Parashospitaltriff PDF

PARAS HMRI HOSPITALPATNA Schedule of charges 2016 version 2.
02
SOC- 2.02
INDEX
Department/Services Code Page No.
General Charges
Room Tariff 2
Consultation CON 3
OT charges 3
Emergency Room ER 4
Services : Procedure/Surgery
Anesthesia AN 7
Cardiology CD 8
CTVS CT 9
Dental DN 11
Dermatology (Skin and Cosmetic Centre) DM 17
ENT EN 23
General & Laproscopic surgery GS 27
Gestroentology GI 33
Interventional Radiology IR 34
Medical Oncology MO 37
Nephrology NP 38
Neurology NU 39
Neuro surgery NS 40
Obstetrics and Gynecology OG 42
Onco surgery OS 57
Opthalmology OP 58
Orthopeadic OR 60
Pain Clinic PC 66
Pediatric PD 67
Physiotherapy PT 69
Plastic surgery PS 70
Psyciatry PY 83
Respiratory Medicine RM 84
Spine SP 85
Urology UR 87
Miscellaneous services MS 90
Investigation
Blood Bank BD 92
Cardiology CI 92
Lab LB 93
Radiology RD 97
Charges are effective from 1st Aug'2016
Charges are subject to change without prior notice
Room Tariff and Billing Guidelines
Bed category Room rent / day IP Consultation/ visit Emergency IP
VIP Suite 13,500 1,800 Consultn/visit
2,250
Deluxe Room 7,000 1,200 1,500
Single Room 6,000 1,000 1,250
Twin Sharing 4,000 850 1,060
General Ward 2,400 700 875
Day Care 1,500 700 875
NICU level 1/Nursery - -
NICU level 2 - -
NICU level 3 - -
PICU level 1 - -
PICU level 2 - -
CCU/CTVS ICU 7,500 1,000 1,250
MICU/SICU 7,500 1,000 1,250
Neuro ICU 7,500 1,000 1,250
HDU 5,500 1,000 1,250
Room Charging Pattern :
It will be 24 hrs based .
Grace period will be 2 hours for discharging patient
If the overall stay is less than 8 hours then half day room rent will be charged
NICU level of care is defined as:

Level I: Observation
Admission directly inand
to initial
ICU nursery care (i.e washing, tube feeding, oral medicines etc.)
Where a patient is admitted to ICU bed directly, the charges for procedures/surgeries will be in line with rates applicable for single bed if they are not listed
separately.
Patient BedHowever,
Transfer if- the
Thepatient
higher opts for a category
bed category of thewhich is higher
bed transfer daythan Single
will be bed at the time of transfer from ICU, the procedures /surgeries will be
charged
Post surgery change of bed category - If patient change the bed category from lower to higher after the surgery, then the complete surgery/procedure charges will
be applicable
Attendant bedascharges:
per the higher category.
The attendant of ICU patient is allowed to retain the bed from 9 PM to 6AM, additional bed charges will be applicable as per actual . Only one attendant may stay in a
room
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PARAS HMRI HOSPITALPATNA Schedule of charges 2016 version 2.02
Service charges will be added to investigations and procedures wherever they are not defined separately as per the category of ward.
Consumables, medicines etc. will be charged additionally on the basis of actual usage
Consultation and Billing Guidelines
OPD CONSULTATION Consultation charges/visit
CON1001 Director/HOD 1000-1200
CON1002 Super Specialist consultant 600-800
CON1003 Specialist / Jr. consultant 400-500
CON1004 Follow up visit ( within10 days) Nill
CON1005 Dietician (one visit per day) 300
IPD CONSULTATION
CON2001 Room visit 600 - 1600
CON2002 Emergency visit 750-2000
CON2003 Dietician (one visit per day) 100
CON2004 ICU Intervisit (visit charges) for every ICU Patient per day one visit 1,250
Note : Two visits are mandatory. Additional visit shall be at written request of attendant or the attending doctor which shall be charged separately.
The charges are for visits / consultation from 8 A.M. to 8 P.M. Any visit after 8 P.M. will be treated as Emergency visit and 25% extra will be charged
Post operative visit charges by operating Surgeon/ Surgical Team upto two days will be charged at 50% of the normal charges. If patient is referred to another
consultant,
One full
dietician charges
visit is mandatory for each admitted patient and it is valid for 3 days only.
Surgery Breakup
Surgeon Fee 100% as per bed category
Assistant Surgeon fee 30% of Surgeon fee
OT Charges 50% of Surgeon fee
Anesthetist charges 30% of Surgeon fee
Standby Anesthetist charges 10% of Surgeon fee
OT Gases 20% of Surgeon fee
Cath lab / DSA lab /LR charges 30% of Surgeon fee
Note : Case 1 : If two or more surgeries are performed at same timeon the same area, then the 50% of X amount will be charged for the second and subsequent surgery
(lower
Case 2 charged).
: All unplanned surgeries performed from 8 PM to 8 AM shall be charged 25% additional emergency charges on the total tariff rate of X
Case 3: Cardiologist standby in the OT will be charged at 40% of the surgeon’s fees.
Case 4: In case of Additional assistant surgeon fee, should be given in estimates.
Case 5:Radiology & lab, 8 PM to 8 AM 25% will be Extra charge on base value.
Case 6:Radiology & lab on Sunday and Holidays , 25% will be Extra charge on base value.
Equipment Charges:
Any specific equipment hired from outside the Paras Hospital would be charged additionally as specified in the pricing policy or as actual; whichever is higher from
the patient
If more than(Unless specified)(In house) or private is used in same surgery then patient will be billed as per actual usage of equipment.
one equipment
Emergency Services
Service code Service name Charges ( Rs.)
Emergency service
ER1001 Registration charges 100
ER1002 Emergency bed charges ( Per hours)* First 1 hours no bed charges 500
ER1003 Minor OT charges/ Procedure Room 25% of procedure
ER1004 Anesthesia charges in minor OT 20% of procedure
Consultation
ER2001 Consultation ( CMO / EMO) 300
ER2002 Consultation (Specialist/Super specialist/HOD) As per OPD consultation
Investigation
ER3001 ECG 250
ER3002 Blood Pressure monitoring 100
ER3003 Blood Sugar monitoring 120
ER3004 Troponin-T
Ambulance
ER4001 BLS Ambulance Charges upto 5 Km 750
ER4002 Ambulance Charges additional per Km 40
ER4009 ALS Ambulance Charges upto 5 Km 1,500
ER4010 Ambulance Activation /advance charges for outside Patna. 2,000
ER4003 Doctor Charges upto 100 km 2,000
ER4011 Doctor Charges 100 - 200 km 4,000
ER4012 Doctor Charges more than 200 km 6,000
ER4004 Additional Nurse / support staff charges 2,000
ER4005 Equipment Charges 1,000
ER4006 Oxygen/Hr In Ambulance 100
ER4007 Ambulance Waiting Charges per hr 500
Procedure
ER5004 Abcess I & D 3,500
ER5005 Burn Dressing (Small) 1,800
ER5006 Burn Dressing (Medium) 3,500
ER5007 Cast Application 3,000
ER5009 Closed Reduction Of Pop Application 4,000
ER5012 Cvp Line 2,500
ER5016 Debridement 4,500
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ER5019 Dressing Small 300
ER5020 Dressing Medium 450
ER5021 Dressing large 600

ER5027 Folley'S Catherization 600
ER5028 Foreign Body Removal 2,500
ER5029 Catheter removal 200
ER5030 Incision And Drainage 1,500
ER5031 Infusion Pump 500
ER5032 Ingrowing Toe Nail Removal 1,500
ER5033 Intercostal Drainage 4,000
ER5035 Intra Muscular Injection 100
ER5036 Intubation 1,000
ER5037 Iv Infusion 100
ER5039 Nail Bed Wedge Excision 1,600
ER5040 Nasal Bone Reduction 4,000
ER5041 Nebulisation 200
ER5042 P.O.P Removal 400
ER5043 Pleural /Tapping (Diagnostic) 600
ER5044 Pleural /Tapping (Therapeutic) 2,000
ER5045 Ryle Tube Insertion 700
ER5047 Strapping Chest 1,500
ER5048 Suture Removal 250
ER5049 Suturing Less Than 6 700
ER5050 Suturing More Than 6 1,800
ER5053 Urethral Dilation 2,100
ER5054 Gastric Lavage 1,000
ER5055(A) Ascitic Tapping (Digonistic) 1,000
ER5055(B) Ascitic Tapping (Therapeutic) 1,500
ER5056 Bladder wash 500
ER5057 Strapping cervical with figure of 8 bandage 2,000
ER5060 Pulled elbow manipulamlm 700
ER5061 Pop Below Elbow Cast Application 1,600
ER5062 Pop Below Elbow Slab Application 1,100
ER5063 Pop Below Knee Cast Application 2,100
ER5064 Pop Below Knee Slab Application 1,600
ER5065 Pop Hip Spica Application Single 4,800
ER5066 POP Above Elbow Cast Application 2600
ER5067 POP Above Knee Cast Application 3000
ER5068 Abcess I & D (Large) > 10 m.m 3000
ER5069 Abcess I & D (Medium) > 5 mm. to 10 m.m 1500
ER5070 Abcess I & D (Small) < 5m.m 750
ER5074 Enema Administration 270
ER5077 Suturing With Staple 700
ANESTHESIA
Service
Service Name OPD/Six/ Nine bed Two bed Single room Deluxe room VIP Suite
Code
AN1001 ABG Sampling 440 585 660 770 880
AN1002 Anaesthesia Standby (For Other Procedures) 1,200 1,596 1,800 2,100 2,400
AN1003 Anesthesia Visit For Emergency Management 1,540 2,048 2,310 2,695 3,080
AN1004 Arterial Line 2,500 3,325 3,750 4,375 5,000
AN1005 Bipap Procedure Charges 1,210 1,609 1,815 2,118 2,420
AN1006 Bronchoscopy 3,300 4,389 4,950 5,775 6,600
AN1007 Broncoscopy With Lavage 3,850 5,121 5,775 6,738 7,700
AN1008 Caudal Anesthesia (Continuous) 10,780 14,337 16,170 18,865 21,560
AN1009 Caudal Injection (Single Shot) 30% of procedure
AN1010 Change Of Tracheostomy Tube 550 732 825 963 1,100
AN1011 Consultation Pain Management 770 1,024 1,155 1,348 1,540
AN1012 Continuous Plexus Block 4,400 5,852 6,600 7,700 8,800
AN1013 CPR Charges (Cardio Pulmonary Resuscitation) Emergency Resuscitation 2,200 2,926 3,300 3,850 4,400
AN1014 Cvp Line 3,000 3,990 4,500 5,250 6,000
AN1016 Endotracheal Intubation 880 1,170 1,320 1,540 1,760
AN1017 Endotracheal Intubation Nasal 990 1,317 1,485 1,733 1,980
AN1018 Epidural Blood Patch 2,970 3,950 4,455 5,198 5,940
AN1019 Epidural Catheterization 3,300 4,389 4,950 5,775 6,600
AN1020 Femoral Vein Acess 1,430 1,902 2,145 2,503 2,860
AN1021 Fiber Optic Intubation 3,300 4,389 4,950 5,775 6,600
AN1022 GA For Cath Lab Procedures 4,950 6,584 7,425 8,663 9,900
AN1023 GA For ECT 3,300 4,389 4,950 5,775 6,600
AN1024 I/V Cannula On Floors 880 1,170 1,320 1,540 1,760
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AN1025 Intubation And Ventilator Mgmt 5,000 6,650 7,500 8,750 10,000
AN1026 Labour Analgesia 5,500 7,315 8,250 9,625 11,000
AN1027 Mac For Cath Lab Procedures 30% of procedure
AN1028 MAC Per Hr >2 Hr 20% of procedure
AN1029 PA Catheter Placement 3,300 4,389 4,950 5,775 6,600
AN1030 Patient Controlled Analgesia 3,300 4,389 4,950 5,775 6,600
AN1031 PCEA (Patient Controlled Epidural Anaest 4,950 6,584 7,425 8,663 9,900
AN1032 Recanulation Tracheostomy 1,320 1,756 1,980 2,310 2,640
AN1035 Ryles Tube Insertion- Anesthesia 700 930 1,050 1,230 1,400
AN1036 Sedation For Nacro Analysis 3,300 4,389 4,950 5,775 6,600
AN1037 Single Shot Nerve Block 30% of procedure
AN1038 Tracheostomy Percutaneous 7,000 9,310 10,500 12,250 14,000
AN1039 Trans Esophageal Echocardiography 3,520 4,682 5,280 6,160 7,040
AN1042 PAC 800 1,064 1,200 1,400 1,600
AN1043 Epidural Anaesthesia Management( in ward) 700 930 1,050 1,230 1,400
AN1045 Out of OT Anaesthesia (anaesthesia given other than OT ) 3000 3990 4500 5250 6000
AN1046 Post operative pain relief 700 931 1,050 1,225 1,400
CARDIOLOGY
Service Stay
Code day
CARDIOLOGY PACKAGE
CD1001 Coronary Angiography (CAG) 1 13,500 13,500 18,000 20,000 25,000
CD1029 Coronary Angiography Day Care (CAG) 1 9,900 9,900 9,900 9,900 9,900
CD1002 Peripheral Angiography 1 13,000 13,000 17,000 19,000 22,000
CD1003 Check Angiography 1 7,500 7,500 8,000 9,000 10,000
CD1004 Coronary Angioplasty ( PTCA) 2 ICU+1 Day 3 109,900 109,900 126,700 143,600 165,300
CD1005 Peripheral Angioplasty 2 ICU+1Day 3 99,900 99,900 126,000 153,000 180,000
CD1015 Primary Angioplasty Emergency PTCA (2Days ICU and 1 Days Opted Category) 111,000 111,000 128,000 145,000 167,000
CD1006 Carotid Angioplasty 2 ICU+1 DAY 3 99,900 99,900 126,000 153,000 180,000
CD1017 EPS Complex 1 26,000 26,000 32,000 35,000 40,000
CD1007 EPS Basic ( additional catheter cost Extra) 1 13,000 13,000 16,000 17,500 20,000
CD1018 Ballon Volvoplasty (1 Day ICU + Cost of ballon extra) 1 40,800 40,800 49,800 52,200 56,700
CD1009 EPS and RFA(Additional catheter cost extra) 1 103,000 103,000 129,000 135,000 150,000
CD1019 CardioVersion includes TEE 1 13,700 13,700 17,200 18,000 20,000
CD1020 TPI+PPI (2 Days ICU+1 Day Opted Category ) 3 65,000 65,000 81,700 85,500 95,000
CD1010 Permanent Pacemaker Implantation Single Chamber (1 Day ICU + 1 Day Opted Category) 2 50,000 50,000 65,000 70,000 85,000
Permanent Pacemaker Implantation Double Chamber (2 Days ICU + 1 Days Opted

CD1021 3 75,000 75,000 97,800 105,000 127,800
category)
CD1022 Pulse Generator Replacement S/C (1 Day ICU) 1 26,300 26,300 34,200 36,800 44,700
CD1023 Pulse Generator Replacement D/C (1 Day ICU) 1 31,300 31,300 40,700 43,800 53,200
CD1024 Pulse Generator Replacement ICD (1 Day ICU) 1 31,300 31,300 40,700 43,800 53,200
CD1025 Pulse Generator Replacement CRT (1 Day ICU) 1 40,000 40,000 52,200 56,000 68,200
CD1016 BMV/PTMC (1 Day ICU + 1 Day Opted Category) includes TEE 2 71,446 71,446 92,838 100,004 121,396
CD1027 IABP (1 Day ICU) Including Ballon 1 75,000 75,000 97,800 105,000 127,800
CD1011 ICD Implantation 3 85,050 85,050 110,017 120,167 150,033
CD1028 Temporary Pacing (Including Wire/ lad Cost) 1 9,100 9,100 11,800 12,900 16,000
CD1012 Cardiac Cath Study 1 11,000 11,000 12,000 12,000 15,000
CD1013 ASD/VSD Device closure ( device extra and delevery sheath Extra) 3 85,000 85,000 110,000 120,000 130,000
CD1014 Septal Ablation 1 100,000 100,000 115,000 130,000 150,000
CD1030 Coil Embolization ( Medicines, Coil, Spl Catheter, Dye extra) 1 44,400 44,400 51,200 57,600 66,800
Package Includes: room rent as specified, cath lab charges, Professional fees of cardiologist, basic Investigations , Routine drugs , disposables in Cath Lab and Non Ionic Dye
Basic Investigations include- (CAG,Coil Embolization ONLY)-(Annexure – 1 A) Complete Blood Count, Blood Sugar, Renal Function Test (Na, K, Urea,Creatinine), ECG, Chest X Ray,
HbsAg, HIV 1 &2, Blood Grouping,PT ( INR)X1 Each
Basic Investigations include- (PTCA ONLY)-(Annexure – 1 B)-Complete Blood Count, Blood Sugar, Renal Function Test (Na, K, Urea,Creatinine),Chest X Ray, HbsAg, HIV 1 &2, Blood
Grouping,PT ( INR),Pre-Post CPK MB, - Echo Screening x1 Each,ECG X3
Basic Investigations include- (EPS,RFA ,AICD/CRT ONLY)-(Annexure – 1 C)-Complete Blood Count, Blood Sugar, Renal Function Test(Na, K, Urea,Creatinine),Chest X Ray, HbsAg, HIV
1 &2, Blood Grouping,PT ( INR), x1 Each,ECG X2
Basic Investigations include- (PG Replacement ONLY)-(Annexure – 1D)- - PT/INRX1

Basic Investigations include- (CardioVersion ONLY)-(Annexure – 1 E)- - PT/INRX1,ECG X2
Package excludes: Stent Cost , implant cost, Gp IIb/ IIIa inhibitor, Other devices like Rota & Atherectomy equipment , additional stay, Professional charges of other consultants,
any additional procedure/investigation and Use of special drugs/ consumables. New wire and Balloon cost extra
Service OPD/ Six/ Nine

Service Name Two bed Single room Deluxe room VIP Suite
Code bed
CARDIOLOGY PROCEDURES
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CD2004 Ivc Filter Insertion (filter cost extra) 45,000 59,850 67,500 78,750 90,000
CD2005 Pericardial Aspiration 4,000 5,320 6,000 7,000 8,000
CD2006 Arrhythmia Control 2,600 3,458 3,900 4,550 5,200
CD2007 Programming(For first Time) 1,000 1,330 1,500 1,750 2,000
CD2008 Programming(2nd time or onwards) 1,500 1,995 2,250 2,625 3,000
CTVS
Service Stay Two

Service Name Six/ Nine bedded Single room Deluxe room VIP Suite
Code day bedded
CTVS Packages
CT1001 CABG(3 Days ICU & 4 Days Opted Category) 7 165,000 185,000 205,000 215,000 300,000
CT1002 Redo CABG (3 Days ICU & 4 Days Opted Category) 7 190,000 210,000 230,000 240,000 310,000
CT1003 CABG+AVR(3 Days ICU & 4 Days Opted Category) 7 200,000 220,000 240,000 250,000 320,000
CT1004 Single Valve Replacement/Repair(3 Days ICU & 4 Days Opted Category) 7 160,000 185,000 205,000 215,000 300,000
CT1005 Double Valve Replacement(3 Days ICU & 4 Days Opted Category) 7 190,000 210,000 230,000 240,000 310,000
CT1006 Mitral valve Replacement(3 Days ICU & 4 Days Opted Category) 7 160,000 185,000 205,000 215,000 300,000
CT1007 Pericardectomy/Sternotomy(3 Days ICU & 4 Days Opted Category) 7 105,000 115,000 125,000 135,000 145,000
CT1008 Repair of Tetralogy of Fallot(3 Days ICU & 4 Days Opted Category) 7 160,000 185,000 205,000 215,000 300,000
CT1009 A.S.D(3 Days ICU & 4 Days Opted Category) 7 160,000 185,000 205,000 215,000 300,000
CT1010 V.S.D(3 Days ICU & 4 Days Opted Category) 7 170,000 195,000 205,000 215,000 300,000
CT1011 Closed Heart Surgery(3 Days ICU & 4 Days Opted Category) 7 85,000 95,000 105,000 115,000 125,000
CT1012 Aorto-Femoral Bypass &Lleo Formal Bypass 7 95,000 115,000 125,000 135,000 145,000
CT1013 Femoro- Femoral Bypass & Femoro-Popliteal Bypass 7 95,000 115,000 125,000 135,000 145,000
CT1014 Upper & Lower Limb Grafting (2 Days ICU & 3 Days Category) 5 65,000 85,000 95,000 105,000 115,000
CT1015 CABG+LV CLOT REMOVAL(3 Days ICU & 4 Days Opted Category) 7 180,000 200,000 220,000 230,000 300,000
CT1016 CABG+LA CLOT REMOVAL(3 Days ICU & 4 Days Opted Category) 7 170,000 195,000 205,000 215,000 300,000
CT1017 CABG+LV ANEURYSM REPAIR(3 Days ICU & 4 Days Opted Category) 7 190,000 210,000 230,000 240,000 310,000
CT1018 CABG+MVR(3 Days ICU & 4 Days Opted Category) 7 200,000 220,000 240,000 250,000 320,000
CT1019 CABG+DVR(3 Days ICU & 4 Days Opted Category) 7 220,000 240,000 250,000 265,000 330,000
CT1020 CABG+TVR(3 Days ICU & 4 Days Opted Category) 7 220,000 240,000 250,000 265,000 330,000
CT1021 CABG+MV. ANNULOPLASTY(3 Days ICU & 4 Days Opted Category) 7 190,000 210,000 230,000 240,000 310,000
CT1022 REDO MVR/AVR(3 Days ICU & 4 Days Opted Category) 7 190,000 210,000 230,000 240,000 310,000
CT1023 REDO DVR(3 Days ICU & 4 Days Opted Category) 7 200,000 220,000 240,000 250,000 320,000
CT1024 REDO TVR(3 Days ICU & 4 Days Opted Category) 7 220,000 240,000 250,000 265,000 330,000
CT1026 Peripheral AV Malformation 3 50,000 56,700 61,600 65,100 82,600
CT 1027 Sternal Wire Removal 20,000 22,700 24,700 26,000 33,000
Package Includes: room rent as specified, Cardiac surgeon and cardiologist fee ,OT, OT gases, Anesthesia, Surgeon , basic Investigations , Medical & Surgical consumables used
intra-operatively & during the stay of the patient, except as defined under exclusion list even during the 7 days of procedure. Ventilation during the stay in OTR/ICU for number of
days specified under procedure.
Basic Investigations include- Complete Hemogram,ESR,BT,CT,Prothrombin Time, PTTK,Urea,Creatinine,Serum Electrolytes,Blood Sugar, echo, doppler(canotid/groin)INR, Urine
R/M, X-Ray Chest & CPK. USG ABD/PELVIS, PERIPHERAL ARTERIAL DOPPLER, THYROID PROFILE, CRP - up to 2 times , LFT - up to 2 times , Microbiology samples for culture/staining -
up to 4 times , 1 ECHO and All ABG(18times) done intra-operatively & post operatively.
Package excludes: additional stay, Professional charges of other consultants, any additional procedure/investigation and Use of special drugs/ consumables,ABG more than 5 times
,Any such treatment for a disease/condition which is not related to the intended procedure will not be the part of procedure cost even during the duration of procedure . Blood
Transfusion ( Blood to be donated by patients relatives ) . Cost of cell saver & Swan Ganz catheter, Human Albumin, Cost of valves or any other graft/implants additional.
Service
Service Name Six/ Nine bed Two bed Single room Deluxe room VIP Suite
Code
Cardiac Surgery
CT2001 PERICARDIAL TAPPING 3,780 5,027 5,670 6,615 7,560
CT2002 Pericardial Window 12,000 15,960 18,000 21,000 24,000
CT2003 Emergency Ot Team Stand By Ist Hour 18,000 18,000 18,000 18,000 18,000
CT2004 High risk / Emergency charges 30,000 30,000 30,000 30,000 30,000
Service
Code
Thoracic surgery
CT3001 Anterior Chest Wall Repair 20,000 26,600 30,000 35,000 40,000
CT3002 Bronchopulmonary Fistula (Bpf) Repair 25,000 33,250 37,500 43,750 50,000
CT3003 Chest Wall Resection 15,000 19,950 22,500 26,250 30,000
CT3004 Decortication (Pleurectomy) 18,000 23,940 27,000 31,500 36,000
CT3005 Decortication Of Lung 22,000 29,260 33,000 38,500 44,000
CT3006 Decortication Procedure 15,000 19,950 22,500 26,250 30,000
CT3007 Diagnostic Thoracoscopy 12,000 15,960 18,000 21,000 24,000
CT3008 Explotory Thoracotomy 15,000 19,950 22,500 26,250 30,000
CT3009 Intercostal Drainage Of Empyema 4,500 5,985 6,750 7,875 9,000
CT3010 Posterior Lateral Thoracotomy 18,000 23,940 27,000 31,500 36,000
CT3011 Surgery For Empyema 15,000 19,950 22,500 26,250 30,000
CT3012 Surgery For Thoracic Outlet Sy 22,600 30,058 33,900 39,550 45,200
CT3013 Therapeutic Thoracoscopy 12,000 15,960 18,000 21,000 24,000
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CT3014 Thoracoplasty 25,000 33,250 37,500 43,750 50,000
CT3015 Thoracotomy 12,000 15,960 18,000 21,000 24,000
CT3016 Tracheobronchial Injury Repair 15,000 19,950 22,500 26,250 30,000
CT3017 Treatment Of Rib Fractures 12,000 15,960 18,000 21,000 24,000
CT3018 Treatment Of Sternal Fracture 12,000 15,960 18,000 21,000 24,000
CT3019 Chest/Pleural Aspiration In Ot 1,500 1,995 2,250 2,625 3,000
CT3020 Decortication For Empyema Thoracis 12,000 15,960 18,000 21,000 24,000
CT3021 Diagnostic Thoracoscopy And Biopsy 6,000 7,980 9,000 10,500 12,000
CT3022 Diagnostic Thoracoscopy And Drainage 4,000 5,320 6,000 7,000 8,000
CT3023 Excision Of Cervical Rib/ Scalenotomy 8,000 10,640 12,000 14,000 16,000
CT3024 Excision Of Chest Wall Tumor( Excluding Ribs) 6,000 7,980 9,000 10,500 12,000
CT3025 Excision Of Chest Wall Tumor(Including Ribs) 14,000 18,620 21,000 24,500 28,000
CT3026 Excision Of Mediastinal Tumors(Open) 16,000 21,280 24,000 28,000 32,000
CT3027 Harvesting Of Muscle Pedicle Graft And Reinforcement Of Bronchisl Stump 24,000 31,920 36,000 42,000 48,000
CT3028 Intercostal Block 3,000 3,990 4,500 5,250 6,000
CT3029 Lobectomy In Life Threating Hemoptysis 30,000 39,900 45,000 52,500 60,000
CT3030 Open Lung Biopsy 12,000 15,960 18,000 21,000 24,000
CT3031 Open Pleural Biopsy 5,000 6,650 7,500 8,750 10,000
CT3032 Thoracoscopic Mediastinal Lymph Node Biopsy 16,000 21,280 24,000 28,000 32,000
CT3033 Thoracoscopic Mediastinal Tumors Excision 27,000 35,910 40,500 47,250 54,000
CT3034 Thoracotomy And Evacuation Of Hematoma 13,000 17,290 19,500 22,750 26,000
CT3035 Thoracotomy And Re Exploration For Bleeding 13,000 17,290 19,500 22,750 26,000
CT3036 Thoractomy For Anterolateral Decompression 13,000 17,290 19,500 22,750 26,000
CT3037 Thymectomy(Open) 15,000 19,950 22,500 26,250 30,000
CT3038 sternal resutruing 8,000 10,000 15,000 20,000 30,000
Vascular Surgery
CT4001 Arterio-Venous Fistula High 10,000 13,300 15,000 17,500 20,000
CT4002 Branched Aortic Endograft Plac 37,800 50,274 56,700 66,150 75,600
CT4003 Carotid - Carotid Bypass 15,800 21,014 23,700 27,650 31,600
CT4004 Carotid Artery Stenting 19,300 25,669 28,950 33,775 38,600
CT4005 Carotid Body Tumour 19,300 25,669 28,950 33,775 38,600
CT4006 Embolectomy 15,000 19,950 22,500 26,250 30,000
CT4007 Endovascular Repair Of Abdominal 30,000 39,900 45,000 52,500 60,000
CT4008 Hd Access Major 6,200 8,246 9,300 10,850 12,400
CT4009 Leg Fasciotomy 15,800 21,014 23,700 27,650 31,600
CT4010 Ligation Artery Subclavian 3,000 3,990 4,500 5,250 6,000
CT4011 Peripheral Arterial Exposure P 12,000 15,960 18,000 21,000 24,000
CT4012 Peripheral Arterial Transposit 15,800 21,014 23,700 27,650 31,600
CT4013 Peripheral Artery Endarterecto 18,000 23,940 27,000 31,500 36,000
CT4014 Peripheral Bypass Using Vein 24,000 31,920 36,000 42,000 48,000
CT4015 Repair Of Aortic Coarctation 30,000 39,900 45,000 52,500 60,000
CT4016 Simple Av Fistula Ligation 15,000 19,950 22,500 26,250 30,000
CT4017 Treatment Of Ateriovenous Fis 15,800 21,014 23,700 27,650 31,600
DENTAL
Service
Service name Charges ( Rs.)
Code
CONSERVATIVE DENTISTRY
DN1001 Ceramic Inlay Grade 1 6,000
DN1004 Ceramic Onlay Grade 1 8,000
DN1008 Composite Inlay Direct 4,000
DN1009 Composite Veneer 3,500
DN1010 Core Build Up Grade 1 1,000
DN1011 Core Build Up Grade 2 1,500
DN1012 Fluoride Application Per Quadrant 1,000
DN1013 Fluoride Application Per Sitting 500
DN1014 Fluoride Varnish Per Visit 1,000
DN1015 Indirect Pulp Capping 1,000
DN1016 Metal Inlay Grade 1 3,000
DN1017 Metal Inlay Grade 2 5,000
DN1018 Pit And Fissure Sealant Per Tooth Grade 1 800
DN1019 Pit And Fissure Sealant Per Tooth Grade 2 1,000
DN1020 Pit And Fissure Sealant Per Tooth Grade 3 1,500
DN1021 Post And Core Grade 1 1,500
DN1022 Post And Core Grade 2 2,500
DN1023 Pulpectomy 3,000
DN1025 Restoration Compomer Class 5 1,000
Page 6
DN1026 Restoration Composite 500
DN1027 Restoration Composite Class 1 1,200
DN1030 Restoration Composite Class 4 850
DN1031 Restoration Glass Ionomer Class 1 500
DN1035 Restoration Intermediate 600
DN1036 Restoration Miracle Mix 1,500
DN1037 Restoration Pulp Capping 600
DN1038 Restoration Silver Amalgam Grade 1 800
DN1039 Restoration Silver Amalgam Grade 2 1,000
DN1040 Restoration Silver Amalgam Grade 3 1,500
DN1041 Restoration Silver Amalgam Mod 2,200
DN1042 Restoration Temporary 500
DN1043 Root Canal 1St Sitting 1,600
DN1044 Root Canal 2Nd Sitting 2,000
DN1045 Root Canal Access Filling Composite 1,000
DN1046 Root Canal Access Filling GIC 600
DN1047 Root Canal Opening 1,200
DN1048 Root Canal Rotary 5,000
DN1049 Root Canal Treatment Anterior 3,500
DN1050 Root Canal Anterior Single Sitting 5,000
DN1051 Root Canal Treatment Posterior 4,500
DN1052 Root canal posterior Single sitting 6,000
DN1053 Re- Root canal treatment 5,000
Service
Code
PROSTHODONTICS
DN2001 All Ceramic Table Top Per Unit Grade 1 10,000
DN2002 All Ceramic Table Top Per Unit Grade 2 12,000
DN2003 Appliance Cleft Palate 5,000
DN2004 Bridge Per Unit 1,500
DN2005 Cast Partial Denture Grade 1 11,000
DN2006 Cast Partial Denture Grade 2 15,000
DN2007 Complete Denture Grade 1 15,000
DN2008 Complete Denture Grade 2 20,000
DN2009 Complete Denture Grade3 25,000
DN2013 Crown Removal 750
DN2014 Emax Laminates 1 12,000
DN2015 Emax Laminates 2 18,000
DN2016 Flexidenture Grade 1 11,000
DN2017 Flexidenture Grade 2 15,000
DN2018 Flexi Denture Grade3 18,000
DN2019 Full Ceramic Metal Free Crown Grade 1 10,000
DN2024 Laminate Per Tooth 10,000
DN2025 Lumineers 18,000
DN2026 Crown Porcelein 3,300
DN2027 Night Guard Grade 1 3,000
DN2028 Night Guard Grade 2 4,000
DN2029 Obturator 8,500
DN2030 Porcelein Crown 2Nd Sitting 2,000
DN2031 Porcelein Crown Per Sitting 2,500
DN2032 Porcelein Pfm Crown Grade 1 4,500
DN2036 Porcelein Veneer 10,000
DN2037 Procera Crown Grade 1 10,000
DN2038 Procera Crown Grade 2 20,000
DN2039 Re Cementation Of Bridge 800
DN2040 Re Cementation Of Crown 500
DN2041 Re-Lining Grade 1 1,400
Page 7
DN2044 Repair Of Denture Grade 1 600
DN2045 Repair Of Denture Grade 2 1,000
DN2046 Rpd Per Additional Tooth 500
DN2047 Rpd Plate 5,000
DN2048 Rpd Type 1 Per Tooth 900
DN2049 Rpd Type 2 Per Tooth 1,500
DN2050 Smile Designing Lower 15,000
DN2051 Smile Designing Upper 15,000
DN2052 Space Maintainer 4,500
DN2053 Arcylic Crown 1,000
DN2054 crown Lava 14,000
DN2055 crown Lava(CAD-CAM) 18,000
DN2056 crown with ceramic facing 4,000
DN2057 crown metal 2,500
DN2058 crown acrylic 2,500
Service
Code
PERIODONTICS
DN3001 Bone graft grade 1 (GTR) 12,000
DN3002 Bone graft grade 2 (GTR) 15,000
DN3003 Bonegraft Grade 1 5,000
DN3006 Enameloplasty Per Tooth 600
DN3007 Flap Surgery Full Mouth Grade 1 6,000
DN3010 Flap Surgery Per Quadrant Grade 1 1,100
DN3016 Gingival Contouring Per Tooth 600
DN3017 Gingival Currettage Per Quadrant 3,000
DN3018 Gingival Currettage Per Tooth 600
DN3019 Gingival Laser Contouring Per Tooth 1,000
DN3020 Gingivectomy 1,100
DN3021 Gingivectomy Per Quadrant 6,000
DN3022 Gingivectomy Per Tooth 800
DN3023 Gum Treatment Grade 1 1,100
DN3026 Polishing Per Tooth 700
DN3027 Re-Contouring Per Tooth 500
DN3028 Scaling Polishing Grade 1 1,500
DN3031 Sub Gingival Scaling,Root Planning Grade 1 1,500
DN3032 Sub Gingival Scaling,Root Planning Grade 2 2,000
DN3033 Gum Treatment full mouth grade1 8,000
DN3034 Gum Treatment full mouth grade2 12,000
DN3035 Oral Praphylaxn 1,000
COSMETIC DENTISTRY
DN4001 Bleach follow up 5,000
DN4002 bleaching trays 2,200
DN4003 Brite smile teeth whitening 1 18,000
DN4004 Brite smile teeth whitening 2 20,000
DN4005 De sensitising treatment per tooth 800
DN4006 Homebleach with trays 5,000
DN4007 Teeth bleaching grade 1 8,000
DN4008 Teeth bleaching grade 2 10,000
DN4009 Walking bleach 2,500
DN4010 Zoom bleach 15,000
Service
Code
ORTHODONTICS
DN5001 Fixed orthodontic treatment visit grade 1 2,000
DN5002 Fixed orthodontic treatment visit grade 2 5,000
DN5003 Fixed orthodontic ceramic braces grade 1 50,000
DN5006 Fixed orthodontic ceramic self ligating 80,000
Page 8
DN5007 Fixed orthodontic lingual grade 1 75,000
DN5010 Fixed orthodontic self ligating metal braces 50,000
DN5011 Fixed orthodontic treatment (metal) grade 1 35,000
DN5014 Fixed orthodontic treatment installment 10,000
DN5015 Orthodontic treatment (clearpath/invisilign) grade 1 150,000
DN5016 Orthodontic treatment (clearpath/invisilign) grade 2 175,000
PEDODONTICS
DN6001 Fixed Orthodontic Retainer 8,000
DN6002 Fixed Orthodontic Retainer Grade 1 6,000
DN6003 Growth Modifiers Grade 1 8,000
DN6004 Growth Modifiers Grade 2 10,000
DN6005 Pediatric Obturator 5,000
DN6006 Removable Appliance Bite Plate 4,000
DN6007 Removable Appliance By Trainer Therapy 8,000
DN6008 Removable Appliance Grade 1 (Retainer) 5,500
DN6009 Removable Appliance Habit Breaking Grade 1 3,500
DN6010 Removable Appliance Habit Breaking Grade 2 5,000
DN6011 Removable Appliance Therapy Grade 2 8,000
DN6012 Removable Appliance Therapy Grade 3 12,000
DN6013 Retainer Re-Making 1,500
DENTAL RADIOLOGY
DN7001 Alveolectomy Grade 1 2,500
DN7002 Alveolectomy Grade 2 3,500
DN7003 Alveoplasty Grade 1 2,500
DN7004 Alveoplasty Grade 2 3,500
DN7005 Apisectomy Single Tooth Grade 1 5,500
DN7006 Apisectomy Single Tooth Grade 2 With Bone Graft 8,500
DN7007 Biopsy Grade 1 2,500
DN7013 Canine Exposure Grade 1 5,000
DN7014 Canine Exposure Grade 2 6,500
DN7015 Closure Of Oaf 6,500
DN7016 Collagen Plug Dressing 2,000
DN7017 Cyst Enucleation Grade 1 5,500
DN7018 Cyst Enucleation Grade 2 8,500
DN7019 Dental Suturing Grade 1 600
DN7020 Dental Suturing Grade 2 1,000
DN7021 Drainage Of Abscess Grade 1 600
DN7022 Drainage Of Abscess Grade 2 1,000
DN7023 Drainage Of Abscess Grade 3 2,000
DN7024 Extraction Of Braces Treatment Per Tooth 1,000
DN7025 Extraction Of Deciduous Tooth Grade 1 500
DN7026 Extraction Of Deciduous Tooth Grade 2 1,000
DN7031 Extraction Of Tooth Grade 1 500
DN7032 Extraction Of Tooth Grade 2 800
DN7033 Extraction Of Tooth Grade 3 1,000
DN7034 Extraction Surgical Removal Of Tooth Grade 1 1,500
DN7037 Frenectomy Grade 1 3,500
DN7038 Frenectomy Grade 2 5,500
DN7039 Imf Grade 1 15,000
DN7040 Imf Grade 2 18,000
DN7041 Imf Removal 1,500
DN7049 Indirect Sinus Lift 5,000
DN7050 Nerve Avulsion 15,000
DN7051 Nerve Block 1,500
DN7052 Opurculectomy 1,000
DN7053 Removal Of Fractured Deccayed Tooth 1,700
DN7054 Ridge Splinting Grade 1 5,000
DN7055 Ridge Splinting Grade 2 8,000
DN7056 Sinus Lift Grade 1 Direct 15,000
DN7057 Sinus Lift Grade 2 Direct 20,000
DN7058 Socket Currettage 1,000
DN7059 Splinting Grade 1 2,500
DN7060 Splinting Grade 2 3,000
Page 9
DN7061 Surgical Extraction Of Impacted Tooth Grade 1 4,500
DN7066 Surgical Extraction Of Root From Maxillary Sinus 10,000
DN7067 Suturing Laceration 2,000
DN7068 Tooth Re-Implantation With Splinting 5,000
DN7069 Treatment Of Dry Socket Grade 1 2,000
DN7070 Treatment Of Dry Socket Grade 2 3,000
ORAL SURGERY
DN8001 IOPAR 200
DN8002 Lateral Cephalogram 440
DN8003 OPG 440
DN8004 RVG 200
DN8005 X ray 150
IMPLANTOLOGY
DN9001 Study models 800
DN9002 implant grade 1 28,000
DN9007 mini implant grade 1 18,000
DN9010 implant supported denture with 2 implants 150,000
DN9011 implant supported denture with 4 implants 260,000
DN9012 implant abutment grade1 5,000
DN9013 implant abutment grade 2 7,500
DN9014 implant abutment grade 3 9,500
DN9015 implant abutment Zirconia grade 1 15,000
DN9016 implant abutment Zirconia grade 2 20,000
DN9017 Implant crown grade 1 5,000
DN9020 immediate loading implant per implant 60,000
DERMATOLOGY (SKIN & COSMETIC CENTRE)
Service
Code
SKIN & COSMETIC PROCEDURES
DM1001 Acne Laser 4 Session 7,500
DM1002 Acne Laser Single Session 2,200
DM1003 Biopsy Skin Cscs 3,200
DM1004 Biopsy Mucosal 2,700
DM1005 Biopsy Nail 3,300
DM1006 Botox Procedure Administration (Per Unit) 250
DM1007 Chemical Cautary - Genital Warts (Per Sitting) 800
DM1008 Chemical Cautary - Xanthelasma (Per Sitting) - Both eyelids 2,000
DM1009 Chemical Cautary - Xanthelasma (Per Sitting) - One eyelid 1,000
DM1010 Chemical Cautery (Per Lesion) 350
DM1011 Chemical Cautry For Xanthelasma (small) 650
DM1012 Co2 Laser - Plantar & Palmar Wart (Per Lesion) 1,320
DM1013 Co2 Laser (Per Lesion) 610
DM1014 Co2 Laser For Xanthelasma 1,320
DM1015 Collagen Induction Therapy (Per Sitting) 2,750
DM1016 Comedone Extraction ( Per Lesion) 250
DM1017 Comedone Extraction Large Area 2,000
DM1018 Comedone Extraction Small Area 1,000
DM1019 Corn Removal Per Lesion 2,400
DM1020 Cyst Removal (Large) 2,400
DM1021 Cyst Removal (Medium) 1,600
DM1022 Cyst Removal (Small) 800
DM1023 Dark Circle 4 Session (peel) 3,500
DM1024 Dark Circle Per Session(peel) 1,080
DM1025 Dermabrasion-Small 16,500
DM1026 Dermabrasion-Medium 27,500
DM1027 Dernabrasion-Large 44,000
DM1028 Dressing Skin (Large) 550
DM1029 Dressing Skin (Medium) 350
DM1030 Dressing Skin (Small) 200
Page 10
DM1031 Facial Rajuvenation Per Sitting (IPL) 2,500
DM1032 Facial Rejuvenasion 4 session(IPL) 7,500
DM1033 Fillers (Per 0.5 Ml) 15,000
DM1034 Fillers (Per 1.0 Ml) 25,000
DM1035 Fraxel Deep Scars ( 4 Session) 92,000
DM1036 Fraxel Deep Scars (Per Session) 26,000
DM1037 Fraxel ( 4 Session) Large 68,000
DM1038 Fraxel ( 4 Session) Medium 46,000
DM1039 Fraxel ( 4 Session) Small 24,000
DM1040 Fraxel (Per Session) Large 20,000
DM1041 Fraxel (Per Session) Medium 13,000
DM1042 Fraxel (Per Session) Small 7,500
DM1043 Glycolic Peels (Arms) 5 Sitting 14,000
DM1044 Glycolic Peels (Arms) Per Sitting 3,000
DM1045 Glycolic Peels (Back) 5 Sitting 14,000
DM1046 Glycolic Peels (Back) Per Sitting 3,000
DM1047 Glycolic Peels (Face) 5 Sitting 7,500
DM1048 Glycolic Peels (Face) Per Sitting 1,800
DM1049 Glycolic Peels (Legs) 5 Sitting 14,000
DM1050 Glycolic Peels (Legs) Per Sitting 3,000
DM1051 Glycolic Peels (Neck) 5 Sitting 4,800
DM1052 Glycolic Peels (Neck) Per Sitting 1,200
DM1053 Hair Analysis 550
DM1054 Hair Removal Laser (Abdomen) 6+2 Sitting (Female) 46,000
DM1055 Hair Removal Laser (Abdomen) 6+2 Sitting (Male) 52,000
DM1056 Hair Removal Laser (Abdomen) Per Sitting (Female) 8,000
DM1057 Hair Removal Laser (Abdomen) Per Sitting (Male) 9,000
DM1058 Hair Removal Laser (Arms) 6+2 Sitting(Female) 44,000
DM1059 Hair Removal Laser (Arms) 6+2 Sitting (Male) 49,500
DM1060 Hair Removal Laser (Arms) Per Sitting (Female) 7,000
DM1061 Hair Removal Laser (Arms) Per Sitting (Male) 7,700
DM1062 HAIR REMOVAL LASER (BACK) 6+2 SITTING (FEMALE) 60,000
DM1063 Hair Removal Laser (Back) 6+2 Sitting (Male) 66,000
DM1064 Hair Removal Laser (Back) Per Sitting (Female) 8,800
DM1065 Hair Removal Laser (Back) Per Sitting (Male) 11,000
DM1066 Hair Removal Laser (Beard Shaping) 6+2 Sitting (Male) 16,500
DM1067 Hair Removal Laser (Beard Shaping) Per Sitting (Male) 2,750
DM1068 Hair Removal Laser (Bikni Area) 6+2 Sitting (Female) 26,400
DM1069 Hair Removal Laser (Bikni Area) 6+2 Sitting (Male) 28,600
DM1070 Hair Removal Laser (Bikni Area) Per Sitting (Female) 4,400
DM1071 Hair Removal Laser (Bikni Area) Per Sitting (Male) 5,500
DM1072 Hair Removal Laser (Chest) 6+2 Sitting (Female) 38,500
DM1073 Hair Removal Laser (Chest) 6+2 Sitting (Male) 44,000
DM1074 Hair Removal Laser (Chest) Per Sitting(Female) 5,500
DM1075 Hair Removal Laser (Chest) Per Sitting (Male) 6,600
DM1076 Hair Removal Laser (Ear Lobes) 6+2 Sitting 8,800
DM1077 Hair Removal Laser (Ear Lobes) Per Sitting 1,650
DM1078 Hair Removal Laser (Fore Head) 6+2 Sitting (Female) 13,200
DM1079 Hair Removal Laser (Fore Head) 6+2 Sitting(Male) 16,500
DM1080 Hair Removal Laser (Fore Head) Per Sitting (Female) 2,200
DM1081 Hair Removal Laser (Fore Head) Per Sitting (Male) 2,750
DM1082 Hair Removal Laser (Full Body) 6+2 Sitting (Female) 242,000
DM1083 Hair Removal Laser (full Body) 6+2 Sitting (Male) 264,000
DM1084 Hair Removal Laser (full Body) Per Sitting(Female) 44,000
DM1085 Hair Removal Laser (full Body) Per Sitting (Male) 55,000
DM1086 Hair Removal Laser (Full Legs) 6+2 Sitting(Female) 66,000
DM1087 Hair Removal Laser (Full Legs) 6+2 Sitting (Male) 71,500
DM1088 Hair Removal Laser (Full Legs) Per Sitting (Female) 12,000
DM1089 Hair Removal Laser (Full Legs) Per Sitting (Male) 13,000
DM1090 Hair Removal Laser (Half Face) 6+2 Sitting 19,800
DM1091 Hair Removal Laser (Half Face) Per Sitting 3,080
DM1092 Hair Removal Laser (Lower Arms) per Sitting (Female) 5,500
DM1093 Hair Removal Laser (Lower Arms) per Sitting(Male) 6,600
DM1094 Hair Removal Laser (Lower Arms) 6+2 Sitting (Female) 38,500
DM1095 Hair Removal Laser (Lower Arms) 6+2 Sitting(Male) 44,000
DM1096 Hair Removal Laser (Lower Legs) 6+2 Sitting (Female) 41,000
DM1097 Hair Removal Laser (Lower Legs) 6+2 Sitting (Male) 42,000
DM1098 Hair Removal Laser (Lower Legs) Per Sitting (Female) 8,200
DM1099 Hair Removal Laser (Lower Legs) Per Sitting (Male) 8,400
DM1100 Hair Removal Laser (Mid Brow) 6+2 Sitting 8,800
DM1101 Hair Removal Laser (Mid Brow) Per Sitting 1,650
Page 11
DM1102 Hair Removal Laser (Mid-Riff) 6+2 Sitting (Female) 30,800
DM1103 Hair Removal Laser (Mid-Riff) Per Sitting (Female) 4,400
DM1104 Hair Removal Laser (Periareolar) 6+2 Sitting (Female) 15,400
DM1105 Hair Removal Laser (Periareolar) Per Sitting (Female) 2,200
DM1106 Hair Removal Laser (Pubic Area) 6+2 Sitting (Female) 28,600
DM1107 Hair Removal Laser (Pubic Area) 6+2 Sitting (Male) 17,600
DM1108 Hair Removal Laser (Pubic Area) Per Sitting (Female) 5,500
DM1109 Hair Removal Laser (Pubic Area) Per Sitting (Male) 3,300
DM1110 Hair Removal Laser (Scalp) 6+2 Sitting (Male) 60,500
DM1111 Hair Removal Laser (Scalp) Per Sitting (Male) 12,100
DM1112 Hair Removal Laser (Side Locks) 6+2 Sitting 22,000
DM1113 Hair Removal Laser (Side Locks) Per Sitting 3,850
DM1114 Hair Removal Laser (Umbilical/Naval Line) 6+2 Sitting (Female) 17,600
DM1115 Hair Removal Laser (Umbilical/Naval Line) Per Sitting (Female) 3,300
DM1116 Hair Removal Laser (Under Arms) 6+2 Sitting (Female) 24,200
DM1117 Hair Removal Laser (Under Arms) 6+2 Sitting (Male) 27,500
DM1118 Hair Removal Laser (Under Arms) Per Sitting (Female) 4,400
DM1119 Hair Removal Laser (Under Arms) Per Sitting (Male) 5,500
DM1120 Hair Removal Laser (Upper Lips) 6+2 Sitting 10,450
DM1121 Hair Removal Laser (Upper Lips) Per Sitting 2,200
DM1122 Hair Removeal Laser (Full Face) Per Sitting 5,280
DM1123 Hair Tranplantation (Per graft) 70
DM1124 Hair Tranplantation Level - I 30,250
DM1125 Hair Tranplantation Level - II 60,500
DM1126 Hair Tranplantation Level - III 90,750
DM1127 Hair Tranplantation Level - IV 121,000
DM1128 Hair Tranplantation Level - V 151,250
DM1129 Hair Tranplantation Level - VI 181,500
DM1130 Incision & Drainage (Large) 6,100
DM1131 Incision & Drainage (Medium) 4,800
DM1132 Incision & Drainage (Small) 2,550
DM1133 Intra Lesional Therapy (Per Sitting) 500
DM1134 Intralesion Inj. (Single Lession) 500
DM1135 Intralesional Steroid Large Area 2,000
DM1136 Intralesional Steroid Small Area 1,000
DM1137 Iontophoresis (Per Week) 2,200
DM1138 Laser Acne Treatment Per Sitting (face & neck) 3,630
DM1139 Laser Hair Reducation Scalp (6+2 Session) 66,550
DM1140 Laser Hair Reducation Scalp( Per Session) 13,000
DM1141 Microderma Brasion (Face) Per Sitting 2,000
DM1142 Microderma Brasion (Arms) 5 Sitting 15,400
DM1143 Microderma Brasion (Arms) Per Sitting 3,500
DM1144 Microderma Brasion (Back) 5 Sitting 15,400
DM1145 Microderma Brasion (Back) Per Sitting 3,500
DM1146 Microderma Brasion (Face) 5 Sitting 7,500
DM1147 Microderma Brasion (Legs) 5 Sitting 15,400
DM1148 Microderma Brasion (Legs) Per Sitting 3,500
DM1149 Microderma Brasion (Neck) 5 Sitting 6,000
DM1150 Microderma Brasion (Neck) Per Sitting 1,400
DM1151 Microscopic Hair Analysis 600
DM1152 Milia Extraction (Per Lesion) 330
DM1153 Milia Treatment (Upto 10 Lession) 1,680
DM1154 Mole Removal (Per Mole) 3,600
DM1155 Nail Avulsion Per Nail 3,800
DM1156 Nbuvb Phototherapy (Derma) Per Sitting 600
DM1157 Nbuvb Phototherapy Per Month 4,400
DM1158 Nbuvb Phototherapy Localized Per Sitting 330
DM1159 Paring Lesion (Large) Per Sitting 1,800
DM1160 Paring Lesion (Medium) Per Sitting 1,200
DM1161 Paring Lesion (Small) Per Sitting 600
DM1162 Patch Test 3,200
DM1163 Lipolysis 1 (non surgical) 6,600
DM1164 Lipolysis II (non surgical) 11,000
DM1165 Lipolysis III (non surgical) 16,500
DM1166 Punch Grafting (Per Punch) 550
DM1167 Q Switched Laser (Per Sitting) 7,700
DM1168 Rf Cautery (Per Lesion) 400
DM1169 Salicylic Acid Peel 5 Sitting 6,600
DM1170 Salicylic Acid Peel Per Sitting 1,500
DM1171 Scar Revision (Large) Per Sitting 31,350
DM1172 Scar Revision (Medium) Per Sitting 19,250
Page 12
DM1173 Scar Revision (Small) Per Sitting 7,800
DM1174 Skin Smear 440
DM1175 Skin Stitching more than 6 Stitches 3,000
DM1176 Skin Stitching Up To 6 Stitches 1,800
DM1177 Skin Tightning (Large) 20,000
DM1178 Skin Tightning (Medium) 15,000
DM1179 Skin Tightning (Small) 10,000
DM1180 Smear For Fungus Making Charges 330
DM1181 Smear Making Charges 330
DM1182 Tattooing- Small 6,000
DM1183 Tattooing - Medium 14,500
DM1184 Tattooing- Large 30,000
DM1185 Tca Peel ( Arms) 5 Sitting 18,000
DM1186 Tca Peel (Arms) Per Sitting 4,200
DM1187 Tca Peel (Back )5 Sitting 14,000
DM1188 Tca Peel (Back) Per Sitting 3,000
DM1189 Tca Peel (Face) 5 Sitting 10,000
DM1190 Tca Peel (Face) Per Sitting 2,400
DM1191 Tca Peel (Legs) 5 Sitting 18,000
DM1192 Tca Peel (Legs) Per Sitting 4,200
DM1193 Tca Peel (Neck) 5 Sitting 6,000
DM1194 Tca Peel (Neck) Per Sitting 1,800
DM1195 Thermage Face A 33,000
DM1196 Thermage Face B 44,000
DM1197 Thermage Face C 55,000
DM1198 Tumor Excision Large 12,000
DM1199 Tumor Excision Medium 8,000
DM1200 Tumor Excision Small 5,600
DM1201 Vascular (Large) Per Sitting 12,100
DM1202 Vascular (Medium) Per Sitting 5,000
DM1203 Vascular (Small) Per Sitting 1,200
DM1204 Vitiligo Surgery (Large) 60,500
DM1205 Vitiligo Surgery (Medium) 30,250
DM1206 Vitiligo Surgery (Small) 11,880
DM1207 Wound Debridement (Large) Per Sitting 4,950
DM1208 Wound Debridement (Small) Per Sitting 1,800
DERMATOLOGY INVESTIGATIONS
DM2001 ALLERGY TESTING N 1,980
DM2002 ALLERGY TESTING D 2,420
DM2003 ALLERGY TESTING I 2,750
DM2004 ALLERGY TESTING V 3,300
DM2005 ALLERGY TESTING V+ I 4,840
DM2006 ALLERGY TESTING V + N + I 5,500
DM2007 ALLERGY TESTING V + I + D 6,050
DM2008 ALLERGY TESTING COMPLETE 6,600
ENT
Code bed
Minor procedure/surgery
EN1001 Adenoidectomy 5,570 7,408 8,355 9,748 11,140
EN1002 Anterior & Posterior Nasal Packing 6,930 9,217 10,395 12,128 13,860
EN1003 Anterior Tracheal Wall Flap 4,200 5,586 6,300 7,350 8,400
EN1004 Antral Wash Outs Bilateral 2,730 3,631 4,095 4,778 5,460
EN1005 Antral Wash Outs Unilateral 1,680 2,234 2,520 2,940 3,360
EN1006 Aspiration & Drainage With Pressure Bandage Haematoma Pinna 2,100 2,793 3,150 3,675 4,200
EN1007 Aural Polypectomy 4,100 5,453 6,150 7,175 8,200
EN1008 Bronchoscopy With Foreign Body Removal 6,720 8,938 10,080 11,760 13,440
EN1009 Caldwell Lucs Operation 8,820 11,731 13,230 15,435 17,640
EN1010 Cauterization Bleeding Point Nose Cautery Electric 2,100 2,793 3,150 3,675 4,200
EN1011 Cauterization Bleeding Point Nose Sliver Nitrate 840 1,117 1,260 1,470 1,680
EN1012 Cautery Patching Ear 3,990 5,307 5,985 6,983 7,980
EN1013 Direct Laryngoscopy / Fodl 4,730 6,291 7,095 8,278 9,460
EN1014 Ear - Foreign Body removal 420 559 630 735 840
EN1015 Ear Packing 170 226 255 298 340
EN1016 Endoscopic Adenoidectomy 9,450 12,569 14,175 16,538 18,900
EN1017 ETF 470 625 705 823 940
EN1018 Eum (Exam Under Microscope) Ent 740 984 1,110 1,295 1,480
EN1019 Excision Branchial Cyst 7,980 10,613 11,970 13,965 15,960
EN1020 Excision Branchial Fistula 7,980 10,613 11,970 13,965 15,960
EN1021 Excision Branchial Sinus 9,350 12,436 14,025 16,363 18,700
Page 13
EN1022 Excision Growth External Auditory Canal 5,360 7,129 8,040 9,380 10,720
EN1023 Excision Of Nasal Synaechae (Adhesions) Bilateral 4,730 6,291 7,095 8,278 9,460
EN1024 Excision Of Nasal Synaechae (Adhesions) Unilateral 3,470 4,615 5,205 6,073 6,940
EN1025 Excision Sebaceous Cyst Neck 2,730 3,631 4,095 4,778 5,460
EN1026 Excision Submandibular Gland 9,350 12,436 14,025 16,363 18,700
EN1027 Fibre Optic Laryngoscopy 2,100 2,793 3,150 3,675 4,200
EN1028 Fibreoptic Nasal Endoscopy 2,100 2,793 3,150 3,675 4,200
EN1029 Foreign Body - Nose/ Oral Cavity -Removal 1,010 1,343 1,515 1,768 2,020
EN1030 Foreign Body Hypopharynx 6,720 8,938 10,080 11,760 13,440
EN1031 Foreign Body Larynx 6,720 8,938 10,080 11,760 13,440
EN1032 Injection Nasal Turbinates/Sub Mucosal Fibrosis 420 559 630 735 840
EN1033 Intra Nasal Ethemoidectomy Bilateral 10,500 13,965 15,750 18,375 21,000
EN1034 Intra Oral Removal Of Calculus Submandibular Duct 3,470 4,615 5,205 6,073 6,940
EN1035 Intranasal Antrostomy Unilateral 4,730 6,291 7,095 8,278 9,460
EN1036 Intra nasal Ethemoidectomy 9,350 12,436 14,025 16,363 18,700
EN1037 Lymph Node Biopsy Neck 3,570 4,748 5,355 6,248 7,140
EN1038 Myringotomy Bilateral 5,360 7,129 8,040 9,380 10,720
EN1039 Myringotomy Bilateral With Gromets 7,980 10,613 11,970 13,965 15,960
EN1040 Myringotomy Unilateral 3,470 4,615 5,205 6,073 6,940
EN1041 Myringotomy Unilateral With Gromets 6,090 8,100 9,135 10,658 12,180
EN1042 Nasal Endoscopy (Ent) 2,100 2,793 3,150 3,675 4,200
EN1043 Nasal Packing Anterior 3,470 4,615 5,205 6,073 6,940
EN1044 Nasal Packing With Catheter Balloons B/L (Endoscopy Assisted) 4,620 6,145 6,930 8,085 9,240
EN1045 Nasal Packing With Catheter Balloons U/L (Endoscopy Assisted) 3,470 4,615 5,205 6,073 6,940
EN1046 Nasal Polypectomy Bilateral 9,350 12,436 14,025 16,363 18,700
EN1047 Nasal Polypectomy Unilateral 6,720 8,938 10,080 11,760 13,440
EN1048 Oesophagoscopy With Foreign Body Removal 6,720 8,938 10,080 11,760 13,440
EN1049 Oto Endoscopy 1,160 1,543 1,740 2,030 2,320
EN1050 Partial Glossectomy 4,200 5,586 6,300 7,350 8,400
EN1051 Partial Turbinectomy 5,250 6,983 7,875 9,188 10,500
EN1052 Peritonsillar Abscess Incision & Drainage 3,360 4,469 5,040 5,880 6,720
EN1053 Pre Auricular Sinus Excision 7,980 10,613 11,970 13,965 15,960
EN1054 R.F Of Palate 5,250 6,983 7,875 9,188 10,500
EN1055 R.F Of Tongue 5,250 6,983 7,875 9,188 10,500
EN1056 R.F Of Turbinate 5,250 6,983 7,875 9,188 10,500
EN1057 Reduction Manipulation Of Nasal Bones 5,360 7,129 8,040 9,380 10,720
EN1058 Removal Of Foreign Body Ears 2,100 2,793 3,150 3,675 4,200
EN1059 Removal Of Foreign Body Nose 2,100 2,793 3,150 3,675 4,200
EN1060 Removal Of Imf Wire 1,680 2,234 2,520 2,940 3,360
EN1061 Removal Of Nasal Pack 1,470 1,955 2,205 2,573 2,940
EN1062 Removal Of Wax Ears Bilateral 740 984 1,110 1,295 1,480
EN1063 Removal Of Wax Ears Unilateral 420 559 630 735 840
EN1064 Repair Of Split Lobules Bilateral 2,630 3,498 3,945 4,603 5,260
EN1065 Repair Of Split Lobules Unilateral 1,890 2,514 2,835 3,308 3,780
EN1066 Repair Palatal Fistula 9,350 12,436 14,025 16,363 18,700
EN1067 Retropharyngeal Abscess Incision & Reainage 6,720 8,938 10,080 11,760 13,440
EN1068 Septal Abscess Incision & Drainage 5,250 6,983 7,875 9,188 10,500
EN1069 Septal Anscess Incision & Drainage 2,940 3,910 4,410 5,145 5,880
EN1070 Septal Hematoma Incision & Drainage 5,250 6,983 7,875 9,188 10,500
EN1071 Septoplasty 8,400 11,172 12,600 14,700 16,800
EN1072 Sinus Endoscopy 3,470 4,615 5,205 6,073 6,940
EN1073 Submucosal Cauterization Turbinates 2,100 2,793 3,150 3,675 4,200
EN1074 Submucosal Diathermy Turbinates 2,100 2,793 3,150 3,675 4,200
EN1075 Suction Clearance Ears / Nose - Bilateral 340 452 510 595 680
EN1076 Suction Clearance Ears / Nose - Unilateral 340 452 510 595 680
EN1077 Suturing Of Small Wounds Neck 1,790 2,381 2,685 3,133 3,580
EN1078 Suturing Of Small Wounds Nose 1,790 2,381 2,685 3,133 3,580
EN1079 Syringing Ears - Wax 210 279 315 368 420
EN1081 Thyroglossal Cyst Excision 9,350 12,436 14,025 16,363 18,700
EN1082 Thyroglossal Sinus Excision 9,350 12,436 14,025 16,363 18,700
EN1083 Tinnites Matching 420 559 630 735 840
EN1084 Tongue Tie Release & Suturing 3,360 4,469 5,040 5,880 6,720
EN1085 Tonsillectomy 9,350 12,436 14,025 16,363 18,700
EN1086 Tracheostomy 9,350 12,436 14,025 16,363 18,700
EN1087 Turbinectomy 5,040 6,703 7,560 8,820 10,080
EN1088 Uvuloplasty 5,250 6,983 7,875 9,188 10,500
EN1089 Video Laryngoscopy 2,310 3,072 3,465 4,043 4,620
Code bed
Major surgery
EN2001 Adenotonsillectomy 10,610 14,111 15,915 18,568 21,220
Page 14
EN2002 Anterior Ethemoidal Artery Ligation 10,610 14,111 15,915 18,568 21,220
EN2003 Carotid Body Tumour Excision 33,600 44,688 50,400 58,800 67,200
EN2004 Choanal Atresia 13,230 17,596 19,845 23,153 26,460
EN2005 Closure Of Oro Antral Fistula 10,610 14,111 15,915 18,568 21,220
EN2006 Cochlear Implantation 42,000 55,860 63,000 73,500 84,000
EN2007 Cortical Mastoidectomy 13,230 17,596 19,845 23,153 26,460
EN2008 Dilation Oesophageal Strictures 10,610 14,111 15,915 18,568 21,220
EN2009 Endo Lymphatic Sac Cecompression 18,900 25,137 28,350 33,075 37,800
EN2010 Endoscopic Csf Fistula Repair 19,950 26,534 29,925 34,913 39,900
EN2011 Endoscopic Dcr 13,440 17,875 20,160 23,520 26,880
EN2012 Endoscopic Orbital Decompression 18,900 25,137 28,350 33,075 37,800
EN2013 Endoscopic Sphenoethmoidectomy 23,100 30,723 34,650 40,425 46,200
EN2014 Endoscopic Sphenoidectomy 23,100 30,723 34,650 40,425 46,200
EN2015 Excision Cum Repair Laryngeal Stenosis 14,600 19,418 21,900 25,550 29,200
EN2016 Excision Cum Repair Tracheal Stenosis 14,600 19,418 21,900 25,550 29,200
EN2017 Excision Nasopharyngeal Angiofibroma 22,580 30,031 33,870 39,515 45,160
EN2018 Excision Pharyngeal Diverticulum 13,230 17,596 19,845 23,153 26,460
EN2019 Excision Pharyngeal Pouch 13,230 17,596 19,845 23,153 26,460
EN2020 Ext Ethmoidectomy 13,230 17,596 19,845 23,153 26,460
EN2021 Facial Nerve Decompression 19,950 26,534 29,925 34,913 39,900
EN2022 Fracture Naso Ethmoidal Comples 13,230 17,596 19,845 23,153 26,460
EN2023 Functional Endoscopic Sinus Surgery 15,960 21,227 23,940 27,930 31,920
EN2024 Glomus Jugulare Tumor Trans Tympanic Approach 42,000 55,860 63,000 73,500 84,000
EN2025 Laryngeal Web Excision 10,610 14,111 15,915 18,568 21,220
EN2026 Laryngectomy Conservative 19,950 26,534 29,925 34,913 39,900
EN2027 Laryngectomy Total 19,950 26,534 29,925 34,913 39,900
EN2028 Laryngo Fissurotomy 13,230 17,596 19,845 23,153 26,460
EN2029 Lateral Pharyngotomy 13,230 17,596 19,845 23,153 26,460
EN2030 Lateral Rhinotomy 13,230 17,596 19,845 23,153 26,460
EN2031 Ligation Ext Carotid Artery 10,610 14,111 15,915 18,568 21,220
EN2032 Ligation Sphenopalatine Artery 10,610 14,111 15,915 18,568 21,220
EN2033 Mastoid Cavity Obliteration 14,600 19,418 21,900 25,550 29,200
EN2034 Mastoidectomy Modified 14,600 19,418 21,900 25,550 29,200
EN2035 Mastoidectomy Radical 14,600 19,418 21,900 25,550 29,200
EN2036 Maxillectomy 19,950 26,534 29,925 34,913 39,900
EN2037 Microlaryngeal Surgery 13,230 17,596 19,845 23,153 26,460
EN2038 Myringoplasty 13,230 17,596 19,845 23,153 26,460
EN2039 Ossiculoplasty 13,230 17,596 19,845 23,153 26,460
EN2040 Pan Endoscopy & Biopsy 10,610 14,111 15,915 18,568 21,220
EN2041 Parapharyngeal Abscess Incision & Drainage 11,450 15,229 17,175 20,038 22,900
EN2042 Post Cochlear Implant 34,650 46,085 51,975 60,638 69,300
EN2043 Radical Ethemoidal Surgery 19,950 26,534 29,925 34,913 39,900
EN2044 Radical Frontal Surgery 19,950 26,534 29,925 34,913 39,900
EN2045 Radical Sphenoid Surgery 19,950 26,534 29,925 34,913 39,900
EN2046 Rhinoplasty Augmented 15,750 20,948 23,625 27,563 31,500
EN2047 Rhinoplasty Corrective 15,750 20,948 23,625 27,563 31,500
EN2048 Rhinoplasty Cum Septoplasty 15,750 20,948 23,625 27,563 31,500
EN2049 Stapedectomy 14,600 19,418 21,900 25,550 29,200
EN2050 Styloidectomy 13,230 17,596 19,845 23,153 26,460
EN2051 Thyroidectomy 14,600 19,418 21,900 25,550 29,200
EN2052 Transantral Ethmoidectomy (Horgans) 14,600 19,418 21,900 25,550 29,200
EN2053 Tympanomastoidectomy 18,710 24,884 28,065 32,743 37,420
EN2054 Tympanoplasty 14,600 19,418 21,900 25,550 29,200
EN2055 Vidian Neurectomy 14,600 19,418 21,900 25,550 29,200
EN2056 Ear Lobule Repair 3,150 4,190 4,725 5,513 6,300

