LUNG CENTER OF THE PHILIPPINES

PHILHEALTH CASE RATES

MOST COMMON PROCEDURE CASE RATES

RVS CODE DESCRIPTION CASE RATE PROF. FEE HCI FEE

19100 Biopsy of breast; needle core 3,640 840 2,800
19101 Biopsy of breast; incisional 5,560 1,260 4,300
19120 Excision of cyst,fibroadenoma or 8,020 2,520 5,500
other benign breast tissue 1 or more
lesion
19160 Mastectomy,partial 22,000 8,800 13,200
19180 Mastectomy,simple,complete 22,000 8,800 13,200
19200 Mastectomy, radical 22,000 8,800 13,200
19240 Mastectomy, modified radical 22,000 8,800 13,200
27125 Partial Hip replacement 37,180 18,480 18,700
27130 Total Hip replacement 53,400 29,400 24,000
31600 Tracheostomy,planned 12,120 6,720 5,400
31601 Tracheostomy,planned;under 2 years 12,540 7,140 5,400
31603 Tracheostomy,emergency procedure 7,140 4,760 2,380
31622 Bronchoscopy,diagnostic, w/ or w/o 10,960 5,460 5,500
cell washing or brushing
31625 Bronchoscopy, w/ biopsy 10,960 5,460 5,500
31635 Bronchoscopy; w/ removal of foreign 18,000 8,400 9,600
body
31640 Bronchoscopy; w/ excision of tumor 30,300 16,800 13,500
32000 Thoracentesis 1,260 840 420
32005 Chemical Pleurodesis 10,540 5,040 5,500
32020 Tube Thoracotomy 7,980 5,320 2,660
32100 Thoracotomy,major 37,800 21,000 16,800
32220 Decortication,pulmonary;total 38,440 19,740 18,700
32225 Decortication,pulmonary;partial 30,300 16,800 13,500
32310 Pleurectomy,parietal 37,800 21,000 16,800
32320 Decortication & parietal pleurectomy 37,800 21,000 16,800
32400 Biopsy of pleura 5,560 1,260 4,300
32402 Biopsy,pleura;open 37,180 18,480 18,700
32405 Biopsy, lung or mediastinum 8,440 2,940 5,500
32440 Removal of lung,total pneumonectomy 46,500 25,200 21,300
32480 Removal of lung,other than total 41,160 24,360 16,800
pneumonectomy;single lobe (lobectomy)
32482 Removal of lung,other than total 46,500 25,200 21,300
Pneumonectomy; 2 lobes (bilobectomy )
32500 Removal of lung,other than total 40,320 23,520 16,800
pneumonectomy;wedge resection
32601 Thoracoscopy,lungs & pleura w/o biopsy 11,980 5,880 6,100
32602 Thoracoscopy,lung & pleura w/ biopsy 12,900 6,300 6,600
32605 Thoracoscopy,mediastinal space w/o biopsy 12,120 6,720 5,400
32606 Thoracoscopy,mediastinal space w/ biopsy 12,120 6,720 5,400
32650 Thoracoscopy; w/ pleurodesis 12,120 6,720 5,400
32651 Thoracoscopy,w/ partial pulmonary 12,120 6,720 5,400
decortication
32652 Thoracoscopy; w/ total pulmonary decortication 12,120 6,720 5,400
32655 Thoracoscopy; w/ excision-plication of bullae 41,160 24,360 16,800
including any pleural procedure
32656 Thoracoscopy, w/ parietal pleurectomy 38,640 21,840 16,800
32659 Thoracoscopy, w/ creation of pericardial 38,640 21,840 16,800
window or partial resection of pericardial sac
32660 Thoracoscopy, w/ total pericardiectomy 41,160 24,360 16,800
32661 Thoracoscopy, w/ excision of pericardial cyst, 41,160 24,360 16,800
tumor or mass
32662 Thoracoscopy, w/ excision of mediastinal cyst, 41,160 24,360 16,800
 tumor or mass
32663 Thoracoscopy, w/ lobectomy,total or segmental 46,500 25,200 21,300
33010 Pericardiocentesis 8,020 2,520 5,500
33015 Tube pericardiostomy 9,700 4,200 5,500
36430 Outpatient transfusion of blood or blood products;1 or more 3,640 840 2,800
36488 Placement of central venous catheter (jugular or 9,700 4,200 5,500
other vein) (e.g.,hemodialysis,chemotherapy);
percutaneous cutdown
36825 Creation of atriovenous fistula 12,900 6,300 6,600
38220 Bone marrow aspiration or biopsy 10,880 3,780 7,100
38500 Biopsy or excision or lymph nodes 5,680 1,680 4,000
38505 Biopsy or excision or lumph nodes; by needle, 5,680 1,680 4,000
Superficial ( e.g., cervical,inguinal,axilliary)
38510 Biopsy or excision or lymph nodes; deep cervical 8,260 3,360 4,900
39000 Mediastinotomy 18,000 8,400 9,600
39200 Excision of mediastinal cyst 37,800 21,000 16,800
39220 Excision of mediastinal tumor 41,160 24,360 16,800
39400 Mediastinoscopy 14,960 7,560 7,400
