門諾醫院-Mennonite Christian Hospital

健保部分給付項目「陶瓷人工髖關節」及「骨髓內固定」之相關規定說明

(一)部分給付差額資訊公開(人工髖關節及骨髓內固定).pdf
(二)本院使用品項之相關資訊如下：

陶瓷人工髖關節
特材代碼	品名規格/健保使用規範	廠牌	健保給付點數	病患自付差額
FBHBCCERA1Z1	西羅索陶瓷半人工髖關節組	Zimmer	35,195	37,430
FBHBCCERA1Z1	席萊斯股骨系統-(陶瓷半人工髖關節組含陶瓷股骨頭)	Zimmer	35,195	37,430
FBHBCCERA3Z1	內外側錐形人工股骨修補系統-(百優陶瓷半人工髖關節組含百優陶瓷股骨頭	Zimmer	35,195	65,000
FBHBCCERA3Z1	席萊斯股骨系統-(百優陶瓷半人工髖關節組含百優陶瓷股骨頭)	Zimmer	35,195	68,248
FBHPCCERA3Z1	百優螺釘固定式陶瓷全人工髖關節組(With傳統THR)	Zimmer	39,396	97,519
FBHPCCERA3Z1	百優螺釘固定式陶瓷全人工髖關節組(With CLS System)	Zimmer	39,396	96,462
FBHPCCERA3Z1	百優螺釘固定式陶瓷全人工髖關節組(With M/L Taper THR)	Zimmer	39,396	100,019
FBHPCCERA4Z1	百優螺釘固定式陶瓷全人工髖關節組(With Kinectiv M/L Taper THR)	Zimmer	49,319	105,000
FBHPCCERA5Z1	百優陶瓷股骨頭全人工髖關節組(含百優陶瓷股骨頭)	Zimmer	39,396	65,019
FBHPCCERA5Z1	席萊斯全人工髖關節股骨系統(含百優陶瓷股骨頭)	Zimmer	39,396	67,000
FBHPCCERA6Z1	"捷邁"百優人工髖關節系統:陶瓷股骨柄組合式(陶瓷HEAD) "ZIMMER"BIOLOX CERAMIC FEMORAL HEADS:BIOLOX DELTA CERAMIC TOTAL HIP SYSTEM	Zimmer	49,319	67,000
FBHLE29866Z1	"邦美"今適穩人工髖臼系統聚乙烯襯墊 - E1抗氧化超耐磨襯墊(天然維他命E) "Biomet" G7 Acetabular System Polyethylene Acetabular Liner- E1 Liner(Vitamin E)	Zimmer	4,018	93,424
FBHLCCERA2Z1	"捷邁"百優人工髖關節系統:陶瓷髖臼杯內襯 "ZIMMER"BIOLOX CERAMIC FEMORAL HEADS:BIOLOX DELTA TAPER LINER(CERAMIC)	Zimmer	4,018	35,883
FBHHCCERA2Z1	重建型百優陶瓷股骨頭	Zimmer	4,352	64,450
FBHHCCERA2Z1	百優人工髖關節系統(百優陶瓷股骨頭-首次型)	Zimmer	4,352	63,683
FBHRCCERA2Z1	"捷邁"百優人工髖關節系統:重建型(陶瓷HEAD) "ZIMMER"BIOLOX CERAMIC FEMORAL HEADS:BIOLOX DELTA CERAMIC REVISION HIP SYSTEM	Zimmer	52,796	68,935
FBHRCCERA3Z1	"捷邁"百優人工髖關節系統:重建型(陶瓷HEAD+陶瓷LINER) "ZIMMER"BIOLOX CERAMIC FEMORAL HEADS:BIOLOX DELTA CERAMIC REVISION HIP SYSTEM	Zimmer	52,796	101,157
FBHPEVTMA1BM	"邦美"今適穩維他命Ｅ陶瓷人工髖關節系統 "Biomet" G7 Vitamin E Ceramic Total Hip System	BIOMET	39,396	157,265
FBHPEVTMA5BM	"邦美"今適穩組合式維他命Ｅ陶瓷人工髖關節系統 "Biomet" G7 Kinectiv Vitamin E Ceramic Total Hip System	BIOMET	49,319	157,265
FBHREVTMA1BM	"邦美"今適穩維他命Ｅ陶瓷重建型人工髖關節系統 "Biomet" G7 Vitamin E Ceramic Revision Total Hip System	BIOMET	52,796	160,249
※凡符合傳統人工髖關節組之適應症者，如自願選用陶瓷人工髖關節組時，則按傳統人工髖關節組給付，超過部分由病患自付。

骨髓內固定

特材代碼	品名規格/健保使用規範	廠牌	健保給付點數	病患自付差額
FBNG118785S1	"信迪思"長股骨髓內釘系統 "Synthes"PFNA II Implant	SYNTHES	19,036	51,500
FBNG122572Z1	“捷邁”人工骨髓內釘-髓內釘組 “Zimmer” Natural Nail System Cephalomedullary Nail-CM SET	Zimmer	19,036	57,868
FBN05TB495Z1	“捷邁”骨釘系統-脛骨組“ZIMMER” NATURAL NAIL SYSTEM-TIBIAL SET	Zimmer	19,036	55,964
FBN05MHN01S1	"信迪思"多方向鎖定肱骨髓內釘系統(組)"SYNTHES"MULTILOC HUMERAL NAILING SYSTEM	SYNTHES	19,036	49,714
FBN05FM492Z1	“捷邁”骨釘系統-股骨組“ZIMMER” NATURAL NAIL SYSTEM-FEMORAL SET	Zimmer	19,036	55,964
FBN05ETN00S1	"信迪思"萬向脛骨髓內釘系統-中空脛骨髓內釘組"SYNTHES"EXPERT TIBIA NAIL SYSTEM: EXPERT TIBIAL NAIL CANNULATED TITANIUM ALLOY	SYNTHES	19,036	50,964
FBN05A2FN0S1	"信迪思"第二代順行股骨髓內釘植入物-股骨順行髓內釘組"SYNTHES"EXPERT A2FN ANTEGRADE FEMORAL NAIL IMPLANTS	SYNTHES	19,036	49,714

(三)健保醫療材料實施部分給付內容，請連結到→ 這裡

更新日期:2022/06/20 公告單位:健保系統課