Code bed
Speech and Hearing clinic
EN3001 ASSR 2,630 3,498 3,945 4,603 5,260
EN3002 BERA/ABR 2,630 3,498 3,945 4,603 5,260
EN3003 BOA/FFA 530 705 795 928 1,060
EN3004 Ear Mould 1,050 1,397 1,575 1,838 2,100
EN3005 Hearing Aid Trail 420 559 630 735 840
EN3006 Hearing Screening Neonatal 580 771 870 1,015 1,160
EN3007 Impedance 840 1,117 1,260 1,470 1,680
EN3008 OAE 1,160 1,543 1,740 2,030 2,320
EN3009 Pure Tone Audiometery (Pta) 500 665 750 875 1,000
EN3010 Audio Metery 420 559 630 735 840
EN3011 Speech Therapy(Per session) 630 838 945 1,103 1,260
EN3012 Tone Decay Test 290 386 435 508 580
Page 15
EN3013 Tympanometery 840 1,117 1,260 1,470 1,680
EN3014 TDI/SISI 530 705 795 928 1,060
GENERAL & LAPAROSCOPIC SURGERY
Code bed
Minor Procedure/surgery
GS1001 Abscess Incision & Drainage 2,200 2,926 3,300 3,850 4,400
GS1002 Abscess Incision & Drainage In Ot 2,750 3,658 4,125 4,813 5,500
GS1003 Adhesiolysis 9,900 13,167 14,850 17,325 19,800
GS1004 Adhesiolysis & Division Of Bands 9,900 13,167 14,850 17,325 19,800
GS1005 Anal Dilatation Lords Procedure 2,310 3,072 3,465 4,043 4,620
GS1006 Anal Fistula Plug 9,900 13,167 14,850 17,325 19,800
GS1007 Anchoring Of Gaestrotomy Tube Under La 1,870 2,487 2,805 3,273 3,740
GS1008 Appendectomy 9,900 13,167 14,850 17,325 19,800
GS1009 Appendicular Abscess Drainge 8,800 11,704 13,200 15,400 17,600
GS1010 Axillary Dissection 8,800 11,704 13,200 15,400 17,600
GS1011 Biopsy Lymph Node 4,950 6,584 7,425 8,663 9,900
GS1012 Biopsy Lymph Node Axilla 4,950 6,584 7,425 8,663 9,900
GS1013 Biopsy Lymph Node Inguinal 4,950 6,584 7,425 8,663 9,900
GS1014 Bladder Repair 6,600 8,778 9,900 11,550 13,200
GS1015 Breast Abscess Incision & Drainage 4,950 6,584 7,425 8,663 9,900
GS1016 Breast Lumpectomy 6,600 8,778 9,900 11,550 13,200
GS1017 Breast Quatrantectomy 11,000 14,630 16,500 19,250 22,000
GS1018 Burst Abdomen Repair 10,450 13,899 15,675 18,288 20,900
GS1019 Carbuncle (Large) 8,800 11,704 13,200 15,400 17,600
GS1020 Carbuncle (Small) 5,500 7,315 8,250 9,625 11,000
GS1021 Cholangiogram Intra Operative 3,850 5,121 5,775 6,738 7,700
GS1022 Cholecystostomy 9,350 12,436 14,025 16,363 18,700
GS1023 Circumcision 5,500 7,315 8,250 9,625 11,000
GS1024 Colostomy Bag Application 660 878 990 1,155 1,320
GS1025 Colostomy Closure 9,350 12,436 14,025 16,363 18,700
GS1026 Core Excision Under La 2,750 3,658 4,125 4,813 5,500
GS1027 Corn Excision Under La 1,650 2,195 2,475 2,888 3,300
GS1028 Corn Excision Under La - Multiple 3,300 4,389 4,950 5,775 6,600
GS1029 Cyst Removal (Skin) 2,970 3,950 4,455 5,198 5,940
GS1030 Diabetic Gangrene (Major) 8,030 10,680 12,045 14,053 16,060
GS1031 Diabetic Gangrene (Minor) 4,840 6,437 7,260 8,470 9,680
GS1032 Dissection Lymph Node pelvis 11,550 15,362 17,325 20,213 23,100
GS1033 Dressing In Ot 2,200 2,926 3,300 3,850 4,400
GS1034 Escharotomy 3,850 5,121 5,775 6,738 7,700
GS1035 Excision Lipoma Of Large Lump Back 8,690 11,558 13,035 15,208 17,380
GS1036 Excision Lipoma U\A 6,270 8,339 9,405 10,973 12,540
GS1037 Excision Of Dilated Duct 5,500 7,315 8,250 9,625 11,000
GS1038 Excision Of Spermatocoele 5,500 7,315 8,250 9,625 11,000
GS1039 Excision Of Tumour 6,820 9,071 10,230 11,935 13,640
GS1040 Excision Sebaceous Cyst (Small ) 3,300 4,389 4,950 5,775 6,600
GS1041 Exscision Of Ranula 8,800 11,704 13,200 15,400 17,600
GS1042 Fingernail Removal 1,650 2,195 2,475 2,888 3,300
GS1043 Fisherectomy 9,900 13,167 14,850 17,325 19,800
GS1044 Fistula In Ano Low Level 10,560 14,045 15,840 18,480 21,120
GS1045 Foreign Body Removal Under La 3,300 4,389 4,950 5,775 6,600
GS1047 Foreign Body Removal-Deep-Under Ga 8,250 10,973 12,375 14,438 16,500
GS1048 Six/ Ninenier Gangrene 6,600 8,778 9,900 11,550 13,200
GS1049 Gangrene (Major) 8,800 11,704 13,200 15,400 17,600
GS1050 Gastrostomy 8,470 11,265 12,705 14,823 16,940
GS1051 Gynaecomastia Unilatral Breast 9,900 13,167 14,850 17,325 19,800
GS1052 Haemorrhoidectomy 9,900 13,167 14,850 17,325 19,800
GS1053 Hernia Epigastric 8,800 11,704 13,200 15,400 17,600
GS1054 Hernia Femoral 9,350 12,436 14,025 16,363 18,700
GS1055 Hernia Inguinal Repair Unilateral 10,450 13,899 15,675 18,288 20,900
GS1056 Hernia Lumber 11,000 14,630 16,500 19,250 22,000
GS1057 Hernia Spigelian 11,000 14,630 16,500 19,250 22,000
GS1058 Hernia Supraumblical 11,000 14,630 16,500 19,250 22,000
GS1059 Hernia Umbilical 9,900 13,167 14,850 17,325 19,800
GS1060 Hernia Ventral 10,450 13,899 15,675 18,288 20,900
GS1061 Hydrocele/Spermatocoele 7,040 9,363 10,560 12,320 14,080
GS1062 Ileostomy 7,150 9,510 10,725 12,513 14,300
GS1063 Injection Ganglion 2,200 2,926 3,300 3,850 4,400
GS1064 Injection Varicose Veins 3,300 4,389 4,950 5,775 6,600
GS1065 Instrussusception (Simple Reduction) 9,350 12,436 14,025 16,363 18,700
GS1066 Intesntinal Resction And Anastomosis 11,550 15,362 17,325 20,213 23,100
Page 16
GS1067 Intestinal Perforation 10,450 13,899 15,675 18,288 20,900
GS1068 Ischiorectal Abscess 7,260 9,656 10,890 12,705 14,520
GS1069 Jejunostomy 9,020 11,997 13,530 15,785 18,040
GS1070 Lap. Diagnostic (Gen Surg) 7,700 10,241 11,550 13,475 15,400
GS1071 Lap. Hernia (Lap. Repair ) In Children 9,900 13,167 14,850 17,325 19,800
GS1072 Lap. Ligation Of Varicocele 10,780 14,337 16,170 18,865 21,560
GS1073 Laparotomy Exploratory 18,700 24,871 28,050 32,725 37,400
GS1074 Lateral Sphicterotomy 7,700 10,241 11,550 13,475 15,400
GS1075 Manual Evacuation Of Rectum 2,200 2,926 3,300 3,850 4,400
GS1076 Mastectomy Unilateral 10,450 13,899 15,675 18,288 20,900
GS1077 Meckels Diverticulum 11,000 14,630 16,500 19,250 22,000
GS1078 Mesenteric Cyst Excision 11,000 14,630 16,500 19,250 22,000
GS1079 Metoplasty 4,400 5,852 6,600 7,700 8,800
GS1080 Nail Bed Wedge Excision 1,980 2,633 2,970 3,465 3,960
GS1081 Non Scalpel Vasectomy 7,700 10,241 11,550 13,475 15,400
GS1082 Oesophageoscopy For Foreign Body Removal 8,250 10,973 12,375 14,438 16,500
GS1083 Omentopexy 7,700 10,241 11,550 13,475 15,400
GS1084 Open Drainage Of Liver Abscess 10,560 14,045 15,840 18,480 21,120
GS1085 Para Phimosis 3,300 4,389 4,950 5,775 6,600
GS1086 Perforated Duodenal Ulcer Simple 11,000 14,630 16,500 19,250 22,000
GS1087 Perforated Gastric Ulcer Simple 11,000 14,630 16,500 19,250 22,000
GS1088 Perianal Abscess (Superficial) 11,000 14,630 16,500 19,250 22,000
GS1089 Phimosis Under La 4,400 5,852 6,600 7,700 8,800
GS1090 Pilonidal Sinus Excision Only 9,900 13,167 14,850 17,325 19,800
GS1091 Port Removal 3,850 5,121 5,775 6,738 7,700
GS1092 Ranula Deroofing / Excision 7,700 10,241 11,550 13,475 15,400
GS1093 Rectal Polypectomy 6,600 8,778 9,900 11,550 13,200
GS1094 Reduction Of Inguinal Hernia 2,750 3,658 4,125 4,813 5,500
GS1095 Repair Of Perineal Tear 7,150 9,510 10,725 12,513 14,300
GS1096 Sialography 9,900 13,167 14,850 17,325 19,800
GS1097 Sigmoidpexy 8,250 10,973 12,375 14,438 16,500
GS1098 Skin Grafting Spilt 11,000 14,630 16,500 19,250 22,000
GS1099 Superficial Cyst Large 4,950 6,584 7,425 8,663 9,900
GS1100 Superficial Tumor Large 4,950 6,584 7,425 8,663 9,900
GS1101 Superficial Tumor Small 2,860 3,804 4,290 5,005 5,720
GS1102 Superficial Tumor Small (Multiple) 4,400 5,852 6,600 7,700 8,800
GS1103 Suprapubic Drainage (Cystostomy) 5,500 7,315 8,250 9,625 11,000
GS1104 Suture Large Laceration 3,850 5,121 5,775 6,738 7,700
GS1105 Suturing Of Massive Lacerated Facial Wound 9,900 13,167 14,850 17,325 19,800
GS1106 Suturing Of Multiple Small Wound 4,950 6,584 7,425 8,663 9,900
GS1107 Suturing Of Single Major Wound 4,950 6,584 7,425 8,663 9,900
GS1108 Total Nail Bed Ablation 1,980 2,633 2,970 3,465 3,960
GS1109 Tube Ceacostomy 5,500 7,315 8,250 9,625 11,000
GS1110 Umbilectomy 8,800 11,704 13,200 15,400 17,600
GS1111 Umbilical Cut Down 2,750 3,658 4,125 4,813 5,500
GS1112 Wound Debridement In Operation Theatre 7,150 9,510 10,725 12,513 14,300
GS1113 Wound Delayed Suturing 9,900 13,167 14,850 17,325 19,800
GS1114 Wound Gunshot Debridement 11,000 14,630 16,500 19,250 22,000
GS1115 Thoracic Water seal drainge 6,050 8,047 9,075 10,588 12,100
GS1116 Sector Mastectomy 11,000 14,630 16,500 19,250 22,000
GS1117 Large Fibroadenoma 8,800 11,704 13,200 15,400 17,600
GS1118 Multiple Fibroadenoma/Bilateral 8,800 11,704 13,200 15,400 17,600
GS1119 Rectal BX Under GA 2,750 3,658 4,125 4,813 5,500
GS1120 Peritoneal Tapping 2,200 2,926 3,300 3,850 4,400
GS1121 Cut Back Operation For Anal Stenosis 6,050 8,047 9,075 10,588 12,100
GS1122 Fissurectomy + Rectal Dilatation+ Sentinel piles 11,000 14,630 16,500 19,250 22,000
GS1123 Fistula In Ano Single Opening 10,560 14,045 15,840 18,480 21,120
GS1124 Divarication of Recti Repair 8,800 11,704 13,200 15,400 17,600
GS1125 Laparatomy For Rectopexy 8,250 10,973 12,375 14,438 16,500
GS1126 Injection Sclerotheraphy in OPD for Keloid/ Hemangioma 2,200 2,926 3,300 3,850 4,400
GS1127 Incision BX 1,650 2,195 2,475 2,888 3,300
GS1128 Excision of Massive Lipoma/cyst/Keloid 8,690 11,558 13,035 15,208 17,380
GS1129 Wide Local Excision of Lump 9,790 13,021 14,685 17,133 19,580
GS1130 Extensive/Multiple Wound debridement 8,580 11,411 12,870 15,015 17,160
GS1131 Excision of Perineal Mass 9,900 13,167 14,850 17,325 19,800
GS1132 Ligation and Stripping Of Varicose Veins 8,800 11,704 13,200 15,400 17,600
GS1133 Excision Of Recurrent Varicose Vein 10,450 13,899 15,675 18,288 20,900
GS1134 Excision Of Recurrent Lump 11,000 14,630 16,500 19,250 22,000
GS1135 Tube Ligation 7,700 10,241 11,550 13,475 15,400
GS1136 Excision Of Lipoma 5,500 7,315 8,250 9,625 11,000
GS1137 Eyelid Repair (Coloboma) 11,000 7,315 16,500 19,250 22,000
Page 17
GS1138 Eyelid Repair (Injuries) 8,250 10,973 12,375 14,438 16,500
GS1139 Aspiration Liver Abscess 2,717 3,614 4,076 4,755 5,434
GS1140 Biopsy Liver 2,717 3,614 4,076 4,755 5,434
GS1141 Biopsy True Cut Needle 1,430 1,902 2,145 2,503 2,860
GS1142 Biopsy Ulcer In Opd/Ward 1,430 1,902 2,145 2,503 2,860
GS1143 Dressing (Large) 1,100 1,463 1,650 1,925 2,200
GS1144 Dressing (Medium) 660 878 990 1,155 1,320
GS1145 Dressing (Small) 350 466 525 613 700
GS1146 Ingrowing Toe Nail Removal In Opd/Ward 1,650 2,195 2,475 2,888 3,300
GS1147 Reinjection For Heamorrohoids 737 980 1,106 1,290 1,474
GS1148 Venesection 990 1,317 1,485 1,733 1,980
Major Surgeries
GS2096 Abdominoperineal Pull Through Resection With Colorectal Anastomosis ULAR/LAR/AR 23,100 30,723 34,650 40,425 46,200
GS2097 Abdominoperineal Resection Of Rectum (APR) 23,100 30,723 34,650 40,425 46,200
GS2001 Abscess Drainage Perinephric 12,100 16,093 18,150 21,175 24,200
GS2002 Abscess Drainage Psoas 12,100 16,093 18,150 21,175 24,200
GS2003 Abscess Drainage Subdiapragmatic 12,100 16,093 18,150 21,175 24,200
GS2078 Achalasia Oesophago Cardiomyotomy 19,800 26,334 29,700 34,650 39,600
GS2109 Adrenal Gland Neoplasm Excision 24,200 32,186 36,300 42,350 48,400
GS2023 Adrenalectomy Sub Total Bilateral 16,500 21,945 24,750 28,875 33,000
GS2024 Adrenalectomy Sub Total Unilateral 16,500 21,945 24,750 28,875 33,000
GS2061 Adrenalectomy Total Bilateral 19,250 25,603 28,875 33,688 38,500
GS2025 Anal Sphincter Repair Following Injury 16,500 21,945 24,750 28,875 33,000
GS2107 Biliary Peritonitis 23,100 30,723 34,650 40,425 46,200
GS2121 Biliary Structure 25,300 33,649 37,950 44,275 50,600
GS2026 Breast Conservation Surgery 16,500 21,945 24,750 28,875 33,000
GS2128 Bronchoplasty Fistula Closure 33,000 43,890 49,500 57,750 66,000
GS2124 Cbd Injury 27,500 36,575 41,250 48,125 55,000
GS2018 Cholecystectomy 13,750 18,288 20,625 24,063 27,500
GS2127 Choledochal Cyst 27,500 36,575 41,250 48,125 55,000
GS2054 Cholescystectomy & Choledochodudenostomy 16,500 21,945 24,750 28,875 33,000
GS2027 Cholesystectomy & Choledocho Lithotomy 16,500 21,945 24,750 28,875 33,000
GS2028 Colostomy 14,300 19,019 21,450 25,025 28,600
GS2106 Congenital Oesophageal Atresia & Tracheoesophageal Fistula 23,100 30,723 34,650 40,425 46,200
GS2055 Cysto Gastostomy 17,600 23,408 26,400 30,800 35,200
GS2079 Diaphragmatic Hernia Repair 18,700 24,871 28,050 32,725 37,400
GS2080 Diaphragmatic Rupture Repair 18,700 24,871 28,050 32,725 37,400
GS2044 Dissection Lymph Node Neck 14,850 19,751 22,275 25,988 29,700
GS2110 Distall Pancratectomy 23,100 30,723 34,650 40,425 46,200
GS2132 Esophageal Stricture 30,800 40,964 46,200 53,900 61,600
GS2133 Esophagectomy 30,800 40,964 46,200 53,900 61,600
GS2098 Excision Of Choledocal Cyst 23,100 30,723 34,650 40,425 46,200
GS2090 Excision Of Hydatid Cyst Of Liver 20,350 27,066 30,525 35,613 40,700
GS2017 Fistula In Ano High Level 13,200 17,556 19,800 23,100 26,400
GS2045 Gastrectomy Sub Total 16,500 21,945 24,750 28,875 33,000
GS2111 Gastrectomy Total 24,200 32,186 36,300 42,350 48,400
GS2029 Gastro Jejunostomy 15,400 20,482 23,100 26,950 30,800
GS2030 Gynaecomastia Bilateral Breast 15,400 20,482 23,100 26,950 30,800
GS2031 Haemorrhoidectom Stapled 14,300 19,019 21,450 25,025 28,600
GS2004 Hemangioma (Gen-Sur) 12,100 16,093 18,150 21,175 24,200
GS2005 Hemicolectomy Left 12,100 16,093 18,150 21,175 24,200
GS2006 Hemicolectomy Right 12,100 16,093 18,150 21,175 24,200
GS2112 Hepaticojejunostomy For Structure 23,100 30,723 34,650 40,425 46,200
GS2032 Hernia Incisional 15,400 20,482 23,100 26,950 30,800
GS2042 Hernia Inguinal Repair Bilateral 15,400 20,482 23,100 26,950 30,800
GS2033 Hernia Obstructed (Any Type) 15,400 20,482 23,100 26,950 30,800
GS2066 Hernia recurrent bilateral 18,700 24,871 28,050 32,725 37,400
GS2034 hernia recurrent unilateral 15,400 20,482 23,100 26,950 30,800
GS2035 Hernia Strangulated (Any Type) 15,400 20,482 23,100 26,950 30,800
GS2052 Hernia Ventral With Mesh 16,500 21,945 24,750 28,875 33,000
GS2007 Hernioplasty Inguinal Unilateral 13,200 17,556 19,800 23,100 26,400
GS2073 Hiatus Hernia Repair 18,040 23,993 27,060 31,570 36,080
GS2008 Imperforate Anus With Low Opening 12,100 16,093 18,150 21,175 24,200
GS2036 Internal Iliac Artery Ligation B/L 14,300 19,019 21,450 25,025 28,600
GS2048 Intestinal Fistula 15,400 20,482 23,100 26,950 30,800
GS2043 KIDNEY INJURY REPAIR 15,400 20,482 23,100 26,950 30,800
GS2016 Lap Adhesiolysis (Gen Surg) 11,550 15,362 17,325 20,213 23,100
GS2091 Lap Assisted /Lapraoscopic Bowel Resection 18,150 24,140 27,225 31,763 36,300
GS2009 Lap Inguinal Hernia -Unilateral 11,000 14,630 16,500 19,250 22,000
Page 18
GS2046 Lap Umbillical Hernia 13,750 18,288 20,625 24,063 27,500
GS2047 Lap. Appendectomy 13,750 18,288 20,625 24,063 27,500
GS2113 Lap. AR, APR 22,000 29,260 33,000 38,500 44,000
GS2062 Lap. Cholecsytectomy 15,950 21,214 23,925 27,913 31,900
GS2074 Lap. Choledhocodudenostomy 16,940 22,530 25,410 29,645 33,880
GS2063 Lap. Closure Of Duodenal/ Intestinal Perforations 15,950 21,214 23,925 27,913 31,900
GS2119 Lap. Colonic Surgery 22,440 29,845 33,660 39,270 44,880
GS2099 Lap. Diaphragm Repair 19,800 26,334 29,700 34,650 39,600
GS2114 Lap. Diaphragm Repair With Mesh 22,000 29,260 33,000 38,500 44,000
GS2064 Lap. Gastrojejunostomy 15,950 21,214 23,925 27,913 31,900
GS2105 Lap. Hiatus Hernia 20,680 27,504 31,020 36,190 41,360
GS2075 Lap. Hydatid Cyst. Liver 16,940 22,530 25,410 29,645 33,880
GS2076 Lap. Inguinal Hernia - Bilateral 16,940 22,530 25,410 29,645 33,880
GS2067 Lap. Lumbar Sympathectomy 16,500 21,945 24,750 28,875 33,000
GS2120 Lap. Nephrectomy 22,550 29,992 33,825 39,463 45,100
GS2068 Lap. Rectopexy 16,500 21,945 24,750 28,875 33,000
GS2092 Lap. Splenectomy 18,700 24,871 28,050 32,725 37,400
GS2081 Lap. Splenorrhaphy 17,600 23,408 26,400 30,800 35,200
GS2093 Lap. Surgery For Pancreatic Pseudocyst (Cystogastostomy) 18,700 24,871 28,050 32,725 37,400
GS2065 Lap. Ureterolithotomy/Pyelolithotomy 15,950 21,214 23,925 27,913 31,900
GS2051 Lap. Ventral Hernia (Incisional) 14,740 19,604 22,110 25,795 29,480
GS2094 Lap. Video Assisted Thorcoscopic Surgery 18,700 24,871 28,050 32,725 37,400
GS2082 Laparotomy With Removal Of Infected Mesh 19,800 26,334 29,700 34,650 39,600
GS2010 Laproscopic Diagnostic With Node Biopsy 11,000 14,630 16,500 19,250 22,000
GS2100 Lieno Renal Shunt(Warren Shunt) 22,000 29,260 33,000 38,500 44,000
GS2101 Ligation Varices Oesophageal 22,000 29,260 33,000 38,500 44,000
GS2019 Liver Injury Repair 14,300 19,019 21,450 25,025 28,600
GS2115 Liver Left Lobectomy 24,200 32,186 36,300 42,350 48,400
GS2116 Liver Partial Resection 24,200 32,186 36,300 42,350 48,400
GS2117 Liver Resection ( Lobctomy) 24,200 32,186 36,300 42,350 48,400
GS2129 Liver Right Lobectomy 29,700 39,501 44,550 51,975 59,400
GS2134 Liver Trisegmentectomy 35,200 46,816 52,800 61,600 70,400
GS2060 Mastectomy Bilateral 17,600 23,408 26,400 30,800 35,200
GS2069 Meso Caval Shunts 22,000 29,260 33,000 38,500 44,000
GS2049 Modified Neck Dissection 15,400 20,482 23,100 26,950 30,800
GS2037 Modified Radical Mastectomy 14,300 19,019 21,450 25,025 28,600
GS2083 Oesophageal Tear Repair 18,150 24,140 27,225 31,763 36,300
GS2056 Omentectomy 15,950 21,214 23,925 27,913 31,900
GS2118 Pancreas Head Ca Triple Bypass Surgery 23,100 30,723 34,650 40,425 46,200
GS2077 Pancreatectomy Partial 22,000 29,260 33,000 38,500 44,000
GS2102 Pancreatectomy Total 22,000 29,260 33,000 38,500 44,000
GS2084 Pancreatic Abscess Necrosectomy And Open Drainage 19,800 26,334 29,700 34,650 39,600
GS2122 Pancreatic Tumors 24,200 32,186 36,300 42,350 48,400
GS2038 Pancreaticojejunostomy 19,800 26,334 29,700 34,650 39,600
GS2050 Parathyroidectomy 15,400 20,482 23,100 26,950 30,800
GS2020 Partial Glossectomy 13,200 17,556 19,800 23,100 26,400
GS2011 Perforated Ulcer Complicated 13,200 17,556 19,800 23,100 26,400
GS2039 Pilonidal Sinus Excision And Primary Closure 15,400 20,482 23,100 26,950 30,800
GS2057 Porto Caval Shunt 22,000 29,260 33,000 38,500 44,000
GS2070 Pseudocyst Drainage Internal 18,700 24,871 28,050 32,725 37,400
GS2126 Radical Cholecystectomy 27,500 36,575 41,250 48,125 55,000
GS2108 Radical Gastrectomy 23,100 30,723 34,650 40,425 46,200
GS2085 Radical Hemicolectomy 19,800 26,334 29,700 34,650 39,600
GS2095 Radical Neck Dissection 19,800 26,334 29,700 34,650 39,600
GS2058 Rectal Prolapse Repair 16,500 21,945 24,750 28,875 33,000
GS2071 Repair Of Bile Duct Stricture 22,000 29,260 33,000 38,500 44,000
GS2130 Resection & Transplant Of Oesophagus For Cancer Colon 33,000 43,890 49,500 57,750 66,000
GS2131 Resection Of Growth Of Common Hepatic Duct And Repair 30,800 40,964 46,200 53,900 61,600
GS2136 Retroperitoneal L.N dissection 66,000 87,780 99,000 115,500 132,000
GS2059 Retroperitoneal Mass 19,800 26,334 29,700 34,650 39,600
GS2125 Retroperitoneal Tumor 27,500 36,575 41,250 48,125 55,000
GS2012 Simple Closure Of Perforated Duodenal\Gastric Ulcer 13,750 18,288 20,625 24,063 27,500
GS2040 Splenctomy 16,500 21,945 24,750 28,875 33,000
GS2053 Splenorrhaphy 16,500 21,945 24,750 28,875 33,000
Subcardiac Porto Azygos Disconnection And Devascularisation Of Lower Oesophagus And
GS2086 19,800 26,334 29,700 34,650 39,600
Proximal Stomach
GS2013 Super Facial Paratoidectomy 13,200 17,556 19,800 23,100 26,400
GS2072 Thoracotomy Exploratory 17,600 23,408 26,400 30,800 35,200
GS2087 Thoracotomy For Removal Of Oesophageal Foreign Body 19,800 26,334 29,700 34,650 39,600
GS2103 Total Colectomy & Ileorectal Anastomosis 22,000 29,260 33,000 38,500 44,000
GS2104 Total Procto Colectomy 22,000 29,260 33,000 38,500 44,000
Page 19
GS2088(A) Transection Oesophagus Using Eea Stapler 18,700 24,871 28,050 32,725 37,400
GS2088(B) Transhiatal esophayectimy 22,000 29,260 33,000 38,500 44,000
GS2088(C) transthoracic esophayectomy 27,500 36,575 41,250 48,125 55,000
GS2014(A) Transverse Colectomy 16,500 21,945 24,750 28,875 33,000
GS2014(B) Right Hemicolectomy 16,500 21,945 24,750 28,875 33,000
GS2014( C) Left colectomy 16,500 21,945 24,750 28,875 33,000
GS2022 Vagotomy Highly Selective 13,750 18,288 20,625 24,063 27,500
GS2015 Varicocelectomy 12,100 16,093 18,150 21,175 24,200
GS2041 Varicose Veins Of Limbs Excision 14,300 19,019 21,450 25,025 28,600
GS2021 Vassography 13,200 17,556 19,800 23,100 26,400
GS2135 Whipples 45,100 59,983 67,650 78,925 90,200
GS2089 Wound Gunshot Debridement And Primary Closure/Removal Of Bullet 19,800 26,334 29,700 34,650 39,600
GS2144 Excision Of Submamdibular Gland U/L 13,200 17,556 19,800 23,100 26,400
GS2145 Suprahyoid Block Dissection 14,300 19,019 21,450 25,025 28,600
GS2146 Thyroglossal Fistula 13,750 18,288 20,625 24,063 27,500
GS2147 Thyroid Nodule Excision 13,200 17,556 19,800 23,100 26,400
GS2148 Total/ Radical Parotidectomy 19,800 26,334 29,700 34,650 39,600
GS2149 Excision PF Thyroid Cyst 13,750 18,288 20,625 24,063 27,500
GS2150 Subtotal Thyroidectomy/Hemi 15,950 21,214 23,925 27,913 31,900
GS2151 Near Total Thyroidectomy 17,600 23,408 26,400 30,800 35,200
GS2152 Revision Thyroidectomy 19,800 26,334 29,700 34,650 39,600
GS2153 Thyroid Lobectomy 15,950 21,214 23,925 27,913 31,900
GS2154 Subcutaeonus Mastectomy B/L 15,400 20,482 23,100 26,950 30,800
GS2155 Splenectomy (Thoraco-Laparatomy) 22,000 29,260 33,000 38,500 44,000
GS2156 Fisssurectomy Plus Hemorrhoidectomy 17,600 23,408 26,400 30,800 35,200
GS2157 Anoplasty 13,200 17,556 19,800 23,100 26,400
GS2158 Complicated/Recurrent Fistula In Anon 16,500 21,945 24,750 28,875 33,000
GS2159 Hemorrhoidectomy + Fistula In Ano 18,700 24,871 28,050 32,725 37,400
GS2160 Horse Shoe Fistula in Ano 17,600 23,408 26,400 30,800 35,200
GS2161 Exploratory Laparatomy for Pancreatic Mass + Palliative Gastro-jejunostomy 28,600 38,038 42,900 50,050 57,200
GS2162 Fissurectomy+ Fistulectomy 18,700 24,871 28,050 32,725 37,400
GS2163 Fissurectomy +Hemorrhoidectomy+Fistulectomy 24,750 32,918 37,125 43,313 49,500
GS2164 Splenectomy +Porta Azygos Dissection 23,100 30,723 34,650 40,425 46,200
GS2165 Fistula In Ano Multiple Opening 15,400 20,482 23,100 26,950 30,800
GS2166 Emergency Laparatomy (Traumatic) 19,800 26,334 29,700 34,650 39,600
GS2167 Emergency Laparatomy Gun Shot 23,100 30,723 34,650 40,425 46,200
GS2168 Laparatomy for Ruptured Liver Abscess/Ruptured Hydatid Cyst 19,800 26,334 29,700 34,650 39,600
GS2169 Appendicular Lamp /Perforation 12,100 16,093 18,150 21,175 24,200
GS2170 Emergency Hemorrhoidectomy 12,100 16,093 18,150 21,175 24,200
GS2171 Laparatomy For Hypertrophic Pyloric Stenosis 14,850 19,751 22,275 25,988 29,700
GS2172 Achalasia Cardia Surgery 19,800 26,334 29,700 34,650 39,600
GS2173 Lapratomy For Megacolon (SAVE'S) 19,800 26,334 29,700 34,650 39,600
GS2174 Laparatomy for Massive Incisional/Ventral Hernia 17,600 23,408 26,400 30,800 35,200
GS2175 Laparatomy for Recurrent Incisional Hernia 18,700 24,871 28,050 32,725 37,400
GS2176 Laparatomy Appendicectomy Plus Check for Koch's 12,100 16,093 18,150 21,175 24,200
GS2177 Recurrent VVF/RVF Repair(Low type) 17,600 23,408 26,400 30,800 35,200
GS2178 Recurrent VVF/RVF Repair( High type) 19,800 26,334 29,700 34,650 39,600
GS2179 Excision Recurrent /Multiple Sinuses 12,100 16,093 18,150 21,175 24,200
GS2180 Filarial Scrotoplasty 13,200 17,556 19,800 23,100 26,400
GS2181 Fournier's Gangrene 15,400 20,482 23,100 26,950 30,800
GENERAL & LAPAROSCOPIC SURGERY PACKAGE

