Sri Ganga Ram Policy - From Apps Portal PDF

Sir Ganga Ram Hospital
Schedule of Charges (2018-19)
Bed Charges
SNo Bed Category Amount (Rs.)
1 Birthing Suite (LR) 12600

2 Category 1-A (Premium Suite) 20000
3 Category 1-B (Suite) 17000
4 Category 1-C (Deluxe) 12600
5 Category 1-D (Single Room) 9500
6 Category 2 7000
7 Category 3 5250
8 Category 3 ( Paediatric ) 3300
9 Daycare 3000
10 Daycare ( Paediatric ) 1850
11 OT Daycare Over Night Stay 6000
12 Joint Replacement Category 1 10500
13 Joint Replacement Category 3 6250
14 Kidney Transplant 10500
15 Medical Treatment Room 3000
16 Nursery Category 1 5500
Intensive care charges
SNo Service Area Code Cat-1D Cat-2 Cat-3
1 CCU / IMCU monitoring charges INTMONCHCCU 13900 11600 9300

2 HDU monitoring charges INTMONCHHDU 12200 9700 7500
3 ICU monitoring charges INTMONCHICU 13900 11600 9300
4 Liver Transplant unit monitoring charges INTMONCHLTU 13900 11600 9300
5 Paediatric ICU monitoring charges INTMONCHPICU 13900 11600 9300
6 Post-operative ICU monitoring charges INTMONCHPOICU 13900 11600 9300
7 Thoracic HDU monitoring charges INTMONCHTHDU 9650 9650 9650
Note: All these charges are for providing intensive care monitoring including the bed charges, which will
be applicable depending upon the category of accommodation at the time of admission or at the time of
shifting i n these areas.
1
Other Special Care Charges
Cat-1C / D
Premium
All Cat
Cat-1A
Cat-1B
Cat-2
Cat-3
SNo Service Area
Suite
1 Labour room charges for delivery 4600 4600 4600 2600 1300
INTMONCHLR
2 NNU charges - level 1 2000

NNULEV1
3 NNU charges - level 2 3050

NNULEV2
4 NNU charges - level 3 4800 4800 4800 4600 4300

NNULEV3
5 Observation nursery charges 750

ONC
* These charges will be charged in addition to bed charges depending on the type of accommodation/ requirement.
INTENSIVE CARE AREAS

Intensive Care monitoring charges include bed to bed nursing care round the clock, critical care doctors’ cover round the clock,
continuous monitoring of all vital parameters, CVP monitoring, arterial line monitoring and PA catheter, etc. with the support of state
of the art equipment.
LABOUR ROOM
Patients of Category 1D / 2 discharged directly from labour waiting room will be charged according to Category 2 bed charges only.
ROOMS / BEDS
In case the patient is shifted from lower category to higher category, the charges for the consultant visits, investigations charges and
operation charges from the date of admission will be as per higher category.
DAY-CARE SURGERY
i) The operation charges for the day care procedures/surgeries will be that of Category 2.
For patients staying for less than 6 hours, day care service charges would be Rs. 3000/- towards bed charges and other miscellaneous
services. If patient stays in day care beyond 6 hours, the bed charges will be that of Category 2. However, if patient requires hospitalization,
the professional charges of doctor, investigations & OT Charges, etc. will be according to the category where patient is admitted or Category
2 whichever is higher.
ii) No bed charges are levied for the procedures done under local anaesthesia/sedation where the doctor fee is upto Rs. 5800/-
GENERAL INFORMATION
1. Checking In / Out
i. If patient is discharged within 24 hrs. of admission, room/bed charges are charged only for one day.
ii. Room charges will be billed for full day on the day of admission irrespective of time of checking-in (room charges are billed from
10.00 am and valid upto 10.00 AM next day).
Half -day Room Rent - If room is vacated before 01.00 PM
iii. If the patient is discharged within 3 hours of admission on the recommendations of consultant, no room rent and consultant visit fee are
charged. However, the investigations/drugs/medical & surgical procedures done during this period will be charged.
2. Procedure/ Investigation Charges

i. Unless otherwise specified, rates for Category 1 & 2 will be same as for Private OPD (POPD), while the rates for Category 3 will be
same as for General OPD (GOPD).
ii. Daycare patients will be charged at Category 2 rates, unless otherwise specified.
iii. Rates marked as common will apply to all categories.
3. General Ward (Free ward).

No room rent/ intensive care charges/ investigations/ Doctors fee are levied for patients admitted in General Ward.
2
4. Operation charges
i) In case more than one surgeon performs a single procedure, total operation charges will not exceed those fixed for that particular
surgery except where there is written request and consent from the patient or his relative desiring the presence or participation of
another surgeon. In such event, both surgeons would be entitled to charge their full fees.
ii) In case a surgeon feels that in the best interest of the patient, he requires the presence of another doctor in another speciality or
subspeciality then two together are entitled to charge - between themselves equal to 1.5 times of the prescribed operation charge of that
procedure. This is conveyed to the patient’s relatives and recorded in the case sheet.
iii) If more than one surgeon perform two different procedures at the same time on a particular patient, they shall be entitled to charge their
separate fees in respect of procedure performed.
iv) For re-exploratory surgery at different sittings, the operation charges will not exceed 50% of that procedure.
v) Surgeons can charge for visits after the 5th Post Operative day.
vi) The operation/procedure charges/visit fees for patients admitted in Category 1A / B will be double the charges of Category 1C/D.
vii) The charges for Category 2 / 3 will be 80% / 60% of Category 1D charges respectively.
viii) The charges for Operation theatre will be 70% of Surgeons Fee for patients operated under General Anaesthesia and patients operated
under Regional Blocks.
ix) The charges for Operation theatre will be 50% of Surgeons Fee for patients operated under Local Anaesthesia.
x) The charges for Cath lab will be 48% of Consultants Fee for patients undergoing procedure in Cath lab.
xi) The Hospital charges for general anaesthesia (consumables) will be 15% of Surgeons Fee.
xii) The Hospital charges for local anaesthesia (consumables) will be Rs. 320/- per procedure.
xiii) The charges for Anaesthetist Fee will be 30% of Surgeons Fee for patients operated under General Anaesthesia.
xiv) Anaesthetist Fee will be 20% of Surgeons Fee for patients operated under Local Anaesthesia (minor cases) with stand by.
xv) The Cardiologist’s charges for monitoring (if required / requested) will be 20% of Surgeons Fee.
xvi) The Neurologist / Neurosurgeon charges for standby/monitoring (if required / requested) will be 20% of Surgeons Fee.
xvii) In case, a patient is transferred from lower category to higher category after operation, will be charged according to the charges of
higher category from the date of admission itself.
xviii) In case one surgeon performs a procedure / operation and another procedure / operation of the same type is also required, the charges of the
higher cost surgery will be charged at actual and the lower cost surgery will be charged at 50% rates.
xix) If surgery is assisted by Robotic Surgery, additional Robotic Surgery charges as per Schedule of charges will be payable.
xx) All TPA/ Corporate patients will bear all the charges not approved by respective TPAs/ Corporates and will have to pay at actual at the time of
discharge.
5. ADVANCE BOOKING CHARGES & ADVANCES AT THE TIME OF ADMISSION
i) Room booking / maternity booking
S.NO. Type of accommodation Amount (Rs.)

1. Category 1A 20000
2. Category 1B 17000
3. Category 1C 12600
4. Category 1D 9500
5. Category - 2 7000
7. Category - 3 5250
Note :
1. Maternity Advance : Non-refundable
2. Room booking advance/cancellation of the booking should be before the date of admission. After the due date advance is non-
refundable.
3
ii) Advance deposit at the time of admission:
S.NO. Type of accommodation Amount (Rs.)
1. Categroy 1A/ 1B 100000

2. Categroy 1C/ 1D 80000
3. Category 2 70000
5. Category 3 50000
6. Day Care Cases AS PER OPERATION
7. ICU/PICU/CCU/IMCU/NNU (All Intensive care areas) 120000
Note : TPA patients will have to deposit Rs. 50,000/- as advance at the time of admission.
iii) In surgical cases (confirmed booking)
S.NO. Department Category 1 Category 2 Category 3
1. GI Surgery 120000 100000 70000
2. General Surgery 50000 40000 30000
3. Neuro Surgery 120000 100000 70000
4. Ortho-Surgery 70000 60000 50000
5. Kidney Transplantation 750000
6. Cardiac Package 100% 100% 100%
7. Liver Transplant (adult) 100% (as per package)

8. Liver Transplant (Paediatrics) 1700000
Blood Transfusion Services
Blood bank crossmatch charges

Cat-1B Suite
All Category
Cat-1D NH/
Gen.Ward
Cat-2 SNH
Cat-4 Bed
Premium
Gen.OPD
Casualty
Pvt.OPD
Cat-1A
SNo Description [Code]
1 X-match brought from outside 150

hospital [CROOUTBLD]
2 BLOOD DONOR SCREENING TESTS
[BLOODDS]
Anti HBc - IgM ( hepatitis B virus serology ) 1810 1090
[ANTIHBC]
HBsAg ( Australia antigen ) [HBSAG] 820 490
Hepatitis C virus serology antibody test [HCV] 1090 650
HIV antibody test [HIV] 820 490
RPR [VDRL] 350 210
3 CROSSMATCH OF BLOOD / RED CELLS
[CMBROS]
ABO & Rh D and Antibody screening of patient's 700
blood ( pre-transfusion ) WITH X-MATCH
[ABSCREEN]
BLOOD GROUP - 1 FOR BLOOD / PACKED CELL 150
X-MATCH (mention quantity) [BG1CM]
BLOOD GROUPING -2 FOR X-MATCH [BG2]
4
4 CROSSMATCH OF FFP / PLATELETS /
CRYOPRECIPITATE / GRANULOCYTES
[XMATCHBLPR]
[ABSCREEN]
BLOOD GROUPING-1 FFP / PLATELETS Etc. FOR 150

X-MATCH (Mention quantity) [BG1]
5 CROSSMATCH FOR ALL BLOOD
COMPONENT [XMATCHPAOS]
[ABSCREEN]
BLOOD GROUP - 1 FOR PLATELET APHERESE 150
X-MATCH [BGPLP]
BLOOD GROUP - 1 FOR CRYOPRECIPITATE 150
X-MATCH [BGCRO]
BLOOD GROUP - 1 FOR FFP X-MATCH [BGFP] 150
BLOOD GROUP - 1 FOR GRANULOCYTES X-MATCH 150
[BGRAN]
BLOOD GROUP - 1 FOR PLATELETS X-MATCH 150
[BGPLA]
BLOOD GROUP - 1 FOR BLOOD / PACKED CELL 150
X-MATCH (mention quantity) [BG1CM]
BLOOD BANK ISSUE Cat-1B Suite
All Category
Cat-1D NH/
Gen.Ward
Cat-2 SNH
Cat-4 Bed
Premium
Gen.OPD
Casualty
Pvt.OPD
Cat-1A
1 Issue Fresh Frozen Plasma (FFP)

leukocyte reduced (NAT Tested) +
Additional transfusion Charges
[FFPNATOS]
Issue Fresh Frozen Plasma (FFP) leukocyte reduced 400
(NAT Tested) [FFPNAT]
2 Issue Cryoprecipitate leucocyte reduced

(AHF - factor VIII) per unit + Additional
transfusion Charges [ICRYOLROS]
Issue Cryoprecipitate leucocyte reduced (AHF - 830
factor VIII) per unit [ICRYOLR]
3 Issue packed red cells (Only for Cardiac

Surgery Packages) + Additional
transfusion Charges [IPRCCSTHDIAOS]
Issue packed red cells (Only for Cardiac Surgery 5030
Packages) [IPRCCSTHDIA]
4 Issue Red Blood Cells leukocytes

depleted ( NAT Tested) excluding X
Match + Additional transfusion charges
[IRCBLDROS]
Issue Red Blood Cells leukocytes depleted ( NAT 5030
Tested) excluding X Match [RBCNAT]
5 Issue red cells (Paed Cardiac Surgery +

Additional transfusion charges)
[IRCPATCOS]
Issue red cells (Paed Cardiac Surgery) [IRCPCS] 5030
6 Issue single donor platelet concentrate
INCLUDING SCREENING TESTS ( platelet
apheresis by cell separator ) +
Additional transfusion Charges
[ISCPLATOS]
5
Issue single donor platelet concentrate INCLUDING 11000
SCREENING TESTS ( platelet apheresis by cell
separator ) [ISCPLAT]
7 Issue Platelets concentrate leukocyte

reduced ( NAT tested) + Additional
transfusion Charges [PCNATOS]
Issue Platelets concentrate leukocyte reduced ( NAT 400
tested) [PCNAT]
Blood bank issue charges
Cat-1B Suite
All Category
Cat-1D NH/
Gen.Ward
Cat-2 SNH
Cat-4 Bed
Premium
Gen.OPD
Casualty
Pvt.OPD
Cat-1A
1 Infectious marker test ( donor 750

refused for apheresis ) [IMTDR]
2 Issue Cryoprecipitate leucocyte 830
reduced (AHF - factor VIII) per unit
[ICRYOLR]
3 Issue Fresh Frozen Plasma (FFP) 400
leukocyte reduced (NAT Tested)
[FFPNAT]
4 Issue packed red cells ( Dialysis ) 2250
[IPRCCSD]
5 Issue packed red cells (Only for 5030
Cardiac Surgery Packages)
[IPRCCSTHDIA]
6 Issue Platelets concentrate leukocyte 400
reduced ( NAT tested) [PCNAT]
7 Issue Red Blood Cells leukocytes 5030
depleted ( NAT Tested) excluding X
Match [RBCNAT]
8 Issue red cells (Paed Cardiac Surgery) 5030
[IRCPCS]
9 Issue single donor platelet 11000
concentrate INCLUDING SCREENING
TESTS ( platelet apheresis by cell
separator ) [ISCPLAT]
10 Issue single donor platelet 10250
concentrate with prior SCREENING
TESTS ( platelet apheresis by cell)
[ISCPLATES]
11 Single Donor Platelet apheresis with 14000
Additive Solution ( PAS )
[PLAAPEASO]
Blood bank procedure charges

Cat-1B Suite
All Category
Cat-1D NH/
Gen.Ward
Cat-2 SNH
Cat-4 Bed
Premium
Gen.OPD
Casualty
Pvt.OPD
Cat-1A
1 Aphaeresis Collection & Storage 71500 71500 66000 55000 38500

[APRESCOSTO]
6
2 Cryo preservation of bone marrow 75080 75080 69300 63530 43890
without processing ( Up to one year
in LN2 at -80oC ) [CRPBMWP1]
3 Granulocyte apheresis procedure 26560 26560 24250 20330 24250 20330 12700
[GRAPPR]
4 Phlebotomy for polycythemia vera 1590 1590 1590 1390 1450 790 790
[PHEPOLV]
5 Plasma exchange procedure by cell 38100 38100 31760 25400 31760 25400 19000
separator ( Charges of FFP extra )
[PLEXPR]
6 PLASMAPHERESIS WITH ANTIBODY 66000 66000 63000 55000 63000 55000 52000
FILTER [AWANF]
7 Pooling of blood products by sterile 360 360 300 250 300 250 200
connecting device [POPLSTCON]
8 PRP (Platelet Rich Plasma) [PRP] 3000 2300
9 Stem cell harvesting and 82580 82580 76230 63520 44470
preservation at -80 C ( upto to 1 Year
) [STEMCELLPR]
10 Stem cells harvesting without 36380 36380 33950 26670 33350 26670 14670
cryopreservation [ASCHWCRYO]
Blood Bank Test Charges

SNo Description Code POPD GOPD
1 ABO / RH New Born ABORH 630 530
2 ABO/RH + DAT New Born ABODAT 800 640
3 Anti body identification ABI 4450 3780
4 Anti body titer ( IgM ) ABTIGM 520 360
5 Anti body titer ( IgM + IgG ) ABTIGMG 1150 820
6 Antibody Screening ANTIS 660 330
7 Antibody Tier ( IgM & IgG ) (Anti A , Anti B ) ATIGMI 2050 1760
8 Antibody Tier ( IgM ) (Anti A , Anti B ) ATIGM 1030 880
9 BLOOD GROUP - 1 FOR BLOOD / PACKED CELL BG1CM 150 150
X-MATCH (mention quantity)
10 Blood group - ABO + Rh(D) BGROUP 520 310
11 Compatibility testing with irregular antibody ( One CTI 1040 1040
Card )
12 Compatibility testing with irregular antibody ( Two CTTWO 2080 2080
Card )
13 DAT Titre DATT 2200 1540
14 Direct Antihuman Globulin Test ( DAT ) DCT 950 750
15 Indirect Antihuman Globulin Test ( IAT ) ICT 1270 980
16 Minor Blood Grouping ( Blood Bank )/Red Cell RCEP 5320 4480
Extended Phenoype
17 Monospecific Coombs Test (IgG, IgM, C3d) MCIGMC 1800 1320
18 Red Cell Rh & Kell Phenotype ( patient ) RCRHK 1270 1020
19 Screening of cold antibodies SCAB 660 400
20 Subclasses IgG ( IgG1 , IgG2 & IgG3 ) SUBIG 1210 1030
21 Titre of cold antibodies at room temp and 4 degree C TITCART4 1450 1100
22 Titre of incomplete antibody by ICT ICTRE 1100 940
7
Alternative medicine charges
Ayurveda charges
SNo Code Description POPD GOPD All CAT
1 AYURYCC Ayurveda consultation charge 250
2 AYURDHA Ayurveda treatment - Dhara ( per sitting ) 2170
3 AYURELNA Ayurveda treatment - Elakizhi / Navarakazhi ( per sitting ) 500
4 AYURNAS Ayurveda treatment - Nasyam ( per sitting ) 500
5 AYURZL Ayurveda treatment - Pizhichil ( per sitting ) 2040
6 AYURPODI Ayurveda treatment - Podikizhi ( per sitting ) 500
7 AYURTAR Ayurveda treatment - Tarpanam ( per sitting ) 380
8 AYURUPMO Ayurveda treatment - Upanaham ( per sitting ) 330
9 AYURUTV Ayurveda treatment - Uttara Vasti ( per sitting ) 500
10 AYURYTUPS Ayurveda treatment - Uzhichil ( per sitting ) 640
11 AYURVAS Ayurveda treatment - Vasti ( per sitting ) 380
Homeopathy charges
12 HOMMEDCH Homeopathy Medicines charges (1 week) 130 110
13 HOMMEDCH Homeopathy Medicines charges (2 weeks) 250 230
2
3
4
PIP scan charges

