CGHS MUMBAI RATES FOR HOSPITALS - 2010 (Updated on 30th ...

CGHS Mumbai 2010 rate list

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CGHS MUMBAI RATES FOR HOSPITALS - 2010 (Updated on 30th May 2021)

S.No NAME OF INVESTIGATION / TREATMENT PROCEDURE

Rate for NABH Hospital

Rate for Non NABH Hospital

Rate for Super Specialty Hospital

OPD Procedures1 Consultation OPD 293 255 3452 Consultation- for Inpatients 104 90 3453 Dressings of wounds 173 1504 Suturing of wounds with local anaesthesia(LA) 230 2005 Aspiration Pleural Effusion - Diagnostic 460 4006 Aspiration Pleural Effusion - Therapeutic 575 5007 Abdominal Aspiration - Diagnostic 575 5008 Abdominal Aspiration - Therapeutic 633 5509 Pericardial Aspiration 633 55010 Joints Aspiration 920 80011 Biopsy Skin 920 80012 Removal of Stitches 230 20013 Venesection 115 10014 Phimosis Under LA 230 20015 Sternal puncture 1380 120016 Injection for Haemorrhoids 288 25017 Injection for Varicose Veins 460 40018 Catheterization 500 42519 Dilatation of Urethra 144 12520 Incision & Drainage 518 45021 Intercostal Drainage 1035 90022 Peritoneal dialysis 575 500

Skin23 Excision of Moles 345 30024 Excision of Warts 575 50025 Excision of Molluscum contagiosum 575 50026 Excision of Venereal Warts 575 50027 Excision of Corns 575 50028 I/D Injection Keloid(Intralesional Injection) 575 50029 Chemical Cautery (s) 403 350

Ophthalmology30 Subconjunctival/sub tenon’s injections in one eyes 230 20031 Subconjunctival/sub tenon’s injections in both eyes 81 7032 Pterygium surgery 6325 550033 Conjunctival peritomy 1150 1000

34 Conjunctival wound repair or exploration following blunt trauma 3795 3300

35 Removal of corneal foreign body 345 30036 Cauterization of ulcer/subconjunctival injection in one eye 173 15037 Cauterization of ulcer/subconjunctival injection in both eyes 86 7538 Corneal grafting - Penetrating keratoplasty 173 150


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39 Corneal grafting - Lamellar keratoplasty 16100 1400040 Cyanoacrylate /fibrin glue application for corneal perforation 5750 500041 Bandage contact lenses for corneal perforation 575 50042 Scleral grafting or conjunctival flap for corneal perforation 575 50043 Keratoconus correction with therapeutic contact lenses 3450 300044 Ultraviolet (UV) radiation for cross-linking for keratoconus 2875 250045 EDTA for band shaped keratopathy 2300 200046 Arcuate keratotomy for astigmatism 345 30047 Re-suturing (Primary suturing) of corneal wound 2300 200048 Penetrating keratoplasty with glaucoma surgery 3450 300049 Penetrating keratoplasty with vitrectomy 23000 2000050 Penetrating keratoplasty with IOL implantation 23000 2000051 DALK- Deep anterior lamellar keratoplasty 16100 1400052 Keratoprosthesis stage I and II 17250 15000

53 DSAEK- Descemet’s stripping automated endothelial keratoplasty 23000 20000

54 ALTK- Automated lamellar therapeutic keratoplasty 17250 1500055 Probing and Syringing of lacrimal sac- in one eye 3450 300056 Probing and Syringing of lacrimal sac- in both eye 1150 100057 Dacryocystorhinostomy - Plain 2300 2000

58 Dacryocystorhinostomy - Plain with intubation, and/or with lacrimal implants 4600 4000

59 Dacryocystorhinostomy - conjunctival with implant 9200 800060 Canaliculoplasty 6900 600061 Dacryocystectomy 4025 350062 Punctal plugs for dry eyes 4600 400063 Refraction 288 25064 Indirect ophthalmoscopy 58 5065 Orthoptic check up- with synoptophore 92 8066 Lees charting or Hess charting 173 15067 Orthoptic exercises 575 50068 Pleoptic exercises 144 12569 Perimetry/field test - Goldman 173 15070 Perimetry/field test - automated 345 30071 Fluorescein angiography for fundus or iris 863 75072 Ultrasound A Scan 345 30073 Ultrasound B Scan 230 20074 Indocyanine green angiography 345 30075 Corneal endothelial cell count with specular microscopy 1725 150076 Corneal topography 403 35077 Corneal pachymetry 345 30078 Auto refraction 230 20079 Macular function tests 44 38


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80 Potential acuity metry 173 15081 Laser interferometry 345 30082 OCT- Optical coherence tomography 345 30083 HRT- Heidelberg retinal tomography 1438 125084 GDx Nerve fibre layer analyzer 2300 200085 UBM - Ultrasound biomicroscopy 2300 200086 Non Contact tonometry 230 20087 IOP measurement with schiotz 58 5088 IOP measurement with applanation tonometry 35 3089 Three mirror examination for retina 58 5090 90 D lens examination 115 10091 Gonioscopy 115 10092 Chalazion incision and curettage in one eye 115 10093 Chalazion incision and curettage in both eyes 431 37594 Ptosis surgery with fasanella servat procedure 460 40095 Ptosis surgery with LPS resection one lid 6670 580096 Ptosis surgery with Sling surgery one lid 6670 580097 Ectropion surgery- one lid 5750 500098 Ectropion surgery- both lids 5175 450099 Epicanthus correction 5750 5000100 Cantholysis and canthotomy 2300 2000101 Entropion surgery- one lid 2300 2000102 Entropion surgery- both lids 4600 4000103 Tarsorrhaphy 2300 2000104 Suturing of lid lacerations 2300 2000105 Lid retraction repair 4600 4000106 Concretions removal 575 500107 Bucket handle procedure for lid tumours 58 50108 Cheek rotation flap for lid tumours 9200 8000109 Orbitotomy 11500 10000110 Enucleation 9200 8000111 Enucleation with orbital implants and artificial prosthesis 5175 4500112 Evisceration 6900 6000113 Evisceration with orbital implants and artificial prosthesis 6900 6000114 Telecanthus correction 9200 8000115 Orbital decompression 9200 8000116 Exenteration 17250 15000117 Exenteration with skin grafting 17250 15000

118 Fracture orbital repair 23000 20000119 Retinal laser procedures 2300 2000120 Retinal detachment surgery (RDS) 1725 1500121 Retinal detachment surgery with scleral buckling 17250 15000122 Buckle removal 9200 8000


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123 Silicone oil removal 3450 3000124 Anterior retinal cryopexy 3450 3000125 Squint correction for one eye 3450 3000126 Squint correction for both eyes 7475 6500127 Trabeculectomy 11500 10000128 Trabeculotomy 9200 8000129 Trabeculectomy with Trabeculotomy 6900 6000130 Trephination 16100 14000131 Goniotomy 3450 3000132 Glaucoma surgery with Glaucoma valves 5750 5000133 Cyclocryotherapy 4600 4000134 YAG laser iridotomy 2300 2000135 YAG laser capsulotomy 1725 1500136 ALT-Argon laser trabeculoplasty 1495 1300137 PDT-Photodynamic therapy 2300 2000138 TTT- Transpupillary thermal therapy 17250 15000139 PTK- Phototherapeutic keratectomy 3450 3000140 Argon/diode laser for retinal detachment 2300 2000141 Intralase application for keratoconus 920 800142 EOG- Electrooculogram 920 800143 ERG- Electroretinogram 1079 938144 VEP- visual evoked potential 827 719145 Vitrectomy- pars plana 2300 2000146 Intravitreal injections of antibiotics 3450 3000147 Intravitreal injections of avastin excluding cost of drug 2300 2000148 Intravitreal injections of Ranibizumab excluding cost of drug 4600 4000149 X Ray orbit 5750 5000150 CT Orbit and brain 1600 1840151 MRI Orbit and brain 2760 2400152 Dacryocystography 3450 3000153 Orbital angiographic studies 1725 1500154 Extracapsular cataract extraction (ECCE) with IOL 5750 5000155 Small Incision Cataract Surgery (SICS) with IOL 5750 5000156 Phaco with foldable IOL (silicone and acrylic)/PMMA IOL 10781 9375157 Pars plana lensectomy with/without IOL 10350 9000

158 Secondary IOL implantation- AC IOL PC IOL or scleral fixated IOL 8050 7000

159 Cataract extraction with IOL with capsular tension rings (Cionni ring) 8050 7000

160 Optic nerve sheathotomy 2875 2500161 Iridodialysis repair or papillary reconstruction 9200 8000162 Iris cyst removal 4600 4000163 Lid Abscess incision and Drainage 920 800


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164 Orbital Abscess incision and Drainage 575 500165 Biopsy (eye) 3450 3000166 Paracentesis (eye) 1150 1000167 Scleral graft for scleral melting or perforation 345 300168 Amniotic membrane grafting 1840 1600169 Cyclodiathermy 5750 5000170 Intraocular foreign body removal 5750 5000171 Electrolysis (eye) 345 300172 Perforating injury repair (eye) 1725 1500173 Botulinum injection for blepharospasm or squint 4025 3500

Dental Procedures174 Flap Operation per quadrant 414 360175 Gingivectomy per quadrant 1397 1215176 Reduction & immobilization of fracture-Maxilla Under LA 840 730177 Reduction & immobilization of fracture-Mandible Under LA 6900 6000178 Splints/Circummandibular wiring under LA 8050 7000179 Splints/Circummandibular wiring under GA 23000 20000180 Internal wire fixation/plate fixation of Maxilla under LA 23000 20000181 Internal wire fixation/plate fixation of Maxilla under GA 28750 25000182 Internal wire fixation/plate fixation of Mandible under LA 28750 25000183 Internal wire fixation/plate fixation of Mandible under GA 28750 25000184 Extraction per tooth under LA 173 150185 Complicated Extraction per tooth under LA 173 150186 Extraction of impacted tooth under LA 575 500

187 Extraction in mentally retarded/patients with systemic diseases/patient with special needs under short term GA 1725 1500

188 Cyst & tumour of Maxilla/mandible by enucleation/excision/marsupialization upto 4 cms under LA 4600 4000

189Cyst & tumour of Maxilla/mandible by enucleation/excision/marsupialization more than 4 cms under LA

2875 2500

190Cyst & tumour of Maxilla/mandible by enucleation/excision/marsupialization size more than 4 cms under GA

3450 3000

191 Temporomandibular(TM) joint ankylosis- under GA 5750 5000192 Biopsy Intraoral-Soft tissue 6900 6000193 Biopsy Intraoral-Bone 430 374194 Hemi mandibulectomy without graft 5693 4950195 Hemi mandibulectomy with graft 20700 18000196 Segmental mandibulectomy without graft 17250 15000197 Segmental mandibulectomy with graft 20700 18000198 Maxillectomy- Total without graft 17250 15000199 Maxillectomy- Total with graft 24725 21500200 Maxillectomy- partial with graft 23000 20000201 Maxillectomy- partial without graft 18400 16000


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202 Release of fibrous bands & grafting -in (OSMF) treatment under GA 14950 13000

203 Pre-prosthetic surgery- Alveoloplasty204 Pre-prosthetic surgery - Ridge augmentation 1725 1500205 Root canal Treatment(RCT) Anterior teeth(per tooth)206 Root canal Treatment(RCT) Posterior teeth(per tooth) 1035 900207 Apicectomy- Single root 1495 1300208 Apicectomy-Multiple roots 920 800209 Metal Crown-per unit 1380 1200210 Metal Crown with Acrylic facing per unit 1035 900211 Complete single denture-metal based 345 300212 Complete denture- acrylic based per arch 14950 13000213 Removable partial denture-Metal based-upto 3 teeth 6900 6000214 Removable partial denture-Metal based-more than 3 teeth 6900 6000215 Removable partial denture-Acrylic based-upto 3 teeth 6900 6000216 Removable partial denture-Acrylic based-more than 3 teeth 6900 6000217 Amalgam restoration-per tooth 690 600218 Composite Restoration-per tooth-anterior tooth 288 250219 Glass Ionomer Restoration(Filling)-per tooth 518 450220 Scaling & polishing 288 250221 Removable Orthodontics appliance- per Arch 518 450222 Fixed Orthodontics-per Arch 1840 1600223 Space maintainers-Fixed 13800 12000224 Habit breaking appliances-removable 1150 1000225 Habit breaking appliances-Fixed 4025 3500226 Expansion plate 7475 6500227 Feeding appliance for cleft palate 3450 3000228 Maxillofacial prosthesis (nasal/auricular/orbital/facial lost part) 4025 3500229 Functional orthodontic appliances230 Obturator (Maxillofacial) 4025 3500231 Occlusal night guard(splint) 3450 3000

ENT, Head and NeckENT

232 Pure Tone Audiogram (PTA) 230 200233 Impedance with stapedial reflex 403 350234 Short Increment Sensitivity Index (SISI) Tone Decay 403 350235 Multiple hearing assessment test to Adults 403 350236 Speech Discrimination Score 604 525237 Speech Assessment 138 120238 Speech therapy per session of 30-40 minutes 230 200239 Cold Calorie Test for Vestibular function 138 120240 Removal of foreign body From Nose 230 200241 Removal of foreign body From Ear 460 400


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242 Syringing (Ear) 460 400243 Polyp removal under LA 230 200244 Polyp removal under GA 978 850245 Peritonsillar abscess drainage under LA 2070 1800246 Myringoplasty 1380 1200247 Stapedectomy 4025 3500248 Myringotomy with Grommet insertion 11615 10100249 Tympanotomy 4600 4000250 Tympanoplasty 11500 10000251 Mastoidectomy 17250 15000252 Otoplasty 19550 17000253 Labyrinthectomy 20125 17500254 Skull Base surgery 17250 15000255 Facial Nerve Decompression 33350 29000256 Septoplasty 25300 22000257 Submucous Resection 11500 10000258 Septorhinoplasty 8625 7500259 Rhinoplasty- Non-cosmetic 20125 17500260 Fracture Reduction of Nasal Bone 19550 17000261 Intranasal Diathermy 8050 7000262 Turbinectomy 2875 2500263 Endoscopic Dacryocystorhinostomy (DCR) 7475 6500