Code bed
LP2001 Lap-Cholecystectomy (2 Days Stay) 2 50,000 62,500 81,250 93,750 112,500
Inclusions TWO DAYS STAY IN CHOSEN BED CATEGORY. LAP. CHOLE Annexure
CONSUMABLES & MEDICINES UPTO Rs. 6500/-.if more than charge will be extra
1 1
TLC ECG
SURGERY CHARGES,OT CHARGES,OT GAS,ASST. SURGEON CHARGES,ANAESTHESIA DLC 1 X-ray Chest 1
CHARGES. Hb 1
PAC CHARGES. Platelet Count 1
GENERAL SURGEON VISIT CHARGES. Urea 1
EQUIPMENT CHARGES. S. Creatinine 1
INVESTIGATION (Lap. Chole Annexure) Na+ 1
K+ 1
LFT 1
HIV 1
HCV 1
HbsAg 1
Bariatric /Metabolic Surgery Package
Page 20
Service Name Single room Deluxe room VIP Suite
Code bed Two bed
BM1001 LAP SLEEVE GASTRECTOMY 4Day 320,000 380,000 450,000

200000 240000
BM1002 LAP SLEEVE GASTRECTOMY COMPLEX 4Day 480,000 570,000 675,000

300000 360000
BM1003 GASTRIC BYPASS 4Day 400,000 475,000 562,500

250000 300000
BM1004 GASTRIC BAND 4Day 304,000 361,000 427,500

190000 228000
GESTROENTEROLOGY
Service Name Single room Deluxe room VIP Suite
Code bed Two bed
GI1001 Colonoscopy And Sclero Therapy Of Ulcer 6,000 7,980 9,000 10,500 12,000
GI1002 Colonoscopy Left Sided 3,000 3,990 4,500 5,250 6,000
GI1003 Colonoscopy Left Sided With Biopsy 3,400 4,522 5,100 5,950 6,800
GI1004 Colonoscopy Whole 4,400 5,852 6,600 7,700 8,800
GI1005 Colonoscopy Whole With Biopsy 4,800 6,384 7,200 8,400 9,600
GI1006 Dilation Achalasia 10,500 13,970 15,750 18,380 21,000
GI1007 Dilation Of Esophageal Stricture 4,620 6,140 6,930 8,090 9,240
GI1008 Diltation Subsequent 2,940 3,910 4,410 5,150 5,880
GI1009 Emergency Colonoscopy Whole 6,600 8,778 9,900 11,550 13,200
GI1010 Emergency Colonoscopy Whole Sided With Biopsy 7,000 9,310 10,500 12,250 14,000
GI1011 Emergency Endoscopic Foreign Body Removal 7,350 9,780 11,030 12,860 14,700
GI1012 Emergency Ercp With Biliary Stenting 23,100 30,720 34,650 40,430 46,200
GI1013 Emergency Ugi Endoscopy 4,520 6,010 6,780 7,910 9,040
GI1014 Emergency Ugi Endoscopy With Biopsy 4,830 6,420 7,250 8,450 9,660
GI1015 Emergency Variceal Banding Oesophageal (Evl) First Visit 6,930 9,220 10,400 12,130 13,860
GI1016 Endoscopic Biopsy 420 560 630 740 840
GI1017 Endoscopic Colonic Stenting 9,450 12,570 14,180 16,540 18,900
GI1018 Endoscopic Cystogastrostomy 15,750 20,950 23,630 27,560 31,500
GI1019 Endoscopic Esopahgeal Stenting 9,450 12,570 14,180 16,540 18,900
GI1020 Endoscopic Foreign Body Removal 4,730 6,290 7,100 8,280 9,460
GI1021 Endoscopic Percuateneous Gastrostomy 5,570 7,410 8,360 9,750 11,140
GI1022 Endoscopic Placement Of Ryles Tube 3,470 4,620 5,210 6,070 6,940
GI1023 Endoscopic Procedure For Biopsy 530 700 800 930 1,060
GI1024 Endoscopic Sclerotherapy First Visit 4,410 5,870 6,620 7,720 8,820
GI1025 Endoscopic Sclerotherapy Subsequent Visit 3,890 5,170 5,840 6,810 7,780
GI1026 Endoscopic Ultrasound 8,720 11,600 13,080 15,260 17,440
GI1027 Enteral Tts Dilatation 6,930 9,220 10,400 12,130 13,860
GI1028 Enteroscopy 3,890 5,170 5,840 6,810 7,780
GI1029 Ercp Therapeutic 11,550 15,360 17,330 20,210 23,100
GI1030 Ercp Diagnostic 9,030 12,010 13,550 15,800 18,060
GI1031 Ercp Endoscopic Papilotomy 15,750 20,950 23,630 27,560 31,500
GI1032 Ercp Nasobiliary Drainage 15,750 20,950 23,630 27,560 31,500
GI1033 Ercp With Biliary Stenting 15,750 20,950 23,630 27,560 31,500
GI1034 Ercp With Pancreatic Stenting 15,750 20,950 23,630 27,560 31,500
GI1035 Gastric Glue Injection 5,780 7,690 8,670 10,120 11,560
GI1036 Helicobacter Pylori Testing 420 560 630 740 840
GI1037 Microlith Study 5,780 7,690 8,670 10,120 11,560
GI1038 Naso Jejunal Tube Placement 1,050 1,400 1,580 1,840 2,100
GI1039A Peg Tube Replacement 5,250 6,980 7,880 9,190 10,500
GI1039B Peg Tube Removal 3,150 4,190 4,730 5,510 6,300
GI1040 Piles Banding 2,000 2,660 3,000 3,500 4,000
GI1041 Piles Sclero Therapy 2,000 2,660 3,000 3,500 4,000
GI1042 Polypectomy 7,350 9,780 11,030 12,860 14,700
GI1043 PTBD 3,360 4,470 5,040 5,880 6,720
GI1044 Sclerotherapy Of Ulcer 3,990 5,310 5,990 6,980 7,980
GI1045 Sengstaken Tube Placement 2,310 3,070 3,470 4,040 4,620
GI1046 Side Viewing Endoscopy 3,990 5,310 5,990 6,980 7,980
GI1047 Sigmoidoscopy 2,500 3,321 3,750 4,381 5,000
GI1048 Ugi Endoscopy 3,000 3,990 4,500 5,255 6,000
GI1049 Ugi Endoscopy With Biopsy 3,360 4,470 5,040 5,880 6,720
GI1050 Variceal Banding Oesophageal (Evl) First Visit 4,620 6,140 6,930 8,090 9,240
GI1051 Variceal Banding Subsequent (Evl) 3,680 4,890 5,520 6,440 7,360
LB6002 Ascitic Fluid Analysis - Culture 1,000 1,200 1,200 1,200 1,200
ER5055 Ascitic Tapping(Digonistic) 1,000 1,000 1,000 1,000 1,000
GI2001 Hemo Clip Application 4,400 5,850 6,600 7,700 8,800
INTERVENTIONAL RADIOLOGY
Service code Service name Six/ Nine Bed Two bed Single room Deluxe room VIP Suite
Page 21
INTERVENTIONAL PACKAGE
IR1001 CHECK DSA 12,000 14,000 16,000 18,000 20,000
IR1002 DSA 20,000 24,444 28,889 31,111 33,333
IR1003 Ablation of vericose veins 75,000 80,000 85,000 90,000 100,000
Packages Includes: 1 days room rent, Professional fees of Doctor, DSA lab charges, MAC and local anesthesia, basic Investigations , Equipment charges, Routine drugs , disposables
in DSA Lab and Non Ionic Dye (1)
PackageS excludes: additional stay, Professional charges of other consultants, any additional procedure/investigation and Use of special drugs/ consumables, non ionic dye more
than 1, .Catheter (Picard catheter/Head Hunter 1 cathether), if used.If done under GA, the charges will be extra as per the bed category.
Basic Investigations include- Complete Blood Count, Blood Sugar, Renal Function Test (Na, K, Urea, Creatinine), PT, APTT.,
Routine Disposables include- Angio Protection Cover, syringes-6, needles,IV fluid, Guide wire- Terumo, ECG Electrode Adult, Gloves, I.V. Set (Non-Vented),Introducer Needle,
Introducer Sheath , Nimodip Inj. 50 ml, Optiray200 ml and Xylocaine 2% Inj. 30 ml,
Service code Service name Six/ Nine Bed Double Bed Single room Deluxe room VIP Suite
INTERVENTIONAL PROCEDURE
IR2001 Abdominal Aortic Aneurysm Graft 31,000 41,230 46,500 54,250 62,000
IR2002 Angioplasty For Carotid / Vertebral Artery Stenosis 43,500 57,855 65,250 76,125 87,000
IR2003 Aortic Angioplasty / Stenting 27,500 36,575 41,250 48,125 55,000
IR2004 Aortic Stent Graft Endoleak Embolization 26,500 35,245 39,750 46,375 53,000
IR2005 Aortogram / Specific Single Aortogram 7,900 10,507 11,850 13,825 15,800
IR2006 Arterio- Portogram 13,500 17,955 20,250 23,625 27,000
IR2007 Bronchial Artery Embolization 18,500 24,605 27,750 32,375 37,000
IR2008 Bronchial Artery Evaluation 8,500 11,305 12,750 14,875 17,000
IR2009 Carotid Angiogram 7,900 10,507 11,850 13,825 15,800
IR2010 Ccf Occlusion 47,700 63,441 71,550 83,475 95,400
IR2011 Central Venogram / Arm Venogram (Diagnostic) 3,700 4,921 5,550 6,475 7,400
IR2012 Central Venogram / Arm Venogram Interventional 10,500 13,965 15,750 18,375 21,000
IR2013 Cerebral Angiogram 12,600 16,758 18,900 22,050 25,200
IR2014 Cerebral Avm Embolization ( Besides Vb Territory) 42,100 55,993 63,150 73,675 84,200
IR2015 Chemoembolization Of Hepatic Tumour/Mets 26,300 34,979 39,450 46,025 52,600
IR2016 Chest Port Insertion For Chemotherapy 7,400 9,842 11,100 12,950 14,800
IR2017 Coiling Of Intracranial Aneurysm 36,800 48,944 55,200 64,400 73,600
IR2018 Coiling Of Intracranial Aneurysm Attempted 26,300 34,979 39,450 46,025 52,600
IR2019 Coiling Of Multiple Aneurysm 42,100 55,993 63,150 73,675 84,200
IR2020 Dialysis Catheter Insertion (Ij,Femoral) Tunnelled/Exchange 4,500 5,985 6,750 7,875 9,000
IR2021 Embolization For Nasal Bleeding / Sinus Mass / Preop Embolization 14,700 19,551 22,050 25,725 29,400
IR2022 Embolization For Vertebral Body Hemangioma / Mets 21,000 27,930 31,500 36,750 42,000
IR2023 Embolization Of External Carotid Artery/ Single Vessel For Tumour 22,100 29,393 33,150 38,675 44,200
IR2024 Embolization Of Spinal Tumours 28,500 37,905 42,750 49,875 57,000
IR2025 Embolization Of Tumour Fed By Both Ica & Eca 42,100 55,993 63,150 73,675 84,200
IR2026 Embolization Of Tumour Fed By Va / Ba 40,000 53,200 60,000 70,000 80,000
IR2027 Emperical Any Artery Embolisation 26,300 34,979 39,450 46,025 52,600
IR2028 Endovenous Laser Ablation Of Varicose Veins 52,000 69,160 78,000 91,000 104,000
IR2029 Evaluation For Nasal Bleeding / Nasal Mass /Bleeding 9,500 12,635 14,250 16,625 19,000
IR2030 Fallopian Tube Catheterization (For Blocked Tube) 10,500 13,965 15,750 18,375 21,000
IR2031 Followup For Nephrostomy Drainage Cathetar 1,600 2,128 2,400 2,800 3,200
IR2032 Gdc Coiling Of Intracranial Aneurysms With Spasm 46,500 61,845 69,750 81,375 93,000
IR2033 Gi Bleed And Ischemia (Tripple Vessel) Evaluation 10,500 13,965 15,750 18,375 21,000
IR2034 Gi Bleed Embolisation 15,900 21,147 23,850 27,825 31,800
IR2035 Gi Ischemia Intervention (Angioplasty/Stenting) 15,900 21,147 23,850 27,825 31,800
IR2036 Glue Embolization Of Tumours 40,000 53,200 60,000 70,000 80,000
Head & Neck Vessels Evaluation (Cerebral + Carotid + Subclavian+Vertebral)For Tumour/
IR2037 14,700 19,551 22,050 25,725 29,400
Hemanioma
IR2038 Image Guided Dialysis Catheter Insertion (Ij,Subclavian,Femoral) Non-Tunnelled 2,100 2,793 3,150 3,675 4,200
IR2039 Image Guided Peripheral Insertion Of Central Catheter. (Picc) 3,700 4,921 5,550 6,475 7,400
IR2040 Inferior Vena Cava Membranotomy And Angioplasty / Stenting 19,000 25,270 28,500 33,250 38,000
IR2041 Intra Arterial Thrombolysis 35,800 47,614 53,700 62,650 71,600
IR2042 Intra Vascular Catheter / Foreign Body Removal 3,700 4,921 5,550 6,475 7,400
IR2043 Intracranial Angioplasty 43,200 57,456 64,800 75,600 86,400
IR2044 Intracranial Drug Therapy For Post Sah Vasospasam 26,500 35,245 39,750 46,375 53,000
IR2045 Intracranial Stenting 43,200 57,456 64,800 75,600 86,400
IR2046 Ivc Filter Retrieval 19,000 25,270 28,500 33,250 38,000
IR2047 Llaic Angioplasty / Stenting 21,000 27,930 31,500 36,750 42,000
IR2048 Management Of Dural Sinus Thrombosis 43,200 57,456 64,800 75,600 86,400
IR2049 Mediastinal Syndromes Interventional 12,700 16,891 19,050 22,225 25,400
IR2050 Naso Jejunal Intubation 3,200 4,256 4,800 5,600 6,400
IR2051 Partial Splenic Embolization 26,500 35,245 39,750 46,375 53,000
IR2052 Pcn/Ptbd With Stenting 17,900 23,807 26,850 31,325 35,800
IR2053 Pelvic Congestion Syndrome (Ovarian Vein) Embolisation Interventional 21,000 27,930 31,500 36,750 42,000
Page 22
IR2054 Percutaneous Transhepatic Cholangiogram 5,300 7,049 7,950 9,275 10,600
IR2055 Percutanous Nephrostomy & Drainage (Rt/Lt) 8,500 11,305 12,750 14,875 17,000
IR2056 Peripheral Angiography (Diagnostic) (One Limb) 9,500 12,635 14,250 16,625 19,000
IR2057 Peripheral Arterial Angioplasty With Stent Rt/Lt (Interventional) 18,500 24,605 27,750 32,375 37,000
IR2058 Peripheral Arterial Angioplasty Without Stent Rt/Lt(Interventional) 18,500 24,605 27,750 32,375 37,000
IR2059 Peripheral Arterial Thrombolysis Rt/Lt 23,200 30,856 34,800 40,600 46,400
IR2060 Peripheral Hemangioma Sclerotherapy (Direct) 1,300 1,729 1,950 2,275 2,600
IR2061 Peripheral Hemangioma Sclerotherpy / Embolisation (Transarterial) 18,500 24,605 27,750 32,375 37,000
IR2062 Peripheral Trauma Interventional 18,500 24,605 27,750 32,375 37,000
IR2063 Portal Vein Embolisation 19,000 25,270 28,500 33,250 38,000
IR2064 Post Ptbd Check Cholangiogram Pre/Intra/Post Procedure 2,100 2,793 3,150 3,675 4,200
IR2065 Post Sah Intracranial Angioplasty For Spasm 40,000 53,200 60,000 70,000 80,000
IR2066 Pre / Post Procedure Usg Evaluation For Fibroids / Adenomyosis / Uterus/Body 630 838 945 1,103 1,260
IR2067 Proximal Occlusion Of Internal Carotid Artery 44,210 58,799 66,315 77,368 88,420
IR2068 Ptbd External Drainage (Single) 7,900 10,507 11,850 13,825 15,800
IR2069 Ptbd- Externo Internalisation 10,500 13,965 15,750 18,375 21,000
IR2070 Ptbd Internalisation 6,310 8,392 9,465 11,043 12,620
IR2071 Ptbd- Post Operative/ Biliary Leak 10,500 13,965 15,750 18,375 21,000
IR2072 Pudendal Artery Evaluation 11,600 15,428 17,400 20,300 23,200
IR2073 Radiofrequency Ablation Of Hepatic Tumours/Mets 21,000 27,930 31,500 36,750 42,000
IR2074 Renal Artery Angiography 11,600 15,428 17,400 20,300 23,200
IR2075 Renal Artery Angioplasty 18,500 24,605 27,750 32,375 37,000
IR2076 Renal Artery Embolization (One Side) 8,500 11,305 12,750 14,875 17,000
IR2077 Renal Artery Stenting 18,500 24,605 27,750 32,375 37,000
IR2078 Spinal Angiogram 16,900 22,477 25,350 29,575 33,800
IR2079 Spinal Avm Embolization / Avf Embolization 47,500 63,175 71,250 83,125 95,000
IR2080 Stenting For Vertebral Artery Stenosis 32,500 43,225 48,750 56,875 65,000
IR2081 Stenting For Carotid Artery Stenosis 32,500 43,225 48,750 56,875 65,000
IR2082 Test Occlusion Test 29,500 39,235 44,250 51,625 59,000
IR2083 Tips (Trans-Juglar Porto-Systimic Shunt) Interventional 28,500 37,905 42,750 49,875 57,000
IR2084 Trans Arterial Chemotherapy Infusion 21,000 27,930 31,500 36,750 42,000
IR2085 Transjuglar Liver Biopsy 6,900 9,177 10,350 12,075 13,800
IR2086 Uretic Stent (Double Pigtail / J) Rt/Lt Interventional 10,500 13,965 15,750 18,375 21,000
IR2087 Usg Guided Aneurysm Embolisation 7,500 9,975 11,250 13,125 15,000
IR2088 Uterine Artery / Pelvic Angiography For Post Partum Hemorrhage / Others (Diagnostic) 12,100 16,093 18,150 21,175 24,200
IR2089 Uterine Artery / Pelvic Embolization For Post Partum Hemorrhage (Embolisation) 15,800 21,014 23,700 27,650 31,600
IR2090 Uterine Artery Embolization For Fibroids 15,800 21,014 23,700 27,650 31,600
IR2091 Uterine Artery Embolization For Fibroids-Pre Myomectomy 14,800 19,684 22,200 25,900 29,600
IR2092 Venous Sampling (Adrenal & Renal Vein) 7,900 10,507 11,850 13,825 15,800
IR2093 Venous Sinus Sampling (Petrosal Sinus) 28,500 37,905 42,750 49,875 57,000
IR2094 Vericoseal Evaluation 14,800 19,684 22,200 25,900 29,600
IR2095 Vericoseal Interventional 20,000 26,600 30,000 35,000 40,000
IR2096 Vertebroplasty (Verteral Body/ Pelvic Bone / Specific Bone) 28,500 37,905 42,750 49,875 57,000
IR2097 Intra veneous Thrombolysis 10,000 13,300 15,000 17,500 20,000
MEDICAL ONCOLOGY
Code bed
CHEMOTHERAPHY
MO1001 CHEMOTHERAPHY HIGH DOSE(PER DAY) 2,200 2,926 3,300 3,850 4,400
MO1002 CHEMOTHERAPHY INFUSIONAL (UPTO 6 HRS) 2,200 2,926 3,300 3,850 4,400
MO1003 CHEMOTHERAPHY INTRA PLEURAL(PER DAY) 2,200 2,926 3,300 3,850 4,400
MO1004 CHEMOTHERAPHY INTRA VESICAL(PER DAY) 4,500 5,985 6,750 7,875 9,000
MO1005 CHEMOTHERAPHY INTRA-THECAL (PER DAY) 4,400 5,852 6,600 7,700 8,800
MO1006 CHEMOTHERAPHY MULTIPLE DRUG BOLUS(PER DAY) 900 1,197 1,350 1,575 1,800
MO1007 CHEMOTHERAPHY MULTIPLE DRUG INFUSIONAL(PER DAY) 2,500 3,325 3,750 4,375 5,000
MO1008 CHEMOTHERAPHY SINGLE DRUG INFUSIONAL(PER DAY) 1,500 1,995 2,250 2,625 3,000
MO1009 CHEMOTHERAPY ORAL( PER DAY) 1,100 1,463 1,650 1,925 2,200
MO1010 CHEMOTHERAPY PLANNING AND COUNSELLING 2,000 2,660 3,000 3,500 4,000
Procedures
MO2001 BIOPSY BONE(NEEDLE) (ONCO) 5,000 6,650 7,500 8,750 10,000
MO2002 BIOPSY TRUCUT IMAGE GUIDED(ONCO) 3,500 4,655 5,250 6,125 7,000
MO2003 FNAC(ONCO) 2,000 2,660 3,000 3,500 4,000
MO2004 MONOCLONAL ANTIBODY THERAPY(PER DAY) 4,000 5,320 6,000 7,000 8,000
MO2005 PLEURAL / ABDOMINAL PARACENTESIS 3,000 3,990 4,500 5,250 6,000
MO2006 PICC LINE INSERTION 4,000 5,320 6,000 7,000 8,000
MO2007 Biological agent / Immunotherapy 4,000 5,320 6,000 7,000 8,000
Nuclear Medicine
Page 23
Service
Service Name OPD RATE IPD RATE
Code
NM0001 3 PHASE BONE SCAN 4,000 4,800
NM0002 99MTC-TETROFOSMIN PARATHYROID SCAN 10,000 12,000
NM0003 ADENOSINE TETRAFOSMIN CARDIAC SCAN 15,000 18,000
NM0004 CARDIAC PET-CT FDG PET WITH VIABILITY ONLY 8,000 9,600
NM0005 CARDIAC PET-CT FDG WITH REST PERFUSION 13,000 15,600
NM0006 DIAMOX ECD BRAIN PERFUSION SCAN (SPECT) 13,000 15,600
NM0007 DMSA RENAL SCAN 3,000 3,600
NM0008 DMSA V WHOLE BODY SCAN 6,000 7,200
NM0009 DRCG 3,000 3,600
NM0010 DTPA CAPTROPRIL RENOGRAM (PRE & POST) 8,000 9,600
NM0011 ECD BRAIN PERFUSION SCAN (SPECT) 6,000 7,200
NM0012 EXERCISE STRESS TETRAFOSMIN CARDIAC SCAN 10,000 12,000
NM0013 GE REFLUX(GER)/GASTRIC EMPTYING 2,000 2,400
NM0014 GFR-BLOOD SAMPLING METHOD(ABSOLUTE GFR) 2,000 2,400
NM0015 GI BLEED (TO-RBS/SCOLLOID) 5,000 6,000
NM0016 HEPATO-BILLIARY SCAN (HIDA) 4,000 4,800
NM0017 I-131 THERAPY (10 MCI) (BRIT) 10,000 12,000
NM0018 I-131 THERAPY (15 MCI) (BRIT) 14,000 16,800
NM0019 I-131 THERAPY (5 MCI) 5,000 6,000
NM0020 I-131 THERAPY (PER MCI) 1,500 1,800
NM0021 LIVER SCAN (PHYTATE/COLLOID PLANAR) 3,000 3,600
NM0022 LUNG PERFUSIONSCAN 5,000 6,000
NM0023 LUNG VENTILATIONSCAN 3,000 3,600
NM0024 MECKEL''S DIVERTICULUM 3,000 3,600
NM0025 NUCLEAR MEDICINE SEDATION CHARGES 1,500 1,800
NM0026 PARATHYROID INTRA-OPERATIVE LOCALIZATION 10,000 12,000
NM0027 PET-CT REPORT REVIEW CHARGES 2,500 3,000
NM0028 PET-CT DEMENTIA IMAGING WITHOUT CONTRAST 8,000 9,600
NM0029 PET-CT DEMENTIA IMAGING WITH CONTRAST 10,000 12,000
NM0030 PULMONARY SHUNTING & TC99MAA SCANNING 7,000 8,400
NM0031 RADIONUCLIDE DTPA CISTERNOGRAPHY. 7,500 9,000
NM0032 RADIONUCLIDE S. COLLOID LYMPHOSCINTIGRAPHY 7,500 9,000
NM0033 RENAL DYNAMIC SCAN (TC-99M DTPA) WITH GFR 4,000 4,800
NM0034 RENAL SCAN WITH GFR BLOOD SAMPLING METHOD 4,500 5,400
NM0035 RESTING TETROFOSMIN M.P. SCAN WITH ISOSORBIDE INTERVENTION 6,000 7,200
NM0036 SALIVARY GLAND IMAGING 2,500 3,000
NM0037 SCROTAL SCAN 3,000 3,600
NM0038 SENTINEL LYMPH NODE MAPPING 6,000 7,200
NM0039 SENTINEL LYMPH NODE MAPPING WITH INTRA-OPERATIVE LOCALIZATION 8,000 9,600
NM0040 SPECT REPORT REVIEW 1,000 1,200
NM0041 SUB. PARA THYROID SCAN/MIBI PARA THYROID SCAN 7,000 8,400
NM0042 THYROID SCAN 3,000 3,600
NM0043 VENTILATION PERFUSION SCAN 8,000 9,600
NM0044 WHOLE BODY BONE SCAN 4,000 4,800
NM0045 WHOLE BODY BONE SCAN SPECT 5,000 6,000
NM0046 WHOLE BODY F18 BONE SCAN 10,000 12,000
NM0047 WHOLE BODY I-131 SCAN 5,000 6,000
NM0048 WHOLE BODY PET-CT WITH CONTRAST 22,000 26,400
NM0049 WHOLE BODY PET-CT WITH TRIPLE PHASE 25,000 30,000
NM0051 PET CT-INECTION IMAGING-WITHOUT CONTRAST 16,000 19,200
NM0052 TRODAT SCAN 9,000 10,800
NM0053 Phosphorous-32 (P-32) 5,000 6,000
NM0054 Samarium-153 (SM-153) 10,000 12,000
Radiotherapy - Radiation Charges

OPD OPD
Rate Rate
Total
Service Site Preplannin service Radiotherapy
Code Service Name g Code
A1 A2 A1+ A2
RO0001 IGRT All 65,000 RO0002 85000 150,000
RO0003 IMRT All 45,000 RO0004 80000 125,000
RO0005 VMAT All 70,000 RO0006 130000 200,000
RO0007 SBRT All 80,000 RO0008 120000 200,000
RO0009 SRS Brain Brain 65,000 RO0010 85000 150,000
RO0011 SRT Brain Brain 60,000 RO0012 115000 175,000
RO0013 3 D CRT All 25,000 RO0014 50000 75,000
RO0015 Conventional All 20,000 RO0016 40000 60,000
RO0017 Palliative(low) Upto 5 All 10,000 RO0018 15000 25,000
Page 24
RO0019 Palliative(high ) Upto 10 All 10,000 RO0020 25000 35,000
RO0024 IGRT with Pet CT All 75,000 RO0025 90000 165,000
RO0026 IMRT With Pet CT All 55,000 RO0027 85,000 140000
RO0028 VMAT with Pet CT All 80,000 RO0029 135,000 215000
RO0030 SBRT with Pet CT Brain 90,000 RO0031 125,000 215000
RO0032 SRS Brain with Pet CT Brain 75,000 RO0033 90,000 165000
RO0034 SRT Brain with Pet CT Brain 70,000 RO0035 120,000 190000
RO0036 3 D CRT with Pet CT All 35,000 RO0037 57,000 92000
RO0038 Conventional with Pet CT All 30,000 RO0039 47,000 77000
RO0040 Palliative(low) Upto 5 with Pet CT All 20,000 RO0041 22,000 42000
RO0042 Palliative(high ) Upto 10 with Pet CT All 20,000 RO0043 32,000 52000
Note- Package Includes Treatment Planing,casts,imaging contrast and exclude any radiological/nuclear Med investigations and Room charges
Radiotherapy - Brachy Charges

Service OPD Rate
Service Name
Code
Includes Brachy 13000
charges,
Anesthetist
Charges, CT &
Stimulation
Interacavitary (Brachytherapy) per sitting Charges.
RO3001
Includes Brachy 17000
charges,
Anesthetist
Charges, CT &
Stimulation
Interstetial Implantation per sitting (Brachytherapy) - Charges.
RO3002
RO3003 Intraluminal Therapy per sitting (Brachytherapy) 10000
RO3004 Mould Therapy per sitting (Brachytherapy) 7000
Radiotherapy - Others
Service
Service Name
Code
RO0021 RT Planning MRI Add: 1000 to routine charges
RO0022 RT Planning CT Add: 500 to routine charges
RO0023 RT planning Angio Add: 2000 to routine charges
Notes
(cost of RT planning CT scan would be under RT imaging charges), contouring of images and treatment planning
2. RT(Radiotherapy) includes the entire cost of multiple fraction radiotherapy as has been planned for a patient.
3. All the simulation imaging costs shall be charged under a separate head
NEPHROLOGY
Code bed
Dialysis
NP1001 Hemodialysis (Reuse Of Dialyzer) 2,200 2,926 3,300 3,850 4,400
NP1002 Hemodialysis (Single Use Of Dialyzer) 2,800 3,724 4,200 4,900 5,600
NP1003 Hemodialysis (High Permiabilty dialyzer Reuse) 2,600 3,458 3,900 4,550 5,200
NP1004 Hemodialysis (High Permiablity Dialyzer Single Use) 3,200 4,256 4,800 5,600 6,400
NP1005 Emergency Hemodialysis 3,800 5,054 5,700 6,650 7,600
NP1007 Acute Peritoneal Dialysis 4,000 5,320 6,000 7,000 8,000
NP1008 Paediatric/Neonatal Peritoneal Dialysis 3,500 4,655 5,250 6,125 7,000
NP1009 SLEDD ( upto 8 hrs) 7,500 9,975 11,250 13,125 15,000
Procedures
NP2001 Arterio Venous Fistula Or Shunt 9,000 11,970 13,500 15,750 18,000
NP2002 Capd Catheter Placement Or Removal 9,000 11,970 13,500 15,750 18,000
NP2003 Capd Training 7,000 9,310 10,500 12,250 14,000
NP2004 Femoral Vein Catheterization 1,500 1,995 2,250 2,625 3,000
NP2005 Internal Jugular Or Subclavian Catheterization 4,000 5,320 6,000 7,000 8,000
NP2006 Kidney Biopsy 6,000 7,980 9,000 10,500 12,000
NP2007 Perma Cath Procedure Charges 6,600 8,778 9,900 11,550 13,200
NP2008 Perm-Cath (Cuffed Catheter) Placement 6,600 8,778 9,900 11,550 13,200
NP2009 Perm-Cath Removal 2,000 2,660 3,000 3,500 4,000
NEUROLOGY
Service
Code
NU1001 EEG Routine 2,500 3,321 3,750 4,381 5,000
NU1002 EEG Bed Side 3,680 4,890 5,520 6,440 7,360
NU1006 Video EEG less than 1 hour 3,150 4,190 4,730 5,510 6,300
NU1007 EMG One Limb* 2,730 3,630 4,100 4,780 5,460
NU1008 EMG Two Limbs* 3,360 4,470 5,040 5,880 6,720
NU1009 EMG more than two Limbs* 4,730 6,290 7,100 8,280 9,460
Page 25
NU1010 Ncv & Emg All Six/ Nine Limbs* 7,880 10,480 11,820 13,790 15,760
NU1011 Ncv Facial Nerve 3,150 4,190 4,730 5,510 6,300
NU1012 Ncv Motor & Sensory One Limb 3,000 3,989 4,505 5,253 6,000
NU1013 Ncv Motor & Sensory Two Limb 3,500 4,656 5,250 6,125 7,000
NU1014 Ncv Motor & Sensory more than two Limbs 5,000 6,649 7,505 8,753 10,000
NU1015 Intraoperative Monitoring 6,300 8,380 9,450 11,030 12,600
NU1016 Lumber Puncture 2,200 2,923 3,300 3,855 4,400
NU1017 Repetitive Nerve Stimulation 3,150 4,190 4,730 5,510 6,300
NU1018 TCD 4,200 5,590 6,300 7,350 8,400
NU1019 Tensilon Test / Neostigmine Test 2,100 2,790 3,150 3,680 4,200
NU1021 Tremor Study 3,680 4,890 5,520 6,440 7,360
NU1023 Blink Reflex 3,150 4,190 4,730 5,510 6,300
NU1024 Brachial Plexus Study 5,670 7,540 8,510 9,920 11,340
NU1025 Braintstem Auditary Evoked Response 3,150 4,190 4,730 5,510 6,300
NU1026 Somato Sensory Evoked Potential 3,150 4,190 4,730 5,510 6,300
NU1027 Visual Evoked Potential 3,150 4,190 4,730 5,510 6,300
NU1028 VEEG ( Overnight/12 hours) 10,500 13,970 15,750 18,380 21,000
NU1029 VEEG ( 24 hours) 15,750 20,950 23,630 27,560 31,500
Botulin Toxin Inj ( Group 1) ( Blepharospasm/Hemefacial spam/Spasticity each limb/
NU1030 3,150 4,190 4,730 5,510 6,300
Trigeminal neuralgia)
Botulin Toxin Inj ( Group2) (Cervical/limb dystonia/chronic migraine/spasmodic
NU1031 4,730 6,290 7,100 8,280 9,460
dysphonia/writer's cramp))
NU1032 Tysabri Infusion Charges 2,100 2,790 3,150 3,680 4,200
NU1033 Mini Mental Status Examination 2,100 2,790 3,150 3,680 4,200
NU1034 Emergency EEG 4,730 6,290 7,100 8,280 9,460
NU1035 ERP (Event Related Potential) 3,150 4,190 4,730 5,510 6,300
NU1036 I.V. Thrombolysis 10,500 13,970 15,750 18,380 21,000
NU1037 Short Term VEEG up to 4 hours 5,250 6,980 7,880 9,190 10,500
NU1038 Sleep Study Overnight 15,750 20,950 23,630 27,560 31,500
NU1039 Sleep Study titration 10,500 13,970 15,750 18,380 21,000
NU1040 Split Night Study 18,900 25,140 28,350 33,080 37,800
NU1041 Sympathetic Skin Response 3,150 4,190 4,730 5,510 6,300
NU1042 VEEG every additional hour 1,050 1,400 1,580 1,840 2,100
* Cost of EMG needle additional as per actual
NEURO SURGERY
Service
Code
CATEGORY-A
NS1001 Aneurysms 46200 61446 77154 98868 137214
NS1002 Craniotomies & Tumour Surgery - Craniopharyngioma 46200 61446 77154 98868 137214
NS1003 Cvj/Foremen Magnum 46200 61446 77154 98868 137214
NS1005 Im Tumours 46200 61446 77154 98868 137214
NS1006 Insular Glioma 46200 61446 77154 98868 137214
NS1007 Intraventricular Tumors 46200 61446 77154 98868 137214
NS1008 Post Fossa (Cp Angle) 46200 61446 77154 98868 137214
NS1009 Skull Base /Post Fossa (Cp Angle) 46200 61446 77154 98868 137214
LSF3T Lumber Spine Fusion >3 Level/ Traspendicular 46200 61446 77154 98868 137214
CC2LA Cervical Corpectomy > 2 Level 46200 61446 77154 98868 137214
CMWAD Cervical Microdisectomy with artificial Disc 46200 61446 77154 98868 137214
DORSA Dorsal Fusion 46200 61446 77154 98868 137214
CATEGORY-B
NS2001 All Craniotomies For Elective Surgery Except Category A 36960 49159 61721 79090 109769
NS2002 Brachial Plexus With Neurotization 36960 49159 61721 79090 109769
NS2003 Cranioplasty/Csf Rhinorrhea 36960 49159 61721 79090 109769
NS2004 Craniotomies For Glioma 36960 49159 61721 79090 109769
NS2005 Craniotomies For Trauma 36960 49159 61721 79090 109769
NS2006 Craniotomy For Ich 36960 49159 61721 79090 109769
NS2007 Intracranial Abscebes Excision 36960 49159 61721 79090 109769
NS2008 Mvd 36960 49159 61721 79090 109769
NS2009 Neurotization 36960 49159 61721 79090 109769
NS2011 Tnts 36960 49159 61721 79090 109769
NSBDM Dorsal Microdisectomy 36960 49159 61721 79090 109769
CMWFB Cervical Microdisectomy with Fusion 36960 49159 61721 79090 109769
NSCLB Cervical Laminoplasty 36960 49159 61721 79090 109769
NSLSF Lumber Spine Fusion 36960 49159 61721 79090 109769
TCCL1 Transpendicular/Cervical Corpectomy Level-1 36960 49159 61721 79090 109769
CATEGORY-C
NS3001 Bone Flap Replacement 30030 39941 50149 64262 89188
NS3002 Brachial Plexus With Neurolysis 30030 39941 50149 64262 89188
NS3003 Carotid Endarterectomy 30030 39941 50149 64262 89188
NS3004 Craniostnosis (Single) 30030 39941 50149 64262 89188
Page 26
NS3006 Endoscopic Surgery 30030 39941 50149 64262 89188
NS3008 Meningocoele 30030 39941 50149 64262 89188
NS3009 Multiple Burr Hole 30030 39941 50149 64262 89188
NS3010 Nerve Repair / Nerve Entrapment Under Ga 30030 39941 50149 64262 89188
NS3011 Reexploration (With In 24 Hrs) 30030 39941 50149 64262 89188
NS3012 Removal Of Depressed Bone Segment With Dural Repair 30030 39941 50149 64262 89188
NS3013 Scalp Avm 30030 39941 50149 64262 89188
NS3014 Sdh ( Bilateral) 30030 39941 50149 64262 89188
NS3015 Sdh Evaculation 30030 39941 50149 64262 89188
NS3017 Vp Shunt 30030 39941 50149 64262 89188
NS3018 Steriotectic Biopsy 30030 39941 50149 64262 89188
NSCLM Lumber Microdisectomy 30030 39941 50149 64262 89188
NSCCM Cerrvical Microdisectomy 30030 39941 50149 64262 89188
NSCCL Cerrvical Laminectomy 30030 39941 50149 64262 89188
NSCDL Dorsal Laminectomy 30030 39941 50149 64262 89188
NSCLL Lumber Laminectomy 30030 39941 50149 64262 89188
NSCCR Csf Rhinorrhea 30030 39941 50149 64262 89188
CATEGORY-D
NS4001 Brain Abcess / Cyst Aspiration 17908 23815 29909 38324 53185
NS4002 Burr Hole 17908 23815 29909 38324 53185
NS4004 Chronic Sdh 17908 23815 29909 38324 53185
NS4005 Excision Osteoma 17908 23815 29909 38324 53185
NS4006 Shunt Revision 17908 23815 29909 38324 53185
NS4007 Va Shunt Revision 17908 23815 29909 38324 53185
NSBFR Bone Flap Replacement 17908 23815 29909 38324 53185
NSR48 Reexploration (within 48 Hrs) 17908 23815 29909 38324 53185
NSCTR Carpal Tunnel Release 17908 23815 29909 38324 53185
CATEGORY-E
NS5001 Evd 8668 11528 14476 18546 25740
NS5002 External Ventricular Drain 8668 11528 14476 18546 25740
NS5003 Icp Monitoring 8668 11528 14476 18546 25740
NS5004 Lumber Drain 8668 11528 14476 18546 25740
NS5005 Muscle Biopsy 8668 11528 14476 18546 25740
NS5006 Scalp Avulsion 8668 11528 14476 18546 25740
NS5007 Skull Traction 8668 11528 14476 18546 25740
NS5008 Tic Injection 8668 11528 14476 18546 25740
NS5009 Venticular Tap 8668 11528 14476 18546 25740
Others
NS6002 Exploration Of Wound Unrepair 16753 22286 27973 35849 49753
NS6003 Removal Of Icp Monitoring 869 1155 1452 1859 2585
NS6004 Removal Of Shunt (Omaya) 1386 1848 2310 2970 4114
NS6005 Shunt Removal 1155 1540 1925 2475 3432
Service
NEURO PACKAGE
Code
NS7001 Lumber Microdisectomy 3 92,400 115,500 150,150 184,800 207,900
Inclusions 3 Days stay in chosen bed categaory Neuro Surgery Annexure
CONSUMABLES & MEDICINES UPTO Rs. 10000/-.if more than will Charge Exclude in package Complete Heamogram 1
SURGERY CHARGES,OT CHARGES,OT GAS,ASST. SURGEON CHARGES,ANAESTHESIA CHARGES. Urea 1
S. Creatinine 1
PAC Visit Na+ 1
Neuro Surgeon Visit Charges K+ 1
INVESTIGATION (Neuro Surgery Annexure) only Renal profile / KFT (Equevalent to colum no-2,3,4,5)
EQUIPMENT CHARGES (C-ARM) PT 1
DITECIAN VISIT HIV 1
Exclusions STAY BEYOND 3 DAYS AND ICU STAY Extra. HCV 1
IPD CONSULTS OTHER THAN NEURO SURGEON. HbsAg 1
ADMISTRATION CHARGE(MRD) ECG 1
X-ray Chest 1
Note: Any Charges over & above the package would be charge on actuals.
OBSTETRICS AND GYNAECOLOGY
Service Name Stay Two bed Single room Deluxe room VIP Suite
Code bed
IP PACKAGE
OG3001 Normal Delivery 2 30,000 39,000 48,000 55,000 66,000
OG3002 LSCS 3 50,000 64,000 78,000 89,000 100,000
dayc
OG3003 D&C 19,000
are
Packages Includes: room rent, Doctor fee, OT/LR charges, local anesthesia, basic Investigations (CBC, Blood Sugar, PT, APTT, Hbsag and HIV) , Routine drugs , disposables, One
NST, Dietician
PackageS visit, Physiotherapy
excludes: additional stay, Professional charges of other consultants, any additional procedure/investigation and Use of special drugs/ consumables, Blood transfusion,
Epidural/ GA charges with consumables, Neonatal attendence at the time of delivery and baby bill.
Minor Surgery/procedure
Page 27
OG1001 Abdominal Adhesiolysis -Sever 7,000 9,310 10,500 12,250 14,000
OG1002 Abdominal salpingectomy U/L 9,000 11,970 13,500 15,750 18,000
OG1003 Abortion Mid Trimester 9,600 12,768 14,400 16,800 19,200
OG1004 Adhesolysis mild 6,000 7,980 9,000 10,500 12,000
OG1005 Aminiocentesis 3,600 4,788 5,400 6,300 7,200
OG1006 Amnioinfusion 5,500 7,315 8,250 9,625 11,000
OG1007 A-V Fistula, Ttts , Fetal RFA 6,600 8,778 9,900 11,550 13,200
OG1008 Bartholin Abscess Incision & Drainage 2,900 3,857 4,350 5,075 5,800
OG1009 Bartholin Cyst Excision Bilateral 3,700 4,921 5,550 6,475 7,400
OG1010 Bartholin Cyst Excision Unilateral 2,650 3,525 3,975 4,638 5,300
OG1011 Biopsy Of Ovary 3,500 4,655 5,250 6,125 7,000
OG1012 Biopsy Of Vaginal Mucosa; Extensive, Requiring Suture (Including Cysts) 2,800 3,724 4,200 4,900 5,600
OG1013 Biopsy Of Vaginal Mucosa; Simple (Separate Procedure) 2,250 2,993 3,375 3,938 4,500
OG1014 Biopsy Of Vulva Or Perineum; Each Separate Additional Lesion 2,250 2,993 3,375 3,938 4,500
OG1015 B-Lynch Suturing 2,650 3,525 3,975 4,638 5,300
OG1016 Contrast Material For Saline Infusion Sonohysterography (Sis) Or Hsg 1,200 1,596 1,800 2,100 2,400
OG1017 Cautery Of Cervix; Electro Or Thermal 1,700 2,261 2,550 2,975 3,400
OG1018 Cautery Of Cervix; Laser Ablation 3,500 4,655 5,250 6,125 7,000
OG1019 Cerclage of Cervix, During Pregnancy; laparoscopic 8,300 11,039 12,450 14,525 16,600
OG1020 Cerclage Of Cervix, During Pregnancy; Abdominal 6,600 8,778 9,900 11,550 13,200
OG1021 Cerclage Of Cervix, During Pregnancy; Vaginal(Mcdonald) 3,500 4,655 5,250 6,125 7,000
OG1022 Cerclage Of Uterine Cervix, Nonobstetrical 3,500 4,655 5,250 6,125 7,000
OG1023 Cervical Biopsy 2,350 3,126 3,525 4,113 4,700
OG1024 Cervical Polypectomy 2,550 3,392 3,825 4,463 5,100
OG1025 Clitoroplasty For Intersex State 9,600 12,768 14,400 16,800 19,200
OG1026 Closure Of Urethrovaginal Fistula 8,300 11,039 12,450 14,525 16,600
OG1027 Closure Of Urethrovaginal Fistula; With Bulbocavernosus Transplant 9,600 12,768 14,400 16,800 19,200
OG1028 Colpocentesis (Separate Procedure) 2,550 3,392 3,825 4,463 5,100
OG1029 Colpocleisis (Le Fort Type) 5,200 6,916 7,800 9,100 10,400
OG1030 Colpopexy, Vaginal; Intra-Peritoneal Approach (Uterosacral, Levator Myorrhaphy) 9,600 12,768 14,400 16,800 19,200
OG1031 Colporrhaphy Anterior 5,200 6,916 7,800 9,100 10,400