16 PIPS PIP scan 700 700
Yoga charges
Cat-1D Single
Cat-2 Double
Cat 1B Suite
Cat 1A-Pre/
All Category
Cat-4 Bed
SNo Code Description

1 YCRPSS Yoga - cardiac rehabilitation and prevention ( for 9710 4860 3640 2440
six sessions )
2 YCRPSGRS Yoga - cardiac rehabilitation and prevention for 740
SGRH staff ( for six sessions )
3 YGSMSS Yoga - general stress management ( for six 3260 1630 1230 820
sessions )
4 YGSMSGS Yoga - general stress management for SGRH staff 740
( for six sessions )
5 YTC3S YOGA - Training charges ( 3 sessions ) 1150
6 YTC6S YOGA - Training charges ( 6 sessions ) 2300
7 YTCHC YOGA - Training charges for health Checkup 0
patients
8 YTCVC YOGA Visit Charges 100
8
Anaesthetists PAC charges
Cat-1D Single/
Cat-2 Double
OT Day Case
Thalassemia
Cat 1B Suite
Cat 1A-Pre/
All Category
Cat-4 Bed/
GOPD
POPD
1 PACCHARGES Anaesthetists charges for PAC 3500 1750 1400 1050
Doctor monitoring charges

2 CSADS Cardiac Surgery Assistance During Chest 28980 23184 17390
Surgery ( Minor ) - Doctors monitoring
charges
3 CCCSC Critical care consultant standby charges 3500 1750 1400 1050
Doctor visit charges

4 CLPSCC Clinical psychologist consultation charges 850
5 DOCVISITCHA Doctor visit charges 3500 1750 1400 1050 300
RGE1
6 DOCVISITCHA Doctor visit charges (category 2 units only) 2780 1390 1110 830
RGE2
7 DOCVISITDEVP Doctor visit charges (development 1000 500 400 300
ED paediatrics)
8 LACSTDF Lactation / Stress consultation ( per visit ) - 2060 1030 820 620
Neonatology
9 NEPHKTCHRG Nephrologists charges for kidney 88000 44000 44000 44000
transplant patient care
10 PAEDVISITFEE Paediatric / Neonatologists visit charges 3500 1750 1400 1050
for newborns
11 FETALIUT DOCTORS VISIT CHARGES FOR IUT 1580
Remarks :
1. Treating Unit will be allowed to charge two visits per day.
2. Referal Unit will be allowed to charge one visit per day irrespective of the number of visits.
3. Treating Unit in Cardiology, Neonatology and Paediatrics will be allowed to charge 2 ½ visits per day irrespective of the number of
visits from non-packaged patients in CCU, Neonatology and PICU.
4. Category 1A (Premium Suites)/ Category 1B (Suites) : Twice the Category 1D (Single Room) charges i.e. Operation charges and
professional fees will be twice the fee chargeable for Category 1D (Single Room).
5. For new born babies born in the Hospital and shifted to NICU, Consultants will be allowed to charge visit fee.
6. For Post surgery patients, Anasthesia Consultants personally visiting the patients will be allowed to charge visit fees after 24 hours.
7. For patients admitted to the main ICU under Critical Care Unit, the Critical Care Consultants will be allowed to charge 2.5 visits per
day, and for patients admitted in ICU under other Units, Critical Care Consultants will be allowed to charge 1.5 visit per day and
treating unit will be allowed to charge 1.5 visit irrespective of the number of visits.
Laboratory and Imaging Charges

CT Scan Charges
SNo Description Code POPD/ GOPD/

CAT 1/CAT2 CAT3
1 CT 3D surface rendering (plain) CTGBI 2500 2500
2 CT abdomen to ankle joint CTABDANK 25400 25400
9
3 CT angiography (non-ionic contrast) lower abdomen CTANGLO 19300 19300
& pelvis
4 CT angiography (non-ionic contrast) upper abdomen CTAN 19300 19300
5 CT angiography abdomen & chest CTAAC 25400 25400
6 CT angiography brain CTANGIOB 13800 13800
7 CT angiography neck CTANGION 13800 13800
8 CT angiography neck & brain CTANGIONB 18000 18000
9 CT angiography thorax and descending/thoracic aorta CTANGIO 17950 17950
10 CT angiography whole abdomen and abdominal aorta CTANGIOA 19300 19300
11 CT ankle joint (non-ionic contrast) both sides CTANKCTBS 7620 7620
12 CT ankle joint (non-ionic contrast) left side CTANKCTLS 7620 7620
13 CT ankle joint (non-ionic contrast) right side CTANKCTRS 7620 7620
14 CT ankle joint (plain) both sides CTANKPLBS 5500 5500
15 CT ankle joint (plain) left side CTANKPLLS 5500 5500
16 CT ankle joint (plain) right side CTANKPLRS 5500 5500
17 CT bronchoscopy CTBRP 9000 9000
18 CT cardiac calcium scoring CTCCSP 6100 6100
19 CT cisternography CTCIST 9000 9000
20 CT colonoscopy CTCP 9000 9000
21 CT coronary angiograpy CTCTAP 13500 13500
22 CT denta scan ( OPG ) CTDSP 8940 8940
23 CT elbow joint (non-ionic contrast) both sides CTELBCTBS 7620 7620
24 CT elbow joint (non-ionic contrast) left side CTELBCTLS 7620 7620
25 CT elbow joint (non-ionic contrast) right side CTELBCTRS 7620 7620
26 CT elbow joint (plain) both sides CTELBPLBS 5500 5500
27 CT elbow joint (plain) left side CTELBPLLS 5500 5500
28 CT elbow joint (plain) right side CTELBPLRS 5500 5500
29 CT Enterography CTE 11500 11500
30 CT extended study for body scan CTES 1880 1880
31 CT extended study for single scan CTESSS 3760 3760
32 CT face (extended) (non- ionic contrast) CTFACECE 8640 8640
33 CT face / salivary glands (non-ionic contrast) CTFACENI 6810 6810
34 CT face / salivary glands (plain) CTFACEP 4570 4570
35 CT face angiography CTFACEANG 13800 13800
36 CT FNAC procedure (scan done from our hospital) CTFNACIN 7000 7000
37 CT FNAC procedure (scan provided from outside CTFNACOUT 9000 9000
hospital)
38 CT foot (non-ionic contrast) both sides CTFTCTBS 7620 7620
39 CT foot (non-ionic contrast) left side CTFTCTLS 7620 7620
40 CT foot (non-ionic contrast) right side CTFTCTRS 7620 7620
41 CT foot (plain) both sides CTFTPLBS 5500 5500
42 CT foot (plain) left side CTFTPLLS 5500 5500
43 CT foot (plain) right side CTFTPLRS 5500 5500
44 CT full abdomen (non-ionic contrast) CTFANI 9800 9800
45 CT full abdomen (oral contrast only) CTFACT 8130 8130
46 CT full abdomen (plain) CTFAP 7700 7700
47 CT full thorax (non-ionic contrast) CTFTNI 8640 8640
48 CT full thorax (plain) CTFTP 6100 6100
49 CT guided aspiration procedure CTASPIR 7000 7000
50 CT guided aspiration procedure (scan provided from CTGAP 9000 9000
outside hospital)
51 CT guided drain placement procedure CTDRAIN 9500 9500
52 CT guided drain placement procedure (scan provided CTGAPD 9500 9500
from outside hospital)
10
53 CT guided pigtail catheter drain placement procedure CTPIG 9500 9500
54 CT hand (non-ionic contrast) both sides CTHACTBS 7620 7620
55 CT hand (non-ionic contrast) left side CTHACTLS 7620 7620
56 CT hand (non-ionic contrast) right side CTHACTRS 7620 7620
57 CT hand (plain) both sides CTHAPLBS 5500 5500
58 CT hand (plain) left side CTHAPLLS 5500 5500
59 CT hand (plain) right side CTHAPLRS 5500 5500
60 CT head (bone window) CTHBW 3050 3050
61 CT head (extended) (non- ionic contrast) CTHEADEXTDN 4570 4570
62 CT head (extended) (plain) CTHEADEXTDP 4060 4060
63 CT head (non-ionic contrast) CTHNI 4170 4170
64 CT head (plain) CTHP 2640 2640
65 CT head (plain) with 3D scan CTHP3D 6100 6100
66 CT high resolution pituitary (non-ionic contrast) CTHRNI 8330 8330
67 CT high resolution pituitary (plain) CTHRPP 4570 4570
68 CT high resolution pns coronal (plain) CTRPNS 3050 3050
69 CT hip joint (non-ionic contrast) both sides CTHIPCTBS 7620 7620
70 CT hip joint (plain) both sides CTHIPPLBS 5500 5500
71 CT knee joint (non-ionic contrast) both sides CTKNCTBS 7620 7620
72 CT knee joint (non-ionic contrast) left side CTKNCTLS 7620 7620
73 CT knee joint (non-ionic contrast) right side CTKNCTRS 7620 7620
74 CT knee joint (plain) both sides CTKNPLBS 5500 5500
75 CT knee joint (plain) left side CTKNPLLS 5500 5500
76 CT knee joint (plain) right side CTKNPLRS 5500 5500
77 CT KUB (non-ionic contrast) CTKUBCT 10750 10750
78 CT KUB (plain) CTKUBPL 7300 7300
79 CT KUB extended (non-ionic contrast) CTKUBECT 12290 12290
80 CT KUB extended (plain) CTKUBEPL 9040 9040
81 CT Liver donor evaluation CTLIVDONEVAL 20900 20900
82 CT Low Dose Screening Chest CTLDC 2440 2440
83 CT lower abdomen (non-ionic contrast) CTLANI 7700 7700
84 CT lower abdomen (oral contrast only) CTLACT 4500 4500
85 CT lower abdomen (plain) CTLAP 3810 3810
86 CT lower thorax (non-ionic contrast) CTLTNI 6100 6100
87 CT lower thorax (plain) CTLTP 3810 3810
88 CT myclo CTMYCLO 9000 9000
89 CT neck (extended) (non- ionic contrast) CTNECKCE 10260 10260
90 CT neck / larynx (non-ionic contrast) CTNECKNI 6900 6900
91 CT neck / larynx (plain) CTNECKP 4600 4600
92 CT orbit (extended) (non- ionic contrast) CTOCE 10260 10260
93 CT orbit (non-ionic contrast) CTONI 7000 7000
94 CT orbit (plain) CTOP 5500 5500
95 CT perfusion studies CTPSP 13800 13800
96 CT peripheral angiography (non-ionic contrast) CTFACTBS 17950 17950
forearm both sides
97 CT peripheral angiography (non-ionic contrast) CTFACTLS 17950 17950
forearm left side
98 CT peripheral angiography (non-ionic contrast) CTFACTRS 17950 17950
forearm right side
99 CT peripheral angiography (non-ionic contrast) upper CTUACTBS 17950 17950
arm both sides
100 CT peripheral angiography (non-ionic contrast) upper CTUACTLS 17950 17950
arm left side
11
101 CT peripheral angiography (non-ionic contrast) upper CTUACTRS 17950 17950
arm right side
102 CT peripheral angiography (non-ionic contrast) whole CTWULCTBS 17950 17950
upper limb both sides
103 CT peripheral angiography (non-ionic contrast) whole CTWULCTLS 17950 17950
upper limb left side
104 CT peripheral angiography (non-ionic contrast) whole CTWULCTRS 17950 17950
upper limb right side
105 CT peripheral angiography hip and thigh both sides CTHATBS 17950 17950
106 CT peripheral angiography hip and thigh left side CTHATLS 17950 17950
107 CT peripheral angiography hip and thigh right side CTHATRS 17950 17950
108 CT peripheral angiography lower leg both sides CTLLBS 17950 17950
109 CT peripheral angiography lower leg left side CTLLLS 17950 17950
110 CT peripheral angiography lower leg right side CTLLRS 17950 17950
111 CT peripheral angiography whole lower limb both CTWLLBS 17950 17950
sides
112 CT peripheral angiography whole lower limb left side CTWLLLS 17950 17950
113 CT peripheral angiography whole lower limb right CTWLLRS 17950 17950
side
114 CT peripheral venography (non-ionic contrast) CTVFACTBS 17950 17950
forearm both sides
115 CT peripheral venography (non-ionic contrast) CTVFACTLS 17950 17950
forearm left side
116 CT peripheral venography (non-ionic contrast) CTVFACTRS 17950 17950
forearm right side
117 CT peripheral venography (non-ionic contrast) upper CTVUACTBS 17950 17950
arm both sides
118 CT peripheral venography (non-ionic contrast) upper CTVUACTLS 17950 17950
arm left side
119 CT peripheral venography (non-ionic contrast) upper CTVUACTRS 17950 17950
arm right side
120 CT peripheral venography (non-ionic contrast) whole CTVWULCTBS 17950 17950
upper limb both sides
121 CT peripheral venography (non-ionic contrast) whole CTVWULCTLS 17950 17950
upper limb left side
122 CT peripheral venography (non-ionic contrast) whole CTVWULCTRS 17950 17950
upper limb right side
123 CT peripheral venography hip and thigh both sides CTVHATBS 17950 17950
124 CT peripheral venography hip and thigh left side CTVHATLS 17950 17950
125 CT peripheral venography hip and thigh right side CTVHATRS 17950 17950
126 CT peripheral venography lower leg both sides CTVLLBS 17950 17950
127 CT peripheral venography lower leg left side CTVLLLS 17950 17950
128 CT peripheral venography lower leg right side CTVLLRS 17950 17950
129 CT peripheral venography whole lower limb both CTVWLLBS 17950 17950
sides
130 CT peripheral venography whole lower limb left side CTVWLLLS 17950 17950
131 CT peripheral venography whole lower limb right side CTVWLLRS 17950 17950
132 CT PNS axial / coronal (non-ionic contrast) CTACNI 6810 6810
133 CT PNS axial / coronal (plain) CTACP 4570 4570
134 CT PNS axial / coronal / sagittal (non-ionic contrast) CTACSNI 7620 7620
135 CT PNS axial / coronal / sagittal (plain) CTACSP 5280 5280
136 CT renal angiography CTRENANG 17900 17900
137 CT review CD charges CTRCDC 2000 2000
138 CT review CD with written report charges CTRCWR 3000 3000
12
139 CT Review film charges CTRFC 1500 1500
140 CT Review Film with written report charges CTRFW 2500 2500
141 CT sacro iliac joints (non-ionic contrast) CTSIJCT 7620 7620
142 CT sacro iliac joints (plain) CTSIJPL 5500 5500
143 CT scan / MRI images on compact disc CTSMCD 510 510
144 CT scanogram (plain) CTSCP 2000 2000
145 CT sella (plain) CTSELLAP 4600 4600
146 CT shoulder joint (non-ionic contrast) both sides CTSJCTBS 7620 7620
147 CT shoulder joint (non-ionic contrast) left side CTSJCTLS 7620 7620
148 CT shoulder joint (non-ionic contrast) right side CTSJCTRS 7620 7620
149 CT shoulder joint (plain) both sides CTSJPLBS 5500 5500
150 CT shoulder joint (plain) left side CTSJPLLS 5500 5500
151 CT shoulder joint (plain) right side CTSJPLRS 5500 5500
152 CT spine (3 vertebral levels) (non-ionic contrast) CTSNIV 7620 7620
153 CT spine (3 vertebral levels) (plain) CTSPV 5500 5500
154 CT spine extended study CTSES 6810 6810
155 CT spine extended study (with contrast) CTSEC 10260 10260
156 CT stereotactic localization (contrast) CTSL 4500 4500
157 CT sterotactic localization CTSLP 3500 3500
158 CT temporal bone ( package ) CTTBPK 4570 4570
159 CT temporal bone (non-ionic contrast) CTTBNI 8500 8500
160 CT temporal bone (plain) high resolution CTTBP 6100 6100
161 CT Trucut biopsy procedure (scan done from our CTTBIN 8000 8000
hospital)
162 CT Trucut biopsy procedure (scan provided from CTTBOUT 9000 9000
outside hospital)
163 CT upper abdomen & liver volumetery (non-ionic CTUALVCT 21340 21340
contrast)
164 CT upper abdomen (dual phase non-ionic contrast) CTUACT 19300 19300
165 CT upper abdomen (non-ionic contrast) CTUANI 7700 7700
166 CT upper abdomen (oral contrast only) CTUAOCT 4500 4500
167 CT upper abdomen (plain) CTUAP 3800 3800
168 CT upper abdomen (triple phase non-ionic contrast) CTUATCT 19300 19300
169 CT upper abdomen (triple phase non-ionic contrast) - CTUATCTDO 17500 17500
FOR DONOR
170 CT upper thorax (non-ionic contrast) CTUTNI 6100 6100
171 CT upper thorax (plain) CTUTP 3850 3850
172 CT venography brain CTVBR 13800 13800
173 CT venography neck CTVNE 13800 13800
174 CT venography neck & brain CTVNAB 18000 18000
175 CT venography thorax and descending/thoracic aorta CTVTAD 19300 19300
176 CT venography whole abdomen and abdominal aorta CTVWA 19300 19300
177 CT Visipaque add-on 30 ml CTVISI30 1490 1490
178 CT Visipaque add-on 60 ml CTVISI60 2990 2990
179 CT wrist (non-ionic contrast) both sides CTWRCTBS 7620 7620
180 CT wrist (non-ionic contrast) left side CTWRCTLS 7620 7620
181 CT wrist (non-ionic contrast) right side CTWRCTRS 7620 7620
182 CT wrist (plain) both sides CTWRPLBS 5500 5500
183 CT wrist (plain) left side CTWRPLLS 5500 5500
184 CT wrist (plain) right side CTWRPLRS 5500 5500
CT Scan Dye Charges
13
CAT 1/CAT2 CAT3
1 Additional CT non-ionic contrast (10 ml) CTADCT10 300 300
6 Additional CT rectal contrast CTADCT 300 300
7 Additional film (CT scan) CTADFILM 510 510
8 CT additional oral contrast CTAOC 300 300
9 Pressure injector usage in CT scan CTPI 410 410
Biochemical Genetics Charges

