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Specia Speciality Name Procedure ID Procedure Name Package Preauth Procedu Govern

lity ID Amount Required re Type ment


Reserve
d

M1 General Medicine M100001 Acute gastroenteritis with moderate dehydration 0 No Trust No


M1 General Medicine M100002 Recurrent vomiting with dehydration 0 No Trust No
M1 General Medicine M100003 Dysentery 0 No Trust No
M1 General Medicine M100004 Renal colic 0 No Trust No
M1 General Medicine M100005 Acute bronchitis 0 No Trust No
M1 General Medicine M100006 Pneumothroax 0 No Trust No
M1 General Medicine M100007 Accelerated hypertension 0 No Trust No
M1 General Medicine M100008 Congestive heart failure 0 No Trust No
M1 General Medicine M100009 Severe anemia 0 No Trust No
M1 General Medicine M100010 Diabetic ketoacidosis 0 No Trust No
M1 General Medicine M100011 Acute febrile illness 0 No Trust No
M1 General Medicine M100012 Acutre excaberation of COPD 0 No Trust No
M1 General Medicine M100013 UTI 0 No Trust No
M1 General Medicine M100014 Malaria 0 No Trust No
M1 General Medicine M100015 Dengue fever 0 No Trust No
M1 General Medicine M100016 Chikungunya fever 0 No Trust No
M1 General Medicine M100017 Leptospirosis 0 No Trust No
M1 General Medicine M100018 Enteric fever 0 No Trust No
M1 General Medicine M100019 Pneumonia 0 No Trust No
M1 General Medicine M100020 Acute excaberation of ILD 0 No Trust No
M1 General Medicine M100021 Liver abscess 0 No Trust No
M1 General Medicine M100022 Acute viral hepatitis 0 No Trust No
M1 General Medicine M100023 Snake bite 0 No Trust No
M1 General Medicine M100024 Acute organophosphorus poisoning 0 No Trust No
M1 General Medicine M100025 Other poisoning 0 No Trust No
M1 General Medicine M100026 Pyrexia of unknown origin 0 No Trust No
M1 General Medicine M100027 Pericardial/ Pleural tuberculosis 0 No Trust No
M1 General Medicine M100028 Systematic lupus erythematosus 0 No Trust No
M1 General Medicine M100029 Vasculitis 0 No Trust No
M1 General Medicine M100030 Seizures 0 No Trust No
M1 General Medicine M100031 Bacterial/ fungal endocarditis 0 No Trust No
M1 General Medicine M100032 Acute inflammatory demyelinating polyneuropathy 0 No Trust No
M1 General Medicine M100033 Lung abscess/ Empyema 0 No Trust No
M1 General Medicine M100034 Acute and chronic meningitis 0 No Trust No
M1 General Medicine M100035 Viral encephalitis 0 No Trust No
M1 General Medicine M100036 Persistent/ Chronic diarrohea 0 No Trust No
M1 General Medicine M100037 Acute and chronic pancreatitis 0 No Trust No
M1 General Medicine M100038 Visceral leishmaniasis 0 No Trust No
M1 General Medicine M100039 HIV with complications 0 No Trust No
M1 General Medicine M100040 Neuromuscular disorders 0 No Trust No
M1 General Medicine M100041 Metabolic encephalopathy 0 No Trust No
M1 General Medicine M100042 Sickle cell Anemia 0 No Trust No
M1 General Medicine M100043 Poisonings with unstable vitals 0 No Trust No
M1 General Medicine M100044 Type 1/2 respiratory failure 0 No Trust No
M1 General Medicine M100045 Acute asthmatic attack 0 No Trust No
M1 General Medicine M100046 Acutre excaberation of COPD 0 No Trust No
M1 General Medicine M100047 Severe pneumonia 0 No Trust No
M1 General Medicine M100048 Acute gastroenteritis with severe dehydration 0 No Trust No
M1 General Medicine M100049 Hypertensive emergencies 0 No Trust No
M1 General Medicine M100050 Dengue hemorrhagic fever/Dengue shock syndrome 0 No Trust No
M1 General Medicine M100051 Complicated malaria 0 No Trust No
M1 General Medicine M100052 Heat stroke 0 No Trust No
M1 General Medicine M100053 Hyperosmolar Non-Ketotic coma 0 No Trust No
M1 General Medicine M100054 Cerebrovascular accident 0 No Trust No
M1 General Medicine M100055 Severe sepsis/Septic shock 0 No Trust No
M1 General Medicine M100056 Upper GI bleeding (conservative) 0 No Trust No
M1 General Medicine M100057 Upper GI bleeding (endoscopic) 0 No Trust No
M1 General Medicine M100058 Lower GI hemorrhage 0 No Trust No
M1 General Medicine M100059 Immune mediated CNS disorders such as autoimmune encephalitis 0 No Trust No
M1 General Medicine M100060 Acute transverse myelitis 0 No Trust No
M1 General Medicine M100061 Guillian Barre Syndrome 0 No Trust No
M1 General Medicine M100062 Hydrocephalus 0 No Trust No
M1 General Medicine M100063 Cerebral sino-venous thrombosis 0 No Trust No
M1 General Medicine M100064 AKI/ renal failure(dialysis payable separately as an add on package for ) 0 No Trust No
M1 General Medicine M100065 Status epilepticus 0 No Trust No
M1 General Medicine M100066 Status asthmaticus 0 No Trust No
M1 General Medicine M100067 Respiratory failure due to any cause (pneumonia, asthma, COPD, ARDS, foreign body, 0 No Trust No
M1 General Medicine M100068 Blood and blood component transfusion 0 No Trust No
M1 General Medicine M100069 Plasmapheresis - per session 2000 Yes Trust No
M1 General Medicine M100070 Haemodialysis/Peritoneal Dialysis (only for ARF) - per session 2000 Yes Trust No
M1 General Medicine M100071 High end radiological diagnostic (CT, MRI, Imaging including nuclear imaging) - can 5000 Yes Trust No
M1 General Medicine M100072 High end histopathology (Biopsies) and advanced serology investigations - can only 5000 Yes Trust No
M2 Paediatric medical m M200001 Diarrhoea 0 No Trust No
M2 Paediatric medical m M200002 Acute dysentery 0 No Trust No
M2 Paediatric medical m M200003 Pneumonia 0 No Trust No
M2 Paediatric medical m M200004 Urinary tract infection 0 No Trust No
M2 Paediatric medical m M200005 Acute Exacerbation of asthma 0 No Trust No
M2 Paediatric medical m M200006 Acute glomerulonephritis 0 No Trust No
M2 Paediatric medical m M200007 Acute urticaria/ Anaphylaxis acute asthma 0 No Trust No
M2 Paediatric medical m M200008 Poisonings with normal vital signs 0 No Trust No
M2 Paediatric medical m M200009 Febrile seizures/other seizures 0 No Trust No
M2 Paediatric medical m M200010 Epileptic encephalopathy 0 No Trust No
M2 Paediatric medical m M200011 Optic neuritis 0 No Trust No
M2 Paediatric medical m M200012 Aseptic meningitis 0 No Trust No
M2 Paediatric medical m M200013 Trauma 0 No Trust No
M2 Paediatric medical m M200014 Pyrexia of unexplained origin 0 No Trust No
M2 Paediatric medical m M200015 Chronic cough 0 No Trust No
M2 Paediatric medical m M200016 Wheezing 0 No Trust No
M2 Paediatric medical m M200017 Unexplained seizures 0 No Trust No
M2 Paediatric medical m M200018 Global developmental delay/ Intellectual disability of unknown etiology 0 No Trust No
M2 Paediatric medical m M200019 Dysmorphic children 0 No Trust No
M2 Paediatric medical m M200020 Rickets 0 No Trust No
M2 Paediatric medical m M200021 Unexplained severe anemia 0 No Trust No
M2 Paediatric medical m M200022 Short stature 0 No Trust No
M2 Paediatric medical m M200023 Musculoskeletal problems 0 No Trust No
M2 Paediatric medical m M200024 Developmental and behavioral disorders 0 No Trust No
M2 Paediatric medical m M200025 Diabetic ketoacidosis 0 No Trust No
M2 Paediatric medical m M200026 Nephrotic syndrome with peritonitis 0 No Trust No
M2 Paediatric medical m M200027 Pyogenic meningitis 0 No Trust No
M2 Paediatric medical m M200028 Persistent/ Chronic diarrhea 0 No Trust No
M2 Paediatric medical m M200029 Acute severe malnutrition 0 No Trust No
M2 Paediatric medical m M200030 Dengue 0 No Trust No
M2 Paediatric medical m M200031 Enteric fever 0 No Trust No
M2 Paediatric medical m M200032 Chikungunya 0 No Trust No
M2 Paediatric medical m M200033 Acute hepatitis 0 No Trust No
M2 Paediatric medical m M200034 Kala azar 0 No Trust No
M2 Paediatric medical m M200035 Tuberculosis 0 No Trust No
M2 Paediatric medical m M200036 HIV with complications 0 No Trust No
M2 Paediatric medical m M200037 Infantile cholestasis 0 No Trust No
M2 Paediatric medical m M200038 Haemolytic uremic syndrome 0 No Trust No
M2 Paediatric medical m M200039 ITP 0 No Trust No
M2 Paediatric medical m M200040 Juvenile myasthenia 0 No Trust No
M2 Paediatric medical m M200041 Kawasaki Disease 0 No Trust No
M2 Paediatric medical m M200042 Persistent pneumonia 0 No Trust No
M2 Paediatric medical m M200043 Empyema 0 No Trust No
M2 Paediatric medical m M200044 Immune haemolytic anemia 0 No Trust No
M2 Paediatric medical m M200045 Cyanotic spells 0 No Trust No
M2 Paediatric medical m M200046 Rheumatic fever 0 No Trust No
M2 Paediatric medical m M200047 Rheumatoid arthritis 0 No Trust No
M2 Paediatric medical m M200048 Encephalitis 0 No Trust No
M2 Paediatric medical m M200049 Chronic meningitis 0 No Trust No
M2 Paediatric medical m M200050 Intracranial ring enhancing lesion with complication (neurocysticercosis, tuberculoma 0 No Trust No
M2 Paediatric medical m M200051 Refractory seizures 0 No Trust No
M2 Paediatric medical m M200052 Floppy infant 0 No Trust No
M2 Paediatric medical m M200053 Acute neuroregression 0 No Trust No
M2 Paediatric medical m M200054 Neuromuscular disorders 0 No Trust No
M2 Paediatric medical m M200055 Opsoclonus myoclonus syndrome 0 No Trust No
M2 Paediatric medical m M200056 Acute ataxia 0 No Trust No
M2 Paediatric medical m M200057 Steven Johnson syndrome 0 No Trust No
M2 Paediatric medical m M200058 Metabolic encephalopathy 0 No Trust No
M2 Paediatric medical m M200059 Ketogenic diet initiation in refractory epilepsy 0 No Trust No
M2 Paediatric medical m M200060 Inborn errors of metabolism 0 No Trust No
M2 Paediatric medical m M200061 Wilson’s disease 0 No Trust No
M2 Paediatric medical m M200062 Celiac disease 0 No Trust No
M2 Paediatric medical m M200063 Unexplained jaundice 0 No Trust No
M2 Paediatric medical m M200064 Unexplained hepatosplenomegaly 0 No Trust No
M2 Paediatric medical m M200065 Severe pneumonia 0 No Trust No
M2 Paediatric medical m M200066 Severe exacerbation of asthma 0 No Trust No
M2 Paediatric medical m M200067 Acute kidney injury 0 No Trust No
M2 Paediatric medical m M200068 Poisonings 0 No Trust No
M2 Paediatric medical m M200069 Serious trauma with unstable vitals 0 No Trust No
M2 Paediatric medical m M200070 Upper GI hemorrhage 0 No Trust No
M2 Paediatric medical m M200071 Lower GI hemorrhage 0 No Trust No
M2 Paediatric medical m M200072 Acute abdomen 0 No Trust No
M2 Paediatric medical m M200073 Liver abscess 0 No Trust No
M2 Paediatric medical m M200074 Complicated malaria 0 No Trust No
M2 Paediatric medical m M200075 Severe dengue with shock 0 No Trust No
M2 Paediatric medical m M200076 Congestive cardiac failure 0 No Trust No
M2 Paediatric medical m M200077 Brain abscess 0 No Trust No
M2 Paediatric medical m M200078 Acute encephalitic syndrome 0 No Trust No
M2 Paediatric medical m M200079 Acute demyelinating myelopathy, 0 No Trust No
M2 Paediatric medical m M200080 Immune mediated CNS disorders such as autoimmune encephalitis 0 No Trust No
M2 Paediatric medical m M200081 Acute transverse myelitis 0 No Trust No
M2 Paediatric medical m M200082 Guillain Barre Syndrome 0 No Trust No
M2 Paediatric medical m M200083 Hydrocephalus 0 No Trust No
M2 Paediatric medical m M200084 Intracranial space occupying lesion 0 No Trust No
M2 Paediatric medical m M200085 Cerebral malaria 0 No Trust No
M2 Paediatric medical m M200086 Acute ischemic stroke 0 No Trust No
M2 Paediatric medical m M200087 Cerebral sino-venous thrombosis 0 No Trust No
M2 Paediatric medical m M200088 Respiratory failure due to any causes (pneumonia, asthma, foreign body, poisoning, h 0 No Trust No
M2 Paediatric medical m M200089 Acute transverse myelitis 0 No Trust No
M2 Paediatric medical m M200090 Acute encephalitis –infectious/immune-mediated 0 No Trust No
M2 Paediatric medical m M200091 Convulsive non convulsive status epilepticus 0 No Trust No
M2 Paediatric medical m M200092 Cerebral herniation 0 No Trust No
M2 Paediatric medical m M200093 Intracranial hemorrhage 0 No Trust No
M2 Paediatric medical m M200094 Hepatic encephalopathy 0 No Trust No
M2 Paediatric medical m M200095 Complicated bacterial meningitis 0 No Trust No
M2 Paediatric medical m M200096 Raised intracranial pressure 0 No Trust No
M2 Paediatric medical m M200097 Hypertensive encephalopathy 0 No Trust No
M2 Paediatric medical m M200098 CRRT (per session) 8000 Yes Trust No
M2 Paediatric medical m M200099 Blood and blood component transfusion up to a limit of 2 days 0 Yes Trust No
M2 Paediatric medical m M200100 Blood and blood component transfusion for indications like Thalassemia/Hemoglobinop 0 Yes Trust No
M2 Paediatric medical m M200101 High end radiological diagnostic (CT, MRI, Imaging including nuclear imaging) - can 5000 Yes Trust No
M2 Paediatric medical m M200102 High end histopathology (Biopsies) and advanced serology investigations - can only 5000 Yes Trust No
M3 Neo-natal M300001 Basic neonatal care package (Rs. 500 per day, maximum 1500) 0 Yes Trust No
M3 Neo-natal M300002 Special Neonatal Care Package (Rs. 3000 per day, maximum of 18000 - pre-auth aft 0 Yes Trust No
M3 Neo-natal M300003 Intensive Neonatal Care Package (Rs. 5000 per day, maximum of Rs. 50,000 – pre-au 0 Yes Trust No
M3 Neo-natal M300004 Advanced Neonatal Care Package (Rs. 6000 per day, maximum of Rs. 75,000 – pre-a 0 Yes Trust No
M3 Neo-natal M300005 Critical Care Neonatal Package (Rs. 7000 per day, maximum of Rs. 1,20,000 – pre-a 0 Yes Trust No
M3 Neo-natal M300006 Chronic Care Package (Rs. 3000 per day, maximum of Rs. 30,000) 0 Yes Trust No
M3 Neo-natal M300007 High Risk Newborn Post Discharge Care Package (Protocol Driven) 2400 Yes Trust No
M3 Neo-natal M300008 Laser Therapy for Retinopathy of Prematurity (Irrespective of no. of eyes affected) - 1500 Yes Trust No
M3 Neo-natal M300009 Advanced Surgery for Retinopathy of Prematurity 15000 Yes Trust No
M3 Neo-natal M300010 Ventriculoperitoneal Shunt Surgery (VP) or Omaya Reservoir or External Drainage f 5000 Yes Trust No
M4 Paediatric cancer M400001 Acute lymphoblastic leukemia (chemotherapy including diagnostics): induction 55000 Yes Trust No
M4 Paediatric cancer M400002 Acute lymphoblastic leukemia (chemotherapy including diagnostics): consolidation 35000 Yes Trust No
M4 Paediatric cancer M400003 Acute lymphoblastic leukemia (chemotherapy including diagnostics): maintainence 15000 Yes Trust No
M4 Paediatric cancer M400004 Acute lymphoblastic leukemia: radiation 5000 Yes Trust No
M4 Paediatric cancer M400005 Acute lymphoblastic leukemia: Supportive care/ rehabilitation 20000 Yes Trust No
M4 Paediatric cancer M400006 Acute myeloid leukemia (chemotherapy including diagnostics): induction 55000 Yes Trust No
M4 Paediatric cancer M400007 Acute myeloid leukemia (chemotherapy including diagnostics): consolidation 35000 Yes Trust No
M4 Paediatric cancer M400008 Acute myeloid leukemia: Supportive care/ rehabilitation 30000 Yes Trust No
M4 Paediatric cancer M400009 Hodgkin Lymphoma (Favorable group) (chemotherapy including diagnostics): induct 45000 Yes Trust No
M4 Paediatric cancer M400010 Hodgkin Lymphoma (Favorable group): radiation 10000 Yes Trust No