264 Endoscopic Surgery ENT 15525 13500265 Septal Perforation Repair 16100 14000266 Antrum Puncture 16100 14000267 Lateral Rhinotomy 1150 1000268 Craniofacial resection 1725 1500

269 Caldwell Luc Surgery (Radical Antrostomy for maxillary sinus) 35650 31000

270 Angiofibroma Excision 12650 11000271 Endoscopic Hypophysectomy 24725 21500272 Endoscopic Optic Nerve Decompression 40250 35000273 Decompression of Orbit 40250 35000274 Punch/Wedge biopsy 32200 28000275 Tonsillectomy 5750 5000276 Uvulopalatoplasty 13800 12000

277 Functional Endoscopic Sinus Surgery (FESS) for Antrochoanal polyp 28750 25000

278 Functional Endoscopic Sinus Surgery (FESS) for ethmoidal polyp 25300 22000

279 Polyp removal ear 28750 25000280 Polyp removal Nose (Septal polyp) 13800 12000


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281Mastoidectomy plus Ossiculoplasty including TORP (Total Ossicular Replacement Prosthesis) or PORP (Partial Ossicular Replacement Prosthesis)

13800 12000

282 Endolymphatic sac decompression 46000 40000283 Diagnostic endoscopy under GA 34500 30000284 Young's operation for Atrophic rhinitis 13225 11500285 Vidian neurectomy for vasomotor Rhinitis 17250 15000286 Nasal Packing- Anterior 23000 20000287 Nasal Packing- Posterior 3450 3000288 Ranula Excision 5750 5000289 Tongue Tie excision 9775 8500290 Submandibular Duct Lithotomy 3450 3000291 Adenoidectomy 6900 6000292 Palatopharyngoplasty 8050 7000293 Cleft Palate repair at S. No. 1028 at S. No. 1028294 Pharyngoplasty 20700 18000295 Styloidectomy 20700 18000296 Direct laryngoscopy including Biopsy under GA 15525 13500297 Oesophagoscopy with foreign body removal from Oesophagus 17250 15000298 Bronchoscopy with foreign body (FB) removal 23000 20000

Head and Neck299 Ear Lobe Repair one side 566 492

300 Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin Only 690 600

301 Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin and Cartilage 4370 3800

302 Partial Amputation of Pinna 5175 4500303 Total Amputation of Pinna 7130 6200304 Total Amputation & Excision of External Auditory Meatus 9200 8000305 Excision of Cystic Hygroma 12075 10500306 Excision of Cystic Hygroma Extensive 8625 7500307 Excision of Branchial Cyst 14375 12500308 Excision of Branchial Sinus 11615 10100309 Excision of Pharyngeal Diverticulum 10465 9100310 Excision of Carotid Body-Tumours 11615 10100311 Operation for Cervical Rib 23926 20805312 Block Dissection of Cervical Lymph Nodes 17653 15350313 Pharyngectomy & Reconstruction 23230 20200314 Operation for Carcinoma Lip - Wedge Excision 36007 31310315 Operation for Carcinoma Lip - Vermilionectomy 9758 8485

316 Operation for Carcinoma Lip - Wedge Excision and Vermilionectomy 9292 8080

317 Estlander Operation (Estlander flap in plastic surgery of lips) 10465 9100318 Abbe Operation(Abbe flap in plastic surgery of lips) 9200 8000


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319 Cheek Advancement 10465 9100320 Excision of the Maxilla 11615 10100321 Excision of mandible-segmental 22304 19395322 Mandibulectomy 20125 17500323 Partial Glossectomy 22425 19500324 Hemiglossectomy 6900 6000325 Total Glossectomy 13938 12120

326 Combined Mandibulectomy and Neck Dissection Operation (Commando Operation) 26019 22625

327 Parotidectomy - Superficial 29900 26000328 Parotidectomy - Total 23000 20000329 Parotidectomy - Radical 29900 26000330 Repair of Parotid Duct 29900 26000331 Removal of Submandibular Salivary gland 21850 19000332 Hemithyroidectomy 10925 9500333 Partial Thyroidectomy (lobectomy) 17250 15000334 Subtotal Thyroidectomy 16100 14000335 Total Thyroidectomy 21850 19000336 Resection Enucleation of thyroid Adenoma 27600 24000337 Total Thyroidectomy and Block Dissection 12777 11110338 Excision of Lingual Thyroid 36800 32000339 Excision of Thyroglossal Cyst/Fistula 26019 22625340 Excision of Parathyroid Adenoma/Carcinoma 11615 10100341 Laryngectomy 25553 22220342 Laryngopharyngectomy 32200 28000343 Hyoid Suspension 42976 37370344 Genioplasty 13800 12000345 Direct Laryngoscopy including biopsy under GA 15525 13500346 Phonosurgery 7475 6500347 Fibreoptic examination of Larynx(FOL) under LA 19550 17000348 Microlaryngeal Surgery 11500 10000349 Laryngofissure 13800 12000350 Tracheal Stenosis Excision 24150 21000

Head and Neck cancer351 Excisional Biopsies 11270 9800352 Benign Tumour Excisions 4313 3750353 Temporal Bone subtotal resection 13800 12000354 Modified Radical Neck Dissection 28750 25000355 Carotid Body Excision 28750 25000356 Total Laryngectomy 46000 40000357 Flap Reconstructive Surgery 25300 22000358 Parapharyngeal Tumour Excision 23000 20000359 Breast


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360 Drainage of abscess 20125 17500361 Excision of lumps 6969 6060362 Local mastectomy-simple 10465 9100363 Radical mastectomy-formal or modified 17825 15500364 Excision of mammary fistula 29038 25250365 Segmental resection of breast 17423 15150

General surgeryInjury of Superficial Soft Tissues

366 Suturing of small wounds 269 234367 Secondary suture of wounds 4000 3400368 Debridement of wounds 575 500369 Removal of foreign bodies 633 550

Biopsies370 Excision of Cervical Lymph Node 2277 1980371 Excision of Axillary Lymph Node 2530 2200372 Excision of Inguinal Lymph Node 2933 2550373 Excision Biopsy of Ulcers 2933 2550374 Excision Biopsy of Superficial Lumps 4370 3800375 Incision Biopsy of Growths/Ulcer 4428 3850376 Trucut Needle Biopsy 2530 2200377 Percutaneous Kidney Biopsy 2530 2200378 Marrow Biopsy (Open) 2703 2350

379 Muscle Biopsy Listed under Investigations

Listed under Investigations

380 Scalene Node Biopsy 2645 2300381 Excision of Sebaceous Cysts 2875 2500382 Excision of Superficial Lipoma 2070 1800383 Excision of Superficial Neurofibroma 2875 2500384 Excision of Dermoid Cysts 3450 3000385 Haemorrhoidectomy 24375 20720386 Stapler haemorrhoidectomy 43700 38000387 Keloid excision 19550 17000

388 Varicose vein surgery-Trendelenburg operation with suturing or ligation 11500 10000

Oesophagus389 Atresia of Oesophagus and Tracheoesophageal Fistula 25300 22000390 Operations for Replacement of Oesophagus by Colon 29273 25455391 Oesophagectomy for Carcinoma Oesophagus 35075 30500392 Oesophagectomy for Carcinoma Oesophagus 35075 30500393 Achalasia Cardia Transthoracic 14870 12930394 Achalasia Cardia Abdominal 17250 15000395 Oesophago Gastrectomy for mid 1/3 lesion 14640 12730396 Heller’s Operation 34500 30000


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397 Colon-Interposition or Replacement of Oesophagus 27600 24000398 Oesophago Gastrectomy – Lower Orringer procedure 12650 11000

Abdomen399 Gastroscopy 2243 1950400 Gastric & Duodenal Biopsy (Endoscopic) 2530 2200401 Pyloromyotomy 3163 2750402 Gastrostomy 12075 10500403 Simple Closure of Perforated peptic Ulcer 12650 11000404 Vagotomy Pyloroplasty / Gastro Jejunostomy 14950 13000405 Duodenojejunostomy 17825 15500406 Partial/Subtotal Gastrectomy for Carcinoma 26450 23000407 Partial/Subtotal Gastrectomy for Ulcer 29900 26000408 Operation for Bleeding Peptic Ulcer 29900 26000409 Gastrojejunostomy & Vagotomy 26450 23000410 Operation for Gastrojejunal Ulcer 26450 23000411 Total Gastrectomy for Cancer 26450 23000412 Highly Selective Vagotomy 27600 24000413 Selective Vagotomy & Drainage 26450 23000414 Congenital Diaphragmatic Hernia 18400 16000415 Hiatus Hernia Repair- Abdominal 21062 18315416 Hiatus Hernia Repair- Transthoracic 21062 18315417 Exploratory Laparotomy 21062 18315418 Epigastric Hernia Repair 17250 15000419 Umbilical Hernia Repair 16100 14000420 Ventral/Incisional Hernia Repair 16100 14000421 Inguinal Hernia - Herniorrhaphy 18400 16000422 Inguinal Hernia - Hernioplasty 18975 16500423 Femoral Hernia Repair 23575 20500424 Rare Hernias Repair (Spigelian, Obturator, Lumbar, Sciatic) 18975 16500425 Splenectomy - For Trauma 22425 19500426 Splenectomy - For Hypersplenism 27600 24000427 Splenorenal Anastomosis 27600 24000428 Portocaval Anastomosis 32200 28000429 Direct Operation on Oesophagus for Portal Hypertension 37375 32500430 Mesentericocaval Anastomosis 33350 29000431 Warren Shunt(Distal Splenorenal Shunt) 41400 36000432 Pancreaticoduodenectomy(Whipple's procedure) 41400 36000433 Bypass Procedure for Inoperable Carcinoma of Pancreas 41400 36000434 Cystojejunostomy or Cystogastrostomy 29900 26000435 Cholecystectomy 27600 24000436 Cholecystectomy & Exploration of Common Bile Duct (CBD) 19550 17000437 Repair of Common Bile Duct (CBD) 25300 22000438 Operation for Hydatid Cyst of Liver 24150 21000


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439 Cholecystostomy 25300 22000440 Hepatic Resections (Lobectomy /Hepatectomy) 19550 17000441 Operation on Adrenal Glands - Bilateral 27600 24000442 Operation on Adrenal Glands - Unilateral for Tumour 31625 27500443 Appendicectomy 21275 18500444 Appendicular Abscess – Drainage 21275 18500445 Mesenteric Cyst- Excision 14375 12500446 Peritonioscopy/Laparoscopy 15813 13750447 Jejunostomy 6900 6000448 Ileostomy 18400 16000449 Resection & Anastomosis of Small Intestine 27025 23500450 Duodenal Diverticulum 27025 23500451 Operation for Intestinal Obstruction 27025 23500452 Operation for Intestinal perforation 27600 24000453 Benign Tumour of Small Intestine 27600 24000454 Excision of Small Intestine Fistula 26163 22750455 Operations for Haemorrhage of Small Intestines 25875 22500456 Operations of the Duplication of the Intestines 28750 25000

457 Operations for Recurrent Intestinal Obstruction (Noble Plication & Other Operations for Adhesions) 32200 28000

458 Ileosigmoidostomy 32200 28000459 Ileotransverse Colostomy 27025 23500460 Caecostomy 27025 23500461 Loop Colostomy Transverse Sigmoid 5750 5000462 Terminal Colostomy 20125 17500463 Closure of Colostomy 25875 22500464 Right Hemicolectomy 27025 23500465 Left Hemicolectomy 27025 23500466 Total Colectomy 27025 23500467 Operations for Volvulus of Large Bowel 27025 23500468 Operations for Sigmoid Diverticulitis 31625 27500469 Fissure in Ano with internal sphinctrectomy with fissurectomy 27025 23500470 Fissure in Ano - Fissurectomy 15870 13800471 Rectal Polyp-Excision 18400 16000472 Operation of Haemorrhoids - Lords procedure 7475 6500473 Fistula in Ano - High Fistulectomy 9775 8500474 Fistula in Ano - Low Fistulectomy 22425 19500475 Prolapse Rectum - Thiersch Wiring 13800 12000476 Prolapse Rectum - Rectopexy 14375 12500477 Prolapse Rectum - Grahams Operation 10925 9500478 Operations for Hirschsprung Disease 27600 24000479 Excision of Pilonidal Sinus 20125 17500480 Abdominoperineal Excision of Rectum 17250 15000


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481 Anterior Resection of Rectum 29900 26000482 Pull Through Abdominal Resection 29900 26000483 Operations for Neuroblastoma 27600 24000

ICU/CCU procedures (Special Care Cases)484 Coronary Care with Cardiac Monitoring including ECG & Diet 3715 3230 4370485 Compressed air / piped oxygen (per hour) 58 50486 Ventilator charges (per day) 115 100 265487 Paediatric care for newborn (per day) 1380 1200 1795488 Incubator charges (per day) 1380 1200 1200489 Neonatal ICU charges (per day) 575 500 1795490 Resuscitation 978 850 880491 Exchange Transfusion 288 250 880492 Pneupac ventilator in Nursery (per day) 345 300 1200

