diff --git a/admin/src/api/tcm.ts b/admin/src/api/tcm.ts
index 9f749516..d1215643 100644
--- a/admin/src/api/tcm.ts
+++ b/admin/src/api/tcm.ts
@@ -61,6 +61,14 @@ export function tcmDiagnosisDetail(params: any) {
     return request.get({ url: '/tcm.diagnosis/detail', params })
 }
 
+/** 设置复诊接诊率统计起始偏移（统计诊次=实单序号+偏移；1=二诊起，2=三诊起） */
+export function tcmDiagnosisSetRevisitSlotStartOffset(params: {
+    id: number
+    revisit_slot_start_offset: number
+}) {
+    return request.post({ url: '/tcm.diagnosis/setRevisitSlotStartOffset', params })
+}
+
 /** 诊单挂号 / 取消挂号 操作日志 */
 export function tcmDiagnosisGuahaoLogList(params: { id: number }) {
     return request.get({ url: '/tcm.diagnosis/guahaoLogList', params })
diff --git a/admin/src/views/consumer/prescription/components/PrescriptionOrderDetailDrawer.vue b/admin/src/views/consumer/prescription/components/PrescriptionOrderDetailDrawer.vue
index 37a8e4ad..053b7c2c 100644
--- a/admin/src/views/consumer/prescription/components/PrescriptionOrderDetailDrawer.vue
+++ b/admin/src/views/consumer/prescription/components/PrescriptionOrderDetailDrawer.vue
@@ -1290,11 +1290,15 @@ const detailFullAddress = computed(() => {
 const servicePackageOptions = ref<ServicePackageOption[]>([])
 
 async function loadServicePackageOptions() {
+    if (servicePackageOptions.value.length > 0) return
     try {
         const data: any = await getDictData({ type: 'server_order' })
-        servicePackageOptions.value = normalizeServicePackageOptions(data?.server_order)
+        const opts = normalizeServicePackageOptions(data?.server_order)
+        if (opts.length > 0) {
+            servicePackageOptions.value = opts
+        }
     } catch {
-        servicePackageOptions.value = []
+        /* 请求被同参数请求取消或失败时保留现值，open() 时会重试 */
     }
 }
 
@@ -1639,6 +1643,8 @@ async function updateJdLogistics() {
 
 // ─── 打开 / 刷新 ───
 async function open(id: number) {
+    // 页面级同参数字典请求会取消抽屉挂载时的那次（axios 去重取消），打开时兜底重试
+    void loadServicePackageOptions()
     // 显式彻底清空缓存，防止前一次弹窗的数据残留
     detailData.value = null
     detailUnlinkedPayOrders.value = []
diff --git a/admin/src/views/consumer/prescription/order_list.vue b/admin/src/views/consumer/prescription/order_list.vue
index 96a823e0..b8408da2 100644
--- a/admin/src/views/consumer/prescription/order_list.vue
+++ b/admin/src/views/consumer/prescription/order_list.vue
@@ -298,7 +298,7 @@
                         :fetch-fun="prescriptionOrderExport"
                         :params="prescriptionOrderExportParams"
                         :page-size="pager.size"
-                        export-hint="导出范围与上方筛选一致（履约状态、创建时间及其他条件均会生效）。含「自媒体渠道（挂号渠道来源）」：优先取该单关联处方登记的挂号；无则诊单下同患者挂号取 id 最大的一条（与前台挂号选择的记录一致）；业绩侧栏带渠道筛选导出时与同页列表高亮挂号同源。「服务套餐」按字典 server_order 解析展示。「处方」导出主方/辅方药材明细；「主方/辅方服用方式、天数」与详情侧栏、处方笺同口径（天数优先取订单 medication_days，缺省回退处方 usage_days / 辅方 aux_usage）。「关联收款记录」与详情侧栏同源（已支付/已退款/待审核），每笔两行展示（摘要行+明细行），多笔空行分隔，单元格自动换行。「签收日期」与详情/业绩看板同源，仅读物流库（轨迹/签收时间）：导出不再实时查快递100，速度只取决于数据库；签收时间由 `tcm:backfill-sign-time` 命令与物流自动更新定时任务落库，刚发货尚未同步的单子会暂时为空，待下次回填/定时任务刷新后显示。"
+                        export-hint="导出范围与上方筛选一致（履约状态、创建时间及其他条件均会生效）。含「自媒体渠道（挂号渠道来源）」：优先取该单关联处方登记的挂号；无则诊单下同患者挂号取 id 最大的一条（与前台挂号选择的记录一致）；业绩侧栏带渠道筛选导出时与同页列表高亮挂号同源。「服务套餐」按字典 server_order 解析展示。「处方」导出主方/辅方药材明细；「主方/辅方服用方式、天数」与详情侧栏同口径（主方/辅方天数分别取处方 usage_days、辅方 aux_usage.usage_days；「天数」列为订单 medication_days）。「关联收款记录」与详情侧栏同源（已支付/已退款/待审核），每笔两行展示（摘要行+明细行），多笔空行分隔，单元格自动换行。「签收日期」与详情/业绩看板同源，仅读物流库（轨迹/签收时间）：导出不再实时查快递100，速度只取决于数据库；签收时间由 `tcm:backfill-sign-time` 命令与物流自动更新定时任务落库，刚发货尚未同步的单子会暂时为空，待下次回填/定时任务刷新后显示。"
                     />
                 </el-form-item>
             </el-form>
diff --git a/admin/src/views/stats/revisit_rate/index.vue b/admin/src/views/stats/revisit_rate/index.vue
index 95cc95b2..00ece189 100644
--- a/admin/src/views/stats/revisit_rate/index.vue
+++ b/admin/src/views/stats/revisit_rate/index.vue
@@ -46,7 +46,7 @@
                                 <b>当月被指派总数</b>：当月内诊单被指派给医助（按指派操作时间落月，<b>剔除勾选「继承」的指派</b>)的诊单数，按「医助 × 诊单」去重；部门行 / 合计行按诊单去重。
                             </p>
                             <p>
-                                <b>诊次（第 N 次下单）</b>：患者（诊单）名下计入业绩的业务订单（剔除已取消 / 拒收 / 退款）按下单时间升序的全局序号，<b>跨月累计不重置</b>——如 5 月指派后旗下成交 4 单为二诊~五诊，下月再成交即为六诊。
+                                <b>诊次（第 N 次下单）</b>：患者（诊单）名下计入业绩的业务订单（剔除已取消 / 拒收 / 退款）按下单时间升序编号为「实单序号」，<b>统计诊次 = 实单序号 + 诊单偏移</b>（默认偏移 1 → 第 1 笔实单为二诊；偏移 2 → 第 1 笔实单为三诊，5 笔实单等价七诊）。诊次<b>跨月累计不重置</b>。诊单可在「业务订单」tab 配置偏移量。
                             </p>
                             <p>
                                 <b>当月 N 诊单数</b>：当月内下单且诊次为 N 的订单数，归属下单时点<b>持有该患者的医助</b>（指派可在往月；释放后不再归属；「继承」指派会转移持有人但不计被指派数）。
diff --git a/admin/src/views/tcm/appointment/list.vue b/admin/src/views/tcm/appointment/list.vue
index 4be8fade..9672425f 100644
--- a/admin/src/views/tcm/appointment/list.vue
+++ b/admin/src/views/tcm/appointment/list.vue
@@ -83,6 +83,23 @@
                         <el-radio-button value="0">未确认</el-radio-button>
                     </el-radio-group>
                 </div>
+                <div class="filter-group">
+                    <span class="filter-label">部门</span>
+                    <el-tree-select
+                        v-model="formData.assistant_dept_id"
+                        :data="departmentTreeRaw"
+                        class="filter-dept-select"
+                        clearable
+                        filterable
+                        check-strictly
+                        :default-expand-all="true"
+                        node-key="id"
+                        size="small"
+                        :props="assistantDeptTreeProps"
+                        placeholder="选父级含子级"
+                        @change="handleAssistantDeptChange"
+                    />
+                </div>
             </div>
 