CAT 1/CAT2 CAT3
1 Alpha feto protein - AFP ( Serum / Amniotic fluid ) BAFP 800 650
2 Alpha glucosidase enzyme assay ( Pompies disease ) BPOM 5050 4000
3 Aryl sulphatase - A enzyme assay ( Metachromatic BARA 3800 3000
leukodystrophy )
4 Aryl sulphatase - B enzyme assay ( MPS type VI ) BMP6 5400 4300
5 Beta galactosidase enzyme assay ( GMI gang / MPS BMP7 4050 3200
IVB )
6 Beta glucorinidase enzyme assay ( MPS VII ) BGAC 4050 3200
7 Beta glucosidase enzyme assay ( Gaucher's disease ) BGM1 3800 3000
8 Beta Hexosaminidase A enzyme assay ( Tay Sach's BTAYSACH 5100 4050
disease )
9 Biotinidase enzyme assay BIOTINEA 2500 2000
10 Fucosidase enzyme assay ( Fucosidosis ) BFUC 5100 4050
11 Galactocerebrosidase enzyme assay ( Krabbe disease BKRB 5100 4050
)
12 Galactose - 6 - Sulphatase MPS IV A ( Morquio IV A G6SF 4500 3600
disease ) - Biochemical Genetics
13 Iduronate 6 sulphate enzyme assay ( Hunter disease , IDSUEA 6350 5050
MPS II )
14 Iduronidase enzyme assay ( Hurler disease , MPS I ) BHUR 5100 4050
15 Methylmalonic acid test BMAT 600 500
16 Sphingomyelinase enzyme assay ( Niemann Picks BNPD 5100 4050
disease )
17 Succinyl acetone BSA 3500 2800
18 1st Trimester biochemical screen ( PAPP , Fr, Beta BFTS 2300 1800
HCG )
19 2nd Trimester triple test BTR2 2800 2200
20 Alkaptonuria ( Qualitative ) BALK 1200 950
21 Amino acid analysis (Quantitative UPLC) BUPLC 5000 4000
22 Amino acid chromatography (Plasma/urine) + Urine BAAM 2200 1750
Metabolic screening tests
23 Anti Leptin Anti Bodies test ALABT 1200 950
24 Anti phospholipid IgG antibodies screening for eight BPG 1200 950
antigens
25 Anti phospholipid IgM antibodies screening for eight BPM 1200 950
antigens
26 Biogenetic Prenatal diagnosis BPND 12500 10000
14
27 Biogenetic Prenatal diagnosis- Non hydrops (any four BPND-NH 16500 13000
enzymes)
28 Ceruloplasmin (Serum) BCPL 1250 1000
29 Chitotriosidase enzyme (Gaucher disease) BCHT 2600 2050
30 Dual marker+ Pre-eclampsia test BFTPE 4000 3200
31 Enzyme Package - (organomegaly) - BEPK 11500 9200
Gaucher+NP+GM1
32 Epimerase Enzyme BGEP 2800 2200
33 Fabry disease-alpha-Galactosidase enzyme BFD 4400 3500
34 Fibroblast Growth Factor ( FGF - 21 ) BFGF21 1450 1150
35 Free beta HCG ( Genetics lab ) BFBH 1350 1050
36 G6PD (Quantitative) BG6PD 800 650
37 Galactokinase (Heparin blood) BGK 3650 2900
38 Galactose BGAL1P 3850 3050
39 Galactose 1 Phosphate BGALP 2800 2200
40 Galactosemia - Galactitol estimation in urine by BGLTT 2000 1600
GC-MS
41 Galactosemia - GALT enzyme (Quantitative) + Urine BGGLT 4500 3600
Galactitol (GC-MS) urine by GC-M5
42 Galactosemia enzyme ( GALT Quantitative ) GALT 3000 2400
43 Galactosemia Panel: Galt+ Epimerase+ Galactose+ BGALEM 10000 8000
Gal-1-PO4
44 Genetic Medicine: Thyroid stimulating hormone ( TSH BTT4 660 525
) and T4 estimation ( Filter paper )
45 Genetic Medicine: Thyroid stimulating hormone BTSH 450 350
estimation ( TSH )
46 Genetic Medicine: Thyroid stimulating hormone BTH6 925 750
estimation ( TSH ) , F T4 and F T3
47 Genzyme (>40) Fabry (?-galactosidase) GENFGAL 210 2100
48 Genzyme (>40) Gaucher(?-glucosidase) GENGLU 0
200 2000
49 Genzyme (>40) Gaucher(chitotiosidase) GENCHITO 175 1750
50 Genzyme (>40) Hurler (?-iduronidase) GENHIDU 230 2300
51 Genzyme (>40) Niemann Pick A&B GENNIE 0
310 3100
52 Genzyme (>40) Pompe (?-glucosidase) GENPGLU 0
230 2300
53 Gliadin IgA antibody BGLA 0
1700 1350
54 I-Cell disease in plasma (beta_Galactosidase+ BIC 11500 9200
alpha-Fucosidase + alpha-mannosidase
55 Inhibin A BINH 970 750
56 Interleukin -2 BIL2 970 750
57 Late Infantile - Tripeptidyl Peptidases BNIL2 4100 3250
58 Mannosidase enzyme assay ( Mannosidosis A & B ) BMAN 6350 5050
59 Mannosidosis (Mannosidase A enzyme) BMANA 3850 3050
60 Mannosidosis (Mannosidase B enzyme) BMANB 3850 3050
61 Minor blood group antigens (Fya+Jka+KCcEe) BMINOR 2400 1920
62 Morquio IVB-MPS IV-B- beta Galactosidase BMP7G 4100 3250
63 Mps Quantitative + Electrophoresis + 3 enzymes - BQEMPS126 22000 17500
MPS 1+2+6
64 Mps Quantitative + Electrophoresis + 4 enzymes of BQEMPSIII 25000 20000
MPS III
65 Multiple Sulfatase deficiency ( Three enzymes ) BMSD 15000 12000
66 NCL, INFANTILE PALMITOYL PROTEIN THIOESTERASE BNIL1 4100 3250
67 New born screening ( TSH, G6PD, 17 OHP ) - Genetics NBSM 1200 950
lab
68 Nitro blue tetrazolium dye test - Slide ( NBT ) NBT 850 650
15
69 Organic acid analysis by Gas Choromatography-Mass BOA 4500 3600
Spectrometry (GC-MS)
70 PAPP - A assay BPAP 1450 1150
71 PAPP A + DlGF BPAPL 3350 2650
72 Phospholipid 8 pro IgG to identify which of the eight BG8 1700 1350
antigens is positive
73 Phospholipid 8 pro IgM to identify which of the eight BM8 1700 1350
antigens is positive
74 Porphobilinogen ( Qualitative ) BPOR 1200 950
75 Porphobilinogen (Quantitative) BPORQ 1500 1200
76 Porphyria - Porphobilinogen in urine & plasma ( BPORUPL 1800 1450
Qualitative )
77 Porphyria - Porphobilinogen in urine ( Qualitative + BPORQNQL 2500 2000
Quantitative )
78 Porphyria (Qualitative) in blood BPOR BL 1000 800
79 Pre- eclampsia Test BPE 2100 1650
80 Quadruple test (Triple markers + Inhibin A) BQAD 3400 2700
81 Quantitative MPS estimation BQMPS 2300 1850
82 Sandoff disease-Hexosaminidase (A+B) enzyme BSD 5100 4050
83 Sanfillipo A disease ( Heparan sulphamidase ) BMP3A 5700 4550
84 Sanfillipo disease-MPS III B-alpha-hexosaminidase BMP3B 5100 4050
(alpha-N acetyl glucosaminidase)
85 Sanfillipo disease-MPS III D-alpha-hexosaminidase BMP3D 5300 4200
(alpha-N acetyl glucosaminide 6 - sulfate)
86 Sanfillipo Type C ( Acetye COA ) BMP3C 5100 4050
87 Sanfillippo (A+B) BMP3 (A+B) 10000 8000
88 Sanfillippo (C+D) BMP3 (C+D) 10000 8000
89 Schindler - alpha N - Acetylgalactosaminidase BNAGA 5500 4400
90 Succinyl acetone in blood + urine succinyl acetone on BSA-GC 7500 6000
GC-MS
91 Sugar chromatography BSC 1650 1300
92 Sweat test for cystic fibrosis - lab charges BSWT 1200 950
93 Tandem Mass Screening in newborn - High Risk BTMSH 3000 3000
94 Tandem Mass Screening in newborn ( Outsourced ) BTMSN 2000 2000
95 Tandem Mass Screening in newborn ( Outsourced ) + BTMSNBNBSG 3000 2700
NBS (SGRH)
96 Tay Sach + Sandoff BTSSD 9200 7350
97 TNF-alpha BTNF 1200 950
98 Transglutaminase antibody ( igA ) BTGM 1350 1050
99 Unconjugated estriol assay ( Serum ) BEST 1100 880
100 Urinary Iodine BUI 1500 1200
101 Urine for MPS screen ( Biochemical genetics ) BURN 400 300
102 Urine Metabolic tests BAMT 600 450
103 Urine MPS Electrophoresis BUME 4000 3200
104 VLCFA Analysis BVLC 8500 6800
105 WOLMAN DISEASE - ACID ESTERASE BWM 5100 4050
Cytogenetics Charges

CAT 1/CAT2 CAT3
1 Ataxia Telengiectasia chromosomal analysis ( CAT 7300 5100
Bieomycin Assay )
16
2 Blood chromosome analysis CBLD 3650 2550
3 Fanconi's syndrome chromosomal analysis ( CFA 7300 5100
Mitomycin Assay )
4 Fish 5 probe (13, 18, 21, X, Y) FISH5P 8500 6050
5 Fish chromosome 13, 21 FISH1321 6050 4250
6 Fish chromosome 16 FISHC16 6050 4250
7 Fish chromosome 21 FISHC21 6050 4250
8 Fish chromosome X, Y,18 FISHXY18 6050 4250
9 Fish Di George syndrome - N 25 probe FISHDGSN25P 6050 4250
10 Fish Di George syndrome - Tuple 1 probe FISHDGST1P 6050 4250
11 Fish microdeletion FISH1P 6050 4250
12 Fish Miller Decker / Lis gene FISHMDLG 6050 4250
13 Fish Prader Willi syndrome FISHPWS 6050 4250
14 Fish Smith - Magenis FISHSM 6050 4250
15 Fish williams syndrome FISHWS 6050 4250
16 Abortus Material chromosomal analysis ( Long Term CPOC 7300 5100
Culture )
17 Amniotic fluid chromosomal analysis ( Cell Culture ) CAF 10900 7650
18 Bone Marrow chromosomal analysis CBM 5500 3900
19 Chorionic villi chromosomal analysis ( Long Term CVS 10900 7650
Culture )
20 Cord blood prenatal chromosomal analysis CCB 5500 3900
21 Fibroblast Culture for other tests CFB 4250 3000
22 FISH - ALK (2p23) FALK 9650 7250
23 FISH - BCR/ABL [t(9;22)] for CML FBCRABL 6050 4250
24 FISH - Burkitt's Lymphoma t8;14 FBL 6050 4250
25 FISH - EGFR (7p12), (7p11.1-q11.1) FEGFR 9650 7250
26 FISH - HER2/Neu (CEP17) FHER2 9650 7250
27 FISH - N-MYC/CEP2 for neuroblastoma FMYC 9650 7250
28 FISH - RBI for Retinoblastoma (13q14) FRBI 6050 4250
29 FISH - X,Y Chimerism Screening FCXY 6050 4250
30 FISH 5probs + prenatal Microarray (180k) F5MIC(180K) 30000 30000
31 FISH ALL Panel FALLP 15000 10500
32 FISH AML Panel FAMLP 15000 10500
33 FISH CLL Panel FCLLP 15000 10500
34 FISH MDS Panel FMDSP 15000 10500
35 FISH Multiple myeloma Panel FMMP 15000 10500
36 Microarray-prenatal(60K) CMIC-PRE 25000 25000
37 POC Microarray (60K) CPOC - MIC(60K) 15000 15000
38 Postnatal Microarray CMIC - POST (180K) 30000 25000
39 Recurrent Abortion chromosomal analysis - Husband CRACH 0 0
40 Recurrent Abortion chromosomal analysis - Wife CRAC 6050 4250
41 Amniotic fluid chromosomal analysis + Fish 5 probe CAF5P 14300 9900
$$ Fish 5 probe (13, 18, 21, X, Y) FISH5P
Amniotic fluid chromosomal analysis ( Cell Culture ) CAF
Amniotic fluid chromosomal analysis + Fish 5 probe (LABEL ONLY) CAF5POS
Genetics Procedures

CAT 1/CAT2 CAT3
1 Genetic counselling ( Doctor fee + Hospital Charges ) PGCDFHC
Genetic counselling - Doctor fee PGCDF
2420 1690
17
Genetic counselling - Hospital Charges PGCHC 240 170
HLA - Serological & Molecular

CAT 1/CAT2 CAT3
1 SAB+QPRA (HLSAQPRA) SABQPRA 40000 40000
HLA PRA Q-SCREEN HQPRA
Luminex Single Antigen HLA - Class I HLSA I
Luminex Single Antigen HLA - Class II HLSA II
HLA Serological & Molecular Charges

CAT 1/CAT2 CAT3
1 DNA - Isolation & storage (HLA Genetics) HDNA 750 500
2 AB HAB 3850 2640
3 AB + DR - One Person HABR1 13500 9500
4 AB+DR - Additional person (beyond 2 persons) HABR3 10000 7000
5 AB+DR - Two persons HABR2 25000 17500
6 ABC + DR + DQ (Donor) HABCRQ2D 0 0
7 ABC+DR+DQ HBCRQ 17000 12000
8 Antibody Immune Profile (HIMMUNP) HIMMUNP 9000 7000
9 Antiobody Immuneprofile Post Tx (DSA+QPRA) HIMMUNPOST 8000 6000
10 Anti-paternal Cytotoxic antibodies - APCA HAP 6000 4500
11 DNA Fingerprinting - Donor HDNAFPD 0 0
12 DNA FINGERPRINTING (Additional Person) HDNAFP3 7000 5000
13 DNA FINGERPRINTING STUDY HDNAFP 20000 15000
14 Donor Lysate HDLYSATE 1000 500
15 DQ2 / DQ8 Celiac Disease ( High Risk Genotype ) HDCEL 6500 4500
16 DQB1-06, Narcolepsy HDQ6 2500 1750
17 DR2-Narcolepsy, M.S. Goodpasture syndrome HDR2 4500 3150
18 DR3- , Addison disease, Derm Nerp- HDR3 4500 3150
19 DR4-Pemphigus Rhd A, Giant cell Art - HDR4 4500 3150
20 DR5- Pauciart Rhd A, Scleroderma, Hashimotos Thyr, HDR5 4500 3150
21 DR7- PS., MCGN, Antiphospholipid AB Sy, Behcets - HDR7 4500 3150
22 HLA - A Locus Typing HLAA 5000 3500
23 HLA - B Locus Typing HLAB 5000 3500
24 HLA - C Locus Typing HLAC 5000 3500
25 HLA - DR&DQ Typing HLADRDQ 6500 4550
26 HLA ABC DNA HABC 15000 10500
27 HLA B27 HB27 2000 1400
28 HLA DQ Alpha ( HQA ) HLADQA 3500 2400
29 HLA DQ Alpha / Beta ( DNA ) HDRQ 6500 4550
30 HLA DQ Beta ( HQB ) HLADQB 2500 1750
31 HLA DSA ( BY LUMINEX ) HDSA 7000 5500
32 HLA DSA Post Tx HDSAPOSTx 6000 5000
33 HLA Mitochondrial DNA Polymorphism HMITDNAPOL 0 0
34 HLA PRA % HPRAC1C2 8500 6500
35 HLA PRA Q-SCREEN HQPRA 4000 2800
36 HLA tissue cross match serology - Donor HCMD 0 0
37 HLA tissue cross match serology - Patient / Recipient HCM 6000 4500
18
38 HLA Typing - AB ( DNA ) HABM 9500 7000
39 HLA Typing - ABC+DR+DQ ( Two Persons) HABCRQ2 30000 21000
40 HLA Typing - C and DQ (DNA) HLACDQ 5500 3850
41 HLA Typing - DR ( DNA ) HDRM 5000 3500
42 HLA Typing ( 2 persons ) and Tissue cross match ( HCRMATD 0 0
serology ) - Donor
43 HLA Typing ( 2 persons ) and Tissue cross match ( HCRMAT 25000 20000
serology ) - Patient / Recipient
44 HLA Y-STR Polymorphism ( SECOND OF TWO ) HYSTRPOL 7000 5000
45 HLA-B5, Behcet's disease HLAB5 5500 4000
46 Luminex Single Antigen HLA - Class I HLSA I 22500 20000
47 Luminex Single Antigen HLA - Class II HLSA II 20500 18000
48 Merosin / Dysferlin staining / Alpha dystroglycan HMA 3000 2000
49 Merosin staining - Prenatal diagnosis ( Immunostain HMMP 15000 10500
and DNA Studies )
50 Muscle biopsy - Calpain Staining ( Western Blot ) HMBCSWB 4400 3080
51 Muscle biopsy - Dysferlin staining HMUDF 2970 1980
52 Muscle biopsy - Dystrophin staining HMUDT 3500 2450
53 Muscle biopsy - Merosin staining HMUM 3000 2000
54 Muscle biopsy - Sacrogylcan staining HMUS 6000 4000
55 Muscular dystrophy staining profile ( Muscle biopsy - HMDSP 9000 6300
Dystrophin staining and Sacrogylcan staining )
56 PRA % class 1 HPRA% 9000 6500
57 SKIN BIOPSY - EPIDERMOLYSIS BULLOSA SCREENING HSKINBIO 5000 3500
Molecular Genetics Charges