Cardiovascular and cardiac surgery & investigations493 Atrial Septal Defect (ASD) closure 196650 167153 196650494 Ventricular septal defect (VSD) with graft 161000 140000 161000495 TOF/TAPVC/TCPC/REV/RSOV repair 155250 135000 155250496 BD Glenn/Left atrium myxoma 155250 135000 155250497 Senning/Arterial Switch Operation (ASO) with graft 57500 50000 57500498 Double Switch Operation (DSO) 86250 75000 86250499 Atrioventricular(AV) canal repair 57500 50000 57500500 Fontan procedure 86250 75000 86250501 Conduit repair 155250 135000 155250502 Coronary Artery Bypass Graft surgery (CABG) 166750 145000 166750503 CABG + Intra Aortic Balloon Pump (IABP) 184000 160000 184000504 CABG + Valve 184000 160000 184000505 Ascending aorta replacement 184000 160000 184000506 Double Valve Replacement (DVR) 178735 155422

507 Mitral valve Replacement(MVR)/ Aortic valve Replacement(AVR) 184000 160000 184000

508 Mitral Valve repair + Aortic Valve repair 161000 140000 161000509 Aortofemoral bypass 95450 95450 95450510 Blalock-Taussig shunt (BT Shunt) / Coarctation 70150 61000 70150511 Pulmonary Artery Banding (PA Banding) Septostomy 69000 60000 69000512 Pericardiectomy 13800 12000 13800

513 Congenital cytomegalovirus (CMV)/ patent ductus arteriosus (PDA) 57500 50000 57500

514 CABG without bypass 57500 50000 57500515 Gunshot injury 86250 75000 86250516 Heart transplant 69000 60000 69000517 Balloon coronary angioplasty/PTCA 127650 127650 127650518 Intra coronary stenting 57500 50000 57500519 Direct stenting 115000 100000 115000


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520 Directional atherectomy 103500 90000 103500521 Rotablation 46000 40000 46000

522 Percutaneous transvenous mitral commissurotomy (PTMC)/percutaneous mitral balloon valvotomy 46000 46000 46000

523 CART 18400 18400 18400524 Cardiac Catheterization (CATH) 13800 13800 13800525 Coarctation dilatation 17250 15000 17250526 Permanent pacemaker implantation-VVI (Single Chamber) 28750 25000 28750527 Permanent pacemaker implantation- DDD (Dual Chamber) 69000 60000 69000528 Permanent pacemaker implantation- Biventricular 74750 65000 74750

529 Automatic Implantable Cardioverter Defibrillator (AICD) implantation 103500 90000 103500

530 Combo device implantation 132250 115000 132250531 Electrophysiological studies 25300 21505 21505532 Endomyocardial biopsy 46000 40000 46000533 Intra Aortic Balloon Pump (IABP) 28750 25000 28750534 Intravascular coils - one coil (additional coil charges extra) 57500 50000 57500535 Radiofrequency - RF ablation 80500 70000 80500536 Septostomy 57500 50000 57500

537 Aortic valve balloon dilatation (AVBD) / pulmonary valve balloon dilatation (PVBD) 46000 40000 46000

538 Digital subtraction angiography(DSA) - Peripheral artery 18515 13685 15738539 Digital subtraction angiography(DSA)- Venogram at S. No 540 at S. No 540 at S. No 540540 Venous Digital subtraction angiography(DSA) 11500 10000 11500541 CT Guided biopsy 11500 10000 11500542 Sinogram 3450 3000 3450543 Cine - Barium 3450 3000 3450544 CT guided PTA 5175 4500 5175545 Digital subtraction angiography(DSA) + PTA 8050 7000 8050546 Embolisation 6900 6000 6900547 Intravascular Ultrasound (IVUS) 9200 8000 9200548 Vascular stent 17250 15000 17250549 Aortic stent graft for aortic aneurysm 57500 50000 57500550 Inferior Vena Cava (IVC) Filter 47610 41400 47610551 ASD/VSD/PDA closure device 57500 50000 57500

552 Electrocardiogram (ECG) Listed under Investigations


553 Treadmill Test (TMT) Listed under Investigations


554 Echocardiography/Holter analysis 920 800 920555 2D Transesophageal Echocardiography (TEE) 1455 1265 1455556 Stress Echo - Exercise 1455 1265 1455557 Stress Echo - Dobutamine 1455 1265 1455558 Stress Thallium - Exercise 2300 2000 2300


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559 Stress Thallium - Pharmacological 2875 2500 2875560 Coronary angiography (CAG) 8625 7500 8625561 CT coronary angiography 10120 8800 10120562 Cardiac CT scan 10120 8800 10120563 Cardiac MRI 3450 3000 3450564 MR Angiography 6900 6000 6900

Obstetrics and Gynaecology565 Normal delivery with or without Episiotomy & Perineal repair 8625 7500566 Vacuum delivery 12075 10500567 Low Forceps delivery 16100 14000568 Low Mid Cavity forceps delivery 13225 11500569 Caesarean Section(CS) 13225 11500570 Caesarean Hysterectomy 26450 23000571 Rupture Uterus, closure & repair with Tubal Ligation 26450 23000572 Perforation of Uterus after D/E Laparotomy & Closure 26450 23000573 Laparotomy for Ectopic Rupture 20700 18000574 Laparotomy-peritoneal Lavage and Drainage 20700 18000575 Laparotomy-failed laparoscopy to explore 15525 13500576 Salpingectomy 8050 7000577 Salpingo-Oophorectomy 14950 13000578 Ovarian Cystectomy- laparoscopic 18975 16500579 Ovarian Cystectomy- laparotomy 18975 16500580 Oophorectomy-laparoscopic 17825 15500581 Oophorectomy-laparotomy 28750 25000582 Broad Ligament Haematoma Drainage 31625 27500

583 Exploration of perineal Haematoma & Resuturing of Episiotomy 9775 8500

584 Exploration of abdominal Haematoma (after laparotomy + LSCS) 13800 12000

585 Internal podalic version and breech extraction 2553 2220586 Manual Removal of Placenta 6325 5500587 3rd stage complication from extra institutional delivery, etc 4600 4000588 Examination under anaesthesia (EUA) 6325 5500589 Burst abdomen Repair 2875 2500590 Gaping Perineal Wound Secondary Suturing 15525 13500591 Gaping abdominal wound Secondary Suturing 2300 2000592 Complete perineal tear-repair 4600 4000593 Exploration of PPH-tear repair 4600 4000594 Destructive Operation 5980 5200

595 Suction evacuation vesicular mole, Missed abortion Dilatation and Evacuation (D & E) 14375 12500

596 Colpotomy - drainage P/V needing EUA 8050 7000597 Repair of post coital tear/perineal injury 5750 5000598 Excision of urethral caruncle 5463 4750


16






599 Shirodkar/ McDonalds stitch 5175 4500600 Abdominal Hysterectomy 2300 2000601 Vaginal Hysterectomy 3450 3000602 Myomectomy - laparotomy 23575 20500603 Myomectomy - laparoscopic 20125 17500604 Vaginoplasty 23000 20000605 Laparotomy for Ectopic Pregnancy 23000 20000606 Vulvectomy - Simple 20700 18000607 Vulvectomy- Radical 29325 25500608 Rectovaginal Fistula (RVF) Repair 21821 18975609 Manchester Operation 29325 25500610 Perineorrhaphy 20700 18000611 Colporrhaphy with mesh 20700 18000612 Colporrhaphy without mesh 25300 22000613 Enterocoele(Vaginal Prolapse) repair 20700 18000

614 Shirodkar sling Operation or other sling operations for prolapse uterus 14950 13000

615 Laparoscopic sling operations for prolapse uterus 23000 20000616 Diagnostic Curettage 34500 30000617 Fractional Curettage 4600 4000618 Dilatation and Curettage (D & C) and Cervical Biopsy 5175 4500619 Polypectomy (Gynaecology) 5750 5000620 Other-Minor Operation Endometrial 2875 2500621 Excision Vaginal Cyst/Bartholin's Cyst 5750 5000622 Excision Vaginal Septum 5750 5000

623 Laparoscopy -Diagnostic with chromopertubation and or adhesiolysis and drilling 5750 5000

624 Laparoscopic Sterilization 8050 7000625 Laparoscopy Operative 8625 7500626 Laparoscopically Assisted Vaginal Hysterectomy (LAVH) 23000 20000627 Total laparoscopic hysterectomy 39675 34500628 Drilling of Ovary 34500 30000

629 Laparoscopic treatment of Ectopic pregnancy-salpingectomy/salpingostomy conservative 21850 19000

630 Laparotomy treatment of Ectopic pregnancy at S. No. 605 at S. No. 605631 Conization of cervix 43700 38000632 Trachelorrhaphy of cervix for early CA cervix 30475 26500633 Hysteroscopic cannulation 29900 26000634 Laparotomy recanalization of Fallopian tubes- (Tubuloplasty) 17250 15000635 Laparoscopic recanalization of Fallopian tubes- (Tubuloplasty) 34500 30000636 Colposcopy 34500 30000637 LEETZ (Large Loop Excision of Transformation Zone) 9200 8000638 Loop Electrosurgical procedures 28750 25000639 Chorionic villus sampling (CVS) 34500 30000


17






640 Interventional Ultrasonography 17250 15000641 Amniocentesis 4600 4000

642 Karyotyping Listed under Investigations


643 Hysteroscopic endometrial ablation644 Thermal balloon ablation 17250 15000645 Ultrasonographic myolysis 28750 25000646 Laparoscopic cystectomy 11500 10000647 Intrauterine Insemination (IUI) 34500 30000648 Intracytoplasmic sperm injection (ICSI)649 Antiretroviral Therapy 5750 5000650 Laparotomy abdominal sacrocolpopexy 11500 10000651 Laparotomy Vault suspension 34500 30000652 Laparoscopic abdominal sacrocolpopexy 34500 30000653 Laparoscopic Vault suspension 34500 30000654 Laparotomy radical lymphadenectomy 34500 30000655 Laparoscopic radical lymphadenectomy 34500 30000

656 Pap smear Listed under Investigations


657 Endometrial aspiration cytology 633 550

658 Transvaginal sonography (TVS for follicular monitoring/aspiration) 11500 10000

659 Laparoscopic treatment for stress incontinence 690 600660 Transvaginal tapes for Stress incontinence 34500 30000661 Transobturator tapes for Stress incontinence 17250 15000662 Interventional radiographic arterial embolization 17250 15000663 Diagnostic cystoscopy at S. No. 717 at S. No. 717664 Staging laparotomy surgery for Carcinoma Ovary 5750 5000665 Internal Iliac ligation 48300 42000666 Stepwise devascularisation 35650 31000667 Assisted breech delivery 23000 20000668 Cordocentesis 21275 18500669 Intrauterine fetal blood transfusion 11500 10000

670 Hysteroscopy Transcervical Resection of Endometrium (TCRE)

671 Hysteroscopy Removal of Intrauterine Contraceptive Device (IUCD) 20700 18000

672 Hysteroscopy Removal of Septum 11500 10000673 Hysteroscopy Diagnostic 15525 13500674 Wertheim Hysterectomy for Cancer cervix 12075 10500675 Sterilization Post partum (minilap) 37950 33000676 Sterilization interval (minilap) 6900 6000677 Abortion - Dilatation and Curettage (D & C) 6900 6000678 Abortion - Dilatation and Evacuation (D & E) 7475 6500


18






679 Medical Termination of Pregnancy (MTP)- 1st Trimester 7475 6500680 Medical Termination of Pregnancy (MTP) - 2nd Trimester 5175 4500681 Triple test 8625 7500682 Quadruple test 2530 2200683 Biophysical score 690 600684 Fetal nuchal translucency 345 300685 HPV (Human Papillomavirus) testing 575 500686 β HCG 460 400

Nephrology and Urology687 Partial Nephrectomy - open 27025 23500688 Partial Nephrectomy-laparoscopic/endoscopic 27025 23500689 Nephrolithotomy -open 32200 28000690 Nephrolithotomy -laparoscopic/endoscopic 27025 23500691 Pyelolithotomy-open 32200 28000692 Pyelolithotomy -laparoscopic/endoscopic 23000 20000693 Operations for Hydronephrosis -pyeloplasty open 28750 25000

694 Operations for Hydronephrosis -pyeloplasty laparoscopic/endoscopic 25300 22000

695 Operations for Hydronephrosis Endopyelotomy antegrade 33350 29000696 Operations for Hydronephrosis Endopyelotomy retrograde 33350 29000697 Operations for Hydronephrosis - ureterocalicostomy 37950 33000698 Operations for Hydronephrosis-Ileal ureter 37950 33000699 Open Drainage of Perinephric Abscess 37950 33000

700 Percutaneous Drainage of Perinephric Abscess - Ultrasound guided 14950 13000

701 Cavernostomy 34500 30000702 Operations for Cyst of the Kidney -open 20700 18000703 Operations for Cyst of the Kidney -laparoscopic/endoscopic 18400 16000704 Ureterolithotomy -open 40114 34882705 Ureterolithotomy-laparoscopic/endoscopic 17250 15000706 Nephroureterectomy -open 46000 40000707 Nephroureterectomy -laparoscopic/endoscopic 17250 15000708 Operations for Ureter for - Double Ureters 40057 34832709 Operations for Ureter for - Ectopia of Single Ureter 28750 25000710 Operations for Vesicoureteric Reflux (VUR) -Open 32200 28000

711 Operations for Vesicoureteric Reflux (VUR)- laparoscopic/endoscopic 36225 31500

712 Operations for Vesicoureteric Reflux (VUR)/ Urinary incontinence with bulking agents 63250 55000

713 Ureterostomy - Cutaneous 40057 34832714 Ureterocolic anastomosis 23000 20000715 Formation of an Ileal Conduit 23000 20000716 Ureteric Catheterization 10950 8278717 Biopsy of Bladder (Cystoscopic) 8625 7500


