ABSTRAK Tindakan operasi orthopaedi membutuhkan tarif yang tinggi karena dilakukan dengan alat berteknologi tinggi, proses perawatan komplek dan seringkali menggunakan implan berharga mahal. Terdapat variasi tarif rumah sakit pada operasi orthopaedi yang perlu diidentifikasi penyebabnya. Penelitian bertujuan mengetahui komponen tarif dan menganalisa faktor-faktor yang berhubungan dengan tarif operasi orthopaedi pasien JKN pada prosedur anggota tubuh atas, sendi tungkai bawah dan fusi tulang belakang pada lengkungan tulang belakang di RSUP Fatmawati tahun 2017. Desain penelitian adalah cross sectional dengan pendekatan kuantitatif melalui menghitung tagihan dan pendekatan kualitatif melalui wawancara mendalam. Hasil penelitian menunjukkan gambaran rata-rata tarif prosedur anggota tubuh atas Rp22.264.612 terdiri atas komponen bahan alat 51%, jasa rumah sakit 14% dan jasa pelayanan 35%, gambaran rata-rata tarif prosedur sendi tungkai bawah Rp61.700.637 yaitu bahan alat 75%, jasa rumah sakit 10% dan jasa pelayanan 15%, dan gambaran rata-rata tarif prosedur fusi tulang belakang Rp79.501.208 yaitu bahan alat 63%, jasa rumah sakit 11% dan jasa pelayanan 26%. Faktor penggunaan dan harga implan, tingkat keparahan, lama hari rawat, dan penggunaan ICU mempengaruhi tarif pada tiga prosedur, sedangkan faktor metode cost plus pricing dan kelas perawatan tidak mempengaruhi tarif pada tiga prosedur. RSUP Fatmawati telah melakukan upaya untuk mengatasi variasi tarif pada komponen bahan alat, jasa rumah sakit dan jasa pelayanan. Rumah Sakit perlu melakukan perhitungan unit cost berkala, pembuatan unit cost pada tagihan yang belum memiliki unit cost, pemenuhan dan kepatuhan Clinical Pathway dan Panduan Praktik Klinis untuk tindakan operasi khususnya yang memiliki lama hari rawat dan jumlah terbanyak Kata kunci: variasi tarif operasi orthopaedi, prosedur anggota tubuh atas, prosedur sendi tungkai bawah, prosedur fusi tulang belakang pada lengkungan tulang belakang, implan. ABSTRACT Orthopedic surgery requires high rates because it is done with high-tech tools, complex maintenance process and often use expensive implans. There are variations in hospital rates on orthopedic surgery that need to be identified. The objectives of the study were to determine the tariff components and to analyze factors related to the operating tariffs of JKN patients on upper limb procedures, lower limb joints and spinal fusion in the spinal arch at Fatmawati Hospital 2017. This study is cross-sectional study design with quantitative approach through counting the bill and qualitative approaches through in-depth interviews. The results of this study showed that the average tariff procedure of the limbs of Rp22,264,612 consisted of 51% of appliance component, 14% hospitals service and 35% service, the average cost of lower limb joint procedure Rp61,700,637,%, hospital services 10% and service 15%, and average picture tariff of spinal fusion procedure Rp79.501.208 yaitu appliance 63%, hospital services 11% and service 26%. Factors of use and implanation rates, severity, length of stay, and use of ICUs affect tariffs on three procedures, while cost plus pricing and treatment class methods do not affect tariffs on three procedures. RSUP Fatmawati has made efforts to overcome the variation of tariff on components of equipment, hospital services and services. Hospital need to calculate unit cost periodically, unit cost creation on bills that do not have unit cost, compliance and compliance Clinical Pathway and Clinical Practice Guidelines for surgery, especially those with long days of service and the highest number Key words : tariif variations of orthopeadi surgery, upper limb procedures, lower limb joint procedures, spine fusion procedures in the spinal cord, implans.