CAT 1/CAT2 CAT3
1 Achondroplasia mutation study MACH 5000 3500
2 Albinism - common Indian mutation MALB 5000 3500
3 Albinism - OCA1 sequencing tyrosinase gene MAOSTG 20000 16000
4 Albinism - OCA2 P gene-Common deletion MAOGCD 5000 3500
5 Aneuploidy screening by MLPA MLPA 7000 5000
6 Angelman syndrome DNA test - Methylation MANG 6000 4200
7 Apert syndrome mutation study (2 mutation) MAPE 5000 3500
8 Congenital adrenal hyperplasia ( Prenatal diagnosis - MCAPF 0 0
linkage analysis ) - family member
9 Craniosynostosis ( non specific ) FGFR3 mutation - MCNS 5000 3500
Pro250Arg
10 Crigler Najjar Syndrome (Sequencing) UGT1A1 gene MCNJS 22000 16000
11 Cystic fibrosis - CF Diagnosis ( Delta 508 mutation ) MCF1 4000 2500
12 Cystic megalencephaly MLC 1 gene mutation MLC1 5000 3500
13 Cystic megalencephaly MLC 1 prenatal diagnosis MLC1-P 15000 12000
14 DNA - Isolation & storage (Molecular Genetics) MDNA 700 500
15 Duchenne muscular dystrophy ( DMD ) deletion MDD 4200 3000
testing
16 Duchenne muscular dystrophy ( DMD ) prenatal MDP 15000 12000
diagnosis
17 Factor V Leiden mutation MFVL 2700 1900
18 Folate polymorphism 3'5 MTHFR - ( 677C>T, MFOL 4200 3000
1298A>C )
19
19 Fragile X syndrome ( Methylation test - confirmatory MFXM 6000 4200
)
20 Fragile X syndrome screen MFXS 3300 2300
21 Friedreich ataxia - molecular diagnosis MFAMD 5500 4000
22 Gilbert's disease ( UGT1A1 Promoter polymorphism ) MGDP 3600 2500
23 Herpes virus infection PCR MHER 3300 2300
24 Huntington disease gene analysis MHD 4200 3000
25 Hypochondroplasia common mutation MHCM 6000 4200
26 Infection - Cytomegalovirus ( CMV ) PCR - Genetic MCMV 3300 2300
Medicine
27 Infection - PCR for Rubella Virus ( Genetics ) MR41 4200 3000
28 Maternal cell contamination (MCC) of fetal sample MMCC 7000 5000
by molecular analysis
29 Microdeletion-5 MLPA (Confirmation P245) MLDL5 7000 5000
30 Mitochondrial / LEIGHS - 3 mutations MLE 8000 6000
31 Mitochondrial / MELAS - 3 mutations MEL 8000 6000
32 Mitochondrial / MERRF - 2 mutations MER 7000 5000
33 Mitochondrial / NARP - 2 mutations MNAR 7000 5000
34 Mitochondrial mutations package ( ALL ) MT4 12000 9000
35 Myotonic dystrophy - Type 1 ( 19q 13.3 ) MDM 5500 4000
36 Myotonic dystrophy - Type 2 ( 3q 21 ) MMDT2 5500 4000
37 Parvo virus infection ( PCR ) MPAR 3300 2300
38 Prenatal diagnosis ( Includes test for MCC ) MPND 15000 12000
39 RH typing ( Rh+ or Rh- ) MMRHT 3300 2300
40 Sequencing restrictive dermopathy ( specific SRD 5500 4000
mutation )
41 Spinal muscular atrophy ( SMA ) - molecular MSMA 4000 2700
diagnosis
42 Spinal muscular atrophy ( SMA ) - prenatal diagnosis MSMP 15000 12000
43 Sry + Amxy gene study ( Y chromosome ) MSAGS 5000 3000
44 Thalassemia beta prenatal diagnosis ( Repeat test ) MTPR 13000 10000
45 Thanatophoric dwarfism ( common mutation ) MTD 5000 3500
46 Toxoplasmosis infection PCR ( Genetics ) MTOX 3300 2300
47 1p36 MLPA ML1p36 7000 5000
48 Achondroplasia Gene Sequencing FGFR3 MACS 30000 22500
49 Achondroplasia with Acantharis Nigricans - SADDAN MSAD 5000 3500
mutation Lys 650 Met in FGFR3 gene
50 ACTN3 GENOTYPING MACTP 3300 2300
51 Acute necrotizing encephalopathy ( ANE ) RANBP2 MANE 5500 4400
gene mutation T585M
52 Adenosine Deaminase Deficiency- SCID – ADA gene MADA 25000 20000
sequencing
53 Adrenoleukodystrophy (X-linked ALD) sequencing of MXALD 30000 22500
ABCD1 gene
20
54 ADSpastic paraplegia 4, (SPG4) - SPAST gene targeted MSPASTT 5500 4000
exon 12
55 Aicardi-Goutieres syndrome 3 (AGS3) - RNASEH2C MRNASEH2CT 5500 4000
gene, targeted exon 2
56 AICARDI-GOUTIERES SYNDROME ex 2+3 MRNASEH2C 10000 7000
57 Alagille syndrome 1 targeted exon 12 MJAG 1 5500 4000
58 Albinism - OCA2 sequencing P gene MOCA2SQ 30000 27000
59 Albinism - OCA3 sequencing TYRP1 gene MOCA3SQ 20000 16000
60 Albinism (All 3 genes) MACBNGS 40000 35000
61 Alkaptonuria gene sequencing (NGS) MALK1 35000 35000
62 Allgrove Syndrome -AAAS gene sequencing MAAS 26000 22000
63 Alpha 1 anti-trypsin ( Z, X & M mutations ) MAAT 35000 30000
64 Alpha Thalassemia - Deletions MATH 6000 4200
65 Androgen Insentivity- AR MLPA MLARA 7000 5000
66 Androgen receptor gene sequencing MARC 20000 16000
67 Aneuploidy screening (21, 18, 13,X,Y, chm) - MANU 5000 3500
Additional to other PND
68 APC gene analysis for Adenomatous Polyposis MAPCNGS 35000 35000
Syndrome (APC) (By NGS)
69 Apo E genotyping MAPO 3600 2500
70 Arginosuccinicaciduria -ASL gene sequencing MASL 35000 27000
71 ARKPD ARKPD 35000 35000
72 ARKPD-NGS panel MARNG 3500 35000
73 Atrial Septal Defect + Atrioventricular Block- NKX2 MNKX2 15000 12000
gene sequencing
74 Autosomal Dominant Polycystic Kidney Disease - ADPKD 40000 40000
ADPKD 1+2 sequencing- NGS
75 Barth syndrome (3-methylglutaconic aciduria type II) MTAZ 22000 17000
TAZ gene sequencing
76 Bartter syndrome type 2 - KCNJ1 TARGETED MKCNJ1T 5500 4000
MUTATION
77 BASAL CELL NEVUS CARCINOMA, MPTCH1 7000 5000
HOLOPROSENCEPHALY (Exon 20)
78 BCR - ABL Qualitative ( Molecular Genetics ) CBA 3600 2500
79 BCR - ABL Quantitative ( Molecular Genetics ) CBAR 7000 5000
80 Beckwith-Weidemann / Silver Russel (Chr11 UPD MBWS11 8800 6600
?MLPA)
81 Beta - Ketothiolase sequencing - ACAT1 Gene MBKT 22000 17000
82 BILATERAL FRONTOPARIETAL POLYMICROGYRIA ex6 MGPR56 7000 5000
83 Biotinidase Deficiency- BTD gene sequencing MBTD 19000 14500
84 Biotin-responsive basal ganglia disease (BBGD), MSLC19A3 19800 15000
SLC19A3 gene sequencing
85 Blepharophimosis –ptosis-epicanthus inversion MFOXL2 22000 17000
syndrome ( BPES) FOXL2 gene sequencing
86 BPES- FOXL2/TWIST1 MLPA MLFOX 7000 5000
87 BRAF exon 15 gene sequencing MBRAF 6000 4200
88 BRANCHIOOTORENAL (BOR) SYNDROME MEYA1 7000 5000
89 BRCA 1 and 2 gene analysis (BY NGS) MBRANGS 36750 31500
90 BRCA 1 and 2 gene analysis (BY NGS) + MLPA MBRANGSD 48000 40000
91 BRCA1 DELETION / DUPLICATION CBRD 7000 5000
92 BRCA2 DELETION / DUPLICATION CBR2D 7000 5000
93 BRCA2 MUTATION ( 27 EXONS BY SEQUENCING ) CBR2 50000 38000
94 Breast cancer- BRCA2/CHEK2 MLPA MLBRCH 7000 5000
21
95 Bruton type X-linked Agammaglobulinemia (XLA)- MBTK 35000 27000
BTK gene sequencing
96 C - KITGene Mutations ( 4 Exons ) MCKIT 10000 7200
97 Calpainopathy - CAPN3 gene sequencing MCAPN 36000 32000
98 Calpainopathy- CAPN3 2 common mutations MCAL 8800 6600
99 Calpainopathy-CAPN3 MLPA MLCAP 7000 5000
100 Camurati-Engelmann disease - TGFB-1 gene MTGFB1 22000 17000
sequencing
101 Canavan disease -ASPA, MLPA MLCAN 7000 5000
102 Canavan disease gene sequencing MSCG 20000 16000
103 Carpenter syndrome- RAB23 gene sequencing MRAB23 20000 16000
104 Cataract-2 congenital Autosomal recessive (FYCO1 MFYO1 33000 26000
gene)
105 Catecholaminergic polymorphic ventricular MTRDN 7000 5000
tachycardia (TRIADIN) (Exon 5)
106 CFTR gene analysis (By NGS) MCFTRNGS 30000 25000
107 CFTR gene analysis (By NGS) + dosage MCFTRNGSD 37000 30000
108 Charcot - Marie tooth Disease- EGR2 gene MEGR2 13000 11000
sequencing
109 Charcot - Marie tooth Disease- GDAP1 gene MGDAP1 16500 13200
sequencing
110 Charcot - Marie tooth Disease- MFN2 gene MMFN2 28000 22000
sequencing
111 Charcot - Marie tooth Disease- MPZ gene sequencing MMPZ 16500 13200
112 Charcot - Marie tooth Disease- PRX gene sequencing MPRX 25000 20000
113 Charcot - Marie tooth Disease/ HNPP ( PMP 22 gene ) MCMT 7000 5000
dosage
114 Charcot Marie Tooth disease X-linked -GJB1 MLPA MLCMX 7000 5000
115 Charcot-Marie-Tooth - X-Linked GJB1 gene MCMTX 17000 13500
sequencing
116 Charcot-Marie-Tooth disease, type 4J targeted MFIG4 11000 7700
mutations exon 16 and IVS7
117 Chicken Pox Infection- Varicella PCR (AF) MVA 4000 2700
118 Chicken Pox Infection- Varicella PCR (blood) MVB 3000 2100
119 Chimerism analysis (quantitative )per sample MCHIMER 7000 5000
120 Chronic granulomatous disease (CGD) x linked CYBB MCYBB 25000 20000
gene sequencing
121 Chronic granulomatous disease CDG1- Targeted MPMM2 9000 7000
PMM2 gene mutation analysis
122 CHRONIC GRANULOMATOUS DISEASE exon 5 MCYBB1 7000 5000
123 Citrullinemia type 1-ASS1 gene sequencing MASS1 35000 27000
124 Cleidocranial dysplasia - RUNX2 gene sequencing MRUNX2 28000 22000
125 COLD-INDUCED SWEATING SYNDROME (exon 2) MCRLF 1 7000 5000
126 Colon Cancer (NRAS/KRAS gene Exon 2,3,4 gene MNRAS 13000 10000
sequencing)
127 COMBINED OXIDATIVE PHOSPHORYLATION MMTO1 7000 5000
DEFICIENCY 10 (COXPD10)ex 7
128 COMBINED OXIDATIVE PHOSPHORYLATION MAARS2T 7000 5000
DEFICIENCY 8 (COXPD8),
LEUKOENCEPHALOPATHYWITH OVARIAN FAILURE
(LKENP)exon3
129 Combined pituitary hormone deficiency 3 - LHX3 MLHX3 19800 15000
GENE
22
130 Complex I, mitochondrial respiratory chain, MNDUFS6 5500 4000
deficiency, NDUFS6 targeted single exon
131 Cong Adernal Hyperplasia CYP - 21A2 Gene MCAS 20000 17000
Sequencing
132 Cong. Adrenal hyperplasia - Deletions by dosage test MCHD 7000 5000
133 Cong. Adrenal hyperplasia -CYP21A 1 gene MCAHC 25000 20000
sequecing+ deletion/duplication
134 CONGENITAL GLYCOSYLATION 1Q disorder( KAHRIZI MSRD5A3 7000 5000
SYNDROME)exon1
135 Congenital Insensitivity to Pain with Anhidrosis (CIPA) MCIPA 15000 12000
-( Prenatal Diagnosis by Linkage )TRKA( NTRK1) gene
136 CONGENITAL MYASTHENIC SYNDROME (exon 14) MCOLQ 7000 5000
137 Congenital Myasthenic Syndrome-RAPSN gene RAPSN 7000 5000
Common mutation(p. N88K)
138 Conradi Hunermann syndrome- EBP gene sequencing MEBP 16500 13200
139 Corneal Dystrophy-CHST gene sequencing MCHST 20000 16000
140 Cortical dysplasia (Exon 24) MKIF5C 7000 5000
141 Crouzon Disease : FGFR 2 gene (2 Mutation) MCRZ 10000 7000
142 Cyclical Neutropenia-ELA2 gene sequencing MELA2 20000 16000
143 CYP2C9 ( 1,2,3 ) VKORC1(1639G>A) GENOTYPING MCYY 5500 4000
144 Cystic Fibrosis -CFTR MLPA MLCF 7000 5000
145 Cystic Fibrosis, Gene sequencing MCFS 30000 25000
146 Cystic Megalencephaly (MLC2) HEPACAM gene MPEPACAM 22000 17000
sequencing
147 Cystic Megalencephaly - MLC1 Gene Sequencing MLCS 22000 17000
148 Deafness - Connexin 26 - Gene Sequencing MD2S 7000 5500
149 Deafness -(Non syndromic X linked Hearing loss gene MXNSHL 15000 12000
sequencing-POU3F4 gene )
150 Deafness Connexin 30 Gene Deletion MSD 3600 3000
151 Deafness -Connexin 30 gene sequencing MDD30 9000 7000
152 Deafness Connexin 31 Gene Sequencing MD31 7000 5000
153 Deafness Dystonia Optic Neuronopathy Syndrome- MMTS 16500 13200
Mohr Tranebjaerg syndrome. TIMM8A gene
sequencing
154 Deafness -Mondini defect-KCNJ10 gene sequencing MMD 15000 12000
155 Deafness -SLC26A4 Gene Sequencing MSLC26A4 35000 35000
156 Deafness-Mondini defect-FOXI1 gene sequencing MFOXI 1 12000 9000
157 Deletion - 22q deletion - ( Conotruncal Heart disease MD22D 12000 9000
)
158 Dengue fever - Molecular diagnosis MDENG 4200 3000
159 DENT DISEASE 2, LOWE SYNDROMEex 22 MOCRL 7000 5000
160 Dentatorubral - Pallidoluysian atrophy ( Triplet repeat MDRPLA 5000 3500
)
161 Desbuquois Dysplasia- CANT1 gene sequencing MCANT 16500 13200
162 Desbuquois Dysplasia- CHST3 gene sequencing MCHSTT 22000 18000
163 Diabetes Mellitus -Type 1 - SIRTI gene sequencing MSIRT 25000 20000
164 Diastrophic Dysplasia-SLC26A2 gene sequencing MSLC26A2 20000 16000
165 Dilated Cardiomyopathy, Hypertrophic MYBPC3T 5500 4000
cardiomyopathy- MYBPC3 targeted 1 exon
166 DMD - Dosage Studies in Females MDDF 9000 7000
167 DMD gene analysis (By NGS) MDMDNGS 30000 25000
168 DNA - Isolation & storage for POC MDNAPOC 1200 800
169 DNA isolation and storage of fetal sample MDNAFETAL 1200 800
23
170 Donnai-Barrow syndrome- LRP2 gene targeted MLRP2 11000 7700
mutation exon 23 & 27
171 Duchenne muscular dystrophy ( DMD ) deletion DMDMLPA 9000 7000
analysis by MLPA ( 79 exons )
172 Dyschromatosis Symmetrica hereditaria 1 (DSH1) hot MADAR 11000 7700
spot
173 Dystonia ( DYT5 gene sequencing ) MDYT5 15000 11000
174 Dystonia (DYT1 gene sequencing) MDYT1 15000 11000
175 Dystonia (DYT1,6,12,16) MLPA MLDYT 7000 5000
176 Dystrophic Epidermolysis Bullosa (AD)-COL7A1 MEBAD 15000 11000
-EXONS72-75 gene sequencing
177 Ectodermal Dysplasia - hypohidrotic X - linked EDA MEDS 20000 16000
gene
178 EGFR Gene Mutations ( 4 Exons ) MEGFR 10000 7200
179 Emery Driefuss Muscular Dystrophy -EMD gene MEMD 15000 11000
sequencing
180 Emery-Dreifuss muscular dystrophy 2, autosomal MLMNAS 5500 4000
dominant (EDMD2) targeted exon 11
181 Enterovirus PCR (Genetics) MEV 3300 2300
182 Epidermolysis bulllosa simplex - KRT14 (exons1,4 MEBKRT14 15000 11000
and6)
183 Epidermolysis bulllosa simplex - KRT5(exons1,4 and6) MEBKRT5 15000 11000
184 Epidermolysis bullosa dystrophica, autosomal MCOL7A1 11000 7700
dominant (DDEB) hotspot exons 105, 116
185 Epidermolysis Bullosa panel (NGS) MEBPP 35000 35000
186 Epilepsy - SCN1a gene sequencing MSCN 35000 35000
187 Establishment and validation of known mutation MEVKM 19000 14500
188 Establishment and validation of known mutation- MEVKMSGRH 13000 10000
sgrh only
189 Ethylmalonic encephalopathy METHE-1 22000 17000
190 Fabry disease GLA gene sequensing MGLA 22000 17000
191 Factor XIII deficiency (Exon 10) MF13A1 7000 5000
192 Familial Exudative Vitreoretinopathy - FZD4 exon2 MFZD4 5000 3500
mutation
193 FAMILIAL HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS MPRF1 13000 10000
194 Familial Hypercholesteriemia-APOB gene (exon 26 MFHAPOB 9000 7000
and exon 29)
195 Familial Hypercholesterolemia 6 Genes ( NGS Panel ) MFHP 25000 25000
( LDLR, ApoB, PCK59, ApoE, LDLRAPI )
196 Familial Hypercholesterolemia- LDLR gene MFHLDLR 28000 22000
sequencing
197 Familial Hypercholesterolemia- PCSK9 gene MFHPCSK9 22000 17000
sequencing
198 Familial Juvenile Nephronophthisis- NPHP1 MLPA MLNPH 7000 5000
199 Familial renal glucosuria SLC5A2 gene sequencing MSLC5A2 25000 20000
200 Family Member of Patient MFMD 0 0
201 Farber lipogranulomatosis (Exon 6,12) MASAH1 10000 7000
202 FGFR1 +FGFR2+FGFR3 gene analysis (By NGS) MFGFRNGS 40000 35000
203 FGFR2 probemix MLPA MLFGR2 9000 7000
204 FGFR2 sequencing ( Crouzon, Jackson Weiss, Pfeiffer, MFGFR2S 30000 22500
AD craniosynostosis)
205 FGFR3 Gene Sequencing ( Achondroplasia , MFGS 30000 22500
Hypochondroplasia Thonotrophic Dwarfism )
24
206 Fibrodysplasia ossificans progressiva (FOP), ACVR1 MACVR1 22000 17000
gene sequencing
207 FLT3 mutations(AML) MFLT3 4000 2700
208 Fragile X in Females MSXF 8800 6600
209 Frontotemporal lobar dimentia ( MAPT ) exons 9-13 ) MMAPT 15000 11000
sequencing
210 Fructose intolerance Aldolase B deficiency – ALDOB MALDOB 19800 15000
gene sequencing
211 Fructose-1-6 Bisphosphatase Deficiency - FBP Gene MFBP 18000 15000
Sequencing (7 Exons )
212 Fukutin related protein-Fukuyama congenital MFKRP 19000 14500
muscular dystrophy- FKRP gene sequencing
213 Fukuyama congenital muscular dustrophy-FKTN gene MFKTN 28000 22000
sequencing
214 G-6- PD ONE MUTATION MGP1 3300 2300
215 G-6-PD ( Mediterranean & Orissa types ) - G6PD MG6PD 6000 4200
216 Galactokinase deficiency - GALKI gene Sequencing MGALKI 18000 15000
217 Galactosemia Gene sequencing ( GALT ) GALTSEQ 22000 17000
218 Gaucher disease - GBA gene sequencing MGDSG 30000 22500
219 Gilbert's Disease Sequencing - UGT1A1 Gene MGDS 22000 18000
220 GLUTARIC ACIDEMIA TYPE II, exon6 METFB 7000 5000
221 Glutaric acidemia type II-ETFB gene, targeted exon 6 METFBT 5500 4000
222 Glutaric Aciduria-GCDH gene sequencing MGCDH 20000 16000
223 Glycogen Storage 1A Gene Sequencing MGSDS 15000 11000
224 Glycogen Storage disease III- known targeted MGSD3 7000 5000
mutation AGL gene
225 GM1 Gangliosidosis-GLB1 gene sequencing MGLB1 28000 22000
226 Goldberg-Sphrintzen syndrome-KIAA1279 gene MKIAA1279 28000 22000
sequencing
227 Grebe syndrome- GDF5 gene sequencing MGDF5 16500 13200
228 Gyrate Atrophy of Choroid and Retina- OAT gene MOAT 28000 22000
sequencing
229 HADDAD syndrome- PHOX2B gene sequencing MHADDAD 15000 11000
230 Haemochromatosis ( 2 mutations ) MHACM 5000 3500
231 Hallermann Strieff Syndrome-GJA1 gene sequencing MHSS 8800 6600
232 Hallervorden Spatz - PANK2 Common mutation MHSC 6600 4500
233 Hallervorden-Spatz Syndrome - PANK2 gene MHSDSEQ 28000 22000
sequencing
234 Hb D Iran MHBD 3300 2300
235 Hb D Punjab MHBP 3300 2300
236 Hb E MHBE 3300 2300
237 Hb Q India MHBQI 3300 2300
238 Hb Sickle MHBSI 3300 2300
239 Heme oxygenase 1 deficiency HO 1 gene targeted MHO 1 5500 4000
mutation
240 Hemolytic uremic syndrome atypical 1 (AHUS1) - CFH MCFHT 5500 4000
241 Hemophilia A - Gene sequencing MHAS 35000 27000
242 Hemophilia A Inversions 1/22 MHAI 6000 4200
243 Hemophilia B - Gene sequencing MHBS 22000 17000
244 Hemophilia B- MLPA MLF9 7000 5000
245 HEPATOCEREBRAL MITOCHONDRIAL DNA DEPLETION MMPV17 10000 7000
SYNDROMEex5+6
246 HFI - ALDOB - Agarwal mutaion MHFIA 5500 4000
25
247 HLA-B 1502 GENOTYPING, CARBAMAZEPINE, HB1502 3600 2500
PHENYTOIN
248 HLA-B 5701, GENOTYPING, ABACAVIR HB5701 1800 1200
249 HNPCC - MLH1 / MSH2 DELETION / DUPLIATIONS MID 7000 5000
250 HNPCC - MLH1 Gene Sequencing MMLH1 35000 27000
251 HNPCC - MLH1/ MSH2 MICRO SATELLLTE INSTABILITY MIT 8000 5600
( MSI )
252 HNPCC - MSH2 Gene Sequencing MMSH2 26000 22000
253 HNPCC - MSH6 Gene Sequencing MMSH6 19000 14500
254 Holocarboxylase deficiency HLCS full gene MHLCS 25000 20000
255 HOMOCYSTINURIA CBS gene Sequencing MCBS 28000 22000
256 Human Telomere-7 (dosage ch9p,10p,11p and MLTEL7 7000 5000
12p)MLPA
257 Hyperoxaluria AGXT gene sequencing MHO 22000 17000
258 Hyperoxaluria-AGXT MLPA MLAGX 7000 5000
259 Hypomyelination with Congenital Cataract- FAM126A MHCF 26000 22000
gene sequencing
260 IDH1(R132) IDH2 (R172) Mutations in Gliomas MIDH 10000 7000
261 IDH1/IDH2 and MGMTMLPA IDH1/IDH2 16000 12000
262 IDUA Full gene (Hurler Syndrome) all 14 exons MIDUA 30000 22500
263 Iminitib Resistance mutation analysis CIR 9000 7000
264 INCONTINENTIA PIGMENTI NEMO GENE COMMON MNEMO 5000 3500
DELETION
265 Infantile neuroaxonal dystrophy ( INAD ) PLA2G6 MPLA2G6 25000 20000
gene sequencing
266 IPEX syndrome (immunodysregulation MFOXP3 6600 4400
polyendocrinopathy enteropathy X-linked syndrome)
Targeted mutation FOXP3 gene
267 isovaleryl-CoA dehydrogenase DEFICIENCY (Exon 2) MIVD 7000 5000
268 JAK-2 mutation ( Molecular Genetics ) MJACK2 3300 2300
269 Jarcho levin syndrome - MESP2 gene sequencing MMESP2 20000 16000