19






718 Diathermy Destruction of Bladder Neoplasm 8625 7500719 Cystolitholapaxy 12650 11000720 Operations for Injuries of the Bladder 26019 22625721 Suprapubic Drainage (Cystostomy/vesicostomy) 8775 7630722 Simple Cystectomy 11500 10000723 Diverticulectomy -open 32200 28000724 Diverticulectomy- laparoscopic/endoscopic 31050 27000725 Diverticulectomy -Endoscopic incision of neck 37950 33000726 Augmentation Cystoplasty 37950 33000727 Operations for Exstrophy of the Bladder- Single stage repair 32775 28500728 Operations for Exstrophy of the Bladder- Multistage repair 28750 25000

729 Operations for Exstrophy of the Bladder- simple cystectomy with urinary diversion 37375 32500

730 Repair of Ureterocele -Open 41400 36000731 Repair of Ureterocele -laparoscopic/endoscopic 18400 16000732 Repair of Ureterocele -Endoscopic incision 57500 50000733 Open Suprapubic Prostatectomy 46000 40000734 Open Retropubic Prostatectomy 27600 24000735 Transurethral Resection of Prostate (TURP) 27600 24000736 Urethroscopy/ Cystopanendoscopy 28750 25000737 Internal urethrotomy -Optical 6900 6000738 Internal urethrotomy -Core through urethroplasty 14950 13000739 Urethral Reconstruction -End to end anastomosis 28750 25000

740 Urethral Reconstruction - substitution urethroplasty (Transpubic urethroplasty) 28750 25000

741 Posterior Urethral Valve fulguration 40250 35000742 Operations for Incontinence of Urine - Male -Open 28750 25000743 Operations for Incontinence of Urine - Male -Sling 25300 22000744 Operations for Incontinence of Urine - Male-Bulking agent 34500 30000745 Operations for Incontinence of Urine - Female -Open 46000 40000746 Operations for Incontinence of Urine - Female-Sling 25300 22000747 Operations for Incontinence of Urine - Female-Bulking agent 34500 30000748 Reduction of Paraphimosis 15021 13062749 Circumcision 3450 3000750 Meatotomy 6900 6000751 Meatoplasty 4025 3500752 Operations for Hypospadias + Chordee Correction 5750 5000753 Operations for Hypospadias - Second Stage 11500 10000754 Operations for Hypospadias - One Stage Repair 9200 8000755 Operations for Crippled Hypospadias 11500 10000756 Operations for Epispadias -primary repair 17825 15500757 Operations for Epispadias-crippled epispadias 34500 30000758 Partial Amputation of the Penis 34500 30000


20






759 Total amputation of the Penis 14950 13000760 Orchidectomy-Simple 21275 18500761 Orchidectomy-Radical 14950 13000

762 Post Radical Orchidectomy retroperitoneal lymph node dissection 28750 25000

763 Epididymectomy 18750 15938

764 Adrenalectomy Unilateral/Bilateral for Tumour/For Carcinoma- Open 14950 13000

765 Adrenalectomy Unilateral/Bilateral for Tumour/For Carcinoma -laparoscopic/endoscopic 23000 20000

766 Operations for Hydrocele - Unilateral 69000 60000767 Operations for Hydrocele - Bilateral 8625 7500768 Vasectomy (Should be free for Family Welfare) 12075 10500769 Operation for Torsion of Testis 15021 13062

770 Microsurgical Vasovasostomy /Vaso epididymal anastomosis(VEA) 15525 13500

771 Operations for Varicocele Unilateral - Microsurgical 20700 18000772 Operations for Varicocele Palomo's Unilateral - Laparoscopic 14950 13000773 Operations for Varicocele Bilateral - Microsurgical 27600 24000774 Operations for Varicocele Bilateral - Laparoscopic/Palomo 27600 24000

775 Block Dissection of ilio-inguinal Nodes - One Side (For Ca Penis) 27600 24000

776 Block Dissection of ilio-inguinal Nodes - Both Sides (For Ca Penis) 28750 25000

777 Excision of Filarial Scrotum 34845 30300778 Emergency Dialysis Femoral Puncture 18975 16500779 Emergency Dialysis Subclavian Puncture 2070 1800780 Arteriovenous Fistula/Shunt for Haemodialysis 2300 2000

781 Bilateral (single lumen) Femoral Catheterization for Haemodialysis 8625 7500

782 Haemodialysis-For seronegative cases 1610 1400783 Haemodialysis -For seropositive cases 2875 2500784 Double Lumen Subclavian Catheter 3450 3000785 Continuous Arteriovenous Haemofiltration 2300 2000786 Subclavian Access 5750 5000787 Femoral Access 2875 2500788 Plasma Exchange/ Plasmapheresis 1725 1500789 Donor Nephrectomy (Open) 46000 40000 49000790 Donor Nephrectomy (Laparoscopic) 48300 42000 75000791 Renal Transplantation (Cadaver) 115000 100000 300770792 Post transplant Collection drainage for Lymphocele 5750 5000 5750793 Transplant Nephrectomy 21275 18500 87500794 Bilateral Nephroureterectomy 29900 26000 87500795 Vascular Prosthetic Graft 29900 26000 50750796 Continuous Ambulatory Peritoneal Dialysis (CAPD) 43700 38000 28000


21






797 Percutaneous Nephrolithotomy (PCNL) - Unilateral 13800 12000 59500798 Percutaneous Nephrolithotomy (PCNL) - Bilateral 11270 9800 89250799 Endoscopic Bulking agent Injection 28175 24500 42000800 Testicular Biopsy 34500 30000 6500801 Gil-Vernet's Extended Pyelolithotomy 5750 5000 3500802 Radical Nephrectomy -Open 26450 23000 65000803 Radical Nephrectomy -Laparoscopic/Endoscopic 25300 22000 65000804 Radical Nephrectomy plus IV thrombus 34500 30000 65000805 Radical Nephrectomy plus IV thrombus plus cardiac bypass 126500 110000 175000806 Vesico Vaginal Fistula (VVF) Repair 34500 30000 49000807 Radical Cystectomy-Ileal conduit 23575 20500 65000808 Radical Cystectomy- continent diversion 34500 30000 87500809 Nephrectomy Simple -Open 46000 40000 42000810 Nephrectomy Simple-Laparoscopic/Endoscopic 21275 18500 65000811 Nephrostomy -Open 26450 23000 28000812 Nephrostomy -Laparoscopic/Endoscopic 14950 13000 17500

813 Ureteric Reimplant for Megaureter/Vesicoureteric reflux/ureterocele (open) 20125 17500 32500

814 Ureteric Reimplant for Megaureter/Vesicoureteric reflux/ureterocele (Laparoscopic) 13800 12000 32500

815 Partial Cystectomy 13800 12000 31500

816 Transurethral Resection of Prostate (TURP) & Transurethral Resection of Bladder Tumour (TURBT) 18400 16000 42000

817 Transurethral Resection of Prostate (TURP) with Cystolithotripsy 29900 26000 35000

818 Closure of Urethral Fistula 15021 13062 37500819 Orchidopexy - Unilateral -Open 14950 13000 17500820 Orchidopexy - Unilateral- Laparoscopic/Endoscopic 13800 12000 35000821 Orchidopexy - Bilateral -Open 16675 14500 26250822 Orchidopexy - Bilateral -Laparoscopic/Endoscopic 16100 14000 45000823 Cystolithotomy -Suprapubic 18975 16500 15000824 Endoscopic Removal of Stone in Bladder 11500 10000 23800

825 Resection Bladder Neck Endoscopic /Bladder neck incision/transurethral incision on prostate 17250 15000 27300

826 Ureteroscopic Surgery 25000 21250 25000827 Urethroplasty 1st Stage 25000 21250 25000828 Scrotal Exploration 17500 14875 17500829 Perineal Urethrostomy 25000 21250 25000830 Dilatation of Stricture Urethra under GA 5400 4590 5400831 Dilatation of Stricture Urethra under LA 2500 2125 2500832 Laparoscopic Nephrectomy at S. No. 810 at S. No. 810 at S. No. 810833 Laparoscopic partial Nephrectomy at S. No. 688 at S. No. 688 65000834 Retroperitoneoscopic nephrolithotomy 60000 51000 65000835 Laparoscopic pyelolithotomy 50000 52436 61690


22






836 Retroperitoneoscopic operation for Hydronephrosis 45000 38250 80000837 Laparoscopic surgery for Renal cyst 69000 60000 61950838 Laparoscopic ureterolithotomy at S.No.705 at S.No.705 57430839 Laparoscopic Nephroureterectomy at S.No.707 at S.No.707 78730840 Laparoscopy assisted orchidopexy 69000 60000 42500841 Laparoscopic operation for varicocele 23000 20000 35000842 Extracorporeal Shock Wave Lithotripsy (ESWL) 22483 19550843 Uroflow Study (Uroflowmetry) 460 400 950844 Urodynamic Study (Cystometry) 1742 1515 5700845 Cystoscopy with Retrograde Catheter -Unilateral /RGP 3835 3335 9000846 Cystoscopy with Retrograde Catheter - Bilateral /RGP 5589 4860 12000847 Cystoscopy with Bladder Biopsy (Cold Cup Biopsy) 3381 2940 12500

848 Voiding Cystourethrogram and retrograde urethrogram (Nephrostogram) 414 360 3670

849 Radical prostatectomy-Open 17825 15500 75000850 Radical prostatectomy-Laparoscopic 32200 28000 95000851 Radical prostatectomy- Robotic (Robotic Partial Nephrectomy) 40250 35000 220100

852 Holmium YAG Prostate surgery/ Optical Internal Urethrotomy (OIU)/Core through/Stone lithotripsy/Bladder tumour 17250 15000 65000

853 High Intensity Focused Ultrasound (HIFU) (Robotic) for Carcinoma prostate and renal cell carcinoma 4600 4000 220100

854 Prosthetic surgery for urinary incontinence855 Transrectal Ultrasound (TRUS) guided prostate biopsy 46000 40000

Neurosurgery856 Craniotomy and Evacuation of Haematoma - Subdural 86595 75300 75300857 Craniotomy and Evacuation of Haematoma - Extradural 30188 26250 75300858 Evacuation / Excision of Brain Abscess by craniotomy 33810 29400 97750859 Excision of Lobe (Frontal, Temporal, Cerebellum etc.) 35018 30450 157400860 Excision of Brain Tumour - Supratentorial 39123 34020 133925861 Excision of Brain Tumour - Infratentorial 53130 46200 133925862 Surgery of spinal Cord Tumour 53130 46200 78200863 Ventriculoatrial /Ventriculoperitoneal Shunt 40469 35190 35190864 Twist Drill Craniostomy 24150 21000 23460865 Subdural Tapping 15564 13534 35190866 Ventricular Tapping 4025 3500 35190867 Abscess Tapping 4025 3500 35190868 Placement of Intracranial pressure (ICP) Monitor 4025 3500 23460869 Urokinase Therapy for ICH (Intracranial Haematoma) 3450 3000 35190870 Skull Traction Application 2300 2000 23460871 Lumbar Pressure Monitoring 6900 6000 23460872 Vascular Malformations 6969 6060 133950873 Thecoperitoneal Shunt 6969 6060 35190874 Meningo Encephalocele Excision and repair 6969 6060 97750875 Meningomyelocele Repair 24995 21735 64515


23






876 CSF Rhinorrhoea Repair 28980 25200 97750877 Cranioplasty 38640 33600 97750878 Posterior Cervical Discectomy 35650 31000 58650879 Anterior Cervical Discectomy 29900 26000 58650880 Brachial Plexus Exploration and Micro Suturing (neurotization) 29900 26000 97750881 Median Nerve Decompression 20700 18000 35190882 Peripheral Neurectomy (Trigeminal) 10120 8800 8800883 Trigeminal Rhizotomy 20700 18000884 Cranial Nerve Anastomosis 20700 18000 133950885 Peripheral Nerve Surgery - Major 17250 15000 133950886 Peripheral Nerve Surgery - Minor 16261 14140 64515887 Ventriculoatrial /Ventriculoperitoneal Shunt (without valve) 11615 10100888 Nerve Biopsy 10120 8800 8800889 Brain Biopsy 5808 5050 83100890 Anterior Cervical Spine Surgery with fusion 16261 14140 97750891 Anterolateral Decompression of spine 38640 33600 83100892 Brain Mapping 38640 33600893 Cervical or Dorsal or Lumbar Laminectomy 4646 4040 58650

894 Combined Trans-oral Surgery & Craniovertebral (CV) Junction Fusion 34500 30000 157400

895 Craniovertebral Junction (CVJ) Fusion procedures 60950 53000 107525896 Depressed Fracture Elevation 43470 37800 83100897 Lumbar Discectomy 33810 29400 58650898 Endarterectomy (Carotid) 32240 28035 97750899 Radiofrequency Ablation (RFA) for Trigeminal Neuralgia 29900 26000 58650900 Spasticity Surgery 4646 4040901 Spinal Fusion Procedure 48300 42000 107525902 Spinal Intramedullary Tumours 45425 39500 127100903 Spina Bifida Surgery Major 46000 40000 107525904 Spina Bifida Surgery Minor 25875 22500 78200905 Stereotaxic Procedures - biopsy / aspiration 25875 22500 83100906 Transsphenoidal Surgery 8050 7000 133950907 Trans Oral Surgery 56350 49000 157400908 Implantation of Deep Brain Stimulation (DBS) -one electrode 5980 5200 157400909 Implantation of Deep Brain Stimulation (DBS) -two electrodes 51750 45000 157400910 Endoscopic aqueductoplasty 86250 75000 97750911 Facial nerve reconstruction 100050 87000 55000912 Recanalisation of venous sinuses 67850 59000 140000913 Carotid stenting 42263 36750 133950914 Cervical disc arthroplasty 30188 26250 127075915 Lumbar disc arthroplasty 92000 80000 127075916 Corpus callosotomy 67850 59000 133950917 Hemispherectomy 64400 56000 157400