M4 Paediatric cancer M400011 Hodgkin Lymphoma (Favorable group): Supportive care/ rehabilitation 15000 Yes Trust No
M4 Paediatric cancer M400012 Hodgkin Lymphoma (unfavorable group): chemotherapy including diagnostics 70000 Yes Trust No
M4 Paediatric cancer M400013 Hodgkin Lymphoma (unfavorable group): radiation 15000 Yes Trust No
M4 Paediatric cancer M400014 Hodgkin Lymphoma (unfavorable group): Supportive care/ rehabilitation 25000 Yes Trust No
M4 Paediatric cancer M400015 Non-Hodgkin Lymphoma: chemotherapy including diagnostics 100000 Yes Trust No
M4 Paediatric cancer M400016 Non-Hodgkin Lymphoma: Supportive care/ rehabilitation 50000 Yes Trust No
M4 Paediatric cancer M400017 Retinoblastoma (Intraocular): chemotherapy including diagnostics 45000 Yes Trust No
M4 Paediatric cancer M400018 Retinoblastoma (Intraocular): radiation 10000 Yes Trust No
M4 Paediatric cancer M400019 Retinoblastoma (Intraocular): surgery 10000 Yes Trust No
M4 Paediatric cancer M400020 Retinoblastoma (Intraocular): supportive care/ rehabilitation 20000 Yes Trust No
M4 Paediatric cancer M400021 Retinoblastoma (extraocular): chemotherapy including diagnostics 65000 Yes Trust No
M4 Paediatric cancer M400022 Retinoblastoma (extraocular): radiation 10000 Yes Trust No
M4 Paediatric cancer M400023 Retinoblastoma (extraocular): supportive care/ rehabilitation 35000 Yes Trust No
M4 Paediatric cancer M400024 Brain tumors: chemotherapy including diagnostics 40000 Yes Trust No
M4 Paediatric cancer M400025 Brain tumors: radiation 30000 Yes Trust No
M4 Paediatric cancer M400026 Brain tumors: surgery 40000 Yes Trust No
M4 Paediatric cancer M400027 Brain tumors: supportive care/ rehabilitation 25000 Yes Trust No
M4 Paediatric cancer M400028 Wilms tumors: chemotherapy including diagnostics 20000 Yes Trust No
M4 Paediatric cancer M400029 Wilms tumors: radiation 5000 Yes Trust No
M4 Paediatric cancer M400030 Wilms tumors: surgery 20000 Yes Trust No
M4 Paediatric cancer M400031 Histiocytosis: chemotherapy including diagnostics 45000 Yes Trust No
M4 Paediatric cancer M400032 Histiocytosis: supportive care/ rehabilitation 5000 Yes Trust No
M4 Paediatric cancer M400033 Bone tumors/soft tissue sarcomas : chemotherapy including diagnostics 80000 Yes Trust No
M4 Paediatric cancer M400034 Bone tumors/soft tissue sarcomas : radiation 25000 Yes Trust No
M4 Paediatric cancer M400035 Bone tumors/soft tissue sarcomas : surgery (inlcuding prosthesis) 80000 Yes Trust No
M4 Paediatric cancer M400036 Bone tumors/soft tissue sarcomas : supportive care/ rehabilitation 50000 Yes Trust No
M4 Paediatric cancer M400037 Chronic Myeloid Leukemia : chemotherapy including diagnostics 80000 Yes Trust No
M4 Paediatric cancer M400038 Chronic Myeloid Leukemia : supportive care/ rehabilitation 20000 Yes Trust No
M5 Medical Oncology M500001 Lymphoma, Non-Hodgkin’sR-CHOP Regimen (per cycle) x 6 25000 Yes Trust No
M5 Medical Oncology M500002 Multiple MyelomaBortezomib+ lenalidomide+ dexamethasone, per cycle x6 20000 Yes Trust No
M5 Medical Oncology M500003 Multiple MyelomaBortezomib+ cyclophosphamide+ dexamethasone, per cycle x 6 10000 Yes Trust No
M5 Medical Oncology M500004 Multiple MyelomaMPT - melphalan, thalidomide and prednisolone, per cycle x 9 6000 Yes Trust No
M5 Medical Oncology M500005 Multiple MyelomaBortezomib + dexamethasone, per cycle x 9 6000 Yes Trust No
M5 Medical Oncology M500006 Multiple MyelomaThalidomide+Dexamethasone(Oral)/ month - max 12 months 3000 Yes Trust No
M5 Medical Oncology M500007 Colon Rectum5-Fluorouracil-Oxaliplatin - Leucovorin (FOLFOX) - Max. 6 cycles (Per 10000 Yes Trust No
M5 Medical Oncology M500008 Bone Tumors/Osteosarcoma/ Hepatoblastoma -OperableCisplatin/carboplatin - Adria 3000 Yes Trust No
M5 Medical Oncology M500009 Lymphoma, Hodgkin'SAdriamycin Bleomycin VinblastinDacarbazine (ABVD) - max 8 cy 10000 Yes Trust No
M5 Medical Oncology M500010 CervixCisplatin/Carboplatin (AUC2) along with RT- max 6 cycles (Per cycle) 5000 Yes Trust No
M5 Medical Oncology M500011 Neuroblastoma Stage I –IIIVariable Regimen – Neuroblastoma - max 1 year (Per cyc 9000 Yes Trust No
M5 Medical Oncology M500012 Wilm'sTumorSIOP/National Wilms Tumour Study Group (NWTS) regimen(Stages I - V 7000 Yes Trust No
M5 Medical Oncology M500013 Colon - rectumMonthly 5-FU 4000 Yes Trust No
M5 Medical Oncology M500014 BreastPaclitaxel weekly x 12 weeks 4000 Yes Trust No
M5 Medical Oncology M500015 BreastCyclophosphamide/Methotrexate/5Fluorouracil (CMF) (Per cycle) 1500 Yes Trust No
M5 Medical Oncology M500016 BreastTamoxifen tabs - maximum 12 cycles (Per month) 100 Yes Trust No
M5 Medical Oncology M500017 BreastAdriamycin/Cyclophosphamide (AC) – per cycle (Maximum 4 cycles) 3000 Yes Trust No
M5 Medical Oncology M500018 Breast5- Fluorouracil A-C (FAC) – per cycle (Maximum 6 cycles) 3100 Yes Trust No
M5 Medical Oncology M500019 BreastAC (AC Then Taxol) 3000 Yes Trust No
M5 Medical Oncology M500020 Small Cell Lung CancerCisplastin/Etoposide (IIIB) – per cycle (Max. 6 cycles only) 4000 Yes Trust No
M5 Medical Oncology M500021 Oncology oesophagusCisplatin + 5 FU(Neoadjuvant Chemotherapy)/Adjuvant (ADJ)- p 3000 Yes Trust No
M5 Medical Oncology M500022 StomachDocetaxel +Oxaliplatin+5FU20,000 per cycle for 4 cyclesCapOX- 10,000 per 4000 Yes Trust No
M5 Medical Oncology M500023 BreastAromatase Inhibitors (Anastazole/Letrozole/Exemestane) - maximum 900 Yes Trust No
M5 Medical Oncology M500024 Urinary BladderWeekly Cisplatin/Carboplatin- max 6 cycles with RT (Per week) 2000 Yes Trust No
M5 Medical Oncology M500025 Urinary BladderMethotraxateVinblastin Adriamycin Cyclophosphamide (MVAC) 5000 Yes Trust No
M5 Medical Oncology M500026 RetinoblastomaCarbo/Etoposide/Vincristine-max 6 cycles (Per cycle) 4000 Yes Trust No
M5 Medical Oncology M500027 Febrile NeutropeniaIV antibiotics and other supportive therapy (Per episode) 30000 Yes Trust No
M5 Medical Oncology M500028 Vaginal/ Vulval CancerCisplastin/5-FU 3000 Yes Trust No
M5 Medical Oncology M500029 OvaryTaxol + Carboplatin-max 6 cycles (Per cycle) 15000 Yes Trust No
M5 Medical Oncology M500030 Multiple MyelomaMelphalan -Prednisone (oral) – per month (max 12 months) - Ova 1500 Yes Trust No
M5 Medical Oncology M500031 Rectal Cancer Stage 2 And 3Gemcitabine +capecitabine-15,000 per cycle for 6 cycl 4000 Yes Trust No
M5 Medical Oncology M500032 Multiple MyelomaZoledronic acid - Max 12 cycles (Per month) 2000 Yes Trust No
M5 Medical Oncology M500033 Gestational Trophoblast Ds. High RiskEtoposide-Methotrexate-Actinomycin / Cyclop 10000 Yes Trust No
M5 Medical Oncology M500034 Gestational Trophoblast Ds. Low RiskActinomycin- max 10 cycles (Per cycle) 1000 Yes Trust No
M5 Medical Oncology M500035 Gestational Trophoblast Ds. Low RiskWeekly Methotrexate (Per week) max. 10 cycl 1000 Yes Trust No
M5 Medical Oncology M500036 Ovary Germ Cell TumourBleomycin-Etoposide-Cisplatin (BEP) - max cycles 4 (Per c 6000 Yes Trust No
M5 Medical Oncology M500037 ProstateHormonal Therapy - Per month 3000 Yes Trust No
M5 Medical Oncology M500038 TestisBleomycin-Etoposide-Cisplatin (BEP) regimen for germ cell tumour - max cycle 10000 Yes Trust No
M5 Medical Oncology M500039 Acute Myeloid LeukemiaInduction Phase, up to (Daunomycin and cytosine arabinosid 100000 Yes Trust No
M5 Medical Oncology M500040 Acute Myeloid LeukemiaConsolidation Phase, up to (High dose cytosine arabinoside – 75000 Yes Trust No
M5 Medical Oncology M500041 HistocytosisVariable Regimen-Histocyosis-max 1 year (Per month) 8000 Yes Trust No
M5 Medical Oncology M500042 RhabdomyosarcomaVincristine-Actinomycin-Cyclophosphamide (VACTC) based che 6000 Yes Trust No
M5 Medical Oncology M500043 Ewing’s SarcomaVariable Regimen Inv - Hematology, Biopsy – Payable 6000 Yes Trust No
M5 Medical Oncology M500044 Unlisted RegimenPalliative CT- Max 6 cycles (Per cycle) 5000 Yes Trust No
M5 Medical Oncology M500045 Terminally IllPalliative And Supportive Therapy - Per month 3000 Yes Trust No
M5 Medical Oncology M500046 Acute Lymphatic LeukemiaMaintenance Phase - Per month (x 24) 5000 Yes Trust No
M5 Medical Oncology M500047 Acute Lymphatic LeukemiaInduction 50000 Yes Trust No
M5 Medical Oncology M500048 Acute Lymphatic LeukemiaConsolidation Phase 50000 Yes Trust No
M5 Medical Oncology M500049 Head and NeckTab Geftinib/Erlotinib-Max 1 Year (Per month) 3000 Yes Trust No
M5 Medical Oncology M500050 Renal cell carcinomaSunitinib/ Pazopanib (per day) 2500 Yes Trust No
M5 Medical Oncology M500051 Chronic myeloid leukemiaImatinib (per month) x 5 years 6000 Yes Trust No
M5 Medical Oncology M500052 Gall Bladder CancerGemcitabine + cisplatin (per cycle) – for 6 cycles 10000 Yes Trust No
M6 Radiation Oncology M600001 Cobalt 60 External Beam Radiotherapy (Radical/Adjuvant / Neoadjuvant) 20000 Yes Trust No
M6 Radiation Oncology M600002 Cobalt 60 External Beam Radiotherapy (Palliative) 10000 Yes Trust No
M6 Radiation Oncology M600003 Linear Accelerator External Beam Radiotherapy (Palliative) 20000 Yes Trust No
M6 Radiation Oncology M600004 Linear Accelerator, External Beam Radiotherapy 3D CRT/2D Planning (Radical/Adju 50000 Yes Trust No
M6 Radiation Oncology M600005 Linear Accelerator, External Beam Radiotherapy IMRT (Intensity Modulated Radiot 75000 Yes Trust No
M6 Radiation Oncology M600006 Linear Accelerator External Beam Radiotherapy IGRT (Image Guided radiotherapy) 120000 Yes Trust No
M6 Radiation Oncology M600007 SRT(Stereota1036ic radiotherapy) 70000 Yes Trust No
M6 Radiation Oncology M600008 SRS (Streotactic radiosurgery) 70000 Yes Trust No
M6 Radiation Oncology M600009 Respiratory Gating along with Linear Accelerator planning 70000 Yes Trust No
M6 Radiation Oncology M600010 Electron beam with Linear accelerator (Radical) 50000 Yes Trust No
M6 Radiation Oncology M600011 Tomotherapy(Radical/Adjuvant/Neoadjuvant) 75000 Yes Trust No
M6 Radiation Oncology M600012 Brachytherapy High Dose Radiation (Intracavitory) - per fraction, maximum of 4 ses 4500 Yes Trust No
M6 Radiation Oncology M600013 Brachytherapy High Dose Radiation (Interstitial) - for one application, multiple dose 30000 Yes Trust No
M6 Radiation Oncology M600014 Brachytherapy High Dose Radiation (Intraluminal) - per fraction, maximum 4 sessio 4500 Yes Trust No
M7 Emergency Room PackagM700001 Emergency with stable cardiopulmonary status 1000 No Trust No
M7 Emergency Room PackagM700002 Emergency consultation: acute colic, high fever, cut, stitches, soft tissue injury, FB 1000 No Trust YES
M7 Emergency Room PackagM700003 Single bone fracture plaster, nebulization for asthmatic attack, moderate dehydrati 1000 No Trust YES
M7 Emergency Room PackagM700004 Animal bites (Payment after completion of 5th dose) 1700 No Trust No
M8 Mental Disorders Pac M800001 Organic, including symptomatic, mental disorders (routine ward) 0 Yes Trust YES
M8 Mental Disorders Pac M800002 Mental and Behavioural disorders due to psychoactive substance use (routine ward) 0 Yes Trust YES
M8 Mental Disorders Pac M800003 Schizophrenia, schizotypal and delusional disorders (routine ward) 0 Yes Trust YES
M8 Mental Disorders Pac M800004 Mood (affective) disorders (routine ward) 0 Yes Trust YES
M8 Mental Disorders Pac M800005 Neurotic, stress-related and somatoform disorders (routine ward) 0 Yes Trust YES
M8 Mental Disorders Pac M800006 Behavioural syndromes associated with physiological disturbances and physical fact 0 Yes Trust YES
M8 Mental Disorders Pac M800007 Mental retardation (routine ward) 0 Yes Trust YES
M8 Mental Disorders Pac M800008 Organic, including symptomatic, mental disorders (HDU) 0 Yes Trust YES
M8 Mental Disorders Pac M800009 Mental and Behavioural disorders due to psychoactive substance use (HDU) 0 Yes Trust YES
M8 Mental Disorders Pac M800010 Schizophrenia, schizotypal and delusional disorders (HDU) 0 Yes Trust YES
M8 Mental Disorders Pac M800011 Mood (affective) disorders (HDU) 0 Yes Trust YES
M8 Mental Disorders Pac M800012 Neurotic, stress-related and somatoform disorders (HDU) 0 Yes Trust YES
M8 Mental Disorders Pac M800013 Behavioural syndromes associated with physiological disturbances and physical fac 0 Yes Trust YES
M8 Mental Disorders Pac M800014 Mental Retardation (HDU) 0 Yes Trust YES
M8 Mental Disorders Pac M800015 Pre- Electro Convulsive Therapy (ECT) and Pre- Transcranial Magnetic Stimulation 10000 Yes Trust YES
M8 Mental Disorders Pac M800016 Electro Convulsive Therapy (ECT) - per session 3000 Yes Trust YES
M8 Mental Disorders Pac M800017 Transcranial Magnetic Stimulation (TMS) - per session 1000 Yes Trust YES
S1 General Surgery S100001 Adventious Burse – Excision 10000 No Trust No
S1 General Surgery S100002 Anterior Resection for CA 15000 No Trust No
S1 General Surgery S100003 Appendicectomy 10000 No Trust No
S1 General Surgery S100004 Appendicular Abscess – Drainage 12000 No Trust No
S1 General Surgery S100005 Arteriovenous (AV) Malformation of Soft Tissue Tumour - Excision 15000 No Trust No
S1 General Surgery S100006 Bakers Cyst – Excision 6000 No Trust No
S1 General Surgery S100007 Bilateral Inguinal block dissection 25000 No Trust No
S1 General Surgery S100008 Bleeding Ulcer - Gastrectomy vagotomy 25000 No Trust No
S1 General Surgery S100009 Bleeding Ulcer - Partial Gastrectomy 25000 No Trust No
S1 General Surgery S100010 Block dissection Cervical Nodes 10000 No Trust No
S1 General Surgery S100011 Branchial Fistula 14000 No Trust No
S1 General Surgery S100012 Breast Lump - Left – Excision 5000 No Trust No
S1 General Surgery S100013 Breast Lump - Right – Excision 6500 No Trust No
S1 General Surgery S100014 Branchial Cyst 10000 No Trust No
S1 General Surgery S100015 Bursa – Excision 4000 No Trust YES
S1 General Surgery S100016 Bypass - Inoperable Pancreas 15000 No Trust No
S1 General Surgery S100017 Cervial Lymphnodes – Excision 2000 No Trust No
S1 General Surgery S100018 Colostomy 10000 No Trust No
S1 General Surgery S100019 Cyst over Scrotum – Excision 2000 No Trust No
S1 General Surgery S100020 Cystic Mass – Excision 2000 No Trust No
S1 General Surgery S100021 Dermoid Cyst - Large – Excision 4000 No Trust No
S1 General Surgery S100022 Dermoid Cyst - Small – Excision 2000 No Trust YES
S1 General Surgery S100023 Drainage of Ischio Rectal Abscess 4000 No Trust No
S1 General Surgery S100024 Incision and Drainage of large Abscess 4000 No Trust YES
S1 General Surgery S100025 Drainage of Psoas Abscess 7500 No Trust No
S1 General Surgery S100026 Drainage of Subdiaphramatic Abscess 10000 No Trust No
S1 General Surgery S100027 Drainage Pericardial Effusion 13750 No Trust No
S1 General Surgery S100028 Duodenal Diverticulum 20000 No Trust No
S1 General Surgery S100029 Duodenal Jejunostomy 20000 No Trust No
S1 General Surgery S100030 Duplication of Intestine 18000 No Trust No
S1 General Surgery S100031 Hydrocele + Orchidectomy 8000 No Trust No
S1 General Surgery S100032 Epidedectomy 8000 No Trust No