OG1032 Colporrhaphy Posterior 5,200 6,916 7,800 9,100 10,400
OG1033 Colporrhaphy, Suture Of Injury Of Vagina (Nonobstetrical) 3,700 4,921 5,550 6,475 7,400
OG1034 Colposcopy 1,500 1,995 2,250 2,625 3,000
OG1035 Colposcopy +Hysteroscopy+Leep+Eb 7,800 10,374 11,700 13,650 15,600
OG1036 Colposcopy Directed Biopsy 2,000 2,660 3,000 3,500 4,000
Colposcopy Of The Cervix Including Upper/Adjacent Vagina; With Biopsy(S) Of The
OG1037 2,200 2,926 3,300 3,850 4,400
Cervix & Endo, Cure,
Colposcopy Of The Cervix Including Upper/Adjacent Vagina; With Endocervical
OG1038 1,700 2,261 2,550 2,975 3,400
Curettage
Colposcopy Of The Cervix Including Upper/Adjacent Vagina; With Loop Electrode
OG1039 1,700 2,261 2,550 2,975 3,400
Biopsy(S) Of The Cervix
Colposcopy Of The Cervix Including Upper/Adjacent Vagina; With Loop Electrode
OG1040 2,200 2,926 3,300 3,850 4,400
Conization Of The Cervix
OG1041 Colposcopy Of The Entire Vagina, With Cervix If Present 1,700 2,261 2,550 2,975 3,400
OG1042 Colposcopy Of The Entire Vagina, With Cervix If Present; With Biopsy(S) 3,450 4,589 5,175 6,038 6,900
Colposcopy Of The Entire Vagina, With Cervix If Present; With Biopsy(S) Of
OG1043 3,450 4,589 5,175 6,038 6,900
Vagina/Cervix
OG1044 Colposcopy Of The Vulva 1,200 1,596 1,800 2,100 2,400
OG1045 Colposcopy Of The Vulva; With Biopsy(S) 1,700 2,261 2,550 2,975 3,400
OG1046 Colpotomy With Drainage Of Pelvic Abscess 1,700 2,261 2,550 2,975 3,400
OG1047 Colpotomy; With Exploration 3,000 3,990 4,500 5,250 6,000
OG1048 Combined Anteroposterior Colporrhaphy 7,800 10,374 11,700 13,650 15,600
OG1049 Combined Anteroposterior Colporrhaphy; With Enterocele Repair 8,300 11,039 12,450 14,525 16,600
OG1050 Cone Biopsy Of Cervix 5,250 6,983 7,875 9,188 10,500
OG1051 Construction Of Artificial Vagina; Without Graft 9,600 12,768 14,400 16,800 19,200
OG1052 Cryocautery 3,800 5,054 5,700 6,650 7,600
OG1053 Curettage, Postpartum 3,500 4,655 5,250 6,125 7,000
OG1054 Delivery Of Placenta (Separate Procedure) 3,300 4,389 4,950 5,775 6,600
OG1055 Destruction Of Lesion(S), Vulva; Extensive (Eg, Laser, Electro, Cryo, Chemosurgery) 4,400 5,852 6,600 7,700 8,800
OG1056 Destruction Of Lesion(S), Vulva; Simple (Laser Electro, Cryos, Chemosurgery) 3,500 4,655 5,250 6,125 7,000
OG1057 Destruction Of Vaginal Lesion(S); Extensive 3,500 4,655 5,250 6,125 7,000
OG1058 Destruction Of Vaginal Lesion(S); Simple 2,250 2,993 3,375 3,938 4,500
Destruction of Vaginal Lesion(S); Simple (Eg, Laser Surgery, Electrosurgery, Cryosurgery,
OG1059 3,500 4,655 5,250 6,125 7,000
Chemosurge
OG1060 Diag Lap+Chromo+Eb 8,700 11,571 13,050 15,225 17,400
OG1061 Diag Lap+Chromotubation 7,400 9,842 11,100 12,950 14,800
OG1062 Diag Laparo+Hystero 8,700 11,571 13,050 15,225 17,400
OG1063 Diagnostic Lap With Chromotubation 7,400 9,842 11,100 12,950 14,800
Page 28
OG1064 Diagnostic Laparo+Hystero+Eb 8,300 11,039 12,450 14,525 16,600
OG1065 Dilatation And Curettage 5,000 6,650 7,500 8,750 10,000
OG1066 Dilation & Curettage Of Cervical Stump 3,300 4,389 4,950 5,775 6,600
OG1067 Dilation Of Cervical Canal, Instrumental (Separate Procedure) 1,700 2,261 2,550 2,975 3,400
OG1068 Dilation Of Vagina Under Anesthesia 1,700 2,261 2,550 2,975 3,400
OG1069 Drainage Of Ovarian Abscess; Abdominal Approach 5,250 6,983 7,875 9,188 10,500
OG1070 Drainage Of Ovarian Abscess; Vaginal Approach, Open 5,250 6,983 7,875 9,188 10,500
OG1071 Drainage of Ovarian Abscess; Vaginal Approach/ abdominal approach 6,600 8,778 9,900 11,550 13,200
OG1072 Drainage Of Ovarian Cyst(S), Unilateral Or Bilateral, (Sepa. Pro); Vaginal Approach 5,250 6,983 7,875 9,188 10,500
OG1073 Drainage Of Ovarian Cyst(S), Unilateral Or Bilateral, (Sepa. Proc.); Abdominal Approach 5,250 6,983 7,875 9,188 10,500
OG1074 Drainage of Pelvic Abscess, Transvaginal or Transrectal Approach, Percutaneous 6,600 8,778 9,900 11,550 13,200
OG1075 Drainage Of The Abdminal Wall Hematoma 6,000 7,980 9,000 10,500 12,000
OG1076 Endocervical Curettage (Not Done As Part Of A Dilation & Curettage) 2,350 3,126 3,525 4,113 4,700
OG1077 Endomatrial Aspiration 1,500 1,995 2,250 2,625 3,000
OG1078 Endometrial Biopsy 2,100 2,793 3,150 3,675 4,200
OG1079 Enterocele Repair-Vaginal 5,250 6,983 7,875 9,188 10,500
OG1080 Episiotomy 2,150 2,860 3,225 3,763 4,300
OG1081 EUA 3,000 3,990 4,500 5,250 6,000
OG1082 Eua And Needling 3,000 3,990 4,500 5,250 6,000
OG1083 Evacuation Of Retained Poc 3,300 4,389 4,950 5,775 6,600
OG1084 Excision Of Cervical Stump, Abdominal Approach 9,600 12,768 14,400 16,800 19,200
OG1085 Excision Of Cervical Stump, Vaginal Approach 9,600 12,768 14,400 16,800 19,200
OG1086 Excision Of Labial Cyst 3,400 4,522 5,100 5,950 6,800
OG1087 Excision Of Scar Endometriosis 4,600 6,118 6,900 8,050 9,200
OG1088 Excision Of Urethral Caruncle 3,000 3,990 4,500 5,250 6,000
OG1089 Excision Of Vaginal Cyst Or Tumor 3,700 4,921 5,550 6,475 7,400
OG1090 Excision Of Vaginal Septum 4,400 5,852 6,600 7,700 8,800
OG1091 Exploratory Laparotomy (Gyn) 7,200 9,576 10,800 12,600 14,400
OG1092 External Cephalic Version, With Or Without Tocolysis 2,650 3,525 3,975 4,638 5,300
OG1093 Fetal Bladder Tap, Pleural Tap, Ascitic Tap , Therapeutic / Diagnostic Tap 5,250 6,983 7,875 9,188 10,500
OG1094 Fetal Blood Sampling 5,250 6,983 7,875 9,188 10,500
OG1095 Fetal Contraction Stress Test 460 612 690 805 920
OG1096 Fetal Muscle Biopsy 6,600 8,778 9,900 11,550 13,200
OG1097 Fetal Non-Stress Test 300 399 450 525 600
OG1098 Fetal Scalp Blood Sampling 1,700 2,261 2,550 2,975 3,400
OG1099 Fetal Shunting 6,600 8,778 9,900 11,550 13,200
OG1100 Fetal Skin Biopsy 6,600 8,778 9,900 11,550 13,200
OG1101 Fimbrioplasty (Abdominal / Vaginal) 6,600 8,778 9,900 11,550 13,200
OG1102 Foreign Body Removal From Vagina 3,500 4,655 5,250 6,125 7,000
OG1103 Fraction Curettage 3,300 4,389 4,950 5,775 6,600
OG1104 Hematocolpos Excision Septum 3,300 4,389 4,950 5,775 6,600
OG1105 Hydrotubation. 650 865 975 1,138 1,300
OG1106 Hymenectomy 2,800 3,724 4,200 4,900 5,600
OG1107 Hysteroplasty, Repair Of Uterine Anomaly Level 1 8,300 11,039 12,450 14,525 16,600
OG1108 Hysteroplasty, Repair Of Uterine Anomaly (Strassman Type) 6,600 8,778 9,900 11,550 13,200
OG1111 Hysteroscopic Endometrial Biopsy 4,400 5,852 6,600 7,700 8,800
OG1112 Hysteroscopic lateral meteroplasty 8,700 11,571 13,050 15,225 17,400
OG1113 Hysteroscopic Myomectomy single 9,600 12,768 14,400 16,800 19,200
OG1114 Hysteroscopic Polypectomy 5,300 7,049 7,950 9,275 10,600
OG1115 Hysteroscopic Removal Of Lucd 4,400 5,852 6,600 7,700 8,800
OG1116 Hysteroscopic Treatment Of Ectopic Pregnancy; Cervical, With Evacuation 7,400 9,842 11,100 12,950 14,800
OG1117 Hysteroscopic Tubal Cannulation 9,600 12,768 14,400 16,800 19,200
OG1118 Hysteroscopy Diagnostic 3,500 4,655 5,250 6,125 7,000
OG1119 Hysteroscopy, Surgical; With Lysis Of Grade 2 Intrauterine Adhesions (Any Method) 5,250 6,983 7,875 9,188 10,500
OG1121 Hysteroscopy, With Removal Of Impacted Foreign Body 4,400 5,852 6,600 7,700 8,800
Hysteroscopy,+ Endometrial Ablation (Endometrial Resection/Electrosurgical
OG1122 8,300 11,039 12,450 14,525 16,600
Ablation/Thermoablation)
OG1123 Hysterotomy 7,000 9,310 10,500 12,250 14,000
OG1124 Hysterotomy With Tubal Ligation 9,400 12,502 14,100 16,450 18,800
OG1125 Incision & Drainage Of Vaginal Hematoma; Non-Obstetrical 4,000 5,320 6,000 7,000 8,000
OG1126 Incision & Drainage Of Vaginal Hematoma;Obstetrical/Postpartum 4,000 5,320 6,000 7,000 8,000
OG1127 Incision & Drainage Of Vulva Or Perineal Abscess 2,350 3,126 3,525 4,113 4,700
OG1128 Incision & drainage of vulval hematoma < 5cm diameter /125 CC 3,500 4,655 5,250 6,125 7,000
Page 29
OG1129 Incision & drainage of vulval hematoma > 5cm diameter /125 CC 4,400 5,852 6,600 7,700 8,800
OG1130 Induced Abortion /Delivery Of Fetus 4,400 5,852 6,600 7,700 8,800
OG1131 Induced abortion by medical method without D&C 2,650 3,525 3,975 4,638 5,300
OG1132 Induced Abortion, By Dilation & Evacuation 3,300 4,389 4,950 5,775 6,600
Induced Abortion, By One Or > Intra-Amniotic Inj.(Amniocentesis-Inj.), Delivery Of
OG1133 8,300 11,039 12,450 14,525 16,600
Fetus+Hyst
Induced Abortion, By Vaginal Suppositories (Eg, Prostagl&In) Delivery Of Fetus Etc With
OG1134 8,300 11,039 12,450 14,525 16,600
Hyst
OG1135 Insertion Of Levonorgestrel-Releasing Intrauterine System(Mirena) 2,350 3,126 3,525 4,113 4,700
OG1136 Introduction Of Hemostatic Agent / Pack For Nonobstetrical Vaginal Hemorrhage 800 1,064 1,200 1,400 1,600
OG1137 Irrigation of Vagina 1,600 2,128 2,400 2,800 3,200

OG1138 Iucd Insertion (Multiload) 1,500 1,995 2,250 2,625 3,000
OG1139 IUI 3,000 3,990 4,500 5,250 6,000
OG1140 Lap / Vaginal Ovarian Cystectomy < 5 CM 8,500 11,305 12,750 14,875 17,000
OG1141 Lap / vaginal salpingo-Oophorectomy, Complete or Partial 8,700 11,571 13,050 15,225 17,400
OG1142 Lap +/- Hysteroplasty, Repair Of Uterine Anomaly Level 1 9,600 12,768 14,400 16,800 19,200
OG1143 Lap Extensive Adhesiolysis / Involving Bowel Bladder Muscle/Mucosa Prim. Pro.) 9,600 12,768 14,400 16,800 19,200
OG1144 Lap Mild Adhesiolysis-Add On Procedure 4,800 6,384 7,200 8,400 9,600
OG1145 Lap Salpingectomy/ Complete or Partial 9,600 12,768 14,400 16,800 19,200
OG1146 Lap. Adhesolysis (Obs & Gyn) 6,000 7,980 9,000 10,500 12,000
OG1147 Lap. Diagnostic (Obs & Gyn) 5,000 6,650 7,500 8,750 10,000
OG1148 Lap. Multiple Ovarian Dirlling / Puncture 6,800 9,044 10,200 11,900 13,600
OG1149 Lap. Oopherectomy Unilateral 9,000 11,970 13,500 15,750 18,000
OG1150 Lap. Ovarian Cystectomy Single 8,500 11,305 12,750 14,875 17,000
OG1151 Lap. sterlization 5,500 7,315 8,250 9,625 11,000
OG1152 Lap Vaginal Biopsy Of Ovary (Separate Procedure) 8,300 11,039 12,450 14,525 16,600
OG1153 Laparoscopic Drainage Of Ovarian Abscess 8,300 11,039 12,450 14,525 16,600
OG1154 Lap Drainage Of Ovarian Cyst(S) 8,300 11,039 12,450 14,525 16,600
OG1155 Lap Fimbrioplasty 8,300 11,039 12,450 14,525 16,600
OG1156 Lap Salpingostomy (Salpingoneostomy) 8,700 11,571 13,050 15,225 17,400
OG1157 Lap Transposition, Ovary(S) 8,300 11,039 12,450 14,525 16,600
Lap Fulguration Or Excision Of Lesions Of The Ovary, Pelvic Viscera, Or Peritoneal
OG1158 8,300 11,039 12,450 14,525 16,600
Surface
OG1159 Lap With Lysis Of Adhesions (Salpingolysis, Ovariolysis) (Separate Procedure) 8,300 11,039 12,450 14,525 16,600
OG1160 Lap Surgical With Fimbrioplasty 8,300 11,039 12,450 14,525 16,600
OG1161 Lap Surgical With Salpingostomy (Salpingoneostomy) 9,600 12,768 14,400 16,800 19,200
OG1162 Laparotomy (Open & Close) 7,400 9,842 11,100 12,950 14,800
OG1163 Laparotomy Gyn Oopherectomy Unilateral 8,600 11,438 12,900 15,050 17,200
OG1164 Laparotomy Gyn Ovarian Cystectomy Bilateral 9,960 13,247 14,940 17,430 19,920
OG1165 Laparotomy Gyn Ruptured Ovarian Cyst 9,960 13,247 14,940 17,430 19,920
OG1166 Laparotomy with Adhesiolysis MILD 8,300 11,039 12,450 14,525 16,600
OG1167 Laproscopic Removal Of Lost IUCD 8,300 11,039 12,450 14,525 16,600
OG1168 Laproscopic Targeted Biopsy 8,300 11,039 12,450 14,525 16,600
OG1169 Lefords Operation 6,800 9,044 10,200 11,900 13,600
OG1170 Ligation Or Transection Of Fallopian Tube(S), Abdominal/ Vaginal Approach 5,250 6,983 7,875 9,188 10,500
Ligation/Transection Fallopian Tube(S), Abdominal/Vaginal/Postpartum During Same
OG1171 5,250 6,983 7,875 9,188 10,500
Hospitalization
OG1172 Lysis Of Labial Adhesions 2,350 3,126 3,525 4,113 4,700
OG1173 Manual Removal Of Placenta 3,300 4,389 4,950 5,775 6,600
OG1174 Mcdonald Stitching 3,500 4,655 5,250 6,125 7,000
OG1175 Medical Management Of Ectopic Pregnancy 5,000 6,650 7,500 8,750 10,000
OG1176 Mesh Insertion For Repair Pelvic Floor Defect 3,700 4,921 5,550 6,475 7,400
OG1177 Micro colpo hysteroscopy 8,300 11,039 12,450 14,525 16,600
OG1178 MTP-High Risk 5,500 7,315 8,250 9,625 11,000
OG1179 Multiple Pregnancy, Embryo Reduction 5,250 6,983 7,875 9,188 10,500
OG1180 NST 450 599 675 788 900
Occlusion Of Fallopian Tube(S) By Device (Eg, B&, Clip, Falope Ring) Vaginal Or
OG1181 5,250 6,983 7,875 9,188 10,500
Suprapubic Approach
OG1182 Oligo Hydraminos, Amino Infusion 2,650 3,525 3,975 4,638 5,300
OG1183 Pereyra Procedure, Including Anterior Colporrhaphy 6,500 8,645 9,750 11,375 13,000
OG1184 Perineoplasty, Repair Of Perineum, Nonobstetrical (Separate Procedure) 3,500 4,655 5,250 6,125 7,000
OG1185 Placental Biopsy 4,400 5,852 6,600 7,700 8,800
OG1186 Plastic Operation On Urethral Sphincter, Vaginal Approach (Eg, Kelly Urethral Plication) 3,700 4,921 5,550 6,475 7,400
OG1187 Plastic Repair Of Introitus 3,500 4,655 5,250 6,125 7,000

OG1188 Plastic Repair Of Urethrocele 3,500 4,655 5,250 6,125 7,000
OG1189 Polyhydramnios, Amnio Drainage 2,250 2,993 3,375 3,938 4,500
OG1190 Posterior Colporrhaphy, Repair Of Rectocele With Or Without Perineorrhaphy 5,200 6,916 7,800 9,100 10,400
Page 30
OG1191 Removal Of Cerclage Suture Under Anesthesia 850 1,131 1,275 1,488 1,700
OG1192 Removal Of Iucd 600 798 900 1,050 1,200
OG1193 Removal Of Simple Vulval Tumor 2,800 3,724 4,200 4,900 5,600
OG1194 Removal Or Revision Of Sling For Stress Incontinence (Eg, Fascia Or Synthetic) 9,600 12,768 14,400 16,800 19,200
OG1195 Repair Of Perineal Tear Post Coital Or Traumatic 5,250 6,983 7,875 9,188 10,500
OG1196 Repair Of Uterus 9,600 12,768 14,400 16,800 19,200
OG1197 Resuturing of Abdominal Wound deep 2,650 3,525 3,975 4,638 5,300
OG1198 Resuturing of Abdominal Wound superficial 2,250 2,993 3,375 3,938 4,500
OG1199 Resuturing of burst Abdominal Wound 8,300 11,039 12,450 14,525 16,600
OG1200 Revision (Including Removal) Of Prosthetic Vaginal Graft; Open Abdominal Approach 9,600 12,768 14,400 16,800 19,200
OG1201 Revision (Including Removal) Of Prosthetic Vaginal Graft; Vaginal Approach 9,600 12,768 14,400 16,800 19,200
OG1202 Rh Incompatibility, Fetal Intrauterine Transfusion 8,700 11,571 13,050 15,225 17,400
OG1203 Richardson Sling Operation 8,300 11,039 12,450 14,525 16,600
OG1204 Shirodkars Stitching 2,250 2,993 3,375 3,938 4,500
OG1205 Simple Vulvectomy 7,960 10,587 11,940 13,930 15,920
OG1206 Single Pregnancy, Amniocentesis, Therapeutic 3,500 4,655 5,250 6,125 7,000
OG1207 Single Pregnancy, Amniocentesis, Therapeutic High Risk 4,400 5,852 6,600 7,700 8,800
OG1208 Single Pregnancy, Choronic Villus Sampling 4,000 5,320 6,000 7,000 8,000
OG1209 Single Pregnancy, Choronic Villus Sampling High Risk 5,250 6,983 7,875 9,188 10,500
OG1210 Suction & Evacuation -High Risk 5,000 6,650 7,500 8,750 10,000
OG1211 Surgical Treatment Of Ectopic Pregnancy; Cervical, With Evacuation 5,700 7,581 8,550 9,975 11,400
OG1212 Suturing Perineal Tears Ii Degree 3,250 4,323 4,875 5,688 6,500
OG1213 Suturing Perineal Tears Iii Degree 6,500 8,645 9,750 11,375 13,000
OG1214 Three Swab Test (For Vaginal Fistula) 750 998 1,125 1,313 1,500
OG1215 Trachelectomy (Cervicectomy), Amputation Of Cervix (Separate Procedure) 6,600 8,778 9,900 11,550 13,200
OG1216 Trachelorrhaphy, Plastic Repair Of Uterine Cervix, Vaginal Approach 3,500 4,655 5,250 6,125 7,000
OG1217 Transabdominal Amnioinfusion, Including Ultrasound Guidance 2,650 3,525 3,975 4,638 5,300
OG1218 Transcervical Introduction Of Fallopian Tube Catheter 4,400 5,852 6,600 7,700 8,800
OG1219 Transposition, Ovary(S) 6,600 8,778 9,900 11,550 13,200
OG1220 Transvaginal Hydrolaparoscopy Diagnostic 6,600 8,778 9,900 11,550 13,200
OG1221 Transvaginal Hydrolaparoscopy Operative 8,300 11,039 12,450 14,525 16,600
OG1222 Transvaginal Hydrolaparoscopy Operative level 1 8,300 11,039 12,450 14,525 16,600
OG1225 Treatment Of Missed Abortion, Completed Surgically; First Trimester 3,300 4,389 4,950 5,775 6,600
OG1226 Treatment Of Septic Abortion, Completed Surgically 5,000 6,650 7,500 8,750 10,000
OG1227 Tubal Insufflation 1,400 1,862 2,100 2,450 2,800
OG1228 Twin Pregnancy , Amniocentesis, Therapeutic 4,400 5,852 6,600 7,700 8,800
OG1229 Twin Pregnancy , Choronic Villus Sampling 6,600 8,778 9,900 11,550 13,200
OG1230 Twin Pregnancy , Choronic Villus Sampling High Risk 8,300 11,039 12,450 14,525 16,600
OG1231 Twin Pregnancy, Amniocentesis, Therapeutic High Risk 5,250 6,983 7,875 9,188 10,500
OG1232 Umbilical Cord Occlusion 6,600 8,778 9,900 11,550 13,200
OG1233 Uterine Artery Ligation 2,000 2,660 3,000 3,500 4,000
OG1234 Uterine Evacuation & Curettage For Hydatidiform Mole 5,500 7,315 8,250 9,625 11,000
Uterine Suspension, +/- Shortening Round Ligaments,+/- Shortening Sacrouterine
OG1235 9,600 12,768 14,400 16,800 19,200
Ligaments; With Presa
Uterine Suspension,+/- Shortening Round Ligaments+/- Shortening Sacrouterine
OG1236 5,250 6,983 7,875 9,188 10,500
Ligaments; (Sepa. Proc)
OG1237 Vaginal Hysterectomy, For descebded Uterus >500 G; Without Removal Of Tube(S) 4,400 5,852 6,600 7,700 8,800
OG1238 Vaginectomy, Complete Removal Of Vaginal Wall 9,600 12,768 14,400 16,800 19,200
OG1239 Vaginectomy, Partial Removal Of Vaginal Wall; With Removal Of Paravaginal Tissue 9,600 12,768 14,400 16,800 19,200
OG1240 Ventri Suspension 7,500 9,975 11,250 13,125 15,000

OG1241 Ventrosuspension Of The Uterus Alone (Gilliams) 6,200 8,246 9,300 10,850 12,400
OG1242 Visual Inspection Of Cervix 1,070 1,423 1,605 1,873 2,140
OG1243 Vulval Biopsy 2,100 2,793 3,150 3,675 4,200
OG1244 Vulvectomy Simple, Partial 6,600 8,778 9,900 11,550 13,200
OG1245 Vulvectomy Radical, Partial 9,600 12,768 14,400 16,800 19,200
OG1246 Wedge Resection Or Bisection Of Ovary 6,600 8,778 9,900 11,550 13,200
OG1247 Procedure charges for HSG 2,250 2,993 3,375 3,938 4,500
OG1248 Bartholin'S Cyst Marsupialisation (Bilateral) 3,000 3,990 4,500 5,250 6,000
OG1249 Bartholin'S Cyst Marsupialisation (Unilateral) 2,000 2,660 3,000 3,500 4,000
OG1250 Insertion Of Vaginal Ring Pessary 1,200 1,596 1,800 2,100 2,400
OG1251 Laparotomy Gyn Oophrectomy (Bilateral) 10,000 13,300 15,000 17,500 20,000
OG1252 Laparotomy Gyn. Ovarian Cystectomy (Unilateral) 7,000 9,310 10,500 12,250 14,000
OG1253 MTP 5,000 6,650 7,500 8,750 10,000
OG1254 Suturing Of Perineal Tear 30 Including Anal Sphincter Repair 8,500 11,305 12,750 14,875 17,000
Page 31
Major Surgeries
Service
Code
OG2002 Abdominal Myomectomy less than 5 myomas 16,800 22,344 25,200 29,400 33,600
OG2003 Abdominal Myomectomy more than 5 myomas 16,000 21,280 24,000 28,000 32,000
OG2004 Abdominal Operation For Stress Incontinence 14,500 19,285 21,750 25,375 29,000
OG2005 Abdominal salpingectomy/ Complete Or Partial, B/L 14,000 18,620 21,000 24,500 28,000
OG2006 Abortion Mid Trimester (Twin) 14,500 19,285 21,750 25,375 29,000
OG2007 BSO With Omentectomy, TAH & Radical Dissection For Debulking 38,000 50,540 57,000 66,500 76,000
OG2008 Bso With Total Omentectomy, Tah For Malignancy 19,500 25,935 29,250 34,125 39,000
OG2009 Ceaserean Hysterectomy 15,700 20,881 23,550 27,475 31,400
Cesarean Delivery Only, Following Attempted Vaginal Delivery After Previous Cesarean
OG2010 14,000 18,620 21,000 24,500 28,000
Delivery
OG2011 Closure Of Rectovaginal Fistula; Abdominal Approach, With Concomitant Colostomy 16,800 22,344 25,200 29,400 33,600
OG2012 Closure Of Vesicovaginal Fistula; Vaginal Approach 12,700 16,891 19,050 22,225 25,400
OG2013 Colpopexy, Abdominal Approach 11,800 15,694 17,700 20,650 23,600
OG2014 Colpopexy, Vaginal; Extra-Peritoneal Approach (Sacrospinous, Iliococcygeus) 10,500 13,965 15,750 18,375 21,000
Complete Lap Staging For Ovarian Malignancy (Hyst,Bso,Bilateral Pelvic & Aortic Ln
OG2015 46,500 61,845 69,750 81,375 93,000
Sampling, Omente
OG2016 Complex & High Risk Hysterctomy 16,600 22,078 24,900 29,050 33,200
OG2017 Construction Of Artificial Vagina; With Graft 12,700 16,891 19,050 22,225 25,400
OG2018 Delivery (Vacum/Forceps/ Breech) 13,500 17,955 20,250 23,625 27,000
OG2019 Delivery After previous lscs birth(VBAC) 13,500 17,955 20,250 23,625 27,000
OG2021 Delivery Twin 15,000 19,950 22,500 26,250 30,000
OG2022 Diag Lap +Hystero+Chromotubation+Eb 11,800 15,694 17,700 20,650 23,600
OG2023 Endometrial Ablation 14,600 19,418 21,900 25,550 29,200
OG2024 Enterocele Repair-Abdominal 11,000 14,630 16,500 19,250 22,000
OG2025 Excision Of Cervical Stump, Abdominal Approach; With Pelvic Floor Repair 17,500 23,275 26,250 30,625 35,000
OG2026 Excision Of Cervical Stump, Vaginal Approach; With Repair Of Enterocele 11,800 15,694 17,700 20,650 23,600
OG2027 Fentons Operation For Reconstruction Of Vagina 12,700 16,891 19,050 22,225 25,400
OG2028 Hysterectomy Abdominal 11,800 15,694 17,700 20,650 23,600
OG2029 Hysterectomy Vaginal And Repair 16,800 22,344 25,200 29,400 33,600
OG2031 Hysteroplasty, Repair Of Uterine Anomaly / Excision Of Uterine Cornu 12,700 16,891 19,050 22,225 25,400
OG2032 Hysterorrhaphy Of Ruptured Uterus 11,800 15,694 17,700 20,650 23,600
Service
Code
OG2033 Hysterorrhaphy, Repair Of Ruptured Uterus (Nonobstetrical) 13,000 17,290 19,500 22,750 26,000
OG2034 Hysteroscopic Myomectomy multiple 13,000 17,290 19,500 22,750 26,000
Hysteroscopy, Surgical; With Division Or Resection Of Intrauterine Sub Septate Septum
OG2035 13,500 17,955 20,250 23,625 27,000
(Any Method)
OG2037 Lap / Vaginal Ovarian Cystectomy, Unilateral or Bilateral > 5 CM 10,100 13,433 15,150 17,675 20,200
OG2038 Lap / Vaginal Treatment of Ectopic Pregnancy; With Salpingectomy &/or Oophorectomy 10,000 13,300 15,000 17,500 20,000
Lap / Vaginal Treatment Of Ectopic Pregnancy; Without Salpingectomy &/Or

OG2039 10,000 13,300 15,000 17,500 20,000
Oophorectomy
OG2042 Lap +/-Hysteroplasty, Repair Of Uterine Anomaly Level 3 11,800 15,694 17,700 20,650 23,600
OG2043 Lap Burch Colposuspension 12,700 16,891 19,050 22,225 25,400
OG2044 Lap Myomectomy,Excision; 5 Or More Intramural Myomas 18,000 23,940 27,000 31,500 36,000
OG2045 Lap Myomectomy,Excision Less Then 5 Intramural Myomas 14,000 18,620 21,000 24,500 28,000
OG2046 Lap Removal Of B /L Endometrioma With Extensive Adhesiolysis & Clearance Of Pod 16,400 21,812 24,600 28,700 32,800
OG2047 Lap Removal of B/L Endometrioma With Extensive Adhesiolysis 16,400 21,812 24,600 28,700 32,800
Lap Removal Of B/L Endometrioma With Extensive Adhesiolysis/Involving Bowel Bladder
OG2048 16,400 21,812 24,600 28,700 32,800
Muscle/Mucosa
OG2049 Lap Removal Of B/L Endometrioma With Moderate Adhesiolysis & Clearance Of Pod 15,000 19,950 22,500 26,250 30,000
Lap Removal Of B/L Endometrioma With Moderate Adhesiolysis / Involving Bowel

OG2050 15,300 20,349 22,950 26,775 30,600
Bladder Serosa
Lap Removal Of U/L Endometrioma With Extensive Adhesiolysis/Involving Bowel Bladder
OG2051 16,400 21,812 24,600 28,700 32,800
Muscle/Mucosa
Lap Removal Of U/L Endometrioma With Moderate Adhesiolysis / Involving Bowel/
OG2052 15,000 19,950 22,500 26,250 30,000
Bladder Serosa
OG2053 Lap Total Hysterectomy 21,800 28,994 32,700 38,150 43,600
Lap Treatment Of Ectopic Pregnancy; Interstitial, Uterine Pregnancy+ Partial Resection
OG2054 12,700 16,891 19,050 22,225 25,400
Of Uterus
Page 32
OG2055 Lap, Radical Hyst 250-500Gms, Bilat Pelviic L Ectomy & P-Aortic L N Sampling +/- Bso 26,400 35,112 39,600 46,200 52,800
Service
Code
OG2056 Lap, Radical Hyst(Lavh) >500Gms, Bilat Pelviic L Ectomy & P-Aortic L N Sampling +/- Bso 26400 35,112 39,600 46,200 52,800
Lap, Radical Hyst, Bilateral Pelvic Lymphadenectomy & Para-Aortic L N Sampling +/-
OG2057 26400 35,112 39,600 46,200 52,800
Bso
OG2058 Lap, Radical Hyst<250Gms, Bilat Pelviic L Ectomy & P-Aortic L N Sampling +/- Bso 26400 35,112 39,600 46,200 52,800
Lap, Supracervical Hyst, For Uterus > 250-500 G; With Removal Of Tube(S) / Ovary(S) /
OG2059 20500 27,265 30,750 35,875 41,000
Moderate Adhes
Lap, Supracervical Hyst, For Uterus >500 G; With Removal Of Tube(S) / Ovary(S)/With
OG2060 20500 27,265 30,750 35,875 41,000
Severe
Lap, Supracervical Hyst, Uterus 250 G Or Less; With Removal Of Tube(S) &/Or Ovary(S)
OG2061 20500 27,265 30,750 35,875 41,000
/ Adhesiolysis
OG2062 Lap. Assisted Vaginal Hysterectomy (Lavh) 16600 22,078 24,900 29,050 33,200
OG2063 Lap. Ectopic Pregnancy / Tubal Surgery 10000 13,300 15,000 17,500 20,000
Lap. Hysteroplasty, Repair Of Uterine Anomaly (Strassman Type) / Unification Of
OG2064 15300 20,349 22,950 26,775 30,600
Double Uterine Horns
Lap. Myomectomy, Excision; 5 Or More Intramural Myomas/ Intramural Myomas Total
OG2065 12700 16,891 19,050 22,225 25,400
Weight >250 G
OG2066 Lap. Oopherectomy Bilateral 10100 13,433 15,150 17,675 20,200
OG2067 Lap. Ovarian Cystectomy Multiple 11500 15,295 17,250 20,125 23,000
Lap/ Vaginal Treatment Of Ectopic Pregnancy; With Salpingectomy &/Or
OG2068 10000 13,300 15,000 17,500 20,000
Oophorectomy
OG2069 LAP/VAG treatment of ectopic with oophorectomy 10000 13,300 15,000 17,500 20,000
OG2070 Lap/Vaginal Wedge Resection or Bisection of Ovary, Unilateral 10000 13,300 15,000 17,500 20,000
OG2071 Laparoscopic Myomectomy 12700 16,891 19,050 22,225 25,400
OG2072 Laparoscopic Tubotubal Anastomosis 12700 16,891 19,050 22,225 25,400
OG2073 Laparoscopic Tubouterine Implantation 15300 20,349 22,950 26,775 30,600
OG2074 Laparoscopic,Supracervical Hysterectomy, For Uterus >500 G 20500 27,265 30,750 35,875 41,000
OG2075 Laparoscopic,Supracervical Hysterectomy, For Uterus 250-500 G 20500 27,265 30,750 35,875 41,000
OG2076 Laparoscopy, Surgical, Colpopexy (Suspension Of Vaginal Apex) 12700 16,891 19,050 22,225 25,400
OG2077 Laparotomy Gyn Endometriosis 13500 17,955 20,250 23,625 27,000
OG2078 Laparotomy Gyn Extensive Endometriosis (Frozen Pelvis) 17500 23,275 26,250 30,625 35,000
OG2079 Laparotomy Gyn Oopherectomy Bilateral 10400 13,832 15,600 18,200 20,800
OG2080 Laparotomy Gyn Salpingo Oopherectomy Bilateral 10400 13,832 15,600 18,200 20,800
OG2081 Laparotomy Gyn Twisted Ovarian Cyst 10400 13,832 15,600 18,200 20,800
Code bed
OG2082 Lavh (Uterus 500 G) 17500 23,275 26,250 30,625 35,000
OG2083 Lavh, For Uterus >500 G /+/- Bso Or Moderate Adhesiolysis / Removal To Mass 19500 25,935 29,250 34,125 39,000
OG2084 Lavh, For Uterus >500 G ; +/- Bso / Mild Adhesiolysis 17500 23,275 26,250 30,625 35,000
OG2085 Lavh, For Uterus >500 G +/- Bso Severe Adhesiolysis 21800 28,994 32,700 38,150 43,600
OG2086 Lavh, For Uterus 250 G Or Less; /+/- Bso Severe Adhesiolysis 19500 25,935 29,250 34,125 39,000
OG2087 Lavh, For Uterus 250 G Or Less; /+/- Bso Or Moderate Adhesiolysis / Removal To Mass 17500 23,275 26,250 30,625 35,000
OG2088 Lavh, For Uterus 250 G Or Less; +/- Bso / Mild Adhesiolysis 17500 23,275 26,250 30,625 35,000
OG2089 Lavh, For Uterus 250-500 G /+/- Bso Or Moderate Adhesiolysis / Removal To Mass 19500 25,935 29,250 34,125 39,000
OG2090 Lavh, For Uterus 250-500 G ; +/- Bso / Mild Adhesiolysis 17500 23,275 26,250 30,625 35,000
OG2091 Lavh, For Uterus 250-500 G +/- Bso Severe Adhesiolysis 21800 28,994 32,700 38,150 43,600
OG2093 Lscs (previous lscs birth) 16600 22,078 24,900 29,050 33,200
OG2094 Lscs after trial of vaginal delivery 16600 22,078 24,900 29,050 33,200
OG2095 Lscs Twin Pregnancy 20000 26,600 30,000 35,000 40,000
OG2096 Manchester / Forthergil Procedure 11800 15,694 17,700 20,650 23,600
OG2097 Myomectomy Abdominal 16800 22,344 25,200 29,400 33,600
OG2098 Ndvh (Non Descent Vaginal Hyst. 250-500Gm With Moderate Adhesiolysis 19500 25,935 29,250 34,125 39,000
OG2099 Ndvh (Non Descent Vaginal Hyst. 250-500Gm With Severe Adhesiolysis 21800 28,994 32,700 38,150 43,600
OG2100 Ndvh (Non Descent Vaginal Hyst. More Than 500 Gms + Bso / Mild Adhesiolysis 19500 25,935 29,250 34,125 39,000
OG2101 Ndvh (Non Desecent Vaginal Hyst.< Than 250Gm 17500 23,275 26,250 30,625 35,000
OG2102 Ndvh(Non Descent Vaginal Hyst.>Than 250Gm 19500 25,935 29,250 34,125 39,000
Ndvh (Non Descent Vaginal Hyst<Than 250 Gm With Cystectomy/Salpingo
OG2103 17500 23,275 26,250 30,625 35,000
Oophorectomy/Mild Adhesi
OG2104 Ndvh (Non Descent Vaginal Hysterectomy Less Than 250 Gm 12700 16,891 19,050 22,225 25,400
OG2105 Ndvh (Non Descent Vaginal Hysterectomy More Than 500 Gms 17500 23,275 26,250 30,625 35,000
Ndvh >500 Gms Or Previous 2 Or More Cs/Abdomino Pelvic Procedure Severe
OG2106 24000 31,920 36,000 42,000 48,000
Adhesiolysis
Page 33
NDVH 250-500Gm Previous 1Cs/Abdominal Procedure/Nulliparous Removal Of Ovarian
OG2107 21800 28,994 32,700 38,150 43,600
Mass
Ndvh>500 Or Gms+ Previous 2 Or More Cs / Procedure Or Moderate Adhesiolysis /+ to
OG2108 26400 35,112 39,600 46,200 52,800
Mass
OG2109 Non Desent Vaginal Hysterectomy 17500 23,275 26,250 30,625 35,000
Code bed
OG2110 Operative Hysteroscopy Septum Division 13500 17,955 20,250 23,625 27,000
OG2111 Operative Hysteroscopy Synaechae Removal 11500 15,295 17,250 20,125 23,000
OG2112 Purandares Sling 14200 18,886 21,300 24,850 28,400
OG2113 Radical Hysterctomy For Ca Body Of Uterus 35000 46,550 52,500 61,250 70,000
OG2114 Radical Hysterectomy Plus Omentectomy For Ovarian Malignancy 35000 46,550 52,500 61,250 70,000
Radical Trachelectomy, Bilat Pelvic Lymph. & Para-Aortic L N Sampling +/- Removal Of
OG2115 30800 40,964 46,200 53,900 61,600
Tube(S)/Ovary(S
OG2116 Rectovaginal Fistulas Repair Third Degree 11800 15,694 17,700 20,650 23,600
OG2117 Resect Ovarian/ Tubal/ Primary Peritoneal Malig BSO & Omentec 30800 40,964 46,200 53,900 61,600
OG2118 Resection Ovarian/ Tubal / Primary Peritoneal Malignancy With Bso & Omentectomy 17500 23,275 26,250 30,625 35,000
OG2119 Resection Ovarian/ Tubal/ Primary Peritoneal Malignancy With BSO & Omentectomy 24000 31,920 36,000 42,000 48,000
OG2120 Resection Recurrent Ovarian/Tubal/ Pri. Peritoneal/ Uterine Malignancy+Omentectomy 30800 40,964 46,200 53,900 61,600
OG2121 Resuspension Of Post Hysterectomy Vault Prolapse 21500 28,595 32,250 37,625 43,000
OG2122 Salphingectomy Unilateral 10400 13,832 15,600 18,200 20,800
OG2123 Salpingostomy (Salpingoneostomy) 10400 13,832 15,600 18,200 20,800
OG2124 Sub Total Hysterectomy 11800 15,694 17,700 20,650 23,600
Supracervical Abdominal Hyst, 250-500Gms (Subtotal), + Removal Of Tube(S)/ Removal
OG2125 11800 15,694 17,700 20,650 23,600
Of Ovary(S)
Supracervical Abdominal Hyst. >500 (Subtotal), + Removal Of Tube(S)/ Removal Of
OG2126 12500 16,625 18,750 21,875 25,000
Ovary(S)
Supracervical Abdominal Hyst/ <250 Gms(Subtotal), + Removal Of Tube(S)/ Removal Of
OG2127 11800 15,694 17,700 20,650 23,600
Ovary(S)
OG2128 Supracervical Abdominal Hysterectomy (Subtotal), 250-500 Gms 11800 15,694 17,700 20,650 23,600
OG2129 Supracervical Abdominal Hysterectomy(Subtotal),>500 Gms 11800 15,694 17,700 20,650 23,600
Surgery For Ectopic Tubal / Ovarian+ Salpingectomy &/Or Oophorectomy, Abdominal Or
OG2130 10400 13,832 15,600 18,200 20,800
Vaginal
OG2131 Surgical Treatment Of Ectopic Pregnancy; Abdominal Pregnancy 10400 13,832 15,600 18,200 20,800
Surgical Treatment Of Ectopic Pregnancy; Interstitial, Uterine Pregnancy Requiring
OG2132 13800 18,354 20,700 24,150 27,600
Total Hyst,
Surgical Treatment Of Ectopic Pregnancy; Interstitial, Uterine Pregnancy+Partial
OG2133 13800 18,354 20,700 24,150 27,600
Resection Of Uterus
Total Abdominal Hyst +/- Removal Of Tube(S)/ Ovary(S); With Colpo-Urethrocystopexy
OG2134 17500 23,275 26,250 30,625 35,000
(Eg, Burch)
Code bed
OG2135 Total Abdominal Hysterectomy (Obs Gya) 11800 15,694 17,700 20,650 23,600
OG2136 Total Abdominal Hysterectomy uterus < 250gms 11800 15,694 17,700 20,650 23,600
OG2137 Total Abdominal Hysterectomy, + Removal Of Tube(S)/ Ovary(S) 12500 16,625 18,750 21,875 25,000
Total Lap. Hyst. With Extensive Dense Adhesions Involving Bowel & Bladder Muscle /
OG2138 26400 35,112 39,600 46,200 52,800
Mucosa
Total Lap. Hyst. With More Than 500 Gms/ With Moderate Adhesions/Involving Bowel &
OG2139 26400 35,112 39,600 46,200 52,800
Bladder Serosa R
Total Lap.c Hyst.With Extensive Dense Adhesions Involving Bowel & Bladder
OG2140 26400 35,112 39,600 46,200 52,800
Muscle/Mucosa
OG2143 Total Lapradical Hyst(Tlh) Bilat Pelviic L Ectomy & P-Aortic L N Sampling +/- Bso 26400 35,112 39,600 46,200 52,800
OG2144 Total Laproscopic Hysterectomy With Less Than 250 Gms 21800 28,994 32,700 38,150 43,600
OG2145 Total Valvectomy With Desection Of Nodes 26000 34,580 39,000 45,500 52,000
OG2146 Transcervical Resection Of Endometrium 11900 15,827 17,850 20,825 23,800
Transperineal Closure Rectovaginal Fistula; Perineal Body Reconstruction,+/- Levator
OG2147 11900 15,827 17,850 20,825 23,800
Plication
OG2148 Transvaginal Hydrolaparoscopy Operative level 4 11800 15,694 17,700 20,650 23,600
OG2149 Tuboplasty (Oper Microscopy) Bilateral 24000 31,920 36,000 42,000 48,000
OG2150 Tuboplasty (Oper Microscopy) Unilateral 19500 25,935 29,250 34,125 39,000
OG2151 Tubotubal Anastomosis 12500 16,625 18,750 21,875 25,000
OG2152 Tubouterine Implantation 12500 16,625 18,750 21,875 25,000
Vag. Hyst, >500 G; With Colpo-Urethrocystopexy Type, Pereyra Type) +/- Endoscopic
OG2153 26400 35,112 39,600 46,200 52,800
Control/ Severe Ad
Vag. Hyst, For descebded Uterus >500 G; Without Removal of Tube(S) &/Or
OG2154 21800 28,994 32,700 38,150 43,600
Ovary(S),+Repair Of Enteroce
Page 34
Vag. Hyst, For Uterus >500 G; +Removal Of Tube(S) &/Or Ovary(S),+ Repair Of
OG2155 24000 31,920 36,000 42,000 48,000
Enterocele / Moderate Ad
Vag. Myom, of Uterus, 1 To 4 Myoma/ Total Weight of = > 500 G +/- Removal of Surface
OG2156 12700 16,891 19,050 22,225 25,400
Myomas
Vag. Myom, of Uterus, 1 To 4 Myoma/ Total Weight of = 250-500 G +/- Removal of
OG2157 11800 15,694 17,700 20,650 23,600
Surface Myomas
Vag. Myom, of Uterus, 1 To 4 Myoma/Total Weight of = < 250 G +/- Removal of Surface
OG2158 11000 14,630 16,500 19,250 22,000
Myomas
OG2159 Vaginal Delivery Only, After Previous Cesarean (+/- Episiotomy &/Or Forceps / Vaccum) 12700 16,891 19,050 22,225 25,400
OG2160 Vaginal Hyst, For descended Uterus < 250 G;+ A/P repair 11800 15,694 17,700 20,650 23,600
Vaginal Hyst, For Descended Uterus 250-500 G; With Removal Of Tube(S) &/Or
OG2161 15300 20,349 22,950 26,775 30,600
Ovary(S)/Mild Adh.
Code bed
OG2162 17500 23,275 26,250 30,625 35,000
Ovary(S)/Moderate Adh.
OG2163 19500 25,935 29,250 34,125 39,000
Ovary(S)/Severe Adh.
OG2164 Vaginal Hyst, For Uterus 250 G Or Less With Anterior / Posterior Repair 11800 15,694 17,700 20,650 23,600
OG2165 Vaginal Hyst, For Uterus Greater Than 250 G; With Repair Of Enterocele 15300 20,349 22,950 26,775 30,600
OG2166 Vaginal Hyst, With Total Or Partial Vaginectomy; With Repair Of Enterocele 13500 17,955 20,250 23,625 27,000
OG2167 Vaginal Hyst,Uterus 250 G Or Less; Colpo-Urethrocystopexy (Marshall-M-K / Pereyra) +/- 15300 20,349 22,950 26,775 30,600
OG2168 Endos
Vaginal Hysterectomy, For Uterus 250 G 11000 14,630 16,500 19,250 22,000
OG2169 Vaginal Hysterectomy, For Uterus 250 G Or Less;With Repair Of Enterocele 11800 15,694 17,700 20,650 23,600
OG2170 Vaginal Hysterectomy, Radical (Schauta Type Operation) 19500 25,935 29,250 34,125 39,000
OG2171 Vaginal Hysterectomy, With Total Or Partial Vaginectomy 11800 15,694 17,700 20,650 23,600
OG2172 Vaginectomy (Partial); Removal Paravaginal Tissue (Radical) 17500 23,275 26,250 30,625 35,000
OG2173 Vaginectomy, Complete Removal Of Vaginal Wall+ Removal Of Paravaginal Tissue 17500 23,275 26,250 30,625 35,000
OG2174 Vault Repair 13800 18,354 20,700 24,150 27,600