24






918 Endoscopic CSF rhinorrhoea repair 103500 90000 133950919 Burr hole evacuation of chronic subdural haematoma 46345 40300 64515920 Microsurgical excision of Acoustic tumour 33350 29000 97750921 Microsurgical excision of meningiomas 33408 29050 157400922 Epilepsy surgery other than at S. No 916 and 917 36225 31500 157400923 Radiofrequency Ablation (RFA) for facet joint pain syndrome 86595 75300 75300924 Cervical laminoplasty 41688 36250 78200925 Lateral mass C1- C2 screw fixation 48300 42000 107525926 Microsurgical decompression for Trigeminal nerve 26623 23150 97750927 Cerebellar stimulation for hemifacial spasm 4646 4040 133950928 Cerebellar stimulation for other cranial nerve neuralgia 35650 31000

929 Extracranial-Intracranial Bypass Procedures (EC-IC) bypass procedures 46000 40000 133950

930 Stereotactic guided craniotomy 80500 70000 133950931 Baclofen pump implantation 80500 70000 97750932 Programmable Ventriculoperitoneal (VP) shunt 95565 83100 83100933 Endoscopic sympathectomy 38100 33130 97750934 Lumbar puncture 10120 8800 8800935 External ventricular drainage (EVD) 743 646 35190936 Image guided surgery Excision of tethored 28980 25200937 Endoscopic 3rd ventriculostomy 112413 97750 97750

938 Endoscopic cranial surgery / Biopsy / aspiration / aneurysm coiling 181010 157400 157400

939 Endoscopic discectomy (Lumbar, Cervical) 35621 30975 58650940 Aneurysm coiling (Endovascular) 18320 15930 15930941 Endoscopic spinal procedure - aneurysm coiling 35708 31050 133950942 Surgery for skull fractures 41458 36050943 Carpal Tunnel decompression 40469 35190 35190944 Clipping of intracranial aneurysm 24150 21000 157400945 Surgery for intracranial Arteriovenous malformations (AVM) 21793 18950 18950946 Endovascular procedure/embolisation 53188 46250 69400947 4 vessels cerebral angiography 112413 97750 97750948 Foramen magnum decompression for Chiari Malformation 34500 30000 97750

949 Foramen magnum decompression with syringosubarachnoid shunt 35708 31050 133950

950 Dorsal column stimulation for backache in failed back syndrome 70150 61000

951 Surgery for recurrent disc prolapse/epidural fibrosis 57500 50000 78200952 Transsphenoidal Surgery 15410 13400 13400953 Programmable shunts 35621 30975 64515

954 Decompressive craniotomy for hemispherical acute subdural haematoma/brain swelling/large infarct 92000 80000 133950

955 Intra-arterial thrombolysis with Tissue Plasminogen Activator (TPA) (for ischemic stroke ) 92000 80000

956 Stereotactic aspiration of intracerebral haematoma 32545 28300 83100


25






957 Endoscopic aspiration of intracerebral haematoma 41458 36050 75300

958 Stereotactic Radiosurgery for brain pathology (X knife / Gamma knife - One session 69000 60000

959 Stereotactic Radiosurgery for brain pathology (X knife / Gamma knife -Two or more sessions 57500 50000 210000

960 Chemotherapy wafers for malignant brain tumours 19550 14450 25000Paediatric surgery

961 Excision of thyroglossal Duct / Cyst 16100 14000

962 Diaphragmatic Hernia Repair (Thoracic or Abdominal Approach) 23000 20000

963 Tracheoesophageal Fistula (Correction Surgery) 23000 20000964 Colon Replacement of Oesophagus 36800 32000965 Omphalomesenteric Cyst Excision 33350 29000966 Omphalomesenteric Duct Excision 25875 22500967 Meckel's Diverticulectomy 23575 20500968 Omphalocele 1st Stage (Hernia Repair) 23575 20500969 Omphalocele 2nd Stage (Hernia Repair) 20700 18000970 Gastroschisis Repair 23000 20000971 Inguinal Herniotomy 23575 20500972 Congenital Hydrocele 17250 15000973 Hydrocele of Cord 17250 15000974 Torsion Testis Operation 17250 15000975 Congenital Pyloric Stenosis- operation 22425 19500976 Duodenal Atresia Operation 20125 17500977 Pancreatic Ring Operation 22425 19500978 Meconium Ileus Operation at S. No. 1000 at S. No. 1000979 Malrotation of Intestines Operation 23000 20000980 Rectal Biopsy (Megacolon) 25875 22500981 Colostomy Transverse 4359 3790982 Colostomy Left Iliac 23000 20000983 Abdominoperineal Pull Through (Hirschsprung's Disease) 23000 20000984 Imperforate Anus Low Anomaly - Cut Back Operation 29900 26000985 Imperforate Anus Low Anomaly - Perineal Anoplasty 14950 13000

986 Imperforate Anus High Anomaly - Sacro Abdominoperineal Pull Through 20125 17500

987 Imperforate Anus High Anomaly - Closure of Colostomy 27876 24240988 Intussusception Operation 13938 12120

989 Choledochoduodenostomy for Atresia of Extrahepatic Biliary Duct 25875 22500

990 Operation of Choledochal Cyst 29900 26000991 Nephrectomy for Pyonephrosis 29900 26000992 Nephrectomy for Hydronephrosis 29900 26000993 Nephrectomy for Wilms Tumour 29900 26000

994 Paraaortic Lymphadenectomy with Nephrectomy for Wilms Tumour 29900 26000


26






995 Sacrococcygeal Teratoma Excision 33350 29000996 Neuroblastoma Debulking 25875 22500997 Neuroblastoma Total Excision 25875 22500998 Rhabdomyosarcoma wide Excision 29900 26000999 Congenital Atresia & Stenosis of Small Intestine 33350 290001000 Meconium Ileus 29900 260001001 Malrotation and Volvulus of the Midgut 24725 215001002 Excision of Meckel’s Diverticulum 24725 21500

Burns and Plastic surgery1003 Primary Suturing of Wound 3450 30001004 Injection of steroids - Ganglion 1150 10001005 Injection of steroids - Haemangioma 1150 10001006 Free Grafts - Wolfe Grafts 1725 15001007 Free Grafts - Theirech- Small Area 5% 10350 90001008 Free Grafts - Large Area 10% 10350 90001009 Free Grafts - Very Large Area 20% and above 12650 110001010 Skin Flaps - Rotation Flaps 16100 140001011 Skin Flaps - Advancement Flaps 14375 125001012 Skin Flaps - Direct- cross Leg Flaps- Cross Arm Flap 17825 155001013 Skin Flaps - Cross Finger 19550 170001014 Skin Flaps - Abdominal 19550 170001015 Skin Flaps - Thoracic 19550 170001016 Skin Flaps - Arm etc 19550 170001017 Subcutaneous Pedicle Flaps Raising 21850 190001018 Subcutaneous Pedicle Flaps Delay 10925 95001019 Subcutaneous Pedicle Flaps Transfer 11500 100001020 Cartilage Grafting 13800 120001021 Reduction of Facial Fractures of Nose 13225 115001022 Reduction of Facial Fractures of Maxilla 16100 14000

1023 Reduction of Fractures of Mandible & Maxilla - Eyelet Splinting 18975 16500

1024 Reduction of Fractures of Mandible & Maxilla - Cast Metal Splints 10925 9500

1025 Reduction of Fractures of Mandible & Maxilla - Gunning Splints 10925 9500

1026 Internal Wire Fixation of Mandible & Maxilla 11500 100001027 Cleft Lip - Repair 17250 150001028 Cleft Palate Repair 20700 180001029 Primary Bone Grafting for alveolar cleft in Cleft Lip 20700 180001030 Secondary Surgery for Cleft Lip Deformity 15525 135001031 Secondary Surgery for Cleft Palate 15525 135001032 Reconstruction of Eyelid Defects - Minor 18400 160001033 Reconstruction of Eyelid Defects - Major 13800 120001034 Plastic Surgery of Different Regions of the Ear - Minor 17250 15000


27






1035 Plastic Surgery of Different Regions of the Ear - Major 12075 105001036 Plastic Surgery of the Nose - Minor 16100 140001037 Plastic Surgery of the Nose - Major 12075 105001038 Plastic Surgery for Facial Paralysis (Support with Reanimation) 16100 140001039 Pendulous Breast - Mammoplasty 27600 240001040 Underdeveloped Breast - Mammoplasty 27600 240001041 After Mastectomy (Reconstruction) Mammoplasty 24725 215001042 Syndactyly Repair 24725 215001043 Dermabrasion Face 24725 215001044 Upto 30% Burns 1st Dressing 17250 150001045 Upto 30% Burns Subsequent Dressing 932 8101046 30% to 50% Burns 1st Dressing 702 6101047 30% to 50% Burns Subsequent Dressing 1162 10101048 Extensive Burn - above 50% First Dressing 702 6101049 Extensive Burn - above 50% Subsequent dressing 2323 2020

OrthopaedicsPlaster Work

1050 Finger (posterior slab) 771 6701051 Fingers full plaster 345 3001052 Colles Fracture - Below elbow 345 3001053 Colles Fracture - Full plaster 1265 11001054 Colles fracture Anterior or posterior slab 978 8501055 Above elbow full plaster 1265 11001056 Above Knee posterior slab 575 5001057 Below Knee full plaster 771 6701058 Below Knee posterior slab 575 5001059 Tube Plaster (or plaster cylinder) 575 5001060 Above knee full plaster 1265 11001061 Above knee full slab 575 5001062 Minerva Jacket 2990 26001063 Plaster Jacket 3220 28001064 Shoulder spica 2760 24001065 Single Hip spica 2588 22501066 Double Hip spica 2760 2400

Strapping1067 Strapping of Finger 179 1561068 Strapping of Toes 230 2001069 Strapping of Wrist 230 2001070 Strapping of Elbow 345 3001071 Strapping of Knee 345 3001072 Strapping of Ankle 460 4001073 Strapping of Chest 460 4001074 Strapping of Shoulder 621 540


28






1075 Figure of 8 bandage 633 5501076 Collar and cuff sling 633 5501077 Ball bandage 518 450

1078 Application of Plaster of Paris(POP) Casts for Upper & Lower Limbs 633 550

1079 Application of Functional Cast Brace 1438 12501080 Application of Skin Traction 2070 18001081 Application of Skeletal Tractions 1610 14001082 Bandage & Strappings for Fractures 2875 25001083 Aspiration & Intra Articular Injections 276 2401084 Application of Plaster of Paris(POP) Spices & Jackets 1208 10501085 Close Reduction of Fractures of Limb & Plaster of Paris(POP) 4600 40001086 Reduction of Compound Fractures 4600 40001087 Open Reduction & Internal Fixation(ORIF) of Fingers & Toes 5175 4500

1088 Open Reduction of fracture of Long Bones of Upper /Lower Limb - Nailing & External Fixation 8050 7000

1089 Open Reduction of fracture of Long Bones of Upper /Lower Limb - AO Procedures 11270 9800

1090 Tension Band Wirings 11270 98001091 Bone Grafting 6601 57401092 Excision of Bone Tumours 9660 84001093 Excision or other Operations for Scaphoid Fractures 12880 112001094 Sequestrectomy & Saucerization 8050 70001095 Sequestrectomy & Saucerizations -Arthrotomy 9971 86701096 Multiple Pinning Fracture Neck Femur 12880 112001097 Plate Fixations for Fracture Neck Femur 16100 140001098 AO Compression Procedures for Fracture Neck Femur 19550 17000

1099 Open Reduction of Fracture Neck Femur Muscle Pedicle Graft and Internal Fixations 19550 17000

1100 Close Reduction of Dislocations 9971 86701101 Open Reduction of Dislocations 4025 3500

1102 Open Reduction and Internal Fixation (ORIF) of Fracture Dislocations 4600 4000

1103 Neurolysis/Nerve repair 16100 140001104 Nerve Repair with grafting 16675 145001105 Tendon with Transplant or Graft 24150 210001106 Tendon Lengthening/Tendon repair 9971 86701107 Tendon Transfer 9775 85001108 Laminectomy Excision Disc and Tumours 12880 112001109 Split Osteotomy and Internal Fixations 24150 21000

1110 Anterolateral decompression for tuberculosis/ Costotransversectomy 32200 28000

1111 Anterolateral Decompression and Spinal Fusion 29325 255001112 Corrective Osteotomy & Internal Fixation - Short bones 32200 280001113 Corrective Osteotomy & Internal Fixation - Long bones 16100 14000


29






1114 Arthrodesis of Minor Joints 13225 115001115 Arthrodesis of Major Joints 12880 11200

1116 Soft Tissue Operations for Congenital Talipes Equinovarus (CTEV) 9971 8670

1117 Soft Tissue Operations for Polio 9775 85001118 Hemiarthroplasty- Hip 8050 70001119 Hemiarthroplasty- Shoulder 11500 100001120 Operations for Brachial Plexus & Cervical Rib 74750 650001121 Amputations - Below Knee 20786 180751122 Amputations - Below Elbow 8050 70001123 Amputations - Above Knee 8050 70001124 Amputations - Above Elbow 13225 115001125 Amputations - Forequarter 13225 115001126 Amputations - Hind Quarter and Hemipelvectomy 19550 170001127 Disarticulations - Major joint 24150 210001128 Disarticulations - Minor joint 20786 180751129 Arthrography 18400 160001130 Arthroscopy - Diagnostic 13225 115001131 Arthroscopy-therapeutic: without implant 13800 120001132 Arthroscopy-therapeutic: with implant 20700 180001133 Soft Tissue Operation on Joints -Small 20786 180751134 Soft Tissue Operation on Joints -Large 20700 180001135 Myocutaneous and Fasciocutaneous Flap Procedures for Limbs 20700 180001136 Removal of Wires & Screw 9971 86701137 Removal of Plates 8625 75001138 Total Hip Replacement(THR) 103500 90000 1035001139 Total Ankle Joint Replacement 112125 97500 1121251140 Total Knee Joint Replacement(TKR) 126500 110000 1265001141 Total Shoulder Joint Replacement 19550 17000 195501142 Total Elbow Joint Replacement 19550 17000 195501143 Total Wrist Joint Replacement 115000 100000 1150001144 Total finger joint replacement 23000 20000 230001145 Tubular external fixator 44850 390001146 Ilizarov external fixator 46000 400001147 Pelvi acetabular fracture -Internal fixation 46000 40000

