Cardiovascular System

 

Department

Operation Type

UNITS

ANES

Average duration of stay

CARDIAC VALVE

Aortic Valve  

Valvuloplasty , with bypass 

40 

20

 3-7 Days

Replacement

43

20

 Mitral Valve

Valvuloplasty , with bypass 

45

15

Replacement

45

15

 Tricuspid Valve

 Valvuloplasty or valvectomy with bypass

40

20

Replacement

41

20

 Pulmonary Valve

Resection of infundibular stenosis , with or without commissurotomy 

42

20

 

MULTIPLE VALVE PROCEDURES 

 

 Single valve replacement with commissurotomy or valvuloplasty of another valve or annuloplasty

48

20

Double valve replacement 

50

20

Triple valve replacement 

60

20

 

 

 CORONARY ARTERY PROCEDURES

 

 

Coronary artery bypass autogenous ( e . g . sapnenous vein or internalmammary artery) . single artery  

42

25 

Two arteries 

45

25

Three arteries 

48 

25

 Four arteries

51 

25

Five or more arteries

54

25

Six or more coronary grafts

56

25

POST INFARCTION MYOCARDIAL PROCEDURES

Myocardial resection ( e . g ., ventricular aneurysmectomy )

46

20

SEPTAL DEFECT

Patch closure ( with or without anomalous pulmonary venous drainage )

37

20

Repair of complete atrio – ventricular canal with or without prosthetic valve

48

15

Ventricular septal defect , closure , direct

37

20

Closure , patch

38

20

With removal of pulmonary artery band ( with or without gusset )

44

15

Banding of pulmonary artery

24

15

Tetralogy of Fallot , total repair , intact outflow tract

44

15

SHUNTING PROCEDURES

Subclavian to pulmonary artery shunt (Blalock – Taussig type )

30

15

TRANSPOSITION OF THE GREAT VESSELS / TRUNCUS ARTERIOSUS

Repair , transposition of great vessels , aortic pulmonary artery reconstruction ( Jatene type )

70

25

AORTIC ANOMALIES

Coarctation , excision with direct anastomosis ( with or without associated PDA )

30 

15

THORACIC AORTIC ANEURYSM

Ascending arch graft without valve replacement ( with or without suspensor of valve )

45

20

With valve replacement

 50

20

MISCELLANEOUS

Prolonged extracorporeal circulation for cardio pulmonary insufficiency

50

20

ARTERIAL EMBOLECTOMY OR THROMBECTOMY , WITH OR WITHOUT CATHETER

Femoropopliteal , aortoiliac artery , by leg incision

12

7

INTERVASCULAR CANNULIZATION OR SHUNT

Insertion for hemodialysis other purpose vein to vein

3

5

Revision or closure

6

5

Arteriovenous anastomosis direct any site

13

5

REPAIR , LIGATION AND OTHER PROCEDURES

Ligation , major artery ( e . g ., posttraumatic , rupture , etc.) neck

8

10

Complete stripping of long or short saphenous veins  ( unilateral )

7

3

Complete stripping of long and short saphenous veins with radical excision of ulcer and skin graft and / or interruption of communicating veins of lower leg excision of deep fascia ( unilateral )

17.5

bilateral

35

3

 

HEMIC AND LYMPHATIC SYSTEMS

 

Average duration of stay

ANES

UNITS

Operation Type

Department

2-3 Days

7

16

(Splenectomy ( independent procedure

 Spleen ) Excision)

6

8 

(Deep axillary node(s

Lymph Nodes and Lymphatic Channels Incision

 6

21

Cervical lymphadenectomy ( modified radical neck dissection)

RADICAL LYMPHADENECTOMY

 

MEDIASTINUM AND DIAPHRAGM

Average duration of stay

ANES

UNITS

Operation Type

Department

  2-3 Days

 3

 12

Mediastinotomy with exploraton or drainage transthoracic

 ( Mediastinum )

 Incision 

 

