PhilHealth Subsidy & RVS Directory
How your PhilHealth subsidy allowance works for procedures that use FlexiOss®, plus a 2026 RVS reference for orthopedic, spinal, dental / maxillofacial, and otologic surgery — and how a premium biomaterial upgrade is settled through a transparent co-payment.
How PhilHealth Reimbursement Works
PhilHealth reimburses the surgical procedure, not the brand of biomaterial. FlexiOss® is the synthetic graft utilized within that covered procedure.
The procedure is covered
PhilHealth provides a fixed subsidy allowance for the surgical procedure itself — never for any specific commercial brand of biomaterial.
FlexiOss® is the premium upgrade
FlexiOss® is the advanced 3rd-generation synthetic graft the surgeon uses to fill or obliterate the defect during that covered procedure.
A co-payment covers the upgrade
Your subsidy allowance is credited to the hospital bill; the premium material is typically settled through a transparent institutional or out-of-pocket co-payment.
Clinical Sizing Disclaimer: The product variant selections and dimensional sizing recommendations listed within this directory serve as reference guidelines for standard anatomical reconstructions. The final dimensions, length, and specific variant of the FlexiOss® biomaterial deployed must be determined solely by the attending operating physician or surgeon based on real-time intraoperative defect boundaries, clinical judgment, and individual patient presentation.
Patient Health Literacy
Understanding Premium Technology & Co-Payments
Standard healthcare allocations are engineered around standard, legacy materials. However, achieving optimal, long-term surgical success often requires advanced clinical technology. FlexiOss® is a premium, 3rd-generation biphasic biomaterial matrix clinically proven to accelerate bone healing kinetics by up to 50% while preventing graft migration.
In private medical centers, your PhilHealth Case Rate functions as a baseline subsidy allowance—a credit applied directly to your total hospital bill. Because FlexiOss® represents an advanced, specialized tier of bio-engineering, patients routinely navigate a standard co-payment or out-of-pocket structure to cover the premium material cost. Investing in premium biomaterials intraoperatively significantly reduces the long-term risk of structural non-unions, graft rejection, and costly secondary revision surgeries.
2026 RVS & Base Subsidy Allowance Directory
Minor Bone Reconstruction Baseline
Clinical Application
Standard small-defect filling, burr-hole packing, and minor structural stabilization.
Product Line Variant
Recommended Baseline Size
1 cm – 2 cm structural blocks
Base PhilHealth Subsidy Allowance
Credited toward your total hospital bill
₱20,553.00
As a premium, 3rd-generation biomaterial, FlexiOss® typically involves a separate institutional or out-of-pocket co-payment beyond this baseline allowance.
Major Bone Reconstruction Baseline
Clinical Application
Large-segment bone-defect repairs, tumor cavitary packing, and complex skeletal stabilization.
Product Line Variant
Recommended Baseline Size
5 cm × 5 cm or larger customized blocks
Base PhilHealth Subsidy Allowance
Credited toward your total hospital bill
₱35,100.00
As a premium, 3rd-generation biomaterial, FlexiOss® typically involves a separate institutional or out-of-pocket co-payment beyond this baseline allowance.
Co-Payment Subsidy Estimator
Add the procedures planned for your session to estimate the baseline subsidy allowance PhilHealth credits to your hospital bill. With multiple procedures, PhilHealth credits 100% of the highest-valued allowance and 50% of each additional one. A premium biomaterial like FlexiOss® is typically settled through a separate co-payment.
Add one or more procedures above. With a single code you see its base subsidy allowance; add more to simulate a bundled session, with the 50% adjustment for each additional procedure applied automatically.
For Surgeons
Map your operative report to the primary RVS code so the procedure’s subsidy allowance is correctly credited.
For multiple procedures in one session, sequence the highest-valued code first (100%), with each additional one at 50%.
Document defect size, indication, and graft utilization clearly to support a smooth claim at adjudication.
Confirm the current subsidy allowance against the latest PhilHealth circular for your facility tier.
For Patients
Your PhilHealth subsidy allowance is automatically credited toward your total hospital bill.
Premium biomaterials such as FlexiOss® are an advanced upgrade, usually settled through a separate co-payment.
Ask whether your private HMO or insurance can offset part of the biomaterial co-payment.
Confirm your final subsidy and co-payment with your hospital’s PhilHealth and billing desks before your procedure.
Operational Note on Combined Procedures
When a bone-graft application is performed adjunctively alongside a primary stabilizing framework (such as an ORIF plate fixation), PhilHealth credits 100% of the highest-valued subsidy allowance, while the secondary bone-graft component (RVS 20900 / 20902) can be concurrently appended at 50% of its designated subsidy allowance.
Regulatory Note on Dimensions
Variances in pathological presentation, structural degradation, and target defect boundaries mean that actual dimensional consumption will fluctuate. The final determination of required biomaterial dimensions remains strictly under the jurisdiction of the operating surgeon.
Reimbursement Questions
No. PhilHealth provides a fixed subsidy allowance for the surgical procedure — not for any specific commercial biomaterial brand. FlexiOss® is the advanced synthetic graft the surgeon uses within that covered procedure, and the subsidy allowance is credited to the hospital bill.
Disclaimer: The subsidy allowances and RVS codes listed on this page are provided as a general patient-education and reimbursement-mapping resource. Subsidy allocations and approval rules are subject to change without prior notice via new PhilHealth Memoranda, Circulars, or directives. The premium FlexiOss® biomaterial is settled through a separate institutional or out-of-pocket co-payment; final coverage and co-payment values are determined solely by PhilHealth and the hospital upon formal claim adjudication. Veterinary procedures (FlexiOss® Vet) are entirely ineligible for human PhilHealth subsidy allowances and are intentionally excluded from this directory.