             <el-dialog
@@ -542,6 +559,7 @@
 import { usePaging } from '@/hooks/usePaging'
 import { defineAsyncComponent, onMounted, onUnmounted, watch } from 'vue'
 import { appointmentLists, cancelAppointment, completeAppointment, appointmentDetail } from '@/api/doctor'
+import { deptAll } from '@/api/org/department'
 import { getCallSignature, generateMiniProgramQrcode, tcmDiagnosisDetail, prescriptionGetByAppointment } from '@/api/tcm'
 import { getDictData } from '@/api/app'
 import { addDoctorNote } from '@/api/patient'
@@ -603,10 +621,19 @@ const formData = reactive({
     end_date: '',
     date_preset: 'today' as '' | 'yesterday' | 'day_before' | 'today' | 'tomorrow' | 'day_after',
     diagnosis_confirmed: '' as '' | '0' | '1', // ''=全部 1=已确认 0=未确认
+    /** 接诊医生 / 诊单医助 / 挂号医助所属部门（选父级含子级） */
+    assistant_dept_id: '' as number | '',
     /** 为 1 时后端 extend 返回各状态数量，避免额外 4 次列表请求 */
     include_status_counts: 0 as 0 | 1
 })
 
+const departmentTreeRaw = ref<unknown[]>([])
+const assistantDeptTreeProps = {
+    value: 'id',
+    label: 'name',
+    children: 'children'
+}
+
 const activeTab = ref('1')
 const dateCustomVisible = ref(false)
 const statusCount = ref<Record<number, number>>({
@@ -721,6 +748,12 @@ const handleDiagnosisConfirmedChange = () => {
     loadData()
 }
 
+// 部门筛选变更
+const handleAssistantDeptChange = () => {
+    pager.page = 1
+    loadData()
+}
+
 // 快捷日期变更
 const handleDatePresetChange = (val: string | number | boolean | undefined) => {
     const v = String(val || '')
@@ -770,6 +803,7 @@ const handleReset = () => {
     formData.doctor_name = ''
     formData.date_preset = 'today'
     formData.diagnosis_confirmed = ''
+    formData.assistant_dept_id = ''
     const t = new Date()
     const p = (n: number) => String(n).padStart(2, '0')
     formData.start_date = `${t.getFullYear()}-${p(t.getMonth() + 1)}-${p(t.getDate())}`
@@ -1099,7 +1133,13 @@ formData.start_date = `${_today.getFullYear()}-${_pad(_today.getMonth() + 1)}-${
 formData.end_date = formData.start_date
 formData.status = 1
 