S1 General Surgery S100033 Epididymal Swelling –Excision 6000 No Trust No
S1 General Surgery S100034 Epidymal Cyst 4000 No Trust YES
S1 General Surgery S100035 Evacuation of Scrotal Hematoma 5000 No Trust No
S1 General Surgery S100036 Excision Benign Tumor -Small intestine 15000 No Trust No
S1 General Surgery S100037 Excision Bronchial Sinus 8000 No Trust No
S1 General Surgery S100038 Drainage of liver Abscess 8000 No Trust No
S1 General Surgery S100039 Excision Filarial Scrotum 5000 No Trust No
S1 General Surgery S100040 Excision Mammary Fistula 5000 No Trust No
S1 General Surgery S100041 Excision Meckel's Diverticulum 15000 No Trust No
S1 General Surgery S100042 Excision Pilonidal Sinus 8000 No Trust No
S1 General Surgery S100043 Excision Small Intestinal Fistula 15000 No Trust No
S1 General Surgery S100044 Excision of Growth from Tongue only 6000 No Trust No
S1 General Surgery S100045 Excision of Growth from Tongue with neck node dissection 15000 No Trust No
S1 General Surgery S100046 Excision of Swelling in Right Cervical Region 5000 No Trust No
S1 General Surgery S100047 Excision of Large Swelling in Hand 3000 No Trust No
S1 General Surgery S100048 Excision of Small Swelling in Hand 1500 No Trust YES
S1 General Surgery S100049 Excision of Neurofibroma 3000 No Trust No
S1 General Surgery S100050 Exicision of Sinus and Curettage 5000 No Trust No
S1 General Surgery S100051 Fibroadenoma – Bilateral 8000 No Trust No
S1 General Surgery S100052 Fibrodenoma – Unilateral 7000 No Trust No
S1 General Surgery S100053 Fissurectomy 8000 No Trust No
S1 General Surgery S100054 Fissurectomy and Haemorrhoidectomy 12000 No Trust No
S1 General Surgery S100055 Eversion of Hydrocele Sac – Bilateral 10000 No Trust No
S1 General Surgery S100056 Eversion of Hydrocele Sac – Unilateral 5000 No Trust No
S1 General Surgery S100057 Fissurectomy with Sphincterotomy 15000 No Trust No
S1 General Surgery S100058 Foreign Body Removal in Deep Region requiring GA 5000 No Trust No
S1 General Surgery S100059 Fundoplication 20000 No Trust No
S1 General Surgery S100060 G J Vagotomy/ Vagotomy + Pyloroplasty 15000 No Trust No
S1 General Surgery S100061 Ganglion - large – Excision 3000 No Trust No
S1 General Surgery S100062 Ganglion - Small – Excision 2000 No Trust YES
S1 General Surgery S100063 Gastrojejunostomy 15000 No Trust No
S1 General Surgery S100064 Gastrostomy 15000 No Trust No
S1 General Surgery S100065 Graham's Operation for duodenal perforation 15000 No Trust No
S1 General Surgery S100066 Granuloma – Excision 2000 No Trust No
S1 General Surgery S100067 Haemangioma – Excision (large) 10000 No Trust No
S1 General Surgery S100068 Haemangioma – Excision (small) 5000 No Trust No
S1 General Surgery S100069 Haemorrhage of Small Intestine 15000 No Trust No
S1 General Surgery S100070 Hepatic Resection (lobectomy) 20000 No Trust No
S1 General Surgery S100071 Hernia – Epigastric 11000 No Trust No
S1 General Surgery S100072 Hernia – Incisional 15000 No Trust YES
S1 General Surgery S100073 Hernia - Repair release of obstruction 15000 No Trust No
S1 General Surgery S100074 Hernia – Umbilical 11000 No Trust YES
S1 General Surgery S100075 Hernia – Femoral 10000 No Trust YES
S1 General Surgery S100076 Hernioplasty – Inguinal 10000 No Trust No
S1 General Surgery S100077 Herniorraphy 9000 No Trust No
S1 General Surgery S100078 Hiatus Hernia – abdominal 15000 No Trust No
S1 General Surgery S100079 Hydatid Cyst of Liver 12500 No Trust No
S1 General Surgery S100080 Hydrocele - Excision – Unilateral 5000 No Trust YES
S1 General Surgery S100081 Hydrocele - Excision – Bilateral 10000 No Trust YES
S1 General Surgery S100082 IlieoSigmoidostomy 17000 No Trust No
S1 General Surgery S100083 Infected Bunion Foot – Excision 4000 No Trust YES
S1 General Surgery S100084 Inguinal Node (dissection) - Unilateral 10000 No Trust No
S1 General Surgery S100085 Intestinal perforation 12500 No Trust No
S1 General Surgery S100086 Intestinal Obstruction 12500 No Trust No
S1 General Surgery S100087 Intussusception 15000 No Trust No
S1 General Surgery S100088 Jejunostomy 10000 No Trust No
S1 General Surgery S100089 Gastric Perforation 15000 No Trust No
S1 General Surgery S100090 Intestinal Perforation (Resection Anastomosis) 20000 No Trust No
S1 General Surgery S100091 Appendicular Perforation 15000 No Trust No
S1 General Surgery S100092 Burst Abdomen Obstruction 15000 No Trust No
S1 General Surgery S100093 Closure of Hollow Viscus Perforation 15000 No Trust No
S1 General Surgery S100094 Laryngectomy Pharyngeal Diverticulum (Throat) 15000 No Trust No
S1 General Surgery S100095 Ileostomy 10000 No Trust No
S1 General Surgery S100096 Lipoma excision 2500 No Trust YES
S1 General Surgery S100097 Loop Colostomy Sigmoid 12000 No Trust No
S1 General Surgery S100098 Mastectomy 12000 No Trust No
S1 General Surgery S100099 Mesenteric Cyst – Excision 16000 No Trust No
S1 General Surgery S100100 Mesenteric Caval Anastomosis 15000 No Trust No
S1 General Surgery S100101 Microlaryngoscopic Surgery 15000 No Trust No
S1 General Surgery S100102 Oeshophagoscopy for foreign body removal 7500 No Trust No
S1 General Surgery S100103 Oesophagectomy 17500 No Trust No
S1 General Surgery S100104 Portal Hypertension shunt surgery 18000 No Trust No
S1 General Surgery S100105 Pelvic Abscess - Open Drainage 10000 No Trust No
S1 General Surgery S100106 PancreaticoDuodenectomy 25000 No Trust No
S1 General Surgery S100107 Distal Pancreatectomy with PancreaticoJejunostomy 25000 No Trust No
S1 General Surgery S100108 Papilloma Rectum – Excision 4000 No Trust No
S1 General Surgery S100109 Haemorroidectomy+ Fistulectomy 10000 No Trust No
S1 General Surgery S100110 Growth in the Scalp – Excision 4000 No Trust YES
S1 General Surgery S100111 Porto Caval Anastomosis 15000 No Trust No
S1 General Surgery S100112 Pyeloroplasty 10000 No Trust No
S1 General Surgery S100113 Radical Mastectomy 10000 No Trust No
S1 General Surgery S100114 Radical Neck Dissection – Excision 15000 No Trust No
S1 General Surgery S100115 Hernia – Spigelian 5000 No Trust No
S1 General Surgery S100116 Rectal Dilation 2000 No Trust No
S1 General Surgery S100117 Prolapse of Rectal Mass – Excision 10000 No Trust No
S1 General Surgery S100118 Rectopexy 10000 No Trust No
S1 General Surgery S100119 Repair of Common Bile Duct 15000 No Trust No
S1 General Surgery S100120 Resection Anastomosis (Large Intestine) 15000 No Trust No
S1 General Surgery S100121 Resection Anastomosis (Small Intestine) 15000 No Trust No
S1 General Surgery S100122 Retroperitoneal Tumor – Excision 20000 No Trust No
S1 General Surgery S100123 Haemorroidectomy 5000 No Trust No
S1 General Surgery S100124 Salivary Gland – Excision 10000 No Trust No
S1 General Surgery S100125 Segmental Resection of Breast 10000 No Trust No
S1 General Surgery S100126 Scrotal Swelling (Multiple) – Excision 5000 No Trust No
S1 General Surgery S100127 Sigmoid Diverticulum 15000 No Trust No
S1 General Surgery S100128 Simple closure - Peptic perforation 15000 No Trust No
S1 General Surgery S100129 Sinus – Excision 5000 No Trust No
S1 General Surgery S100130 Soft Tissue Tumor (small) – Excision 5000 No Trust YES
S1 General Surgery S100131 Soft Tissue Tumor (large) – Excision 10000 No Trust No
S1 General Surgery S100132 Splenectomy 25000 No Trust No
S1 General Surgery S100133 Submandibular Lymph node – Excision 5000 No Trust No
S1 General Surgery S100134 Submandibular Mass Excision + Reconstruction 20000 No Trust No
S1 General Surgery S100135 Swelling in foot (small) – Excision 1500 No Trust YES
S1 General Surgery S100136 Swelling in foot (large) – Excision 3500 No Trust No
S1 General Surgery S100137 Coloectomy – Total 20000 No Trust No
S1 General Surgery S100138 Pharyngectomy Reconstruction – Total 20000 No Trust No
S1 General Surgery S100139 Tracheal Stenosis (End to end Anastamosis) (Throat) 15000 No Trust No
S1 General Surgery S100140 Tracheoplasty (Throat) 15000 No Trust No
S1 General Surgery S100141 Umbilical Sinus – Excision 5000 No Trust No
S1 General Surgery S100142 Varicose Veins - Excision and Ligation 10000 No Trust No
S1 General Surgery S100143 Vasovasostomy 12000 No Trust No
S1 General Surgery S100144 Volvlous of Large Bowel 25000 No Trust No
S1 General Surgery S100145 Cleft lip operation 12000 No Trust No
S1 General Surgery S100146 Cleft palate repair (for each stage) 12000 No Trust No
S1 General Surgery S100147 Cleft lip palate operation (for each stage) 15000 No Trust No
S1 General Surgery S100148 Aneurysm not Requiring Bypass Techniques t 36000 No Trust No
S1 General Surgery S100149 Aneurysm Resection Grafting 36000 No Trust No
S1 General Surgery S100150 Arterial Embolectomy 10000 No Trust No
S1 General Surgery S100151 Carotid artery aneurysm repair 20000 No Trust No
S1 General Surgery S100152 Carotid Body tumour - Excision 20000 No Trust No
S1 General Surgery S100153 Cholecystectomy Exploration of CBD 22000 No Trust No
S1 General Surgery S100154 Cholecystostomy 10000 No Trust No
S1 General Surgery S100155 Congential Arteriovenus Fistula (large) 20000 No Trust No
S1 General Surgery S100156 Congential Arteriovenus Fistula (small) 10000 No Trust No
S1 General Surgery S100157 Decortication (Pleurectomy) 20000 No Trust No
S1 General Surgery S100158 Dissecting Aneurysms 36000 No Trust No
S1 General Surgery S100159 Distal Abdominal Aorta repair 36000 No Trust No
S1 General Surgery S100160 Estlander Operation (lip) 7000 No Trust No
S1 General Surgery S100161 Excision and Skin Graft of Venous Ulcer 15000 No Trust No
S1 General Surgery S100162 Excision of Parathyroid Adenoma/Carcinoma 22000 No Trust No
S1 General Surgery S100163 Flap Reconstructive Surgery 20000 No Trust No
S1 General Surgery S100164 Split thickness skin grafts – Small (< 4 TBSA) 5000 No Trust No
S1 General Surgery S100165 Split thickness skin grafts – Medium (4 - 8 TBSA) 10000 No Trust No
S1 General Surgery S100166 Split thickness skin grafts – Large (> 8 TBSA) 15000 No Trust No
S1 General Surgery S100167 Free Grafts - Wolfe Grafts 10000 No Trust No
S1 General Surgery S100168 Hemi thyroidectomy 10000 No Trust No
S1 General Surgery S100169 Total thyroidectomy 20000 No Trust No
S1 General Surgery S100170 Laparoscopic Hernia Repair 18000 No Trust No
S1 General Surgery S100171 Lap. Assisted left Hemi colectomy t 25000 No Trust No
S1 General Surgery S100172 Lap. Assisted Right Hemi colectomy t 25000 No Trust No
S1 General Surgery S100173 Lap. Assisted small bowel resection 15000 No Trust No
S1 General Surgery S100174 Lap. Assisted Total Colectomy 25000 No Trust No
S1 General Surgery S100175 Lap. Cholecystectomy CBD exploration 20000 No Trust No
S1 General Surgery S100176 Lap. For intestinal obstruction 15000 No Trust No
S1 General Surgery S100177 Lap. Hepatic resection 25000 No Trust No
S1 General Surgery S100178 Lap. Hydatid of liver surgery 20000 No Trust No
S1 General Surgery S100179 Laparoscopic Adhesinolysis 15000 No Trust No
S1 General Surgery S100180 Laparoscopic Appendicectomy 18000 No Trust No
S1 General Surgery S100181 Laparoscopic Cholecystectomy 15000 No Trust No
S1 General Surgery S100182 Laparoscopic cystogastrostomy 20000 No Trust No
S1 General Surgery S100183 Laparoscopic Gastrostomy 12000 No Trust No
S1 General Surgery S100184 Laparoscopic Hiatus Hernia Repair 22000 No Trust No
S1 General Surgery S100185 Laparoscopic Pyloromyotomy 20000 No Trust No
S1 General Surgery S100186 Laparoscopic Rectopexy 15000 No Trust No
S1 General Surgery S100187 Laparoscopic Spleenectomy 16500 No Trust No
S1 General Surgery S100188 Laparoscopic umbilical hernia repair 15000 No Trust No
S1 General Surgery S100189 Laparoscopic ventral hernia repair 20000 No Trust No
S1 General Surgery S100190 Laparotomy-peritonitis lavage and drainage 10000 No Trust No
S1 General Surgery S100191 Ligation of Ankle Perforators 5000 No Trust No
S1 General Surgery S100192 Lymphatics Excision of Subcutaneous Tissues In Lymphoedema 10000 No Trust No
S1 General Surgery S100193 Repair of Main Arteries of the Limbs 25000 No Trust No
S1 General Surgery S100194 Mediastinal Tumour 20000 No Trust No
S1 General Surgery S100195 Oesophagectomy for Carcinoma Oesophagus 25000 No Trust No
S1 General Surgery S100196 Operation for Bleeding Peptic Ulcer 15000 No Trust No
S1 General Surgery S100197 Operation for Carcinoma Lip – Vermilionectomy 10000 No Trust No
S1 General Surgery S100198 Operation for Carcinoma Lip - Wedge Excision and Vermilionectomy 12000 No Trust No
S1 General Surgery S100199 Operation for Carcinoma Lip - Wedge-Excision 10000 No Trust No
S1 General Surgery S100200 Appendicectomy - Appendicular Abscess – Drainage 12000 No Trust No
S1 General Surgery S100201 Caecostomy 10000 No Trust No
S1 General Surgery S100202 Closure of Colostomy 5000 No Trust No
S1 General Surgery S100203 Coccygeal Teratoma Excision 15000 No Trust No
S1 General Surgery S100204 Congenital Atresia Stenosis of Small Intestine 20000 No Trust No
S1 General Surgery S100205 CystoJejunostomy/or Cystogastrostomy 20000 No Trust No
S1 General Surgery S100206 Drainage of perivertebral abscess 10000 No Trust No
S1 General Surgery S100207 Hernia -hiatus-Transthoracic 25000 No Trust No
S1 General Surgery S100208 Intercostal drainage 2000 No Trust No
S1 General Surgery S100209 Operation for carcinoma lip- cheek advancement 12000 No Trust No
S1 General Surgery S100210 Thymectomy 20000 No Trust No
S1 General Surgery S100211 Operation of Choledochal Cyst 15000 No Trust No
S1 General Surgery S100212 Operations for Acquired Arteriovenous Fistula 15000 No Trust No
S1 General Surgery S100213 Operations for Replacement of Oesophagus by Colon 25000 No Trust No
S1 General Surgery S100214 Hemodialysis per sitting 2000 No Trust No
S1 General Surgery S100215 Parapharyngeal Tumour Excision 20000 No Trust No
S1 General Surgery S100216 Partial/Subtotal Gastrectomy for Carcinoma 22000 No Trust No
S1 General Surgery S100217 Patch Graft Angioplasty 20000 No Trust No
S1 General Surgery S100218 Pericardiostomy 30000 No Trust No
S1 General Surgery S100219 Pneumonectomy 25000 No Trust No
S1 General Surgery S100220 Removal of Foreign Body from Trachea or Oesophagus 5000 No Trust No
S1 General Surgery S100221 Removal Tumours of Chest Wall 20000 No Trust No
S1 General Surgery S100222 Procedures Requiring Bypass Techniques 35000 No Trust No
S1 General Surgery S100223 Resection Enucleation of Adenoma (lung) 10000 No Trust No
S1 General Surgery S100224 Rib Resection Drainage 10000 No Trust No
S1 General Surgery S100225 Skin Flaps - Rotation Flaps 6200 No Trust No
S1 General Surgery S100226 Splenectomy - For Trauma 20000 No Trust No
S1 General Surgery S100227 Surgery for Arterial Aneurism Spleen Artery 20000 No Trust No
S1 General Surgery S100228 Surgery for Arterial Aneurism –Vertebral 25000 No Trust No
S1 General Surgery S100229 Sympathetectomy – Cervical 5000 No Trust No
S1 General Surgery S100230 Temporal Bone resection 15000 No Trust No