3

 21.5

Sternal spli

Digestive System

Average duration of stay

ANES

UNITS

Operation Type

Department

 2-3 Days

7 

 18.5

Vagotomy and pyloro-plasty , with or without gastrostomy

Stomach /Excision

7 

 15.2

Gastrojejunostomy

SUTURE

6

 14.6

Enterolysis of acute bowel obstruction

Intestines ( Except Rectum ) Incision

6

  17.6 

Enterectomy ; resection of small intestine with anastomosis

6

 18.5

Colectomy partial with anastomosis

6

  17.5 

With end colostomy and closure of distal segment ( Hartmann type )procedure

7

 42.5

With rectal mucosectomy , ileoanal anastomosis , creation of ileal reservoir ( S or J ) , with or without loop ileostomy

6

 14.5

Ileostomy

ENTEROSTOMY-EXTERNAL FISTULIZATION OF INTESTINE

6

  11.5 

Colostomy or skin level cecostomy (independent procedure)

6

 13.5

Suture of intestine( enterorrhaphy ) , large or small for perforated ulcer , wound injury or rupture single

SUTURE

6

 10

Closure of enterostomy large or small intestine

6

 10

Appendectomy

(Appendix (Incision

6

11

For ruptured appendix with abscess or generaized peritonitis

7

28

Proctectomy complete combined abdominoperineal

Rectum / Excision

4

15

Excision of rectal pro cidentia with anastomosisperineal approach

4

17.5

Proctopexy for prolapse abdominal

REPAIR

4

 1.5

Fistulotomy subcutaneous

Anus / Incision

4

 0.8

Incision and drainage peri anal abscess superficial

4

 1.2 

Sphincterotomy anal division of anal sphincter (independent procedure)

4

4

Fissurectomy with or with out sphincterotomy

4

 5

Hemorrhoidectomy extern al complete

7

 16

Hepatotomy drainage of abscess/cyst one or more stage

Liver / Incision

7

13.5

Cholecystectomy

Biliary Tract / Excision

7

20

With open exploration of common duct

7

 30

With choledochoenter ostomy

7

  13 

Abdominal drainage for pancreatitis

Pancreas / Incision

7

35

Pancreatectomy proximal

Subtotal with pancreatico

Jejunostomy/pancreaticoduo

denostomy whipple

Pancreas / Excision

6 

10

Exploratory laparotomy

Exploratory celiotomy, Independent procedure

Abdomen , Peritoneum and Omentum / Incision

7

14

Excision of intra abdominal Or retroperitoneal tumor or cyst

Abdomen , Peritoneum and Omentum / Excision

7

 21

extensive

4

 8.5

(Repair inguinal hernia age 5 or older (unilateral

Repair – Hernioplasty Herniorraphy herniotomy

6 

 11.5

(Ventral (independent procedure

4

4

Epigastric simple properi toneal fat (independent procedure

4

  8 

Age 5 or older

7

6.2

Secondary suture of abdominal wall for evisceration or dehiscence

SUTURE

Urinary System

Average duration of stay

ANES

UNITS

Operation Type

Department

 

2-4 Days 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

7

13.5

Drainge of perirenal or Renal abscess (independent procedure)