270 Joubert Syndrome -21 (exon 19 and 23) MCSPP1 10000 7000
271 JUNCTIONAL EPIDERMOLYSIS BULLOSA, MLAMA3 7000 5000
LARYNGO-ONYCHO-CUTANEOUS SYNDROME,
(exon55)
272 Kallman syndrome gene (FGFR1) sequencing MKAL 28000 22000
273 Klippel - Feil syndrome 2 - MEOX1 gene MEOX1 16500 13200
274 Known Mutation ( By Sequencing ) MSQ 5000 3500
275 KRABBE S DISEASE GALC COMMON DELETION MKD 5000 3500
276 Krabbes - GALC gene sequencing MGALC 28000 22000
277 KUFS DISEASE, LATE-INFANTILE NEURONAL CEROID MCLN6T1 7000 5000
LIPOFUSCINOSIS, exon3
278 Lafora Disease-EPM2A gene sequencing MLD1 20000 16000
279 Lafora Disease-NHLRC1 gene sequencing NHLRC1 20000 16000
280 LBSL - DARS 2 gene sequencing MDARS2 33000 26000
281 Leb Hered Optic atrophy - (LHON) 3 mutations MLHO 6000 4200
282 LEBER CONGENITAL AMAUROSIS, CONE-ROD MGUCY2D 7000 5000
DYSTROPHYex 11
283 LEIGH SYNDROME (LS), MITOCHONDRIAL COMPLEX I MNDUFV1 10000 7000
DEFICIENCY (MT-C1D)ex8+9
284 Leigh syndrome with cytochrome c oxidase (COX) MLSCOX 20000 16000
deficiency-SURF1gene sequencing
285 LEPRE1-Related Osteogenesis Imperfecta ( targeted MLEPRE 11000 7700
mutations exons 13 / 14)
26
286 Leri-Weill dyschondrosteosis and Langer mesomelic MSHOX 19800 15000
dysplasia SHOX gene sequencing
287 Lesch Nyhan syndrome HPRT1 gene sequencing MLN 30000 22500
288 LEUKOCYTE ADHESION DEFICIENCY TYPE 1 MITGB2 7000 5000
289 Leukocyte adhesion deficiency type I (LAD1) - ITGB2 MITGB2T 5500 4000
290 Linkage analysis MLA 12000 9000
291 Lissencephaly (Exon 35) MDYNC1H1 7000 5000
292 Lissencephaly DCX gene sequencing MDCX 25000 20000
293 Long QT / Cardiomyopathies / Premature CAD by MCQTNGS 40000 40000
NGS
294 Long QT package (KCNQ1, KCNH2, SCN5A) MLQT 35000 35000
295 Long QT2- KCNH2 gene sequencing MKCNH2 44000 32000
296 Long QT3- SCN5A gene sequencing MSCN5A 65000 45000
297 LOWE SYNDROME LINKAGE STUDIES - FAMILY MLSLF 0 0
MEMBER
298 Lymphedema (Congenital)-FLT4 gene sequencing MCL 20000 16000
299 Lynch syndrome gene panel (by NGS) MLYNCHNGS 40000 35000
300 Machado - Joseph disease - Spino cerebellar ataxia ( MJD 5000 3500
SCA3 )
301 Mandibuloacral dysplasia- LMNA (Lamin A/C) gene MLMNA 6600 4400
targeted mutation
302 Maple Syrup Urine Disease- BCKDHA gene MMSUDA 28000 22000
sequencing
303 Maple Syrup Urine Disease- BCKDHB gene sequencing MMSUDB 28000 22000
304 Maple Syrup Urine Disease- DBT gene sequencing MMSUDDBT 28000 22000
305 Marfan syndrome- FBN1 MLPA MLMAR 9000 7000
306 Marfan Syndrome, Loeys-Deitz Aortic Aneurysm MTGFBR2 7000 5000
Syndrome (Exon8)
307 Maroteaux-Lamy syndrome- MPS VI ASRB gene MASRB 25000 20000
sequencing
308 MCAD gene sequencing (ACADM gene) MACADM 25000 20000
309 MCAD mutation ( Medium chain Acyl-coA MCAD 3300 2300
dehydrogenase )
310 McArdle disease gene sequencing -PYGM gene MPYGM 35000 27000
311 Meckel Gruber- TMEM67 gene targeted analysis MTMEM67 11000 7700
312 MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS MCFHT1 7000 5000
TYPE II exon 21
313 MEN1 GENE MUTATION ( 7 EXONS BY SEQUENCING ) CMEN 22000 17000
314 Menke’s Disease - ATP7A gene targeted mutations MATP7A 8800 6600
315 MENKES, exon 4+5 MATP7AT 10000 7000
316 Mental Retardation - X Linked - Panel MRX 7000 5000
Deletions/Duplications
317 Mental Retardation Panel1 - Multiple MR1 7000 5000
318 Mental Retardation Panel2 - Multiple MR2 7000 5000
319 Merosin-deficient congenital muscular dystrophy 1A MLAMA2S 11000 7700
(MDC1A) targeted exons 27 & 56
320 Metachromatic Leukodystrophy gene sequencing MMLD 22000 17000
321 Metaphyseal Dysplasia - COL 10A1 Gene Sequencing MC10S 22000 17000
322 Methyl Malonic Aciduria- MMAA gene sequencing MMMAA 17000 13500
323 Methyl Malonic Aciduria- MMAB gene sequencing MMMMA 17000 13500
324 Methylmalonic acedimia- MUT gene sequencing MMUT 28000 22000
27
325 Methylmalonic aciduria and homocystinuria type MMACHC 22000 17000
cbIC full gene
326 MGMT Methylation MMGMT 15000 13000
327 MGMT methylation by MLPA MGMT 9000 7000
328 Microcephalic Osteodysplastic Primordial Dwarfism MRNU4ATAC 5500 4000
type 1 (MOPD)
329 Microcephaly -ASPM gene sequencing MASPM 35000 35000
330 Microcephaly -PQBP1 gene sequencing MPQBP1 17000 13500
331 Microdeletion panel MLPA any 1 MMICRO 7000 5000
332 Microdeletion panel MLPA any -2 MMICRO2 11000 8000
333 Microdeletion-1 MLPA (Probe-P245) MLDL1 7000 5000
334 Microdeletion-6 MLPA(Confirmation P245) MLDL6 7000 5000
337 Micropthalmia/ Anopthalmia- FOXE3 gene MFOXE3 9000 7000
sequencing
338 Mitochindrial DNA Genome sequencing MMITOSQ 40000 40000
339 Mitochondrial Deafness-2 mutations(A1555G, MMDEAF 5500 4000
7445G)
340 Mitochondrial DNA depletion syndrome 6 (MDDS6) - MMDDS6T 11000 7700
MPV17 gene, targeted exons 5 & 6
341 Mitochondrial Genome - Deletion/Duplication MGDD 7000 5000
342 Mowat Wison syndrome /deletion duplication MMWSDD 9000 7000
343 Mowat Wison syndrome-ZEB2 gene sequencing MMWS 28000 22000
344 MPS IIIA Sanfillipo Disease-SGSH gene sequencing MMPS3A 28000 22000
345 MPS II Gene Sequencing MMPSII 28000 22000
346 MPS II Hunter syndrome ( IDS gene deletions ) MHUNTD 7000 5000
347 MPS IIIB gene sequencing ( NAGLU gene ) MMPS3B 22000 17000
348 Mucolipidosis II alpha/beta.- GNPTAB gene targeted MGNPTAB 6600 4400
mutation analysis (Exon 13, 19)
349 Mucopolysaccharidosis IVA (Morquio A) - GALNS full MGALNSF 35000 27000
gene
350 Multiple endocrine neoplasia- MEN1 MLPA MLMEN 7000 5000
351 Multiple epiphyseal dysplasia targeted exon 17 MCOL9A2 5500 4000
352 Multiple epiphyseal dysplasia type 3 targeted exon 5 MCOL9A3 5500 4000
353 Multiple Sulphatases- SUMF1 gene sequencing MMS 20000 16000
354 Mutation analysis ( single ) MMAS 5000 3000
355 Myoadenylate Deaminase Deficiency-AMPD1 exon 2 MAMPD1 7000 5000
&3 gene sequencing
356 Myopathy, centronuclear , X-linked targeted MMTM1 5500 4000
mutation
357 Nail Patella syndrome -ex4+5 MLMX1B 10000 7000
358 NBIA Neurodegeneration with brain iron MNBIA 25000 20000
accumulation-PLA2G gene targeted mutations by
sequencing
359 NBIA- PANK2/PLA2G6 MLPA MLPANK 7000 5000
360 NCL - Infantile ( 2 Mutaiton Assay ) ( We advice MNCLH 3300 2300
enzyme assay before this test )
361 NCL - Juvenile ( 1 Mutation - common deletion ) MNCLJ 4000 3000
362 NCL - Late infantile ( 2 Mutations ) MNCLL 4000 3000
363 Neonatal Diabetes Mellitus ABCC8 gene targeted MABCC8 8800 6600
mutation
364 Nephropathic Cystinosis CTNS gene (one mutation) / MCTNST 5500 4000
(exon 10)
28
365 Nephrotic syndrome (NPHS1 and NPHS2 gene MNPHS 40000 40000
sequcencing)
366 Neurofibromatosis (Exon 16) MNF1 7000 5000
367 Neurofibromatosis type 2 NF2 22q12 MLPA MLNF2 7000 5000
368 Neuronal ceriod lipo fucinosis ( NCL ) or Batten MNCLF 9000 7000
disease
369 Neuronal Ceroid Lipofuscinosis(NCL) CLN8 (one MCLN8T 5500 4000
mutation exon 2)
370 Neuronal ceroid-lipofuscinoses 6-CLN 6 gene, MCLN6T 5000 4000
targeted exon3
371 Neuronal Ceroid-Lipofuscinosis 2 (CLN2).- TPP1 gene MTPP1 25000 20000
sequencing
372 NGS panel Deafness MDFNG 35000 35000
373 Niemann Pick disease gene sequencing MNP 30000 22500
374 Niemann-Pick type C disease- NPC MLPA MLNPC 7000 5000
375 Non-ketotic hyperglycinemia (NKH) MGLDC 7000 5000
376 Norrie disease - NDP gene sequencing MNDP 16500 13200
377 NOTCH3 gene sequencing ( cadASIL ) 5 exons MNOT 15000 11000
378 NPM1 gene Mutations(AML) MNPM1 3000 2000
379 Obesity due to leptin deficiency Leptin gene MLEPTIN 13000 11000
sequencing
380 Ocular albinism ( X-linked), GPR143 gene gene MGPR143 25000 20000
sequencing
381 OSTEOGENESIS IMPERFECTA ex13,14,18 MLEPRE1OI 13000 10000
382 Osteogenesis imperfecta type VIII - targeted exon 14 MLEPRE1T 5500 4000
383 Osteopetrosis TCIRG gene common mutations ( exon MTCIRG 8800 6600
13 & 18)
384 OSTEOPETROSIS,common +14-15 MTCIRG1 10000 7000
385 OTC deficiency- MLPA MLOTC 7000 5000
386 OTC gene sequencing MOTC 30000 22500
387 Otopalato digital syndrome FLNA gene (3 exons) MFLNA 11000 7700
388 Pancreatitis- PRSS1 gene sequencing MPRSS 17000 13500
389 Pancreatitis- SPINK1 gene sequencing MSPINK 17000 13500
390 Paramyotonia common mutations Arg 1448 His Thr MPM 7000 5000
1313 Met
391 Pelizaeus Merzbacher Deletion/Duplication MPZD 7000 5000
392 Pelizaeus-Merzbacher disease-PLP1 gene sequencing MPMD 20000 16000
393 Permanent neonatal diabetes mellitus - INS gene MINS 8800 6600
targeted mutation
394 PEROXISOME BIOGENESIS DISORDER 5A/5B exon3 MPEX2 7000 5000
395 PFIC1-Progressive familial intrahepatic cholestasis MATP8B1 35000 35000
type 1 - ATP8B1 gene sequencing
396 PFIC1-Progressive familial intrahepatic cholestasis MATB123 40000 40000
type 1 +2+3
397 PFIC2-Progressive familial intrahepatic cholestasis MABCB11 35000 35000
type 2 -ABCB11 gene Sequencing
398 PFIC3-Progressive familial intrahepatic cholestasis MABCB4 35000 35000
type 3 - ABCB4 gene Sequencin
399 Phenylketonuria - phenylalanine hydroxylase (PAH) MPKU 22000 17000
gene
400 PML-RARA (APML) MPMLRARA 3600 2500
401 POLYCYSTIC KIDNEY AND HEPATIC DISEASE 1 MPKDH1 10000 7000
(AUTOSOMAL RECESSIVE)ex4+61
29
402 Polycystic kidney disease, autosomal recessive MPKHD-1 11000 7700
(ARPKD) targeted exon 11 & 19
403 Pompe disease - GAA gene sequencing MGAA 33000 26000
404 Pompe MLPA MLPOM 7000 5000
405 Pontocerebellar hypoplasia-TSEN54 gene sequencing MTSEN54 40000 40000
406 PORPHYRIA SEQUENCING MPSQ 22000 17000
407 Prader willi syndrome molecular test MPWS 6000 4500
408 Praderwilli/ Angelman - MLPA MLPWAS 7000 5000
409 preconception screening by NGS- six hotspot agarwal M1AGG 22000 18000
mutations
410 Preconception screening by NGS-common genes- MPRNG 30000 22000
MAGG+ HBB, DMD ,CF, Gauher,Criggler najjar,
GALT,Deaf,OCA, Wilson disease
411 preconception screening by NGS-common genes- M2PRESCREEN 30000 22000
MAGG+ HBB, DMD ,CF,Gauhcer,CJ, GALT,Deaf,OCA,
wilson
412 preconception screening cmpehensive MPRESCREEN M3SCREEND 44000 38000
by NGS-+Fx, DOSAGE SMA,DMD,
413 Preconception screening comprehensive Prescreen MSCREN 44000 38000
by NGS-+Fx, Dosage SMA, DMD
414 Prenatal diagnosis by gene sequencing MPNDSEQ 20000 16500
415 Primary Congenital Glaucoma/ Buphthalmos- CYP1B1 MCYP1B1 15000 11000
gene sequencing
416 PROGRESSIVE PSEUDORHEUMATOID DYSPLASIA MWISP3 7000 5000
(PPRD) ex 2
417 Propionic academia- PCCA MLPA MLPCC 7000 5000
418 Propionic aciduria- PCCA gene sequencing MPCCA 35000 35000
419 Propionic aciduria- PCCA gene sequencing- A+B NGS MPCCAB 35000 35000
420 Propionic aciduria- PCCB gene sequencing MPCCB 28000 22000
421 Prothrombin gene polymorphism ( G20210A ) MPRO 3300 2300
422 Pseudoachondroplasia - COMP gene sequencing of MCOMP 17000 13500
exons 10-14, 16
423 PTEN gene sequencing MPTEN 25000 20000
424 Pyknodysostosis-CTSK sequencing MCTSK 25000 20000
425 Pyruvate Carboxylase deficiency - gene sequencing MPCD 35000 27000
426 Pyruvate Dehydrogenase Deficiency (PDH)X-linked - MPDH 28000 22000
PDHA1 gene sequencing
427 RAG1 deficiency MRAG1 21000 16500
428 Rapid-onset dystonia parkinsonism (RDP) (also MATP1A3 33000 26000
known as DYT12)- ATP1A3 gene sequencing
429 RB gene analysis (By NGS) MRBNGS 40000 35000
430 Recessive forms of osteogenesis imperfecta (Intron MPPIB 7000 5000
2)
431 Renpenning Syndrome-PQBP1 gene sequencing MRSPQBP1 21000 16500
432 Respiratory distress syndrome (RDS) due to MRDS 11000 7700
Surfactant Deficiency( three common mutations -
SFTPB, SP-C and ABCA3 gene mutations
433 RET Gene Mutations ( 6 Exons ) MRET 15000 11000
434 Retinoblastoma - Deletion/Duplication MRBDD 7000 5000
435 RETINOBLASTOMA GENE SEQUENCING MRBS 35000 35000
436 Rett syndrome ( MECP2 sequencing and Deletion / MRS 30000 22500
duplication )
437 Rett syndrome atypical -CDKL5 MLPA MLCDK 7000 5000
438 RETT Syndrome MECP2 Deletion/Duplication MRTSQ 7000 5000
30
439 Rett syndrome MECP2 Sequencing MRSS 28000 22000
440 RH genotyping - Both alleles ( +/+ or -/- ) MRH 6000 4200
441 Rh Typing On Fetal DNA in Maternal Blood MRHMB 5000 3500
442 RPE65 Gene Sequencing MRPE65 28000 22000
443 RRM2B - related mitochondrial disease - RRMB2 MRRMB 20000 18000
GENE Sequencing (9 Exons )
444 Russel Silver - Methylatio H - 19 MRSS19 8800 6600
445 Russel Silver ? UPD chr7 MRSS7 8800 6600
446 Saethre- Chotzen syndrome - TWIST gene Dosage MTWISTSD 18000 14000
+sequencing
447 Saethre- Chotzen syndrome - TWIST gene MTWISTS 13000 11000
sequencing
448 Sandhoff disease- HEXB gene sequencing MHEXB 25000 20000
449 Sanjad Sakati syndrome/common mutation - TBCE MTBCE 7000 5000
gene
450 SCID Radiosensitive - DCLRE1C MLPA MLDCLR 7000 5000
451 Sengers Syndrome (Mitochondrial ) exon 13,14 MAGK 10000 7000
452 Sequencing Parkinson ( Gly19 ser mutation ) SGLY19 5500 4000
453 Severe Combined Immunodeficiency (Exon 1) MRFXAP 7000 5000
454 short rib-polydactyly syndrome type 5 MWDR35 7000 5000
455 Sialidosis (Exon 4) MNEU1 7000 5000
456 Simpson-Golabi-Behmel syndrome 1 targeted MGPC3 5500 4000
mutation
457 Sjogren-Larsson syndrome - ALDH3A2 gene targeted MALDH3A2 6600 4400
mutation
458 SJORGEN- LARSSON SYNDROME LINKAGE-ALDH3A2 MSLS 12000 9000
459 SMA carrier screening by MLPA SMAMLPA 7000 5000
460 SMA with respiratory distress1- SMARD1 gene MSMARD 28000 22000
sequencing
461 SPASTIC PARAPLEGIA TYPE 4, exon 12 MSPAST 7000 5000
462 SPG 11 - Q906fs Agrawal mutaion MSPG11A 5500 4000
463 SPINAL BULBAR MUSCULAR ATROPHY CAG REPEATS MSBM 5000 3500
464 Spinal cerebellar ataxia ( SCA ) - one gene MSCA 5000 3500
465 Spinal cerebellar ataxia ( SCA ) - two gene MSCATG 7000 5000
466 Spinal cerebellar ataxia package ( 1, 2, 3, 12 ) MSCA4 12000 9000
467 Spinal cerebellar ataxia package ( 1, 2, 3, 6, 7, 12, 17 ) MSC4 21000 16500
468 Spinal Muscular Atrophy - SMN 1 Gene Sequencing MSMNS 25000 22000
469 Spinal muscular atrophy -SMN2 copy number analysis MSMC 7000 5000
470 Spinocerebellar ataxia with peripheral MSCAN 7000 5000
neuropathy-autosomal recessive-SCAN1 targeted
mutation analysis
471 Spinocerebellar ataxia with peripheral MTDP1 28000 22000
neuropathy-autosomal recessive-TDP1 gene
sequenicng
472 Spondyloepimetaphaseal dysplaisa - KIF22 exon 4 MKIF22 6600 4400
473 Spondyloepiphyseal Dysplasia X-Linked gene MSEDS 17000 13500
Sequencing
474 SSjogren-Larsson syndrome( Prenatal Diagnosis by MSJOL 15000 12000
Linkage )
475 Subtelomeric Deletions / Duplications - All MTELD 7000 5000
Autosomes
476 Surfactant B gene sequencing MSURFB 28000 22000
477 Surfactant C gene sequencing MSURFC 22000 17000
31
478 Tay-Sachs disease (TSD) /GM2 gangliosidosis variant MHEXA 28000 22000
B- HEXA gene sequencing
479 TGM1 GENE SEQ A R CONG ICHTH AND LAMELLAR MIGMS 28000 22000
ICHTHYOSIS
480 Thalassemia - XMN, Bcl1 and HBSIL- MYB MXM3 8800 6600
polymorphism
481 Thalassemia ALPHA globin gene sequencing MALPHAGS 8500 6000
482 Thalassemia Beta globin gene large deletions (HPFH) MBGLD 8500 6000
483 Thalassemia BETA globin gene sequencing MBETAGS 8500 6000
484 Thalassemia beta mutation study - couple MTHC1 8500 6000
485 Thalassemia beta mutation study -child MTHPRO 5000 3500
486 Thalassemia beta mutation study -child and parents MTHCP 8500 6000
487 Thalassemia Intermedia - Bcl1 and HBSIL- MYB MXM2 6600 4400
polymorphism
488 Thalassemia prenatal diagnosis MTHP 15000 12000
489 Thalassemia prenatal diagnosis ( Thalassemia society MTHPTS 12500 10000
patient )
490 THROMBOPHILIA DUE TO PROTEIN C DEFICIENCY MPROC 10000 7000
(Exon 7,9)
491 Thrombophilia profile ( DNA ) - 3 polymorphisms MTHR 7000 5000
492 THROSENEMIA - FAH GENE SEQUENCING MTYS 21000 16500
493 Torsion dystonia 1 ( DYT 1 ) deletion analysis MDYT 3600 2500
494 TP53 DELETION/ DUPLICATION C53D 7000 5000
495 TP53 SEQUENCING CP53 15000 11000
496 TPMT ( 1,2,3A,3B,3C ) GENOTYPING, AZA, MTP5 5500 4000
6MP,6-THIOGUANINE
497 TPMT ( 1,2,3C ) GENOTYPING, MTP3 3300 2300
AZA,6MP,6-THIOGUANINE
498 Tricho hepatoenteric syndrome- TTC37 exon 28 MTTC 5000 3500
common mutation
499 TSC1 and TSC2 gene analysis( By NGS)+ dosage MTCSNGSD 40000 37000
500 Tuberculosis mycobacterium infection ( PCR )- MTBINF 4200 3000
qualitative
501 Tuberous sclerosis ( TSC1 ) deletion / duplication MDTS1 7000 5000
502 Tuberous sclerosis ( TSC1+2)- NGS TUBES 35000 35000
503 Tuberous sclerosis ( TSC2 ) deletion / duplication MDTS2 7000 5000
504 UGT1A1 28 GENOTYPING IRINOTECAN MUGG 3300 2300
505 Unverricht–Lundborg disease MEPM1 8800 6600
506 Usher syndrome and nonsyndromic AR deafness MCDH23 7000 5000
(Exon 58)
507 Usher syndrome type IIa and retinitis pigmentosa MUSH2A 11000 7700
targeted exons 38 & 53
508 validation of NGS mutation- SGRH only MVALSGRH 7000 5000
509 Very Long Chain Fatty Acid Dehydrogenase MACADVL 28000 22000
Deficiency-ACADVL gene
510 VGT1A1 28 ( (TA) ) GENOTYPING, IRINOTECAN MUGT 2500 1750
511 VHL GENE DELETION/ DUPLICATION CVHL 7000 5000
512 VHL GENE MUTATION ( 3 EXONS BY SEQUENCING, CVHS 15000 11000
MLPA )
513 Waardenburg Syndrome - PA X 3 Gene Sequencing MWSS 22000 17000
514 Waardenburg syndrome type 2 (Hirschsprung ) EDN3 MEDN3 19800 15000
gene sequencing
515 WILMS TUMOR 1, ex 9+7 MWT 1 10000 7000
516 Wilson Disease - ATP7B Gene Sequencing MWDS 30000 22500
32
517 Winchester Syndrome - MMP2 gene targeted MMMP2 6600 4400
mutations
518 Wiskott Aldrich gene sequencing- WAS gene MWAS 28000 22000
519 X - L Chondrodysplasia punctata Arse gene MXLCDP 22000 17000
520 X - linked ichthyosis ( deletion in Steroid sulfatase MXIC 5000 3500
gene )
521 X - linked ichthyosis -carrier screening by dosage MXICD 7000 5000
analysis of STS gene
522 X - linked ichthyosis -extent of deletion MXICEXT 7000 5000
523 X- severe combined immunodeficiency MXSCID 28000 22000
(X-SCID)-IL2RG gene sequencing
524 Xeroderma pigmentosum - XPC gene sequencing MXPC 35000 27000
525 XERODERMA PIGMENTOSUM,exon3 MXPA 7000 5000
526 X-linked congenital adrenal hypoplasia- DAX gene MDAX 17000 13500
sequencing
527 X-linked dyserythropoietic anemia and MGATA-1 5500 4000
thrombocytopenia GATA 1 hotspot
528 X-Linked Hydrocephalus - L1CAM gene sequencing ML1CAM 35000 35000
529 X-LINKED MYOTUBULAR MYOPATHY3,12,13 MMTMX 13000 10000
530 XMN polymorphism Gr gene ( thalassemia child ) MXM1 4000 2700
531 Y - chromosome deletions ( DNA ) - 10 MYDL 6000 4200
IVF Investigations Charges

