| Price (IRR) |
Price (USD) |
Code Description |
Row |
| 1 | 1 |
1 |
1 |
| 90,897,300 |
222 |
Pilonidal Sinus Excision |
2 |
| 245,508,900 |
552 |
Radical Mastectomy |
3 |
| 129,896,400 |
165 |
Fibroadenoma Cyst Excision |
4 |
65,805,300
|
114 |
Closed Treatment of Nasal Fracture |
5 |
126,444,300
|
231 |
Open Treatment of Nasal Fracture |
6 |
| 59,950,500 |
111 |
Closed Treatment of Shoulder Dislocation |
7 |
| 57,608,580 |
114 |
Closed Treatment of Humeral Shaft Fracture |
8 |
| 178,719,300 |
449 |
Open Treatment of Radial and Ulnar Shaft Fracture |
9 |
57,859,500
|
96 |
Closed Treatment of Distal Radial Fracture |
10 |
70,656,420
|
162 |
Amputation of Single Finger (Thumb) and Its Metacarpal |
11 |
| 149,470,800 |
468 |
Closed Treatment of Femoral Shaft and Distal Femur Fracture |
12 |
311,732,400
|
690 |
Open Treatment of Femoral Shaft Fracture and Intramedullary Nail
|
13 |
| 117,121,500 |
183 |
Closed Treatment of Femoral Shaft and Distal Femur Fracture |
14 |
| 117,121,500 |
379 |
Open Treatment of Tibial Shaft Fracture |
15 |
| 121,844,100 |
223 |
Nasal Septal Repair with Submucosal Resection |
16 |
| 131,880,900 |
231 |
Radical Incision of Sinus with or without Antrochoanal Polyp Excision (Caldwell Luc) |
17 |
48,780,000
|
224 |
Bronchoscopy |
18 |
| 232,815,000 |
594 |
Total or Partial Splenectomy |
19 |
| 118,498,500 |
196 |
Tonsillectomy |
20 |
| 93,615,600 |
155
|
Adenoidectomy |
21 |
| 241,996,020 |
576 |
Enterolysis |
22 |
| 172,176,000 |
363 |
Appendectomy |
23 |
| 90,897,300 |
230 |
Hemorrhoidectomy |
24 |
| 218,454,900 |
608 |
Colecystectomy |
25 |
| 180,269,700 |
278 |
Primary Inguinal Hernia Repair |
26 |
205,361,700
|
358 |
Abdominal Hernia Repair |
27 |
| 184,869,900 |
282 |
Spiegel or Primary Femoral Hernia Repair |
28 |
| 127,846,900 |
293 |
Umbilical Hernia |
29 |
| 278,128,500 |
310 |
Nephrolithotomy |
30 |
| 273,486,480 |
706 |
Nephrectomy |
31 |
| 84,477,900 |
144 |
Cystouretroscopy |
32 |
| 214,596,900 |
430 |
Resection of Prostate |
33 |
| 349,473,300 |
522 |
Prostate Surgery |
34 |
| 161,450,700 |
242 |
Orchiopexy |
35 |
| 195,246,900 |
264 |
Delivery |
36 |
| 247,521,900 |
301 |
Pain-free Delivery |
37 |
| 216,156,900 |
279 |
Multiple Babies Delivery |
38 |
| 218,666,100 |
290 |
Pain-free Multiple Babies Delivery |
39 |
| 9,184,500 |
332 |
Baby bed and the primary visit of the neonate (Code 901925) shall be added to the items 36 to 39. Note 1: in case of multiple-baby delivery, the baby bed and the visit of neonate shall be calculated based on the number of neonates and, in case of death of the neonate, nothing shall be added. Note 2: in case of illness of the neonate or hospitalization of the neonate after discharge of the mother, the cost of the neonate shall be calculated separately.
|
40 |
| 9,184,500 |
312 |
Baby bed and the primary visit of the neonate shall be added to the items 36 to 39. Note 1: in case of multiple-baby delivery, the baby bed and the visit of neonate shall be calculated based on the number of neonates and, in case of death of the neonate, nothing shall be added. Note 2: in case of illness of the neonate or hospitalization of the neonate after discharge of the mother, the cost of the neonate shall be calculated separately.