OG2175 Vesicovaginal Fistula (Wf)(Gyn) 11800 15,694 17,700 20,650 23,600
Vh + Biopsy, Single Or Multiple, Or Local Excis.Of Lesion,+/- Fulguration
OG2176 11800 15,694 17,700 20,650 23,600
(Sep.Proc.)/Mild Adhesiiol
OG2177 Vulvectomy, Radical, Complete 11800 15,694 17,700 20,650 23,600
OG2178 Vulvectomy, Radical, Complete; With Unilateral Inguinofemoral Lymphadenectomy 19500 25,935 29,250 34,125 39,000
OG2179 Vulvectomy, Radical, Partial; With Bilateral Inguinofemoral Lymphadenectomy 12700 16,891 19,050 22,225 25,400
OG2180 Vulvectomy, Radical, Partial; With Unilateral Inguinofemoral Lymphadenectomy 11800 15,694 17,700 20,650 23,600
OG2181 Vulvectomy,Radical,Complete,With Inguinofemoral,Iliac,&Pelvic Lymphadenectomy 30800 40,964 46,200 53,900 61,600
ONCO SURGERY
Code bed
OS1001 Abdominal Wall Tumor With Meshplasty 20,200 26,866 30,300 35,350 40,400
OS1002 Breast Conservation Surgery ( ONCO) 17,500 23,275 26,250 30,625 35,000
OS1003 Breast Limp Excision 10,200 13,566 15,300 17,850 20,400
OS1004 Breast Mrm/Rm 15,500 20,615 23,250 27,125 31,000
OS1005 Chemoport Flushing 1,500 1,995 2,250 2,625 3,000
OS1006 Chemoport Insertion 5,500 7,315 8,250 9,625 11,000
OS1007 Chemoport Placement 10,000 13,300 15,000 17,500 20,000
OS1008 Chemoport Removal/Adjustment 3,000 3,990 4,500 5,250 6,000
OS1009 Chest Wall Excision With Thoracoplasty 22,500 29,925 33,750 39,375 45,000
OS1011 Commando Surgery 20,000 26,600 30,000 35,000 40,000
OS1012 Eva 5,000 6,650 7,500 8,750 10,000
OS1013 Functional/Sohd/Limited Neck Dissection 14,000 18,620 21,000 24,500 28,000
OS1014 Hemi Scrotectomy 8,500 11,305 12,750 14,875 17,000
OS1015 Hemicolectomy 18,500 24,605 27,750 32,375 37,000
OS1016 Hemiglossectomy 15,000 19,950 22,500 26,250 30,000
OS1017 Hepaticoieimostomy/Biopsy 20,000 26,600 30,000 35,000 40,000
OS1018 Hilar Chdangiocarcinoma 25,800 34,314 38,700 45,150 51,600
OS1019 Hysterectomy Radical For Cancer 18,500 24,605 27,750 32,375 37,000
OS1020 Illeoinguinal Lymph Node Dissection 18,000 23,940 27,000 31,500 36,000
OS1021 Inferior Vena Cava Tumor Thrambectomy 18,500 24,605 27,750 32,375 37,000
OS1022 Inguinal Lymph Node Dissection 10,200 13,566 15,300 17,850 20,400
OS1023 Internal Artery Ligation B/L 14,000 18,620 21,000 24,500 28,000
OS1024 Laryngectomy Total 22,800 30,324 34,200 39,900 45,600
OS1025 Lemkoplakia Excision Biopsy 5,000 6,650 7,500 8,750 10,000
OS1026 Liver Wedge Resection 15,400 20,482 23,100 26,950 30,800
OS1027 Lobectomy/Segmentectomy Liver 20,200 26,866 30,300 35,350 40,400
Page 35
OS1028 Mandibulectomy 15,400 20,482 23,100 26,950 30,800
OS1029 Mediastinotomy 11,000 14,630 16,500 19,250 22,000
OS1030 Metastatectomy Lung Multiple/Single 15,400 20,482 23,100 26,950 30,800
OS1031 Oesophagectomy With Colonic Bypass 32,000 42,560 48,000 56,000 64,000
OS1032 Oesophagectomy With Gastric Pull Up 25,000 33,250 37,500 43,750 50,000
OS1033 Omentectomy 14,600 19,418 21,900 25,550 29,200
OS1034 Ovarian Laprotomy For Ovarian Cancer 24,000 31,920 36,000 42,000 48,000
OS1035 Parathyroidectomy 13,000 17,290 19,500 22,750 26,000
OS1036 Pelvic Exenteration Total 30,000 39,900 45,000 52,500 60,000
OS1037 Pelvic Lymph Node Dissection B/L 15,400 20,482 23,100 26,950 30,800
OS1038 Pelvic Lymph Node Dissection U/L 12,200 16,226 18,300 21,350 24,400
OS1039 Picc Line (Central Line Dress) 200 266 300 350 400
OS1040 Picc Line Insertion 4,000 5,320 6,000 7,000 8,000
OS1041 Picc Line Removal 500 665 750 875 1,000
OS1042 Picc Line Repair 500 665 750 875 1,000
OS1043 Radical Cholecystectomy 23,000 30,590 34,500 40,250 46,000
OS1044 Radical Cholecystectomy with Biliary Anastamotis 25,000 33,250 37,500 43,750 50,000
OS1045 Radical Nephrectomy 22,800 30,324 34,200 39,900 45,600
OS1046 Radical Parotidectomy With Neck Disection 18,500 24,605 27,750 32,375 37,000
OS1047 Resection Of Retro Peritoneal Mass 13,500 17,955 20,250 23,625 27,000
OS1048 Seroma Aspiration 1,500 1,995 2,250 2,625 3,000
OS1049 Soft Tissue Sarcoma, Widelocal Excision 12,500 16,625 18,750 21,875 25,000
OS1050 Thymectomy / Mediastinal Mass Excision 22,800 30,324 34,200 39,900 45,600
OS1051 Total Thyroidectomy With Neck Dissection 20,200 26,866 30,300 35,350 40,400
OS1052 Tripple Bypass For Pancreas 20,200 26,866 30,300 35,350 40,400
OS1053 Wide Excision Of Malignant Ulcer 6,000 7,980 9,000 10,500 12,000
Surgical Oncology (Head and Neck)
Service Single
Service Name OPD/Six/ Nine bed Two Bed Dlx Room VIP/Suite
Code Room
Surgery
SO1001 Micro Laryngoscopy With Biopsy/Digonistic 5000 6650 7500 8750 10000
SO1002 Neckmassexcision–Large 12000 15960 18000 21000 24000
SO1003 Neckmassexcision–Simple 6000 7980 9000 10500 12000
SO1004 Neck Mass Excision- Complex 18000 23940 27000 31500 36000
SO1005 Oral Excisional Biopsy (Large) 5000 6650 7500 8750 10000
SO1006 Oral Excisional Biopsy (Small) 3000 3990 4500 5250 6000
SO1007 Buccal Mucosal Radical Excision 16000 21280 24000 28000 32000
SO1008 Commando Operation 28000 37240 42000 49000 56000
SO1009 Composite Oral Resection - Large 28000 37240 42000 49000 56000
SO1010 Composite Oral Resection - Medium 22000 29260 33000 38500 44000
SO1011 Composite Oral Resection (Small) 18000 23940 27000 31500 36000
SO1012 Para –Paharyngeal Excision Small 16000 21280 24000 28000 32000
SO1013 Para –Paharyngeal Excision Large 24000 31920 36000 42000 48000
SO1014 Parathyroidectomy Simple 12000 15960 18000 21000 24000
SO1015 Parathyroidectomy Complex 18000 23940 27000 31500 36000
SO1016 Partial Maxillectomy 12000 15960 18000 21000 24000
SO1017 Infrastructure Maxillectomy 16000 21280 24000 28000 32000
SO1018 Subtotal Maxillectomy 20000 26600 30000 35000 40000
SO1019 Total Maxillectomy 24000 31920 36000 42000 48000
SO1020 Complex Maxillectomy Extended 28000 37240 42000 49000 56000
SO1021 Laryngeal Procedure- Non Specified 12000 15960 18000 21000 24000
SO1022 Partial Laryngectomy 16000 21280 24000 28000 32000
SO1023 Near Total Laryngectomy 20000 26600 30000 35000 40000
SO1024 Total Laryngectomy 24000 31920 36000 42000 48000
SO1025 Total Laryngectomy + Neck Dissection(Nd) 30000 39900 45000 52500 60000
SO1026 Complex Laryngo-Pharyngectomy 30000 39900 45000 52500 60000
SO1027 Superficial Parotidectomy 14000 18620 21000 24500 28000
SO1028 Adequate Parotidectomy 18000 23940 27000 31500 36000
SO1029 Complex Parotidectomy - 26000 34580 39000 45500 52000
SO1030 Total Parotidectomy 22000 29260 33000 38500 44000
SO1031 Hemithyroidectomy 12000 15960 18000 21000 24000
SO1032 Simple Thyroidectomy 16000 21280 24000 28000 32000
SO1033 Total Thyroidectomy 20000 26600 30000 35000 40000
SO1034 Total Thyroidectomy+ Central/ Nd 25000 33250 37500 43750 50000
SO1035 Total Thyroidectomy+ B/L Nd 30000 39900 45000 52500 60000
SO1036 Tracheo-Oesophageal Puncture/ 5000 6650 7500 8750 10000
SO1037 Tracheostomy (Open) - Elective 5000 6650 7500 8750 10000
SO1038 Tracheostomy (Open) - Emergency 6000 7980 9000 10500 12000
SO1039 Tracheostomy (Percutaneous) – 8000 10640 12000 14000 16000
SO1040 Wide Excision Of Lesion In Head And Neck - Complex 25000 33250 37500 43750 50000
SO1041 Wide Excision Of Lesion In Head And Neck - Major 20000 26600 30000 35000 40000
Page 36
SO1042 Wide Excision Of Lesion In Head And Neck-Medium 16000 21280 24000 28000 32000
SO1043 Wide Excision Of Lesion In Head And Neck - Small 12000 15960 18000 21000 24000
SO1044 Lymph Node (Procedure) 2500 3325 3750 4375 5000
SO1045 Laryngoscopy/Hypopharyngoscopy 5000 6650 7500 8750 10000
SO1046 Endoscopic Nasal Biopsy 2200 2926 3300 3850 4400
SO1047 Excision Of Thyroglossal Fistula / Cyst Sinus 8000 10640 12000 14000 16000
SO1048 Extra-Cranial Skull Base Resection 20000 26600 30000 35000 40000
SO1049 Hemiglossectomy 16000 21280 24000 28000 32000
SO1050 Glossectomy – Subtotal 20000 26600 30000 35000 40000
SO1051 Glossectomy With Or Without Mandibulotomy 24000 31920 36000 42000 48000
SO1052 Glossectomy Complex 30000 39900 45000 52500 60000
SO1053 Glossectomy Partial 12000 15960 18000 21000 24000
SO1054 Infra - Temporal Fossa Resection 16000 21280 24000 28000 32000
SO1055 Micro Laryngoscopy With Biopsy 5000 6650 7500 8750 10000
SO1056 Dl Scopy 4500 5985 6750 7875 9000
SO1057 Local Tissue Flap Repair (S) 5000 6650 7500 8750 10000
SO1058 Local Tissue Flap Repair (L) 10000 13300 15000 17500 20000
SO1059 Nasopharyngeal Tumor Excision 8000 10640 12000 14000 16000
SO1060 Pectoralis Major Myocutaneous Flap Reconstruction 14000 18620 21000 24500 28000
SO1061 Pharyngocutaneous Fistula Repair 5000 6650 7500 8750 10000
SO1062 Submandibular Gland Excision (Malignant) With Supra Omohyoid Neck Dissection 14000 18620 21000 24500 28000
SO1063 Vascular Malformation Neck Excision Major 10000 13300 15000 17500 20000
SO1064 Vascular Malformation Neck Excision Minor 5000 6650 7500 8750 10000
SO1065 Cervico-Facial Resc.(Complex) 20000 26600 30000 35000 40000
SO1066 Cervico-Facial Resction (L) 16000 21280 24000 28000 32000
SO1067 Cervico-Facial Resc. (M) 12000 15960 18000 21000 24000
SO1068 Cervico-Facial Resc. (S) 8000 10640 12000 14000 16000
SO1069 Cervico-Facial Resc. Of Vasc Mass Cmplx 24000 31920 36000 42000 48000
SO1070 Cervico-Facial Resc. Of Vasc Mass Smpl 16000 21280 24000 28000 32000
SO1071 Cmplx Facial Repair-(L) 14400 19152 21600 25200 28800
SO1072 Cmplx Facial Repair-(S) 7000 9310 10500 12250 14000
SO1073 Control Of Hemorrhage Cmplx 10000 13300 15000 17500 20000
SO1074 Control Of Hemorrhage Smpl 5000 6650 7500 8750 10000
SO1075 Reexploration 5000 6650 7500 8750 10000
SO1076 Examination Under Anesthesia 4000 5320 6000 7000 8000
SO1077 Debridement (Head & Neck) 8000 10640 12000 14000 16000
SO1078 Flap Delay 6400 8512 9600 11200 12800
SO1079 Flap Inset To H& N 6400 8512 9600 11200 12800
SO1080 Flap Local To Head & Neck Region (L) 12000 15960 18000 21000 24000
SO1081 Flap Not Specified To Head & Neck Site(S) 6400 8512 9600 11200 12800
SO1082 Flap Not Specified To Head& Neck Site(L) 12800 17024 19200 22400 25600
SO1083 Flap Pedicled To Head & Neck Region (L) 16000 21280 24000 28000 32000
SO1084 Flap Pedicled To Head & Neck Region (S) 8000 10640 12000 14000 16000
SO1085 Laryngotracheal Reconstruction Complex 20000 26600 30000 35000 40000
SO1086 Laryngotracheal Reconstruction Major 16000 21280 24000 28000 32000
SO1087 Laryngotracheal Reconstruction Simple 12000 15960 18000 21000 24000
SO1088 Laryngotracheoplasty-Cmplx 16000 21280 24000 28000 32000
SO1089 Laryngotracheoplasty-Smpl 12000 15960 18000 21000 24000
SO1090 Mandibulotomy Approach 12000 15960 18000 21000 24000
SO1091 Maxillary Swing Approach 19000 25270 28500 33250 38000
SO1092 Microlaryngoscopy-Excision Of Mass Cmplx 9600 12768 14400 16800 19200
SO1093 Microlaryngoscopy-Excision Of Mass Smpl 6400 8512 9600 11200 12800
SO1094 Head Neck Exploration Cmplx 12000 15960 18000 21000 24000
SO1095 Head Neck Exploration Major 8000 10640 12000 14000 16000
SO1096 Head Neck Exploration Smpl 4000 5320 6000 7000 8000
SO1097 Neck Mass Excision Cmplx 14000 18620 21000 24500 28000
SO1098 Oral Resc. Not Otherwise Specified ((L)) 16000 21280 24000 28000 32000
SO1099 Oral Resc. Not Otherwise Specified ((M)) 12000 15960 18000 21000 24000
SO1100 Oral Resc. Not Otherwise Specified ((S)) 8000 10640 12000 14000 16000
SO1101 Oro-Antral Fistula Repair Cmplx 14400 19152 21600 25200 28800
SO1102 Oropharyngeal Resc. Major 18000 23940 27000 31500 36000
SO1103 Oropharyngeal Resc. Extensive 24000 31920 36000 42000 48000
SO1104 Oropharyngeal Resc. Limited 12000 15960 18000 21000 24000
SO1105 Pharyngoesophageal Repair 16000 21280 24000 28000 32000
SO1106 Pharyngotomy 16000 21280 24000 28000 32000
SO1107 Repair Head& Neck Cmplx Not Specified 16000 21280 24000 28000 32000
SO1108 Skin Graft To Head & Neck (L) 12000 15960 18000 21000 24000
SO1109 Skin Graft To Head & Neck (S) 4000 5320 6000 7000 8000
SO1110 Skin Graft To Head & Neck Medium 8000 10640 12000 14000 16000
SO1111 Skull Base Surg Approach Not Specified 24000 31920 36000 42000 48000
SO1112 Skull Base Surg C F Approach Lateral 28000 37240 42000 49000 56000
Page 37
SO1113 Skull Base Surgery C F Approach Ant 28000 37240 42000 49000 56000
SO1114 Skull Base Surgery Resc. Of Lesion 16000 21280 24000 28000 32000
SO1115 Temporal Bone Resc. Extensive 24000 31920 36000 42000 48000
SO1116 Temporal Bone Resc. Limited 12000 15960 18000 21000 24000
SO1117 Thyroglossal Cyst Surgery 8000 10640 12000 14000 16000
SO1118 Tracheal Resc. And Anastamosis Complex 24000 31920 36000 42000 48000
SO1119 Tracheal Resc. And Anastamosis Major 18000 23940 27000 31500 36000
SO1120 Tracheal Resc. And Anastamosis Small 12000 15960 18000 21000 24000
SO1121 Transhyoid Approach 16000 21280 24000 28000 32000
SO1122 Transmaxillary Approach To Inf.Temp Fossa 28000 37240 42000 49000 56000
SO1123 Cervico Facial Resection Small 5000 6650 7500 8750 10000
SO1124 Cervico Facial Resection Medium 10000 13300 15000 17500 20000
SO1125 Cervico Facial Resection Large 15000 19950 22500 26250 30000
SO1126 Cervico Facial Resection Complex 20000 26600 30000 35000 40000
SO1127 Neck Mass Biopsy 5600 7448 8400 9800 11200
SO1128 Neck Mass Excision Simple 9000 11970 13500 15750 18000
SO1129 Oral Mucosal Excision Simple 4500 5985 6750 7875 9000
SO1130 Flap Sectioning 6000 7980 9000 10500 12000
SO1131 Flap Local To Head & Neck Region Small 6700 8911 10050 11725 13400
SO1132 Oroantral Fistula Repair Simple 11200 14896 16800 19600 22400
SO1133 Repair Head & Neck Simple Not Specified 11200 14896 16800 19600 22400
SO1134 Repair Oral Multilayer / Cmplx / Mltpl 12000 15960 18000 21000 24000
SO1135 Repair Oral Simple 6000 7980 9000 10500 12000
SO1136 Panendoscopy 5000 6650 7500 8750 10000
SO1137 Interdental Wiring 4000 5320 6000 7000 8000
SO1138 Oral Resection With Microvascular Flap 40000 53200 60000 70000 80000
SO1139 Oral Resection With Free Flap Gr 1 50000 66500 75000 87500 100000
SO1140 Oral Resection With Free Flap Gr2 60000 79800 90000 105000 120000
SO1141 Oral Resection With Free Flap Gr3 70000 93100 105000 122500 140000
SO1142 Oral Resection Complex With Free Flap 80000 106400 120000 140000 160000
SO1143 Oral Resection Complex With Complex Free Flap 90000 119700 135000 157500 180000
SO1144 Microvascular Flap 20000 26600 30000 35000 40000
SO1145 Soft Tissue Free Flap (Small) 25000 33250 37500 43750 50000
SO1146 Soft Tissue Free Flap (Large) 40000 53200 60000 70000 80000
SO1147 Free Bone Flap 30000 39900 45000 52500 60000
SO1148 Free Fibula Reconstruction Simple 35000 46550 52500 61250 70000
SO1149 Free Fibula Reconstruction Complex 45000 59850 67500 78750 90000
SO1150 Soft Tissue Free Flap Medium 32000 42560 48000 56000 64000
SO1151 Free Flap Major 40000 53200 60000 70000 80000
SO1152 Free Flap Complex 50000 66500 75000 87500 100000
SO1153 Neck Dissection-Extended 20000 26600 30000 35000 40000
SO1154 Neck Dissection-Modified / Radical 16000 21280 24000 28000 32000
SO1155 Neck Dissection-Paratracheal 6400 8512 9600 11200 12800
SO1156 Neck Dissection-Selective 14000 18620 21000 24500 28000
SO1157 Neck Dissection-Sup Mediastinal Via Neck 6400 8512 9600 11200 12800
SO1158 Microlaryngoscopy-Excision Of Mass Cmplx 9600 12768 14400 16800 19200
SO1159 Microlaryngoscopy-Excision Of Mass Smpl 6400 8512 9600 11200 12800
SO1160 Lip Excision Cmplx Excluding Repair 12000 15960 18000 21000 24000
SO1161 Lip Excision Smpl 6400 8512 9600 11200 12800
SO1162 Mandibular Lesion Removal-(L) 16000 21280 24000 28000 32000
SO1163 Mandibular Lesion Removal-(S) 4800 6384 7200 8400 9600
SO1164 Mandibulectomy (Marginal) 9600 12768 14400 16800 19200
SO1165 Mandibulectomy (Segmental) 14400 19152 21600 25200 28800
SO1166 Deep Lymph Node (Procedure) 5000 6650 7500 8750 10000
Service Single
Service Name OPD/Six/ Nine bed Two Bed Dlx Room VIP/Suite
Code Room
Procedure
SO2001 Tracheo-Oesophageal Valve Insertion 1000 1330 1500 1750 2000
SO2002 Hopkin’S Scopy 500 660 750 880 1000
SO2003 Hopkin’S Scopy With Print 750 1000 1120 1300 1500
SO2004 Flexible Laryngoscopy 1800 2400 2700 3150 3600
SO2005 Flexible Laryngoscopy With Bx 2400 3200 3600 4200 4800
SO2006 Abscess/Seroma Aspiration (Large) 750 1000 1120 1300 1500
SO2007 Abscess/ Seroma Aspiration (Small) 400 530 600 700 800
SO2008 Core Needle Biopsy (Procedure) 1200 1600 1800 2100 2400
SO2009 Dressing - Large (Procedure) 800 1060 1200 1400 1600
SO2010 Dressing - Medium (Procedure) 500 660 750 880 1000
SO2011 Dressing - Small (Procedure) 300 400 450 500 600
SO2012 Excision Biopsy (Procedure) 2500 3300 4800 4400 5000
SO2013 Incision Biopsy 1200 1600 1800 2100 2400
SO2014 Deep Lymph Node (Procedure) 5000 6650 7500 8750 10000
Page 38
SO2015 Punch Biopsy (Procedure) 1000 1330 1500 1750 2000
SO2016 Suturing - Large (Procedure) 1000 1330 1500 1750 2000
SO2017 Suturing - Small (Procedure)Direct 500 660 750 880 1000
SO2018 Nasal Endoscopy Simple Opd 500 660 750 880 1000
SO2019 Nasal Endoscopy Complex Opd 750 1000 1120 1300 1500
SO2020 Lymph Node (Procedure) 2500 3300 3750 4400 5000
SO2021 Biopsy Mucosa 1750 2,328 2,625 3,063 3,500
OPTHALMOLOGY
Service
Code
INVESTIGATION
OP1001 A Scan Biometry ( One Eye) 600
OP1002 Autoperimetry (Both Eyes) 1,500
OP1003 B-Scan Ultrasound ( One Eye ) 1,200
OP1004 Clinical Photograph (Both Eyes) 600
OP1005 Clinical Photograph (One Eye) 400
OP1006 Corneal Pachymetry (Both Eyes) 500
OP1007 Corneal Topography/OPD Scan ( Both Eyes) 1,000
OP1008 Examination under GA ( GA & Medicine Extra) 3,000
OP1009 Fundus Fluorescien Angiography (Both Eyes) 2,500
OP1010 Gonioscopy (Both Eyes) 700
OP1011 IOL Master 500
OP1012 OCT Scan (Both Eyes) 3,000
OP1013 Pentacam (Both Eyes) 3,000
OP1014 Schirmers (Both Eyes) 200
Surgery /Procedure
OP2001 ARC 5,000
OP2002 Avastin Injection (One Eye ) 13,000
OP2003 Chalazian 5,000
OP2004 Corneal Foreign Body Removal 1,000
OP2005 Corneal Grafting 55,000
OP2006 Corneal Repairs 15,000
OP2007 Cryopexy 5,000
OP2008 CXL (One Eye) 20,000
OP2009 Cyclocryo per sitting 4,000
OP2010 D.C.R. 20,000
OP2011 Electroepilation 1,000
OP2012 Entropion Correction 12,000
OP2013 Focal Laser one eye 2,500
OP2014 Glaucoma Valve or Ahmad Valve (one eye) 45,000
OP2015 ICL (Both Eyes) 95,000
OP2016 IVTA 3,000
OP2017 Laser OFC 5,000
OP2018 Laser charges Per sitting for one eye 2,500
OP2019 Lensectomy with CTR 20,000
OP2020 Laser TrabeculoPlasty for one eye 5,000
OP2021 Prophylactic Laser (Both eyes) 10,000
OP2022 Prophylactic Laser (One Eye) 7,500
OP2023 Pan Retinal Photocogulation for Diabetic Retinopathy Package Laser (B/E 3 Sitting) 12,500
OP2024 Pan Retinal Photocogulation for Diabetic Retinopathy (per sitting) 2,500
OP2025 Probing in GA ( GA & Medicine Extra) 3,000
OP2026 Pterygium Excision 10,000
OP2027 Pterygium Excision with Conjunctival Autografting 25,000
OP2028 PTK 20,000
OP2029 Ptosis Correction 35,000
OP2030 Punctum Plugs 5,000
OP2031 REFRACTIVE SURGERY (Both Eyes) Aspheric Lasik 45,000
OP2032 REFRACTIVE SURGERY (Both Eyes) Z-Lasik 85,000
OP2033 Retinal Detachment 30,000
OP2034 ROP Screening (Both Eyes) 1,500
OP2035 SO Removal 12,000
OP2036 Squint Correction( Both eyes) 30,000
OP2037 Squint Correction (one eye) 27,000
OP2038 Subconjunctival Injection/S.Tenon’s 700
Service
Code
OP2039(A) Syringing one eye 300
OP2039(B) Syringing both eye 600
OP2040 Toric ICL 125,000
Page 39
OP2041 Trabeculectomy 25,000
OP2042 Vitrectomy with PFCL (Laser+Buckle additional) 38,000
OP2043 Vitrectomy with SOI 30,000
OP2044 Vitrectomy without SOI (Laser+Buckle+Membrane peeling additional) 30,000
OP2045 Yag Laser Capsulotomy 2,700
OP2046 Yag Laser Iridotomy 3,500
Cataract Operation with no injection, no stich-Phaco technique
OP2047 Non Aspheric IOL Package 18,000
OP2048 Aspheric IOL Package 32,000
OP2049 MICS with IOL Package 41,500
OP2050 Toric IOL Package 49,500
OP2051 Multifocal IOL Package 60,500
OP2052 Femto Cataract Surgery ( In addition To any of the above package ) 75,000
NOTE :
All Surgery/procedures will be done on OP/Day care basis. Any stay and investigation charges will be additional
All procedures will be done in Local anesthesia. Any GA charges + OT gases charges will be additional
Minor OT/OT charges are included in the package. Routine OT consumables are included.
CHARGES ARE FOR ONE EYE UNLESS SPECIFIED
ORTHOPEADIC
Service stay OPD/ Six/ Nine

Code day bed
Ortho packages
OR3001 Total Knee replacement (U/L) 7 147,000 161,700 191,100 220,500 264,600
OR3002 Total Knee replacement (B/L) 9 199,000 219,900 251,400 282,800 345,600
OR3003 Total hip replacement (U/L) 7 135,000 145,800 179,550 202,500 257,850
OR3004 Total hip replacement (B/L) 10 220,000 251,400 282,900 324,800 377,100
Total Knee replacement (B/L)
OR3005 10 242,000 284,100 315,700 357,700 410,300
(in same admission Surgery Done in 2 sittings)
Total Hip replacement (B/L)
OR3006 10 242,000 284,100 315,700 357,700 410,300
(in same admission Surgery Done in 2 sittings)
Package Includes: Stay up to (7 days for knee/hip U/L, 9 days for knee B/L, 10 days for hip B/L), Surgeon fee, OT charges, anesthesia charge, basic Investigations ,
Routine drugs and consumables , blood units (upto 2), Physiotherapy
Package excludes: Implant cost, additional stay, Professional charges of other consultants, any additional procedure/investigation, CT/MRI and Use of special drugs/
consumables e.g.Immunoglobins, Albumin, TPNs etc..
Basic Investigations include- COMPLETE HEAMOGRAM/PERIPHERIAL SMEAR AND ESR, COAGULATION PROFILE, LFT, RENAL PROFILE, BLOOD SUGAR , X-RAY CHEST,KNEE
/HIP JOINT, ECG, ECHO.
Minor procedure/surgery
OR1001 Above Elbow Plaster 2310 3069 3465 4048 4620
OR1002 Adductor Tenotomy & Obturator Neurectomy 11550 15367 17325 20218 23100
OR1003 Amputation Of Digits - Single 6930 9218 10395 12133 13860
OR1004 Amputation Of Digits Multiple 11550 15367 17325 20218 23100
OR1005 Amputations-Below Knee 11550 15367 17325 20218 23100
OR1006 Application Of Functional Cast Brace(PTB cast) 2893 3850 4345 5060 5786
OR1007 Arthoscopic Lose Body Removal 10978 14597 16467 19217 21956
OR1008 Arthrodesis Of Small Joints - Hand 10978 14597 16467 19217 21956
OR1009 Arthrotomy Ankle 10978 14597 16467 19217 21956
OR1010 Biopsy Bone 6589 8767 9889 11528 13178
OR1011 Biopsy Muscle (Deep) 5434 7227 8151 9515 10868
OR1012 Bone Grafting 10978 14597 16467 19217 21956
OR1013 Carpal Tunnel Decompression (Ortho) 11550 15367 17325 20218 23100
OR1014 Cervical Traction (Spine) 924 1232 1386 1617 1848
OR1016 Closed Reduction Of Fractures And Pop Application 8778 11671 13167 15367 17556
OR1017 Closed Reduction Of Joint Dislocation 6589 8767 9889 11528 13178
OR1018 Closed Reduction Of Small Joints - IP 5434 7227 8151 9515 10868
OR1019 Closed Reduction Of Small Joints - MP 5434 7227 8151 9515 10868
OR1020 Closed Reduction Of Small Joints - MTP 5434 7227 8151 9515 10868
OR1021 Colles Fracture Closed Reduction And Pop Cast 5775 7678 8668 10109 11550
OR1022 Compartment Syndrome - Leg/Foot/Thigh/Forearm 13860 18436 20790 24255 27720
OR1023 Contracture Release 9240 12287 13860 16170 18480
OR1024 Corrective Lesser Toe Surgery 6589 8767 9889 11528 13178
OR1025 Corrective Surgery Greater Toe 9823 13068 14740 17193 19646
OR1026 CTEV - Manipulation And Corrective Cast 2893 3850 4345 5060 5786
OR1027 CTEV - Manipulation And Corrective Cast B/L 4620 6149 6930 8085 9240
OR1028 De Querveins Release 5775 7678 8668 10109 11550
OR1029 Diagnostic Arthroscopy - Knee 10978 14597 16467 19217 21956
Code bed
OR1030(A) Drainage Abscess (Incision & Drainage)- minor 5544 7370 8316 9702 11088
Page 40
OR1030(B) Drainage Abscess (Incision & Drainage)-major 9240 12287 13860 16170 18480
OR1032 Excision Head Of Radius 9240 12287 13860 16170 18480
OR1033 Excision Of Accessory Navicular 8778 11671 13167 15367 17556
OR1034(A) Excision Of Bone Tumors 9823 13068 14740 17193 19646
OR1034(B) Excision Of Bone Tumors (major) 17325 23045 25993 30316 34650
OR1035 Excision Of Bursa / Bakers Cyst 9240 12287 13860 16170 18480
OR1036 Excision Of Fibula 8668 11528 13002 15169 17336
OR1037 Excision Of Ganglion 7854 10450 11781 13750 15708
OR1038 Excision Of Lower End Ulna 8668 11528 13002 15169 17336
OR1039 Fasciotomy - Forearm 8778 11671 13167 15367 17556
OR1040 Fasciotomy - Leg 8778 11671 13167 15367 17556
OR1041 Hamstring Release 8778 11671 13167 15367 17556
OR1042 Ingrowing Toe Nail Excision (Multiple) 5775 7678 8668 10109 11550
OR1043 Injection Intra Articular (In OT) 1738 2310 2607 3047 3476
OR1044 Injection Intra Articular (Opd/Bedside) 1155 1540 1738 2024 2310
OR1045 Joint Aspiration In OT 1738 2310 2607 3047 3476
OR1046 K-Wire Fixation Of Single Bones - Foot 7513 9988 11275 13145 15026
OR1047 K-Wire fixation Of Single Bones- Hand 7513 9988 11275 13145 15026
OR1048 Manipulation Of Joints 4389 5841 6589 7678 8778
OR1049 Manipulation Of Joints - Elbow 4389 5841 6589 7678 8778
OR1050 Manipulation Of Joints - Knee 4389 5841 6589 7678 8778
OR1051 Manipulation Of Joints - Shoulder 4389 5841 6589 7678 8778
OR1053 Orif Long Bones Of Upper \Lower limb Procedure 17325 23045 25993 30316 34650
OR1054 Orif Small Bones (K-Wire) 8668 11528 13002 15169 17336
OR1055 (A) Osteomyelitis - Surgical Decompression - minor 10978 14597 16467 19217 21956
OR1055(B) Osteomyelitis - Surgical Decompression - major 13860 18436 20790 24255 27720
OR1055(C ) Osteomyelitis - Surgical Decompression - extensive 17325 23045 25993 30316 34650
OR1056 Pelvic Traction 1848 2453 2772 3234 3696
OR1057 Percutaneous K\ Screw - Wire Fixation Under C- Arm - Minor 5775 7678 8668 10109 11550
OR1058 Percutaneous K\ Screw - Wire Fixation Under C- Arm Major 10978 14597 16467 19217 21956
OR1059 POP Above Elbow Cast Application 3003 3993 4510 5258 6006
OR1060 POP Above Elbow Slab Application 2431 3234 3652 4257 4862
OR1061 POP Above Knee Cast Application 3465 4609 5203 6061 6930
OR1062 POP Above Knee Slab Application 3003 3993 4510 5258 6006
OR1063 POP Application - With Closed Reduction Of Fracture Under LA 4389 5841 6589 7678 8778
OR1064 Major Joint Interposition Arthroplasty 17325 23045 25993 30316 34650
OR1065 POP Below Elbow Cast Application 1848 2453 2772 3234 3696
OR1066 POP Below Elbow Slab Application 1276 1694 1914 2233 2552
OR1067 POP Below Knee Cast Application 2431 3234 3652 4257 4862
OR1068 POP Below Knee Slab Application 1848 2453 2772 3234 3696
OR1069 POP Hip Spica Application Single 5544 7370 8316 9702 11088
OR1070 POP Removal 462 616 693 814 924
OR1071 POP Shoulder Spica Application 5544 7370 8316 9702 11088
OR1072 Primary Nerve Repair 13860 18436 20790 24255 27720
OR1073 Pulled Elbow Manipulation 759 1012 1144 1331 1518
OR1074 Readjustment Of Fixator 5544 7370 8316 9702 11088
OR1075 Removal Of Exostosis 9240 12287 13860 16170 18480
OR1076 Removal Of Fixator 1738 2310 2607 3047 3476
OR1077 Removal Of Fixator In OT Under GA 4389 5841 6589 7678 8778
OR1078 Removal Of Implants - Long Bones - Upper Limb 9240 12287 13860 16170 18480
OR1079 Removal Of Implants - Long Bones Lower Limb 9240 12287 13860 16170 18480
Code bed
OR1080 Removal Of K-Wire / Screw Removal/Nail Dynamization 2893 3850 4345 5060 5786
OR1081 Secondary Closure Of Wound 4389 5841 6589 7678 8778
OR1082 Skeletal Traction 1738 2310 2607 3047 3476
OR1083 Skeletal Traction Under GA 4279 5687 6424 7491 8558
OR1084 Skin Grafting 9240 12287 13860 16170 18480
OR1085 Skull Traction 7623 10142 11440 13343 15246
OR1086 Strapping Figure Of 8 Bandages 1155 1540 1738 2024 2310
OR1087 Tendon Repair - Foot 8778 11671 13167 15367 17556
OR1088 Tendon Repair - Hand 8778 11671 13167 15367 17556
OR1089 Trigger Finger Release 9240 12287 13860 16170 18480
OR1090 Wound Debridement (Ortho) Minor 1738 2310 2607 3047 3476
OR1091 Wound Debridement (Ortho) Major 4279 5687 6424 7491 8558
OR1092 Wound Debridement (Ortho) Extensive 6930 9218 10395 12133 13860
OR1093 Aspiration Of Joints 2079 2761 3124 3641 4158
OR1094 K-Wire Removal 583 770 880 1023 1166
OR1095 Single Agent Biophosphate Administration 748 990 1122 1309 1496
OR1096 Single agent bisphosphonate administration 748 990 1122 1309 1496
Page 41
Major Surgery
OR2001 Acetabular / Pelvic Fixation 26565 35332 39853 46486 53130
OR2002 Accetabulum With Hip Dislocation 26565 35332 39853 46486 53130
OR2003 Fracture Pelvic Fix Application 17325 23045 25993 30316 34650
OR2004 Acromioplasty - Sub Acromial Decompression & Excision Of Lateral End Of Clavicle 17325 23045 25993 30316 34650
OR2005 All Reconstructions 14443 19206 21670 25278 28886