Kidney

7

18

Nephrostomy nephrotomy with drainage

7

20

Nephrolithotomy removal of calculus

7

25

Secondary surgical operation for calculus

7

26

Large (staghorn) calculus filling renal pelvis and calyces

7

20

With removal of calculus Pyelolithotomy pelvio lithotomy

7

25

Nephrectomy including Partial ureterectomy any

Approach including rib resection

7

24

With total ureterectomy And bladder cuff Through same incision

7

18

Nephrostomy nephrotomy with drainage

7

20

Nephrolithotomy removal of calculus

7

25

Secondary surgical operation for calculus

7

26

Large staghorn calculus Filling renal pelvis and calyces

7

20

With removal of calculus Pyelolithotomy pelvio lithotomy

7

25

Nephrectomy including Partial ureterectomy and Approach including rib resection

7

24

With total ureterectomy And bladder cuff Through same incision

7

16

Excision or unroofing of cysts of kidney

4

5

Introduction of guide into renal pelvis and/or ureter

with dilation to establish nephrostomy tract percutaneous

Introduction

7

23.5

Pyeloplasty plastic operation on renal pelvis with

or without plastic opera tion on ureter nephropexy

nephrostomy or ureteral splinting

Repair

7

19.6

Ureterolithtomy upper one  third of ureter

Ureter / Incision 

6

18.5

Middle one third of ureter

6

20

Lower one third of ureter

6

22.3

Ureteroneocystostomy Anastomosis of ureter to Bladder or other opera

Tions for correction of Vesicoureteral reflux unilateral

Repair

6

20

Ureterorrhaphy;suture of ureter (Independent procedure )

Suture

5

12

Cystostomy cystotomy with drainage 

 Bladder / Incision

5

12

Cystolithotomy cystotomy with removal of calculus without vesical neck resection 

3

15 

Cystotomy for simple excision

of vesical neck (independent procedure) 

 Bladder / Excision

8 

50

Cystectomy, prostatectomy,urethrectomy and nodes male with ureteroileal conduit

Or sigmoid bladder Including bowel anastomosis

6

20 

Cystoplasty or cystoureth roplasty plastic operation on bladder and/or vesical

neck (anterior Y-plasty vesical fundus resectionetc) any procedure with or without wedge resection of posterior vesical neck 

 

Repair 

 

6

 14.5

Cystorrhaphy suture of bladder wound, injury or rupture simple

 3

4

Insertion and removal indwelling stent 

 

 Cystoscopy / urethroscopy / Cystourethroscopy

 

 

 

3

2

hospital 

 

 

With ureteral catheterization 

 

 

Cistourethroscopy with biopsy

3

3

with or without irrigation , instillation or ureteropyelography exclusive of radiologic service

 

 

With dilation of bladder

 

 

 

 

 

 

 

Transurethral

Surgery

 

 

 

 

 

 

3

3

For interstitial cystitis general or conduction (spinal etc) anesthesia

3

3

With calibration and/or Dilation of urethral stricture or stenosis with or without meatotomy or injection procedure for cystography male or female

3

2.8 

With steroid or other Injection into stricture

3

4

With urethral meatotomy unilateral or bilateral

3

10

Litholapaxy crushing or fragmentation of calculus by any means in bladder

and removal of fragments simple small (less than 2/5cm)

3

13.8 

Complicated or large (over 2/5cm)

3 

5

With manipulation with Out removal of ureteral  Calculus (uretal catheterization is included)

 

12.5 

Rigid ureteroscopy/pyeloscopy including cystoscopy and ureteral dilation

3

16 

With stone removal

3

18

With lithotripsy (any size)

3

17.5 

Diagnostic ureteroscopy with brushing or with biopsy or with fulguration

3 

10

Transurethral resection of vesical neck (independent procedure)

5 

20

Transurethral resection of prostate including control of postoperative bleeding during the initial hospitalization complete (vasectomy meatotomy cystourethroscopy urethral calibration and/or dilation and internal urethrotomy are included)

3

10 

Urethroplasty first stage for fistula diverticulum or stricture (e.g.jahannsen type) 

 

Repair 

 

 

 22

Urethoplasty with tubula rization of posterior urethra and / or lower bladder for incontinence (e.g. terago leadbetter procedure)  

3

4 

Urethromeatoplasty with mucosal advancement 

3

10.2 

Urethrorraphy suture of urethral injury female 

Suture 

3

 6

Closure of urethrostomy or urethrocutaneous fistula male (independent procedure) 

 

 

Male Genital System

Average duration of stay

ANES

UNITS

Operation Type

Department

2-4 Days

 3

8.3

(Excision penile plaque (peyronie's disease

Penis / Excision

3

 3

Surgical excision other than clanp or dorsal slit except newborn

 3

1.4

Injection of corpora cavernosa with pharmacologic agent (s) (e. (g.papaverine phentolamine etc