43020 Esophagotomy, cervical approach, w/ removal of foreign body 12,120 6,720 5,400
43045 Esophagotomy, thoracic approach, w/ removal of foreign body 37,800 21,000 16,800
43107 Total or near esophagectomy, w/o thoracotomy; w/ 55,000 33,600 21,400
pharyngogastrostomy or cervical esophagogastrotomy, w/ or
w/o pyloroplasty
43108 Total or near esophagectomy, w/o thoracotomy; w/ colon 58,800 37,800 21,000
interposition or small bowel reconstruction, including bowel
mobilization, preparation & anastomosis
43112 Total or near total esophagectomy, w/ thoracotomy; w/ 59,640 38,640 21,000
pharyngogastrostomy or cervical esophagogastrotomy, w/ or
w/o pyloroplasty
43113 Total or near esophagectomy, w/ thoracotomy; w/ colon 63,000 42,000 21,000
interposition or small bowel reconstruction, including bowel
 mobilization,preparation & anastomosis
43116 Partial esophagectomy, cervical w/ free intestinal graft, 55,000 33,600 21,400
including microvascular anastomosis, obtaining the graft &
intestinal reconstruction
43117 Partial esophagectomy,distal two-thirds, w/ thoracotomy & 55,000 33,600 21,400
separate abdominal incision, w/ or w/o proximal gastrectomy
w/ thoracic esophagostrotomy, w/ or w/o pyloroplasty
43118 Partial esophagectomy, distal two-thirds; w/ thoracotomy & 58,800 37,800 21,000
separate abdominal incision, w/ or w/o proximal gastrectomy
w/ colon interposition or small bowel reconstruction,including
bowel mobilization,preparation & anastomosis
43121 Partial esophagectomy,distal two-thirds, w/ thoracotomy only 55,000 33,600 21,400
w/ or w/o proximal gastrectomy, w/ thoracic esophagogastrotomy
w/ or w/o pyloroplasty
43122 Partial esophagectomy,thoracoabdominal or abdominal approach, 55,000 33,600 21,400
w/ or w/o proximal gastrectomy, w/ thoracic esophagogastrotomy
w/ or w/o pyloroplasty
43123 Partial esophagectomy, thoracoabdominal or abdominal approach 58,800 37,800 21,000
w/ or w/o proximal gastrectomy; w/ colon interposition or small
bowel reconstruction,including bowel mobilization,preparation &
anastomosis
43124 Total or partial esophagectomy,w/o reconstruction w/ cervical 46,500 25,200 21,300
esophagostomy
43200 Esophagoscopy, rigid or flexible; diagnostic; w/ or w/o collection 10,540 5,040 5,500
of specimen by brushing or washing
43202 Esophagoscopy, rigid or flexible; w/ biopsy, single or multiple 10,540 5,040 5,500
43204 Esophagoscopy, rigid or flexible; w/ injectable sclerosis of 14,960 7,560 7,400
esophageal varices
43205 Esophagoscopy, rigid or flexible; w/ band ligation of esophageal 14,960 7,560 7,400
varices
43215 Esophagoscopy, rigid or flexible; w/ removal of foreign body 14,960 7,560 7,400
43216 Esophagoscopy, rigid or flexible; w/ removal of tumors,polyps or 11,980 5,880 6,100
other lesion by hot biopsy forceps or bipolar cautery
43217 Esophagoscopy, rigid or flexible; w/ removal of tumors,polyps or 12,120 6,720 5,400
other lesion by snare technique
43219 Esophagoscopy, rigid or flexible; w/ insertion of plastic tube 18,000 8,400 9,600
43220 Esophagoscopy, rigid or flexible; w/ balloon dilation 18,000 8,400 9,600
43226 Esophagoscopy, rigid or flexible; w/ insertion of guide wire 18,000 8,400 9,600
43227 Esophagoscopy, rigid or flexible; w/ ablation of tumor,polyps or 18,000 8,400 9,600
other lesion not amenable to removal by hot biopsy forceps,
bipolar cautery or snare technique
43620 Gastrectomy, total; w/ esophagoenterostomy 63,000 42,000 21,000
43621 Gastrectomy, total; w/ Roux-en-Y reconstruction 67,200 46,200 21,000
43622 Gastrectomy, total; w/ formation of intestinal pouch 67,200 46,200 21,000
43631 Gastrectomy, partial, distal; w/ gastroduodenostomy 55,000 33,600 21,400
43632 Gastrectomy, partial, distal; w/ gastrojejunostomy 5,500 33,600 21,400
43633 Gastrectomy, partial, distal; w/ Roux-en-Y reconstruction 63,000 42,000 21,000
43634 Gastrectomy, partial, distal; w/ formation of intestinal pouch 63,000 42,000 21,000