Physiotherapy1148 Ultrasonic therapy 127 1101149 ShortWave Diathermy (SWD) 127 1101150 Electrical stimulation (therapeutic) 127 1101151 Muscle testing and diagnostic 155 1351152 Infrared 155 1351153 Ultraviolet Therapeutic (UV Therapeutic) dose 58 501154 Intermittent Lumbar Traction 127 110


30






1155 Intermittent Cervical traction 75 651156 Wax bath 75 651157 Hot pack 127 1101158 Breathing Exercises & Postural Drainage 58 501159 Cerebral Palsy - exercise 161 1401160 Post polio exercise 127 110

Nuclear MedicineRADIOISOTOPE THERAPY131-Iodine Therapy

1161 131-Iodine Therapy <15 mCi 8300 7055 83001162 131-Iodine Therapy 15-50 mCi 5130 4361 51301163 131-Iodine Therapy 51-100 mCi 12000 10200 188001164 131-Iodine Therapy >100 mCi 15000 12750 188001165 Phosphorus-32 therapy for metastatic bone pain palliation 18000 15300 217001166 Samarium-153 therapy for metastatic bone pain palliation 7130 6061 71301167 Radiosynovectomy with Yttrium 10690 9087 10690

Radiotherapy and ChemotherapyCobalt 60 therapy

1168 Cobalt 60 therapy- Radical therapy1169 Cobalt 60 therapy- Palliative therapy 29325 25500

Linear accelerator1170 Linear accelerator- Radical therapy 60000 51000 950001171 Linear accelerator- Palliative therapy 57500 50000 575001172 3D Planning Radiotherapy 5000 4250 89101173 2D Planning Radiotherapy 5000 4250 65301174 IMRT(Intensity Modulated radiotherapy) 103200 87720 1290001175 SRT (Stereotactic radiotherapy) 62400 53040 780001176 SRS (Stereotactic radiosurgery) 82400 70040 1030001177 IGRT(Image guided radiotherapy) 150400 127840 1880001178 Respiratory Gating-along with Linear accelerator planning 125000 1062501179 Electron beam with Linear accelerator 89060 75701 890601180 Tomotherapy

Brachytherapy- High dose radiation1181 Intracavitary (Brachytherapy) 12000 10200 237501182 Interstitial (Brachytherapy) 34880 303301183 Intraluminal (Brachytherapy) 10000 8500 142501184 Surface mould (Brachytherapy) 4750 4038 47501185 Gliadel Wafer (Brachytherapy) 107830 91656 107830

Chemotherapy1186 Neoadjuvant Chemotherapy1187 Adjuvant Chemotherapy 3450 3000 34501188 Concurrent chemoradiation 5750 5000 57501189 Single drug Chemotherapy 552 480 590


31






1190 Multiple drugs Chemotherapy 2070 1800 20701191 Targeted therapy 2760 2400 27601192 Chemoport facility 9200 8000 92001193 PICC line (Peripherally Inserted Central Catheter) 9200 8000 9200

List of procedures/ tests in GastroenterologyEndoscopic proceduresUpper GI Endoscopy + Lower GI Endoscopy 2513 2185 3000

1194 Diagnostic endoscopy 1035 900 12251195 Endoscopic biopsy 1212 1054 14251196 Endoscopic mucosal resection 3450 30001197 Oesophageal stricture dilatation 5181 4505 61001198 Balloon dilatation of achalasia cardia 6900 60001199 Foreign body removal 3657 3180 43001200 Oesophageal stenting 6647 5780 78201201 Band ligation of oesophageal varices 4985 4335 58651202 Sclerotherapy of oesophageal varices 3657 3180 43001203 Glue injection of varices 4653 4046 54751204 Argon plasma coagulation 8050 70001205 Pyloric balloon dilatation 8050 70001206 Enteral stenting 46000 400001207 Duodenal stricture dilatation 5181 4505 61001208 Single balloon enteroscopy 34500 300001209 Double balloon enteroscopy 34500 300001210 Capsule endoscopy 57500 500001211 Polypectomy (Gastro Intestinal) 3657 3180 43001212 Piles banding 4985 4335 58651213 Colonic stricture dilatation 20700 180001214 Hot biopsy forceps procedures 6900 60001215 Colonic stenting 34500 300001216 Junction biopsy 18400 160001217 Narrow band imaging 34500 300001218 Conjugal microscopy 34500 30000

ERCP

1219 Diagnostic ERCP (Endoscopic Retrograde Cholangiopancreatography) 5865 5100 6900

1220 Endoscopic sphincterotomy 5750 50001221 Common Bile Duct (CBD) stone extraction 8602 7480 101201222 Common Bile Duct (CBD) stricture dilatation 8602 7480 101201223 Biliary stenting (plastic and metallic) 9286 8075 109251224 Mechanical lithotripsy of CBD stones 10925 9500 293251225 Pancreatic sphincterotomy 9286 8075 109251226 Pancreatic stricture dilatation 34500 300001227 Pancreatic stone extraction 8602 7480 10120


32






1228 Mechanical lithotripsy of pancreatic stones 15525 13500 293251229 Endoscopic cystogastrostomy 18400 160001230 Balloon dilatation of papilla 34500 30000

Endoscopic ultrasound1231 Diagnostic ultrasound 1045

1232 Colour Doppler Listed under Investigations


1233 Ultrasound guided FNAC 1955 1700 9701234 Ultrasound guided abscess drainage 1150 1000 9701235 PTBD (Percutaneous transhepatic biliary drainage) 1150 1000 296901236 Biliary stenting at S.No.1223

Angiography 34500 30000 145001237 Diagnostic angiography 1495 1300 168601238 Vascular embolization 23000 200001239 TIPS (Transjugular intrahepatic portosystemic shunt) 46000 400001240 Transjugular liver biopsy 28750 250001241 IVC (Inferior vena cava)venography + hepatic venography 28750 250001242 Balloon angioplasty1243 Muscular stenting 57500 500001244 BRTO(Balloon occluded retrograde intravenous obliteration) 57500 500001245 Portal haemodynamic studies 34500 30000

Manometry and PH metry 34500 300001246 Oesophageal PH metry1247 Oesophageal manometry 28750 250001248 Small bowel manometry 28750 250001249 Anorectal manometry 28750 250001250 Colonic manometry 28750 250001251 Biliary manometry 28750 250001252 Sengstaken Blakemore tube tamponade 28750 250001253 Lintas machles tube tamponade 28750 25000

Biochemistry, Serology and Molecular biology 28750 25000

1254 D-xylose test Listed under Investigations


1255 Fecal fat test/ fecal chymotrypsin/ fecal elastase Listed under Investigations


1256 Breath tests Listed under Investigations


1257 H pylori serology for celiac disease Listed under Investigations


1258 HBV genotyping Listed under Investigations


1259 HCV genotyping Listed under Investigations


Extracorporeal shockwave lithotripsy(ESWL) at S. No. 842 at S. No. 8421268 CBD stones 633 550


33






1269 Pancreatic duct stones 32200 280001270 Liver biopsy 36800 32000

Nephrological procedures1271 Internal jugular vein cannulation 1208 1050 17001272 Renal Biopsy 1380 1200 20401273 Transplant Biopsy 2300 2000 33301274 Acute PD( peritoneal dialysis)catheterization 1725 1500 61801275 Continuous Renal Replacement Therapy 1840 16001276 SLED (Slow Efficiency Dialysis) 25001277 Permacath Insertion 2600 2261 123501278 CAPD ( Insertion and Removal ) 17250 150001279 Femoral Access 17250 150001280 Subclavian Access at S.No.786 at S.No.7861281 Partial Nephrectomy at S.No.687 at S.No.6871282 Nephrolithotomy- laparoscopic/endoscopic at S.No.690 at S.No.6901283 Pyelolithotomy- laparoscopic/ endoscopic 11250 9563 350001284 Pyeloplasty - laparoscopic/endoscopic at S.No.694 at S.No.6941285 Ureterolithotomy- laparoscopic/endoscopic at S.No.705 at S.No.7051286 Formation of an ileal conduit 23000 20000 230001287 Fistula/shunt at S.No.780 at S.No.7801288 Dialysis Femoral Catheterization Bilateral at S.No. 781 at S.No. 7811289 Haemodialysis- For Seronegative cases at S.No. 782 at S.No. 7821290 Haemodialysis- For Seropositive cases at S.No. 783 at S.No. 7831291 Double lumen subclavian catheter at S.No. 784 at S.No. 7841292 Continuous Arteriovenous Haemofiltration at S.No. 785 at S.No. 7851293 Plasma Exchange at S.No.788 at S.No.7881294 Donor nephrectomy- Open at S.No.789 at S.No.7891295 Donor nephrectomy- laparoscopic/endoscopic at S.No. 790 at S.No. 7901296 Renal Transplantation at S.No.791 at S.No.7911297 Lymphocele Post Transplant at S.No. 792 at S.No. 7921298 Transplant Nephrectomy at S.No. 793 at S.No. 793

RATES FOR DIAGNOSTIC LABS & IMAGING CENTRES CGHS MUMBAI In Rupees In Rupees

DENTAL1 Dental IOPA X Ray 70 602 Occlusal X Ray 80 683 OPG X Ray 200 170

PULMONARY4 Lung Ventilation & Perfusion Scan (V/Q Scan) 5000 42505 Lung Perfusion Scan 3000 2550

OSTEOLOGY - -


34






6 Whole Body Bone Scan with SPECT 3500 29757 Three phase whole body Bone Scan 3500 2975

NEUROSCIENCES - -

8 Brain Perfusion SPECT Scan with Technetium 99m radiopharmaceuticals 10000 8500

9 Radionuclide Cisternography for CSF leak 5000 4250GASTRO AND HEPATOBILIARY - -

10 Gastroesophageal Reflux Study (GER Study) 2000 1700

11 Gastrointestinal Bleed (GIB) Study with Technetium 99m labeled RBCs 3500 2975

12 Hepatobiliary Scintigraphy 2500 212513 Meckel's Scan 2000 1700

14 Hepatosplenic Scintigraphy with Technetium- 99m radiopharmaceutical 2500 2125

15 Gastric emptying 1500 1275GENITOURINARY - -

16 Renal Cortical Scintigraphy with Technetium 99m Dimercaptosuccinic acid (DMSA) 3500 2975

17 Dynamic Renography 3500 297518 Dynamic Renography with Diuretic 3500 297519 Dynamic Renography with Captopril 4500 382520 Testicular Scan 1500 1275

ENDOCRINOLOGY - -21 Thyroid Uptake measurements with 131-Iodine 1600 136022 Thyroid Scan with Technetium 99m Pertechnetate 1500 127523 Iodine-131 Whole Body Scan 3000 255024 Whole Body Scan with MIBG 18000 1530025 Parathyroid Scan 5000 4250

RADIOISOTOPE THERAPY - -

26 131-Iodine TherapyListed Under

Treatment Procedures

Listed Under Treatment Procedures

27 131-Iodine Therapy <15 mCiListed Under



28 131-Iodine Therapy 15-50 mCiListed Under



29 131-Iodine Therapy 51-100 mCiListed Under



30 131-Iodine Therapy >100 mCiListed Under



31 Phosphorus-32 therapy for metastatic bone pain palliationListed Under




35






32 Samarium-153 therapy for metastatic bone pain palliationListed Under



33 Radiosynovectomy with YttriumListed Under



CARDIOLOGY34 Stress thallium / Myocardial Perfusion Scintigraphy 9900 841535 Rest thallium / Myocardial Perfusion Scintigraphy 9900 841536 Venography 3500 297537 ECG 50 43

38 Stress Echocardiography- DobutamineListed Under



39 Stress Echocardiography- Exercise 1200 102040 Treadmill Test (TMT) 500 42541 Transesophageal Echocardiography(TEE) 500 42542 Lymphangiography 1650 1403

TUMOUR IMAGING43 Scintimammography 5000 425044 Indium labelled octreotide Scan 75000 63750

PET SCAN - -45 FDG Whole body PET / CT Scan 21000 1785046 Brain I Heart FDG PET / CT Scan 15000 12750

47 Gallium-68 Peptide PET / CT imaging for Neuroendocrine Tumour 17000 14450

48 Non FDG PET / CT ScanLaboratory MedicineClinical Pathology

49 Urine routine- pH,Specific gravity,Sugar,Protein and Microscopy 39 33

50 24 hrs urine for Proteins,Sodium,creatinine 60 5151 Urine Microalbumin 60 5152 Quantitative Albumin/Sugar 24 2053 Urine Bile Pigment and Salt 30 2654 Urine Urobilinogen 30 2655 Urine Ketones 35 3056 Urine Occult Blood 35 3057 Urine total proteins 21 1858 Bence Jones protein 48 4159 Stool routine 39 3360 Stool occult blood 35 3061 Post coital smear examination 100 8562 Semen analysis 80 6863 Body fluid (CSF/Ascitic Fluid etc.)Sugar,Protein etc. 55 47


36






64 Albumin 21 1865 Creatinine clearance 160 136

Haematology66 Haemoglobin (Hb) 19 1667 Total Leucocyte Count (TLC) 32 2768 Differential Leucocyte Count (DLC) 32 2769 Erythrocyte Sedimentation Rate (ESR) 35 3070 Total Red Cell count with MCV,MCH,MCHC,RDW 35 30