Introduction

 3

Plastic operation on penis for straightening of chordee e.g.hypospadias) with or without mobilization of urethra)

Repair

 

12

One stage distal hypospa dias repair (with or with out chordee or circumcision)with simple meatal advancement(e.g.magpi v-flap)

 

14 

(With urethroplasty by local skin flaps (e.g.flip-flap prepucial flap

 

16

With urethroplasty by local skin flaps and mobilization of urethra

 

20.5 

With extensive dissection to correct chordee and urethroplasty with local skin flaps skin graft patch and/or island flap

 

23

One stage proximal penile or penoscrotal hypospa dias repair requiring extensive dissection to correct chordee and urethroplasty by use of skin graft tube and / or island flap

 

26.5 

One stage perineal hypospadias repair requiring extensive dissection to correct chordee and ure throplasty by use of skin graft tube and / or island flap

 

10.5

Repair of hypospadias complacation (i.e.fistula strecture diverticula) by closure incision or excision simple

 

16

Requiring mobilization of skin flaps and urethra plasty with flap or patch graft

 

20 

Requiring extensive dissect tion and urethroplasty with flat patch or tubed graft( includes urinary diversion)c

orpora cavernosa-saphe-nous

 3

 12.5

vein shunt (priapism operation) unilateral or bilatera

 3

 12.5

Corpora cavernosa-corpus spongiosum shuht (pria-psim operation)unilateral or bilateral

 3

3.1

(Incisional unilateral(independent procedure

(Testis ( Excision

 3

4

(Bilateral(independent procedure

 3

 6.3

Orchiectomy simple (including subcapsular)with or without testicular prosthesis scrotal or inguinal approach unilateral

 3

 8.1

bilateral

4

  9.5 

Orchiectomy radical for tumor inguinal approach

4

8.3

Exploration for undescended testis (inguinal or scrotal area) unilateral

 3

10

Reduction of torsion of testis by surgical means with or without fixation of contralateral testis

Repair

4

11

Orchiopexy any type with or without hernia repair unilateral

4

21

bilateral

 3

8

Excision of spermatocele with or without epididymectomy (with hernia repair see49515)

Epididymis / Excision

 3

8

Excision of hydrocele unilateral

TunicaVaginalis Incison

 

5

Scrotal exploration

Scrotum / Incision

 3

4.5

Vasectomy unilateral or bilateral (independent procedure) including postopera tive semen examinations

Vas Deferens Incision

 3

20

Vasovasostomy vasovasor rhaphy uhilateral

Repair

 3

30

bilateral

 3

8

Excision of varicocele or ligation of spermatic veins for varicocele(independent procedure)

Spermatic cord / Excision

4

9.5 

With hernia repair

 3

2

Biopsy prostate needle or punch single or multiple any approach

Prostate / Incision

 

3.4 

(Ultrasound guidance for Bx of prostate (including Bx of prostate

Diagnostic Ultrasound

7

26

Prostatectomy radical

Prostate / Excision

 

 

Suprapubic one or two stages including control of

6 

20

postoperative bleed ing during the initial hospitalization complete (vasectomy meato tomy urethral calibration and/or dilation internal urethrotomy are included)

6 

26

Retropubic radical

 6 

35

Male to female

Intersex Surgery

 Integumentary System

Average duration of stay

ANES

UNITS

Operation Type

Department

 2-3 Days

2.5

Exision of nail matrix , partial or complete ( e.g, ingrown of deformed nail) , for permanent removal

Nails

Reconstruction . nail bed simple

5

6.5 

Excision of pilonidal cyst or sinus Extensive

Miscellaneous

5

8

complicated

8

Excision and repair by free skin graft ( excisional preparation or creation of recipient site): When the defect requiring repair with a free skin graft is created by excision of essentially intact skin , scar or other lesion(  including subcutaneous tissues),identify this excisional procedure separately by using this procedure number and value at 50 percent of the listed value of the free skin graft be used for the repair in accordance with its type , size and location