-onMounted(() => {
+onMounted(async () => {
+    try {
+        const deptTree = await deptAll()
+        departmentTreeRaw.value = Array.isArray(deptTree) ? deptTree : []
+    } catch {
+        departmentTreeRaw.value = []
+    }
     loadData()
     listPollTimer = setInterval(() => {
         loadData({ silent: true })
@@ -1228,6 +1268,10 @@ onUnmounted(() => {
                 padding: 6px 14px;
             }
         }
+
+        .filter-dept-select {
+            width: 200px;
+        }
     }
 }
 
diff --git a/admin/src/views/tcm/diagnosis/components/PatientOrderList.vue b/admin/src/views/tcm/diagnosis/components/PatientOrderList.vue
index d78824ff..cd522ee9 100644
--- a/admin/src/views/tcm/diagnosis/components/PatientOrderList.vue
+++ b/admin/src/views/tcm/diagnosis/components/PatientOrderList.vue
@@ -4,6 +4,43 @@
             <el-empty description="当前诊单未携带患者ID，无法列出业务订单" />
         </div>
         <template v-else>
+            <div v-if="diagnosisId > 0" class="po-revisit-offset-bar mb-3">
+                <div class="po-revisit-offset-bar__main">
+                    <span class="text-sm text-gray-600">复诊统计起始偏移</span>
+                    <el-tooltip placement="top">
+                        <template #content>
+                            <div class="max-w-xs leading-relaxed">
+                                在实单诊次序号上叠加偏移量。设为 1（默认）：第 1 笔实单计为二诊；设为 2：第 1 笔实单计为三诊——若有 5 笔实单，则统计上相当于计至七诊（5+2）。
+                            </div>
+                        </template>
+                        <el-icon class="text-gray-400 align-middle ml-1"><QuestionFilled /></el-icon>
+                    </el-tooltip>
+                    <el-input-number
+                        v-model="revisitSlotStartOffset"
+                        v-perms="['tcm.diagnosis/setRevisitSlotStartOffset']"
+                        :min="1"
+                        :max="20"
+                        :step="1"
+                        controls-position="right"
+                        class="w-[120px] ml-3"
+                        :disabled="offsetSaving"
+                    />
+                    <span class="text-xs text-gray-500 ml-2">
+                        第 1 笔实单计为{{ visitSlotStartLabel }}
+                    </span>
+                </div>
+                <el-button
+                    v-perms="['tcm.diagnosis/setRevisitSlotStartOffset']"
+                    type="primary"
+                    size="small"
+                    :loading="offsetSaving"
+                    :disabled="!offsetDirty"
+                    @click="saveRevisitSlotStartOffset"
+                >
+                    保存
+                </el-button>
+            </div>
+
             <el-table
                 v-loading="pager.loading"
                 :data="pager.lists"
@@ -12,6 +49,23 @@
                 empty-text="暂无业务订单"
             >
                 <el-table-column label="订单编号" prop="order_no" min-width="200" show-overflow-tooltip />
+                <el-table-column label="全局诊次" width="96" align="center">
+                    <template #default="{ row }">
+                        <span v-if="row.global_visit_seq">{{ row.global_visit_seq }}诊</span>
+                        <span v-else class="text-gray-400">—</span>
+                    </template>
+                </el-table-column>
+                <el-table-column label="计入统计" width="96" align="center">
+                    <template #default="{ row }">
+                        <el-tag
+                            v-if="row.counts_for_revisit_rate"
+                            type="success"
+                            size="small"
+                            effect="plain"
+                        >是</el-tag>
+                        <el-tag v-else type="info" size="small" effect="plain">否</el-tag>
+                    </template>
+                </el-table-column>
                 <el-table-column label="金额" width="120" align="right">
                     <template #default="{ row }">
                         <span class="text-red-500 font-semibold">¥{{ formatAmount(row.amount) }}</span>
@@ -63,9 +117,11 @@
 
 <script setup lang="ts">
 import { computed, reactive, ref, watch } from 'vue'
+import { QuestionFilled } from '@element-plus/icons-vue'
 import { usePaging } from '@/hooks/usePaging'
-import { prescriptionOrderLists } from '@/api/tcm'
+import { prescriptionOrderLists, tcmDiagnosisDetail, tcmDiagnosisSetRevisitSlotStartOffset } from '@/api/tcm'
 import PrescriptionOrderDetailDrawer from '@/views/consumer/prescription/components/PrescriptionOrderDetailDrawer.vue'
+import feedback from '@/utils/feedback'
 import {
     formatTime,
     fulfillmentText,
@@ -91,6 +147,25 @@ const { pager, getLists, resetPage } = usePaging({
     size: 10
 })
 