S1 General Surgery S100231 Thorachostomy 10000 No Trust No
S1 General Surgery S100232 Thoracocentesis 1500 No Trust No
S1 General Surgery S100233 Thoracoplasty 20000 No Trust No
S1 General Surgery S100234 Thoracoscopic Decortication 25000 No Trust No
S1 General Surgery S100235 Thoracoscopic Hydatid Cyst excision 20000 No Trust No
S1 General Surgery S100236 Thoracoscopic Lobectomy 25000 No Trust No
S1 General Surgery S100237 Thoracoscopic Pneumonectomy 30000 No Trust No
S1 General Surgery S100238 Thoracoscopic Segmental Resection 25000 No Trust No
S1 General Surgery S100239 Thoracoscopic Sympathectomy 15000 No Trust No
S1 General Surgery S100240 Thrombendarterectomy 15000 No Trust No
S1 General Surgery S100241 Thorax (penetrating wounds) 12500 No Trust No
S1 General Surgery S100242 Total Thyroidectomy and Block Dissection 20000 No Trust No
S1 General Surgery S100243 Trendelenburg Operation 10000 No Trust No
S1 General Surgery S100244 Debridement of Ulcer-Leprosy 5000 No Trust No
S1 General Surgery S100245 Tissue Reconstruction Flap Leprosy 25000 No Trust No
S1 General Surgery S100246 Tendon Transfer-Leprosy 25000 No Trust No
S1 General Surgery S100247 Adhenolysis + Appendicectomy 20000 No Trust No
S1 General Surgery S100248 Hernia - Repair release of obstruction+ Hernioplasty 20000 No Trust No
S1 General Surgery S100249 Aspiration of cold Abscess of Lymphnode 3000 No Trust YES
S1 General Surgery S100250 Aspiration of Empyema 2000 No Trust No
S1 General Surgery S100251 AV Shunt for dialysis 6000 No Trust No
S1 General Surgery S100252 Peritoneal dialysis per sitting 2000 No Trust No
S1 General Surgery S100253 Vasectomy 2500 No Trust No
S1 General Surgery U100 Unspecified Surgical Package 0 Yes Insurer No
S1 General Surgery U100 Unspecified Surgical Package 0 Yes Trust No
S10 Plastic & reconstructiv S1000001 Ear Pinna Reconstruction with costal cartilage/ Prosthesis 30000 Yes Trust No
S10 Plastic & reconstructiv S1000002 Revascularization of limb/digit 25000 Yes Trust No
S10 Plastic & reconstructiv S1000003 Hemangioma – Sclerotherapy (under GA) 35000 Yes Trust No
S10 Plastic & reconstructiv S1000004 Hemangioma – Debulking/ Excision 35000 Yes Trust No
S10 Plastic & reconstructiv S1000005 Tissue Expander for disfigurement following burns/ trauma/ congenital deformity (incl 50000 Yes Trust No
S10 Plastic & reconstructiv S1000006 Scalp avulsion reconstruction 50000 Yes Trust No
S10 Plastic & reconstructiv S1000007 NPWT (Inpatient only) 0 Yes Trust No
S10 Plastic & reconstructiv S1000008 Pressure Sore – Surgery 30000 Yes Trust No
S10 Plastic & reconstructiv S1000009 Diabetic Foot – Surgery 30000 Yes Trust No
S10 Plastic & reconstructiv U100 Unspecified Surgical Package 0 Yes Trust No
S10 Plastic & reconstructiv U100 Unspecified Surgical Package 0 Yes Insurer No
S11 Burns management S1100001 Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns) - any (not req 7000 Yes Trust No
S11 Burns management S1100002 Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns): Upto 40 ; 40000 Yes Trust No
S11 Burns management S1100003 Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns): 40 - 60 ; 50000 Yes Trust No
S11 Burns management S1100004 Total Body Surface Area Burns (TBSA) (thermal/ scald/ flame burns): > 60 ; 80000 Yes Trust No
S11 Burns management S1100005 Electrical contact burns: Low voltage- without part of limb/limb loss; Includes TBSA 30000 Yes Trust No
S11 Burns management S1100006 Electrical contact burns: Low voltage- with part of limb/limb loss; Includes TBSA sk 40000 Yes Trust No
S11 Burns management S1100007 Electrical contact burns: High voltage- without part of limb/limb loss; Includes TBS 50000 Yes Trust No
S11 Burns management S1100008 Electrical contact burns: High voltage- with part of limb/limb loss; Includes TBSA s 60000 Yes Trust No
S11 Burns management S1100009 Chemical burns: Without significant facial scarring and/or loss of function; Includes 40000 Yes Trust No
S11 Burns management S1100010 Chemical burns: With significant facial scarring and/or loss of function; Includes T 60000 Yes Trust No
S11 Burns management S1100011 Post Burn Contracture surgeries for Functional Improvement 50000 Yes Trust No
S11 Burns management S1100012 Post Burn Contracture surgeries for Functional Improvement 50000 Yes Trust No
S11 Burns management U100 Unspecified Surgical Package 0 Yes Insurer No
S11 Burns management U100 Unspecified Surgical Package 0 Yes Trust No
S12 Cardiology S1200001 Balloon Atrial Septostomy 18000 Yes Trust No
S12 Cardiology S1200002 Balloon Aortic Valvotomy 25000 Yes Trust No
S12 Cardiology S1200003 Balloon Mitral Valvotomy 27500 Yes Trust No
S12 Cardiology S1200004 Balloon Pulmonary Valvotomy 25000 Yes Trust No
S12 Cardiology S1200005 Vertebral Angioplasty with single stent (medicated) 50000 Yes Trust No
S12 Cardiology S1200006 Vertebral Angioplasty with double stent(medicated) 65000 Yes Trust No
S12 Cardiology S1200007 Carotid angioplasty with stent (medicated) 130000 Yes Trust No
S12 Cardiology S1200008 Renal Angioplasty with single stent (medicated) 50000 Yes Trust No
S12 Cardiology S1200009 Renal Angioplasty with double stent (medicated) 65000 Yes Trust No
S12 Cardiology S1200010 Peripheral Angioplasty with balloon 25000 Yes Trust No
S12 Cardiology S1200011 Peripheral Angioplasty with stent (medicated) 50000 Yes Trust No
S12 Cardiology S1200012 Coarctation dilatation 25000 Yes Trust No
S12 Cardiology S1200013 Medical treatment of Acute MI with Thrombolysis /Stuck Valve Thrombolysis 10000 Yes Trust No
S12 Cardiology S1200014 ASD Device Closure 80000 Yes Trust No
S12 Cardiology S1200015 VSD Device Closure 80000 Yes Trust No
S12 Cardiology S1200016 PDA Device Closure 40000 Yes Trust No
S12 Cardiology S1200017 PDA multiple Coil insertion 20000 Yes Trust No
S12 Cardiology S1200018 PDA Coil (one) insertion 15000 Yes Trust No
S12 Cardiology S1200019 PDA stenting 40000 Yes Trust No
S12 Cardiology S1200020 Pericardiocentesis 4000 Yes Trust No
S12 Cardiology S1200021 Temporary Pacemaker implantation 5000 Yes Trust No
S12 Cardiology S1200022 Permanent pacemaker implantation (DDR) including Pacemaker value/pulse gen 60000 Yes Trust No
S12 Cardiology S1200023 Permanent pacemaker implantation (VVI) including Pacemaker value/pulse gener 50000 Yes Trust No
S12 Cardiology S1200024 PTCA - single stent (medicated, inclusive of diagnostic angiogram) 65000 Yes Trust No
S12 Cardiology S1200025 PTCA - double stent (medicated, inclusive of diagnostic angiogram) 90000 Yes Trust No
S12 Cardiology S1200026 PTCA - additonal stent (linked to package no:0025) 28849 Yes Trust No
S12 Cardiology S1200027 PTSMA 25000 Yes Trust No
S12 Cardiology S1200028 Pulmonary artery stenting 40000 Yes Trust No
S12 Cardiology S1200029 Pulmonary artery stenting (double) 65000 Yes Trust No
S12 Cardiology S1200030 Right ventricular outflow tract (RVOT) stenting 40000 Yes Trust No
S12 Cardiology S1200031 Rotablation+ Balloon Angioplasty 65000 Yes Trust No
S12 Cardiology S1200032 Rotablation+ Balloon Angioplasty + 1 stent (medicated) 100000 Yes Trust No
S12 Cardiology S1200033 Rotablation+ Balloon Angioplasty + 2 stent (medicated) 125000 Yes Trust No
S12 Cardiology S1200034 Thrombolysis for peripheral ischemia 10000 Yes Trust No
S12 Cardiology S1200035 Bronchial artery Embolisation (for Haemoptysis) 25000 Yes Trust No
S12 Cardiology S1200036 Percutaneous Transluminal Tricuspid Commissurotormy (PTTC) 25000 Yes Trust No
S12 Cardiology S1200037 Coiling - Pseudoaneurysms of Abdomen 55000 Yes Trust No
S12 Cardiology S1200038 Embolization - Arteriovenous Malformation (AVM) in the Limbs 40000 Yes Trust No
S12 Cardiology S1200039 Catheter directed Thrombolysis for: Deep vein thrombosis (DVT), Mesenteric Thromb 50000 Yes Trust No
S12 Cardiology U100 Unspecified Surgical Package 0 Yes Trust No
S12 Cardiology U100 Unspecified Surgical Package 0 Yes Insurer No
S13 Cardio-thoracic & VascS1300001 Coronary artery bypass grafting (CABG) 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300002 Coronary artery bypass grafting (CABG) with Intra-aortic balloon pump (IABP) 110000 Yes Trust No
S13 Cardio-thoracic & VascS1300003 Coronary artery bypass grafting (CABG) + one mechanical Valve Replacement + Intr 150000 Yes Trust No
S13 Cardio-thoracic & VascS1300004 Coronary artery bypass grafting (CABG) with LV Aneurysmal repair 100000 Yes Trust No
S13 Cardio-thoracic & VascS1300005 Coronary artery bypass grafting (CABG) with Mitral Valve repair without ring 100000 Yes Trust No
S13 Cardio-thoracic & VascS1300006 Coronary artery bypass grafting (CABG) with Mitral Valve repair with ring 125000 Yes Trust No
S13 Cardio-thoracic & VascS1300007 Coronary artery bypass grafting (CABG) with post MI Ventricular Septal Defect (Ventr 100000 Yes Trust No
S13 Cardio-thoracic & VascS1300008 Open Mitral Valvotomy 75000 Yes Trust No
S13 Cardio-thoracic & VascS1300009 Closed Mitral Valvotomy 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300010 Open Pulmonary Valvotomy 75000 Yes Trust No
S13 Cardio-thoracic & VascS1300011 Mitral Valve Repair 80000 Yes Trust No
S13 Cardio-thoracic & VascS1300012 Tricuspid Valve Repair 80000 Yes Trust No
S13 Cardio-thoracic & VascS1300013 Aortic Valve Repair 80000 Yes Trust No
S13 Cardio-thoracic & VascS1300014 Ring for any Valve Repair 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300015 Mitral Valve Replacement (mechanical valve) 120000 Yes Trust No
S13 Cardio-thoracic & VascS1300016 Mitral Valve Replacement (biological valve) 125000 Yes Trust No
S13 Cardio-thoracic & VascS1300017 Aortic Valve Replacement (mechanical valve) 120000 Yes Trust No
S13 Cardio-thoracic & VascS1300018 Aortic Valve Replacement (biological valve) 125000 Yes Trust No
S13 Cardio-thoracic & VascS1300019 Tricuspid Valve Replacement (mechanical valve) 120000 Yes Trust No
S13 Cardio-thoracic & VascS1300020 Tricuspid Valve Replacement (biological valve) 125000 Yes Trust No
S13 Cardio-thoracic & VascS1300021 Double Valve Replacement (mechanical valve) 150000 Yes Trust No
S13 Cardio-thoracic & VascS1300022 Double Valve Replacement (biological valve) 155000 Yes Trust No
S13 Cardio-thoracic & VascS1300023 Ross Procedure 105000 Yes Trust No
S13 Cardio-thoracic & VascS1300024 Atrial Septal Defect (ASD) 75000 Yes Trust No
S13 Cardio-thoracic & VascS1300025 Ventricular Septal Defect (VSD) 75000 Yes Trust No
S13 Cardio-thoracic & VascS1300026 Atrioventricular septal defect/ Atrioventricular (AV) Canal Defect 100000 Yes Trust No
S13 Cardio-thoracic & VascS1300027 Intracardiac repair (ICR) for Tetralogy of Fallot (TOF) 100000 Yes Trust No
S13 Cardio-thoracic & VascS1300028 Pulmonary Valvotomy + Right Ventricular Outflow Tract (RVOT) Resection 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300029 Aortopulmonary Window (AP Window) 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300030 Surgery for Hypertrophic Obstructive Cardiomyopathy (HOCM) 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300031 Ebsteins 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300032 Fontan 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300033 Total Anomalous Pulmonary Venous Connection (TAPVC) 105000 Yes Trust No
S13 Cardio-thoracic & VascS1300034 Any RV to PA conduit (Valved) 115000 Yes Trust No
S13 Cardio-thoracic & VascS1300035 Arterial Switch Operation 120000 Yes Trust No
S13 Cardio-thoracic & VascS1300036 Double Switch Operation 120000 Yes Trust No
S13 Cardio-thoracic & VascS1300037 Sennings 105000 Yes Trust No
S13 Cardio-thoracic & VascS1300038 Mustards 105000 Yes Trust No
S13 Cardio-thoracic & VascS1300039 Truncus Arteriosus Surgery 115000 Yes Trust No
S13 Cardio-thoracic & VascS1300040 Root Replacement (Aortic Aneurysm/ Aortic Dissection) / Bental Procedure 145000 Yes Trust No
S13 Cardio-thoracic & VascS1300041 Aortic Arch Replacement 160000 Yes Trust No
S13 Cardio-thoracic & VascS1300042 Aortic Aneurysm Repair using Cardiopulmonary bypass (CPB) 150000 Yes Trust No
S13 Cardio-thoracic & VascS1300043 Aortic Aneurysm Repair without using Cardiopulmonary bypass (CPB) 75000 Yes Trust No
S13 Cardio-thoracic & VascS1300044 Pulmonary Embolectomy 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300045 Surgery for Cardiac Tumour/ Left Atrial (LA) Myxoma/ Right Atrial (RA) Myxoma 95000 Yes Trust No
S13 Cardio-thoracic & VascS1300046 Patent Ductus Arteriosus (PDA) Closure 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300047 Coarctation Repair 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300048 Coarctation Repair with interpostion graft 38000 Yes Trust No
S13 Cardio-thoracic & VascS1300049 Blalock–Thomas–Taussig (BT) Shunt (inclusives of grafts) 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300050 Glenn Shunt (without cardiopulmonary bypass) 35000 Yes Trust No
S13 Cardio-thoracic & VascS1300051 Central Shunt 50000 Yes Trust No
S13 Cardio-thoracic & VascS1300052 Pericardiectomy 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300053 Pulmonary AV Fistula surgery 45000 Yes Trust No
S13 Cardio-thoracic & VascS1300054 Lung Cyst 45000 Yes Trust No
S13 Cardio-thoracic & VascS1300055 Space-Occupying Lesion (SOL) mediastinum 45000 Yes Trust No
S13 Cardio-thoracic & VascS1300056 Surgical Correction of Bronchopleural Fistula 50000 Yes Trust No
S13 Cardio-thoracic & VascS1300057 Diaphragmatic Eventeration 40000 Yes Trust No
S13 Cardio-thoracic & VascS1300058 Oesophageal Diverticula /Achalasia Cardia 35000 Yes Trust No
S13 Cardio-thoracic & VascS1300059 Diaphragmatic Injuries/Repair 35000 Yes Trust No
S13 Cardio-thoracic & VascS1300060 Thoracotomy, Thoraco Abdominal Approach 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300061 Foreign Body Removal with scope 20000 Yes Trust No
S13 Cardio-thoracic & VascS1300062 Bronchial Repair Surgery for Injuries due to FB 35000 Yes Trust No
S13 Cardio-thoracic & VascS1300063 Lung Injury repair 35000 Yes Trust No
S13 Cardio-thoracic & VascS1300064 Thyomectomy 35000 Yes Trust No
S13 Cardio-thoracic & VascS1300065 Pulmonary Valve Replacement 120000 Yes Trust No
S13 Cardio-thoracic & VascS1300066 Intercostal Drainage and Management of ICD, Intercostal Block, Antibiotics Physio 10000 Yes Trust No
S13 Cardio-thoracic & VascS1300067 Encysted Empyema/Pleural Effusion - Tubercular 10000 Yes Trust No
S13 Cardio-thoracic & VascS1300068 First rib Excision by transaxillary approach, Excision of cervical rib / fibrous band / 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300069 Congenital Cystic Lesions 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300070 Pulmonary Sequestration Resection 40000 Yes Trust No
S13 Cardio-thoracic & VascS1300071 Pulmonary artero venous malformation 40000 Yes Trust No
S13 Cardio-thoracic & VascS1300072 Thromboembolectomy (pre-auth not required, usually done as emergency) 20000 No Trust No