Free skin Grafts

6.1

Split skin graft , trunk , scalp arms legs , hands , and feet   ( except multiple digits ) , to 100 sq . cm or each one percent of body area of infants and children

5

Intermediate " delay " of any flap. Primary " delay " small flap or sectioning of pedicle of tubed or direct flap, trunk

Skin Flaps ( skin and Deep Tissue)

5

Scalp, arms and legs

5

Forehead, cheeks, chin mouth, neck, axillae, genitalia, hands and feet

 7

Electrolysis epilation, each hour

Destruction

Mastotomy with exploration or drainage of abscess, deep

Breast  (Incision)

 3.5

Biopsy of breast incisional

5

Excision of cyst, fibro-adenoma or other benign tumor, aberrant breast tissue , duct lesion or nipple lesion , male or female , one or more lesions , unilateral

 7

Mastectomy for gyneconastia through circunareolar or other incision

Mastectomy, partial  ( quadrectomy or more)

17 

With axillary lymphads nectomy

19 

Mastectomy, modified radical, including axillary lymph nodes but leaving pectoral muscles

Musculoskeletal system

 

Department

Operation Type

UNITS

ANES

Average duration of stay

Introduction or remaval

Major joint or bursa (e.g., shoulder, hip, knee joint, subacromial bursa )

0.6

3

2-4 Days

Humerus ( uper arm ) and Elbow / Excision

Excision of tumor, benign, deep, subfascial or intermuscular

 3

 3 

Pelvis and Hip Joint   ( Incision )

Incision and drainage of deep abscess or hematoma

3

Pelvis and Hip joint / Excision

Radical resection of tumor  ( e.g., malignant neoplasm), soft tissue of pelvis and hip area

15 

6

Femur ( Tigh Region ) and Knee joint

Radical resection of tumor ( e.g., malignant neoplasm), soft tissue of knee or thigh area

14

4

Excision of synovial cyst of popliteal space ( e.g., Baker's cyst )

9

AMPUTATION

Leg, through tibia and fibula, any method

14.5 

Toe, metatarsophalangeal joint

  3.1   3

Department

Operation Type

UNITS

ANES

Average duration of stay

Vulva and Introitus ( Incision )

Incision and drainage, abscess of vulva, extensive

0.8 

 3

2-4 Days 

Incision and drainage of Bartholin's abscess, unilateral

0.8

  3

Marsupialization of Bartholin's cyst or abscess

4

 3

Vulva and Introitus (Excision (

Biopsy of vulva (independent procedure )

0.7

    3

Vulvectomy, partial, unilateral or bilateral (but less than 80% of vulvar area)

11

 

4

Hymenectomy, partial or complete excision of hymen

3.5

Hymenotomy

1.1 

3

Excision of Bartholin's tumor or cyst

 4.3 

3

REPAIR

Plastic repair of vulva

4.8

3

Vagina / Excision

Biopsy of vaginal mucosa (independent procedure)

  0.8 

3

Excision of vaginal septum

 5

3

Excision of vaginal cyst or tumor

3.8

3

Vagina/ repaire

Colpoperineorrhaphy, suture of injury of vagina and/or perineum ( non-obstetrical)

 6.5

4

Posteriror colporrhaphy, repair of rectocele (independent procedure)

8

   4

Combined anterior-posterior colporrhaphy

 12 

4

Sling operation for stress incontinence (e.g., fascia or synthetic )

14

 6

Pereyra procedure, including anterior colporrhaphy

12.5

6

Closure of rectovaginal fistula, vaginal approach

13

4

Abdominal approach

17.5 

6

With concomitant colostomy

  19.5 

6

Closure of urethrovaginal fistula

  14.5 

Closure of vesicovaginal fistula, vaginal approach

  14.5

Vagina /manipulation

Dilation of vagina under anesthesia

2

3

Corpus Uteri ( Excision )

Excision / of pelvic floor with repair of pelvic floor

15 

6

Dilation and curettage, diagnostic and/or therapeutic (non-obstetrical)