CAT 1/CAT2 CAT3
1 Post Coital Test PCT 170 100
2 Semen Analysis SANAL 400 240
3 Semen Fructose Test SFRUCK 80 80
4 Semen Processing for IUI / AIH SPFAIH 2100 1280
5 Semen Pus Cells Test (IVF Lab) PUSIVF 80 80
6 Serum Beta hCG (IVF Lab) SHCG 650 400
7 Serum FSH ( Baseline - Day 1 / 2 / 3 of menses ) SFSHBDM 700 420
8 Serum FSH ( Random ) FSH 700 420
9 Serum LH ( Baseline - Day 1 / 2 / 3 of menses ) SLHBDM 700 420
10 Serum LH ( Random ) LH 700 420
11 Serum Oestradiol ( E2 ) - Random OESTR 700 420
12 Serum Oestradiol ( E2 ) ( Baseline - Day 1 / 2 / 3 of SOBDM 700 420
menses )
13 Serum Progesterone PROGEST 700 420
14 Serum Prolactin SPROLAC 700 420
IVF Procedures

CAT 1/CAT2 CAT3
1 CULTURE AND EMBRYO TRANSFER CHARGES ( AFTER CETCPDCHOS
CRYOPRESERVATION ) (EMBRYOLOGIST FEE + HOSPITAL
CHARGES)
Culture and embryo transfer charges ( after cryopreservation ) - Clinical CETCDFCL 11760 10780
doctor fees
Culture and embryo transfer charges ( after cryopreservation ) - CETCDFEMBR
3960 3630
Embryologist fee
Culture and embryo transfer charges ( after cryopreservation ) - hospital CETCDFAHC 20400 18700
service charges
33
2 DIAGNOSTIC SPERM EXTRACTION ( TESA / PESA ) DSEPCADCHOS
(PACKAGE CHARGES + ALL DOCTOR FEES) - WITH
ANASTHESIA
Diagnostic sperm extraction ( TESA / PESA ) - Anasthetist fee TESAAN
2040 1870
Diagnostic sperm extraction ( TESA / PESA ) - Embryologist's fee DSEEF 2460 2260
Diagnostic sperm extraction ( TESA / PESA ) - Hospital service charges DSEHC 1860 1710
Diagnostic sperm extraction ( TESA / PESA ) - Surgeon fee DSEUF
7440 6820
3 DIAGNOSTIC SPERM EXTRACTION ( TESA / PESA ) DSEPCADCHWAOS
(PACKAGE CHARGES + ALL DOCTOR FEES)
Diagnostic sperm extraction ( TESA / PESA ) - Embryologist's fee DSEEF 2460 2260
Diagnostic sperm extraction ( TESA / PESA ) - Hospital service charges DSEHC
1860 1710
Diagnostic sperm extraction ( TESA / PESA ) - Surgeon fee DSEUF 7440 6820
4 Embryo Biopsy 3-4 Embryos (Embryologists fee + Hospital EMBOS
charges + Clinician Charges)
Embryo Biopsy (3-4 Embryos) - Clinician Charges EMBRYOCL
10000 10000
Embryo Biopsy (3-4 Embryos) - Embryologist fee EMBRY 5100 5100
Embryo Biopsy (3-4 Embryos) - Hospital Charges EMBRYO
15300 15000
5 Embryo Biopsy 1-2 Embryos (Embryologists fee + Hospital EMBROS
Embryo Biopsy (1-2 Embryos) - Clinician Charges EMBRCF 5100 5100
Embryo Biopsy (1-2 Embryos) - Embryologist fee EMBRF
2550 2550
Embryo Biopsy (1-2 Embryos) - Hospital Charges EMBRHC 7600 7600
6 Embryo Biopsy 5-8 Embryos (Embryologists fee + Hospital EMBRYOS
Embryo Biopsy (5-8 Embryos) - Clinician Charges EMBCLIN
10000 10000
Embryo Biopsy (5-8 Embryos) - Embryologist fee EMBYOEF 7600 7600
Embryo Biopsy (5-8 Embryos) - Hospital Charges EMBRYOHC
23000 23000
7 Freezing of semen (Embryologists fee + Hospital charges) FRESEMOS
Freezing of semen - Embryologists fee FSEMEEMBR 440 440
Freezing of semen - hospital charges FSEME
1300 1300
Semen Cryo Preservation SCP
8 IVF PROCEDURE ( 1ST OCR - DUO STIM ) - PACKAGE + ALL IVF1OCROS

DOCTOR FEES + HOSPITAL CHARGES
IVF procedure ( 1ST OCR - DUO STIM ) - Anaesthetist Charges IVF1SCRANA
5640 4920
IVF procedure ( 1ST OCR - DUO STIM ) - Clinician Charges IVFSC1OCR 29400 23400
IVF procedure ( 1ST OCR - DUO STIM ) - Embryologists Charges IVFSCOCRST
13800 10800
IVF procedure ( 1ST OCR - DUO STIM ) - Hospital Charges IVF1SOCR 45360 36480
IVF procedure ( 1ST OCR - DUO STIM ) - Package Charges IVF1SPROC 97200 78000
IVF procedure ( 1ST OCR - DUO STIM ) - Ultrasound Charges IVF1SOCR1
3000 2400
9 IVF PROCEDURE ( 1ST CYCLE ) - PACKAGE + ALL DOCTOR IVF1OS
FEES + HOSPITAL CHARGES
IVF CYCLE IVFCY
IVF Embryology Embryology
IVF procedure ( 1st Cycle ) - Clinician Charges IVFSC1CL 29400 21450