+const revisitSlotStartOffset = ref(1)
+const savedRevisitSlotStartOffset = ref(1)
+const offsetSaving = ref(false)
+const offsetLoading = ref(false)
+
+const offsetDirty = computed(
+    () => Number(revisitSlotStartOffset.value) !== Number(savedRevisitSlotStartOffset.value)
+)
+
+const visitSlotStartLabel = computed(() => {
+    const offset = Number(revisitSlotStartOffset.value) || 1
+    const slot = offset + 1
+    const cn = ['', '一', '二', '三', '四', '五', '六', '七', '八', '九', '十']
+    if (slot >= 2 && slot <= 10) {
+        return cn[slot] + '诊'
+    }
+    return `第${slot}诊`
+})
+
 const buildParams = () => {
     Object.keys(queryParams).forEach((k) => delete queryParams[k])
     if (props.diagnosisId > 0) {
@@ -102,6 +177,47 @@ const buildParams = () => {
     queryParams.scene = 'diagnosis_edit'
 }
 
+async function loadRevisitSlotStartOffset() {
+    if (props.diagnosisId <= 0) return
+    offsetLoading.value = true
+    try {
+        const res: any = await tcmDiagnosisDetail({ id: props.diagnosisId })
+        const d = res?.data ?? res ?? {}
+        const offset = Number(d.revisit_slot_start_offset)
+        const val = offset >= 1 && offset <= 20 ? offset : 1
+        revisitSlotStartOffset.value = val
+        savedRevisitSlotStartOffset.value = val
+    } catch {
+        revisitSlotStartOffset.value = 1
+        savedRevisitSlotStartOffset.value = 1
+    } finally {
+        offsetLoading.value = false
+    }
+}
+
+async function saveRevisitSlotStartOffset() {
+    if (props.diagnosisId <= 0) return
+    const offset = Number(revisitSlotStartOffset.value)
+    if (!Number.isFinite(offset) || offset < 1 || offset > 20) {
+        feedback.msgWarning('起始偏移须在 1～20 之间')
+        return
+    }
+    offsetSaving.value = true
+    try {
+        await tcmDiagnosisSetRevisitSlotStartOffset({
+            id: props.diagnosisId,
+            revisit_slot_start_offset: offset
+        })
+        savedRevisitSlotStartOffset.value = offset
+        feedback.msgSuccess('保存成功')
+        getLists()
+    } catch {
+        /* 拦截器已提示 */
+    } finally {
+        offsetSaving.value = false
+    }
+}
+
 // ─── 详情抽屉（共享组件，数据拉取/展示全部在组件内） ───
 const detailDrawerRef = ref<InstanceType<typeof PrescriptionOrderDetailDrawer>>()
 
@@ -117,8 +233,13 @@ const formatAmount = (value: unknown) => {
 watch(
     () => [props.diagnosisId, patientIdNum.value] as const,
     () => {
-        if (!patientIdAvailable.value) { pager.lists = []; pager.count = 0; return }
+        if (!patientIdAvailable.value) {
+            pager.lists = []
+            pager.count = 0
+            return
+        }
         buildParams()
+        void loadRevisitSlotStartOffset()
         resetPage()
     },
     { immediate: true }
@@ -134,4 +255,21 @@ defineExpose({ refresh: () => getLists() })
 .po-empty-tip {
     padding: 24px 0;
 }
+.po-revisit-offset-bar {
+    display: flex;
+    align-items: center;
+    justify-content: space-between;
+    gap: 12px;
+    flex-wrap: wrap;
+    padding: 12px 14px;
+    border: 1px solid var(--el-border-color-lighter);
+    border-radius: 8px;
+    background: var(--el-fill-color-lighter);
+}
+.po-revisit-offset-bar__main {
+    display: flex;
+    align-items: center;
+    flex-wrap: wrap;
+    gap: 4px;
+}
 </style>
diff --git a/server/app/adminapi/controller/tcm/DiagnosisController.php b/server/app/adminapi/controller/tcm/DiagnosisController.php
index 2d1fe24a..e3e74367 100755
--- a/server/app/adminapi/controller/tcm/DiagnosisController.php
+++ b/server/app/adminapi/controller/tcm/DiagnosisController.php
@@ -94,6 +94,24 @@ class DiagnosisController extends BaseAdminController
         return $this->fail(DiagnosisLogic::getError());
     }
 
+    /**
+     * @notes 设置复诊接诊率统计起始偏移（业务订单 tab）
+     */
+    public function setRevisitSlotStartOffset()
+    {
+        $params = (new DiagnosisValidate())->post()->goCheck('setRevisitSlotStartOffset');
+        $ok = DiagnosisLogic::setRevisitSlotStartOffset(
+            (int) $params['id'],
+            (int) $params['revisit_slot_start_offset'],
+            $this->adminInfo
+        );
+        if (!$ok) {
+            return $this->fail(DiagnosisLogic::getError());
+        }
+
+        return $this->success('保存成功');
+    }
+
     /**
      * @notes 删除诊单
      * @return \think\response\Json
diff --git a/server/app/adminapi/lists/doctor/AppointmentLists.php b/server/app/adminapi/lists/doctor/AppointmentLists.php
index 6aae13e2..4b485e77 100755
--- a/server/app/adminapi/lists/doctor/AppointmentLists.php
+++ b/server/app/adminapi/lists/doctor/AppointmentLists.php
@@ -3,6 +3,8 @@
 namespace app\adminapi\lists\doctor;
 
 use app\adminapi\lists\BaseAdminDataLists;
+use app\adminapi\logic\dept\DeptLogic;
+use app\common\model\auth\AdminDept;
 use app\common\model\DiagnosisViewRecord;
 use app\common\model\doctor\Appointment;
 use app\common\model\tcm\Prescription;
@@ -75,6 +77,35 @@ class AppointmentLists extends BaseAdminDataLists implements ListsSearchInterfac
         });
     }
 