S13 Cardio-thoracic & VascS1300073 Surgery for Arterial Aneursysm -Upper/Distal Abdominal Aorta 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300074 Intrathoracic Aneurysm-Aneurysm not Requiring Bypass Techniques 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300075 Intrathoracic Aneurysm-Requiring Bypass Techniques 125000 Yes Trust No
S13 Cardio-thoracic & VascS1300076 Surgery for Arterial Aneurysm Renal Artery 40000 Yes Trust No
S13 Cardio-thoracic & VascS1300077 Operations for Congenital Arteriovenous Fistula 15000 Yes Trust No
S13 Cardio-thoracic & VascS1300078 Operations for Stenosis of Renal Arteries 40000 Yes Trust No
S13 Cardio-thoracic & VascS1300079 Aorto Bi-lliac / Bi femoral /Axillo bi femoral bypass with Synthetic Graft 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300080 Femoro Distal / Femoral - Femoral / Femoral infra popliteal Bypass with Vein Graft 50000 Yes Trust No
S13 Cardio-thoracic & VascS1300081 Femoro Distal / Femoral - Femoral / Femoral infra popliteal Bypass with Synthetic Gr 70000 Yes Trust No
S13 Cardio-thoracic & VascS1300082 Axillo Brachial Bypass using with Synthetic Graft 65000 Yes Trust No
S13 Cardio-thoracic & VascS1300083 Brachio - Radial Bypass with Synthetic Graft 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300084 Excision of body Tumor with vascular repair 35000 Yes Trust No
S13 Cardio-thoracic & VascS1300085 Carotid artery bypass with Synthetic Graft 60000 Yes Trust No
S13 Cardio-thoracic & VascS1300086 Excision of Arterio Venous malformation - Large 50000 Yes Trust No
S13 Cardio-thoracic & VascS1300087 Excision of Arterio Venous malformation - Small 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300088 Deep Vein Thrombosis (DVT) - Inferior Vena Cava (IVC) filter 80000 Yes Trust No
S13 Cardio-thoracic & VascS1300089 Carotid endarterectomy 32000 Yes Trust No
S13 Cardio-thoracic & VascS1300090 Aortic Angioplasty with two stents / Iliac angioplasty with stent Bilateral 90000 Yes Trust No
S13 Cardio-thoracic & VascS1300091 Bilateral thrombo embolectomy 30000 Yes Trust No
S13 Cardio-thoracic & VascS1300092 Aorto-uni-iliac/uni-femoral bypass with synthetic graft 70000 Yes Trust No
S13 Cardio-thoracic & VascU100 Unspecified Surgical Package 0 Yes Trust No
S13 Cardio-thoracic & VascU100 Unspecified Surgical Package 0 Yes Insurer No
S14 Paediatric surgery S1400001 Ankyloglossia Major 15000 No Trust No
S14 Paediatric surgery S1400002 Ankyloglossia Minor 5000 No Trust No
S14 Paediatric surgery S1400003 Hernia Hydrocele 20000 No Trust No
S14 Paediatric surgery S1400004 Sacrococcygeal Teratoma 20000 No Trust No
S14 Paediatric surgery S1400005 Undescended Testis - Bilateral-Palp + Nonpalp 15000 No Trust No
S14 Paediatric surgery S1400006 Undescended Testis - Bilateral Palpable 15000 No Trust No
S14 Paediatric surgery S1400007 Undescended Testis - Bilateral Non-Palpable 20000 No Trust No
S14 Paediatric surgery S1400008 Undescended Testis - Reexploration/ Second Stage 20000 No Trust No
S14 Paediatric surgery S1400009 Undescended Testis - Unilateral-Palpable 15000 No Trust No
S14 Paediatric surgery S1400010 Ano Rectal Malformation - Abd-Perineal PSARP 20000 No Trust No
S14 Paediatric surgery S1400011 Ano Rectal Malformation – Anoplasty 20000 No Trust No
S14 Paediatric surgery S1400012 Ano Rectal Malformation – Cutback 20000 No Trust No
S14 Paediatric surgery S1400013 Ano Rectal Malformation - PSARP 20000 No Trust No
S14 Paediatric surgery S1400014 Ano Rectal Malformation - Redo Pullthrough 15000 No Trust No
S14 Paediatric surgery S1400015 Ano Rectal Malformation - Transposition 15000 No Trust No
S14 Paediatric surgery S1400016 Anti GERD Surgery 10000 No Trust No
S14 Paediatric surgery S1400017 Duplication Cyst Excision 20000 No Trust No
S14 Paediatric surgery S1400018 Fecal Fistula Closure 25000 No Trust No
S14 Paediatric surgery S1400019 Gastrostomy + Esophagoscopy+ Threading 20000 No Trust No
S14 Paediatric surgery S1400020 GI Tumor Excision 30000 No Trust No
S14 Paediatric surgery S1400021 Hirschsprung’s Disease - Myectomy 25000 No Trust No
S14 Paediatric surgery S1400022 Hirschsprung’s Disease - Pull Through 20000 No Trust No
S14 Paediatric surgery S1400023 Hirschsprung’s Disease - Retal Biopsy-Punch 10000 No Trust No
S14 Paediatric surgery S1400024 Hirschsprung’s Disease - Retal Biopsy –Open 10000 No Trust No
S14 Paediatric surgery S1400025 Hirschsprung’s Disease - Sphinecterotomy 15000 No Trust No
S14 Paediatric surgery S1400026 Intussusception - Non –Operative Reduction in infants 20000 No Trust No
S14 Paediatric surgery S1400027 Intussusception – Operative in infants 25000 No Trust No
S14 Paediatric surgery S1400028 Ladds Procedure 30000 No Trust No
S14 Paediatric surgery S1400029 Rectal Polypectomy - Sigmoiescopic (Ga) 8000 No Trust No
S14 Paediatric surgery S1400030 Retro-Peritoneal Lymphangioma Excision 25000 No Trust No
S14 Paediatric surgery S1400031 Congenital Diaphragmatic Hernia 25000 No Trust No
S14 Paediatric surgery S1400032 Congenital Lobar Emphysema 25000 No Trust No
S14 Paediatric surgery S1400033 Exomphalos/gastroschisis 25000 No Trust No
S14 Paediatric surgery S1400034 Cleft Lip and Palate Surgery (per stage) 15000 Yes Trust No
S14 Paediatric surgery U100 Unspecified Surgical Package 0 Yes Insurer No
S14 Paediatric surgery U100 Unspecified Surgical Package 0 Yes Trust No
S15 Surgical Oncology S1500001 Tracheal resection 25000 Yes Trust No
S15 Surgical Oncology S1500002 Sternotomy with superior mediastinal dissection 40000 Yes Trust No
S15 Surgical Oncology S1500003 Substernal bypass 30000 Yes Trust No
S15 Surgical Oncology S1500004 Resection of nasopharyngeal tumour 40000 Yes Trust No
S15 Surgical Oncology S1500005 Myocutaneous flap 20000 Yes Trust No
S15 Surgical Oncology S1500006 Fasciocutaneous flap 15000 Yes Trust No
S15 Surgical Oncology S1500007 Palatectomy- Soft palate 20000 Yes Trust No
S15 Surgical Oncology S1500008 Palatectomy- Hard palate 20000 Yes Trust No
S15 Surgical Oncology S1500009 Microvascular reconstruction 45000 Yes Trust No
S15 Surgical Oncology S1500010 Composite resection 40000 Yes Trust No
S15 Surgical Oncology S1500011 Composite resection with reconstruction(excluding microvascular) 60000 Yes Trust No
S15 Surgical Oncology S1500012 Neck dissection-selective 12000 Yes Trust No
S15 Surgical Oncology S1500013 Neck dissection-comprehensive 16000 Yes Trust No
S15 Surgical Oncology S1500014 Total Maxillectomy 18000 Yes Trust No
S15 Surgical Oncology S1500015 Radical Maxillectomy 25000 Yes Trust No
S15 Surgical Oncology S1500016 Radical parotidectomy 25000 Yes Trust No
S15 Surgical Oncology S1500017 Partial laryngectomy ( voice preserving) 20000 Yes Trust No
S15 Surgical Oncology S1500018 Voice prosthesis 30000 Yes Trust No
S15 Surgical Oncology S1500019 Total Thyroidectomy with central compartment LN dissection 20000 Yes Trust No
S15 Surgical Oncology S1500020 Total Thyroidectomy with central compartment LN dissection with Lateral LN dissecti 25000 Yes Trust No
S15 Surgical Oncology S1500021 Tracheostomy 5000 Yes Trust No
S15 Surgical Oncology S1500022 Axillary dissection 15000 Yes Trust No
S15 Surgical Oncology S1500023 Breast conserving surgery (lumpectomy + axillary surgery) 12000 Yes Trust No
S15 Surgical Oncology S1500024 Lung metastectomy- solitary 30000 Yes Trust No
S15 Surgical Oncology S1500025 Lung metastectomy- multiple (< four) 50000 Yes Trust No
S15 Surgical Oncology S1500026 Lung metastectomy- multiple (> four) 60000 Yes Trust No
S15 Surgical Oncology S1500027 Sleeve resection of lung cancer 70000 Yes Trust No
S15 Surgical Oncology S1500028 Oesophagectomy with two field lymphadenectomy 60000 Yes Trust No
S15 Surgical Oncology S1500029 Oesophagectomy with three field lymphadenectomy 60000 Yes Trust No
S15 Surgical Oncology S1500030 Enucleation of pancreatic neoplasm 25000 Yes Trust No
S15 Surgical Oncology S1500031 Radical Cholecystectomy 25000 Yes Trust No
S15 Surgical Oncology S1500032 Abdominal wall tumour resection 25000 Yes Trust No
S15 Surgical Oncology S1500033 Abdominal wall tumour resection with reconstruction 35000 Yes Trust No
S15 Surgical Oncology S1500034 Oesophageal stenting including stent cost 40000 Yes Trust No
S15 Surgical Oncology S1500035 Triple bypass GI tract 30000 Yes Trust No
S15 Surgical Oncology S1500036 Segmentectomy- hepatobiliary system 50000 Yes Trust No
S15 Surgical Oncology S1500037 Radical Hysterectomy + Bilateral pelvic lymph node dissection + bilateral salpingo 50000 Yes Trust No
S15 Surgical Oncology S1500038 Skin Tumours Wide Excision + Reconstruction 25000 Yes Trust No
S15 Surgical Oncology S1500039 Skin Tumours Amputation 8000 Yes Trust No
S15 Surgical Oncology S1500040 Radical Vaginectomy 30000 Yes Trust No
S15 Surgical Oncology S1500041 Radical Vaginectomy + Reconstruction 35000 Yes Trust No
S15 Surgical Oncology S1500042 Bilateral Pelvic Lymph Node Dissection (BPLND) 20000 Yes Trust No
S15 Surgical Oncology S1500043 Radical Trachelectomy 40000 Yes Trust No
S15 Surgical Oncology S1500044 Vulvectomy with bilateral groin dissection 45000 Yes Trust No
S15 Surgical Oncology S1500045 Limb salvage surgery for bone tumor with prosthesis 70000 Yes Trust No
S15 Surgical Oncology S1500046 Hemipelvectomy 45000 Yes Trust No
S15 Surgical Oncology S1500047 Sacral resection 40000 Yes Trust No
S15 Surgical Oncology S1500048 Chest wall resection with reconstruction for soft tissue / bone tumors 40000 Yes Trust No
S15 Surgical Oncology U100 Unspecified Surgical Package 0 Yes Trust No
S15 Surgical Oncology U100 Unspecified Surgical Package 0 Yes Insurer No
S16 Oral and Maxillofacial S1600001 Fixation of fracture of jaw with closed reduction (1 jaw) using wires - under LA 5000 Yes Trust No
S16 Oral and Maxillofacial S1600002 Fixation of fracture of jaw with open reduction (1 jaw) and fixing of plates/ wire – un 12000 Yes Trust No
S16 Oral and Maxillofacial S1600003 Sequestrectomy 1500 Yes Trust No
S16 Oral and Maxillofacial S1600004 TM joint ankylosis of both jaws - under GA 15000 Yes Trust No
S16 Oral and Maxillofacial S1600005 Release of fibrous bands grafting -in (OSMF) treatment under GA 3000 Yes Trust No
S16 Oral and Maxillofacial S1600006 Extraction of impacted tooth under LA 500 Yes Trust No
S16 Oral and Maxillofacial S1600007 Cyst tumour of Maxilla/mandible by enucleation/excision/marsupialization under LA 2500 Yes Trust No
S16 Oral and Maxillofacial S1600008 Mandible Tumour Resection and reconstruction/Cancer surgery 6000 Yes Trust No
S16 Oral and Maxillofacial S1600009 Cleft lip and palate surgery (each stage) 15000 Yes Trust No
S16 Oral and Maxillofacial U100 Unspecified Surgical Package 0 Yes Trust No
S16 Oral and Maxillofacial U100 Unspecified Surgical Package 0 Yes Insurer No
S2 Otorhinolaryngology S200001 Aural polypectomy 4000 No Trust No
S2 Otorhinolaryngology S200002 Labyrinthectomy 20000 No Trust YES
S2 Otorhinolaryngology S200003 Mastoidectomy 12500 No Trust No
S2 Otorhinolaryngology S200004 Mastoidectomy corticol modified/ radical 11500 No Trust No
S2 Otorhinolaryngology S200005 Mastoidectomy with tympanoplasty 16000 No Trust No
S2 Otorhinolaryngology S200006 Myringoplasty 7500 No Trust No
S2 Otorhinolaryngology S200007 Myringoplasty with Ossiculoplasty 13500 No Trust No
S2 Otorhinolaryngology S200008 Myringotomy – Bilateral 6000 No Trust No
S2 Otorhinolaryngology S200009 Myringotomy – Unilateral 3500 No Trust YES
S2 Otorhinolaryngology S200010 Myringotomy with Grommet - One ear 6500 No Trust No
S2 Otorhinolaryngology S200011 Myrinogotomy with Grommet - Both ear 8500 No Trust YES
S2 Otorhinolaryngology S200012 Ossiculoplasty 9500 No Trust No
S2 Otorhinolaryngology S200013 Partial amputation – Pinna 4000 No Trust YES
S2 Otorhinolaryngology S200014 Excision of Pinna for Growths (Squamous/Basal) Injuries - Total Amputation Excisi 8000 No Trust No
S2 Otorhinolaryngology S200015 Excision of Pinna for Growths (Squamous/Basal) Injuries Total Amputation 6500 No Trust No
S2 Otorhinolaryngology S200016 Stapedectomy 10000 No Trust No
S2 Otorhinolaryngology S200017 Tympanoplasty 9000 No Trust No
S2 Otorhinolaryngology S200018 Vidian neurectomy – Micro 9000 No Trust No
S2 Otorhinolaryngology S200019 Ear lobe repair - single (daycare) 1500 No Trust No
S2 Otorhinolaryngology S200020 Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin and Cartilage 4000 No Trust YES
S2 Otorhinolaryngology S200021 Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skin Only 2500 No Trust No
S2 Otorhinolaryngology S200022 Pharyngectomy and reconstruction 15000 No Trust No
S2 Otorhinolaryngology S200023 Skull base surgery 37000 Yes Trust No
S2 Otorhinolaryngology S200024 Total Amputation Excision of External Auditory Meatus 7500 No Trust No
S2 Otorhinolaryngology S200025 Tympanotomy 4000 No Trust YES
S2 Otorhinolaryngology S200026 Removal of foreign body from ear 3000 No Trust No
S2 Otorhinolaryngology S200027 Aural polypectomy +Tympanoplasty 10000 No Trust No
S2 Otorhinolaryngology S200028 Ant. Ethmoidal artery ligation - open/ endoscopic 11000 No Trust No
S2 Otorhinolaryngology S200029 Antrostomy – Bilateral 8500 No Trust No
S2 Otorhinolaryngology S200030 Antrostomy – Unilateral 6000 No Trust YES
S2 Otorhinolaryngology S200031 Cryosurgery 3000 No Trust No
S2 Otorhinolaryngology S200032 CSF Rhinorrhoea – Repair 14000 No Trust No
S2 Otorhinolaryngology S200033 Septoplasty + FESS 11500 No Trust No
S2 Otorhinolaryngology S200034 Ethmoidectomy – External 11500 No Trust YES
S2 Otorhinolaryngology S200035 Fracture reduction nose with septal correction 8000 No Trust YES
S2 Otorhinolaryngology S200036 Fracture - setting maxilla 8000 No Trust YES
S2 Otorhinolaryngology S200037 Fracture - setting nasal bone 5000 No Trust No
S2 Otorhinolaryngology S200038 Functional Endoscopic Sinus (FESS) 11000 No Trust YES
S2 Otorhinolaryngology S200039 Intra Nasal Ethmoidectomy 5000 No Trust No
S2 Otorhinolaryngology S200040 Rhinotomy – Lateral 7500 No Trust No
S2 Otorhinolaryngology S200041 Nasal polypectomy – Bilateral 9000 No Trust No
S2 Otorhinolaryngology S200042 Nasal polypectomy – Unilateral 6000 No Trust No
S2 Otorhinolaryngology S200043 Turbinectomy Partial – Bilateral 3000 No Trust No
S2 Otorhinolaryngology S200044 Turbinectomy Partial – Unilateral 2000 No Trust No
S2 Otorhinolaryngology S200045 Radical fronto ethmo sphenodectomy 18000 No Trust No
S2 Otorhinolaryngology S200046 Rhinoplasty 15000 No Trust No
S2 Otorhinolaryngology S200047 Septoplasty 5000 No Trust No
S2 Otorhinolaryngology S200048 Youngs operation 3000 No Trust No
S2 Otorhinolaryngology S200049 Angiofibrom Excision 18000 No Trust No
S2 Otorhinolaryngology S200050 Cranio-facial resection 22500 No Trust No
S2 Otorhinolaryngology S200051 Endoscopic DCR 7000 No Trust No
S2 Otorhinolaryngology S200052 Endoscopic Hypophysectomy 21000 No Trust No
S2 Otorhinolaryngology S200053 Intranasal Diathermy 3000 No Trust No
S2 Otorhinolaryngology S200054 Rhinosporidiosis 5000 No Trust No