OR2006 Amputation - Fore Quarter 21945 29183 32923 38401 43890
OR2007 Amputation - Hind Quarter 26565 35332 39853 46486 53130
OR2008 Amputation -AE 13860 18436 20790 24255 27720
OR2009 Amputation -AK 13860 18436 20790 24255 27720
OR2010 Amputation -BE 11550 15367 17325 20218 23100
OR2011 Amputation -BK 11550 15367 17325 20218 23100
OR2014 Ao Compression Procedure For Facture Neck Femur 20790 27654 31185 36388 41580
OR2015 Arthrodesis Of Major Joints - Hip 24255 32263 36388 42449 48510
OR2016 Arthrodesis Of Major Joints - Knee 21945 29183 32923 38401 43890
OR2017 Arthrodesis Of Major Joints - Pantalar 21945 29183 32923 38401 43890
OR2018 Arthrodesis Of Major Joints - Shoulder 21945 29183 32923 38401 43890
OR2019 Arthrodesis Of Major Joints Elbow 21945 29183 32923 38401 43890
OR2020 Arthrodesis Of Small Joints - Foot 13860 18436 20790 24255 27720
OR2021 Arthroscopic Acl Reconstruction 26565 35332 39853 46486 53130
OR2022 Arthroscopic Acromioplasty 21945 29183 32923 38401 43890
OR2023 Arthroscopic And Osseochondral Fracture/Lesion Fix 21945 29183 32923 38401 43890
OR2024 Arthroscopic Excision Of Cyst 16753 22286 25135 29315 33506
OR2025 Arthroscopic Joint Debridement 13288 17677 19932 23254 26576
OR2026 Arthroscopic Meniscal Repair 27720 36872 41580 48510 55440
OR2027 Arthroscopic Menisectomy 16170 21505 24255 28303 32340
OR2028 Arthroscopic Pcl Reconstruction 32923 43791 49390 57618 65846
OR2029 Arthroscopic Synovectomy Knee 21945 29183 32923 38401 43890
OR2030 Arthroscopic Synovectomy Shoulder 21945 29183 32923 38401 43890
OR2031 Arthroscopic Synovectomy Wrist 16753 22286 25135 29315 33506
OR2032 Arthroscopy - Therapeutic : Without Implant 13860 18436 20790 24255 27720
OR2033 Arthroscopy-Therapeutic With Implant 20790 27654 31185 36388 41580
OR2034 Arthrotomy Hip 17325 23045 25993 30316 34650
Service
Code
OR2035 Arthrotomy Knee 12705 16896 19063 22231 25410
OR2036 Arthrotomy Wrist 12705 16896 19063 22231 25410
OR2037 Bipolar Arthroplasty 23100 30723 34650 40425 46200
OR2038 Bone Grafting For Fracture Non Union 23100 30723 34650 40425 46200
OR2039 Change Of Tibial Articular Height 16170 21505 24255 28303 32340
OR2040 Closed Nailing Of Long Bones - Humerus 17325 23045 25993 30316 34650
OR2041 Closed Nailing Of Long Bones - Tibia/Fibula 17325 23045 25993 30316 34650
OR2042 Closed Nailing Of Long Bones - Ulna/Radius 20790 27654 31185 36388 41580
OR2043 Closed Nailing Of Long Bones Femur 20790 27654 31185 36388 41580
Closed Reduction Percutaneous K Wire And Above Elbow Cast For Supracondylar
OR2044 12705 16896 19063 22231 25410
Fracture
OR2046 Complex Knee Ligament Reconstruction And Stabilisation 32340 43010 48510 56595 64680
OR2049 Core Decompression 17325 23045 25993 30316 34650
OR2050 Core Decompression/Fibular Sturt Graft 23100 30723 34650 40425 46200
OR2054 Cross Finger Flaps 14443 19206 21670 25278 28886
OR2055 Ctev (Club Foot) Corrective Bone Surgery 17325 23045 25993 30316 34650
OR2056 Curretage Of Tumor And Bone Grafting 19063 25355 28600 33363 38126
OR2059 Diagnostic Arthroscopy - Ankle 13860 18436 20790 24255 27720
OR2060 Diagnostic Arthroscopy - Hip 16170 21505 24255 28303 32340
OR2061 Diagnostic Arthroscopy-Shoulder 13860 18436 20790 24255 27720
OR2062 Diagnostic Arthroscopy - Wrist 13860 18436 20790 24255 27720
OR2063 Difficult And Complex Fracture Fixation 24255 32263 36388 42449 48510
OR2064 Disarticulation - Ankle 13288 17677 19932 23254 26576
OR2065 Disarticulation - Elbow 13860 18436 20790 24255 27720
OR2066 Disarticulation - Hip 21945 29183 32923 38401 43890
OR2068 Excision Of Bone Tumors - Deep 17325 23045 25993 30316 34650
OR2069 External Fixator For Fracture Long Bones Upper Limb 13288 17677 19932 23254 26576
OR2070 External Fixator For Fracture long Bones Lower Limb 17325 23045 25993 30316 34650
OR2071 Fixation Aeromio Cervicular Joint Dislocation 16170 21505 24255 28303 32340
OR2072 Fixation Of Fracture Around Hip-D.H.S./Cannulated Screw 23100 30723 34650 40425 46200
OR2075 Fusion - Sub Talar 17325 23045 25993 30316 34650
OR2076 Fusion - Tripple Arthrodesis 23100 30723 34650 40425 46200
OR2077 Girdlestone Arthroplasty 17325 23045 25993 30316 34650
OR2078 Ilizarov & Complex External Fixator 23100 30723 34650 40425 46200
OR2079 Infected Tka First Stage 17325 23045 25993 30316 34650
Page 42
OR2080 Infected Tka Joint Debridement + Poly Exchange 17325 23045 25993 30316 34650
Service
Code
OR2081 Infected Tka Second Stage 28875 38401 43318 50534 57750
OR2082 Jpatellar Realignment Procedure 17325 23045 25993 30316 34650
OR2083 K Wire Fixation Multiple (Foot And Hand) 12705 16896 19063 22231 25410
OR2087 Local Flaps 13860 18436 20790 24255 27720
OR2088 Major Tendon Transfers 17325 23045 25993 30316 34650
OR2091 Microvascular Free Flap(Plastic) 32340 43010 48510 56595 64680
OR2092 Mosaic Plasty -Knee 26565 35332 39853 46486 53130
OR2093 Multiple Hand Fracture And Tendon Injuries With Skin Loss 26565 35332 39853 46486 53130
OR2094 Multiple Hand Fracture Without Skin Loss 17325 23045 25993 30316 34650
OR2095 Nerve Decompression (Ortho) 11550 15367 17325 20218 23100
OR2096 Open Reduction Of Joint Dislocation (Major) Hip,Elbow,Knee,Shoulder 17325 23045 25993 30316 34650
OR2097 Open Reduction Of Joint Dislocation (Minor) 12705 16896 19063 22231 25410
OR2098 Open Reduction With Internal Fixation With Bone Grafting Major 20790 27654 31185 36388 41580
OR2099 Open Reduction With Internal Fixation With Bone Grafting Minor 11550 15367 17325 20218 23100
OR2100 Open Synovectomy - Wrist 13860 18436 20790 24255 27720
OR2101 Open Synovectomy -Knee 13860 18436 20790 24255 27720
OR2102 ORIF - Periprosthetic Fractures 28875 38401 43318 50534 57750
OR2103(A) ORIF Bimalleolar Fracture Ankle 20790 27654 31185 36388 41580
OR2103(B) ORIF Elbow 13860 18436 20790 24255 27720
OR2104 ORIF Both Bone Forearm 20790 27654 31185 36388 41580
OR2105 ORIF Fracture Claceneum 17325 23045 25993 30316 34650
OR2106 ORIF Fracture Clavicle 18480 24574 27720 32340 36960
OR2107 ORIF Fracture Lateral Malleolus 13860 18436 20790 24255 27720
OR2108 ORIF Fracture Lower End Radius 17325 23045 25993 30316 34650
OR2109 ORIF Fracture Medial Malleolus 13860 18436 20790 24255 27720
OR2110 ORIF Fracture Olecranon 13860 18436 20790 24255 27720
OR2111 ORIF Fracture Patella 16291 21670 24442 28512 32582
OR2112 ORIF Fracture Radial Head 13860 18436 20790 24255 27720
OR2113 ORIF Fracture Scaphoid 17325 23045 25993 30316 34650
OR2114 ORIF Fracture Supracondylar Humerus 13860 18436 20790 24255 27720
OR2115 ORIF Fracture Talus 16753 22286 25135 29315 33506
OR2116 ORIF Single Bone Forearm 12705 16896 19063 22231 25410
OR2117 Osteotomy - Around Hip 18480 24574 27720 32340 36960
OR2118 Osteotomy - Calcaneal 12705 16896 19063 22231 25410
OR2119 Osteotomy - French 13860 18436 20790 24255 27720
OR2120 Osteotomy - High Tibial 17325 23045 25993 30316 34650
OR2121 Paediatric Hip Surgery - Open Reduction Of CDH 18480 24574 27720 32340 36960
OR2122 Paediatric Hip Surgery - Perthes/ SCFE/ Open Reduction Of CDH 18480 24574 27720 32340 36960
Service
Code
OR2123 Paediatric Hip Surgery - SCFE 18480 24574 27720 32340 36960
OR2124 Patella Replacement 16170 21505 24255 28303 32340
OR2125 Patellectomy 16170 21505 24255 28303 32340
OR2128 Total Joint Replacement - Unilateral - Elbow 34650 46090 51975 60643 69300
OR2131 Total Joint Replacement - Unilateral - Wrist 27720 36872 41580 48510 55440
OR2132 Total Joint Replacement Unilateral - Ankle 27720 36872 41580 48510 55440
OR2133 Total Joint Replacement-Unilateral - Shoulder 34650 46090 51975 60643 69300
OR2134 Total Joint Replacement - Bilateral - Elbow 50820 67595 76230 88935 101640
OR2137 Total Joint Replacement - Bilateral - Wrist 50820 67595 76230 88935 101640
OR2138 Total Joint Replacement Bilateral - Ankle 50820 67595 76230 88935 101640
OR2139 Total Joint Replacement-Bilateral - Shoulder 50820 67595 76230 88935 101640
OR2140 Quadriceps Plasty Without Arthroscopy 16401 21813 24607 28699 32802
OR2141 Recurrent Dislocation Patella Stabilization - (Open Method) 17325 23045 25993 30316 34650
OR2142 Recurrent Dislocation Stabilization - Shoulder/Elbow (Arthroscopic Method) 26565 35332 39853 46486 53130
OR2143 Recurrent Dislocation Stabilization - Shoulder/Elbow (Open Method) 23100 30723 34650 40425 46200
OR2144 Removal Of Cyst/ Loose Body From Knee 16170 21505 24255 28303 32340
OR2145 Removal Of Fracture Fragment - Hip 17325 23045 25993 30316 34650
OR2146 Repair Of Multiple Tendons Of Hand 17325 23045 25993 30316 34650
OR2147 Resurface Hip Arthroplasty Unilateral 34650 46090 51975 60643 69300
OR2148 Revision THR (One Stage) 36960 49159 55440 64680 73920
OR2149 Revision TKR (One Stage) 34650 46090 51975 60643 69300
OR2150 Rotation Flaps 16170 21505 24255 28303 32340
OR2151 Rotator Cuff Repair - Open With Sub Acromial Decompression 17325 23045 25993 30316 34650
OR2153 Sequestractomy & Saucerization - Arthrotomy 16170 21505 24255 28303 32340
OR2154 Shoulder Arthroscopy. Rotator Cuff Repair 32340 43010 48510 56595 64680
OR2155 Single Nerve Repair - Major Nerve 13860 18436 20790 24255 27720
OR2156 Single Tendon Grafting 12705 16896 19063 22231 25410
OR2157 Small Joint Replacement 17325 23045 25993 30316 34650
Page 43
OR2158 Soft Tissue Operation of Joints -Large 20218 26895 30327 35387 40436
OR2163 Cavitatory Tumor Resection & Graft 19635 26114 29458 34364 39270
OR2164 Unicompartment Knee Replacement - Unilateral 26565 35332 39853 46486 53130
OR2165 Vascular Repair Artery & Vien 20790 27654 31185 36388 41580
OR2166 Vascular Repair With Vien Grafts 27720 36872 41580 48510 55440
OR2167 Large Tumor Resection With Mega Prosthetic Replacement 40425 53768 60643 70741 80850
OR2168 Large Tumor Resection With Mega Prosthetic Replacement/Muscle Flap 46200 61446 69300 80850 92400
OR2169 ORIF complex fracture upper limb 17325 23045 25993 30316 34650
OR2170 ORIF complex fracture Lower limb 20790 27654 31185 36388 41580
OR2171 Complex Hip fracture 28875 38401 43318 50534 57750
OR2172 Tenotomy plus COP for CTEV U/L 5775 7678 8668 10109 11550
OR2173 Tenotomy plus COP for CTEV B/L 8668 11528 13002 15169 17336
OR2174 Soft tissue release for CTEV U/L 11550 15367 17325 20218 23100
OR2175 Soft tissue release for CTEV B/L 17325 23045 25993 30316 34650
OR2176 Arthrolysis Elbow 17325 23045 25993 30316 34650
OR2177 Judet Quadricep plasty standard 17325 23045 25993 30316 34650
OR2178 Judet Quadricep plasty extensive 23100 30723 34650 40425 46200
OR2179 Shoulder Hemiarthroplasty 28875 38401 43318 50534 57750
OR2180 Distal forearm osteotomy 17325 23045 25993 30316 34650
OR2181 Deformity correction minor 13860 18436 20790 24255 27720
OR2182 Deformity correction standard 17325 23045 25993 30316 34650
OR2183 Deformity correction major 23100 30723 34650 40425 46200
PAIN CLINIC
Code bed
PC1001 Epidural Steroid Injection/Arterial Line 4,500 5,985 6,750 7,875 9,000
PC1002 Intracostal Block For Pain Relief 1,250 1,663 1,875 2,188 2,500
PC1003 Peripheral Nerve Block 2,000 2,660 3,000 3,500 4,000
PC1004 Re Injection Of Trigeminal N Within Seven Days 1,000 1,330 1,500 1,750 2,000
PC1005 Stellate Ganglion Block 1,250 1,663 1,875 2,188 2,500
PC1006 Trigeminal N 10,000 13,300 15,000 17,500 20,000
PAEDIATRIC
Code bed
Investigation
PD1001 ABG Sampling 600 798 900 1,050 1,200
PD1002 Oto Acountic Emission 800 1,064 1,200 1,400 1,600
PAEDIATRIC PROCEDURES
PD2001 Abscess Incision & Drainage Large 4,000 5,320 6,000 7,000 8,000
PD2002 Arterial Line 3,000 3,990 4,500 5,250 6,000
PD2003 Cpap Procedure Charges 1,500 1,995 2,250 2,625 3,000
PD2004 Cvp Line 3,000 3,990 4,500 5,250 6,000
PD2005 Et Intubation 1,200 1,596 1,800 2,100 2,400
PD2006 Exchange Transfusion With Total Double Volume 7,500 9,975 11,250 13,125 15,000
PD2007 Foetal Monitoring CTG 760 1,011 1,140 1,330 1,520
PD2008 Initiation Of Ventilation (One Time Charge) 3,000 3,990 4,500 5,250 6,000
PD2009 Nasotracheal Et Intubation 1,200 1,596 1,800 2,100 2,400
PD2010 Neonatal Attendence At Delivery 3,000 3,990 4,500 5,250 6,000
PD2011 Pain Relief & IU Section 2,000 2,660 3,000 3,500 4,000
PD2012 Partial Exchange Transfusion 3,500 4,655 5,250 6,125 7,000
PD2013 Rt Insertion 750 998 1,125 1,313 1,500
PD2014 Surfectant Therapy 3,500 4,655 5,250 6,125 7,000
PD2015 Umblical Arterial/Venous Catherization 2,500 3,325 3,750 4,375 5,000
PD2016 Phototherapy 900 1,197 1,350 1,575 1,800
PAEDIATRIC SURGERY
PD3001 Abdominoperineal Pull Through (Duhamels) 14,000 18,620 21,000 24,500 28,000
PD3002 Abscess Incision & Drainage 2,100 2,793 3,150 3,675 4,200
PD3003 Anal Dilatation 2,000 2,660 3,000 3,500 4,000
PD3004 Anal Transposition For Ectopic Anus 6,700 8,911 10,050 11,725 13,400
PD3005 Antireflux Surgery (Fundoplication) 14,000 18,620 21,000 24,500 28,000
PD3006 Appendicetomy 7,800 10,374 11,700 13,650 15,600
PD3007 Biliary Atresia (Asais Portoenterostomy) 19,500 25,935 29,250 34,125 39,000
PD3008 Biopsy Rectal 2,900 3,857 4,350 5,075 5,800
PD3009 Bladder Exostrophy Repair (Bladder Turn In) 19,500 25,935 29,250 34,125 39,000
PD3010 Bladder Exostrophy Repair Complete Repair 21,500 28,595 32,250 37,625 43,000
PD3011 Branchial Fistula 9,800 13,034 14,700 17,150 19,600
PD3012 Bronchoscopy With Foreign Body Removal 6,000 7,980 9,000 10,500 12,000
PD3013 Choledochal Cyst Excision 19,500 25,935 29,250 34,125 39,000
PD3014 Chordee Correction 6,700 8,911 10,050 11,725 13,400
PD3015 Circumcision 4,500 5,985 6,750 7,875 9,000
Page 44
PD3016 Cleft Lip Repair 11,000 14,630 16,500 19,250 22,000
PD3017 Cleft Palate Repair (Complete Cleft) 11,000 14,630 16,500 19,250 22,000
PD3018 Cleft Palate Repair (Incomplete Cleft) 13,000 17,290 19,500 22,750 26,000
PD3019 Clitorovaginoplasty (Feminizing Genitoplasty) 21,500 28,595 32,250 37,625 43,000
PD3020 Colostomy & Multiple Colonic Biopsies 11,000 14,630 16,500 19,250 22,000
PD3021 Colostomy 12,000 15,960 18,000 21,000 24,000
PD3022 Colostomy Closure 8,500 11,305 12,750 14,875 17,000
PD3023 Congenital Diaphragmatic Hernia 21,500 28,595 32,250 37,625 43,000
PD3024 Cystolithotomy 6,500 8,645 9,750 11,375 13,000
PD3025 Cystoscopic Fulguration Of Posterior Urethral Valves 11,000 14,630 16,500 19,250 22,000
PD3026 Dep Seated Abscess Drainage 4,800 6,384 7,200 8,400 9,600
PD3027 Diaphragm Eventeration Repair 16,000 21,280 24,000 28,000 32,000
PD3028 Epispadias Repair 11,000 14,630 16,500 19,250 22,000
PD3029 Esophageal Atresia With Tef (Primary Repair) 21,500 28,595 32,250 37,625 43,000
PD3030 Esophageal Replacement Surgery (Gastric Pull -Up) 21,500 28,595 32,250 37,625 43,000
PD3031 Esophagostomy & Gastrotomy 9,600 12,768 14,400 16,800 19,200
PD3032 Excision Cyst / Tumour Benign Small 3,800 5,054 5,700 6,650 7,600
Code bed
PD3033 Excision Of Tumor 4,800 6,384 7,200 8,400 9,600
PD3034 Excision Scrococcygeal Teratoma 16,000 21,280 24,000 28,000 32,000
PD3035 Excision Wide Rhabdomyosarcoma 16,000 21,280 24,000 28,000 32,000
PD3036 Exomphalos 19,500 25,935 29,250 34,125 39,000
PD3037 Gastroschisis Repair 19,500 25,935 29,250 34,125 39,000
PD3038 Gastrostomy 6,500 8,645 9,750 11,375 13,000
PD3039 Hemicolectomy Unilateral 8,000 10,640 12,000 14,000 16,000
PD3040 Hemi-Nephroureterectomy 17,000 22,610 25,500 29,750 34,000
PD3041 Hernia Epigastric 7,600 10,108 11,400 13,300 15,200
PD3042 Hernia Inguinal Bilateral 11,000 14,630 16,500 19,250 22,000
PD3043 Hernia Inguinal unilateral 8,000 10,640 12,000 14,000 16,000
PD3044 Hernia Umbilical 7,600 10,108 11,400 13,300 15,200
PD3045 Intussusception Reduction 9,800 13,034 14,700 17,150 19,600
PD3046 Laparotomy 7,600 10,108 11,400 13,300 15,200
PD3048 Liver Hydatid 14,500 19,285 21,750 25,375 29,000
PD3049 Lymph Node Biopsy 4,800 6,384 7,200 8,400 9,600
PD3050 Malrotation Of Intestine 9,600 12,768 14,400 16,800 19,200
PD3051 Meatotomy 2,000 2,660 3,000 3,500 4,000
PD3052 Meckels Diverticulectomy 8,700 11,571 13,050 15,225 17,400
PD3053 Neonatal Intestinal Atresia 12,800 17,024 19,200 22,400 25,600
PD3054 Nephrectomy / Nephroureterectomy 12,800 17,024 19,200 22,400 25,600
PD3055 Nephrostomy Open 12,000 15,960 18,000 21,000 24,000
PD3056 Nephrostomy Percutaneous 5,100 6,783 7,650 8,925 10,200
PD3057 Orchidopexy Bilateral 11,500 15,295 17,250 20,125 23,000
PD3058 Orchidopexy Unilateral 8,000 10,640 12,000 14,000 16,000
PD3059 Ovarian Cystectomy 11,000 14,630 16,500 19,250 22,000
PD3060 Pediatric Bronchoscopy - Diagnostic 8,000 10,640 12,000 14,000 16,000
PD3061 Pediatric Bronchoscopy - Removal Of Foreign Body 10,000 13,300 15,000 17,500 20,000
PD3062 Posterior Sagittal Anorctoplasty 21,000 27,930 31,500 36,750 42,000
PD3063 Prepucial Adhesions Deduction 1,750 2,328 2,625 3,063 3,500
PD3064 Pulmonary Hydatid 16,000 21,280 24,000 28,000 32,000
PD3065 Pyelolithotomy 8,800 11,704 13,200 15,400 17,600
PD3066 Pyeloplasty 12,600 16,758 18,900 22,050 25,200
PD3067 Pyloric Stenosis (Pyloromyotomy) 8,700 11,571 13,050 15,225 17,400
PD3068 Rectal Polyp 4,800 6,384 7,200 8,400 9,600
PD3069 Rescetion & Anastamosis Of Intestine 11,000 14,630 16,500 19,250 22,000
PD3070 Rigid Bronchoscopy (Paed) 6,000 7,980 9,000 10,500 12,000
PD3071 Spina Bifida Repair (Large) 13,800 18,354 20,700 24,150 27,600
PD3072 Spina Bifida Repair (Small) 11,000 14,630 16,500 19,250 22,000
PD3073 Splenectomy 11,000 14,630 16,500 19,250 22,000
PD3074 Suprapubic Cystostomy 6,500 8,645 9,750 11,375 13,000
PD3075 Syndactyly Release 11,000 14,630 16,500 19,250 22,000
PD3076 Thoracotomy & Cyst Excision 16,000 21,280 24,000 28,000 32,000
PD3077 Thoracotomy & Decortication 13,000 17,290 19,500 22,750 26,000
PD3078 Thoracotomy Lobectomy 16,000 21,280 24,000 28,000 32,000
PD3079 Throcotomy Pneumonectomy 21,500 28,595 32,250 37,625 43,000
PD3080 Thyroglossal Cyst 8,500 11,305 12,750 14,875 17,000
PD3081 Torsion Testis 7,500 9,975 11,250 13,125 15,000
PD3082 Torticollis Release 9,800 13,034 14,700 17,150 19,600
PD3083 Ureteric Reimplantation - Bilateral 19,500 25,935 29,250 34,125 39,000
PD3084 Ureteric Reimplantation - Unilateral 13,000 17,290 19,500 22,750 26,000
PD3085 Ureterostomy Bilateral 11,000 14,630 16,500 19,250 22,000
Page 45
PD3086 Ureterostomy Unilateral 8,500 11,305 12,750 14,875 17,000
PD3087 Urethral Dilatation 2,000 2,660 3,000 3,500 4,000
PD3088 Urethral Fistula Repair 13,000 17,290 19,500 22,750 26,000
PD3089 Urethroplasty Second stage Correction 16,000 21,280 24,000 28,000 32,000
PD3090 Urethroplasty Single Stage Distal Hypospadias 16,000 21,280 24,000 28,000 32,000
PD3091 Urethroplasty Single Stage Mid/Pros Hypospadias 19,500 25,935 29,250 34,125 39,000
PD3092 Ventriculo - Peritoneal Shunt Placement 11,000 14,630 16,500 19,250 22,000
PD3093 Vesicostomy 8,500 11,305 12,750 14,875 17,000
PD3094 Vilms Tumour / Neuroblastoma Excision 17,000 22,610 25,500 29,750 34,000
PHYSIOTHERAPY
Code bed
PT1001 Antenatal Classes 1,000 1,330 1,500 1,750 2,000
PT1002 Combination Therapy Upto Two Modalities 380 505 570 665 760
PT1003 Combination Therapy Upto Three Modalities 550 732 825 963 1,100
PT1004 Combination Therapy Upto Five Modalities 900 1,197 1,350 1,575 1,800
PT1005 Combination Therapy Upto Six/ Nine Modalities 700 931 1,050 1,225 1,400
PT1006 Continous Passive Mobilizer 200 266 300 350 400
PT1007 Exercise Thetrapy+ Chest Therapy 200 266 300 350 400
PT1008 Exercises Teaching 200 266 300 350 400
PT1009 Exercises Therapy Upto 15 Min 300 399 450 525 600
PT1010 Exercises Therapy Up To 30 Mins 400 532 600 700 800
PT1011 Exercises Therapy Up To 45 Mins 450 599 675 788 900
PT1012 Gym Charges Three Months 2,500 3,325 3,750 4,375 5,000
PT1013 Gym Charges One Month 1,000 1,330 1,500 1,750 2,000
PT1014 Gym Charges One Year 7,500 9,975 11,250 13,125 15,000
PT1015 Hot/Cold Packs 200 266 300 350 400
PT1016 Interferential Therapy 200 266 300 350 400
PT1017 Isokinetics 200 266 300 350 400
PT1018 Laser Unit/ Biofeed Back 220 293 330 385 440
PT1019 Muscle Stimulator 200 266 300 350 400
PT1020 Paraffin Wax Bath 200 266 300 350 400
PT1021 Physiotherapy At Home (10 Visits) 6,000 6,000 6,000 6,000 6,000
PT1024 Physiotherapy Charges 200 266 300 350 400
PT1025 Physiotherapy Consult 300 399 450 525 600
PT1026 Physiotherapy Emergency Visit 600 798 900 1,050 1,200
PT1027 Physiotherapy Neuro Surgery 600 798 900 1,050 1,200
PT1028 Post Natal Exercises 300 399 450 525 600
PT1029 Pre Natal Exercises 300 399 450 525 600
PT1030 Short Wave Diathermy 200 266 300 350 400
PT1031 Tens/Muscle Stimulation 200 266 300 350 400
PT1032 Traction 200 266 300 350 400
PT1033 Ultra Violet LR 200 266 300 350 400
PT1034 Ultrasound 200 266 300 350 400
PT1035 vacuum therapy 300 399 450 525 600
PLASTIC SURGERY
Code bed
Minor Surgery/Procedure
PS1001 Alar Adjustment (Nose) Both 8,000 10,640 12,000 14,000 16,000
PS1002 Alar Adjustment (Nose) Single 6,800 9,044 10,200 11,900 13,600
PS1003 Alveolar fracture- closed reduction 6,400 8,512 9,600 11,200 12,800
PS1004 Alveolar fracture- open reduction 9,600 12,768 14,400 16,800 19,200
PS1005 Arch bar application 12,000 15,960 18,000 21,000 24,000
PS1006 Arch Bar Removal 3,000 3,990 4,500 5,250 6,000
PS1007 Arthrodesis of hand & foot bone(s) 9,600 12,768 14,400 16,800 19,200
PS1008 Arthroscopic median nerve decompression 7,800 10,374 11,700 13,650 15,600
PS1009 Blepharoplasty upper /lower lid for ectropion (single eye) 7,800 10,374 11,700 13,650 15,600
PS1011 Botox per unit (cost of botox additional) 120 160 180 210 240
PS1012 Burn Dressing (Large ) 7,500 9,975 11,250 13,125 15,000
PS1013 Burn Dressing (Medium ) 3,500 4,655 5,250 6,125 7,000
PS1014 Burn Dressing (small ) 2,000 2,660 3,000 3,500 4,000
PS1015 Burn Grafting Small 12,000 15,960 18,000 21,000 24,000
PS1016 Chemical peel of face 2,000 2,660 3,000 3,500 4,000
PS1017 Chordee correction 9,000 11,970 13,500 15,750 18,000
PS1018 Circumcision Hypospadias repair 7,900 10,507 11,850 13,825 15,800
PS1019 Closed reduction of fracture scaphoid 9,000 11,970 13,500 15,750 18,000
PS1020 Contracture release for camptodactyly single finger 9,600 12,768 14,400 16,800 19,200
Page 46
PS1021 Correction of simple bifid thumb/ finger 7,800 10,374 11,700 13,650 15,600
PS1022 Correction of simple bifid toe 7,800 10,374 11,700 13,650 15,600
PS1023 Cubital tunnel release 7,800 10,374 11,700 13,650 15,600
PS1024 Debridement Extensive 9,600 12,768 14,400 16,800 19,200
PS1025 Debridement Foot and ankle 6,200 8,246 9,300 10,850 12,400
PS1026 Debridement for hand injuries 6,400 8,512 9,600 11,200 12,800
PS1027(A) Debridement Large 6,100 8,113 9,150 10,675 12,200
PS1027(B) Debridement medium 5,100 6,783 7,650 8,925 10,200
PS1028 Debridement Small 4,200 5,586 6,300 7,350 8,400
PS1029 Debridement Thigh and knee 6,200 8,246 9,300 10,850 12,400
PS1030 Delay of flap 4,000 5,320 6,000 7,000 8,000
PS1031 Dermabraison post-injury 7,800 10,374 11,700 13,650 15,600
PS1032 Dermabrasion partial face 9,600 12,768 14,400 16,800 19,200
PS1033 Dermofat graft-large 9,200 12,236 13,800 16,100 18,400
PS1034 Dermofat graft-small 7,800 10,374 11,700 13,650 15,600
PS1035 Distractor/ jess application for fracture proximal phalynx 9,600 12,768 14,400 16,800 19,200
PS1036 Distractor/jess application for metacarpal fracture 9,600 12,768 14,400 16,800 19,200
PS1037 Dorsal slit of prepuce 4,000 5,320 6,000 7,000 8,000
PS1038 Drainage of subungual haematoma 4,000 5,320 6,000 7,000 8,000
PS1039 Dressing in OT- major 5,500 7,315 8,250 9,625 11,000
PS1040 Dressing in OT-minor/suture removal 1,650 2,195 2,475 2,888 3,300
PS1041 Dressing In Ward /OPD (Large) 1,650 2,195 2,475 2,888 3,300
PS1042 Dressing In Ward /OPD (Medium) 1,000 1,330 1,500 1,750 2,000
PS1043 Dressing In Ward /OPD (Small) 500 665 750 875 1,000
PS1044 Ear Lobule Repair Single 5,000 6,650 7,500 8,750 10,000
PS1045 Ear Lobule Repair Both Sides 9,000 11,970 13,500 15,750 18,000
PS1046 Epicanthus correction 9,600 12,768 14,400 16,800 19,200
PS1047 Exc of carbuncle 7,800 10,374 11,700 13,650 15,600
PS1048 Exc of extra digit (Excluding thumb) 7,800 10,374 11,700 13,650 15,600
PS1049 Exc of extremity lesion+z-plasty of other adjacent tissue tran 9,600 12,768 14,400 16,800 19,200
PS1050 Exc of ganglion 7,800 10,374 11,700 13,650 15,600
PS1051 Exc of hand/foot lesion + z-plasty/other adjacent tissue tran 10,000 13,300 15,000 17,500 20,000
PS1052 Exc of head & neck lesion + z-plasty/other adjacent tissue tran 12,000 15,960 18,000 21,000 24,000
Code bed
PS1053 Exc of multiple cysts 9,600 12,768 14,400 16,800 19,200
PS1054 Exc of pilonidal sinus + out primary CLSR 9,600 12,768 14,400 16,800 19,200
PS1055 Exc of scalp lesion + z-plasty/other adjacent tissue tran 8,500 11,305 12,750 14,875 17,000
PS1056 Exc of skin lesion- face (less than 2cm) 7,800 10,374 11,700 13,650 15,600
PS1057 Exc of trunk lesion + z-plasty/other adjacent tissue tran 9,600 12,768 14,400 16,800 19,200
PS1058 Excision Of Mole/Cyst 4,500 5,985 6,750 7,875 9,000
PS1059 Expander inflation 600 798 900 1,050 1,200
PS1060 Expander insertion > 3 (for additional per expander) 2,500 3,325 3,750 4,375 5,000
PS1061 Eyelid Wedge Resection & Reconstruction 9,600 12,768 14,400 16,800 19,200
PS1062 Face Scar Simple 9,500 12,635 14,250 16,625 19,000
PS1063 Facial Bones Close Fracture Nose 8,000 10,640 12,000 14,000 16,000
PS1064 Facial Bones Mandible Fracture Closed Reduction 9,600 12,768 14,400 16,800 19,200
PS1065 Filler / area (excluding cost) 4,000 5,320 6,000 7,000 8,000
PS1066 Flap insetting (small) 5,700 7,581 8,550 9,975 11,400
PS1067 Groin /abdominal flap cover for hand injurie-small (Sl fl) 9,600 12,768 14,400 16,800 19,200
PS1068 Hair transplant (per graft) 70 93 105 123 140
PS1069 Hand Surgery - Nail Bed Injury - One Finger 7,500 9,975 11,250 13,125 15,000
PS1070 Hand Surgery Repair & Graft 7,000 9,310 10,500 12,250 14,000
PS1071 Head and neck repair-simple 7,000 9,310 10,500 12,250 14,000
PS1072 Hemangioma (Excision Small) 9,000 11,970 13,500 15,750 18,000
PS1073 Intralesional injection (in OT) 2,300 3,059 3,450 4,025 4,600
PS1074 Jaw cyst Exc- simple/unilocular 7,800 10,374 11,700 13,650 15,600
PS1075 Kenacort injection 600 798 900 1,050 1,200
PS1076 K-wire fixation for fracture distal phalynx 7,800 10,374 11,700 13,650 15,600
PS1077 K-wire fixation for fracture middle phalynx 7,800 10,374 11,700 13,650 15,600
PS1078 K-wire fixation for fracture proximal phalynx 7,800 10,374 11,700 13,650 15,600
PS1079 K-wire fixation for metacarpal fracture 9,600 12,768 14,400 16,800 19,200
PS1080 K-wire fixation of fracture scaphoid 9,600 12,768 14,400 16,800 19,200
PS1081 Labial fold excision 9,600 12,768 14,400 16,800 19,200
PS1082 Lacerated Wound (Other Than Face And Finger) Large 9,600 12,768 14,400 16,800 19,200
PS1083 Lacerated Wound Face Simple very large 10,000 13,300 15,000 17,500 20,000
PS1084 Lacerated Wound Face Simple Large 8,000 10,640 12,000 14,000 16,000
PS1085 Lacerated Wound Face Simple Medium 5,000 6,650 7,500 8,750 10,000
PS1086 Lacerated Wound Face Simple Small 2,500 3,325 3,750 4,375 5,000
PS1087 Lacerated Wound Finger Simple Small 3,000 3,990 4,500 5,250 6,000
PS1088 Lacerated Wound Finger Single Large 4,250 5,653 6,375 7,438 8,500
Page 47
PS1089 Lid entropion correction- both eyes 10,000 13,300 15,000 17,500 20,000
PS1090 Lid entropion correction- single eye 6,400 8,512 9,600 11,200 12,800
PS1091 Local head and neck flap- small 12,000 15,960 18,000 21,000 24,000
PS1092 Local transposition flap- small 7,800 10,374 11,700 13,650 15,600
PS1093 Midline etching 7,800 10,374 11,700 13,650 15,600
PS1094 MRI JOINT extra ARTHROGRAPHY 9,600 12,768 14,400 16,800 19,200
PS1096 Nasal bone fracture- closed reduction + out manipulation 8,000 10,640 12,000 14,000 16,000
PS1097 Nasal pack removal 1,600 2,128 2,400 2,800 3,200
PS1098 Naso-maxillary fracture (lefort ii)- closed reduction 9,000 11,970 13,500 15,750 18,000
PS1099 Nerve biopsy 4,000 5,320 6,000 7,000 8,000
PS1100 Percutaneous reduction of malar fracture 8,500 11,305 12,750 14,875 17,000
PS1101 Pressure Sore Skin Graft Only 8,000 10,640 12,000 14,000 16,000
PS1102 Radial club hand- distractor/external fixator application 9,600 12,768 14,400 16,800 19,200
Code bed
PS1103 Radiofrequency ablation Additional moles 780 1,037 1,170 1,365 1,560
PS1104 Radiofrequency ablation Two moles 4,500 5,985 6,750 7,875 9,000
PS1105 Reconstructive rhinoplasty -forehead flap (stage 2 of 2 ) 9,600 12,768 14,400 16,800 19,200
PS1106 Reimplantation each additional finger (after two fingers) 15,000 19,950 22,500 26,250 30,000
PS1107 Removal Of Implants (Mandible) 6,500 8,645 9,750 11,375 13,000
PS1108 Repair of lid coloboma 7,800 10,374 11,700 13,650 15,600
PS1109 Screw fixation of fracture scaphoid 9,600 12,768 14,400 16,800 19,200
PS1110 Shortening and CLSR of finger stump 7,800 10,374 11,700 13,650 15,600
PS1111 Skin graft for head and neck-small 10,000 13,300 15,000 17,500 20,000
PS1112 Skin grafting -minor 10,000 13,300 15,000 17,500 20,000
PS1113 Small multiple lacerations 6,400 8,512 9,600 11,200 12,800
PS1114 Tarsorrhaphy 2,300 3,059 3,450 4,025 4,600
PS1115 Tarsorrhaphy release 780 1,037 1,170 1,365 1,560
PS1116 Tendon transfer for polio 10,000 13,300 15,000 17,500 20,000
PS1117 Tendon transfer for median nerve injuries (opponensplasty) 10,000 13,300 15,000 17,500 20,000
PS1118 Tendon transfer for radial nerve injuries - single 10,000 13,300 15,000 17,500 20,000
PS1119 Tenolysis of flexor/ extensor tendons- single 7,800 10,374 11,700 13,650 15,600
PS1120 Tm joint dislocation- closed reduction 9,600 12,768 14,400 16,800 19,200
PS1121 Trigger finger release 6,400 8,512 9,600 11,200 12,800
PS1122 V-y flap cover of amputation stump 9,600 12,768 14,400 16,800 19,200
PS1123 Zimmer splint application for one finger 7,800 10,374 11,700 13,650 15,600
PS1138 Piercing Pinna - Bilateral 1,400 1,862 2,100 2,450 2,800
PS1139 Piercing Pinna - Unilateral 900 1,197 1,350 1,575 1,800
Major Surgery
PS2001 Abdominoplasty 30,000 39,900 45,000 52,500 60,000
PS2002 Abdominoplasty + limited incision 15,000 19,950 22,500 26,250 30,000
PS2003 Abdominoplasty with liposuction 40,000 53,200 60,000 70,000 80,000
PS2004 Alt perforator free flap 40,000 53,200 60,000 70,000 80,000
PS2005 Alveolar bone gr 14,000 18,620 21,000 24,500 28,000
PS2006 Ao plating for fracture distal phalynx 10,000 13,300 15,000 17,500 20,000
PS2007 Ao plating for fracture middle phalynx 10,000 13,300 15,000 17,500 20,000
PS2008 Ao plating for fracture proximal phalynx 10,000 13,300 15,000 17,500 20,000
PS2009 Ao plating for metacarpal fracture 10,000 13,300 15,000 17,500 20,000
PS2010 Augmentation phalloplasty free flap 45,000 59,850 67,500 78,750 90,000
PS2011 AV Fistula High 18,000 23,940 27,000 31,500 36,000
PS2012 AV Fistula Low 12,000 15,960 18,000 21,000 24,000
PS2013 B/L sagittal split osteotomy-advancement 28,000 37,240 42,000 49,000 56,000
PS2014 B/L sagittal split osteotomy-setback 28,000 37,240 42,000 49,000 56,000
PS2015 Baggy Eyelids Bilateral 19,000 25,270 28,500 33,250 38,000
PS2016 Baggy Eyelids Unilateral 15,000 19,950 22,500 26,250 30,000
PS2017 Belt lipectomy 35,000 46,550 52,500 61,250 70,000
PS2018 Blepharoplasty upper lid 14,000 18,620 21,000 24,500 28,000
PS2019 Blepharoplasty upper lid for ectropion (both eyes) 16,000 21,280 24,000 28,000 32,000
PS2020 Blepharpplasty lower lid for entropion (both eyes) 16,000 21,280 24,000 28,000 32,000
PS2021 Brachial plexus exploration & nerve transfer/neurotization 19,000 25,270 28,500 33,250 38,000
PS2022 Brachial plexus exploration + nerve gr 31,000 41,230 46,500 54,250 62,000
PS2023 Brachial plexus exploration and nerve repair 19,000 25,270 28,500 33,250 38,000
PS2024 Brachial plexus repair- neurolysis 19,000 25,270 28,500 33,250 38,000
PS2025 Brachioplasty / arm lift 17,000 22,610 25,500 29,750 34,000
PS2026 Breast augmentation 25,000 33,250 37,500 43,750 50,000
PS2027 Breast augmentation -dual plane 28,000 37,240 42,000 49,000 56,000
PS2028 Brow/ forehead lift 15,000 19,950 22,500 26,250 30,000
PS2029 Burn Grafting Extensive 30,000 39,900 45,000 52,500 60,000
PS2030 Burn Grafting large 24,000 31,920 36,000 42,000 48,000
PS2031 Burn Grafting medium 16,000 21,280 24,000 28,000 32,000
Page 48
Code bed
PS2032 Burns contracture release- multiple fingers/ extensive 19,000 25,270 28,500 33,250 38,000
PS2033 Burns contracture release-one finger/toe/minor 11,000 14,630 16,500 19,250 22,000
PS2034 Burns contracture release-two fingers/toes/medium 15,000 19,950 22,500 26,250 30,000
PS2035 Buttock implant 17,000 22,610 25,500 29,750 34,000
PS2036 Button hole deformity correction - multiple fingers 19,000 25,270 28,500 33,250 38,000
PS2037 Button hole deformity correction- two fingers 17,000 22,610 25,500 29,750 34,000
PS2038 Button hole deformity correction-single finger 14,000 18,620 21,000 24,500 28,000
PS2039 Calf implant 15,000 19,950 22,500 26,250 30,000
PS2040 Carpal tunnel release operation + guyons canal release 11,000 14,630 16,500 19,250 22,000
PS2041 Carpal tunnel release operation + opponensplasty 19,000 25,270 28,500 33,250 38,000
PS2042 Carpal tunnel release operation + synovectomy 17,000 22,610 25,500 29,750 34,000
PS2043 Centralisation of chin 14,000 18,620 21,000 24,500 28,000
PS2044 Chin augmentation- multiple sliding osteotomies 11,000 14,630 16,500 19,250 22,000
PS2045 Chin augmentation- osteotomy + bone graft 17,000 22,610 25,500 29,750 34,000
PS2046 Chin augmentation- prosthetic/allograft 14,000 18,620 21,000 24,500 28,000
PS2047 Chin augmentation- single sliding osteotomy 15,000 19,950 22,500 26,250 30,000
PS2048 Chin reduction 17,000 22,610 25,500 29,750 34,000
PS2049 Cleft lip + anterior palate repair B/L 20,000 26,600 30,000 35,000 40,000
PS2050 Cleft lip + anterior palate repair U/L 17,000 22,610 25,500 29,750 34,000
PS2051 Cleft Lip Bilateral (Complete) (Plastic) 18,000 23,940 27,000 31,500 36,000
PS2052 Cleft Lip Bilateral (Incomplete) (Plastic) 14,000 18,620 21,000 24,500 28,000
PS2053 Cleft Lip Unilateral (Complete) (Plastic) 14,000 18,620 21,000 24,500 28,000
PS2054 Cleft Lip Unilateral (Incomplete) (Plastic) 12,500 16,625 18,750 21,875 25,000
PS2055 Cleft Palate (Complete) (Plastic) 15,000 19,950 22,500 26,250 30,000
PS2056 Cleft Palate (Soft Palate) (Plastic) 14,000 18,620 21,000 24,500 28,000
PS2057 Cleft Palate Fistula (Plastic Surg) 16,000 21,280 24,000 28,000 32,000
PS2058 Closed aesthetic rhinoplasty 15,000 19,950 22,500 26,250 30,000
PS2059 Coccygeal Bdsr Exc + flap CLSR 17,000 22,610 25,500 29,750 34,000
PS2060 Coccygeal Bdsr Exc + primary CLSR 14,000 18,620 21,000 24,500 28,000
PS2061 Composite graft (medium) 15,000 19,950 22,500 26,250 30,000
PS2062 Composite Graft (Large) 16,000 21,280 24,000 28,000 32,000
PS2063 Composite graft (small) 12,500 16,625 18,750 21,875 25,000
PS2064 Contracture release for camptodactyly multiple fingers 17,500 23,275 26,250 30,625 35,000
PS2065 Contracture release of camptodactyly two fingers 11,000 14,630 16,500 19,250 22,000
PS2066 Contracture release of lips 14,000 18,620 21,000 24,500 28,000
PS2067 Contracture release of neck 19,000 25,270 28,500 33,250 38,000
PS2068 Contracture release + tendon transfer for camptodactyly 2 fingers 15,000 19,950 22,500 26,250 30,000
PS2069 Contracture release + tendon transfer for camptodactyly 1 finger 11,000 14,630 16,500 19,250 22,000
PS2070 Contracture release+tendon transfer for camptodactyly multiple fingers 22,000 29,260 33,000 38,500 44,000
PS2071 Correction of complex bifid thumb (wassal type 1) 10,000 13,300 15,000 17,500 20,000
Code bed
PS2077 Correction of inverted nipple- B/L 19,000 25,270 28,500 33,250 38,000
PS2078 Correction of inverted nipple- U/L 11,000 14,630 16,500 19,250 22,000
PS2079 Correction of macrostomia U/L 10,000 13,300 15,000 17,500 20,000
PS2080 Correction of mallet finger 10,000 13,300 15,000 17,500 20,000
PS2081 Correction of mallet finger- extensor tendon repair 15,000 19,950 22,500 26,250 30,000
PS2082 Correction of mallet finger- tendon repair + k-wiring 16,000 21,280 24,000 28,000 32,000
PS2083 Correction of microstomia B/L 15,000 19,950 22,500 26,250 30,000
PS2084 Corrective Rhinoplasty (Plastic Surg) 23,000 30,590 34,500 40,250 46,000
PS2085 Cranioplasty with bone graft 23,000 30,590 34,500 40,250 46,000
PS2086 Cranioploasty with implant 19,000 25,270 28,500 33,250 38,000
PS2087 Craniostenosis (MCS)-reconstruction of cranial vault 37,000 49,210 55,500 64,750 74,000
PS2088 Craniostenosis (MSC)-reconstruction of cranial vault & BG 30,000 39,900 45,000 52,500 60,000
PS2089 Craniostenosis (SCS)- reconstruction of cranial vault 24,000 31,920 36,000 42,000 48,000
PS2090 Craniostenosis (SCS)-reconstruction of cranial vault & BG 28,000 37,240 42,000 49,000 56,000
PS2091 Cross lip pedicle flap (abbe estlander) 14,000 18,620 21,000 24,500 28,000
PS2092 CT UROGRAPHY 11,000 14,630 16,500 19,250 22,000
PS2093 David chuangs muscle transfer procedure 28,000 37,240 42,000 49,000 56,000
PS2094 Dcia flap 40,000 53,200 60,000 70,000 80,000
PS2095 Debulking of macrodactyly 19,000 25,270 28,500 33,250 38,000
PS2096 Dermabrasion full face 15,000 19,950 22,500 26,250 30,000
PS2097 Diep flap 40,000 53,200 60,000 70,000 80,000
PS2098 Digital nerve graft 15,000 19,950 22,500 26,250 30,000
Page 49
PS2099 Digital nerve repair 12,500 16,625 18,750 21,875 25,000
PS2100 Dimple creation B/L 18,000 23,940 27,000 31,500 36,000
PS2101 Dimple creation U/L 11,000 14,630 16,500 19,250 22,000
PS2102 Dorsal dermodesis for nail bed injuries 11,000 14,630 16,500 19,250 22,000
PS2103 Ear Deformity Bat Ears (Plastic) 14,000 18,620 21,000 24,500 28,000
PS2104 Ectropion (Both) (Plasitc Surg) 14,100 18,753 21,150 24,675 28,200
PS2105 Ectropion (Upper Eyelid) (Plasti Surg) 10,000 13,300 15,000 17,500 20,000
PS2106 Endoscopic face lift 30,000 39,900 45,000 52,500 60,000
PS2107 Endoscopic brow/ forehead lift 19,000 25,270 28,500 33,250 38,000
PS2108 Endoscopic gynaecomastia Exc - B/L 25,000 33,250 37,500 43,750 50,000
PS2109 Endoscopic gynaecomsatia Exc- U/L 15,000 19,950 22,500 26,250 30,000
PS2110 Epicanthus & telecanthus correction 11,000 14,630 16,500 19,250 22,000
PS2111 Exc of extra digit + ligament reconstruction (Exclud. thumb) 14,000 18,620 21,000 24,500 28,000
PS2112 Exc of L superfic soft tissue mas/tumor Exclude neuroma/gang 14,000 18,620 21,000 24,500 28,000
PS2113 Exc of M superfic soft tissue mas/tumor Exclude neuroma/gang 11,000 14,630 16,500 19,250 22,000
PS2114 Exc of neuroma- major nerve 17,000 22,610 25,500 29,750 34,000
PS2115 Exc of neuroma-minor nerve 11,000 14,630 16,500 19,250 22,000
PS2116 Exc of pilonidal sinus + flap cover 18,000 23,940 27,000 31,500 36,000
PS2117 Exc of pilonidal sinus + primary CLSR 11,000 14,630 16,500 19,250 22,000
PS2118 Exc of scar/ lesion/wound and skin gr-major 27,000 35,910 40,500 47,250 54,000
PS2119 Exc of scar/ lesion/wound and skin gr-medium 20,000 26,600 30,000 35,000 40,000
PS2120 Exc of scar/ lesion/wound and skin gr-minor 14,000 18,620 21,000 24,500 28,000
Code bed
PS2121 Exc of skin lesion-face (more than 2cm) 11,000 14,630 16,500 19,250 22,000
PS2122 Exc of supernumerary/ breast/nipple 11,000 14,630 16,500 19,250 22,000
PS2123 Excision of keloid ear lobule 11,000 14,630 16,500 19,250 22,000
PS2124 Expander insertion -two 14,000 18,620 21,000 24,500 28,000
PS2125 Expander insertion-single 11,000 14,630 16,500 19,250 22,000
PS2126 Expander insertion-three 17,500 23,275 26,250 30,625 35,000
PS2127 Expander removal & contouring - multiple 22,000 29,260 33,000 38,500 44,000
PS2128 Expander removal & contouring - single 15,000 19,950 22,500 26,250 30,000
PS2129 Exploration & repair f popliteal arterial injur prmry repair 13,000 17,290 19,500 22,750 26,000
PS2130(A) Exploration & repair radial arterial injury prmry repair 15,000 19,950 22,500 26,250 30,000
PS2130(B) Exploration & repair ulnar arterial 16,000 21,280 24,000 28,000 32,000
PS2131 Exploration & repair radial arterial injury- use vein ptch 18,000 23,940 27,000 31,500 36,000
PS2132 Exploration & repair popliteal arterial injury use vein gr 22,000 29,260 33,000 38,500 44,000
PS2133 Exploration & repair popliteal arterial injury use vein ptch 19,000 25,270 28,500 33,250 38,000
PS2134 Exploration & repair radial arterial/Ulnar arterial injury- use vein gr 22,000 29,260 33,000 38,500 44,000
PS2135 Extended parotidectomy 18,000 23,940 27,000 31,500 36,000
PS2136 Extensor tendon repair (zone-1) 14,000 18,620 21,000 24,500 28,000
PS2137 Extensor tendon repair (zone-2) - two tendons 18,000 23,940 27,000 31,500 36,000
PS2138 Extensor tendon repair (zone-2) -single tendon 14,000 18,620 21,000 24,500 28,000
PS2139 Extensor tendon repair (zone-3) - multiple tendons 25,000 33,250 37,500 43,750 50,000
PS2140 Extensor tendon repair (zone-3) - single tendon 14,000 18,620 21,000 24,500 28,000
PS2151 Eye Lid Reconstruction - Partial (Plastic Surg) 15,000 19,950 22,500 26,250 30,000
PS2152 Eye Lid Reconstruction - Total (Plastic Surg) 20,000 26,600 30,000 35,000 40,000
PS2153 Face (thread lift) 15,000 19,950 22,500 26,250 30,000
PS2154 Face lift- classic operation 25,000 33,250 37,500 43,750 50,000
PS2155 Face lift- facial suspension 14,000 18,620 21,000 24,500 28,000
PS2156 Face lift- mid face 18,500 24,605 27,750 32,375 37,000
PS2157 Face lift- minimum scar 18,500 24,605 27,750 32,375 37,000
PS2158 Face lift- with smas 25,000 33,250 37,500 43,750 50,000
Code bed
PS2159 Face Scar Complicated And Large 20,000 26,600 30,000 35,000 40,000
PS2160 Face Scar Medium 16,000 21,280 24,000 28,000 32,000
PS2161 Facial bi-partition for hypertelorism 38,000 50,540 57,000 66,500 76,000
PS2162 Facial Bones Compound Fracture Nose 12,000 15,960 18,000 21,000 24,000
PS2163 Facial Bones Frontal Bone Fracture Bilateral 13,500 17,955 20,250 23,625 27,000
PS2164 Facial Bones Frontal Bone Fracture Unilateral 11,000 14,630 16,500 19,250 22,000
Page 50
PS2165 Facial Bones Malar Fracture Open Reduction (Orif) 14,000 18,620 21,000 24,500 28,000
PS2166 Facial Bones Mandibile Fracture Open Reduction (Orif) 14,000 18,620 21,000 24,500 28,000
PS2167 Facial Bones Maxillary Fracture Closed Reduction 15,000 19,950 22,500 26,250 30,000
PS2168 Facial Bones Maxillary Fracture/ Orbital Floor Fracture (Orif) 19,500 25,935 29,250 34,125 39,000
PS2169 Facial reanimation 38,000 50,540 57,000 66,500 76,000
PS2170 Fascia latal sling surgery (eye) 14,000 18,620 21,000 24,500 28,000
PS2171 Fasciocutaneous Flaps (Large) (Plastic) 20,000 26,600 30,000 35,000 40,000
PS2172 Fasciocutaneous Flaps (Small) (Plastic) 15,000 19,950 22,500 26,250 30,000
PS2173 Fat injection 22,000 29,260 33,000 38,500 44,000
PS2174 Fibular osteocutaneous free flap for long bones 45,000 59,850 67,500 78,750 90,000
PS2175 First web release for cleft hand 14,000 18,620 21,000 24,500 28,000
PS2176 Flap Reconstructive Surgery 38,000 50,540 57,000 66,500 76,000
PS2177 Flap Vaginoplasty 25,000 33,250 37,500 43,750 50,000
PS2178 Flexor tendon repair (zone-1) 14,000 18,620 21,000 24,500 28,000
PS2179 Flexor tendon repair (zone-2) - two tendons 18,000 23,940 27,000 31,500 36,000
PS2180 Flexor tendon repair (zone-2) -single tendon 14,000 18,620 21,000 24,500 28,000
PS2181 Flexor tendon repair (zone-3) - multiple tendons 25,000 33,250 37,500 43,750 50,000
PS2183 Flexor tendon repair (zone-3) - single tendon 14,000 18,620 21,000 24,500 28,000
PS2193 Forehead (thread lift) 15,000 19,950 22,500 26,250 30,000
PS2194 Free fibular flap 45,000 59,850 67,500 78,750 90,000
PS2195 Free microvascular/ joint transfer 45,000 59,850 67,500 78,750 90,000
PS2196 Free perforator flap transfer 40,000 53,200 60,000 70,000 80,000
PS2197 Free phalangeal/ bone transfer for brachydactyly 12,500 16,625 18,750 21,875 25,000
PS2198 Free style free flap 40,000 53,200 60,000 70,000 80,000
PS2199 Full thickness skin gr 15,000 19,950 22,500 26,250 30,000
PS2200 Functioning free muscle transfer 50,000 66,500 75,000 87,500 100,000
PS2201 Functioning free muscle transfer- gracilis muscle 50,000 66,500 75,000 87,500 100,000
PS2202 Functioning free muscle transfer- latisimus dorsi muscle 50,000 66,500 75,000 87,500 100,000
Code bed
PS2203 Gracilis muscle/myocutaneous flap-free 40,000 53,200 60,000 70,000 80,000
PS2204 Gracilis muscle/myocutaneous flap-pedicle 20,000 26,600 30,000 35,000 40,000
PS2205 Groin /abdominal flap cover for hand injurie-large (Sl fl) 25,000 33,250 37,500 43,750 50,000
PS2206 Groin /abdominal flap cover for hand injurie-medium (Sl fl) 11,000 14,630 16,500 19,250 22,000
PS2207 Groin/abdominal flap cover for hand injurie-large (2 fl) 25,000 33,250 37,500 43,750 50,000
PS2208 Groin/abdominal flap cover for hand injurie-large (mltpl fl) 25,000 33,250 37,500 43,750 50,000
PS2209 Groin/abdominal flap cover for hand injurie-medium (2 fl) 20,000 26,600 30,000 35,000 40,000
PS2210 Groin/abdominal flap cover for hand injurie-medium(mltpl fl) 20,000 26,600 30,000 35,000 40,000
PS2211 Groin/abdominal flap cover for hand injurie-small (2 fl) 20,000 26,600 30,000 35,000 40,000
PS2212 Groin/abdominal flap cover for hand injurie-small (mltpl fl) 20,000 26,600 30,000 35,000 40,000
PS2213 Groin perforator free flap 40,000 53,200 60,000 70,000 80,000
PS2214 Gynaecomastia Exc-U/L 15,000 19,950 22,500 26,250 30,000
PS2215 Gynaecomsatia Exc- B/L 25,000 33,250 37,500 43,750 50,000
PS2216 Hair graft eyebrow/scar/moustache 11,000 14,630 16,500 19,250 22,000
PS2217 Hand Surgery - Nail Bed Injurymultiple (Plastic Surg.) 11,000 14,630 16,500 19,250 22,000
PS2218 Hand Surgery - Pulp Injury With Flapcover (Plastic Surg.) 16,000 21,280 24,000 28,000 32,000
PS2219 Hand Surgery - Pulp Injury With Graft (Plastic Surg.) 14,000 18,620 21,000 24,500 28,000
PS2220 Hand Surgery Extra Digit (Plastic) 10,000 13,300 15,000 17,500 20,000
PS2221 Hand Surgery Repair With Flap (Plastic) 16,000 21,280 24,000 28,000 32,000
PS2222 Hand Surgery Syndactyly Multiple (Plastic) 17,000 22,610 25,500 29,750 34,000
PS2223 Hand Surgery Syndactyly Single (Plastic Surg.) 12,000 15,960 18,000 21,000 24,000
PS2224 Head and neck repair- complex 18,000 23,940 27,000 31,500 36,000
PS2225 Hemangioma (Excision Large)(Plastic Surg.) 20,000 26,600 30,000 35,000 40,000
PS2226 Hemangioma (Excision Medium) (Plastic Surg.) 18,000 23,940 27,000 31,500 36,000
PS2227 Hemangioma (Extensive) (Plastic Surg.) 30,000 39,900 45,000 52,500 60,000
PS2228 Hypospadias Reconstruction (1st Stage) 14,000 18,620 21,000 24,500 28,000
PS2229 Hypospadias Reconstruction (2Nd Stage) 18,000 23,940 27,000 31,500 36,000
PS2230 Hypospadias Reconstruction Single Stage 25,000 33,250 37,500 43,750 50,000
PS2231 Iliac crest osteocutaneous free flap 40,000 53,200 60,000 70,000 80,000
PS2232 Ischial Bdsr Exc + primary CLSR B/L 19,000 25,270 28,500 33,250 38,000
PS2233 Ischial Bdsr Exc + primary CLSR U/L 14,000 18,620 21,000 24,500 28,000
Page 51
PS2234 Ischial Bdsr Exc + skin gr B/L 22,000 29,260 33,000 38,500 44,000
PS2235 Ischial Bdsr Exc + skin gr U/L 17,500 23,275 26,250 30,625 35,000
PS2236 Ischial Bdsr Exc+myocutaneous/muscle fl CLSR U/L 14,000 18,620 21,000 24,500 28,000
PS2237 Ischial Bdsr Exci. + myocuta./muscle flap CLSR B/L 25,000 33,250 37,500 43,750 50,000
PS2238 Jaw cyst or tumour Exc and bone gr 14,000 18,620 21,000 24,500 28,000
PS2239 Jaw cyst tumour-radical resection 12,500 16,625 18,750 21,875 25,000
PS2240 Jaw cyst/tumour resection&reconstruction of jaw+free fib fl 60,000 79,800 90,000 105,000 120,000
PS2241 Krukenbergs operation 12,500 16,625 18,750 21,875 25,000
PS2242 Lacerated Wound (Other Than Face And Finger) Multiple 13,500 17,955 20,250 23,625 27,000
PS2243 Large Multiple Wounds Face Simple 15,000 19,950 22,500 26,250 30,000
Code bed
PS2244 Lateral artery flap-free 40,000 53,200 60,000 70,000 80,000
PS2245 Latissimus dorsi flap-free 40,000 53,200 60,000 70,000 80,000
PS2246 Latissimus dorsi flap-pedicle 20,000 26,600 30,000 35,000 40,000
PS2247 Lefort i osteotomy + advancement 27,000 35,910 40,500 47,250 54,000
PS2248 Lefort i osteotomy + application of distractor 27,000 35,910 40,500 47,250 54,000
PS2249 Lefort i osteotomy + impaction/ intrusion 25,000 33,250 37,500 43,750 50,000
PS2250 Lefort iii (extracranial) advancement 31,000 41,230 46,500 54,250 62,000
PS2251 Lefort iii (intracranial) advancement- monobloc 31,000 41,230 46,500 54,250 62,000
PS2252 Lefort iii + lefort i advancement 31,000 41,230 46,500 54,250 62,000
PS2253 Lefort iii complicated fracture- open reduction (orif) 20,000 26,600 30,000 35,000 40,000
PS2254 Lefort iii fracture (complicated-open reduction + bg (orif) 25,000 33,250 37,500 43,750 50,000
PS2255 Lefort iii osteotomy + application of distractor 31,000 41,230 46,500 54,250 62,000
PS2256 Lid tumour Exc and repair+ skin/mucosal gr/fl construction 18,000 23,940 27,000 31,500 36,000
PS2257 Ligament reconstruction for hypoplastic thumb 13,000 17,290 19,500 22,750 26,000
PS2258 Lip reconstuction + multiple flaps 25,000 33,250 37,500 43,750 50,000
PS2259 Lip reconstuction + singleflaps 20,000 26,600 30,000 35,000 40,000
PS2260 Lip reduction 15,000 19,950 22,500 26,250 30,000
PS2261 Lipectomy 10,000 13,300 15,000 17,500 20,000
PS2262 Lipectomy (Abdomen) (Plastic Surg.) 13,500 17,955 20,250 23,625 27,000
PS2263 Lipoinjection > 20ml 19,000 25,270 28,500 33,250 38,000
PS2264 Lipoinjection 10 - 20ml 15,000 19,950 22,500 26,250 30,000
PS2265 Lipoinjection Upto 10ml 11,000 14,630 16,500 19,250 22,000
PS2266 Liposuction (Large) (Plastic Surg.) 30,000 39,900 45,000 52,500 60,000
PS2267 Liposuction (Medium) (Plastic Surg.) 25,000 33,250 37,500 43,750 50,000
PS2268 Liposuction (Small) (Plastic Surg.) 14,000 18,620 21,000 24,500 28,000
PS2269 Liposuction and Exc of gynaecomastia -B/L 30,000 39,900 45,000 52,500 60,000
PS2270 Liposuction and Exc of gynaecomastia -U/L 20,000 26,600 30,000 35,000 40,000
PS2271 Local head and neck flap-large 20,000 26,600 30,000 35,000 40,000
PS2272 Local head and neck flap-medium 15,000 19,950 22,500 26,250 30,000
PS2273 Local transposition flap-large 18,000 23,940 27,000 31,500 36,000
PS2274 Local transposition flap-medium 15,000 19,950 22,500 26,250 30,000
PS2275 Long bone - Free Fibula 45,000 59,850 67,500 78,750 90,000
PS2276 Lump/Tumour Excision With Cover (Large) (Plastic Surg.) 18,000 23,940 27,000 31,500 36,000
PS2277 Lump/Tumour Excision With Cover (Medium) (Plastic Surg.) 13,000 17,290 19,500 22,750 26,000
PS2278 Lump/Tumour Excision With Cover (Small) (Plastic Surg.) 10,000 13,300 15,000 17,500 20,000
PS2279 Lymphaticovenous shunt 22,000 29,260 33,000 38,500 44,000
PS2280 Lympho venous anastomosis i 20,000 26,600 30,000 35,000 40,000
PS2281 Lympho venous anastomosis ii 30,000 39,900 45,000 52,500 60,000
PS2282 Lympho venous anastomosis iii 40,000 53,200 60,000 70,000 80,000
PS2283 Lympho venous anastomosis iv 50,000 66,500 75,000 87,500 100,000
PS2284 Malar reduction 18,000 23,940 27,000 31,500 36,000
PS2285 Malar/ cheek implant 14,000 18,620 21,000 24,500 28,000
PS2286 Mammoplasty Reduction (Plastic) 30,000 39,900 45,000 52,500 60,000
PS2287 Mandible fracture- percutaneous reduction/ external fixation 11,000 14,630 16,500 19,250 22,000
PS2288 Mandible Reconstruction By Bone Flap (Plastic Surg.) 45,000 59,850 67,500 78,750 90,000
PS2289 Mandible Reconstruction By Bone Graft (Plastic Surg.) 30,000 39,900 45,000 52,500 60,000
PS2290 Mandible Reconstruction By Plate (Cost Of Plate Separate) 22,000 29,260 33,000 38,500 44,000
PS2291 Mandible reonstruction + implant 15,000 19,950 22,500 26,250 30,000
Code bed
PS2292 Mandibular condylar fracture/open reduction 20,000 26,600 30,000 35,000 40,000
PS2293 Maxillary lefort i fr. (complicated)- open reduction (orif) 13,000 17,290 19,500 22,750 26,000
PS2294 Maxillary lefort i fr. (complicated) open reduction+bg (orif) 15,000 19,950 22,500 26,250 30,000
PS2295 Maxillary lefort i fracture - open reduction (orif) 11,000 14,630 16,500 19,250 22,000
PS2296 Maxillary reconstruction +out bone graft 11,000 14,630 16,500 19,250 22,000
PS2297 Maxillary reconstruction(complicated) + bone graft 14,000 18,620 21,000 24,500 28,000
PS2298 Maxillo-mandibular cyst enucleation/ marsupialisation 11,000 14,630 16,500 19,250 22,000
PS2299 Median nerve graft 22,000 29,260 33,000 38,500 44,000
PS2300 Median nerve repair 15,000 19,950 22,500 26,250 30,000
Page 52
PS2301 Medpore ear reconstruction B/L 38,000 50,540 57,000 66,500 76,000
PS2302 Medpore ear reconstruction U/L 27,000 35,910 40,500 47,250 54,000
PS2303 Microtia First Stage (Plastic Surg.) 19,000 25,270 28,500 33,250 38,000
PS2304 Microtia Second Stage (Plastic Surg.) 16,000 21,280 24,000 28,000 32,000
PS2305 Microtia Third Stage (Plastic Surg.) 11,000 14,630 16,500 19,250 22,000
PS2306 Microvascular Repair (Plastic Surg.) 18,000 23,940 27,000 31,500 36,000
PS2307 Mid face lift + lowerlid blepharoplasty 19,000 25,270 28,500 33,250 38,000
PS2308 Mucosal graft for urethra 11,000 14,630 16,500 19,250 22,000
PS2309 Myocutaneous Flap (Large) (Plastic Surg.) 20,000 26,600 30,000 35,000 40,000
PS2310 Myocutaneous Flap (Small) (Plastic Surg.) 15,000 19,950 22,500 26,250 30,000
PS2311 Nail bed reconstruction- multiple fingers 18,500 24,605 27,750 32,375 37,000
PS2312 Nail bed reconstruction- single finger 11,000 14,630 16,500 19,250 22,000
PS2313 Nail bed reconstruction- two fingers 15,000 19,950 22,500 26,250 30,000
PS2314 Nail bed repair- two nail beds 10,000 13,300 15,000 17,500 20,000
PS2315 Nasal bone fracture (simple)- open reduction 11,000 14,630 16,500 19,250 22,000
PS2316 Nasal Tip Correction (Plastic) 12,000 15,960 18,000 21,000 24,000
PS2317 Nasalbone Grafting (Plastic Surg.) 10,000 13,300 15,000 17,500 20,000
PS2318 Naso-ethmoid fracture -open reduction + fixation (orif) 13,000 17,290 19,500 22,750 26,000
PS2319 Naso-ethmoid fracture -open reduction +out fixation 11,000 14,630 16,500 19,250 22,000
PS2320 Naso-maxilary cmplicatd fr.(lefort ii)-openreduction(orif+bg 22,000 29,260 33,000 38,500 44,000
PS2321 Naso-maxillary cmplicatd fr.(lefort ii)-open reduction(orif) 20,000 26,600 30,000 35,000 40,000
PS2322 Naso-maxillary fracture (lefort ii)- open reduction(orif) 18,000 23,940 27,000 31,500 36,000
PS2323 Neck (thread lift) 15,000 19,950 22,500 26,250 30,000
PS2324 Neo-umbiloplasty 13,500 17,955 20,250 23,625 27,000
PS2325 Nerve exploration +neurolysis for median nerve 11,000 14,630 16,500 19,250 22,000
PS2326 Nerve Grafting Single (Plastic Surg.) 20,000 26,600 30,000 35,000 40,000
PS2327 Nerve grafting Three grafts 38,000 50,540 57,000 66,500 76,000
PS2328 Nerve grafting Two grafts 31,000 41,230 46,500 54,250 62,000
PS2329 Nerve Repair Multiple (Peripheral) (Plastic Surg.) 24,000 31,920 36,000 42,000 48,000
PS2330 Nerve transfer Double 31,000 41,230 46,500 54,250 62,000
PS2331 Nerve transfer Single 22,000 29,260 33,000 38,500 44,000
PS2332 Nerve transfer Triple 38,000 50,540 57,000 66,500 76,000
PS2333 Neurolysis of lateral popliteal nerve 18,500 24,605 27,750 32,375 37,000
PS2334 Neurovascular island flap-free 40,000 53,200 60,000 70,000 80,000
PS2335 Neurovascular island flap-pedicle 20,000 26,600 30,000 35,000 40,000
PS2336 Nipple reconstruction-B/L 15,000 19,950 22,500 26,250 30,000
PS2337 Nipple reconstruction-U/L 11,000 14,630 16,500 19,250 22,000
Code bed
PS2338 Oblique triangular flap for finger tip injuries 13,000 17,290 19,500 22,750 26,000
PS2339 On-top plasty / pollicization 18,500 24,605 27,750 32,375 37,000
PS2340 Open reduction and ligament repair of wrist 13,000 17,290 19,500 22,750 26,000
PS2341 Open tip composite rhinoplasty 22,000 29,260 33,000 38,500 44,000
PS2342 Orbital blow out fr.-open reduction + alloplastic implant 14,000 18,620 21,000 24,500 28,000
PS2343 Orbital blow out fracture-open reduction + bone graft 17,000 22,610 25,500 29,750 34,000
PS2344 Orbital complicated fracture-open reduction 14,000 18,620 21,000 24,500 28,000
PS2345 Orbital simple fracture-open reduction 11,000 14,630 16,500 19,250 22,000
PS2346 Orbtal repositioning for hypertelori ext.cranial approach+bg 38,000 50,540 57,000 66,500 76,000
PS2347 Orbtal repositioning for hypertelori-extcran&intcran appr 38,000 50,540 57,000 66,500 76,000
PS2348 Orbtal repositioning for hypertelori-extcran&intcran appr+bg 40,000 53,200 60,000 70,000 80,000
PS2349 Orbtal repositioning for hypertelorism ext.cranial approach 36,000 47,880 54,000 63,000 72,000
PS2350 Orif and bone gr for non-union of scaphoid 14,000 18,620 21,000 24,500 28,000
PS2351 Orif and vascularisd bone gr for non-union of scaphoid 27,000 35,910 40,500 47,250 54,000
PS2352 Osteotomy for metacarpal malunion 13,000 17,290 19,500 22,750 26,000
PS2353 Osteotomy for phalangeal malunion 11,000 14,630 16,500 19,250 22,000
PS2354 Other Bdsr Exc + myocutaneous flap CLSR 19,000 25,270 28,500 33,250 38,000
PS2355 Other Bdsr Exc + primary CLSR 13,500 17,955 20,250 23,625 27,000
PS2356 Other Bdsr Exc + skin flap CLSR 17,500 23,275 26,250 30,625 35,000
PS2357 Other Bdsr Exc + skin gr 17,500 23,275 26,250 30,625 35,000
PS2358 Otoplasty for acquired ear deformity B/L 17,500 23,275 26,250 30,625 35,000
PS2359 Otoplasty for acquired ear deformity U/L 14,000 18,620 21,000 24,500 28,000
PS2360 Otoplasty for bat ears B/L 17,500 23,275 26,250 30,625 35,000
PS2361 Otoplasty for bat ears U/L 11,000 14,630 16,500 19,250 22,000
PS2362 Otoplasty for lop ears U/L 10,000 13,300 15,000 17,500 20,000
PS2363 Palatal fistula CLSR Famm flap 19,000 25,270 28,500 33,250 38,000
PS2364 Palatal fistula CLSR Mucosal flap 15,000 19,950 22,500 26,250 30,000
PS2365 Palatal fistula CLSR Tongue flap 15,000 19,950 22,500 26,250 30,000
PS2366 Parascapular flap 25,000 33,250 37,500 43,750 50,000
PS2367 Pedicle flap over of amputation stump 11,000 14,630 16,500 19,250 22,000
PS2368 Pedicled flap - medium 14,000 18,620 21,000 24,500 28,000
PS2369 Pedicled omental transfer for sternal wound 15,000 19,950 22,500 26,250 30,000
Page 53
PS2370 Penile lengthening 17,500 23,275 26,250 30,625 35,000
PS2371 Penile Surgery (Erectile Dysfuction - Inflatable) 23,000 30,590 34,500 40,250 46,000
PS2372 Penile Surgery (Erectile Dysfunction - Malleable) 19,500 25,935 29,250 34,125 39,000
PS2373 Perforator pedicle flap 22,000 29,260 33,000 38,500 44,000
PS2374 Peri-areolar breast lift/ mastopexy 18,500 24,605 27,750 32,375 37,000
PS2375 Pharyngeal flap pharyngoplasty 15,000 19,950 22,500 26,250 30,000
PS2376 Pollicization for hypoplastic thumb 30,000 39,900 45,000 52,500 60,000
PS2377 Post bariatric surgery Reverse thigh lift 22,000 29,260 33,000 38,500 44,000
PS2378 Post bariatric surgery Thighplasty 19,000 25,270 28,500 33,250 38,000
PS2379 Post bariatric surgery Upper body lift 27,000 35,910 40,500 47,250 54,000
PS2380 Pressure Sore Major (Plastic Surg.) 20,000 26,600 30,000 35,000 40,000
PS2381 Pressure Sore Medium (Plastic Surg.) 16,000 21,280 24,000 28,000 32,000
PS2382 Pressure Sore Minor (Plastic Surg.) 12,000 15,960 18,000 21,000 24,000
PS2383 Proximal row carpectomy 14,000 18,620 21,000 24,500 28,000
PS2384 Ptosis (Plastic) 12,500 16,625 18,750 21,875 25,000
PS2385 Radial artery flap -pedicle 22,000 29,260 33,000 38,500 44,000
PS2386 Radial artery flap-free 40,000 53,200 60,000 70,000 80,000
Code bed
PS2388 Radial club hand- centralisation radialisation 14,000 18,620 21,000 24,500 28,000
PS2389 Radial club hand- osteotomy of ulna 19,000 25,270 28,500 33,250 38,000
PS2390 Radial club hand-free epiphysis/fibula transfer 32,000 42,560 48,000 56,000 64,000
PS2391 Radial collateral ligament reconstruction of thumb 14,000 18,620 21,000 24,500 28,000
PS2392 Radial collateral ligament repair of thumb 11,000 14,630 16,500 19,250 22,000
PS2393 Radial nerve graft 22,000 29,260 33,000 38,500 44,000
PS2394 Radial nerve repair 15,000 19,950 22,500 26,250 30,000
PS2395 Radiofrequency ablation Single mole 11,000 14,630 16,500 19,250 22,000
PS2396 Ray resectiion for macrodactyly 15,000 19,950 22,500 26,250 30,000
PS2397 Reconstructive + cartilage graft 22,000 29,260 33,000 38,500 44,000
PS2398 Reconstructive rhinoplasty-forehead flap (single stage) 25,000 33,250 37,500 43,750 50,000
PS2399 Reconstructive rhinoplasty-forehead flap(stg 1 of 2 ) 18,000 23,940 27,000 31,500 36,000
PS2400 Redo palatoplasty 15,000 19,950 22,500 26,250 30,000
PS2401 Reduction mammoplasty-U/L 20,000 26,600 30,000 35,000 40,000
PS2402 Reimplantation of fingers- Six/ Nine or more fingers 45,000 59,850 67,500 78,750 90,000
PS2403 Reimplantation of fingers- three fingers 40,000 53,200 60,000 70,000 80,000
PS2404 Reimplantation of upper limb at palm level 45,000 59,850 67,500 78,750 90,000
PS2405 Reimplantation of upper limb at upper arm level 45,000 59,850 67,500 78,750 90,000
PS2406 Flap Insetting (Large) 22,000 29,260 33,000 38,500 44,000
PS2407 Removal of breast implant 14,000 18,620 21,000 24,500 28,000
PS2408 Repair of lacrimal canaliculi 11,000 14,630 16,500 19,250 22,000
PS2409 Repair of lid coloboma + skin/mucosal gr/flap construction 11,000 14,630 16,500 19,250 22,000
PS2410 Repair of lid injuries 11,000 14,630 16,500 19,250 22,000
PS2411 Repair of lid injuries + flaps or grafts 12,500 16,625 18,750 21,875 25,000
PS2412 Repair of oro-antral fistula 11,000 14,630 16,500 19,250 22,000
PS2413 Replantation Hand 45,000 59,850 67,500 78,750 90,000
PS2414 Replantation Multiple Fingers 45,000 59,850 67,500 78,750 90,000
PS2415 Replantation One Finger 30,000 39,900 45,000 52,500 60,000
PS2416 Replantation Other Parts 40,000 53,200 60,000 70,000 80,000
PS2417 Revascularisation of finger -single 14,000 18,620 21,000 24,500 28,000
PS2418 Revascularisation of upper limb at forearm level 25,000 33,250 37,500 43,750 50,000
PS2419 Revascularization of fingers- Six/ Nine or more fingers 35,000 46,550 52,500 61,250 70,000
PS2420 Revascularization of fingers- three fingers 30,000 39,900 45,000 52,500 60,000
PS2421 Revascularization of fingers-two fingers 25,000 33,250 37,500 43,750 50,000
PS2422 Revascularization of upper limb at palm level 25,000 33,250 37,500 43,750 50,000
PS2423 Revascularization of upper limb at upper arm level 25,000 33,250 37,500 43,750 50,000
PS2424 Revascularization of upper limb at wrist level 25,000 33,250 37,500 43,750 50,000
PS2425 Reverse abdominoplasty/ torsoplasty 20,000 26,600 30,000 35,000 40,000
PS2426 Reverse dermal cross finger flap for finger tip injuries 14,000 18,620 21,000 24,500 28,000
PS2427 Segmental mandibular osteotomy (multiple) 19,000 25,270 28,500 33,250 38,000
PS2428 Segmental mandibular osteotomy (single) 15,000 19,950 22,500 26,250 30,000
PS2429 Segmental maxillary osteotomy (multiple) 19,000 25,270 28,500 33,250 38,000
PS2430 Segmental maxillary osteotomy (single) 15,000 19,950 22,500 26,250 30,000
PS2431 Single stage proximal Hypospadias repair 22,000 29,260 33,000 38,500 44,000
PS2432 Skin graft for head and neck- large 16,000 21,280 24,000 28,000 32,000
Code bed
PS2433 Skin graft of amputation stump 16,000 21,280 24,000 28,000 32,000
PS2434 Skin grafting-major 20,000 26,600 30,000 35,000 40,000
PS2435 Snow-litters procedure for cleft hand 19,000 25,270 28,500 33,250 38,000
PS2436 Sphincter pharyngoplasty 15,000 19,950 22,500 26,250 30,000
PS2437 Split skin grafting-medium 14,000 18,620 21,000 24,500 28,000
Page 54
PS2438 Sternomastoid release bipolar 15,000 19,950 22,500 26,250 30,000
PS2439 Sternomastoid release unipolar 11,000 14,630 16,500 19,250 22,000
PS2440 Superficial parotidectomy 13,500 17,955 20,250 23,625 27,000
PS2441 Superficial parotidectomy for recurrent tumour 13,500 17,955 20,250 23,625 27,000
PS2442 Swan neck deformity correction- multiple fingers 18,500 24,605 27,750 32,375 37,000
PS2443 Swan neck deformity correction- single finger 14,000 18,620 21,000 24,500 28,000
PS2444 Swan neck of deformity correction- two fingers 17,500 23,275 26,250 30,625 35,000
PS2445 Tendon gr - stage 1 14,000 18,620 21,000 24,500 28,000
PS2446 Tendon gr - stage 2 18,500 24,605 27,750 32,375 37,000
PS2447 Tendon transfer for median nerve injuries-multiple 20,000 26,600 30,000 35,000 40,000
PS2448 Tendon transfer for radial nerve injuries- multiple 20,000 26,600 30,000 35,000 40,000
PS2449 Tendon transfer for ulnar nerve injuries- multiple 20,000 26,600 30,000 35,000 40,000
PS2450 Tendon Transfer Single (Plastic Surg.) 17,500 23,275 26,250 30,625 35,000
PS2451 Thenar flap for finger tip injuries 14,000 18,620 21,000 24,500 28,000
PS2452 Thoracic pedicle flap 18,000 23,940 27,000 31,500 36,000
PS2453 Tm joint dislocation (cmplicatd)-closed red./imf(arch bars) 14,000 18,620 21,000 24,500 28,000
PS2454 Tm joint dislocation-open reduction 14,000 18,620 21,000 24,500 28,000
PS2455 Toe transfer- great toe 50,000 66,500 75,000 87,500 100,000
PS2456 Toe transfer- second toe 50,000 66,500 75,000 87,500 100,000
PS2457 Total parotidectomy 18,000 23,940 27,000 31,500 36,000
PS2458 Total parotidectomy (+ nerve gr) 22,000 29,260 33,000 38,500 44,000
PS2459 Total parotidectomy (nerve preserving) 18,000 23,940 27,000 31,500 36,000
PS2460 Total parotidectomy for recurrent tumour (+ nerve gr) 22,000 29,260 33,000 38,500 44,000
PS2461 Total parotidectomy for recurrent tumour (nerve preserving) 18,000 23,940 27,000 31,500 36,000
PS2462 Transverse etching (abdominal) 12,500 16,625 18,750 21,875 25,000
PS2463 Trapezius muscle transfer 25,000 33,250 37,500 43,750 50,000
PS2464 Triceps to biceps muscle transfer 25,000 33,250 37,500 43,750 50,000
PS2465 Trochanteric Bdsr Exc + primary CLSR B/L 17,500 23,275 26,250 30,625 35,000
PS2466 Trochanteric Bdsr Exc + primary CLSR U/L 14,000 18,620 21,000 24,500 28,000
PS2467 Trochanteric Bdsr Exc + skin flap CLSR B/L 19,000 25,270 28,500 33,250 38,000
PS2468 Trochanteric Bdsr Exc + skin flap CLSR U/L 17,500 23,275 26,250 30,625 35,000
PS2469 Trochanteric Bdsr Exc + skin gr B/L 22,000 29,260 33,000 38,500 44,000
PS2470 Trochanteric Bdsr Exc + skin gr U/L 17,500 23,275 26,250 30,625 35,000
PS2471 Trochanteric Bdsr Exc+myocutaneous fl CLSRB/L 22,000 29,260 33,000 38,500 44,000
PS2472 Trochanteric Bdsr Exc+myocutaneous fl CLSRU/L 17,500 23,275 26,250 30,625 35,000
PS2473 Ulnar artery forearm free flap 30,000 39,900 45,000 52,500 60,000
PS2474 Ulnar collateral ligament reconstruction of thumb 12,500 16,625 18,750 21,875 25,000
PS2475 Ulnar collateral ligament repair of thumb 10,000 13,300 15,000 17,500 20,000
PS2476 Ulnar nerve graft 22,000 29,260 33,000 38,500 44,000
PS2477 Ulnar nerve repair 15,000 19,950 22,500 26,250 30,000
PS2478 Upper extremity 38,000 50,540 57,000 66,500 76,000
PS2479 Vaginal tightening + perineorraphy 22,000 29,260 33,000 38,500 44,000
PS2480 Vanginoplasty 17,500 23,275 26,250 30,625 35,000
PS2481 V-y advancement flap for finger tip injuries 13,000 17,290 19,500 22,750 26,000
PS2482 Wide Exc of lesion in head and neck-major 17,500 23,275 26,250 30,625 35,000
PS2483 Wide Exc of lesion in head and neck-minor 10,000 13,300 15,000 17,500 20,000
PS2484 Zimmer splint application for multiple fingers 11,000 14,630 16,500 19,250 22,000
PSYCHIATRY & CLINICAL PSYCOLOGY