|
41 |
| 98.843.100 |
237 |
Hydrocele Excision |
42 |
| 146.293.602 |
240 |
Varicocele Excision or Hernia Repair |
43 |
| 324.955.860 |
792 |
Radical Prostatectomy |
44 |
| 129.625.680 |
160 |
Colpoperineorrhaphy |
45 |
| 155.637.720 |
238 |
Anterior Colporraphy, Rectocele |
46 |
| 190.055.580 |
413 |
Anterior Colporrhaphy via Abdomen or Vagina |
47 |
| 720.078.300 |
140 |
Curettage |
48 |
| 258.891.300 |
525 |
Total Hysterectomy |
49 |
| 157.539.000 |
330 |
Oophorectomny
|
50 |
| 224.598.900 |
434 |
Ectopic (Tubal) Pregnancy Treatment, Salpingectomy |
51 |
| 595.902.000 |
370 |
Cesarean |
52 |
| 8.230.400 |
63 |
Baby bed and the primary visit of the neonate (Code 901925) shall be added to the items 36 to 39. Note 1: in case of multiple-baby delivery, the baby bed and the visit of neonate shall be calculated based on the number of neonates and, in case of death of the neonate nothing shall be added. Note 2: in case of illness of the neonate or hospitalization of the neonate after discharge of the mother, the cost of the neonate shall be calculated separately |
53 |
| 102.754.800 |
154 |
Infectious Abortion Treatment |
54 |
| 338.619.600 |
651 |
Total or Subtotal Thyroidectomy for Malignancy along with Limited Cervical Dissection/Radical Cervical Dissection |
55 |
| 286.344.600 |
578 |
Total Thyroidectomy, Subtotal Including Substernal Thyroidectomy for Benign Cases |
56 |
| 246.943.800 |
885 |
Creation of Shunt: ventriculoatrial, Ventriculojugular, Ventriculoauricular, Ventriculoperitoneal, or from Ventricle to Pleura or other Sites, or Ventriculocysternostomy (Torkildsen Operation |
57 |
| 297.365.700 |
589 |
Disc Herniation Laminectoy |
58 |
| 333.330.900 |
740 |
Laminectomy, Spinal Stenosis |
59 |
| 103.443.300 |
195 |
Neurolysis or Neuroplasty |
60 |
| 143.297.760 |
314 |
Cataract Operation |
61 |
| 146.057.880 |
327 |
Endocapsular Lens Aspiration |
62 |
| 124.771.500 |
314 |
Cataract Operation without Lens Prosthesis Insertion |
63 |
| 211.068.600 |
332 |
Strabismus |
64 |
| 247.782.900 |
473 |
Tympanoplasty without mastoidectomy |
65 |
| 38.056.200 |
74 |
Ophthalmologic examination and assessment under generalized anesthesia |
66 |
| 62.041.500 |
152 |
Extraction of deep pin |
67 |
| 76.678.500 |
118 |
Closed treatment of radial shaft fracture |
68 |
| 295.692.900 |
740 |
Bone fixation in femoral fracture |
69 |
147.354.300
|
470 |
Arterio-venous anastomosis |
70 |
| 43.669.500 |
121 |
Upper Gastrointestinal Endoscopy |
71 |
| 101.082.000 |
207 |
Abscess Incision and drainage |
72 |
| 96.900.000 |
152 |
Fissurectomy with or without sphyncterotomy |
73 |
| 245.508.900 |
201 |
Surgical treatment of anal fistula (fistulectomy/fistulotomy) |
74 |
| 68,294,400 |
525 |
Ureterolithotomy |
75 |
| 220.305.300 |
376 |
Transurethral resection of tumors (TURT) of any size |
76 |
| 111.333.300 |
216 |
Cystourethroscopy |
77 |
| 125.755.800 |
215 |
Excision of varicocele without hernial repair |
78 |
| 214.832.400 |
538 |
Suprapubic prostatectomy |
79 |
| 68.732.700 |
143 |
Inductive Abortion by dilatation and curettage (obstetrics) |
80 |
| 74.169.300 |
156 |
Cerclage of the cervix |
81 |
| 192.667.800 |
333 |
Myomectomy |
82 |
| 276.873.900 |
552 |
Total or partial hysterectomy |
83 |
| 238.650.300 |
262 |
Diagnostic laparoscopy |
84 |
| 377.660.100 |
889 |
Craniectomy or craniotomy for evacuation of hematoma |
85 |
| 214.266.300 |
487 |
Repair of corneal and/or sclera laceration |
86 |
| 104.279.700 |
161 |
Excision or displacement of pterygium with or without graft |
87 |
| 204.647.700 |
342 |
Glaucoma Surgery |
88 |
| 126.862.500 |
292 |
Intraocular implant of lens prosthesis (secondary implant) |
89 |
| 43.911.000 |
111 |
Chalazion excision |
90 |
| 176.293.740 |
305 |
Creation of dacryocystorhinostomy (DCR)/a fisula from lacrimal sac to nasal cavity |
91 |
| 52.275.000 |
88 |
Nasolacrimal duct stenting |
92 |
6.500.000.000
|
17,000 |
AML- Haploidentical Allogenic Transplantation |
93 |
| 6.000.000.000 |
10,000 |
Primary Brain NHL- Autologous |
94 |
| 5.500.000.000 |
17,000 |
AML- And All , MDS , Cll Full Match Sibling Allogenic Transplantation |
95 |
| 6.200.000.000 |
10,000 |
HD- Autologous |
96 |
| 6.000.000.000 |
15,000 |
Multiple Myeloma Autologous Transplantation |
97 |