFLAMATORIO, DEPOSITO DE ESTEROIDES, ANALGESICOS LOCALES, PARCHE HEMATICO, TOMA O QUIMIOTERAPIA EN ESPACIO INTRATECAL

69.00 137.00 343.00 727.00 1,028.00 1,165.00

959 34-108 BLOQUEO DE NERVIOS PERIFERICOS ( CIATICO, INTRAESCAPULAR, ARTICULACION ) 34.00 68.00 170.00 360.00 510.00 578.00



VERSIÓN 2009


960 34-109 BLOQUE DE PLEXO CERVICAL Y BRAQUIAL 159.00 317.00 793.00 1,681.00 2,378.00 2,695.00

961 34-110 BLOQUEO INTERCOSTAL CON ANESTESICO O NEUROLITICO 33.00 66.00 165.00 350.00 495.00 561.00

962 34-111 BLOQUEO NEUROLITICO DE LOS NERVIOS CRANEALES, ABORDAJE DEL HIPOGLOSO, NERVIO TRIGEMINO O GANGLIO DE GASSER 105.00 211.00 527.00 1,117.00 1,581.00 1,792.00

963 34-112 COLOCACION DE CATETERES EPIDURALES PERIDUROGRAFIA Y RETIRO DE CATETER 75.00 149.00 373.00 791.00 1,120.00 1,269.00

964 34-113 COLOCACION DE CATETERES EPIDURALES O INTRATECALES ( BOMBA DE INFUSION ELASTOMERICAS O COMPUTARIZADA ) 224.00 448.00 1,119.00 2,372.00 3,356.00 3,804.00

965 34-114 COLOCACION DE INFUSION PORTATIL BOMBA ELASTOMERICA ( COLOCACION DE SISTEMA DE ANALGESICO INTRATECAL DEFINITIVO, IMPLANTADA 12.00 25.00 62.00 131.00 185.00 210.00

966 34-115 CULTIVO DE PUNTA DE CATETER O SITIO CONTAMINADO 12.00 24.00 60.00 126.00 179.00 202.00

967 34-116 INFUSION PARENTERAL ( HIDRATACION O INFUSION DE MEDICAMENTOS 14.00 28.00 71.00 150.00 212.00 241.00

968 34-117 INSTALACION DE DISPOSITIVO SUBCUTANEO 13.00 26.00 64.00 136.00 193.00 218.00

969 34-118 INSTALACION DE SONDA ( NASOGASTRICA, VESICAL, Y RECTAL O MICROENEMA ) 19.00 37.00 93.00 198.00 280.00 317.00

970 34-119 INSTALACION DE TENS ESTIMULACION TRANSCUTANEA Y -O ACUPUNTURA 74.00 149.00 372.00 789.00 1,117.00 1,266.00

971 34-120 MICROPARECENTESIS 13.00 26.00 65.00 137.00 194.00 219.00

972 34-121 NERVIOS ESPLACNICOS DIAGNOSTICO Y-O PRONOSTICO 124.00 247.00 618.00 1,310.00 1,854.00 2,101.00

973 34-122 NEUROADHENOLISIS ( BLOQUEO LITICO DE HIPOFISIS ) 172.00 345.00 862.00 1,827.00 2,586.00 2,931.00

974 34-123 NUROPLASTIA Y ADHERENSIOLISIS 284.00 568.00 1,419.00 3,008.00 4,256.00 4,824.00

975 34-124 OXIGENO CON MICRONEBULIZACIONES Y-O NEBULIZADOR 26.00 52.00 131.00 277.00 392.00 445.00

976 34-125 PROGRAMA DE ATENCION AL ENFERMO EN EL HOGAR PAEH (CUIDADOS PALIATIVOS EN VISITA A DOMICILIO) 67.00 133.00 334.00 707.00 1,001.00 1,134.00

977 34-126 RADIOFRECUENCIA 298.00 595.00 1,488.00 3,154.00 4,463.00 5,058.00

978 34-127 RISOLISIS ( LITICO SUBARACNOIDEO ) 170.00 340.00 850.00 1,801.00 2,549.00 2,889.00

979 34-128 RISOLISIS EN SILLA DE MONTAR 195.00 390.00 976.00 2,068.00 2,927.00 3,317.00

980 34-129 SISTEMA NERVIOSO AUTONOMO, ABORDAJE PARA INHIBICION DEL GANGLIO ESTRELLADO 120.00 240.00 600.00 1,271.00 1,799.00 2,038.00