Service
Service Name Charges ( Rs.)
Code
CONSULTATION
PY1003 Psychotherapy Consultation 1,100
PY1007 Psychotherapy Consultation On Sunday 1,650
PY1008 Psychotherapy Family Therapy 1,250
PY1009 Psychotherapy Family Therapy On Sunday 1,825
PY1010 Psychiatry First Consultation 800
PY1011 Psychiatry Follow Up Consultation 700
PY1012 Psychiatry Long Consultation 1,200
PSYCHOMETRY PROCEDURES
PY2001 Assessment of relationship and conflict (2 session) 2,500
PY2003 ECT 2,300
PY2004 Intelligence Testing (2 Session) 3,000
PY2007 Memory Testing (1 Session) 2,500
PY2008 Neuropsychological Assessment (3 Session) 4,500
PY2009 Personality Assessment (2 Session) 2,500
PY2010 Pre-Academic Skills(1 Session) 2,000
PY2011 Psycho- Diagnostics (2 Session) 3,500
PY2012 Specific Learning Disability(2 Session) 4,000
Biofeedback Therapy ( For Tension, Headache, Migraine, Panic attack, Writer's cramp etc.)
PY3001 Neuro disorder (Single session) 2,500
Page 55
PY3002 Neuro disorder (5 sessions) 10,000
PY3003 Neuro disorder (10 sessions) 18,000
PY3004 Psyciatry disorder (Single session) 2,500
PY3005 Psyciatry disorder (5 sessions) 10,000
PY3006 Psyciatry disorder (10 sessions) 18,000
RESPIRATORY MEDICINE
Service Name Two bed Single bed Deluxe room VIP Suite
Code bed
RM1001 Bronchopleural Fistula 15,000 15,000 15,000 15,000 15,000
RM1002 Bronchoscopy 4,500 5,985 6,750 7,875 9,000
RM1003 Bronchoscopy With B.A.L (Lavage) With Biopsy 12,000 12,000 12,000 12,000 12,000
RM1004 Bronchoscopy With B.A.L (Lavage) 10000 13300 15000 17500 20000
RM1005 Bronchoscopy With TBLB (Transbronchial Lung Biopsy) 12,000 12,000 12,000 12,000 12,000
RM1006 Decortication Lung 16,000 21,280 24,000 28,000 32,000
RM1007 Diagnostics Thoracoscopy 6,000 7,980 9,000 10,500 12,000
RM1008 Intercostal Drainage 9000 11970 13500 15750 18000
RM1009 Intercostal Drainage For Pneumothorax 9000 11970 13500 15750 18000
RM1010 Lobectomy 17,000 22,610 25,500 29,750 34,000
RM1011 Lung Biopsy Open 6,000 7,980 9,000 10,500 12,000
RM1012 Mediastinal Mass Excision 18,000 23,940 27,000 31,500 36,000
RM1013 PFT ( Pulmonary Function Test) 850 1,275 1,381 1,594 1,806
RM1014 Pleurectomy & Excision Of Empyema Without Lung Resection 16,000 21,280 24,000 28,000 32,000
RM1015 Pleurodesis Chemical 7000 9310 10500 12250 14000
RM1016 Pleurodesis Talk Insuffolation 7000 9310 10500 12250 14000
RM1017 Pleural biopsy 7000 9310 10500 12250 14000
RM1018 Pleural Taping Diagnostic 2000 2660 3000 3500 4000
RM1019 Pleural Taping Therapeutic 4000 5320 6000 7000 8000

RM1020 Pneumonectomy 20,000 26,600 30,000 35,000 40,000
RM1021 Rib Resection & Drainage 8,000 10,640 12,000 14,000 16,000
RM1022 Sleep Study 8000 10,000 12,000 14,000 16,000
RM1023 Split Night Study 8,000 10,000 12,000 14,000 16,000
RM1024 Thoracoplasty & Apicolysis 15,000 19,950 22,500 26,250 30,000
RM1025 Thoracotomy Exploratory 15,000 19,950 22,500 26,250 30,000
RM1026 Titration Study 8,000 10,000 12,000 14,000 16,000
RM1027 Video Assited Thorcoscopy Therapeutic 18,000 23,940 27,000 31,500 36,000
RM1028 CT Guided FNAC/Biopsy 5,000 6,650 7,500 8,750 10,000
RM1029 Bronchoscopy for Foreign Body Removal 12,000 15,960 18,000 21,000 24,000
RM1030 USG Guided FNAC 3,000 3,990 4,500 5,250 6,000
RM1031 USG Guided Biopsy 4,000 5,320 6,000 7,000 8,000
RM1032 ICD Tube Removal 3000 3990 4500 5250 6000
SPINE
Service
Service Name OPD
Code
Spine OP packages
SP1001 Nerve Blocks ( Level one ) 9,900
SP1002 Nerve Blocks ( Level Two ) 13,200
SP1003 Nerve Blocks ( Level Three or more ) 17,600
Package Includes: Doctor fee, OT charges, Equipment charges and Routine drugs and consumables
Stay
Spine IP packages Six/ Nine bed Two bed Single bed Deluxe room VIP Suite
days
SP2001 Endoscopic Discectomy (one level) 1 161,700 219,450 242,550 288,750 323,400
SP2002 Endoscopic Discectomy (two level/Biportal) 1 242,550 317,680 358,050 404,250 462,000
SP2003 Endoscopic Spine Fusion (one level) 2 225,280 300,410 346,610 398,530 456,390
SP2004 Fenestration (one level) 2 94,710 115,500 127,050 150,150 173,250
SP2005 Fenestration (two level) 2 115,500 138,600 155,980 173,250 207,900
SP2006 Intersegmental Decompression (one level) 4 202,180 231,110 265,760 311,960 346,610
SP2007 Intersegmental Decompression (two levels) 4 231,000 265,650 300,300 346,500 404,250
SP2008 Laminectomy (one level) 2 84,370 104,060 120,230 138,710 155,980
SP2009 Laminectomy (two and more levels) 3 107,470 132,880 152,570 173,360 202,180
SP2010 Microdiscectomy (one level) 3 138,600 173,250 196,350 219,450 254,100
SP2011 Microdiscectomy (Two level) 3 184,800 219,450 242,550 283,030 323,400
SP2012 Microdiscectomy (three level and above) 3 225,280 300,410 346,610 398,530 456,390
SP2013 Spinal Instrumentation (one/two level) 5 184,800 225,280 254,100 294,580 334,950
SP2014 Spinal Instrumentation (three or more levels) 5 231,000 265,650 300,300 346,500 404,250
SP2015 TLIF (one level) 4 202,180 231,110 265,760 311,960 346,610
SP2016 TLIF (two or more level) 5 231,000 265,650 300,300 346,500 404,250
Package Includes: Stay as mentioned, Surgeon fee, OT charges, anesthesia charge, basic Investigations , Routine drugs and consumables , Equipment charges & Physiotherapy
Page 56
Package excludes: Implant cost, additional stay, Professional charges of other consultants, any additional procedure/investigation, CT/MRI and Use of special drugs/ consumables
e.g. tisseal/tissue patch etc.
Procedure/surgery Six/ Nine bed Two bed Single bed Deluxe room VIP Suite
SP3001 Antero Lateral Decompression and reconstruction 50,248 66,825 75,372 87,934 100,496
SP3002 Bone Flap Removel 35,233 46,860 52,855 61,655 70,466
SP3003 Bone Grafting Any Site Medium 8,899 11,836 13,354 15,576 17,798
SP3004 Bone Grafting only( in Non Union)Large 11,209 14,905 16,819 19,613 22,418
SP3005 Carpal Tunnel Syndrome 26,565 35,332 39,853 46,486 53,130
SP3006 Cervical Decompressive Laminectomy 35,233 46,860 52,855 61,655 70,466
SP3007 Combined anterior & posterior procedure for spine anomaly 69,300 92,169 103,950 121,275 138,600
SP3008 CT guided Nerve Root Block (one level) 8,899 11,836 13,354 15,576 17,798
SP3009 CT guided Nerve Root Block (Two level) 12,133 16,137 18,205 21,230 24,266
SP3010 Decompressive Laminectomy (1 or 2 levels) 21,530 28,630 32,300 37,680 43,060
SP3011 Decompressive Laminectomy (3 or more levels) 29,689 39,490 44,539 51,953 59,378
SP3012 Discography (One Level) 3,817 5,082 5,731 6,677 7,634
SP3013 Discography (Two Level) 5,775 7,678 8,668 10,109 11,550
SP3014 Discography (Three Level and above) 8,899 11,836 13,354 15,576 17,798
SP3015 Endoscopic cervical disectomy 51,975 69,124 77,968 90,959 103,950
SP3016 Endoscopic cervical disectomy with fusion 66,418 88,341 99,627 116,237 132,836
SP3017 Epidural Steroid Injection 2,893 3,850 4,345 5,060 5,786
SP3018 Facetal Injection (Single level) 2,893 3,850 4,345 5,060 5,786
SP3019 Facetal Injection (Mutiple Level) 5,203 6,919 7,810 9,108 10,406
SP3020 Fibular Strut Grafting 12,705 16,896 19,063 22,231 25,410
SP3021 Interlaminar Fenestration spine 23,100 30,723 34,650 40,425 46,200
SP3022 Kyphoplasty One Level 35,233 46,860 52,855 61,655 70,466
Procedure/surgery Six/ Nine bed Two bed Single bed Deluxe room VIP Suite
SP3023 Kyphoplasty Two Level 47,355 62,986 71,038 82,874 94,710

SP3024 Kyphoplasty Three Level and above 51,975 69,124 77,968 90,959 103,950
SP3025 LCS Decompression 29,458 39,182 44,187 51,557 58,916
SP3026 Manipulations skull traction 4,741 6,303 7,117 8,294 9,482
SP3027 Microdisectomy & artificial disc replacement (One level) 50,248 66,825 75,372 87,934 100,496
SP3028 Microdisectomy & artificial disc replacement (Two level) 57,178 76,043 85,767 100,067 114,356
SP3029 Microdisectomy & artificial disc replacement (Three level) 61,798 82,192 92,697 108,152 123,596
SP3030 Microscopic Intersegmental Decompression One Level 50,248 66,825 75,372 87,934 100,496
SP3031 Microscopic Intersegmental Decompression Two Level 57,178 76,043 85,767 100,067 114,356
SP3032 Minerva Jacket Application 12,133 16,137 18,205 21,230 24,266
SP3033 Nerve Root Block one Level 3,817 5,082 5,731 6,677 7,634
SP3034 Nerve Root Block Three Level 8,899 11,836 13,354 15,576 17,798
SP3035 Nerve Root Block Two Level 5,775 7,678 8,668 10,109 11,550
SP3036 Nerve root entrapment release 9,240 12,287 13,860 16,170 18,480
SP3037 Percutaneous CT guided biopsy 12,133 16,137 18,205 21,230 24,266
SP3038 Percutaneous Transforaminal Endoscopic Spinal Fusion ( One Level) 57,178 76,043 85,767 100,067 114,356
SP3039 Percutaneous Endoscopic Spinal Fusion ( Two Levels) 69,300 92,169 103,950 121,275 138,600
SP3040 Percutaneous Fluoroscopic guided biopsy 8,899 11,836 13,354 15,576 17,798
SP3041 Percutaneous Spinal fracture stabilization with pedicle screws 51,975 69,124 77,968 90,959 103,950
SP3042 Percutaneous Endoscopy Disectomy (Level I) 66,990 89,100 100,485 117,238 133,980
SP3043 Percutaneous Endoscopy Disectomy (Level II) 86,625 115,214 129,943 151,591 173,250
SP3044 Posterior vertebral column resection with instrumentation 57,178 76,043 85,767 100,067 114,356
SP3045 Postero lateral fusion Spondylolisthesis 35,233 46,860 52,855 61,655 70,466
SP3046 Posteroior decompression with fusion 26,565 35,332 39,853 46,486 53,130
SP3047 Revision Surgery for Lumbar / Cervical Disc Disease 61,798 82,192 92,697 108,152 123,596
SP3048 Sacroiliac Joint injection ( Bilateral) 7,161 9,526 10,747 12,529 14,322
SP3049 Sacroiliac Joint injection ( Unilateral) 4,741 6,303 7,117 8,294 9,482
SP3050 Scoliosis AP release instrumentation spine 66,990 89,100 100,485 117,238 133,980
SP3051 Scoliosis anteroposterior release spine with cast 51,975 69,124 77,968 90,959 103,950
SP3052 Scoliosis correction Posterior - spine 66,990 89,100 100,485 117,238 133,980
SP3053 Spinal Dysraphism 50,248 66,825 75,372 87,934 100,496
SP3054 Spinal Fracture posterior fixation 32,030 42,600 48,050 56,050 64,060
SP3055 Spinal Fracture posterior fixation with fusion 47,355 62,986 71,038 82,874 94,710
SP3056 Spinal jacket application 7,161 9,526 10,747 12,529 14,322
SP3057 Spinal Tumor 50,248 66,825 75,372 87,934 100,496
SP3058 Trans Oral Decompression For CV Junction Anomaly 50,248 66,825 75,372 87,934 100,496
SP3059 Translaminar Microdisectomy One Level 47,355 62,986 71,038 82,874 94,710
SP3060 Translaminar Microdisectomy Two Level 57,178 76,043 85,767 100,067 114,356
SP3061 Translaminar Microdisectomy Three Level 61,798 82,192 92,697 108,152 123,596
SP3062 Vertebral column resection 66,418 88,341 99,627 116,237 132,836
SP3063 Vertebral Instrumentation 61,798 82,192 92,697 108,152 123,596
SP3064 Vertebroplasty One Level 26,565 35,332 39,853 46,486 53,130
SP3065 Vertebroplasty Two Level 32,340 43,010 48,510 56,595 64,680
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SP3066 Vertebroplasty Three Level and above 41,580 55,297 62,370 72,765 83,160
SP3067 Removal of spinal cord stimulator minor 23,683 31,493 35,530 41,448 47,366
SP3068 Removal of spinal cord stimulator major 35,233 46,860 52,855 61,655 70,466
SP3069 Implant removal minor 8,085 10,758 12,133 14,146 16,170
SP3070 Implant removal major 26,565 35,332 39,853 46,486 53,130
SP3071 Implant repositioning minor 4,048 5,379 6,072 7,084 8,096
SP3072 Implant repositioning major 14,443 19,206 21,670 25,278 28,886
SP3073 Re exploration of spine surgery minor 2,310 3,069 3,465 4,048 4,620
SP3074 Re exploration of spine surgery major 13,288 17,677 19,932 23,254 26,576
SP3075 Release of tethered cord 29,458 39,182 44,187 51,557 58,916
SP3076 Fusion surgery minor 11,550 15,367 17,325 20,218 23,100
SP3077 Fusion surgery major 26,250 34,910 39,380 45,940 52,500
UROLOGY
Code bed
Minor Surgery/Procedures
UR1001(A) A V Fistula- RC AVF 7,000 9,310 10,500 12,250 14,000
UR1001(B) A V Fistula- BC AVF 9,000 11,970 13,500 15,750 18,000
UR1001( C) A V Fistula-BBT AVF 11,000 14,630 16,500 19,250 22,000
UR1002 Capd Catheter Insertion 6,000 7,980 9,000 10,500 12,000
UR1003 Capd Catheter Removal 6,000 7,980 9,000 10,500 12,000
UR1004 Catheterization 1,000 1,330 1,500 1,750 2,000
UR1005 Catheter Removal 200 266 300 350 400
UR1006 Chordee Correction 6,500 8,645 9,750 11,375 13,000
UR1007 Circumcision 4,500 5,985 6,750 7,875 9,000
UR1008 Cmg +Uroflowmetry 4,500 5,985 6,750 7,875 9,000
UR1009 Cmg+Emg 4,500 5,985 6,750 7,875 9,000
UR1010 Cmg+Emg+Uroflowmetry 5,000 6,650 7,500 8,750 10,000
UR1011 Cystolithotomy Suprapubic 6,700 8,911 10,050 11,725 13,400
UR1012 Cystometery (Bedside) 2,500 3,325 3,750 4,375 5,000
UR1013 Cystometrogram (Cmg) 3,800 5,054 5,700 6,650 7,600
UR1014 Cystoscopic Clot Evacuation 5,000 6,650 7,500 8,750 10,000
UR1015 Cystoscopic Removal Of Foreign Bodies 6,000 7,980 9,000 10,500 12,000
UR1016 Cystoscopic Uretheral Alignment 9,000 11,970 13,500 15,750 18,000
UR1017 Cystoscopy Diagnostic 3,500 4,655 5,250 6,125 7,000
UR1018 Cystoscopy With Bladder Biopsy 4,500 5,985 6,750 7,875 9,000
UR1019 Cystoscopy With Retrograde Catheterisation Bilateral 6,000 7,980 9,000 10,500 12,000
UR1020 Cystoscopy With Retrograde Catheterisation Unilateral 5,000 6,650 7,500 8,750 10,000
UR1021 Debridement Of Fronier Gangrene 8,000 10,640 12,000 14,000 16,000
UR1022 Dilatation Of Stricture Urethra Under GA 2,500 3,325 3,750 4,375 5,000
UR1023 Dilation Of Stricture Urethra Without Anesthesia 1,500 1,995 2,250 2,625 3,000
UR1024 Dj Stent Removal Bilateral 2,500 3,325 3,750 4,375 5,000
UR1025 Dj Stent Removal Unilateral 2,000 2,660 3,000 3,500 4,000
UR1026 Dj Stenting Bilateral 7,500 9,975 11,250 13,125 15,000
UR1027 Dj Stenting Unilateral 6,500 8,645 9,750 11,375 13,000
UR1028 Drainage Of Scrotal Abscess 4,500 5,985 6,750 7,875 9,000
UR1029 Endoscopic Removal Of Stone In Bladder 9,000 11,970 13,500 15,750 18,000
UR1030 Endoscopic ureterocele incision U/L 8,000 10,640 12,000 14,000 16,000
UR1031 Excision Of Epididymis 8,000 10,640 12,000 14,000 16,000
UR1032 Excision Of Spermatocoele 6,000 7,980 9,000 10,500 12,000
UR1033 Exploratory Scrototomy 4,000 5,320 6,000 7,000 8,000
UR1034 Frenuloplasty 2,000 2,660 3,000 3,500 4,000
UR1035 Hydrocele U/L 5,000 6,650 7,500 8,750 10,000
UR1036 Intravasical Bcg Injection 1,000 1,330 1,500 1,750 2,000
UR1038 Lymph Node Biopsy 2,500 3,325 3,750 4,375 5,000
UR1039 Meatoplasty 7,000 9,310 10,500 12,250 14,000
UR1040 Meatotomy (Adult) 2,500 3,325 3,750 4,375 5,000
UR1041 Needle Aspiration (Renal Cyst) 6,000 7,980 9,000 10,500 12,000
UR1042 Nephrostomy (Open) 8,000 10,640 12,000 14,000 16,000
UR1043 Nephrostomy (Percutaneous) 8,000 10,640 12,000 14,000 16,000
UR1044 Non Scalpel Vasectomy 6,000 7,980 9,000 10,500 12,000
UR1045 Optical Urethrotomy 8,500 11,305 12,750 14,875 17,000
UR1046 Orchidectomy Unilateral (Uro) 7,000 9,310 10,500 12,250 14,000
UR1047 Orchidectomy Bilateral (Uro) 9,000 11,970 13,500 15,750 18,000
UR1048 Orchidopexy Unilateral 8,000 10,640 12,000 14,000 16,000
UR1049 Para Phimosis 2,600 3,458 3,900 4,550 5,200
UR1050 Penile Injection With Or Without Teaching Sessions 2,000 2,660 3,000 3,500 4,000
UR1051 Percutaneous Cystolithotomy (Pccl) 8,800 11,704 13,200 15,400 17,600
UR1052 Percutaneous Kidney 5,000 6,650 7,500 8,750 10,000
UR1053 Perineal Urethrostomy 11,000 14,630 16,500 19,250 22,000
UR1054 R.G.P B/L 5,000 6,650 7,500 8,750 10,000
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UR1055 R.G.P U/L 4,000 5,320 6,000 7,000 8,000
UR1056 Resection Bladder Neck Endoscopic 9,000 11,970 13,500 15,750 18,000
UR1057 Scrotal Cyst Excision 6,000 7,980 9,000 10,500 12,000
Code bed
UR1058 Semino Vesiculogram 3,200 4,256 4,800 5,600 6,400
UR1059 Sildinafil essection test 1,000 1,330 1,500 1,750 2,000
UR1060 Sting Endoscopic Surgery Bilateral 8,000 10,640 12,000 14,000 16,000
UR1061 Suprapubic Drainage ( Cystostomy ) 4,000 5,320 6,000 7,000 8,000
UR1062 Testicular Biopsy 3,000 3,990 4,500 5,250 6,000
UR1063 Trans Rectal Prostate Biopsy 3,000 3,990 4,500 5,250 6,000
UR1064 Trans Rectal Trus Guided Prostate Biopsy 3,500 4,655 5,250 6,125 7,000
UR1065 Trocar Cystostomy 3,500 4,655 5,250 6,125 7,000
UR1066 Ureteral Reimplantation U/L 9,000 11,970 13,500 15,750 18,000
UR1067 Uretrolithotomy 9,000 11,970 13,500 15,750 18,000
UR1068 Uroflowmetry 800 1,064 1,200 1,400 1,600
UR1069 Vasectomy 4,400 5,852 6,600 7,700 8,800
UR1070 BLADDER NECK INCISION 9,000 11,970 13,500 15,750 18,000
UR1071 DORSAL SLIT 3,000 3,990 4,500 5,250 6,000
UR1072 GENITO URINARY INJURY REPAIR 8,000 10,640 12,000 14,000 16,000
UR1073 HORMONAL INJECTION FOR CA PROSTATE 800 1,064 1,200 1,400 1,600
UR1074 INTRAVESICAL MEDICINE INSTILLATION 1,000 1,330 1,500 1,750 2,000
UR1075 NEPHROSTOMY CHANGE 1,000 1,330 1,500 1,750 2,000
UR1076 POSTERIOR URETHRAL VALVE FULGURATION 9,000 11,970 13,500 15,750 18,000
UR1077 TORSION TESTIS (UNILATERAL) 7,500 9,975 11,250 13,125 15,000
UR1078 URETHRAL Stone removal 9,000 11,970 13,500 15,750 18,000
UR1079 Vesicostomy 8,500 11,305 12,750 14,875 17,000
UR1080 Bladder wash 2,000 2,660 3,000 3,500 4,000
Major surgery - - - - -
UR2001 Abscess Drainage Perinephric 10,000 13,300 15,000 17,500 20,000
UR2002 Adrenalectomy Bilateral 22,000 29,260 33,000 38,500 44,000
UR2003 Adrenalectomy Unilateral 15,000 19,950 22,500 26,250 30,000
UR2004 Andreson Hynes Pyeloplasty 13,000 17,290 19,500 22,750 26,000
UR2005 Bladder Diverticulectomy Excision 15,000 19,950 22,500 26,250 30,000
UR2006 Bladder Injury Repair 10,000 13,300 15,000 17,500 20,000
UR2007 Bladder Stone Removal 10,000 13,300 15,000 17,500 20,000
UR2008 Botox inj. 11,000 14,630 16,500 19,250 22,000
UR2009 Buccal Mucosel Urethroplasty 18,000 23,940 27,000 31,500 36,000
UR2010 Closure Fo Urethral Fistula 12,000 15,960 18,000 21,000 24,000
UR2011 Cystectomy Partial (Bladder) 10,000 13,300 15,000 17,500 20,000
UR2012 Cystectomy Radical 20,000 26,600 30,000 35,000 40,000
UR2013 Cystectomy Radical With Uretrosigmoidostomy 23,000 30,590 34,500 40,250 46,000
UR2014 Cystectomy Radical With Continent Diversion 30,000 39,900 45,000 52,500 60,000
UR2015 Cystectomy Radical With Ileal Conduit 25,000 33,250 37,500 43,750 50,000
UR2016 Cystectomy Total (Bladder Removal) 20,000 26,600 30,000 35,000 40,000
UR2017 Endopyelotomy 16,000 21,280 24,000 28,000 32,000
UR2018 Epispadias Repair 15,000 19,950 22,500 26,250 30,000
UR2019 Exystropy Repair (Urology) 15,000 19,950 22,500 26,250 30,000
UR2020 Gil Vernit Extended Pyelolithotomy 13,000 17,290 19,500 22,750 26,000
UR2021 Cytoplasty Augmentation 18,000 23,940 27,000 31,500 36,000
UR2022 Inguinal Lymph Node Dissection B/L 15,000 19,950 22,500 26,250 30,000
UR2023 Inguinal Lymph Node Dissection U/L 10,000 13,300 15,000 17,500 20,000
UR2024 Kidney Injury Repair 12,000 15,960 18,000 21,000 24,000
UR2025 Lap Adnenolectomy B/L 30,000 39,900 45,000 52,500 60,000
UR2026 Lap Adnenolectomy U/L 20,000 26,600 30,000 35,000 40,000
UR2027 Lap Nephrectomy 20,000 26,600 30,000 35,000 40,000
UR2028 Lap Orchidopexy/Orchidectomy 15,000 19,950 22,500 26,250 30,000
UR2029 Lap Renal Cyst Excision 14,000 18,620 21,000 24,500 28,000
UR2030 Lap Uretero Lithotomy/Pyelolithotomy 12,000 15,960 18,000 21,000 24,000
UR2031 Lap. Nephro - Ureterectomy 33,000 43,890 49,500 57,750 66,000
UR2032 Lap. Pyeloplasty 20,000 26,600 30,000 35,000 40,000
UR2033 Lap. Radical Cystectomy 45,000 59,850 67,500 78,750 90,000
UR2034 Lap. Radical Nephrectomy 25,000 33,250 37,500 43,750 50,000
UR2035 Lap. Radical Prostatectomy 40,000 53,200 60,000 70,000 80,000
Code bed
UR2043 Micro Ligation Of Varicocele 11,000 14,630 16,500 19,250 22,000
UR2044 Nephrectomy (Simple) 12,000 15,960 18,000 21,000 24,000
UR2045 Nephrectomy Complicated Tumor Or Adhesions 16,000 21,280 24,000 28,000 32,000
UR2046 Nephrectomy Nephroureterectomy (Radical) 20,000 26,600 30,000 35,000 40,000
UR2047 Nephrolithotomy 13,000 17,290 19,500 22,750 26,000
Page 59
UR2048 Nesbits Procedure 14,000 18,620 21,000 24,500 28,000
UR2049 Orchidopexy Bilateral 11,500 15,295 17,250 20,125 23,000
UR2050 Partial Nephrectomy 20,000 26,600 30,000 35,000 40,000
UR2051(B) PCNL (Percutaneous Nephrolithotomy) - simple 15,000 19,950 22,500 26,250 30,000
UR2051(A) PCNL (Percutaneous Nephrolithotomy) - pertial staghoen 18,000 23,940 27,000 31,500 36,000
UR2051(C ) PCNL (Percutaneous Nephrolithotomy) - staghoen 20,000 26,600 30,000 35,000 40,000
UR2052 PCNL with Endopylerotomy 22,000 29,260 33,000 38,500 44,000
UR2053 Pelvic Floor Repair 15,000 19,950 22,500 26,250 30,000
UR2054 Pelvicflor Repair-Mesh (Anterior) 15,000 19,950 22,500 26,250 30,000
UR2055 Pelvicflor Repair-Mesh (Posterior) 17,000 22,610 25,500 29,750 34,000
UR2056 Pelvicflor Repair-Mesh (Total) 25,000 33,250 37,500 43,750 50,000
UR2057 Penile Posthesis (Inflatable) 30,000 39,900 45,000 52,500 60,000
UR2058 Penile Posthesis (Semimaleable) 20,000 26,600 30,000 35,000 40,000
UR2059 Penis Fracture Repair 10,000 13,300 15,000 17,500 20,000
UR2060 Penis Partial Amputation (Uro) 11,000 14,630 16,500 19,250 22,000
UR2061 Penis Total Amputation (Uro) 15,000 19,950 22,500 26,250 30,000
UR2062 Perineal End Of End Urethroplasty 15,000 19,950 22,500 26,250 30,000
UR2063 Prostatectomy Open 15,000 19,950 22,500 26,250 30,000
UR2064 Prostatic Stenting 15,000 19,950 22,500 26,250 30,000
UR2065 Pyelolithotomy 13,000 17,290 19,500 22,750 26,000
UR2066 Radical Prostatectomy 27,000 35,910 40,500 47,250 54,000
UR2067 Retrograde Intrarenal Surgery (Rirs) 17,000 22,610 25,500 29,750 34,000
UR2068 Retroperitoneal Tumor excision 21,000 27,930 31,500 36,750 42,000
UR2069 Rplnd 22,000 29,260 33,000 38,500 44,000
UR2070 Sling Surgery For Incontinence 14,000 18,620 21,000 24,500 28,000
UR2071 Substitution Urethroplasty 25,000 33,250 37,500 43,750 50,000
UR2072 Transpubic Urethroplasty 30,000 39,900 45,000 52,500 60,000
UR2073(A) Transurethral Resection Of Bladder Tumor(small) 14,000 18,620 21,000 24,500 28,000
UR2073(b) Transurethral Resection Of Bladder Tumor(large) 16,000 21,280 24,000 28,000 32,000
UR2074(A) Transurethral Resection Of Prostate (Turp) - small 14,000 18,620 21,000 24,500 28,000
UR2074(B) Transurethral Resection Of Prostate (Turp) - large 16,000 21,280 24,000 28,000 32,000
UR2075 Ureter Uretrostomy 15,000 19,950 22,500 26,250 30,000
UR2076 Uretero Sigmoid Diversion 15,000 19,950 22,500 26,250 30,000
UR2077(A) Ureteroscopic Removal Of Stone(URS) grade-I 12,000 15,960 18,000 21,000 24,000
UR2077(B) Ureteroscopic Removal Of Stone(URS) grade-II 14,000 18,620 21,000 24,500 28,000
UR2078 Ureteral Reimplantation B/L 15,000 19,950 22,500 26,250 30,000
UR2079 Urethroplasty First Stage 10,000 13,300 15,000 17,500 20,000
UR2080 Urethroplasty One Stage Procedure 16,000 21,280 24,000 28,000 32,000
UR2081 Urethroplasty Second Stage 12,000 15,960 18,000 21,000 24,000
UR2082 Uretro Calicostomy 25,000 33,250 37,500 43,750 50,000
UR2083 Urs+Dj Stenting(Uni)+Cystoscopy Diag 16,000 21,280 24,000 28,000 32,000
UR2084 Vaso Epididymostomy 10,000 13,300 15,000 17,500 20,000
UR2085 Vaso Epididymostomy (Under Microscope) 14,000 18,620 21,000 24,500 28,000
UR2086 Vasovasostomy (Under Microscope) 12,000 15,960 18,000 21,000 24,000
UR2087 Vesicovaginal Fistula 18,000 23,940 27,000 31,500 36,000
UR2088 MAGPI 14,000 18,620 21,000 24,500 28,000
UR2089 MITROFANOFF 20,000 26,600 30,000 35,000 40,000
UR2090 NEPHRECTOMY RADICAL 22,800 30,324 34,200 39,900 45,600
UR2091 PEYRONNIEE PLAGUE EXCISION & VEIN GRAFTING 16,000 21,280 24,000 28,000 32,000
UR2092 TIP URETHROPLASTY 15,000 19,950 22,500 26,250 30,000
UR2093 URETEROLYSIS (UNILATERAL) 12,000 15,960 18,000 21,000 24,000
UR2094 URETHROPLASTY DISTAL HYPOSPADIAS 16,000 21,280 24,000 28,000 32,000
UR2095 URETHROPLASTY MID PROXIMAL HYPOSPADIAS 19,500 25,935 29,250 34,125 39,000
UR2096 WEBBED PENIS RELEASE 15,000 19,950 22,500 26,250 30,000
UR2097 Ureteric injury Repair 12,000 15,960 18,000 21,000 24,000
Lithotripcy Package
UR2039 Lithotripcy Level I 15,000
UR2040 Lithotripcy Level Ii 22,500
UR2041 Lithotripcy Level Iii 29,000
UR2042 Lithotripcy Level Iv 36,000
The package include Surgeon fee, OT charges and equipment charges only. Any room rent/ investigation/ Anesthesia/ pharmacy and consumables will be additional.
Laser equipment charge