IVF procedure ( 1st cycle ) - Embryologists Fee IVFSC1EMBF
13800 9900
IVF procedure ( 1st cycle ) - package charges IVF1PC 97200 71500
IVF procedure ( 1st Cycle ) - Anaesthetists Charges IVF1SCAC
5640 4510
IVF procedure ( 1st Cycle ) - Hospital Charges IVF1SCHC
45360 33440
IVF procedure ( 1st Cycle ) - Ultasound Charges IVF1SCUC 3000 2200
10 IVF PROCEDURE ( 2ND OCR - DUO STIM ) - PACKAGE + ALL IVF2OCROS
DOCTOR FEES + HOSPITAL CHARGES
IVF procedure ( 2ND OCR - DUO STIM ) - Anaesthetist Charges IVF2SCRANA 2820 2460
IVF procedure ( 2ND OCR - DUO STIM ) - Clinician Charges IVFSC2OCR 14700 11700
IVF procedure ( 2ND OCR - DUO STIM ) - Embryologists Charges IVFS2COCRST
6900 5400
IVF procedure ( 2ND OCR - DUO STIM ) - Hospital Charges IVF2SOCR 22680 18240
IVF procedure ( 2ND OCR - DUO STIM ) - Ultrasound Charges IVF2SOCR2 1500 1200
34
11 IVF PROCEDURE ( 2ND CYCLE ) - PACKAGE + ALL DOCTOR IVF2OS
FEES + HOSPITAL CHARGES
IVF CYCLE IVFCY
IVF Embryology Embryology
IVF procedure ( 2nd Cycle ) - Clinician Charges IVFSC2CL 20400 17050

IVF procedure ( 2nd cycle ) - Embryologists Fee IVFSC2EMBF
9720 8030
IVF procedure ( 2nd cycle ) - package charges IVF2PC 69000 58300
IVF procedure ( 2nd Cycle ) - Anaesthetists Charges IVF2SCAC
4320 3740
IVF procedure ( 2nd Cycle ) - Hospital Charges IVF2SCHC 31560 26950
IVF procedure ( 2nd Cycle ) - Ultasound Charges IVF2SCUC 3000 2530
12 Egg Freezing (Every additional 9 oocytes) IVFEF
Egg Freezing (Every additional 9 oocytes) - Embryologist Fee EFEF 2500 2500
Egg Freezing (Every additional 9 oocytes) - Hospital Charges EFHC
7600 7600
13 Egg Freezing (Non Fertility Preservation :upto 9 oocytes) IVFEN
Egg Freezing (Non Fertility Preservation :upto 9 oocytes) - Embryologists EFDCN 6400 6400
Charges
Egg Freezing (Non Fertility Preservation :upto 9 oocytes) - Hospital EFHCN
19000 19000
Charges
14 Oocyte Cryopreservation cycle (upto 9 oocytes) IVFOC9O

Oocyte Cryopreservation cycle (upto 9 oocytes) - Anaesthetist pool OCAP
4500 4500
Oocyte Cryopreservation cycle (upto 9 oocytes) - Consultant Fee OCCF 19500 19500
Oocyte Cryopreservation cycle (upto 9 oocytes) - Embryologist Fee OCEF 11500 11500
Oocyte Cryopreservation cycle (upto 9 oocytes) - Hospital Charges OCHC 30000 30000
Oocyte Cryopreservation cycle (upto 9 oocytes) - PAC Charges OCPAC 1000 1000
Oocyte Cryopreservation cycle (upto 9 oocytes) - Ultrasound Charges OCUC
2650 2650
15 Egg Freezing (Renewal Charges per year) IVFRC
Egg Freezing (Renewal Charges per year) - Embryologist Charges EFRDC
3800 3800
Egg Freezing (Renewal Charges per year) - Hospital Charges EFRHC 11500 11500
16 IVF procedure ( Registration ) - (Valid for 3 Months) IVFROS
IVF procedure ( Registration ) - Packages Charges IVFRPC
12450 11400
IVF procedure ( Registration) - Clinician Charges IVFRC 1320 1210
IVF procedure ( Registration) - Embryologists Fee IVDEM
450 400
IVF procedure ( Registration) - Hospital Charges IVFHC 8760 8030
IVF procedure ( Registration) - Ultasound Charges IVFULT 1920 1760
17 Oocyte aspiration (no oocytes retrieved and further IVF OOCYTEASPOS
suspended) (Package charges + all doctor fees + Hospital
charges)
IVF CYCLE IVFCY
Oocyte aspiration (no oocytes retrieved and further IVF suspended) - OAAF
3700 3000
Anaesthetist fee
Oocyte aspiration (no oocytes retrieved and further IVF suspended) OACF 10500 8700
Clinical Doctor fee
Oocyte aspiration (no oocytes retrieved and further IVF suspended) - OAHA 8500 8000
Hospital amount
Oocyte aspiration (no oocytes retrieved and further IVF suspended) - OAUC
2200 1750
Ultrasound charges
18 IVF procedure ( OCR - DUO STIM ) - Registration Charges REGIVFOS

IVF procedure Registration ( OCR - DUO STIM ) - Clinician Charges IVFOCR1
1250 1250
IVF procedure Registration ( OCR - DUO STIM ) - Embryologist Charges REGEMBRO 400 400
IVF procedure Registration ( OCR - DUO STIM ) - Hospital Charges IVFOCRDUO2 10950 10950
IVF procedure Registration ( OCR - DUO STIM ) - Package Charges IVFREGPAC 15000 15000
IVF procedure Registration ( OCR - DUO STIM ) - Ultrasound Charges REGULTRA 2400 2400
19 Renewal charges for embryo cryopreservation (for every RENCRYOOS
six months) - (Embryologist fee + Hospital charges)
Renewal charges for embryo cryopreservation (for every six months) - RCSCRYOEMBR 1250 1250
embryologists fee
Renewal charges for embryo cryopreservation (for every six months) - RCSCRYO 3700 3700
hospital charges
20 Re-Vitrification (Embryologists fee + Hospital charges) REVITEOS
35
Re-Vitrification - Embryologist fee REVITEMB 2760 2760
Re-Vitrification - Hospital Charges REVITEHC
7875 7875
21 Embryo cryopreservation for 1-3 bactes (Embryologist fee SPERMCRYO
+ hospital charges)
Embryo cryopreservation ( freezing ) charges (Embryologists fee) SCRYCEMB 6480 5940
Embryo cryopreservation ( freezing ) charges (Hospital amount) SCRYC
19200 17600
22 Embryo cryopreservation for 4-6 bactes (Embryologist fee SPERMCRYO46
+ hospital charges)
19200 17600
23 Embryo cryopreservation for 7-9 bactes (Embryologist fee SPERMCRYO79
+ hospital charges)
19200 17600
24 REPEAT DIAGNOSTIC SPERM EXTRACTION ( TESA / PESA ) TESADHCHCOS
(PACKAGE CHARGES + ALL DOCTOR FEES + HOSPITAL
CHARGES)
Repeat diagnostic sperm extraction ( TESA / PESA ) - Anasthesia fee RDTPA
1750 1750
Repeat diagnostic sperm extraction ( TESA / PESA ) - Embryologist's fee RDSEEF 680 680
Repeat diagnostic sperm extraction ( TESA / PESA ) - Hospital charges RDSEHC 620 620
Repeat diagnostic sperm extraction ( TESA / PESA ) - Surgeon fee RDSEUF
2000 2000
25 Fetal reduction in IVF lab (All charges) FETALRED
OS
Fetal reduction in IVF lab - Anaesthetist fee FETALREDAC 3100 2840
Fetal reduction in IVF lab - Surgeon fee FETALREDDF
11090 10160
Fetal reduction in IVF lab – Ultrasound charges FETALREDUL 4520 4150
26 IVF procedure ( Registration 2) - (Valid for 5 Months) IVFR2OS
IVF procedure ( Registration 2) – Clinician Charges IVFREG2 2620 2400
IVF procedure ( Registration 2) -Embryologists Fee IVFEMB2
860 790
IVF procedure ( Registration 2) – Hospital Charges IVFREGHC2 17400 15950
IVF procedure ( Registration 2) – Package Charges IVFR2PC
24000 22000
IVF procedure ( Registration 2) – Ultasound Charges IVFREGUC2 3120 2860
Biochemistry Laboratory Charges

CAT 1/CAT2 CAT3
1 Fluid Amylase FLUAMY 450 300
2 Fluid Bilirubin ( Total & Direct ) FLUBIL 300 180
3 Fluid Bilirubin ( Total & Direct ) - for Kidney KT-FLUBIL 175 175
Transplant
4 Fluid Bilirubin ( Total & Direct ) - for Liver Transplant LT-FLUBIL 175 175
5 Fluid Bun FLUMIS 160 100
6 Fluid Calcium FLUCAL 220 130
7 Fluid Chloride FLUCHL 185 110
8 Fluid Cholesterol FLUCHOL 200 120
9 Fluid Creatinine FLUCREAT 180 110
10 Fluid Glucose FLUGLU 120 80
11 Fluid LDH PFLDH 300 180
12 Fluid Lipase FLULIP 450 300
13 Fluid Osmolality FLUOSM 750 600
14 Fluid Potassium FLUPOT 185 110
15 Fluid Protein & albumin PFPROT 350 200
36
16 Fluid Sodium FLUIDSOD 185 110
17 Fluid Triglycerides FLUTRIG 310 190
18 Fluid Uric Acid FLUUA 250 150
19 24 Hours Urine ( Calcium, Phosphorus ) 24CPU 420 260
20 24 Hours Urine Calcium 24C 220 130
21 24 Hours Urine Chloride 24CHLO 200 130
22 24 Hours Urine Creatinine 24UCR 200 120
23 24 Hours Urine Micro Albumin 24URINALB 400 250
24 24 Hours Urine Phosphorous 24P 220 130
25 24 Hours Urine Potassium 24UP 200 120
26 24 Hours Urine Protein (Excludes Albumin) 24URINPROT 300 180
27 24 Hours Urine Protein (Excludes Albumin) - ( Kidney KT-24URINPROT 175 100
Transplant )
28 24 Hours Urine Protein (Excludes Albumin) - ( Liver LT-24URINPROT 175 100
Transplant )
29 24 Hours Urine Sodium 24US 200 120
30 24 Hours Urine Uric Acid 24U 250 150
31 Active B12 ACTIVEB12 1300 1100
32 Acute Cardiac Profile CPA 3500 2100
33 Adenosine Deaminase ( ADA ) - CSF ADAC 600 360
34 Adenosine Deaminase ( ADA ) - Fluid ( Enter ADA 600 360
Specimen in Processing Notes )
35 Adenosine Deaminase ( ADA ) - Serum ADAS 600 360
36 Alkaline Phosphatase ( ALP ) ALKP 200 130
37 Alphafetoprotein (AFP) AFP 950 800
38 ALT / SGPT SGPT 200 130
39 ALT / SGPT ( Kidney Transplant ) KT-SGPT 125 125
40 ALT / SGPT ( Liver Transplant ) LT-SGPT 125 125
41 Amikacin levels AMICA 2000 1200
42 Ammonia SEA 1000 600
43 Amylase AMYL 450 300
44 Anaemia Profile ( Biochemical ) ENP 3800 2300
45 Angiotensin Converting Enzyme ( ACE ) ACE 1000 750
46 Animal Allergen Mix - Blood ANIM 1100 700
47 Anti Mullerian Hormone BAMH 2250 2000
48 Apolipoprotein A1 APA1 1100 660
49 Apolipoprotein B APAB 1100 660
50 AST / SGOT SGOT 200 130
51 AST / SGOT ( Kidney Transplant ) KT-SGOT 125 125
52 AST / SGOT ( Liver Transplant ) LT-SGOT 125 125
53 Bence Jones Proteins ( Urine ) BJP 350 210
54 Beta 2 Microglobulin (Serum) B2MICROS 1500 900
55 Bicarbonate BCAR 300 180
56 Bilirubin ( Total & Direct ) BILL 300 180
57 Bilirubin ( Total & Direct ) - ( Kidney Transplant ) KT-BILL 175 175
58 Bilirubin ( Total & Direct ) - ( Liver Transplant ) LT-BILL 175 175
59 Blood Glucose 1 Hour After 50gm Glucose ( Glucose BLGL1 120 75
Spot Test )
60 Blood Lead Test BLT 850 750
61 BUN BUN 160 100
62 BUN ( Dialysis ) D-BUN 85 85
63 BUN ( Kidney Transplant ) KT-BUN 85 85
64 BUN ( Liver Transplant ) LT-BUN 85 85
65 CA 125 CA125 1300 800
37
66 CA 15-3 CA153 1300 800
67 CA 19-9 CA199 1300 800
68 Calcium CALC 220 130
69 Calcium ( Dialysis) D-CALC 120 120
70 CAPD Fluids ( 24 Hrs Protein ) C-UPRO 300 180
71 Carbamazepine ( CPZ ) / Tegretol Assay CPZA 1250 900
72 Cardiac Checkup Extended Profile CCUE 6000 3600
73 Cardiac Profile CPC 2200 1350
74 CCR - Creatinine Clearance CCR 500 300
75 CCR - Creatinine Clearance ( Liver Transplant ) LT-CCR 375 225
76 CEA ( Carcino-Embryonic Antigen ) CEA 850 550
77 Chloride CHLO 185 110
78 CK ( CPK ) CPK 450 270
79 CKMB ( Activity ) CKMB ( ACTIVITY ) 475 285
80 CKMB ( MASS ) CKMBM 500 300
81 Comprehensive Allergy Panel Mixes ( CAPMIX ) - ALLERGYP 12500 7600
Blood
82 Comprehensive Individual Allergy Panel ( COMPALL ) - EXTENSIVE 32000 19300
Blood
83 Creatinine Clearance including serum creatinine, KT-CCR 375 225
proteins & CCR ( Kidney Transplant )
84 CRP ( HS ) High Sensitivity C-Reactive Protein HS 600 360
85 CSF ( Glucose/Protein/Chloride ) BCSF 500 300
86 CSF Albumin CSFALB 375 230
87 CSF Chloride CSFC 185 110
88 CSF Glucose CSFS 120 80
89 CSF IgA ( Immunoglobulin ) CSFIGA 700 420
90 CSF LDH CSFLDF 300 180
91 CSF Methotrexate Level METHOCSF 1800 1100
92 CSF Protein CSFP 350 200
93 Dehydroepiandrosterone Sulfate ( DHEA-S ) DHEAS 1000 800
94 Diabetes Monitoring Profile (Glu F,PP Insulin F,PP DIAMP 1800 1500
HbA1c)
95 Diabetes Screening Profile (Glu F,PP Insulin F,PP) DIASP 1200 1000
96 Diabetic Profile DP 850 510
97 Digoxin Level (SGRH Bioch.) DIGO 900 600
98 Drug Panel - Blood DRUGP 4600 2800
99 D-Xylose Excretion Test - 25 grams (5 hours sample) DXYL25 750 450
100 D-Xylose Excretion Test - 5 grams (5 hours sample) DXYL 750 450
101 Eczema Mini Panel - Blood ECZEMAM 6600 4000
102 Eczema Panel Extensive ( EXZEMA EX ) - Blood ECZEMA 15000 9000
103 Extended Lipid Profile ELIPP 3600 2200
104 Extended Metabolic Profile (Diabetic Profile, Insulin EMETP 6500 6500
F+PP, C Peptide F+PP, Renal Function, Liver Function,
Lipid Profile, Homocystine, Magnesium, hsCRP, Bile
Acids, Anemia Profile, Vitamin D, TSH, fT3, fT4)
105 Ferritin FERI 900 540
106 Fluid Alkaline Phosphatase ( ALP ) ALKPF 200 130
107 Fluid Lipid Profile FLIPP 1100 660
108 Folic Acid FACID 900 550
109 Food Allergen Mix - Blood FOOD 1100 700
110 Food Intolerance Test FIT 5500 5500
111 Food Panel Extensive ( FPEX ) - Blood ASTHMA 10300 6200
112 Free/Total PSA Ratio FTPA 1200 900
38
113 FRUCTOSAMINE FRUCT 900 750
114 Gamma GT GAMMA GT 300 180
115 Gentamicin Level ( Gentamycin ) GENTA 950 570
116 Glucose F GLUF 120 80
117 Glucose F ( Dialysis ) D-GLUF 80 80
118 Glucose F ( Kidney Transplant ) KT-GLUF 80 80
119 Glucose F ( Liver Transplant ) LT-GLUF 80 80
120 Glucose F + Glucose PP ( 75 g Glucose ) GTT6 250 150
121 Glucose PP GLUP 120 80
122 Glucose PP ( Dialysis ) D-GLUP 80 80
123 Glucose PP ( Kidney Transplant ) KT-GLUP 80 80
124 Glucose PP ( Liver Transplant ) LT-GLUP 80 80
125 Glucose Random GLUR 120 80
126 Glucose Random ( Dialysis ) D-GLUR 80 80
127 Glucose Random ( Kidney Transplant ) KT-GLUR 80 80
128 Glucose Random ( Liver Transplant ) LT-GLUR 80 80
129 Glucose Tolerance Test ( 100 g ) - ½ hrly x 3 hrs GTT8 750 450
130 Glucose Tolerance Test ( 100 g ) - 1 hrly x 3 hrs GTT3 450 280
131 Glucose Tolerance Test ( 75 g ) - ½ hrly x 2½ hrs GTT4 700 420
132 Glucose Tolerance Test ( 75 g ) - ½ hrly x 3 hrs GTT5 750 450
135 Glucose Tolerance Test ( Standard GTT ) ( 75 g ) - ½ GTT1 650 390
hrly x 2 hrs
136 Glycosylated Haemoglobin ( HbA1c ) GLYCOHA 800 550
137 Grass Allergen Mix - Blooc GRASS 1100 700
138 HDL Cholesterol HDL 310 190
139 HE - 4 HE4 3500 3500
140 HE - 4 And CA 125 HE4CA 4000 4000
141 Homocysteine HMYT 1250 900
142 hS Troponin I TROP 1100 660
143 i Valproie Acid IVA 800 650
144 Immunoglobulin A ( IgA ) IGA 700 420
145 Immunoglobulin E ( IgE ) IGE 700 420
146 Immunoglobulin G ( IgG ) IGG 700 420
147 Immunoglobulin M ( IgM ) IGM 700 420
148 Immunological profile ( IgA, IgG, IgM ) IMMPROF 1800 1100
149 Immunological profile ( IgA, IgG, IgM, IgE ) IMMPROF-I 2200 1320
150 Individual Allergen - Blood INDIVIDUALA 1100 700
151 Interleukin 6 ( IL6 ) INTER 1400 900
152 Lactate SLACTALI 450 270
153 LACTATE (FLUID) LACFLU 450 270
154 LDH LDH 300 180
155 LDL Cholesterol LDL 450 280
156 Legume Allergen Mix LEGUM 1100 700
157 LFT - Liver Function Test ( Hepatic Profile ) HEPA 1350 800
158 LFT - Liver Function Test ( Hepatic Profile ) - ( Liver LT-HEPA 575 575
Transplant )
159 Lipase SLIPASE 450 300
160 Lipid Profile LIPP 1100 660
161 Lipoprotein ( a ) LP 1000 850
162 Magnesium SMAG 300 180
163 Metabolic Profile (Ca,Phos, ALP, Lipid Profile, Vitamin METAPRO 4000 2500
B12, Glu F,PP, HbA1C, TSH, Uric Acid, Insulin F)
39
164 Mold Allergen Mix - Blood MOLD 1100 700
166 NGAL (Plasma) NGALP 1900 1300
167 NGAL (Urine) NGALU 1900 1300
169 NT- proBNP ( Biochemistry Lab ) NTPRO 1900 1500
170 Ostase (Bone Alkaline Phosphatase) OSTASE 1800 1800
171 Phadiatop Atopic Screening Test - Blood ATOPIC 1100 700
172 Phenytoin / Dilantin Assay PHEN 1200 900
173 Phosphorus PHOS 220 130
174 Phosphorus ( Dialysis ) D-PHOS 110 110
175 Potassium POTA 185 110
176 Potassium ( Dialysis ) D-POTA 100 100
177 Potassium ( Kidney Transplant ) KT-POTA 100 100
178 Potassium ( Liver Transplant ) LT-POTA 100 100
179 Prostatic Specific Antigen ( PSA ) PROST 800 480
180 Renal Anaemia Profile ( Biochemical ) ARENP 1300 780
(Fe,TIBC,Transferrin,Ferretin)
181 Renal Biochemical Profile - Basic RENPI 1280 770
(BUN,Creat,Ca,PO,4,Na,K,Bicarbonate)
182 Renal Biochemical Profile - Complete RENPP 1800 1100
(BUN,Creat,Ca,PO4,Na,K,RBS,Uric,Prot,AlkPo4,Choles
t,Bicarbonate)
183 Respiratory Panel Extensive ( RESPEX ) - Blood WHEEZE 14000 8500
184 Respiratory Panel-Mini (RESPMINI) - Blood WHEEZERM 8000 5000
185 RFT with eGFR RFTEGFR 1300 780
186 Serum Cortisol SRC 600 450
187 Serum Creatinine CREA 180 110
188 Serum Creatinine ( Dialysis ) D-CREA 100 100
189 Serum Creatinine ( Kidney Transplant ) KT-CREA 100 100
190 Serum Creatinine ( Liver Transplant ) LT-CREA 100 100
191 Serum Iron IRON 400 240
192 Serum Iron Binding Capacity ( TIBC ) TIBC 500 300
193 Serum Methotrexate Level METHO 1800 1100
194 Serum Osmolality SEROSM 750 600
195 Serum Pre - albumin level SPAL 1200 850
196 Serum procalcitonin SPROC 2200 1800
197 Serum total bile acids STBA 1100 700
198 Sodium SODI 185 110
199 Sodium ( Dialysis ) D-SODI 100 100
200 Sodium ( Kidney Transplant ) KT-SODI 100 100
201 Sodium ( Liver Transplant ) LT-SODI 100 100
202 Sodium + Potassium + Chlorides + Bicarbonate SPC 700 420
203 Soluble Transferrin Receptor STRAREC 2500 2500
204 Stone Qualitative Analysis STON 800 700
205 Tacrolimus test TACRO 2200 2200
206 Theophylline THEO 1500 1000
208 Total Beta- hCG ( Biochemistry ) BHC 750 450
209 Total Cholesterol CHOL 200 120
210 Total Proteins TPRO 350 200
211 Total Proteins ( Dialysis ) D-TPRO 200 200
212 Transferrin TF 700 420
213 Tree Allergen Mix - Juniperus - Blood TREEJ 1100 700
214 Tree Allergen Mix - Pines - Blood TREEP 1100 700
215 Triglycerides TRIG 310 190
216 Tumor Necrosis Factor Alpha ( TNF Alpha ) TUFA 1200 1000
40
217 Uric Acid URIA 250 150
218 Urinary ( Urine ) VMA (24 hours) UVMA 2000 1200
219 Urinary Albumin creatinine ratio UACR 350 210
220 Urine Osmolality OSMLU 750 600
221 Urine Spot Calcium : Creatinine Ratio SPOTCC 350 210
222 Urine Spot Test for Calcium USCA 200 130
223 URINE SPOT TEST FOR CHLORIDE CHLOSP 185 110
224 Urine Spot Test for Creatinine USCREAT 180 110
225 Urine Spot Test for Microalbumin ( Biochemistry ) MA 375 230
226 Urine Spot Test for Phosphorus USPOTPH 185 110
227 Urine Spot Test for Potassium UK 185 110
228 Urine Spot Test for Protein & Creatinine ( PC Ratio ) USPRCR 375 230
229 Urine Spot Test for Protein ( Excludes Albumin ) USPROT 300 180
230 Urine Spot Test for Sodium UNA 185 110
231 Urine Spot Test for Uric Acid USUR 250 150
232 Vancomycin Level VANCO 1200 1000
233 Veg. Food Panel ( VEGFP ) - Blood ASTHMAR 8000 5000
234 Vegetable Allergen Mix - Blood VEGE 1100 700
235 Vitamin B 12 ( B12 ) VB12 900 540
236 VLDL Cholesterol VLDL 960 570
237 Weed Allergen Mix - Blood WEED 1100 700
238 Zinc Serum ZINCZN 800 500
239 Zinc Urine ZINCU 800 500
240 Glucose F + Glucose PP GLUCP 220 130
Blood gas analysis charges