+    /**
+     * 按部门筛选：接诊医生、诊单医助或挂号医助所属部门命中子树即可（选父级含子级）
+     *
+     * @param mixed $query
+     */
+    private function applyAssistantDeptIdFilter($query): void
+    {
+        if (!isset($this->params['assistant_dept_id']) || $this->params['assistant_dept_id'] === '' || (int) $this->params['assistant_dept_id'] <= 0) {
+            return;
+        }
+        $rootDeptId = (int) $this->params['assistant_dept_id'];
+        $deptIds    = DeptLogic::getSelfAndDescendantIds($rootDeptId);
+        $deptIds    = array_values(array_filter(array_map('intval', $deptIds), static function (int $id): bool {
+            return $id > 0;
+        }));
+        if ($deptIds === []) {
+            $query->whereRaw('0 = 1');
+
+            return;
+        }
+        $inList = implode(',', $deptIds);
+        $adTbl  = (new AdminDept())->getTable();
+        $query->whereRaw(
+            "(EXISTS (SELECT 1 FROM `{$adTbl}` ad WHERE ad.`admin_id` = a.`doctor_id` AND ad.`dept_id` IN ({$inList}))"
+            . " OR EXISTS (SELECT 1 FROM `{$adTbl}` ad WHERE ad.`admin_id` = u.`assistant_id` AND ad.`dept_id` IN ({$inList}))"
+            . " OR EXISTS (SELECT 1 FROM `{$adTbl}` ad WHERE ad.`admin_id` = a.`assistant_id` AND ad.`dept_id` IN ({$inList})))"
+        );
+    }
+
     /**
      * 渠道筛选：与 AppointmentLogic 一致，兼容仅有 channel_source、仅有 channels、或两者皆有的表结构
      *
@@ -191,6 +222,8 @@ class AppointmentLists extends BaseAdminDataLists implements ListsSearchInterfac
 
         $this->applyAssistantIdFilter($query);
 
+        $this->applyAssistantDeptIdFilter($query);
+
         $this->applyChannelSourceFilter($query, $chFilter);
 
         // 是否确认诊单：1=已确认 0=未确认
@@ -373,6 +406,8 @@ class AppointmentLists extends BaseAdminDataLists implements ListsSearchInterfac
 
         $this->applyAssistantIdFilter($query);
 
+        $this->applyAssistantDeptIdFilter($query);
+
         $this->applyChannelSourceFilter($query, $chFilter);
 
         if ((int) ($this->params['exclude_cancelled'] ?? 0) === 1) {
diff --git a/server/app/adminapi/lists/tcm/PrescriptionOrderLists.php b/server/app/adminapi/lists/tcm/PrescriptionOrderLists.php
index adc90482..7801036b 100755
--- a/server/app/adminapi/lists/tcm/PrescriptionOrderLists.php
+++ b/server/app/adminapi/lists/tcm/PrescriptionOrderLists.php
@@ -741,6 +741,10 @@ class PrescriptionOrderLists extends BaseAdminDataLists implements ListsSearchIn
         }
         unset($item);
 
+        if ($this->shouldBypassListVisibilityForDiagnosisEdit()) {
+            $this->appendDiagnosisEditVisitSeqFields($lists);
+        }
+
         $this->appendPrescriptionOrderAssignSnapshotErCenterFlags($lists);
 
         if ((int) ($this->params['yeji_order_drawer'] ?? 0) === 1) {
@@ -1417,6 +1421,69 @@ class PrescriptionOrderLists extends BaseAdminDataLists implements ListsSearchIn
         );
     }
 