S2 Otorhinolaryngology S200055 Septo-rhinoplasty 12500 No Trust No
S2 Otorhinolaryngology S200056 Adeno Tonsillectomy 8000 No Trust No
S2 Otorhinolaryngology S200057 Adenoidectomy 5000 No Trust No
S2 Otorhinolaryngology S200058 Arytenoidectomy 10000 No Trust No
S2 Otorhinolaryngology S200059 Choanal atresia 12500 No Trust No
S2 Otorhinolaryngology S200060 Tonsillectomy + Myrinogotomy 10000 No Trust No
S2 Otorhinolaryngology S200061 Pharyngeal diverticulum's – Excision 10000 No Trust No
S2 Otorhinolaryngology S200062 Laryngectomy with block dissection 25000 No Trust No
S2 Otorhinolaryngology S200063 Laryngofissure 5000 No Trust No
S2 Otorhinolaryngology S200064 Laryngophayryngectomy 20000 No Trust No
S2 Otorhinolaryngology S200065 Maxilla – Excision 12500 No Trust No
S2 Otorhinolaryngology S200066 Oro Antral fistula 7500 No Trust No
S2 Otorhinolaryngology S200067 Parapharyngeal – Exploration 12500 No Trust No
S2 Otorhinolaryngology S200068 Parapharyngeal Abscess – Drainage 12500 No Trust No
S2 Otorhinolaryngology S200069 Peritonsillor abscess under LA 2500 No Trust No
S2 Otorhinolaryngology S200070 Pharyngoplasty 10000 No Trust No
S2 Otorhinolaryngology S200071 Retro pharyngeal abscess – Drainage 5000 No Trust No
S2 Otorhinolaryngology S200072 Tonsillectomy + Styloidectomy 10000 No Trust No
S2 Otorhinolaryngology S200073 Thyroglossal Fistula/ cyst – Excision 7000 No Trust No
S2 Otorhinolaryngology S200074 Tonsillectomy – (Uni/ Bilateral) 7500 No Trust No
S2 Otorhinolaryngology S200075 Total Parotidectomy 18000 No Trust No
S2 Otorhinolaryngology S200076 Superficial Parotidectomy 12000 No Trust No
S2 Otorhinolaryngology S200077 Uvulophanyngo Plasty 14000 No Trust No
S2 Otorhinolaryngology S200078 Commondo Operation (glossectomy) 17500 No Trust No
S2 Otorhinolaryngology S200079 Excision of Branchial Cyst 7000 No Trust No
S2 Otorhinolaryngology S200080 Excision of Branchial Sinus 7000 No Trust No
S2 Otorhinolaryngology S200081 Excision of Cystic Hygroma Major/ Extensive 10000 No Trust No
S2 Otorhinolaryngology S200082 Excision of Cystic Hygroma Minor 5000 No Trust No
S2 Otorhinolaryngology S200083 Excision of the Mandible Segmental 7500 No Trust No
S2 Otorhinolaryngology S200084 Hemi-mandibulectomy with graft 15000 No Trust No
S2 Otorhinolaryngology S200085 Hemiglossectomy 6000 No Trust No
S2 Otorhinolaryngology S200086 Palatopharyngoplasty 10000 No Trust No
S2 Otorhinolaryngology S200087 Partial Glossectomy 5000 No Trust No
S2 Otorhinolaryngology S200088 Ranula excision 5000 No Trust No
S2 Otorhinolaryngology S200089 Removal of Submandibular Salivary gland 5000 No Trust No
S2 Otorhinolaryngology S200090 Total Glossectomy 15000 No Trust No
S2 Otorhinolaryngology S200091 Total Laryngectomy + Neck dissection 25000 Yes Trust No
S2 Otorhinolaryngology S200092 Laryngopharyngectomy with Gastric pull-up/ jejunal graft 30000 Yes Trust No
S2 Otorhinolaryngology S200093 Excision of CA cheek/ oral cavity + radial forearm flap 30000 Yes Trust No
S2 Otorhinolaryngology S200094 Excision of growth Jaw + free fibular flap reconstruction 30000 Yes Trust No
S2 Otorhinolaryngology U100 Unspecified Surgical Package 0 Yes Trust No
S2 Otorhinolaryngology U100 Unspecified Surgical Package 0 Yes Insurer No
S3 Opthalmology S300001 Buckle Removal 5000 Yes Trust No
S3 Opthalmology S300002 Canaliculo Dacryocysto Rhinostomy 10000 Yes Trust No
S3 Opthalmology S300003 Capsulotomy (YAG) 1500 Yes Trust No
S3 Opthalmology S300004 Corneal Grafting 8500 Yes Trust No
S3 Opthalmology S300005 Prophylactic Cryoretinopexy- Closed 2500 Yes Trust No
S3 Opthalmology S300006 Cyclocryotherapy/Cyclophotocoagulation 3000 Yes Trust No
S3 Opthalmology S300007 Pterygium + ConjunctivalAutograft 9000 Yes Trust No
S3 Opthalmology S300008 Dacryocystectomy with implants 10000 Yes Trust No
S3 Opthalmology S300009 Enucleation 6000 Yes Trust No
S3 Opthalmology S300010 Enucleation with Implant 11000 Yes Trust No
S3 Opthalmology S300011 Exenteration 15000 Yes Trust No
S3 Opthalmology S300012 Glaucoma Surgery (Trabeculectomy only) with or without Mitomycin C, including pos 10000 Yes Trust No
S3 Opthalmology S300013 Intraocular Foreign Body Removal from Anterior Segment 4000 Yes Trust YES
S3 Opthalmology S300014 Intraocular Foreign Body Removal from Posterior Segment 20000 Yes Trust YES
S3 Opthalmology S300015 Lensectomy /pediatric lens aspiration 9000 Yes Trust No
S3 Opthalmology S300016 Limbal Dermoid Removal 4000 Yes Trust No
S3 Opthalmology S300017 Surgical Membranectomy 8000 Yes Trust No
S3 Opthalmology S300018 Perforating Corneo - Scleral Injury 10000 Yes Trust No
S3 Opthalmology S300019 Ptosis Surgery 10000 Yes Trust YES
S3 Opthalmology S300020 IRIS Prolapse – Repair 4000 Yes Trust No
S3 Opthalmology S300021 Retinal Detachment Surgery 15000 Yes Trust No
S3 Opthalmology S300022 Small Tumour of Lid – Excision + Lid Reconstruction 10000 Yes Trust No
S3 Opthalmology S300023 Socket Reconstruction with amniotic membrane 8000 Yes Trust No
S3 Opthalmology S300024 Iridectomy – Laser 2000 Yes Trust No
S3 Opthalmology S300025 Iridectomy – Surgical 3000 Yes Trust No
S3 Opthalmology S300026 Iris cyst removal 2500 Yes Trust No
S3 Opthalmology S300027 Vitrectomy 7500 Yes Trust No
S3 Opthalmology S300028 Vitrectomy + Retinal Detachment surgery (pre-auth required) 17500 Yes Trust No
S3 Opthalmology S300029 Cataract with foldable hydrophobic acrylic IOL by Phaco emulsification tech 7500 Yes Trust No
S3 Opthalmology S300030 Cataract with non-foldable IOL using SICS technique 5000 Yes Trust No
S3 Opthalmology S300031 Cataract with foldable hydrophobic acrylic IOL by Phaco emulsification tech + Glau 10500 Yes Trust No
S3 Opthalmology S300032 Cataract with non-foldable IOL using SICS technique + Glaucoma 6500 Yes Trust No
S3 Opthalmology S300033 Conjunctival tumour excision + AMG 5000 Yes Trust No
S3 Opthalmology S300034 Entropion correction 4000 Yes Trust No
S3 Opthalmology S300035 Ectropion correction 5000 Yes Trust No
S3 Opthalmology S300036 Evisceration 3500 Yes Trust No
S3 Opthalmology S300037 Laser for retinopathy (per sitting) 1500 Yes Trust No
S3 Opthalmology S300038 Lid tear 5000 Yes Trust No
S3 Opthalmology S300039 Orbitotomy 10000 Yes Trust No
S3 Opthalmology S300040 Squint correction (per muscle) 4000 Yes Trust No
S3 Opthalmology S300041 Anterior Chamber Reconstruction +Perforating corneo - Scleral Injury + IOL 11500 Yes Trust No
S3 Opthalmology S300042 PRP - Retinal Laser including 3 sittings 5000 Yes Trust No
S3 Opthalmology U100 Unspecified Surgical Package 0 Yes Insurer No
S3 Opthalmology U100 Unspecified Surgical Package 0 Yes Trust No
S4 Obstetrics & Gynaecol S400001 Hysterectomy ± Salpingo-oophorectomy 20000 No Trust YES
S4 Obstetrics & Gynaecol S400002 Abdominal Myomectomy 16000 No Trust No
S4 Obstetrics & Gynaecol S400003 Surgeries for Prolapse - Sling Surgeries 16000 No Trust No
S4 Obstetrics & Gynaecol S400004 Surgeries for Stress Incontinence 'Burch' 35000 No Trust No
S4 Obstetrics & Gynaecol S400005 Hysterotomes - 2nd Trimester abortions 5000 No Trust No
S4 Obstetrics & Gynaecol S400006 Incisional Hernia Repair 15000 No Trust No
S4 Obstetrics & Gynaecol S400007 Radical Hysterectomy (Wertheims) 20000 No Trust No
S4 Obstetrics & Gynaecol S400008 Laparotomy and proceed for Ovarian Cancers. Omentomy with Bilateral Salpingo-o 20000 No Trust No
S4 Obstetrics & Gynaecol S400009 Non descent vaginal hysterectomy 14000 No Trust No
S4 Obstetrics & Gynaecol S400010 Vaginal hysterectomy with anterior and posterior colpoperineorrhaphy 16000 No Trust No
S4 Obstetrics & Gynaecol S400011 Vaginal surgical repair for vesico-vaginal fistula 10000 No Trust No
S4 Obstetrics & Gynaecol S400012 Sacrocolpopexy 16000 No Trust No
S4 Obstetrics & Gynaecol S400013 Repair for rectovaginal fitulas 10000 No Trust No
S4 Obstetrics & Gynaecol S400014 Vaginoplasty 10000 No Trust No
S4 Obstetrics & Gynaecol S400015 LLETZ 15000 No Trust No
S4 Obstetrics & Gynaecol S400016 Colpotomy 1200 No Trust No
S4 Obstetrics & Gynaecol S400017 Dilation and Evacuation (D E) 5000 No Trust YES
S4 Obstetrics & Gynaecol S400018 Cervical biopsy and Polypectomy 3000 No Trust YES
S4 Obstetrics & Gynaecol S400019 Bartholins Cyst Enucleation/ Incision drainage 3000 No Trust YES
S4 Obstetrics & Gynaecol S400020 Vulvectomy simple 15000 No Trust No
S4 Obstetrics & Gynaecol S400021 Radical Vulvectomy 15000 No Trust No
S4 Obstetrics & Gynaecol S400022 Diagnostic laparoscopy 11000 No Trust No
S4 Obstetrics & Gynaecol S400023 Laparoscopic hysterectomy (TLH) 20000 No Trust No
S4 Obstetrics & Gynaecol S400024 Laparoscopic myomectomy 15000 No Trust No
S4 Obstetrics & Gynaecol S400025 Laparoscopic cystectomy 15000 No Trust No
S4 Obstetrics & Gynaecol S400026 Laparoscopic ovarotomy 10000 No Trust No
S4 Obstetrics & Gynaecol S400027 Laparoscopic adhesiolysis 6000 No Trust No
S4 Obstetrics & Gynaecol S400028 Laparoscopic tubal surgeries - salpingectomy, salpingotomy 11000 No Trust No
S4 Obstetrics & Gynaecol S400029 Drag hysteroscopy 6000 No Trust No
S4 Obstetrics & Gynaecol S400030 Hysteroscopic myomectomies 6000 No Trust No
S4 Obstetrics & Gynaecol S400031 Hysteroscopic adhesiolysis 6000 No Trust No
S4 Obstetrics & Gynaecol S400032 Hysteroscopic polypectomy 3000 No Trust No
S4 Obstetrics & Gynaecol S400033 Hysteroscopic IUCD removal 3000 No Trust No
S4 Obstetrics & Gynaecol S400034 Caesarian Delivery 9000 No Trust No
S4 Obstetrics & Gynaecol S400035 Caesarian hysterectomy 16000 No Trust No
S4 Obstetrics & Gynaecol S400036 High risk delivery: Pre-mature delivery 9000 Yes Trust No
S4 Obstetrics & Gynaecol S400037 High risk delivery: Expected Gestation at delivery less than 35 weeks 9000 Yes Trust YES
S4 Obstetrics & Gynaecol S400038 High risk delivery: Mothers with eclampsia or imminent eclampsia 9000 Yes Trust No
S4 Obstetrics & Gynaecol S400039 High risk delivery: Obstructed labour 9000 Yes Trust No
S4 Obstetrics & Gynaecol S400040 High risk delivery: Major Fetal malformation requiring intervention immediately after b 9000 Yes Trust YES
S4 Obstetrics & Gynaecol S400041 High risk delivery: Mothers with severe anaemia (<7 g/dL) 9000 Yes Trust YES
S4 Obstetrics & Gynaecol S400042 High risk delivery: Other maternal and fetal conditions as per guidelines 9000 Yes Trust No
S4 Obstetrics & Gynaecol S400043 Manual removal of placenta 5000 No Trust No
S4 Obstetrics & Gynaecol S400044 Laparotomy for ruptured ectopic 10000 No Trust No
S4 Obstetrics & Gynaecol S400045 MTP > 12 weeks 6500 No Trust No
S4 Obstetrics & Gynaecol S400046 MTP upto 12 weeks 5000 No Trust No
S4 Obstetrics & Gynaecol S400047 MTP upto 8 weeks 3500 No Trust No
S4 Obstetrics & Gynaecol S400048 McDonald's stitch 4000 No Trust No
S4 Obstetrics & Gynaecol S400049 Shirodkar's stitch 4000 No Trust No
S4 Obstetrics & Gynaecol S400050 Tuboplasty 10000 No Trust No
S4 Obstetrics & Gynaecol S400051 Laparotomy for broad ligament haematoma 16000 No Trust No
S4 Obstetrics & Gynaecol S400052 Trans-vaginal tape/ Trans-obturator tape 5000 No Trust No
S4 Obstetrics & Gynaecol S400053 Abdominal Perineal neo construction Cx + Uteria + Vagina 20000 No Trust No
S4 Obstetrics & Gynaecol S400054 Ablation of Endometriotic Spot + Adhenolysis 10000 No Trust No
S4 Obstetrics & Gynaecol S400055 Ablation of Endometriotic Spot +Salpingostomy 10000 No Trust No
S4 Obstetrics & Gynaecol S400056 Adhenolysis + Hernia - Ventral - Lipectomy/Incision 16000 No Trust No
S4 Obstetrics & Gynaecol S400057 Adhenolysis+ Ovarian Cystectomy 10000 No Trust No
S4 Obstetrics & Gynaecol S400058 Adhenolysis+ Salpingostomy 10000 No Trust No
S4 Obstetrics & Gynaecol S400059 Broad Ligment Haemotoma drainage 10000 No Trust No
S4 Obstetrics & Gynaecol S400060 Brust abdomen repair 14000 No Trust No
S4 Obstetrics & Gynaecol S400061 Cone Biopsy Cervix 1000 No Trust No
S4 Obstetrics & Gynaecol S400062 Conventional Tubectomy 4000 No Trust YES
S4 Obstetrics & Gynaecol S400063 Cyst -Vaginal Enucleation 3000 No Trust No
S4 Obstetrics & Gynaecol S400064 Cyst-Labial 3000 No Trust No
S4 Obstetrics & Gynaecol S400065 Cystocele - Anterior repair 12000 No Trust No
S4 Obstetrics & Gynaecol S400066 Cystocele - Anterior Repair + Perineal Tear Repair 13000 No Trust No
S4 Obstetrics & Gynaecol S400067 D C (Dilatation curretage) + Electro Cauterisation Cryo Surgery 4000 No Trust No
S4 Obstetrics & Gynaecol S400068 D C (Dilatation curretage) 3000 No Trust No
S4 Obstetrics & Gynaecol S400069 Diagnostic laparoscopy hysteroscopy for infertility 5000 No Trust No
S4 Obstetrics & Gynaecol S400070 Electro Cauterisation Cryo Surgery 4000 No Trust No
S4 Obstetrics & Gynaecol S400071 Exploration of abdominal haematoma (after laparotomy + LSCS) 14000 No Trust No
S4 Obstetrics & Gynaecol S400072 Fractional Curretage 4000 No Trust No
S4 Obstetrics & Gynaecol S400073 Gaping Perineal wound secondary suturing/ episiotomy 2500 No Trust No
S4 Obstetrics & Gynaecol S400074 HaematoColpo/Excision - Vaginal Septum 5000 No Trust No
S4 Obstetrics & Gynaecol S400075 Hymenectomy Repair of Hymen 7000 No Trust No
S4 Obstetrics & Gynaecol S400076 Amniocentesis 5000 No Trust No
S4 Obstetrics & Gynaecol S400077 Chorionic villus sampling 5000 No Trust No
S4 Obstetrics & Gynaecol S400078 Cordocentesis 5000 No Trust No
S4 Obstetrics & Gynaecol S400079 Intrauterine transfusions 10000 No Trust No
S4 Obstetrics & Gynaecol U100 Unspecified Surgical Package 0 Yes Trust No
S4 Obstetrics & Gynaecol U100 Unspecified Surgical Package 0 Yes Insurer No
S5 Orthopaedics S500001 AC joint reconstruction/ Stabilization/ Acromionplasty 25000 Yes Trust No
S5 Orthopaedics S500002 Accessory bone – Excision (limbs) – congenital, Accessory digits sometime can be 6000 Yes Trust No
S5 Orthopaedics S500003 Amputation - Below Elbow 15000 No Trust No
S5 Orthopaedics S500004 Amputation - Above Elbow 15000 No Trust No
S5 Orthopaedics S500005 Amputation – one or more fingers 6000 No Trust No
S5 Orthopaedics S500006 Amputation – Wrist 15000 No Trust No
S5 Orthopaedics S500007 Amputation - one or more toes/ digits 6000 No Trust No
S5 Orthopaedics S500008 Amputation – Below Knee 15000 No Trust No
S5 Orthopaedics S500009 Amputation – Above Knee 18000 No Trust No
S5 Orthopaedics S500010 Foot Hand Amputation (whole/ partial) 15000 No Trust No
S5 Orthopaedics S500011 Disarticulation (hind for quarter) 25000 Yes Trust No
S5 Orthopaedics S500012 Anterior Spine Fixation 35000 Yes Trust No
S5 Orthopaedics S500013 Posterior Spine Fixation 20000 Yes Trust No
S5 Orthopaedics S500014 Osteochondroma excision/ Excision of Exostosis 10000 Yes Trust No
S5 Orthopaedics S500015 Excision Arthoplasty 15000 Yes Trust No
S5 Orthopaedics S500016 Arthorotomy of any joint 15000 No Trust No
S5 Orthopaedics S500017 Arthrodesis Ankle Triple 15000 Yes Trust No
S5 Orthopaedics S500018 Excision Arthoplasty of Femur head 22500 No Trust No
S5 Orthopaedics S500019 Bimalleolar Fracture Fixation 15000 No Trust No