71 Complete Haemogram -Hb, RBC count and indices, TLC, DLC, Platelet, ESR, Peripheral Smear examination 120 102

72 Platelet count 50 4273 Reticulocyte count 49 4274 Absolute Eosinophil Count (AEC) 50 4275 Packed Cell Volume (PCV) 35 3076 Peripheral Smear Examination 44 3777 Smear for Malaria Parasite 42 3678 Bleeding & Clotting Time 48 4179 Clot Retraction Time 35 3080 RBC / Osmotic Fragility Test 50 4381 LE Cell 77 6582 Foetal Hemoglobin (HbF) 154 13183 Prothrombin Time (PT) 119 10184 Bone Marrow Smear Examination 75 6485 Bone Marrow Smear Examination with Iron stain 256 218

86 Bone Marrow Smear Examination and cytochemistry where required 340 289

87 Activated partial ThromboplastinTime (APTT) 105 8988 Glucose 6 Phosphate Dehydrogenase (G6PD) 250 21389 Rapid test for malaria(card test) 44 3790 WBC cytochemistry for leukemia -Complete panel 890 757

91Bleeding Disorder panel-BT,CT,Platelet count, APTT, Extended DIC studies D-Dimer/Fibrinogen Degradation Products (FDP)

400 340

92 Factor Assays-Factor VIII 750 63893 Factor Assays-Factor IX 700 59594 Factor Assays- other factors 2763 2348

Anti Cardiolipin Antibodies95 IgG 260 22196 IgM 260 22197 IgA 260 221

Antiphospholipid Antibodies98 IgG 260 22199 IgM 260 221100 IgA 260 221


37






101 Thalassemia studies 700 595102 Hb Electrophoresis at S.No.183 at S.No.183103 Sickling studies 77 65

Nutritional Markers104 Serum Iron 100 85105 Total Iron Binding Capacity 100 85106 Vitamin B12 assay 256 218107 Folic Acid assay 350 298108 HDL Cholesterol 100 85

Blood Bank109 Blood Group & RhD Type 33 28110 Cross match 60 51111 Packed cell preparation 40 34112 Coomb’s Test Direct 100 85113 Coomb’s Test Indirect 119 101114 Australia Antigen/ Hepatitis B Surface Antigen (HBsAg) 120 102115 Rh Antibody titre 119 101116 Blood Components-Packed Red Blood Cells(PRBC) per unit 1450 1450117 Blood Components - Fresh Frozen Plasma(FFP) 400 400118 Blood Components - Cryoprecipitate 200 200

Histopathology(HPE)119 Routine-H & E 100 85120 Special stain 100 85121 Immunohistochemistry(IHC) 878 746122 Frozen section 1500 1275123 Paraffin section 200 170

Cytology124 Pap Smear 160 136125 Vaginal Cytology for Hormonal evaluation 160 136126 Body fluid for Malignant cells 200 170127 Fine Needle Aspiration Cytology (FNAC) 250 213128 Special stain on cytology 90 77

Flow Cytometry - -129 Leukemia panel /Lymphoma panel 3575 3039130 CD Count: CD3,CD4,CD8 1000 850

131 Paroxysmal Nocturnal Haemoglobinuria (PNH)Panel- CD55, CD59 1450 1233

Cytogenetics - -132 Karyotyping 2000 1700

Tumour markers - -133 Prostate Specific antigen (PSA)- Total 319 271134 Prostate Specific antigen (PSA)- Free 450 383135 Alpha Fetoprotein (AFP) 345 293


38






136 Human chorionic gonadotropin (HCG) 340 289137 Cancer Antigen 125 (CA 125) 400 340138 Cancer Antigen 19.9 (CA 19.9) 630 536139 Cancer Antigen 15.3 (CA 15.3) 630 536140 Carcinoembryonic Antigen (CEA) 350 298

Biochemistry141 Blood Glucose Random 25 21142 Blood Urea Nitrogen 55 47143 Serum Creatinine 56 48144 Serum Uric Acid 56 48145 Serum Bilirubin Total & Direct 35 30146 Serum Iron at S.No.104 at S.No.104147 Serum Cholesterol 63 54148 Total Iron Binding Capacity(TIBC) 100 85149 Glucose (Fasting & Post Prandial) 48 41150 Serum Calcium -Total 63 54151 Serum Calcium - Ionic 45 38152 Serum Phosphorus 66 56153 Total Protein Albumin/Globulin Ratio (A/G Ratio) 70 60

154 Serum glutamic pyruvic transaminase (SGPT) / Alanine Aminotransferase (ALT) 56 48

155 Serum Glutamic oxaloacetic transaminase (SGOT) / Aspartate Aminotransferase (AST) 56 48

156 Serum Amylase 120 102157 Serum Electrolytes 130 111158 Triglyceride 95 81159 Glucose Tolerance Test (GTT) 100 85160 Creatine Phosphokinase (CPK) 105 89161 Lactate dehydrogenase (LDH) 132 112162 Alkaline Phosphatase(ALP) 63 54163 Acid Phosphatase 80 68164 Creatine Phosphokinase (CPK)/Creatine Kinase (CK) 196 167165 Lithium 140 119166 Dilantin (phenytoin) 439 373167 Carbamazepine 439 373168 Valproic acid 315 268169 Serum Ferritin 315 268170 Blood gas analysis / Arterial Blood Gas (ABG) 460 391

171 Blood gas analysis / Arterial Blood Gas (ABG) with electrolytes 151 129

172 Urine Pregnancy Test 69 58173 HbA1C 165 140174 Kidney Function Tests ( KFT/RFT) 261 222175 Liver Function Tests (LFT) 275 234


39






176 Lipid Profile(Total cholesterol,LDL,HDL,Triglycerides) 215 182

177 Extended Lipid Profile( Total cholesterol, LDL, HDL,Triglycerides,Apo A1,Apo B,Lp(a) ) 700 595

178 Apolipoprotein A1 (ApoA1) 203 173179 Apolipoprotein B (Apo B) 203 173180 Lipoprotein A / Lp A 455 387181 Low density lipoprotein (LDL) 63 54182 Serum Homocysteine 450 383183 Haemoglobin (Hb) Electrophoresis 450 383184 Serum Electrophoresis 300 255185 Fibrinogen 400 340186 Chloride 66 56187 Serum Magnesium 154 131188 GGTP (Gamma Glutamyl Transpeptidase) / GGT 100 85189 Serum Lipase 245 208190 Fructosamine 224 190191 Beta 2 microglobulin (B2M) /β2 microglobulin 100 85192 Albumin 21 18193 Catecholamines 800 680

194 Creatinine clearance (Select CGHS code 65 under investigations) at S.No.65 at S.No.65

Hormones - -195 T3, T4, TSH 213 181196 Triiodothyronine (T3) 75 64197 Tetraiodothyronine (T4) 75 64198 Thyroid stimulating hormone (TSH) 125 106199 Luteinizing hormone (LH) 188 159200 Follicle stimulating hormone(FSH) 188 159201 Prolactin 188 159202 Cortisol 266 226203 Serum Erythropoietin 550 468204 PTH (Parathormone) 618 525205 Calcitonin 840 714206 C-Peptide(connecting peptide) 400 340207 Insulin 325 276208 Progesterone 266 226209 17-hydroxyprogesterone (17-OH Progesterone) 450 383210 Dehydroepiandrosterone sulfate (DHEA-S) 450 383211 Androstenedione 750 638212 Growth Hormone 350 298213 TPO antibody test (Thyroid peroxidase) 385 327214 Thyroglobulin 400 340

Microbiology & Serology - -


40






215 Smear gram stain examination 48 41216 Sputum smear AFB (Acid fast bacillus)stain 56 48217 Vaginal Smear Examination 80 68218 Direct smear and stain examination for cryptosporidium 100 85

219 Direct smear and stain examination for Pneumocystis Carinii (P.carini) 100 85

220 LCB(Lactophenol Cotton Blue) Count for mycology 150 128221 LCB (Lactophenol Cotton Blue ) Count for others 300 255222 Venereal Disease Research Laboratory Test (VDRL) 50 42223 Treponema pallidum hemagglutination(TPHA) test 120 102224 Widal test 70 60225 Rheumatoid Factor test 105 89226 Culture & Sensitivity -bacterial 100 85227 Culture & Sensitivity -Mycobacterial 160 136228 Culture & Sensitivity -mycology 160 136229 C-Reactive Protein (CRP ) 120 102230 C-Reactive Protein (CRP ) - Quantitative 200 170231 ASO Titre 143 122232 Quantitative Human chorionic gonadotropin (HCG) 80 68233 Blood culture & sensitivity- manual 160 136234 Blood culture & sensitivity-automated 300 255235 Vibrio cholerae culture 150 128236 Rapid Blood Culture 320 272237 Rapid AFB Culture 160 136238 C3 Complement 650 552239 C4 Complement 650 552240 Immunoglobulin G (IgG) 195 166241 Immunoglobulin M (IgM) 240 204242 Immunoglobulin A (IgA) 195 166243 Antinuclear antibody(ANA) 320 272244 Anti double stranded DNA (Anti Ds DNA) 385 327245 P ANCA 640 544246 C ANCA 640 544

Infectious disease serology - -247 HAV 553 470248 HBsAg – ELISA 147 125249 Anti HBS 650 552250 Anti HBC Total 490 417

251 Hepatitis B Core Antibody (HBcAb) Level (Hepatitis B Core IgM Antibody) Anti HBc IgM 480 408

252 HBeAg 423 359253 Anti HBe 450 383254 Anti- HCV 400 340


41






255 Anti HEV IgM 1000 850256 Triple Marker 900 765

TORCH - -257 IgG 260 221258 IgM 260 221

Toxoplasmosis - -259 IgG 260 221260 IgM 260 221

CMV(Cytomegalovirus) - -261 IgG 260 221262 IgM 260 221

HSV(Herpes Simplex Virus) - -263 IgG 260 221264 IgM 260 221265 IgE 400 340

Tuberculosis - -266 TB IgG 280 238267 TB IgM 280 238268 TB IgA 280 238

Rubella - -269 Ig G 200 170270 Ig M 200 170271 Ig A 250 213272 Dengue Serology 600 510273 Cysticercosis 340 289274 Hydatid Serology 374 318275 Anti Sperm Antibodies 406 345

HBV DNA276 Hepatitis B Virus (HBV) DNA Qualitative 2340 1989277 Hepatitis B Virus (HBV) DNA Quantitative 1600 1360

HCV RNA - -278 Hepatitis C Virus (HCV) RNA Qualitative 1760 1496279 Human papillomavirus (HPV) serology at S.No.685 at S.No.685280 Rotavirus serology 163 138281 PCR for Tuberculosis (TB) 975 829282 PCR for Human immunodeficiency virus ( HIV) 630 536283 Chlamydia antigen 900 765284 Chlamydia antibody 280 238285 Brucella serology 245 208286 Influenza A serology 943 801

USG, X Ray, CT, MRI, Bone Densitometry - -287 USG for Obstetrics - Anomalies scan 886 770288 Abdomen USG 300 255


42






289 Pelvic USG ( prostate, gynae, infertility etc) 300 255290 Small parts USG (scrotum, thyroid, parathyroid etc) 410 349291 Neonatal head (Transfontanellar) 500 425292 Neonatal spine 500 425293 Contrast enhanced USG 1000 850294 USG Breast 410 349295 USG Hysterosalpingography (HSG) 300 255296 Colour Doppler - Carotid artery 1000 850297 Colour Doppler - Peripheral Artery/Veins 830 706298 Colour doppler - Renal arteries/any other organ 1000 850299 USG guided intervention- aspiration 500 425300 USG guided intervention- FNAC 700 595

301 USG guided intervention - biopsyListed Under



302 USG guided intervention - nephrostomy 800 680X Ray

303 Abdomen AP Supine or Erect (One film) 110 94304 Abdomen Lateral view (one film) 110 94305 Pelvimetry 120 102306 Chest PA view (one film) 70 60307 Chest Lateral view (one film) 70 60308 Mastoids: Towne view, oblique views (3 films) 300 255309 Extremities, bones & Joints AP & Lateral views (Two films) 160 136310 Pelvis AP (one film) 110 94311 TM Joints (one film) 110 94312 Abdomen & Pelvis for KUB 150 128313 Skull AP & Lateral (2 films) 200 170314 Spine AP & Lateral (2 films) 200 170315 PNS (Paranasal sinus) view (1 film) 110 94

X Ray Contrast studies316 Barium Swallow 600 510317 Barium Upper GI study 700 595318 Barium Upper GI study (Double contrast) 700 595319 Barium Meal follow through 1100 935320 Barium Enema (Single contrast/double contrast) 1000 850321 Small bowel enteroclysis 1200 1020322 ERCP (Endoscopic Retrograde Cholangiopancreatography) at S.No.1219 at S.No.1219 at S.No.1219

323 General :Fistulography /Sinography/Sialography/ Dacryocystography/ T- Tube cholangiogram/Nephrostogram 750 638

324 Percutaneous transhepatic cholangiography(PTC) 1500 1275325 Intravenous Pyelography (IVP) 1200 1020326 Micturating Cystourethrography (MCU) 800 680327 Retrograde Urethrography (RGU) 800 680


43






328 Contrast Hysterosalpingography (HSG) 300 255329 X Ray Arthrography 2400 2040330 Cephalography 150 128331 Myelography 1800 1530332 Digital Subtraction Angiography (DSA) – Cerebral arteries 22000 18700

333 Digital Subtraction Angiography (DSA) – Peripheral Artery/arteries 9000 7650

334 Digital Subtraction Angiography (DSA) - Abdomen335 Digital Subtraction Angiography (DSA) - Chest

Mammography336 X Ray Mammography 500 425337 Ultrasound Mammography 500 425338 MRI Mammography 3000 2550