UR1037 Laser Level-1 6,000
ICU/WARD SERVICES
Service
Code
Registration Charges
Page 60
MS1001 REGISTRATION FEE 100
MS1002 Mommy's first card registration 2,000
Monitoring Charges
MS2001 Cardiac Monitoring < 8 Hours 600
MS2002 Cardiac Monitoring > 8 Hours 1,100
MS2003 IABP monitoring per day 2,000
MS2004 ICP Monitoring 2,500
ICU/ Ward services
MS3001 Administrative /MRD Charges 500
MS3002 Alpha Bed Charges (Per Day) 200
MS3003 Attendent Room Charges as per bed occupied
MS3004 Cd Charges For Cath lab/DSA lab) 500
MS3005 Extra Nursing Care (12 Hours) 1,200
MS3008 Injection Charges (Im/Iv) 100
MS3009 Mortuary Sheet 350
MS3010 Nebulization (Per siting)) 200
MS3011 Nebulization (Per Day) 650
MS3012 Oxygen Charge (Per Hour) 50
MS3013 Oxygen Charges Per Day 750
MS3014 Syringe Pump / Infusion Pump 400
MS3015 Vaccination Charge For New Born Baby 50
MS3016 Abg/Elec/Met in wards/critical area 1,440
MS3017 Blood Sugar monitoring(Glucomeeter) 110
MS3023 Mortuary charges (Up to to 12 Hrs) Nil
MS3024 Mortuary charges (after12 Hrs upto 24 Hrs) 1,500
MS3025 Mortuary charges (More than 24 Hrs) 3,000
MS3026 Hospitals Gown Charges (If dress /gown Returned within seven days) 1,000
Equipment charges
MS4001 Harmonic 5,000
MS4002 Laparoscope Charges 5,000
MS4003(A) C Arm( Major) 3,000
MS4003(B) C Arm ( Minor) 1,000
MS4004 Dvt Pump/ Pneumatic per day 600
MS4006(A) Bipap/Cpap Charges (Per Day)- Less Than 8 Hrs 1,000
MS4006(B) Bipap/Cpap Charges (Per Day)- More Than 8 Hrs 2,000
MS4007 Hysteroscope/Cystoscope/ Ureteroscope/ Endoscope 1,000
MS4008 Neuro Endoscope 6,000
MS4009 Ventilator Charges (Less Then 8 Hours) 1,500
MS4010 Ventilator Charges(More Then 8 Hours) 3,000
MS4011 Ventilator Charges - Stand By (Reserved) 1,500
MS4015 Arthroscopic system 4,000
MS4016 Ureterscope/Cystoscope/Nephroscope/ENT scope 1,000
MS4017 ENT Drill 1,000
MS4018 ENT Microscope 1,000
MS4019 Recording system 1,000
MS4020 Onco Microscope 5,000
MS4021 Onco Drill/Saw 6,000
MS4022 Neuro drill 6,000
MS4023 Neuro Microscope 5,000
MS4024 Onco/Neuro Microscope ( Minor) 1,000
MS4025 Onco Drill/Saw ( Minor) 1,000
MS4026 Phaco Machine 3,000
MS4027 Opthal ( Eye) Microscope 1,000
MS4028 Harmonic Probe 1,500
MS4029 Harmonic Focus 1,000
MS4030 Enseal hand probe ( Open surgery) 1,000
MS4031 Enseal hand probe ( Lap surgery) 2,000
MS4032 Linear Cutter 1,000
Other Procedures
MS5005 Aspiration Cold Abscess 1,560
Service
Code
MS5029 Enema Administration 270
MS5033 Gastric Lavage 1,000
MS4013 Difficult Airway Tool 2,000
Blood Bank
Service
Service Name OP CHARGES IP CHARGES
Code
BD1001 Antibody Screening 220 260
BD1002 Apheresis Platelets 13,500 16,200
BD1003 Cross Matching Charges & Blood Grouping 400 480
Page 61
BD1004 Donor Screening For apheresis 1,500 1,800
BD1005 Whole Blood - Processing Charges 2,100 2,520
BD1006 Fresh Frozen Plasma 750 900
BD1007 Packed Cell 1,400 1,680
BD1008 Packed Cell (Leukoreduced) 2,500 3,000
BD1009 Platelet Concentrates (Processing Charges) 750 900
BD1010 Polycythaemia Phlebotomy 500 600
BD1011 Therapeutic Phlebotomy 300 360
BD1012 Subsequent Pack 250 300
BD1013 Thermocol packing Charges 100 120
BD1014 Donor Security Deposit (Refundable) 2,000 2,400
BD1015 TRANSFUSION CHARGES 300 360
CARDIOLOGY INVESTIGATION
Service
Code
CI1001 ECG 300 NA
CI1002 ECG Bedside NA 300
CI1003 Echo Doppler 2,200 NA
CI1004 Echo Doppler (Bed Side) NA 2,500
CI1005 Echo Fetal 2,400 2,880
CI1006 Echo (Paediatrics / Neonatal ) 3,000 3,600
CI1007 Echo Screening 1,350 1,620
CI1008 Echo Stress 3,000 3,600
CI1009 Echo Stress (Dobutamine) 3,500 4,200
CI1010 Echo Trans Esophageal 2,500 3,000
CI1011 Holter Analysis 2,500 3,000
CI1012 Tilt Test 2,700 3,240
CI1013 TMT 1,500 1,800
LABORATORY SERVICES
Service
Code
BIOCHEMISTRY
LB1001 Adenosine Deaminase (ADA) 550 660
LB1002 Alkaline Phosphatase 160 192
LB1003 Amylase 400 480
LB1004 Anti Streprolysin-O\ Aslo\ Aso Titre 500 600
LB1006 Ascitic Fluid Analysis - Sugar/Glucose And Protein 400 480
LB1007 Bilirubin Total And Direct 240 288
LB1008 Blood Sugar (Random) 100 120
LB1009 Blood Sugar 2 Hr. Pp 100 120
LB1010 Blood Sugar Fasting 100 120
LB1011 Calcium 150 180
LB1012 Chloride 160 192
LB1013 Cholesterol 140 168
LB1014 C-Reactive Proteins (CRP) 550 660
LB1015 Creatinine 150 180
LB1016 Creatinine Kinase (CPK) 250 300
LB1017 Creatinine Kinase MB 350 420
LB1018 Electrolytes (NA\K\Cl) 350 420
LB1019 Fluid Amylase 350 420
LB1020 G - 6 Pd Deficiency Test 700 840
LB1021 Ggtp (Gamma Gt) 170 204
LB1022 Glucose Challenge Test (GCT) 110 132
LB1023 Glucose Tolerance Test (75 Gram Glucose) 350 420
LB1024 Glucose Tolerance Test (Gestation 100 Gram Glucose) 350 420
LB1025 Glycosylated Haemoglobin 700 840
LB1026 HDL Cholesterol 250 300
LB1027 Iron And Total Iron Binding Capacity 650 780
LB1028 Lactate, Plasma 800 960
LB1029 LDH Total (Serum) 350 420
LB1030 Lipase 550 660
LB1031 Lipid Profile 800 960
LB1032 Liver Function Test Profile 800 960
LB1033 Magnesium Serum 450 540
LB1034 Microalbuminuria (MAU) 430 516
LB1035 Other Fluid Analysis - LDH 350 420
LB1036 Phosphorus 150 180
LB1037 Pleural Fluid Analysis - LDH 350 420
LB1038 Pleural Fluid Analysis - Sugar/Glucose and Protein 400 480
Page 62
LB1039 Potassium 170 204
LB1040 Renal Profile 950 1,140
LB1041 Rheumatoid Factor Assay 550 660
LB1042 Serum Osmolality 600 720
LB1043 Serum Albumin 110 132
LB1044 SGOT- Aspartate Amino Transferase 150 180
LB1045 SGPT- Alanine Amino Transferase 150 180
LB1046 Sodium 170 204
LB1047 Total Proteins With Albumin\Globulin\A/G 250 300
LB1048 Triglycerides 250 300
LB1049 Troponin-I (Qualitative) 1,200 1,440
LB1050 Troponin-T 1,000 1,200
LB1051 Urea 150 180
LB1052 Uric Acid 150 180
LB1053 Urinary Calcium - Spot 200 240
LB1054 Urinary Calcium 24 Hrs. 200 240
LB1055 Urinary Chloride 24 Hrs. 200 240
LB1056 Urinary Chloride (Spot Sample) 200 240
LB1057 Urinary Creatinine - Spot 200 240
LB1058 Urinary Creatinine 24 Hrs. 200 240
Service
Code
LB1059 Urinary Potassium 24 Hrs. 200 240
LB1060 Urinary Potassium (Spot Sample) 200 240
LB1061 Urinary Protein 24 Hrs. 250 300
LB1062 Urinary Protein(Spot) 250 300
LB1063 Urinary Uric Acid 24 Hrs. 250 300
LB1064 Urine For Sodium (Spot Sample) 250 300
LB1065 Urine Protein/Creatinine Ratio 350 420
LB1066 Venous Blood Gas 700 840
LB1067 Abg/Elec/Met 1,300 1,560
LB1070 KALAZAR (RAPID TEST R K-39) 400 480
CLINICAL PATHOLOGY -
LB2001 Ascitic Fluid - Cell Type\ Cell Count\ Albumin 450 540
LB2002 Bal For Cytology (Cell Count & Cell Type) 300 360
LB2003 Csf Analysis Cell Type\ Cell Count\ Glucose\ Protein 500 600
LB2004 Haemoglobin,Urine 160 192
LB2005 Occult Blood 110 132
LB2006 Other Fluid Analysis - Cell Type And Cell Count 400 480
LB2007 Pleural Fluid Analysis - Cell Type And Cell Count\ 450 540
LB2008 Semen Analysis 410 492
LB2009 Stool For Occult Blood 110 132
LB2010 Stool For Reducing Substance 110 132
LB2011 Stool Ph 110 132
LB2012 Stool Routine And Microscopy. 150 180
LB2013 Urinary Bence Jones Proteins 300 360
LB2014 Urine Albumin 110 132
LB2015 Urine For Bile Pigment 110 132
LB2016 Urine For Bile Salt 110 132
LB2017 Urine For Fat Globules 110 132
LB2018 Urine For Haematuria 100 120
LB2019 Urine For Specific Gravity 110 132
LB2020 Urine Ketone 110 132
LB2021 Urine Pregnancy Test 200 240
LB2022 Urine Routine And Microscopy. 150 180
LB2023 Urine Sugar Fasting 110 132
LB2024 Urine Sugar Pp 100 120
LB2025 Urine Sugar Random 100 120
CYTOLOGY -
LB3001 Fluid Analysis - Cytology For Malignant Cell 700 840
LB3002 Ascitic Fluid Analysis - Cytology For Malignant Cell 700 840
LB3003 Cytology For Nipple Discharge 650 780
LB3004 Extra Slide 160 192
LB3005 Fine Needle Aspiration Cytology (FNAC) 800 960
LB3006 Malignant Cells (Ganga Ram Hospitals) 700 840
LB3007 Pap Smear 550 660
LB3008 Pleural Fluid Analysis - Cytology For Malignant Cell 700 840
LB3009 Slides For Review 550 660
LB3010 Sputum For Malignant Cells And Cytology 650 780
Page 63
LB3011 Tzank Smear 200 240
LB3012 Urine Cytology for Malignant Cells 650 780
HAEMATOLOGY -
LB4001 Absolute Eosinophil Count 140 168
LB4002 Blood Group And Rh Factor 170 204
LB4003 Coagulation Profile 1,550 1,860
LB4004 Complete Blood Count -CBC(HB\TLC\PCV\RBC\Platelet) 400 480
LB4005 Complete Heamogram\ Peripherial Smear And ESR 400 480
LB4006 Coombs Test Direct 400 480
LB4007 Coombs Test Indirect 380 456
LB4008 Ddimer 1,300 1,560
LB4009 DLC 130 156
LB4026 Biopsy Bone Marrow (Procedure) 3,500 4,200
LB4027 Biopsy Nerve 4,500 5,400
LB4028 Exchange Transfusion 3,570 4,284
Service
Code
LB4010 ESR 100 120
LB4011 FDP 750 900
LB4012 Haemoglobin Estimation 125 150
LB4013 Le Cells 220 264
LB4014 Malaria Antigen (Rapid Test For Malaria) 650 780
LB4015 Malarial Parasite 140 168
LB4016 Partial Thromboplastin Time (APTT) 450 540
LB4017 PCV 140 168
LB4018 Peripheral Smear Examination 180 216
LB4019 Platelet Count 130 156
LB4020 Prothrombin Time (With Inr) 350 420
LB4021 RBC Count 110 132
LB4022 Reticulocyte Count 200 240
LB4023 Sickle Cell Test 110 132
LB4024 TLC 130 156
LB4025 BLEEDING AND CLOTTING TIME (BT\CT) 170 204
HISTOPATHOLOGY
LB5001 Biopsy Large 1,700 2,040
LB5002 Biopsy Neuropathology 1,210 1,452
LB5003 Histo Biopsy Extra Slide 200 240
LB5004 Histo Biopsy Small Specimens 1,000 1,200
LB5005 Histo Biopsy Medium Specimens 1,200 1,440
LB5006 Histo Biopsy Review Of Slide 750 900
LB5007 Histo Block For Review (Ganga Ram) 1,000 1,200
LB5008 Immunohistochemistry > Three Markers 5,100 6,120
LB5009 Immunohistochemistry - Three Markers 4,400 5,280
LB5010 Immunohistochemistry - Two Markers 3,000 3,600
LB5011 Immunohistochemistry-One Marker 1,500 1,800
LB5012 Immunohistochemistry Er/Pr 2,500 3,000
LB5013 Immunohistochemistry Her-2-Neu 1,300 1,560
LB5014 Ganga Ram Extra Slide 550 660
LB5016 1-5 Biopsy Samples (May Call as Small Specimen) 3,500 4,200
LB5017 6-10 Biopsy Samples (May Call as Medium Specimen) 6,000 7,200
LB5018 > 10 Biopsy Samples (May Call as Large Specimen) 8,000 9,600
LB5019 Frozen Section (1-2 Specimens) 1,600 1,920
LB5020 Frozen section (3-5 specimen) 2,000 2,400
LB5021 Frozen section (>5 specimen) 2,500 3,000
MICROBIOLOGY -
LB6001 Ascitic Fluid Analysis - AFB Stain 250 300
LB6002 Ascitic Fluid Analysis - Culture 1,000 1,200
LB6003 Ascitic Fluid Analysis - Gram'S Stain 250 300
LB6004 Bal For Culture And Sensitivity 450 540
LB6005 Blood C And S 1,100 1,320
LB6006 Body Fluid Culture (Bactec) 1,000 1,200
LB6007 Cathetertip Culture & Sensitivity 380 456
LB6008 Central Line Tip For Culture & Sensitivity 380 456
LB6009 Conjuctival Swab For C & S 380 456
LB6010 Csf C And S 1,000 1,200
LB6011 Culture And Sensitivity(Other Specimen) 450 540
LB6012 Cvp Line Tip For Culture & Sensitivity 380 456
LB6013 Ear Discharge C And S 380 456
LB6014 Ear Swab C+S 380 456
Page 64
LB6015 Et Secretions For Culture & Sensitivity 380 456
LB6016 Et Tip For Culture & Sensitivity 380 456
LB6017 Eye Swab Culture And Sensitivity 380 456
LB6018 Foleys Catheter Tip For Culture & Sensitivity 380 456
LB6019 High Vaginal Swab Culture And Sensitivity 380 456
LB6020 India Ink 275 330
LB6021 Koh Staining (Small Specimen) 250 300
LB6022 Mantoux / PPD/ Tuberculin Test 110 132
LB6023 Nail Clipping For Fungus 250 300
LB6024 Nasal Swab For Culture & Sensitivity 450 540
LB6025 Other Fluid Analysis - Culture 1,100 1,320
LB6026 Pleural Fluid Analysis - Afb Stain 275 330
LB6027 Pleural Fluid Analysis - Culture 1,100 1,320
LB6028 Pleural Fluid Analysis - Gram'S Stain 250 300
LB6029 Pus C And S 450 540
LB6030 Semen C And S 380 456
LB6031 Smear For AFB Staining 275 330
LB6032 Smear For Fungus 275 330
LB6033 Smear For Gram Staining 275 330
LB6034 Sputum C And S 450 540
LB6035 Sputum For AFB Smear 275 330
Service
Code
LB6036 Stool C/S 380 456
LB6037 Stool For Hanging Drop 160 192
LB6038 Throat Swab C And S 380 456
LB6039 Tip C And S 450 540
LB6040 Tissue For Culture & Sensitivity 450 540
LB6041 Tracheal Secretions For Culture & Sensitivity 450 540
LB6042 Urine C And S 400 480
LB6043 Urine For AFB Smear 250 300
LB6044 Widal Test 220 264
LB6045 Wound Swab C+S 450 540
LB6046 Fungal Culture test 1,000 1,200
SEROLOGY/IMMUNOLOGY
LB7001 Antibody To Hepatitis C Virus (ECI) 1,200 1,440
LB7002 Antibody To Hepatitis C Virus (Rapid) 450 540
LB7003 Beta Hcg Cancer Marker 600 720
LB7004 Chickun Guniya Serology 850 1,020
LB7005 Dengue Ns1 Antigen 1,000 1,200
LB7006 Dengue Serology (Ig M & Ig G) 1,100 1,320
LB7007 Ferritin 650 780
LB7008 Free T3 400 480
LB7009 Free T4 400 480
LB7010 FSH - Follicle Stimulating Hormone 430 516
LB7011 HCG - Beta Specific 600 720
LB7012 Hepatitis B Surface Antigen (ECI) 650 780
LB7013 Hepatitis B Surface Antigen (Rapid) 550 660
LB7014 HIV I & Ii Antibody (Rapid) 410 492
LB7015 HIV I + II Antibody (ECI) 700 840
LB7016 LH - Leuteinizing Hormone 430 516
LB7017 Needle Stick Injury Panel 2,500 3,000
LB7018 Pre Dailysis Screen 2,500 3,000
LB7019 Procalcitonin (Qualitative) 3,000 3,600
LB7020 Prolactin 500 600
LB7021 PSA Total (Prostate Specific Antigen- Cancer Marker) 700 840
LB7022 RPR Test 125 150
LB7023 Thyroid Profile 950 1,140
LB7024 Troponin I (Quantitative) 1,500 1,800
LB7025 TSH (Ultrasensitive) 400 480
LB7026 Typhoid Igm 450 540
LB7027 Vitamin B12 1,150 1,380
LB7028 CA-125 1,300 1,560
LB7029 Rubella IgG 500 600
LB7030 Total IgE 700 840
LB7031 HAV IgM 1,100 1,320
LB7032 Cortisol AM 700 840
LB7033 Cortisol PM 700 840
LB7034 Cortisol Urine 700 840
LB7035 CEA 800 960
LB7036 25 Hydroxy Vitamin D-Total 1,600 1,920
Page 65
LB7037 Cryptococcus Antigen, CSF 1,600 1,920
LB7038 Cryptococcus Antigen, Serum 1,600 1,920
LB7041 LEPTOSPIRA IGM & IGG ( By rapid method) 800 960
LB7042 MICROFIARIA ANTIBODY ( By rapid method) 800 960
Lab panel
LB8001 Blood culture ( Paired ) 1,500 1,800
LB8002 Blood culture with Urine culture and BAL 2,200 2,640
LB8003 Blood culture with Urine culture and Tracheal culture 2,200 2,640
LB8004 Blood culture with Urine culture and ET secretion 2,200 2,640
LB8005 Blood culture with Urine culture and Sputum culture 2,200 2,640
Radiology
Service
Code
Bone densitometry
RD1001 Bone Densitometry Hip 2,500 3,000
RD1002 Bone Densitometry Hip & Spine 3,500 4,200
RD1003 Bone Densitometry Spine Study 2,500 3,000
RD1004 Bone Densitometry Whole body 3,700 4,440
CT SCAN
RD2001 CT-Whole Abdomen Plain 5,000 6,000
RD2002 CT-Whole Abdomen With Contrast 7,000 8,400
RD2003 CT-Upper Abdomen Plain 3,500 4,200
RD2004 CT-Upper Abdomen With Contrast 5,000 6,000
RD2005 CT-Abdomen-Dual Phase CT For Liver 6,000 7,200
RD2006 CT-Abdomen-Pelvis/Lower Abdomen plain 4,500 5,400
RD2007 CT-Abdomen -Pelvis/Lower Abdomen With Contrast 5,500 6,600
RD2008 CT-Angiography - Cerebral 7,000 8,400
RD2009 CT-Angiography-Localised 7,000 8,400
RD2010 CT-Angiography-Carotid Artery 7,000 8,400
RD2011 CT-Angiography-Peripheral/Extremeties 7,500 9,000
RD2012 CT-Angiography-Abd Aorta 7,000 8,400
RD2013 CT-Angiography-Pulmonary 7,500 9,000
RD2014 CT-Angiography-Renal Retery 7,000 8,400
RD2015 CT-Arthrography Screening 1,500 1,800
RD2016 CT-Chest & Whole Abdomen With Contrast 10,000 12,000
RD2017 CT-Chest With Contrast 4,500 5,400
RD2018 CT-Chest plain 3,700 4,800
RD2019 CT-Chest - HRCT 5,500 6,600
RD2020 CT-Guided Catheter Drainage 5,000 6,000
RD2021 CT-Guided FNAC - Level I 2,500 3,000
RD2022 CT-Guided FNAC - Level II 2,750 3,300
RD2023 CT-Guided FNAC - Level III 3,300 3,960
RD2024 CT-Guided Trucut Biopsy Level I 5,000 6,000
RD2025 CT-Guided Trucut Biopsy Level II 6,000 7,200
RD2026 CT-Head Plain 2,600 3,120
RD2027 CT-Head Contrast 3,200 3,840
RD2028 CT-head - Iam/Temporal Bone 3,500 4,200
RD2029 CT-head -Cisternography 4,500 5,400
RD2030 CT-head -Contrast (Non-Ionic) 4,000 4,800
RD2031 CT-head Pitutary- Sella Contrast 4,500 5,400
RD2032 CT-head-Pituitary-Sella 3,500 4,200
RD2033 CT-Joints Plain 4,000 4,800
RD2034 CT-Joints Contrast 5,500 6,600
RD2035 CT-Joints With 3D 5,000 6,000
RD2036 CT-Kub (Plain) 3,600 4,320
RD2037 CT-Maxillo-Facial Trauma 3D 5,000 6,000
RD2038 CT-Neck & Chest With Contrast 5,500 6,600
RD2039 CT-Neck Plain 3,000 3,600
RD2040 CT-Neck/Pharynx/Larynx (Contrast) 4,000 4,800
RD2041 CT-neuro( Follow Up) 1,500 1,800
RD2042 CT-neuro( Limited Window) 1,500 1,800
RD2043 CT-neuro( Repeat) 1,500 1,800
RD2044 CT-Orbits Coronal & Axial 3,000 3,600
RD2045 CT-Pns Axial & Coronal With Contrast 4,000 4,800
RD2046 CT-Pns Axial & Coronal plain 3,000 3,600
RD2047 CT-Pns-Plain Coronal Only 2,500 3,000
RD2048 CT-Posterior Fossa 2,500 3,000
RD2049 CT-Procedures-Diagnostic Aspiration 2,500 3,000
RD2050 CT-Procedures-Therapeutic Aspiration First Visit 2,500 3,000
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RD2051 CT-Procedures-Therapeutic Aspiration Second Visit 2,000 2,400
RD2052 CT-Procedures-Therapeutic Aspiration Third Visit 1,500 1,800
RD2053 CT-Spine-Cervical 4,000 4,800
RD2054 CT-Spine-Lumbar/Dorsal Spine 4,000 4,800
RD2055 CT-Spine-Lumbosacral Spine (Plain) 4,000 4,800
Service
Code
RD2056 CT-Spine-Myelography 5,000 6,000
RD2057 CT-Spine-Thoracis (5 Vertebrae) 3,500 4,200
RD2058 CT-Spine-With Contrast 5,500 6,600
RD2059 CT-Urography 5,500 6,600
RD2060 CT (CD charges)/(Extra Film) 300 360
RD2061 CT-Contrast-Charges Non-Ionic 100 Cc 2,000 2,400
RD2062 CT-Contrast-Charges Non-Ionic 50Cc (300Mg) 1,000 1,200
RD2063 CT-Contrast charges -Visipaque 2,700 3,240
RD2065 CT- face and Neck 4000 4000

RD2066 CT- face and Neck with contrast 5000 5000
RD2067 CT- face and Neck and chest with contrast 7000 7000
RD2068 CT- chest plus upper abdomen(plain) 6500 6500
RD2069 CT- chest plus upper abdomen(with Contrast) 8500 8500
RD2070 CT- triple phase whole abdomen(plain) 7000 7000
RD2071 CT- triple phase whole abdomen with contrast 9000 9000
RD2072 CT- triple phase upper abdomen (plain) 6500 6500
RD2073 CT- triple phase upper abdomen with contrast 8500 8500
RD2074 CT-abdomen angio 7000 7000
Mammography
RD3001 X-Ray Mammography Bilateral 1,500 1,800
RD3002 X-Ray Mammography Unilateral 800 960
MRI
RD4001 MR Angiography Without Contrast 6,000 7,200
RD4002 MR Spectroscopy 5,500 6,600
RD4003 MR Angio Brain 5,500 6,600
RD4004 MR angio Neck Vessels 5,500 6,600
RD4005 MRCP 6,500 7,800
RD4006 MRI Brachial Plexus 7,000 8,400
RD4007 MRI Brain Plain 6,000 7,200
RD4008 MRI Brain Posterior Fossa 6,000 7,200
RD4009 MRI Brain Screening 3,000 3,600
RD4010 MRI Brain With Angiography 9,000 10,800
RD4011 MRI Brain With Contrast 9,000 10,800
RD4012 MRI Brain With Functional 9,000 10,800
RD4013 MRI Brain With Spectroscopy 10,000 12,000
RD4014 MRI Cardiac 6,500 7,800
RD4015 MRI Chest 6,000 7,200
RD4016 MRI Functional 6,000 7,200
RD4017 MRI Knee 6,000 7,200
RD4018 MRI Nasopharynx/Larynx 6,000 7,200
RD4019 MRI Neck / Thyroid 6,000 7,200
RD4020 MRI Orbits 6,000 7,200
RD4021 MRI Peripheral 6,000 7,200
RD4022 MRI Renal Angio 6,000 7,200
RD4023 MRI Screening 3,500 4,200
RD4024 MRI Single Joint 6,000 7,200
RD4025 MRI Single Part - Musculo Skeletal 6,000 7,200
RD4026 MRI Spine Cervical 6,000 7,200
RD4027 MRI Spine Dorsal 6,000 7,200
RD4028 MRI Spine Dorsal With Cont 8,000 9,600
RD4029 MRI Spine Dorsolumbar 6,000 7,200
RD4030 MRI Spine Lumbar 6,000 7,200
RD4031 MRI Spine Screening 3,500 4,200
RD4032 MRI Lower Abdomen 6,000 7,200
RD4033 MRI Upper Abdomen 6,000 7,200
RD4034 MRI Whole Abdomen 9,000 10,800
RD4035 MRI Contrast Charges 3,000 3,600
RD4036 MRI (CD charges)/(Extra Film) 300 360
RD4037 MRI (EXTRA FILM) 360 432
RD4038 MRI VENOGRAPHY 5,500 6,600
RD4039 MRI FACE 6,000 7,200
RD4040 CEREBRAL WITH CAROTID ARTERY ANGIO 9,000 10,800
RD4041 MRICERVICAL SPINE WITH BRACHIAL PLEXUS 9,000 10,800
Page 67
RD4042 MRI EPILEPSY PROTOCOL 7,500 9,000
RD4043 MRI STROKE PROTOCOL 6,000 7,200
RD4044 MRI VERTIGO PROTOCOL 7,500 9,000
RD4045 MRI SELLAR PROTOCOL(WITH CONTRAST) 9,000 10,800
RD4046 MRI TUMOR PROTOCOL 9,000 10,800
RD4047 MRI Stroke protocol (brain + carotid angio) 9000 9,000
RD4048 MRI joint Screning 4000 4,000
RD4049 MRI - brain with cervical spine screening 8000 8,000
RD4050 MRI - cervical spine with brain screening 8000 8,000
RD4051 MRI Urography 6000 7,500
RD4052 Pancreatic protocol (CECT Pancreas + MRCP) 10000 12,000
RD4053 CVA prrotocol ( NCCT Brain + MRI with DW & T2FLAIR) 4000 5,000
RD4054 MRI One region 6000 7,500
ULTRASOUND
RD5001 Ultra Sound 4D For Anomalies 2,500 3,000
RD5002 Ultra Sound 4D Pregnancy 2,500 3,000
RD5003 Ultra Sound Brain 800 960
RD5004 Ultra Sound Breast Unilateral 800 960
RD5005 Ultra Sound Breast Bilateral 1,200 1,440
RD5006 Ultra Sound Carotid Doppler (Screening) 2,000 2,400
RD5007 Ultra Sound Chest 900 1,080
RD5008 Ultra Sound Color Doppler - Both Limbs - Arterial 3,500 4,200
RD5009 Ultra Sound Color Doppler - Both Limbs - Venous 3,500 4,200
RD5010 Ultra Sound Color Doppler - Local Swelling 2,200 2,640
RD5011 Ultra Sound Color Doppler- Abdominal Aorta 2,200 2,640
RD5012 Ultra Sound Color Doppler- Carotids 2,200 2,640
RD5013 Ultra Sound Color Doppler- Obstetrics 2,500 3,000
RD5014 Ultra Sound Color Doppler- Peripheral Arterial One Limb 2,200 2,640
RD5015 Ultra Sound Color Doppler Peripheral Venous One Limb(Screening) 1,000 1,200
RD5016 Ultra Sound Color Doppler Renal (One Side) 2,000 2,400
RD5017 Ultra Sound Color Doppler Vascular (Portable/Bedside) 2,500 3,000
RD5018 Ultra Sound Color Doppler Venous (One Limb) 2,000 2,400
RD5054 Portable machine charges for US 25%of Base price 25%of Base price
RD5055 Ultra Sound (CD charges)/(Extra Film) 200 240
Service
Code
RD5019 Ultra Sound Color Doppler-Penile Doppler 2,500 3,000
RD5020 Ultra Sound Color Doppler-Peripheral Venous One Limb 2,200 2,640
RD5021 Ultra Sound Pelvis Doppler 1,500 1,800
RD5022 Ultra Sound Renal Doppler 2,200 2,640
RD5023 Ultra Sound Scrotal Doppler 2,200 2,640
RD5024 Ultra Sound Color Doppler-Splenoportal Axis 2,200 2,640
RD5025 Ultra Sound Extremity/Joint 1,000 1,200
RD5026 Ultra Sound Fetal Growth Monitoring 2,000 2,400
RD5027 Ultra Sound Follicle Monitoring 1 Days 300 360
RD5028 Ultra Sound Follicle Monitoring 6 Days 1,500 1,800
RD5029 Ultra Sound for MTP 1,500 1,800
RD5030 Ultra Sound Kub 900 1,080
RD5031 Ultra Sound Kub & PVR 1,300 1,500
RD5032 Ultra Sound Kub & Scrotum 2,500 3,000
RD5033 Ultra Sound Lower Abdomen/Pelvis 900 1,080
RD5034 Ultra Sound Neck 1,000 1,200
RD5035 Ultra Sound Obstetrics (Level-I) 1,400 1,700
RD5036 Ultra Sound Obstetrics (Level-II) 2,200 2,600
RD5037 Ultra Sound Orbits 1,000 1,200
RD5038 Ultra Sound Pelvis & Scrotum 2,000 2,400
RD5039 Ultra Sound Pelvis-Transabdominal 1,000 1,200
RD5040 Ultra Sound Pelvis-Transvaginal 2,000 2,400
RD5041 Ultra Sound Pregnancy With Color Doppler 3,000 3,600
RD5042 Ultra Sound Scrotum 1,800 2,160
RD5043 Ultra Sound Sono Salpingogram 2,000 2,400
RD5044 Ultra Sound Thyroid 1,000 1,200
RD5045 Ultra Sound Transrectal 1,500 1,800
RD5046 Ultra Sound Upper Abdomen 1,000 1,200
RD5047 Ultra Sound Whole Abdomen 1,600 1,920
RD5048 Ultrasound Screening 600 720
RD5049 Us Guidance For D&C ( portable charge included) 1,000 1,200
RD5050 Us Guided Biopsy ( needle cost additional) 2,500 3,000
RD5051 Us Guided Catheter Placement 3,000 3,600
Page 68
RD5052 Us Guided FNAC/Diagnostic Aspiration 1,500 1,800
RD5053 Usg Abdomen With Tvs 2,000 2,400
X-RAY
RD6001 X-Ray Abdomen - Decubitus 300 360
RD6002 X-Ray Abdomen - Erect 300 360
RD6003 X-Ray Abdomen - Other 300 360
RD6004 X-Ray Abdomen - Supine 300 360
RD6005 X-Ray Abdomen-Ap 300 360
RD6006 X-Ray Ankle Joint Ap & Lat 500 600
RD6007 X-Ray Arm Ap Only 300 360
RD6008 X-Ray Arm Ap & Lat 500 600
RD6009 X-Ray Barium Enema (Dc) 3,500 4,200
RD6010 X-Ray Barium Meal Follow Through 3,750 4,500
RD6011 X-Ray Barium Swallow 1,500 1,800
RD6012 X-Ray Both Ankle Joint - Lateral 500 600
RD6013 X-Ray Both Knee Joints Ap & Lat 1,000 1,200
RD6014 X-Ray Calcaneum -Ap & Axial 500 600
RD6015 X-Ray Chest -Ap 350 420
RD6016 X-Ray Chest -Decubitus (Right/Left) 300 360
RD6017 X-Ray Chest Lateral (Right/Left) 300 360
RD6018 X-Ray Chest -Other - One View 300 360
RD6019 X-Ray Chest -Pa 350 420
RD6020 X-Ray Chest-Oblique (For Ribs) 300 360
RD6021 X-Ray Clavicle / Acromio -Clav Jt (Right/Left) 300 360
RD6022 X-Ray Coccyx Ap & Lat 500 600
RD6023 X-Ray Colostomy Study 2,200 2,640
RD6024 X-Ray Cystography 2,000 2,400
RD6025 X-Ray Digits-Ap &Lat 500 600
RD6026 X-Ray Elbow Joint -Ap & Lat 500 600
RD6027 X-Ray Femur Ap Only 300 360
RD6028 X-Ray Femur Lat Only 300 360
Service
Code
RD6029 X-Ray Femur-Ap & Lat 500 600
RD6030 X-Ray Fistulography 2,000 2,400
RD6031 X-Ray Fluoroscopy 1,500 1,800
RD6032 X-Ray Foot - Any Other 1 View 300 360
RD6033 X-Ray Foot-Ap & Lat 500 600
RD6034 X-Ray For Tm Joints -Open & Close Mouth Both Side 1,000 1,200
RD6035 X-Ray For Tm Joints -Open & Close Mouth One Side 500 600
RD6036 X-Ray Forearm Ap 300 360
RD6037 X-Ray Forearm -Ap & Lat 500 600
RD6038 X-Ray Gastrografin Study 2,000 2,400
RD6039 X-Ray Hand Ap 300 360
RD6040 X-Ray Hands -Ap & Lat 500 600
RD6041 X-Ray Hands Ap & Obl 500 600
RD6042 X-Ray Hip joint Ap 300 360
RD6043 X-Ray Hip Joint -Ap & Lat 500 600
RD6044 X-Ray Hip joint Lateral 300 360
RD6045 X-Ray Humerus -Ap & Lat 500 600
RD6046 Hystero -Salpingography 2,250 2,700
RD6047 X-Ray Invertogram 300 360
RD6048 X-Ray Ivp (Non-Ionic Contrast) 3,000 3,600
RD6049 X-Ray Ivp + Mcu Film 3,250 3,900
RD6050 X-Ray Knee Joint - Ap & Lat 600 720
RD6051 X-Ray Knee Joints Ap Only 300 360
RD6052 X-Ray Knee Joints Lat Only 300 360
RD6053 X-Ray Kub 300 360
RD6054 X-Ray Leg - Ap & Lat 600 720
RD6055 X-Ray Leg Lat Only 250 300
RD6056 X-Ray Mastoids (One Side) 300 360
RD6057 X-Ray Micturating Cystography 2,000 2,400
RD6058 X-Ray Nasal Bones 500 600
RD6059 X-Ray Neck - For Soft Tissues -Lat 300 360
RD6060 X-Ray Nephrostogram 1,600 1,920
RD6061 X-Ray Pelvis -Ap 300 360
RD6062 X-Ray Pelvis-Ap Incl Both Hip Joints 350 420
RD6063 X-Ray Pns-Waters View 300 360
RD6064 X-Ray Retrograde Urethrography 2,100 2,520
RD6065 X-Ray Sacro-Iliac Joints- Obl 300 360
RD6066 X-Ray Sacro-Iliac Joints-ap 300 360
Page 69
RD6067 X-Ray Scapula Ap & Lat 500 600
RD6068 X-Ray Sella (Pituitary Fossa) 300 360
RD6069 X-Ray Shoulder Joint-Ap 300 360
RD6070 X-Ray Shoulder Joint-Ap & Axial 500 600
RD6071 X-Ray Sialography Unilateral 1,000 1,200
RD6072 X-Ray Sialography Bilateral 1,500 1,800
RD6073 X-Ray Single Film 300 360
RD6074 X-Ray Sinography 1,500 1,800
RD6075 X-Ray Skull -Any 2 Views 500 600
RD6076 X-Ray Skull For Styloid Process 300 360
RD6077 X-Ray Skull Lat 300 360
RD6078 X-Ray Skull Oblique 300 360
RD6079 X-Ray Skull-Ap & Lat 500 600
RD6080 X-Ray Small Bowel Enema 4,500 5,400
RD6081 X-Ray Special Views- For Mandible Ap & Oblique 500 600
RD6082 X-Ray Special Views For Orbits 500 600
RD6083 X-Ray Special Views-For Iam 500 600
RD6084 X-Ray Special Views-For Jugular Foramen 300 360
RD6085 X-Ray Special Views-For Mastoids 500 600
RD6086 X-Ray Spine Dorsal Ap 300 360
RD6087 X-Ray Spine-Cervical Ap 300 360
RD6088 X-Ray Spine-Cervical Ap & Lat 500 600
RD6089 X-Ray Spine-Cervical Both Obl 500 600
RD6090 X-Ray Spine-Cervical Flex & Ext 500 600
RD6091 X-Ray Spine-Cervical Lat 300 360
RD6092 X-Ray Spine-Cervico-Thoracic Ap & Lat 500 600
Service
Code
RD6093 X-Ray Spine-Cv Junction 2 Views 500 600
RD6094 X-Ray Spine-Lumbar Ap 300 360
RD6095 X-Ray Spine-Lumbar Ap & Lat 600 720
RD6096 X-Ray Spine-Lumbar -Both Obl 500 600
RD6097 X-Ray Spine-Lumbar Lat 300 360
RD6098 X-Ray Spine-Lumbo-Sacral Ap & Lat 500 600
RD6099 X-Ray Spine-Lumbo-Sacral Flex & Ext 500 600
RD6100 X-Ray Spine-Thoracic Ap & Lat 500 600
RD6101 X-Ray Spine-Thoraco-Lumbar Ap & Lat 500 600
RD6102 X-Ray Sterno-Clavicular Joint-Both Obliques 500 600
RD6103 X-Ray Sternum Ap & Lat 500 600
RD6104 X-Ray Sternum Lat 300 360
RD6105 X-Ray Sternum Lat & Obl 500 600
RD6106 X-Ray Styloid Process 300 360
RD6107 X-Ray T- Tube Cholangiogram 1,500 1,800
RD6108 X-Ray Thigh Ap & Lat 500 600
RD6109 X-Ray Thigh Ap Only 300 360
RD6110 X-Ray Upper Gi Series 2,800 3,360
RD6111 X-Ray Wirst Joint -Any 3 Views 500 600
RD6112 X-Ray Wrist Joint- 1 View 300 360
RD6113 X-Ray Wrist Joint-Any 2 Views 500 600
RD6114 X-Ray Wrist Joint-Ap & Lat 500 600
RD6115 X-Ray Portable machine charges 175 210
RD6116 X-Ray (CD charges)/(Extra Film) 140 168
RD6117 X-RAY CD CHARGES 160 192
RD6118 SKELETOGRAM X-RAY 1,800 3,600
RD6119 X-Ray Scapula Ap view 300 360
RD6120 X-Ray skull AP view 300 360
RD6121 X-Ray spine -Flexion view 300 360
RD6122 X-Ray spine -Extension view 300 360
RD6123 X-Ray spine -Obturator view 300 360
RD6124 X-Ray Pelvis -llliac View 300 360
RD6125 X-Ray pelvis-obturator View 300 360
RD6126 X-Ray Pelvis -inlet View 300 360
RD6127 X-Ray Pelvis -Outlet View 300 360
RD6128 X-Ray Elbow both oblique 600 720
RD6129 X-Ray leg oblique view 300 360
RD6130 X-Ray knee Tunnel View 300 360
RD6131 X-Ray knee oblique view 300 360
RD6132 X-Ray knee skyline view 300 360
RD6133 X-Ray Ankle Mortis view 300 360
RD6134 X-Ray Ankle Haris view 300 360
RD6135 X-Ray Ankle Brodes view 300 360
Page 70
RD6136 X-Ray Foot oblique View 300 360
RD6137 X-Ray wrist Scaphoid View 300 360
RD6138 X-Ray wrist Oblique . View 300 360
RD6139 X-Ray Cerrvical Spine AP Open mouth View 300 360
RD6140 defaecation proctogram 3,000 3,700
RD6141 Fluoroscopy guided NJ tube placement 3,000 37,000
RD6142 Fluoroscopy 2,000 2,400
RD6143 PTBD 5,000 6,200
RD6144 Fallopian tube recanalization 5,000 7,200
RD6145 Transplant renal doppler 2,200 2,640
Others
RD7001 Anaesthesia/Sedation For Radiology 1,000 1,200
RD7002 Emergency Charges - Radiology 550 600
RD7004 Trans Rectal Prostate Biopsy 3,000 3,600
OPD/WARD SERVICES
OPD/ Ward Service

WS1001 Biopsy (Small) 1,500
WS1002 Biopsy (Large) 3,000
WS1003 Cyst Removal (Small) 1,000
WS1004 Cyst Removal (Medium) 1,500
WS1005 Cyst Removal (Large) 2,500
WS1006 Aspiration Bone Marrow (Procedure) 1000
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PARAS HMRI HOSPITALPATNA Schedule of charges 2016 version 2.

NICU level of care is defined as:

Service code Service name Charges ( Rs.)

Service code Service name Charges ( Rs.)

ER5021 Dressing large 600

Permanent Pacemaker Implantation Double Chamber (2 Days ICU + 1 Days Opted

Basic Investigations include- (PG Replacement ONLY)-(Annexure – 1D)- - PT/INRX1

Service OPD/ Six/ Nine

Service Stay Two

Service OPD/ Six/ Nine

GENERAL & LAPAROSCOPIC SURGERY PACKAGE

BM1001 LAP SLEEVE GASTRECTOMY 4Day 320,000 380,000 450,000

BM1002 LAP SLEEVE GASTRECTOMY COMPLEX 4Day 480,000 570,000 675,000

BM1003 GASTRIC BYPASS 4Day 400,000 475,000 562,500

BM1004 GASTRIC BAND 4Day 304,000 361,000 427,500

Radiotherapy - Radiation Charges

Radiotherapy - Brachy Charges

OG1031 Colporrhaphy Anterior 5,200 6,916 7,800 9,100 10,400

OG1137 Irrigation of Vagina 1,600 2,128 2,400 2,800 3,200

OG1187 Plastic Repair Of Introitus 3,500 4,655 5,250 6,125 7,000

OG1240 Ventri Suspension 7,500 9,975 11,250 13,125 15,000

Lap / Vaginal Treatment Of Ectopic Pregnancy; Without Salpingectomy &/Or

Lap Removal Of B/L Endometrioma With Moderate Adhesiolysis / Involving Bowel

OG2174 Vault Repair 13800 18,354 20,700 24,150 27,600

OG2181 Vulvectomy,Radical,Complete,With Inguinofemoral,Iliac,&Pelvic Lymphadenectomy 30800 40,964 46,200 53,900 61,600

Service stay OPD/ Six/ Nine

OR2005 All Reconstructions 14443 19206 21670 25278 28886

PSYCHIATRY & CLINICAL PSYCOLOGY

RM1002 Bronchoscopy 4,500 5,985 6,750 7,875 9,000

RM1006 Decortication Lung 16,000 21,280 24,000 28,000 32,000

RM1007 Diagnostics Thoracoscopy 6,000 7,980 9,000 10,500 12,000

RM1008 Intercostal Drainage 9000 11970 13500 15750 18000

RM1010 Lobectomy 17,000 22,610 25,500 29,750 34,000

RM1012 Mediastinal Mass Excision 18,000 23,940 27,000 31,500 36,000

RM1015 Pleurodesis Chemical 7000 9310 10500 12250 14000

RM1016 Pleurodesis Talk Insuffolation 7000 9310 10500 12250 14000

RM1017 Pleural biopsy 7000 9310 10500 12250 14000

RM1018 Pleural Taping Diagnostic 2000 2660 3000 3500 4000

RM1019 Pleural Taping Therapeutic 4000 5320 6000 7000 8000

RM1022 Sleep Study 8000 10,000 12,000 14,000 16,000

RM1024 Thoracoplasty & Apicolysis 15,000 19,950 22,500 26,250 30,000

RM1025 Thoracotomy Exploratory 15,000 19,950 22,500 26,250 30,000

RM1026 Titration Study 8,000 10,000 12,000 14,000 16,000

SP3023 Kyphoplasty Two Level 47,355 62,986 71,038 82,874 94,710

Laser equipment charge

RD2065 CT- face and Neck 4000 4000

Service code Service name Charges ( Rs.)

OPD/ Ward Service

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