S5 Orthopaedics S500020 Bone Tumour Excision + reconstruction using implant (malignant/ benign) 50000 Yes Trust No
S5 Orthopaedics S500021 Bone Tumour (malignant/ benign) curettage and bone grafting 20000 Yes Trust No
S5 Orthopaedics S500022 Bone Tumour Excision (malignant/ benign) + Joint replacement (depending upon type 150000 Yes Trust No
S5 Orthopaedics S500023 Clavicle fracture management - conservative (daycare) 3000 No Trust No
S5 Orthopaedics S500024 Close Fixation - Hand Bones 4000 No Trust No
S5 Orthopaedics S500025 Close Fixation - Foot Bones 4000 No Trust No
S5 Orthopaedics S500026 Close Reduction - Small Joints 4000 No Trust No
S5 Orthopaedics S500027 Closed Interlock Nailing + Bone Grafting – femur 19000 No Trust No
S5 Orthopaedics S500028 Closed Interlocking Intermedullary 17500 No Trust No
S5 Orthopaedics S500029 Closed Interlocking Tibia + Orif of Fracture Fixation 25000 No Trust No
S5 Orthopaedics S500030 Closed Reduction and Internal Fixation with K wire 6000 No Trust No
S5 Orthopaedics S500031 Closed Reduction and Percutaneous Screw Fixation (neck femur) 15000 No Trust No
S5 Orthopaedics S500032 Closed Reduction and Percutaneous Pinning 15000 No Trust No
S5 Orthopaedics S500033 Closed Reduction and Percutaneous Nailing 20000 No Trust No
S5 Orthopaedics S500034 Closed Reduction of the Hip (including hip Spika) 7000 No Trust No
S5 Orthopaedics S500035 Debridement Closure of Major injuries - contused lacerated wounds (anti-biotic + d 7000 No Trust No
S5 Orthopaedics S500036 Debridement Closure of Minor injuries 3000 No Trust YES
S5 Orthopaedics S500037 Closed reduction of dislocation (Knee/ Hip) 6000 No Trust YES
S5 Orthopaedics S500038 Closed reduction of dislocation (Shoulder/ Elbow) 5000 No Trust YES
S5 Orthopaedics S500039 Duputryen’s Contracture release + rehabilitation 10000 No Trust YES
S5 Orthopaedics S500040 Exploration and Ulnar nerve Repair 10000 No Trust No
S5 Orthopaedics S500041 External fixation - Long bone 15000 No Trust No
S5 Orthopaedics S500042 External fixation - Small bone 10000 No Trust No
S5 Orthopaedics S500043 External fixation - Pelvis 15000 No Trust No
S5 Orthopaedics S500044 Fasciotomy 7000 No Trust No
S5 Orthopaedics S500045 Fixator with Joint Arthrolysis 20000 No Trust No
S5 Orthopaedics S500046 Fracture - Acetabulum 30000 No Trust No
S5 Orthopaedics S500047 Fracture - Fibula Internal Fixation 10000 No Trust No
S5 Orthopaedics S500048 Fracture - Hip Internal Fixation (Intertrochanteric Fracture with implant) + rehabilitati 17000 No Trust No
S5 Orthopaedics S500049 Fracture - Humerus Internal Fixation 17000 No Trust No
S5 Orthopaedics S500050 Fracture - Olecranon of Ulna 10000 No Trust No
S5 Orthopaedics S500051 Fracture - Radius Internal Fixation 10000 No Trust No
S5 Orthopaedics S500052 Fracture - TIBIA Internal Fixation plating 17000 No Trust No
S5 Orthopaedics S500053 Fracture - Ulna Internal Fixation 10000 No Trust No
S5 Orthopaedics S500054 Head Radius – Excision 8000 No Trust YES
S5 Orthopaedics S500055 High Tibial Osteotomy 17000 No Trust No
S5 Orthopaedics S500056 Closed reduction + Hip Spica 7000 No Trust No
S5 Orthopaedics S500057 Internal Fixation Lateral Epicondyle 10000 No Trust No
S5 Orthopaedics S500058 Internal Fixation of other Small Bones (metatarsals) 10000 No Trust No
S5 Orthopaedics S500059 Limb Lengthening 25000 No Trust No
S5 Orthopaedics S500060 Llizarov Fixation 10000 No Trust No
S5 Orthopaedics S500061 Multiple Tendon Repair 20000 Yes Trust No
S5 Orthopaedics S500062 Nerve Repair Surgery 15000 Yes Trust No
S5 Orthopaedics S500063 Nerve Transposition/Release/ Neurolysis 8000 No Trust No
S5 Orthopaedics S500064 Open Reduction Internal Fixation (2 Small Bones) 10000 No Trust No
S5 Orthopaedics S500065 Open Reduction Internal Fixation (Large Bone) 20000 No Trust No
S5 Orthopaedics S500066 Open Reduction of CDH 30000 No Trust No
S5 Orthopaedics S500067 Open Reduction of Small Joint 15000 No Trust No
S5 Orthopaedics S500068 Open Reduction with bone grafting of nonunion 20000 No Trust No
S5 Orthopaedics S500069 Osteotomy -Small Bone 17000 No Trust No
S5 Orthopaedics S500070 Osteotomy -Long Bone 30000 No Trust No
S5 Orthopaedics S500071 Patellectomy 8000 No Trust No
S5 Orthopaedics S500072 Pelvic Osteotomy with fixation with plaster 30000 No Trust No
S5 Orthopaedics S500073 Percutaneous - Fixation of Fracture 7000 No Trust No
S5 Orthopaedics S500074 Excision of Bursa 3000 No Trust YES
S5 Orthopaedics S500075 Reconstruction of ACL/PCL with implant and brace 30000 Yes Trust No
S5 Orthopaedics S500076 Sequestrectomy of Long Bones + anti-biotics + dressing 25000 No Trust No
S5 Orthopaedics S500077 Tendo Achilles Tenotomy 5000 No Trust No
S5 Orthopaedics S500078 Tendon Grafting 15000 No Trust No
S5 Orthopaedics S500079 Tendon Release/ Tenotomy 5000 No Trust No
S5 Orthopaedics S500080 Tenolysis 5000 No Trust No
S5 Orthopaedics S500081 Tension Band Wiring Patella 15000 No Trust No
S5 Orthopaedics S500082 Application of P.O.P. casts for Upper Lower Limbs 3000 No Trust YES
S5 Orthopaedics S500083 Application of P.O.P. Spikas Jackets 3500 No Trust YES
S5 Orthopaedics S500084 Application of Skeletal Tractions with pin 3000 No Trust YES
S5 Orthopaedics S500085 Application of Skin Traction 1000 No Trust YES
S5 Orthopaedics S500086 Head radius - Excision + Fracture - Ulna Internal Fixation 20000 No Trust No
S5 Orthopaedics S500087 External fixation - both bones of forearms 25000 No Trust No
S5 Orthopaedics S500088 Fracture intercondylarHumerus + olecranon osteotomy 20000 No Trust No
S5 Orthopaedics S500089 Correction of club foot per cast 15000 No Trust YES
S5 Orthopaedics S500090 Arthroscopic Meniscus Repair/ Meniscectomy 20000 Yes Trust No
S5 Orthopaedics S500091 Total Hip Replacement (cemented) 75000 Yes Trust No
S5 Orthopaedics S500092 Total Hip Replacement (cementless) 90000 Yes Trust No
S5 Orthopaedics S500093 Total Hip Replacement (hybrid) 75000 Yes Trust No
S5 Orthopaedics S500094 Bipolar Hemiarthroplasty (hip shoulder) 40000 Yes Trust No
S5 Orthopaedics S500095 Unipolar Hemiarthroplasty 30000 Yes Trust No
S5 Orthopaedics S500096 Total Knee Replacement 80000 Yes Trust No
S5 Orthopaedics S500097 Elbow replacement 40000 Yes Trust No
S5 Orthopaedics S500098 Arthrodesis of shoulder 40000 Yes Trust No
S5 Orthopaedics S500099 Arthrodesis of Knee (with implant) 40000 Yes Trust No
S5 Orthopaedics S500100 Arthrodesis of Wrist (with implant) 30000 Yes Trust No
S5 Orthopaedics S500101 Arthrodesis of Ankle (with implant) 30000 Yes Trust No
S5 Orthopaedics U100 Unspecified Surgical Package 0 Yes Insurer No
S5 Orthopaedics U100 Unspecified Surgical Package 0 Yes Trust No
S6 Polytrauma S600001 Nerve Plexus injuries, Tendon injury repair/reconstruction/ Transfer 50000 No Trust No
S6 Polytrauma S600002 Plexus injury along with Vascular injury repair/ graft 60000 No Trust No
S6 Polytrauma S600003 Internal fixation with Flap cover Surgery for wound in compound fracture 40000 No Trust No
S6 Polytrauma S600004 Head injury requiring Facio-Maxillary Injury repairs fixations (including implants) 35000 No Trust No
S6 Polytrauma S600005 Internal fixation of Pelviacetabular fracture 40000 No Trust No
S6 Polytrauma S600006 Craniotomy and evacuation of Haematoma – subdural/Extra dural along with fixation o 60000 No Trust No
S6 Polytrauma S600007 Craniotomy and evacuation of Haematoma – subdural/Extra dural along with fixation o 75000 No Trust No
S6 Polytrauma S600008 Visceral injury requiring surgical intervention along with fixation of fracture of single 30000 No Trust No
S6 Polytrauma S600009 Visceral injury requiring surgical intervention along with fixation of fracture of 2 or m 45000 No Trust No
S6 Polytrauma S600010 Chest injury with one fracture of long bone (with implants) 35000 No Trust No
S6 Polytrauma S600011 Chest injury with fracture of 2 or more long bones 45000 No Trust No
S6 Polytrauma S600012 Emergency tendons repair ± Peripheral Nerve repair/ reconstructive surgery 30000 No Trust No
S6 Polytrauma U100 Unspecified Surgical Package 0 Yes Insurer No
S6 Polytrauma U100 Unspecified Surgical Package 0 Yes Trust No
S7 Urology S700001 Adrenalectomy-unilateral, open 25000 No Trust No
S7 Urology S700002 Adrenalectomy-unilateral, Laparoscopic 30000 No Trust No
S7 Urology S700003 Adrenalectomy-bilateral, open 32000 No Trust No
S7 Urology S700004 Adrenalectomy-biilateral, Laparoscopic 40000 No Trust No
S7 Urology S700005 Paraganglioma excision with liver mobilization 50000 No Trust No
S7 Urology S700006 Nephrectomy (Benign) Open 25000 No Trust No
S7 Urology S700007 Nephrectomy (Benign) Laparoscopic 30000 No Trust No
S7 Urology S700008 Nephrectomy-Radical (Renal tumor) Open 25000 No Trust No
S7 Urology S700009 Nephrectomy-Radical (Renal tumor) Laparoscopic 30000 No Trust No
S7 Urology S700010 Nephrectomy-Partial or Hemi, Open 30000 No Trust No
S7 Urology S700011 Nephrectomy-Partial or Hemi, Laparoscopic 35000 No Trust No
S7 Urology S700012 Nephro ureterectomy (Benign) Open 25000 No Trust No
S7 Urology S700013 Nephro ureterectomy (Benign) Laparoscopic 30000 No Trust No
S7 Urology S700014 Nephro ureterectomy with cuff of bladder Open 30000 No Trust No
S7 Urology S700015 Nephro ureterectomy with cuff of bladder Laparoscopic 35000 No Trust No
S7 Urology S700016 Pyeloplasty/pyeloureterostomy/pyelopyelostomy Open 25000 No Trust No
S7 Urology S700017 Pyeloplasty/pyeloureterostomy/pyelopyelostomy Laparoscopic 30000 No Trust No
S7 Urology S700018 Endopyelotomy (retrograde with laser/bugbee) 25000 No Trust No
S7 Urology S700019 Endopyelotomy (antegrade with laser/bugbee) 28000 No Trust No
S7 Urology S700020 Ureterocalycostomy Open 25000 No Trust No
S7 Urology S700021 Ureterocalycostomy Laparoscopic 30000 No Trust No
S7 Urology S700022 Uretero-ureterostomy Open 25000 No Trust No
S7 Urology S700023 Uretero-ureterostomy Laparoscopic 35000 No Trust No
S7 Urology S700024 PCNL (Percutaneous Nephrolithotomy) - Bilateral 40000 No Trust No
S7 Urology S700025 PCNL (Percutaneous Nephrolithotomy) - Unilateral 25000 No Trust No
S7 Urology S700026 Extracoporeal shock-wave Lithotripsy (SWL) stone, with or without stent (one side) 13000 No Trust No
S7 Urology S700027 Extracoporeal shock-wave Lithotripsy (SWL) stone, with or without stent (both sides) 26000 No Trust No
S7 Urology S700028 Pyelolithotomy-Open 20000 No Trust No
S7 Urology S700029 Pyelolithotomy-Laparoscopic 30000 No Trust No
S7 Urology S700030 Nephrolithotomy-Open 20000 No Trust No
S7 Urology S700031 Anatrophic nephrolithotomy 30000 No Trust No
S7 Urology S700032 Perinephric Abscess drainage (percutaneous) 10000 No Trust No
S7 Urology S700033 Perinephric Abscess drainage (Open) 20000 No Trust No
S7 Urology S700034 Renal Cyst deroofing or marsupialization-Open 20000 No Trust No
S7 Urology S700035 Renal Cyst deroofing or marsupialization-Laparoscopic 30000 No Trust No
S7 Urology S700036 Nephrostomy-percutaneous ultrasound guided 10000 No Trust No
S7 Urology S700037 Ureterolithotomy-Open 20000 No Trust No
S7 Urology S700038 Ureterolithotomy-Laparoscopic 30000 No Trust No
S7 Urology S700039 Ureteroscopy+stone removal with lithotripsy, lower ureter, unilateral 20000 No Trust No
S7 Urology S700040 Ureteroscopy+stone removal with lithotripsy, upper ureter, unilateral 25000 No Trust No
S7 Urology S700041 Ureteroscopy+stone removal with lithotripsy, bilateral 30000 No Trust No
S7 Urology S700042 Ureterotomy (Cutaneous) 20000 No Trust No
S7 Urology S700043 Endoureterotomy (laser/bugbee) 20000 No Trust No
S7 Urology S700044 Ureteric reimplantation-unilateral-open 20000 No Trust No
S7 Urology S700045 Ureteric reimplantation-bilateral-open 25000 No Trust No
S7 Urology S700046 Ureteric reimplantation-unilateral-Laparoscopic 30000 No Trust No
S7 Urology S700047 Ureteric reimplantation-bilateral-Laparoscopic 35000 No Trust No
S7 Urology S700048 Uretero-vaginal/uterine fistula repair open 27000 No Trust No
S7 Urology S700049 Uretero-vaginal/uterine fistula repair Laparoscopic 37000 No Trust No
S7 Urology S700050 Ureterolysis-open, for retroperitoneal fibrosis (with or without omental wrapping) 20000 No Trust No
S7 Urology S700051 Ureterolysis-Laparoscopic, for retroperitoneal fibrosis (with or without omental wrapp 30000 No Trust No
S7 Urology S700052 Boari flap for ureteric stricture, open 30000 No Trust No
S7 Urology S700053 Boari flap for ureteric stricture, Laparoscopic 40000 No Trust No
S7 Urology S700054 Ileal replacement for ureteric stricture 40000 No Trust No
S7 Urology S700055 DJ stent unilateral including cystoscopy, ureteric catheterization, retrograde pyelogr 10000 No Trust No
S7 Urology S700056 DJ stent bilateral including cystoscopy, ureteric catheterization, retrograde pyelogra 10000 No Trust No
S7 Urology S700057 Ureteric sampling including cystoscopy, ureteric catheterization, retrograde pyelogr 10000 No Trust No
S7 Urology S700058 Ureterocele incision including cystoscopy, ureteric catheterization, retrograde pyelo 15000 No Trust No
S7 Urology S700059 Urachal Cyst excision -open 15000 No Trust No
S7 Urology S700060 Cystolithotomy-open, including cystoscopy 15000 No Trust No
S7 Urology S700061 Cystolithotripsy/Urethral Stone endoscopic, including cystoscopy 15000 No Trust No
S7 Urology S700062 TURBT (Transurethral Resection of the Bladder Tumor) 25000 No Trust No
S7 Urology S700063 TUR-fulgration (Transurethral fulgration of the Bladder Tumor) 18000 No Trust No
S7 Urology S700064 Intravesical BCG/Mitomycin 6 induction cycles (weekly for 6 weeks-total cost of 6 cy 12000 No Trust No
S7 Urology S700065 Intravesical BCG/Mitomycin maintenance for 12 doses (total cost of 12 doses) 24000 No Trust No
S7 Urology S700066 Post TURBT - Check Cystoscopy (Per sitting) with or without cold-cup biopsy 10000 No Trust No
S7 Urology S700067 Diagnostic Cystoscopy 5000 No Trust No
S7 Urology S700068 Bladder Neck incision-endoscopic 15000 No Trust No
S7 Urology S700069 Extrophy Bladder repair including osteotomy if needed + epispadias repair + ureteric 50000 No Trust No
S7 Urology S700070 Bladder injury repair (as an independent procedure with or without urethral injury) 20000 No Trust No
S7 Urology S700071 Bladder injury repair (only to be used if done as a part of ongoing laparotomy/other 10000 No Trust No
S7 Urology S700072 Bladder injury repair with colostomy (as an independent procedure with or without ure 25000 No Trust No
S7 Urology S700073 Partial Cystectomy-open 20000 No Trust No
S7 Urology S700074 Partial Cystectomy-Laparoscopic 30000 No Trust No
S7 Urology S700075 Radical cystectomy with neobladder-open 50000 No Trust No
S7 Urology S700076 Radical cystectomy with continent diversion-open 50000 No Trust No
S7 Urology S700077 Radical Cystectomy with Ileal Conduit-open 50000 No Trust No
S7 Urology S700078 Radical Cystectomy with ureterostomy-open 35000 No Trust No
