[Program Jaminan Kesehatan Nasional menerapkan sistem pembayaran prospektifyaitu dengan tarif INA CBG?s untuk pelayanan di rumah sakit. Tujuan penelitianini yaitu untuk menganalisis selisih biaya layanan dengan tarif INA CBG?s dantarif rumah sakit khusus kasus sectio caesaria dengan kode ICD X (O.342) padapasien BPJS berdasarkan komponen biaya serta mengetahui gambaran perbedaanbiaya layanan tersebut berdasarkan karakteristik pasien. Jenis penelitian iniadalah deskriptif kuantitatif dengan metode cross sectional dengan sampelsebanyak 89 pasien. Dari hasil penelitian didapat rata-rata selisih biaya layananuntuk kasus sectio caesaria dengan diagnosa utama O.342 terhadap tarif rumahsakit adalah selisih negatif (efisien) sebesar Rp 1,236,793,- dengan CRR (costrecovery rate) 120% dan terhadap tarif INA CBG?s adalah selisih positif (tidakefisien) sebesar Rp 1,974,050,- dengan CRR (cost recovery rate) 68% Gambaranperbedaan biaya layanan berdasarkan karakteristik pasien yang memilikihubungan dengan besarnya biaya layanan adalah kelas rawat (p=0,000), diagnosissekunder (p=0,050) dan lama hari rawat (p=0,046), sedangkan yang tidakmemiliki hubungan dengan besarnya biaya layanan adalah umur pasien(p=0,956).;The National Health Insurance Scheme implementing prospective paymentsystem INA CBG's rates for hospital services. The purpose of this study is toanalyze the difference in cost services with INA CBG's rates and hospitals ratesspecialty in patients BPJS with sectio caesaria cases with ICD X (O.342) basedcomponent costs and reveal the differences in cost of these services is based onthe characteristics of the patient. This type of research is quantitative descriptivecross sectional method with a sample of 89 patients. The result is the averagedifference between the cost of services for Caesaria sectio cases with primarydiagnosis O.342 against hospital rates are negative difference (efficient) to Rp1,236,793, - with the CRR (cost recovery rate) of 120% and against the CBG'sINA rates are positive difference (inefficient) to Rp 1,974,050, - with the CRR(cost recovery rate) of 68% service charge difference picture based on thecharacteristics of patients who have a relationship with the cost of the service isambulatory class (p = 0.000), a secondary diagnosis (p = 0.050) and the lengthof stay (p = 0.046), whereas no relation to the cost of the service is the age of thepatients (p = 0.956)., The National Health Insurance Scheme implementing prospective paymentsystem INA CBG's rates for hospital services. The purpose of this study is toanalyze the difference in cost services with INA CBG's rates and hospitals ratesspecialty in patients BPJS with sectio caesaria cases with ICD X (O.342) basedcomponent costs and reveal the differences in cost of these services is based onthe characteristics of the patient. This type of research is quantitative descriptivecross sectional method with a sample of 89 patients. The result is the averagedifference between the cost of services for Caesaria sectio cases with primarydiagnosis O.342 against hospital rates are negative difference (efficient) to Rp1,236,793, - with the CRR (cost recovery rate) of 120% and against the CBG'sINA rates are positive difference (inefficient) to Rp 1,974,050, - with the CRR(cost recovery rate) of 68% service charge difference picture based on thecharacteristics of patients who have a relationship with the cost of the service isambulatory class (p = 0.000), a secondary diagnosis (p = 0.050) and the lengthof stay (p = 0.046), whereas no relation to the cost of the service is the age of thepatients (p = 0.956).]