4

3

Myomectomy, single or multiple, excision of fibroid tumor of uterus, abdominal approach (independent procedure)

12 

6

Vaginal approach

9

Total hysterectomy(corpus and cervix), with or with out tubes, and /or ovaries, one or both

17

Cervical malignancy, with bilateral pelvic lymphade nectomy, including external iliac, hypogastric and obturator nodes ( Wertheim type operation)

35

Vaginal hysterectomy

18.5 

6

With plastic repair of vagina, anterior and/or posterior colporrhaphy

21 

INTRODUCTION

Removal of IUD

0.5 

3

REPAIR

Hysterorrhaphy, repair of ruptured uterus ( non-obstertrical )

 11

Oviduct ( Incision )

Transection of fallopian tube, unilateral or bilateral, abdominal or vaginal approach

10

  6

Salpingectomy, complete or partial, unilateral or bilateral (independent procedure)

10.4 

Salpingo-oophorectomy, complete or partial, bilateral or unilateral (independent procedure)

11.4 

6

Ovary ( Excision )

Ovarian cystectomy (unilateral or bilateral)

 10 

Oophorectomy, unilateral or bilateral, partial or total (independent procedure)

10

6

Resection of ovarian malignancy with bilateral salpingo-oophorectomy and omentectomy

 16 

6

With total abdominal hysterectomy, pelvic and limited para-aortic lymphadenectomy

18

6

ENDOSCOPY-LAPAROSCOPY

For visualization of pelvic viscera

 7.5

6

With fulguration of ovarian or peritoneal lesions

       8.5

   6

With lysis of adhesions

 8.5 

6

Hysteroscopy

    4   6

Maternity Care and Delivery

Average duration of stay

ANES

UNITS

Operation Type

Department

2-4 Days 

 

6

14

Ectopic pregnancy, tubal, requiring salpingectomy or salpingostomy with or without oophorectomy, abdominal or vaginal approach

(FETAL EVALUATION TESTS (Excision

6

15

Hysterorrhaphy of ruptured uterus

REPAIR

 7

15

(Low cervical (independent procedure

CESAREAN SECTION

3

 4.5

Treatment of missed abortion, any trimester, medically or surgically completed

ABORTION

3

10

By vacuum extraction, 2nd trimester

 

Department

Operation Type

UNITSANES

Average duration of stay

Thyroid Gland (Excision)

Thyroid, total lobectomy, unilateral

16

6

2-4 Days 

With contralateral subtotal lobectomy, isthmus included

21

6

Thyroidectomy, total or complete

18

6

Near total

19

6

Subtotal or partial

17 

6

Thyroidectomy, total or subtotal, with limited neck dissection, for malignancy

26 

6

With radical neck dis-section

29

6

Parathyroid, Thymus, Adrenal Glands and Carotid Body( Excision )

Parathyroidectomy or exploration of parathyroid(s)

  18.3 

6

Thymectomy, partial or total (independent procedure)

19.5

13

Adrenalectomy, partial or complete, or exploration of adrenal gland with or without biopsy, transabdominal, lumbar or dorsal (independent procedure), unilateral

 19.5

10

Endocrin System

 

 

Respiratory system

 

Department

Operation Type

UNITS

ANES

Average duration of stay

Trachea and Bronchi ( Incision )

Tracheostomy ( independent procedure )

5.2 

6

2-4 Days 

 

Lungs and Pleura ( Incision )

 

 

Tube thoracostomy with water seal ( independent procedure )

1.5

6

Thoracotomy, major, with exploration and biopsy

 11.5

13

And cyst(s) removal, with or without pleural procedure

16

13 

Decortication ( pulmonary), independent procedure, total

20

15

Lungs and Pleura ( Excision )

 

Pneumonectomy, total

30

13 

Lobectomy, total or segmental

27

  13

 

Female Genital System

 

تاریخ آخرین بروزرسانی   :  1389-10-11 12:06        برو بالای صفحه نسخه قابل چاپ