S7 Urology S700079 Radical Cystectomy with ureterosigmoidostomy-open 35000 No Trust No
S7 Urology S700080 Other Cystectomies 30000 No Trust No
S7 Urology S700081 Suprapubic Cystostomy - Open, as an independent procedure 10000 No Trust No
S7 Urology S700082 Suprapubic Drainage - Closed/Trocar 5000 No Trust No
S7 Urology S700083 VVF/Uterovaginal Repair - Transvaginal approach 25000 No Trust No
S7 Urology S700084 VVF/Uterovaginal Repair - Abdominal,Open 25000 No Trust No
S7 Urology S700085 VVF/Uterovaginal Repair - Abdominal, Laparoscopic 30000 No Trust No
S7 Urology S700086 Hysterectomy as part of VVF/uterovaginal fistula repair (top-up) 5000 No Trust No
S7 Urology S700087 Urethrovaginal fistula repair 30000 No Trust No
S7 Urology S700088 Y V Plasty of Bladder Neck/Bladder Neck Reconstruction 20000 No Trust No
S7 Urology S700089 Augmentation cystoplasty-open 30000 No Trust No
S7 Urology S700090 Augmentation cystoplasty-Laparoscopic 40000 No Trust No
S7 Urology S700091 Open bladder diverticulectomy with/without ureteric re-implantation 25000 No Trust No
S7 Urology S700092 Open simple prostatetctomy for BPH 25000 No Trust No
S7 Urology S700093 TURP-Transurethral Resection of the Prostate, BPH, Monopolar/Bipolar/Laser 25000 No Trust No
S7 Urology S700094 Holmium Laser Prostatectomy 40000 No Trust No
S7 Urology S700095 TURP/Laser + Circumcision 30000 No Trust No
S7 Urology S700096 TURP/Laser + Cystolithotripsy 30000 No Trust No
S7 Urology S700097 TURP/Laser + Cystolithotomy-open 35000 No Trust No
S7 Urology S700098 TURP/Laser + Orchidectomy 30000 No Trust No
S7 Urology S700099 TURP/Laser + TURBT 30000 No Trust No
S7 Urology S700100 TURP/Laser + URS with stone removal 40000 No Trust No
S7 Urology S700101 TURP/Laser + VIU (visual internal Ureterotomy) 40000 No Trust No
S7 Urology S700102 TURP/Laser + Hydrocele surgery 40000 No Trust No
S7 Urology S700103 TURP/Laser + Hernioplasty 40000 No Trust No
S7 Urology S700104 TURP/Laser + Urethral dilatation-non endoscopic 40000 No Trust No
S7 Urology S700105 TURP/Laser + Urethral dilatation-endoscopic 40000 No Trust No
S7 Urology S700106 Radical prostatectomy - open 50000 No Trust No
S7 Urology S700107 Radical prostatectomy - laparoscopic 70000 No Trust No
S7 Urology S700108 Transrectal Ultrasound guided prostate biopsy (minimum 12 core) 10000 No Trust No
S7 Urology S700109 Reduction of Paraphimosis 2000 No Trust No
S7 Urology S700110 Excision of Urethral Caruncle 6000 No Trust No
S7 Urology S700111 Meatoplasty 3500 No Trust No
S7 Urology S700112 Meatotomy 3500 No Trust No
S7 Urology S700113 Post Urethral Valve fulguration 10000 No Trust No
S7 Urology S700114 Urethroplasty-End to end 20000 No Trust No
S7 Urology S700115 Urethroplasty-Substitution-single stage 30000 No Trust No
S7 Urology S700116 Urethroplasty-Substitution-two stage 35000 No Trust No
S7 Urology S700117 Urethroplasty-Transpubic 30000 No Trust No
S7 Urology S700118 Urethroplasty-two stage without substitution 30000 No Trust No
S7 Urology S700119 Perineal Urethrostomy without closure 20000 No Trust No
S7 Urology S700120 Urethrorectal fistula repair 40000 No Trust No
S7 Urology S700121 Urethral Dilatation-non endocopic as an independent procedure 2000 No Trust No
S7 Urology S700122 Urethral Dilatation-endocopic as an independent procedure 5000 No Trust No
S7 Urology S700123 Internal Ureterotomy including cystoscopy as an independent procedure 10000 No Trust No
S7 Urology S700124 Hypospadias repair-single stage 20000 No Trust No
S7 Urology S700125 Hypospadias repair-two or more stage 30000 No Trust No
S7 Urology S700126 Orchiopexy-without laparoscopy, unilateral 15000 No Trust No
S7 Urology S700127 Orchiopexy-without laparoscopy, bilateral 15000 No Trust No
S7 Urology S700128 Orchiopexy-with laparoscopy, unilateral 30000 No Trust No
S7 Urology S700129 Orchiopexy-with laparoscopy, bilateral 30000 No Trust No
S7 Urology S700130 Stress incontinence surgery, open 20000 No Trust No
S7 Urology S700131 Stress incontinence surgery, laparoscopic 30000 No Trust No
S7 Urology S700132 Stress incontinence surgery with slings 35000 No Trust No
S7 Urology S700133 Partial Penectomy 15000 No Trust No
S7 Urology S700134 Total Penectomy + Perineal Urethrostomy 20000 No Trust No
S7 Urology S700135 Ilio-Inguinal lymphadenectomy-unilateral 15000 No Trust No
S7 Urology S700136 Ilio-Inguinal lymphadenectomy-bilateral 25000 No Trust No
S7 Urology S700137 Pelvic lymphadenectomy open, after prior cancer surgery 25000 No Trust No
S7 Urology S700138 Pelvic lymphadenectomy laparoscopic, after prior cancer surgery 30000 No Trust No
S7 Urology S700139 Orchiectomy-High inguinal 12000 No Trust No
S7 Urology S700140 Orchiectomy-simple 10000 No Trust No
S7 Urology S700141 Bilateral Orchidectomy for hormone ablation 10000 No Trust No
S7 Urology S700142 Retroperitoneal lymph node dissection-open 25000 No Trust No
S7 Urology S700143 Retroperitoneal lymph node dissection-Laparoscopic 35000 No Trust No
S7 Urology S700144 Infertility-Scrotal exploration unilateral 10000 No Trust No
S7 Urology S700145 Infertility-Scrotal exploration bilateral 12000 No Trust No
S7 Urology S700146 Infertility-Vasoepididymostomy, microsurgical, unilateral 15000 No Trust No
S7 Urology S700147 Infertility-Vasoepididymostomy, microsurgical, bilateral 20000 No Trust No
S7 Urology S700148 Varicocele-unilateral-non microsurgical 10000 No Trust No
S7 Urology S700149 Varicocele-unilateral-microsurgical 12000 No Trust No
S7 Urology S700150 Varicocele-bilateral-non microsurgical 15000 No Trust No
S7 Urology S700151 Varicocele-bilateral-microsurgical 20000 No Trust No
S7 Urology S700152 Penile prosthesis insertion, Malleable (Indian implant) 30000 No Trust No
S7 Urology S700153 Priapism-aspiration/shunt 15000 No Trust No
S7 Urology S700154 Neurogenic bladder-Package for evaluation/investigation (catheter + ultrasound + cu 7500 Yes Trust No
S7 Urology S700155 Chronic prostatitis-Package for evaluation/investigation (ultrasound + culture + pro 2500 Yes Trust No
S7 Urology S700156 Emergency management of Ureteric stone - Package for evaluation/investigation (ult 3500 Yes Trust No
S7 Urology S700157 Emergency management of Hematuria 0 Yes Trust No
S7 Urology S700158 Emergency management of Acute retention of Urine 0 Yes Trust No
S7 Urology S700159 Acute management of upper urinary tract trauma – conservative 0 Yes Trust No
S7 Urology S700160 Urinary tract trauma – open surgery (exploratory) 20000 No Trust No
S7 Urology S700161 Urinary tract trauma – Laparoscopy surgery 30000 No Trust No
S7 Urology U100 Unspecified Surgical Package 0 Yes Insurer No
S7 Urology U100 Unspecified Surgical Package 0 Yes Trust No
S8 Neurosurgery S800001 Anterior Encephalocele 50000 No Trust No
S8 Neurosurgery S800002 Burr hole 7000 No Trust No
S8 Neurosurgery S800003 Burr hole with chronic Sub Dural Haematoma (including pre and post Op. CT) 20000 No Trust No
S8 Neurosurgery S800004 Carpal Tunnel Release including pre and post Op. MRI 10000 No Trust No
S8 Neurosurgery S800005 Cervical Ribs – Bilateral 35000 No Trust No
S8 Neurosurgery S800006 Cervical Ribs – Unilateral 20000 No Trust No
S8 Neurosurgery S800007 CranioPlasty - Endogenous graft 20000 Yes Trust No
S8 Neurosurgery S800008 CranioPlasty - Exogenous graft 20000 Yes Trust No
S8 Neurosurgery S800009 Craniostenosis 28000 No Trust No
S8 Neurosurgery S800010 Duroplasty - Endogenous 12500 No Trust No
S8 Neurosurgery S800011 Duroplasty - Exogenous 12500 No Trust No
S8 Neurosurgery S800012 Haematoma - Brain (head injuries) (including pre and post Op. CT) 55000 No Trust No
S8 Neurosurgery S800013 Haematoma - Brain (hypertensive) 50000 No Trust No
S8 Neurosurgery S800014 Haematoma (Child subdural) inclusive of General anaesthesia, pre and post Op. CT 50000 No Trust No
S8 Neurosurgery S800015 Laminectomy with Fusion and fixation 50000 No Trust No
S8 Neurosurgery S800016 Laminectomy with Fusion 40000 No Trust No
S8 Neurosurgery S800017 Local Neurectomy 16000 No Trust No
S8 Neurosurgery S800018 Lumbar Disc including pre and post Op. MRI 30000 No Trust No
S8 Neurosurgery S800019 Meningocele – Anterior 36000 No Trust No
S8 Neurosurgery S800020 Meningocele – Lumbar 36000 No Trust No
S8 Neurosurgery S800021 Meningococcal – Occipital 50000 No Trust No
S8 Neurosurgery S800022 Micro discectomy – Cervical 40000 No Trust No
S8 Neurosurgery S800023 Micro discectomy – Lumbar 40000 No Trust No
S8 Neurosurgery S800024 Brachial Plexus – Repair 27000 No Trust No
S8 Neurosurgery S800025 Shunt (peritoneal, ventriculo-atrial/ peritoneal, theco peritoneal) 30000 No Trust No
S8 Neurosurgery S800026 Skull Traction 8000 No Trust No
S8 Neurosurgery S800027 Spine - Canal Stenosis 40000 No Trust No
S8 Neurosurgery S800028 Spine - Decompression Fusion 40000 No Trust No
S8 Neurosurgery S800029 Spine - Decompression Fusion with fixation 50000 No Trust No
S8 Neurosurgery S800030 Spine - Extradural Tumour 30000 No Trust No
S8 Neurosurgery S800031 Spine - Extradural Tumour with fixation 40000 No Trust No
S8 Neurosurgery S800032 Spine - Extradural Haematoma 30000 No Trust No
S8 Neurosurgery S800033 Spine - Extradural Haematoma with fixation 40000 No Trust No
S8 Neurosurgery S800034 Spine - Intradural Tumour 40000 No Trust No
S8 Neurosurgery S800035 Spine - Intradural Tumour with fixation 50000 No Trust No
S8 Neurosurgery S800036 Spine - Intradural Haematoma 40000 No Trust No
S8 Neurosurgery S800037 Spine - Intradural Haematoma with fixation 50000 No Trust No
S8 Neurosurgery S800038 Spine - Intramedullar Tumour 50000 No Trust No
S8 Neurosurgery S800039 Spine - Intramedullar Tumour - fixation 60000 No Trust No
S8 Neurosurgery S800040 Trans Sphenoidal including pre and post Op. MRI 50000 No Trust No
S8 Neurosurgery S800041 Tumours – Supratentorial 50000 Yes Trust No
S8 Neurosurgery S800042 Tumours Meninges – Gocussa 50000 Yes Trust No
S8 Neurosurgery S800043 Tumours Meninges – Posterior 50000 Yes Trust No
S8 Neurosurgery S800044 Ventricular Puncture 15000 No Trust No
S8 Neurosurgery S800045 Brain Biopsy 15000 No Trust No
S8 Neurosurgery S800046 Cranial Nerve Anastomosis 32000 No Trust No
S8 Neurosurgery S800047 Depressed Fracture 40000 No Trust No
S8 Neurosurgery S800048 Nerve Biopsy excluding Hensens 7000 No Trust No
S8 Neurosurgery S800049 Peripheral Neurectomy (Trigeminal) 16500 No Trust No
S8 Neurosurgery S800050 R.F. Lesion for Trigeminal Neuralgia 16500 No Trust No
S8 Neurosurgery S800051 Twist Drill Craniostomy 15000 No Trust No
S8 Neurosurgery S800052 Excision of Brain TumorSupratentorial-Parasagital 50000 Yes Trust No
S8 Neurosurgery S800053 Excision of Brain TumorSupratentorial-Basal 50000 Yes Trust No
S8 Neurosurgery S800054 Excision of Brain TumorSupratentorial-Brainstem 50000 Yes Trust No
S8 Neurosurgery S800055 Excision of Brain TumorSupratentorial-C P Angle 50000 Yes Trust No
S8 Neurosurgery S800056 Excision of Brain TumorSupratentorial others 55000 Yes Trust No
S8 Neurosurgery S800057 Abscess Tapping single 20000 No Trust No
S8 Neurosurgery S800058 Abscess Tapping multiple 30000 No Trust No
S8 Neurosurgery S800059 Excision of Brain Abscess 36000 Yes Trust No
S8 Neurosurgery S800060 Aneurysm Clipping including angiogram 65000 Yes Trust No
S8 Neurosurgery S800061 Additonal clip for Aneurysm Clipping 15000 Yes Trust No
S8 Neurosurgery S800062 External Ventricular Drainage (EVD) including antibiotics 30000 Yes Trust No
S8 Neurosurgery S800063 Spinal Fusion Procedure with implant 40000 Yes Trust No
S8 Neurosurgery S800064 Spina Bifida Surgery 36000 No Trust No
S8 Neurosurgery S800065 Stereotactic Lesioning 60000 Yes Trust No
S8 Neurosurgery S800066 Posterior Cervical Discetomy without implant 30000 No Trust No
S8 Neurosurgery S800067 Posterior Cervical Fusion with implant (Lateral mass fixation) 50000 Yes Trust No
S8 Neurosurgery S800068 Cervical Disc Multiple level without Fusion 40000 Yes Trust No
S8 Neurosurgery S800069 Thoracic/Lumbar Corpectomy with fusion inclusive of implant 60000 Yes Trust No
S8 Neurosurgery S800070 Transoral surgery (Anterior) and CV Junction (Posterior Sterlization) 55000 Yes Trust No
S8 Neurosurgery S800071 Trans oral Surgery 40000 No Trust No
S8 Neurosurgery S800072 Foramen Magnum Decompression 45000 No Trust No
S8 Neurosurgery S800073 Endoscopic CSF Rhinorrhea Repair 30000 No Trust No
S8 Neurosurgery S800074 Muscle Biopsy with report 7000 No Trust No
S8 Neurosurgery S800075 Nerve Decompression 16000 No Trust No
S8 Neurosurgery S800076 Peripheral Nerve Surgery Major 30000 Yes Trust No
S8 Neurosurgery S800077 Peripheral Nerve Surgery Minor 15000 Yes Trust No
S8 Neurosurgery S800078 Epilepsy Surgery 50000 Yes Trust No
S8 Neurosurgery S800079 Arterio venous malformation (AVM) excision (whatever size and location) 50000 Yes Trust No
S8 Neurosurgery S800080 Scalp Arterio venous malformation (AVM) 25000 Yes Trust No
S8 Neurosurgery S800081 Superficial Temporal Artery (STA): middle cerebral artery (MCA) or (other EC - IC) 60000 Yes Trust No
S8 Neurosurgery S800082 Excision of Orbital Tumour 40000 Yes Trust No
S8 Neurosurgery S800083 Gamma Knife radiosurgery (GKRS)/ SRS for tumours/ Arteriovenous malformation 75000 Yes Trust No
S8 Neurosurgery U100 Unspecified Surgical Package 0 Yes Trust No
S8 Neurosurgery U100 Unspecified Surgical Package 0 Yes Insurer No
S9 Interventional Neurora S900001 Coil embolization for aneurysms (includes cost of first 3 coils + balloon and/ or stent 100000 Yes Trust No
S9 Interventional Neurora S900002 Additional coil for coil embolization for aneurysms 24000 Yes Trust No
S9 Interventional Neurora S900003 Dural AVMs/AVFs (per sitting) with glue 70000 Yes Trust No
S9 Interventional Neurora S900004 Dural AVMs/AVFs (per sitting) with onyx 150000 Yes Trust No
S9 Interventional Neurora S900005 Carotico-cavernous Fistula (CCF) embolization with coils. 150000 Yes Trust No
S9 Interventional Neurora S900006 Carotid-cavernous Fistula (CCF) embolization with balloon 75000 Yes Trust No
S9 Interventional Neurora S900007 Cerebral Spinal AVM embolization (per sitting). Using Histoacryl 100000 Yes Trust No
S9 Interventional Neurora S900008 Parent vessel occlusion - Basic 30000 Yes Trust No
S9 Interventional Neurora S900009 Additonal coil for Parent Vessel Occlusion 24000 Yes Trust No
S9 Interventional Neurora S900010 Additonal balloon for Parent Vessel Occlusion 11000 Yes Trust No
S9 Interventional Neurora S900011 Balloon test occlusion 70000 Yes Trust No
S9 Interventional Neurora S900012 Intracranial balloon angioplasty with stenting 160000 Yes Trust No
S9 Interventional Neurora S900013 Intracranial thrombolysis / clot retrieval 160000 Yes Trust No
S9 Interventional Neurora S900014 Pre-operative tumour embolization (per session) 40000 Yes Trust No
S9 Interventional Neurora S900015 Vertebroplasty 40000 Yes Trust No
S9 Interventional Neurora U100 Unspecified Surgical Package 0 Yes Insurer No
S9 Interventional Neurora U100 Unspecified Surgical Package 0 Yes Trust No