981 34-130 SISTEMA NERVIOSO AUTONOMO, ABORDAJE EN GANGLIO DE WALTER 120.00 240.00 600.00 1,271.00 1,799.00 2,038.00

982 34-131 SISTEMA NERVIOSO AUTONOMO, ABORDAJE EN PLEXO CELIACO DE NERVIOS ESPLANICOS 151.00 303.00 757.00 1,604.00 2,270.00 2,572.00

983 34-132 SISTEMA NERVIOSO AUTONOMO, ABORDAJE EN PLEXO HIPOGASTRICO SUPERIOR 120.00 240.00 601.00 1,274.00 1,802.00 2,043.00

984 34-133 TRASLADO DE PACIENTE (A DOMICILIO U HOSPITAL) 40.00 79.00 198.00 419.00 593.00 672.00

985 34-134 VERTEBROPLASTIA, CEMENTOPLASTIA OSEA (BIOPSIA O CEMENTO 449.00 898.00 2,244.00 4,757.00 6,732.00 7,630.00

986 34-135 VISITA DOMICILIARIA ( CLINICA DEL COLOR ) 108.00 217.00 542.00 1,149.00 1,626.00 1,843.00



VERSIÓN 2009


987 34-136 TRASLADOS GUADALAJARA 2,750.00 2,750.00 2,750.00 2,750.00 2,750.00 2,750.00

988 34-137 TRASLADO MEXICO 12,000.00 12,000.00 12,000.00 12,000.00 12,000.00 12,000.00

989 34-138 TRASLADOS LOCALES POR KILOMETRAJE 12.00 12.00 12.00 12.00 12.00 12.00

990 34-139 FOTOCOPIA 1.00 1.00 1.00 1.00 1.00 1.00

991 34-201 CURACION CAMBIO DE APOSITO 12.00 27.00 59.00 124.00 176.00 199.00

992 34-202 CURACION DE SONDAS Y RETIRO DE DRENES 18.00 25.00 88.00 187.00 264.00 299.00

993 34-203 RETIRO DE PUNTOS 17.00 35.00 84.00 177.00 250.00 283.00

994 34-204 CURACION RETIRO DE TEJIDO 22.00 44.00 110.00 233.00 330.00 374.00

995 34-205 CURACION DEBRIDACION DE ABSCESO 34.00 68.00 171.00 361.00 512.00 580.00

996 34-206 PUNCION DE QUISTE 17.00 34.00 85.00 181.00 256.00 290.00

997 34-207 BIOPSIA CON TRUCUT 35.00 60.00 151.00 320.00 453.00 513.00

998 34-208 BIOPSIA INSICIONAL 36.00 73.00 182.00 385.00 545.00 618.00

999 34-209 BIOPSIA POR ASPIRACION CON AGUJA DELGADA 94.00 188.00 470.00 997.00 1,411.00 1,599.00

1000 34-210 CURACION DE CATETER VENOSO CENTRAL 31.00 62.00 155.00 328.00 464.00 526.00

1001 34-211 CURACION HERIDA QUIRURGICA SEPTICA 17.00 35.00 84.00 184.00 261.00 296.00

1002 34-212 CURACION CON CIERRE DE HERIDA QX. SEPTICA 36.00 73.00 182.00 386.00 546.00 619.00

1003 34-213 CURACION CON ESCISION LOCAL 33.00 76.00 164.00 348.00 492.00 558.00

1004 34-214 CURACION DE HERIDA NO SEPTICA 3.00 6.00 15.00 31.00 44.00 49.00

1005 34-215 CURACION GINECOLOGICA 3.00 5.00 13.00 28.00 40.00 45.00

1006 34-216 COLOCACION DE SONDA FOLEY 10.00 19.00 48.00 102.00 144.00 163.00

1007 34-217 COLOCACION DE SONDA NASOGASTRICA 16.00 35.00 81.00 171.00 242.00 275.00

1008 34-218 CAMBIO O RETIRO DE SONDA FOLEY O NASOGASTRICA 7.00 15.00 27.00 57.00 81.00 92.00

1009 34-219 REANIMACION CARDIOPULMONAR CON MONITOREO ESTABLECIDO 107.00 214.00 536.00 1,136.00 1,607.00 1,822.00

1010 34-220 REANIMACION CARDIOPULMONAR ´SIN MONITOREO ESTABLECIDO 35.00 70.00 176.00 373.00 527.00 598.00

1011 34-301 EXTENSION ORBITA INJERTO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1012 34-302 RESECCION MAXILAR SUPERIOR INJERTO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1013 34-303 RESECCION CANCER INTRAORAL COLGAJO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1014 34-304 PARATIDECTOMIA RADICAL INJERTO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1015 34-305 LARINGECTOMIA TOTAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1016 34-306 TIROIDECTOMIA TOTAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1017 34-307 DISECCION RADICAL DE CUELLO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1018 34-308 NEFRECTOMIA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00