+    /**
+     * 诊单编辑-业务订单 tab：标注全局诊次及是否计入复诊接诊率（与 RevisitRateLogic 同口径）
+     *
+     * @param array<int, array<string, mixed>> $lists
+     */
+    private function appendDiagnosisEditVisitSeqFields(array &$lists): void
+    {
+        if ($lists === []) {
+            return;
+        }
+
+        $diagIds = [];
+        foreach ($lists as $row) {
+            $d = (int) ($row['diagnosis_id'] ?? 0);
+            if ($d > 0) {
+                $diagIds[$d] = true;
+            }
+        }
+        $contextDid = (int) ($this->params['context_diagnosis_id'] ?? 0);
+        if ($contextDid > 0) {
+            $diagIds[$contextDid] = true;
+        }
+        $diagIdList = array_keys($diagIds);
+        if ($diagIdList === []) {
+            return;
+        }
+
+        $offsetRows = Diagnosis::whereIn('id', $diagIdList)
+            ->whereNull('delete_time')
+            ->column('revisit_slot_start_offset', 'id');
+        $offsetMap = [];
+        foreach ($offsetRows as $id => $offset) {
+            $offsetMap[(int) $id] = max(1, min(20, (int) $offset));
+        }
+
+        /** @var array<int, int> $seqByOrderId order_id => global seq within diagnosis */
+        $seqByOrderId = [];
+        foreach ($diagIdList as $did) {
+            $q = PrescriptionOrder::where('diagnosis_id', $did)->whereNull('delete_time');
+            YejiStatsLogic::applyPrescriptionOrderNotCancelledForPerformanceQuery($q, '');
+            $orderIds = $q
+                ->order(['create_time' => 'asc', 'id' => 'asc'])
+                ->column('id');
+            $seq = 0;
+            foreach ($orderIds as $oid) {
+                $seq++;
+                $seqByOrderId[(int) $oid] = $seq;
+            }
+        }
+
+        foreach ($lists as &$row) {
+            $oid = (int) ($row['id'] ?? 0);
+            $did = (int) ($row['diagnosis_id'] ?? 0);
+            $seq = (int) ($seqByOrderId[$oid] ?? 0);
+            $offset = (int) ($offsetMap[$did] ?? 1);
+            $effectiveSlot = $seq > 0 ? $seq + $offset : 0;
+            $row['global_visit_seq'] = $effectiveSlot > 0 ? $effectiveSlot : null;
+            $row['raw_visit_seq'] = $seq > 0 ? $seq : null;
+            $row['counts_for_revisit_rate'] = $effectiveSlot >= 2 ? 1 : 0;
+        }
+        unset($row);
+    }
+
     /**
      * 列表行标注：指派日志快照（related_po_creator_id + related_po_create_time）是否指向本业务单，
      * 以及该次操作的新医助（to_assistant_id）是否归属「二中心」部门子树（与 DeptLogic / 业绩看板一致）。
diff --git a/server/app/adminapi/logic/stats/RevisitRateLogic.php b/server/app/adminapi/logic/stats/RevisitRateLogic.php
index 4d653306..47e17620 100644
--- a/server/app/adminapi/logic/stats/RevisitRateLogic.php
+++ b/server/app/adminapi/logic/stats/RevisitRateLogic.php
@@ -15,6 +15,7 @@ use think\facade\Db;
  *                      同一诊单当月被多次指派给同一医助只计 1 次。
  *   - 第 N 次下单   = 诊单（患者）名下计入业绩的业务订单（剔除履约 4/9/10、软删）按 create_time 升序的**全局**序列中第 N 笔；
  *                      诊次**跨月累计不重置**：例如 5 月指派后旗下成交 4 单为二诊~五诊，6 月再成交即为六诊。
+ *                      诊单可配置 `revisit_slot_start_offset`（默认 1：第 1 笔实单计为二诊；设为 2 则第 1 笔实单计为三诊，即在实单序号上叠加偏移，5 笔实单等价于计至七诊）。
  *   - 当月 N 诊单数 = **当月内下单**且全局序号为 N 的订单数，归属下单时点的**持有医助**——
  *                      按指派日志时间线取「订单时间之前最近一次指派」的 to_assistant_id（释放 to=0 即不再归属；
  *                      「继承」指派会转移持有人用于归属，但不计被指派数）。指派可发生在往月。
@@ -323,7 +324,7 @@ class RevisitRateLogic
      * 核心统计上下文：
      *   1. 全量指派日志（≤ 月末）构建持有时间线；
      *   2. 分母：当月非继承指派的「医助 × 诊单」；
-     *   3. 分子：曾被指派诊单的当月订单按全局序号 ≥2 归属持有医助；
+     *   3. 分子：曾被指派诊单的当月订单，统计诊次 = 实单序号 + 诊单偏移（默认第 1 笔实单为二诊）；
      *   4. 应用部门筛选（含组织下级）。
      *
      * @param array{month?:string,dept_ids?:int[]|string} $params
@@ -375,9 +376,10 @@ class RevisitRateLogic
             }
         }
 
-        // 分子：曾被指派诊单的当月订单（全局序号 ≥2），归属下单时点的持有医助
+        // 分子：曾被指派诊单的当月订单，统计诊次 = 实单全局序号 + 诊单偏移（默认偏移 1 → 第 1 笔实单为二诊）
         /** @var array<int, array<int, list<array<string, mixed>>>> $slotOrdersByAssistant */
         $slotOrdersByAssistant = [];
+        $offsetMap = self::fetchRevisitSlotStartOffsetMap(array_keys($candidateDiagSet));
         foreach (array_chunk(array_keys($candidateDiagSet), 2000) as $chunk) {
             $orderRows = self::fetchOrderSeqRows(
                 $chunk,
@@ -387,6 +389,7 @@ class RevisitRateLogic
             $seq = 0;
             $ptr = 0;
             $holder = 0;
+            $offset = 1;
             foreach ($orderRows as $r) {
                 $did = (int) ($r['diagnosis_id'] ?? 0);
                 if ($did <= 0) {
@@ -397,8 +400,10 @@ class RevisitRateLogic
                     $seq = 0;
                     $ptr = 0;
                     $holder = 0;
+                    $offset = self::resolveRevisitSlotStartOffset($did, $offsetMap);
                 }
                 $seq++;
+                $effectiveSlot = $seq + $offset;
                 $ct = (int) ($r['create_time'] ?? 0);
                 // 推进时间线指针：订单时间之前（含同刻）最近一次指派的持有人
                 $tl = $timeline[$did] ?? [];
@@ -407,14 +412,14 @@ class RevisitRateLogic
                     $holder = (int) $tl[$ptr]['to'];
                     $ptr++;
                 }
-                if ($seq < 2 || $seq > self::MAX_VISIT_SLOT) {
+                if ($effectiveSlot < 2 || $effectiveSlot > self::MAX_VISIT_SLOT) {
                     continue;
                 }
                 if ($ct < $startTs || $ct > $endTs) {
                     continue;
                 }
                 if ($holder > 0) {
-                    $slotOrdersByAssistant[$holder][$seq][] = $r;
+                    $slotOrdersByAssistant[$holder][$effectiveSlot][] = $r;
                 }
             }
         }
@@ -619,6 +624,48 @@ class RevisitRateLogic
             ->toArray();
     }
 