43638 Gastrectomy, partial, proximal, thoracic or abdominal approach 63,000 42,000 21,000
including esophagogostrostomy, w/ vagotomy
43639 Gastrectomy, partial, proximal, thoracic or abdominal approach 67,200 46,200 21,000
including esophagogastrostomy, w/ vagotomy; w/ pyloroplasty
43750 Percutaneous placement of gastrostomy tube 8,020 2,520 5,500
43760 Change of gastrostomy tube 5,560 1,260 4,300
43800 Pyloroplasty 37,800 21,000 16,800
43810 Gastroduodenostomy 63,000 42,000 21,000
43820 Gastrojejunostomy, w/o vagotomy 46,500 25,200 21,300
43825 Gastrojejunostomy, w/ vagotomy 53,400 29,400 24,000
43830 Gastrostomy, temporary (tube,rubber or plastic) 37,800 21,000 16,800
43832 Gastrostomy, permanent, w/ construction of gastric tube 37,800 21,000 16,800
44140 Colectomy, partial; w/ anastomosis 58,800 37,800 21,000
44141 Colectomy, partial; w/ skin level cecostomy or colostomy 58,800 37,800 21,000
44143 Colectomy, partial; w/ end colostomy & closure of distal segment 58,800 37,800 21,000
44144 Colectomy, partial; w/ resection; w/ colostomy or ileostomy & 58,800 37,800 21,000
creation of ,mucofistula
44145 Colectomy, partial; w/ coloproctostomy 56,680 35,280 21,400
44146 Colectomy, partial; w/ coloproctostomy, w/ colostomy 58,800 37,800 21,000
44147 Colectomy, partial; abdominal & transanal apparoach 63,000 42,000 21,000
44150 Colectomy, total, abdominal, w/o protectomy, w/ ileostomy or 63,000 42,000 21,000
ileoproctostomy
44151 Colectomy, total, abdominal, w/o protectomy, w/ continent ileostomy 63,000 42,000 21,000
44152 Colectomy, total, abdominal, w/o protectomy, w/ rectal mucosectomy 67,200 46,200 21,000
ileoanal anastomosis, w/ or w/o loop ileostomy
44153 Colectomy, total, abdominal, w/o protectomy, w/ rectal mucosectomy 67,200 46,200 21,000
ileoanal anastomosis, creation of ileal reservoir, w/ or w/o loop
ileostomy
44155 Colectomy, total, abdominal, w/ protectomy; w/ ileostomy 67,200 46,200 21,000
44156 Colectomy, total, abdominal, w/ protectomy; w/ continent ileostomy 67,200 46,200 21,000
44160 Colectomy w/ removal of terminal ileum & ileocolostomy 67,200 46,200 21,000
47420 Choledochotomy or choledochostomy w/ exploration drainage or 37,800 21,000 16,800
removal of calculus, w/ or w/o cholecystectomy; w/o transduodenal
sphincterotomy or sphincteroplasty
47425 Choledochotomy or choledochostomy w/ exploration, drainage or 46,500 25,200 21,300
removal of calculus, w/ or w/o cholecystectomy; w/ transduodenal
sphincterotomy or sphincteroplasty
47480 Cholecystectomy or cholecystotomy w/ exploration, drainage or 30,300 16,800 13,500
removal of calculus
47490 Percutaneous cholecystectomy 30,300 16,800 13,500
47562 Laparoscopy, surgical; cholecystectomy ( any method) 31,000 12,400 18,600
47563 Laparoscopy, surgical; cholecystectomyw/ cholangiography 31,000 12,400 18,600
47564 Laparoscopy, surgical; cholecystectomy w/ exploration of common duct 46,500 25,200 21,300
47570 Laparoscopy, surgical; cholecystoenterostomy 31,000 12,400 18,600
47600 Cholecystectomy 31,000 12,400 18,600
47605 Cholecystectomy; w/ cholangiography 31,000 12,400 18,600
47610 Cholecystectomy w/ exploration of common duct 46,500 25,200 21,300
47612 Cholecystectomy w/ exploration of common duct; w/choledochoenterostomy 53,400 29,400 24,000
47620 Cholecystectomy w/ exploration of common duct; w/ transduodenal 46,500 25,200 21,300
sphincterotomy or sphincteroplasty, w/ or w/o cholangiography
96408 Chemotherapy administration 7,280 1,680 5,600
96440 Chemotherapy administration into pleura cavity,requiring & 5,560 1,260 4,300
including thoracentesis
96445 Chemotherapy administration into peritoneal cavity,requiring 8,020 2,520 5,500
& including peritoneocentesis
96450 Chemotherapy administration into CNS, requiring & including 5,560 1,260 4,300
spinal puncture
96542 Chemotherapy injection,subarchnoid or interventricular via 3,640 840 2,800
subcutaneous resevior