CT339 CT Head -Without Contrast 800 680340 CT Head - with Contrast (+/- CT angiography) 1350 1148341 CT Chest - without contrast (for lungs) 1500 1275342 CT Chest - with contrast (+/- CT angiography) 2500 2125343 CT Scan Upper Abdomen Without Contrast 1700 1445344 CT Scan Upper Abdomen With Contrast 2400 2040345 CT Scan Lower Abdomen Without Contrast 1500 1275346 CT Scan Lower Abdomen With Contrast 2400 2040347 CT Scan Whole Abdomen Without Contrast 3000 2550348 CT Scan Whole Abdomen With Contrast 4500 3825349 CT angiography abdomen/chest 5000 4250350 CT Enteroclysis

351 CT Scan Neck (Thyroid, parathyroid, Soft Tissues) – Without Contrast 1500 1275

352 CT Scan Neck – With Contrast 2200 1870353 CT Scan Orbits - Without Contrast 1400 1190354 CT Scan Orbits - With Contrast 1900 1615355 CT Scan of Paranasal Sinuses- Without Contrast 1250 1063356 CT Scan of Paranasal Sinuses - With Contrast 2100 1785357 CT Spine (Cervical, Dorsal, Lumbar, Sacral)–without contrast 1500 1275358 CT Temporal bone – without contrast 1050 893359 CT - Dental 1500 1275360 CT Scan Limbs -Without Contrast 1500 1275361 CT Scan Limbs -With Contrast including CT angiography 2650 2253362 CT Guided intervention – Biopsy /FNAC 1200 1020

363 CT Guided intervention -percutaneous catheter drainage / tube placement 1535 1305

MRI - -364 MRI Head – Without Contrast 2350 1998365 MRI Head – With Contrast 3350 2848


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366 MRI Orbits – Without Contrast 1700 1445367 MRI Orbits – With Contrast 5000 4250368 MRI Nasopharynx and PNS – Without Contrast 2500 2125369 MRI Nasopharynx and PNS – With Contrast 5000 4250370 MRI Neck - Without Contrast 2400 2040371 MRI Neck- with contrast 5000 4250372 MRI Shoulder – With contrast 5000 4250373 MRI Shoulder – Without contrast 2500 2125374 MRI Shoulder both joints - Without contrast 2500 2125375 MRI Shoulder both joints – With contrast 5000 4250376 MRI Wrist Single joint - Without contrast 2500 2125377 MRI Wrist Single joint - With contrast 5000 4250378 MRI Wrist both joints - Without contrast 2500 2125379 MRI Wrist Both joints - With contrast 5000 4250380 MRI knee Single joint - Without contrast 2500 2125381 MRI knee Single joint - With contrast 5000 4250382 MRI knee both joints - Without contrast 2500 2125383 MRI knee both joints - With contrast 5000 4250384 MRI Ankle Single joint - Without contrast 2500 2125385 MRI Ankle single joint - With contrast 5000 4250386 MRI Ankle both joints - With contrast 5000 4250387 MRI Ankle both joints - Without contrast 2500 2125388 MRI Hip - With contrast 5500 4675389 MRI Hip – without contrast 3000 2550390 MRI Pelvis – Without Contrast 2500 2125391 MRI Pelvis – with contrast 5000 4250392 MRI Extremities - With contrast 5000 4250393 MRI Extremities - Without contrast 2500 2125394 MRI Temporomandibular - Single Joint - With contrast 5000 4250395 MRI Temporomandibular - Single Joint - Without contrast 2500 2125396 MRI Temporomandibular Double Joint - With contrast 5000 4250397 MRI Temporomandibular Double Joint -Without contrast 2500 2125398 MRI Abdomen – Without Contrast 2500 2125399 MRI Abdomen – With Contrast 5000 4250400 MRI Breast - With Contrast 5000 4250401 MRI Breast - Without Contrast 2500 2125402 MRI Spine Screening - Without Contrast 1000 850403 MRI Chest – Without Contrast 2500 2125404 MRI Chest – With Contrast 5000 4250405 MRI Cervical/Cervicodorsal Spine – Without Contrast 2500 2125406 MRI Cervical/Cervicodorsal Spine – With Contrast 5000 4250407 MRI Dorsal/Dorsolumbar Spine - Without Contrast 2500 2125408 MRI Dorsal/Dorsolumbar Spine – With Contrast 5000 4250


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409 MRI Lumbar/Lumbosacral(LS) Spine – Without Contrast 2500 2125410 MRI Lumbar/Lumbosacral(LS) Spine – With Contrast 5000 4250411 Whole body MRI (For oncological workup) 6000 5100412 MRI Angiography – Without Contrast 1200 1020413 MRI Angiography – With Contrast 5000 4250414 Magnetic Resonance Cholecysto Pancreatography (MRCP) 2500 2125415 MR Enteroclysis 2500 2125

Bone Densitometry416 Dexa scan Bone Densitometry - Single Site 1000 850417 Dexa Scan Bone Densitometry - Two sites 1800 1530

418 Dexa scan Bone Densitometry - Three sites (Spine, Hip & extremity) 2300 1955

419 Dexa scan Bone Densitometry Whole body 2950 2508Neurological Investigations and Procedures

420 EEG/Video EEG 350 298421 EMG (Electromyography) 750 638422 Nerve conduction velocity (NCV)(at least 2 limbs) 750 638423 Decremental response (before and after neostigmine) 700 595424 Incremental response 700 595425 SSEP (Somatosensory evoked potentials) 750 638426 Polysomnography(PSG)/ Sleep study 750 638427 Brachial plexus study 750 638428 Muscle biopsy 450 383429 Acetylcholine receptor (AChR) antibody titre 750 638

430 Anti muscle specific receptor tyrosine kinase (Anti MuSK) antibody titre 9500 8075

431 Serum Copper 500 425432 Serum Ceruloplasmin 618 525433 Urinary Copper 500 425

434 Serum Homocysteine Listed under Investigations


435 Serum Valproate level 439 373436 Serum phenobarbitone level 390 332437 Coagulation profile 595 506438 Protein C, Protein S antithrombin – III 700 595439 Serum lactate level 540 459

CSF - -

440 Basic studies including cell count, protein, sugar, gram stain, India Ink preparation and smear for AFP 240 204

441 CSF - Special studies 1200 1020442 PCR for tuberculosis/ Herpes simplex 925 786443 Bacterial culture and sensitivity 200 170444 Mycobacterial culture and sensitivity 200 170445 Fungal culture 150 128


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446 Malignant cells 75 64447 Anti measles antibody titre (with serum antibody titre) 1230 1046448 Viral culture 300 255

449 Antibody titre (Herpes simplex, cytomegalovirus, flavivirus, zoster varicella virus) 2000 1700

450 Oligoclonal band 1500 1275451 Myelin Basic protein 400 340452 Lactate 350 298453 Cryptococcal antigen 850 723

TESTS IN GASTROENTEROLOGY - -454 D-xylose test 1200 1020455 Fecal fat test/ fecal chymotrypsin/ fecal elastase 1200 1020456 Breath tests 1500 1275457 H pylori serology for coeliac disease 250 213458 HBV genotyping 2730 2321459 HCV genotyping 2200 1870

Tests in Endocrinology (in addition to those included under Hormones) - -

460 Urinary vanillylmandelic acid (VMA) 430 366461 Urinary metanephrine/Normetanephrine 400 340462 Urinary free catecholamine 350 298463 Serum catecholamine 450 383464 Serum aldosterone 700 595465 24 Hour urinary aldosterone 920 782466 Plasma renin activity 800 680467 Serum aldosterone/renin ratio 1250 1063468 Osmolality urine 150 128469 Osmolality serum 150 128470 Urinary sodium 94 79471 Urinary Chloride 50 43472 Urinary potassium 94 79473 Urinary calcium 94 79474 Anti TPO (Thyroid peroxidase) antibody at S.No.213 at S.No.213475 Thyroid binding globulin (Thyroglobulin) at S.No.214 at S.No.214476 Serum cortisol at S.No.202 at S.No.202477 24 hr urinary free cortisol 400 340478 Islet cell antibody 950 808

479 Glutamic Acid Decarboxylase Autoantibodies test (GAD antibodies) 1330 1131

480 Insulin associated antibody 449 381481 Insulin-like growth factor-1 (IGF-1) 1500 1275482 Insulin-like growth factor binding protein 3 (IGFBP3) 1650 1403483 Sex hormone binding globulin 1333 1133484 USG guided FNAC thyroid gland 455 387


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485 Free T3 (FT3) 125 106486 Free T4 (FT4) 125 106487 Free T4/TSH 100 85488 Free T3/Free T4/TSH 300 255489 Estradiol (E2) 245 208490 Thyroglobulin antibody 700 595

ADDED W.E.F. 14.01.2020 TREATMENT PROCEDURE & INVESTIGATIONS: UNSPECIFIED

Sr. no. as per Delhi 2014

CGHS TREATMENT PROCEDURE/INVESTIGATION LIST

NABH/NABL Rate in Rupees

Non NABH/Non NABL rates in

Rupees

1781 Kappa Lambda Light Chains, Free, Serum/ Serum free light chains (SFLC) 4025 3500

1782 Serum IGE Level 345 3001783 NT-Pro BNP 2070 18001784 CECT Chest (Including CD) 2875 2500 Including CD1785 MRI-Prostate (Multi-parametric) (Including CD) 6900 Including CD 6000/- including CD1786 HCV RNA Quantitative 1725 15001787 Tacrolimus 2645 23001788 Protein Creatinine Ratio, Urine 138 1201789 Fibroscan Liver 1150 10001790 HLA B27 (PCR) 575 5001791 Mantoux Test 200 1751792 Procalcitonin 2070 18001793 TORCH Test 1288 11201794 Intracoronary OCT (AIIMS Rates) 65000 + GST 65000 + GST

1795 Fractional Flow Reserve (FFR) Wire cost (AIIMS Rates23500 + GST (Wire

Cost),15000/- (Procedure Cost)

23500 + GST (Wire Cost), 12750/-

(Procedure Cost)

ADDED W.E.F. 05.06.2020

1796 Anti –Smooth Muscle Antibody Test (ASMA) 1460 12411797 C ANCA-IFA 1500 12751798 P ANCA-IFA 1500 12751799 Angiotensin converting enzyme (ACE) 1000 850

1800 Endobronchial Ultrasound (EBUS) -Trans bronchial needle aspiration (TBNA) -Using New Needle 18370 15614

1801 Extractable Nuclear Antigens (ENA) - Quantitative 4600 39101802 Chromogranin A 5000 42501803 Faecal calprotectin (fecal calprotectin) 2730 23201804 C3-Complement 650 552


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1805 C4-Complement 650 5521806 Genexpert Test 1035 8801807 DJ stent removal 8700 73951808 Pulmonary Function Test (PFT) / (Spirometry with DLCO) 500 425

1809 EUS (Endoscopic Ultrasound) guided FNAC (Using with Needle) 15000 12750

1810 CT Urography 4500 38251811 Video Laryngoscopy 6000 51001812 CT Angio-Neck Vessels 6000 51001813 H1N1 (RT-PCR) 1084 921

1814 Erythropoietin level (Select CGHS Mumbai rate code 203 under investigations)

See Mumbai code 203

See Mumbai code 203

1815 Anti HEV IgM 1000 8501816 Anti HAV IgM 750 6371817 HBsAg Quantitative 650 5521818 Typhidot IgM 400 340

1819 Hepatitis B Core Antibody (HBcAb) Level (Hepatitis B Core IgM Antibody) 480 408

1820 Anti HBs 650 552

ADDED vide clause 2,5, & 6 of OM F.No. S-11045/36/2012-CGHS (HEC) dated 26.11.2014

1821 Free Triiodothyronine (FT3) 125 1061822 Free Thyroxine (FT4) 125 1061823 Widal Test 70 601824 Dengue Serology 600 5101825 Blood component charges - Whole Blood per Unit 1450 14501826 Blood component charges - Packed Red Cell per Unit 1450 14501827 Blood component charges - Fresh Frozen Plasma 400 4001828 Platelet Concentrate- Random Donor Platelet (RDP) 400 4001829 Blood component charges - Cryoprecipitate 200 200

1830 Platelet Concentrate – Single Donor Platelet (SDP)-Apheresis per unit 11000 11000

1831 CCS Group A Officer of above 40 years of age –Male, Annual Health Check up 2000 2000

1832 CCS Group A Officer of above 40 years of age –Female, Annual Health Check up 2,200 2200

ADDED W.E.F. 07.02.2021

1833 Interleukin 6 (IL 6) 1600 13601834 High resolution computed Tomography (HRCT Chest) 2,000 17001835 Fluid air exchange (per eye) 5000 42501836 C3F8 Gas Injection (per eye) 5000 42501837 Diurnal variation of IOP (per eye) 1500 1275


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1838 Silicone oil injection (per eye) 5000 42501839 Epiretinal Membrane (ERM) Peeling (per eye) 7000 59501840 Epiretinal Membrane (ERM) Removal (per eye) 3000 25501841 Internal limiting membrane (ILM) peeling (per eye) 3000 25501842 Punctoplasty (per eye) 6500 55251843 Punctal plug(Collagen/silicone) (per eye) 4,000 34001844 Laser Trabeculoplasty Gonioplasty (both eyes) 16,000 136001845 Eye laser pulse therapy (per eye) 3500 29751846 Glaucoma valve/Glaucoma Ahmed valve 15000 127501847 Malyugin Ring 10,000 85001848 Globe exploration (eye surgery) 10,000 85001849 Scleral Fixation Tissue glue 8400 71401850 Fiber optic Nasal Endoscopy 2300 19551851 Videostroboscopy 5500 46751852 Video Bronchoscopy with BAL 10,000 8500

1853 Sleep deprived EEG (Rate shall be the same CGHS rate of EEG/Video EEG) Select CGHS Mumbai rate code 420

See Mumbai code 420

See Mumbai code 420

CGHS MUMBAI RATES FOR HOSPITALS - 2010 (Updated on 30th ...

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