+    /**
+     * @param list<int> $diagIds
+     *
+     * @return array<int, int> diagnosis_id => revisit_slot_start_offset
+     */
+    private static function fetchRevisitSlotStartOffsetMap(array $diagIds): array
+    {
+        if ($diagIds === []) {
+            return [];
+        }
+        $out = [];
+        foreach (array_chunk($diagIds, 2000) as $chunk) {
+            $rows = Db::name('tcm_diagnosis')
+                ->whereIn('id', $chunk)
+                ->whereNull('delete_time')
+                ->column('revisit_slot_start_offset', 'id');
+            foreach ($rows as $id => $offset) {
+                $out[(int) $id] = (int) $offset;
+            }
+        }
+
+        return $out;
+    }
+
+    /**
+     * 诊单复诊统计起始偏移（默认 1：第 1 笔实单计为二诊；统计诊次 = 实单序号 + 偏移）
+     *
+     * @param array<int, int> $offsetMap
+     */
+    private static function resolveRevisitSlotStartOffset(int $diagId, array $offsetMap): int
+    {
+        $offset = (int) ($offsetMap[$diagId] ?? 1);
+        if ($offset < 1) {
+            $offset = 1;
+        }
+        if ($offset > 20) {
+            $offset = 20;
+        }
+
+        return $offset;
+    }
+
     /**
      * @param list<int> $diagIds
      *
diff --git a/server/app/adminapi/logic/tcm/DiagnosisLogic.php b/server/app/adminapi/logic/tcm/DiagnosisLogic.php
index dfdb4d12..6eda01ba 100755
--- a/server/app/adminapi/logic/tcm/DiagnosisLogic.php
+++ b/server/app/adminapi/logic/tcm/DiagnosisLogic.php
@@ -748,6 +748,46 @@ class DiagnosisLogic extends BaseLogic
         }
     }
 
+    /**
+     * @notes 诊单指派医助操作记录列表
+     */
+    public static function setRevisitSlotStartOffset(int $diagnosisId, int $offset, array $adminInfo): bool
+    {
+        self::$error = '';
+        if ($diagnosisId <= 0) {
+            self::setError('诊单不存在');
+
+            return false;
+        }
+        if ($offset < 1 || $offset > 20) {
+            self::setError('起始偏移须在 1～20 之间');
+
+            return false;
+        }
+        $diagnosis = Diagnosis::where('id', $diagnosisId)->whereNull('delete_time')->find();
+        if (!$diagnosis) {
+            self::setError('诊单不存在');
+
+            return false;
+        }
+        $old = (int) ($diagnosis->revisit_slot_start_offset ?? 1);
+        if ($old < 1) {
+            $old = 1;
+        }
+        if ($old === $offset) {
+            return true;
+        }
+        try {
+            $diagnosis->save(['revisit_slot_start_offset' => $offset]);
+
+            return true;
+        } catch (\Exception $e) {
+            self::setError($e->getMessage());
+
+            return false;
+        }
+    }
+
     /**
      * @notes 诊单指派医助操作记录列表
      */
diff --git a/server/app/adminapi/logic/tcm/PrescriptionOrderLogic.php b/server/app/adminapi/logic/tcm/PrescriptionOrderLogic.php
index e3efbde8..28dcba4f 100755
--- a/server/app/adminapi/logic/tcm/PrescriptionOrderLogic.php
+++ b/server/app/adminapi/logic/tcm/PrescriptionOrderLogic.php
@@ -3407,17 +3407,14 @@ class PrescriptionOrderLogic
     }
 
     /**
-     * 导出用：主方/辅方服用天数（优先业务订单 medication_days，缺省回退处方 usage_days / 辅方 aux_usage）
+     * 导出用：主方/辅方开立天数（与详情侧栏「处方开立」同口径：主方取处方 usage_days，辅方取 aux_usage.usage_days）
+     * 订单服用天数单独导出在 export_medication_days 列，不在此混用。
      *
      * @param array<string, mixed> $rx
      * @param array<string, mixed>|null $auxUsage
      */
-    private static function resolveExportUsageDays(array $rx, ?array $auxUsage, $orderMedicationDays, bool $isAux): string
+    private static function resolveExportUsageDays(array $rx, ?array $auxUsage, bool $isAux): string
     {
-        $medDays = $orderMedicationDays;
-        if ($medDays !== null && $medDays !== '' && (int) $medDays > 0) {
-            return (string) (int) $medDays;
-        }
         if ($isAux) {
             $days = (int) ($auxUsage['usage_days'] ?? 0);
 