VERSIÓN 2009


1019 34-309 COLECTOMIA PARCIAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1020 34-310 GASTRECTOMIA PARCIAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1021 34-311 HISTERECTOMIA Y OMENTECTOMIA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1022 34-312 VULVECTOMIA RADICAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1023 34-313 DISECCION RADICAL INGUINOPELVICA (UN LADO) 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1024 34-314 CORDOTOMIA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1025 34-315 LAMINECTOMIA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1026 34-316 CRANEOTOMIA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1027 34-317 AMPUTACION MIEMBROS MAYORES 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1028 34-318 DESARTICULACION DE ESTREMIDADES 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1029 34-319 OPERACION COMBINADA (COMANDO9 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1030 34-320 LARINGETOMIA Y DISECCION RADICAL DE CUELLO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1031 34-321 PARATIDECTOMIA Y DISECCION RADICAL DE CUELLO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1032 34-322 TIROIDECTOMIA Y DISECCION RADICAL DE CUELLO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1033 34-323 EXTIRPACION CANCER DE PIEL Y DISECCION RADICAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1034 34-324 CAVIDAD ORAL MAS DISECCION RADICAL DE CUELLO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1035 34-325 GASTRECTOMIA TOTAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1036 34-326 RESECCION DE TUMOR DE PANCREAS 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1037 34-327 RESECCION ABDOMINO PERINEAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1038 34-328 DESARTICULACION INTERESCAPULO-TORA-TORACICA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1039 34-329 DESARTICULACION COXO-FEMORAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1040 34-330 ESPLENECTOMIA BIOPSIA DE GANGLIO, HUESO, HIGADO 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1041 34-331 HISTERECTOMIA RADICAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1042 34-332 EXENTERACION PELVICA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1043 34-333 DISECCION INGUINO-PELVICA BILATERAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1044 34-334 DISECCION RETROPERITONEAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1045 34-335 CRANEOTOMIA RESECCION DE TUMOR CEREBRAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1046 34-336 NEUMONECTOMIA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1047 34-337 COLECISTECTOMIA MAS LAPAROSCOPIA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1048 34-338 PERFUSION FEMORAL CON DISECCION INGUINOFEMORAL 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1049 34-339 CIRUGIA LAPAROSCOPICA 1,230.00 1,525.00 3,234.00 4,576.00 5,186.00 7,626.00

1050 35-001 TRATAMIENTO POR SESION (46-60MIN) 150.00 200.00 300.00 450.00 600.00 850.00



VERSIÓN 2009


1051 37-005 CERTIFICADO PRENUPCIAL (SIN EXAMENES) 10.00 15.00 21.00 28.00 51.00 89.00

1052 37-006 CERTIFICADO MEDICO (SIN EXAMENES) 9.00 15.00 21.00 28.00 51.00 89.00

1053 37-007 CERTIFICADO INTERNACIONAL DE VACUNACION 35.00 73.00 88.00 92.00 118.00 149.00

1054 37-008 EXPEDICION DE CERTIFICADO 5.00 11.00 11.00 11.00 17.00 17.00

1055 39-001 AUDIOMETRIA COMPLETA 96.00 0.00 96.00 144.00 192.00 0.00

1056 39-002 IMPEDANCIOMETRIA 50.00 0.00 50.00 64.00 106.00 0.00

1057 39-003 REFLEJO ESTAPEDIAL 50.00 0.00 50.00 64.00 106.00 0.00

1058 39-004 POTENCIALES AUDITIVOS EVOCADOS 158.00 0.00 158.00 237.00 316.00 0.00

1059 39-005 POTENCIALES DE ESTADO ESTABLE 158.00 0.00 158.00 237.00 316.00 0.00

1060 39-006 OTONEUROLOGICO (V.N.G.) 158.00 0.00 158.00 237.00 316.00 0.00



VERSIÓN 2009

SERVICIOS DE SALUD DE NAYARIT TABULADOR DE ...TABULADOR DE SERVICIOS MÉDICOS-ASISTENCIALES EN...

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