@@ -3990,10 +3987,9 @@ class PrescriptionOrderLogic
             } else {
                 $item['export_aux_usage'] = '';
             }
-            $orderMedDays = $item['medication_days'] ?? null;
-            $item['export_main_usage_days'] = self::resolveExportUsageDays($rxArr, $auxUsageNorm, $orderMedDays, false);
+            $item['export_main_usage_days'] = self::resolveExportUsageDays($rxArr, $auxUsageNorm, false);
             $item['export_aux_usage_days'] = $auxHerbs !== []
-                ? self::resolveExportUsageDays($rxArr, $auxUsageNorm, $orderMedDays, true)
+                ? self::resolveExportUsageDays($rxArr, $auxUsageNorm, true)
                 : '';
 
             $item['export_service_package'] = self::formatServicePackageForExport(
@@ -4906,8 +4902,8 @@ class PrescriptionOrderLogic
 
             return false;
         }
-        if (in_array((int) $order->fulfillment_status, [3, 4], true)) {
-            self::setError('已完成或已取消的订单不可修改');
+        if ((int) $order->fulfillment_status === 4) {
+            self::setError('已取消的订单不可修改');
 
             return false;
         }
diff --git a/server/app/adminapi/validate/tcm/DiagnosisValidate.php b/server/app/adminapi/validate/tcm/DiagnosisValidate.php
index 4f9b5178..cd66935f 100755
--- a/server/app/adminapi/validate/tcm/DiagnosisValidate.php
+++ b/server/app/adminapi/validate/tcm/DiagnosisValidate.php
@@ -44,6 +44,7 @@ class DiagnosisValidate extends BaseValidate
         'end_date' => 'date|checkDateRange',
         'diagnosis_id' => 'require|integer|checkDiagnosisId',
         'tracking_content' => 'require|length:1,1000',
+        'revisit_slot_start_offset' => 'integer|between:1,20',
     ];
 
     protected $message = [
@@ -139,6 +140,13 @@ class DiagnosisValidate extends BaseValidate
         return $this->only(['id']);
     }
 
+    /** 业务订单 tab：设置复诊接诊率统计起始偏移 */
+    public function sceneSetRevisitSlotStartOffset()
+    {
+        return $this->only(['id', 'revisit_slot_start_offset'])
+            ->append('revisit_slot_start_offset', 'require|integer|between:1,20');
+    }
+
     protected function checkDiagnosis($value)
     {
         $diagnosis = Diagnosis::findOrEmpty($value);
diff --git a/server/sql/1.9.20260709/add_diagnosis_revisit_slot_start_offset.sql b/server/sql/1.9.20260709/add_diagnosis_revisit_slot_start_offset.sql
new file mode 100644
index 00000000..f6281d41
--- /dev/null
+++ b/server/sql/1.9.20260709/add_diagnosis_revisit_slot_start_offset.sql
@@ -0,0 +1,7 @@
+-- 诊单：复诊接诊率统计起始偏移（1=从二诊起计，2=从三诊起计…）
+-- 执行前确认表前缀为 zyt_。
+
+ALTER TABLE `zyt_tcm_diagnosis`
+    ADD COLUMN `revisit_slot_start_offset` tinyint(3) unsigned NOT NULL DEFAULT 1
+        COMMENT '复诊接诊率统计起始偏移：统计诊次=实单序号+偏移（1=第1笔实单计二诊，2=计三诊，5笔实单等价七诊）'
+        AFTER `show_card`;
diff --git a/server/sql/1.9.20260709/add_diagnosis_set_revisit_slot_offset_menu.sql b/server/sql/1.9.20260709/add_diagnosis_set_revisit_slot_offset_menu.sql
new file mode 100644
index 00000000..0e8c6b45
--- /dev/null
+++ b/server/sql/1.9.20260709/add_diagnosis_set_revisit_slot_offset_menu.sql
@@ -0,0 +1,14 @@
+-- 诊单业务订单 tab：设置复诊统计起始偏移
+SET @diag_menu_id := (SELECT id FROM zyt_system_menu WHERE perms = 'tcm.diagnosis/lists' LIMIT 1);
+
+INSERT INTO zyt_system_menu (
+    pid, type, name, icon, sort, perms, paths, component,
+    selected, params, is_cache, is_show, is_disable, create_time, update_time
+)
+SELECT
+    @diag_menu_id, 'A', '设置复诊统计起始偏移', '', 71,
+    'tcm.diagnosis/setRevisitSlotStartOffset', '', '',
+    '', '', 0, 1, 0, UNIX_TIMESTAMP(), UNIX_TIMESTAMP()
+FROM DUAL
+WHERE @diag_menu_id IS NOT NULL
+  AND NOT EXISTS (SELECT 1 FROM zyt_system_menu WHERE perms = 'tcm.diagnosis/setRevisitSlotStartOffset');