CAT 1/CAT2 CAT3
1 Blood Gas + S.Elect Analysis BGAPLUS 600 360
2 Blood Gas Analysis BGA 450 270
Cardiac Laboratory Charges

CAT 1/CAT2 CAT3
1 Diagnosis of Acute Myocardial Infarcation ( AMI ) CARAMI 1430 1150
Cardiac Dept
2 Diagnosis of Pulmonary Embolisation ( Cardiac Dept ) CARPE 100 710
3 Panel for diagnosis of breathlessness ( Cardiac Dept. ) CARBL 2050 1711
4 Prothrombin Time INR ( Cardiac Dept ) CARPT 420 280
5 Triage cardio profiler panel (Cardiac Dept.) CATCPP 1710 1370
6 Screening Echo Cardiology SECAROS 1740 1740
Clinical Pathology Charges

CAT 1/CAT2 CAT3
1 Urine examination ( Routine / Microscopy ) URINERE 280 170
2 Urine for Acetone UROK 220 130
3 Urine for albumin / protein UROP 220 130
4 Urine for Bile pigment / salt BPIG 280 170
5 Urine for chyle URC 280 170
41
6 Urine for Dysmorphic RBCs UDYRBC 300 180
7 Urine for haemoglobin URHEM 330 200
8 Urine for myoglobin URMYO 330 200
9 Urine for porphobilinogen URP 380 230
10 Urine for sugar / reducing substance UROG 280 170
11 Urine for urobilinogen UROB 380 230
12 Urine pH URINEPH 180 120
13 Urine specific gravity URINESPGR 180 120
Diabetology Laboratory Charges

CAT 1/CAT2 CAT3
1 Blood Ketone Test BKT 400 350
2 Continuous Glucose Monitoring Facility CONGLUMO 2500 2500
3 Lipid Profile (Endocrinology) TCTT 1200 720
4 Spot Finger Prick Blood Glucose ( Endocrinology ) BGLU 120 80
5 Spot HbA1c ( Endocrinology ) HB-1C 800 550
6 Spot Urine Micro-Albuminuria ( Endocrinology ) UMA 750 540
Haematology Laboratory Charges

CAT 1/CAT2 CAT3
1 Acid phosphatase cytochemistry ( AP ) with/without CYTOAP 2000 1200
tartrate
2 Cell count CELLC 700 420
3 Immunophenotyping ( flow cytometry ) - Acute ACLP 17000 14200
leukemia panel (cMPO, cCD79a, c3, CD45, 19, 10, 5,
7, 3, 14, 13, 34, 33)
4 Immunophenotyping ( flow cytometry ) - Chronic CLLPANEL 17000 14200
lymphocytic leukemia panel ( CLL ) -
k,l,CD45,19,5,10,FMC7,23,103,11c,38,56
5 Immunophenotyping ( flow cytometry ) - Lymphoma LYMPHPANEL 17000 14200
panel (CD45, 19, 10, 5, 7, 3, 4, 8, k, l)
6 Leukocyte alkaline phosphatase ( LAP ) score CYTOLAP 1800 1100
7 Microfilaria ( Peripheral smear ) MF 500 300
8 Myeloperoxidase ( MPO ) CYTOMPO 700 420
9 Nonspecific esterase ( NSE ) - CAE CYTONSE 1800 1080
10 Periodic acid schiff ( PAS ) CYTOPAS 1650 1000
11 Specific esterase ( SE ) - ANAE / ANBE CYTOSE 1840 1100
13 Absolute eosinophil count ( AEC ) AEC 320 190
14 Absolute Lymphocyte Count ( ALC ) ALC 320 190
15 Absolute neutrophil count ( ANC ) ANC 320 190
16 ANA Profile 3 ANA 3000 1800
17 Antibodies to ds - DNA ( Enzyme Immuno Assay ) DNA 1400 840
18 Anti-c ANCA ( anti - PR3 ) AANCA-AP 1950 1170
19 Anticardiolipin antibodies ( ACA ) - IgM ACLM 1400 840
20 Anticardiolipin antibodies ( ACA ) - IgG ACLG 1400 840
21 Anti-p ANCA ( anti - MPO ) AANCA-AM 1950 1170
22 Antithrombin functional assay (Haematology) ANTITHROH 4000 2400
23 APT test APTS 320 200
24 APTT ( Activated partial thromboplastin time ) APTT 700 420
42
25 APTT based inhibitor screen APPTIN 1400 840
26 APTT mixing experiment APTTMIX 1400 840
27 Ascitic fluid cell counts ASF 700 420
28 B2 Glycoprotein 1 ( GPI ) IgG ELISA B2IGG 1700 1000
29 B2 Glycoprotein 1 ( GPI ) IgM ELISA B2IGM 1700 1000
30 Bethesda Assay BETH 16500 9900
31 Bone marrow and peripheral smear examination BMARROW1 2800 1680
32 Bone marrow slides for issue to patient ( 1 slide ) BMSFITP1S 340 200
33 CAPD fluid cell counts CAPD 700 420
34 CBC - Complete blood count CBC 450 270
35 CBC , DLC with Peripheral smear CBCDLCPBF 750 450
36 CD 19 / CD 20 / CD45 by flowcytometry CD1945 3250 1950
37 Cerebrospinal fluid ( CSF ) cell count CSF 700 420
38 Clot retraction test CRT 350 210
39 Clot solubility test ( Factor-XIII ) CST 650 390
40 Coagulation factor IX assay COAGF9 2800 1640
41 Coagulation factor VIII assay COAGF8 2800 1640
42 Coagulation profile screening (PT / APTT/ TT / CBC / CPST 3700 2220
PS )
43 Complete blood count ( CBC ) - ( Dialysis ) DCBC 350 260
44 Complete blood count ( CBC ) - ( Kidney Transplant ) KT-CBC 350 260
45 Complete blood count ( CBC ) - ( Liver Transplant ) LT-CBC 350 260
46 Complete blood count ( CBC ) with Differential CBCDLC 600 360
leukocyte count ( DLC )
47 Complete blood count ( CBC ) with Differential DCBCDLC 450 360
leukocyte count ( DLC ) - ( Dialysis )
48 Complete blood count ( CBC ) with Differential KT-CBCDLC 450 360
leukocyte count ( DLC ) - ( Kidney Transplant )
49 Complete blood count ( CBC ) with Differential LT-CBCDLC 450 360
leukocyte count ( DLC ) - ( Liver Transplant )
50 D-dimer D-DIMER 1800 1100
51 Differential leukocyte count ( DLC ) DLC 420 250
52 Dihydrorhodamine Assay by Flow Cytometry DAFC 2600 1560
53 dRVVT screen dRVVT confirm LACC 2600 1560
54 EMA dye binding test EMADB 1500 900
63 Erythrocyte sedimentation rate ( ESR ) ESR 380 230
64 Factor II assay FACTOR2 3700 2600
65 Factor V assay FACTOR5 3200 2100
66 Factor V Leiden ( APC-R) FVLEDN 4200 2500
67 Factor VII assay FACTOR7 3600 2600
68 Factor X assay FACTOR10 3300 2150
69 Factor Xa Heparin for Enoxaparin FXAENO 4300 2580
70 Factor XI assay FACTOR11 3800 2650
71 Factor XII assay FACTOR12 3800 2650
72 Factor XIII assay FACTOR13 10000 8000
73 Fibrinogen (Quantitative) FIBEST 1400 840
74 FLOW CYTOMETRIC FOR ANY SINGLE PANEL OF FCSLL 3600 2300
LEUKEMIA / LYMPHOMA
75 Flow Cytometry for Leucocyte adhesion defect type 1 FCFL 3350 2200
76 Flowcytometery ( CD 19 and CD 45 ) FLOWCD1945 2100 1260
77 Flowcytometery ( CD 20 and CD 45 ) FLOWCD2045 2100 1260
78 Flowcytometric DHR Assay and NBT slide Test DHRNBT 3250 2250
79 FLOWCYTOMETRIC HLA - CROSS MATCH FCXM 12000 7200
80 Flowcytometric MDS Panel FMYMDS 8500 6150
43
81 Flowcytometry for Myeloma FMY 9000 7500
82 G-6-PD screening ( G6PD ) G6PD 560 350
83 Gastric aspirate for neutrophilis GAS 300 200
84 Haemoglobin ( Hb ) HB 250 150
85 Haemoglobin ( Hb ) - Dialysis DHB 170 130
86 Haemoglobin ( Hb ) - Transplant KT-HB 170 130
87 Haemoglobin ( Hb ) FOR THALASSEMIC PATIENTS HBTH 0 0
ONLY
88 Haemoglobin electrophoresis - acid pH ( 6.0 ) HBELECACI 1100 660
89 Haemoglobin electrophoresis - alkaline pH ( 8.6 ) HBELECALK 1100 660
90 Haemoglobin electrophoresis ( alkaline & acid pH ) HBELEC 2200 1320
91 Haemoglobin F cytochemistry ( Kleihauer test ) HBFCYTO 750 500
92 HB / PCV HBPCV 380 230
93 HbH Inclusion HBHI 500 300
94 Heinz bodies HZB 500 300
95 Hemosiderin in urine HSU 500 320
96 Heparin induced thrombocytopenia (gel card) HITA 2300 1700
97 IgG and IgM antibodies to Leishmania (Rapid test) IGGIGM 1000 600
98 Immature Platelet Fraction IPF 700 420
99 Immunodeficiency / HIV panel ( CD3 / CD4 / CD8 HIVIMM 3400 2000
counts )
100 Immunodeficiency / Non HIV panel BTCELL 3400 2000
101 Immunofixation electrophoresis - 24 hrs urine IMMUNOU 10000 6000
102 Immunofixation electrophoresis - serum IMMUNOS 9000 5400
103 Immunophenotyping ( flow cytometry ) - NK / NKCELL 5200 3100
Obstetric Panel
104 Immunophenotyping ( flow cytometry ) - PNH panel PNHPAN 7700 4600
105 Incubation osmotic fragility ( CBC / PS / Retic) IOFT 1700 1000
106 Iron Stain Bone Marrow ISBM 800 480
107 Malaria antigen test - Plasmodium falciparum / P. PLAS 900 550
vivax ( Immunochromatography )
108 Methaemoglobin estimation MHB 500 300
109 Myositis Profile 3 MSA 3400 2000
110 Osmotic fragility test ( CBC / PS / Retic) OST 1700 1000
111 Pericardial fluid cell count PESF 700 420
112 Peripheral smear for malaria ( MP ) MP 850 500
113 Plasma Hemoglobin PHB 500 300
114 Platelet aggregation test for HIT (confirmatory PAT 1250 1000
functional Assay)
115 Platelet count PLT 250 150
116 Platelet Count for Dengue Patients DENGUEPLT 50 50
117 Platelet function test for bleeding disorders PFTFBD 8700 6200
118 Platelet function test for drug monitoring PFTFDM 6400 4000
119 Platelet function test for von Willebrand disease PFTFVWD 8700 6200
120 Pleural fluid cell count PLSF 700 420
121 Protein C functional assay PROTEINC 4200 2500
122 Protein S functional assay PROTEINS 4200 2500
123 Prothrombin time ( PT ) Haematology Lab PT 420 250
124 PT mixing experiment PTMIX 700 420
125 Renal/BMT Reticulocyte Count RBRC 600 360
126 Reticulocyte count RTIC 600 360
127 Review of stained bone biopsy section received from HBBS 1450 850
outside ( Hematology )
44
128 Screening for beta thalassemia / BTHAL 1650 1000
haemoglobinopathies ( CBC / HbF / HbA2 )
129 Serum Freelight Chain Assay SFLCA 5000 3000
130 Serum protein electrophoresis ( SPE ) PROELECT 2000 1200
131 Sickling test SLT 400 250
132 STEM CELL ENUMERATION ( CD34 + CELL COUNT ) SCEN34 7700 4800
133 Synovial fluid cell count SYSF 700 420
134 Synovial fluid for crystals by Polarizer SYFLD 600 360
135 T-B-NK with CD4 & CD8 counts TBNK 6600 4100
136 Test for HbH Inclusion HBH 550 330
137 Thrombin time ( TT ) TT 790 470
138 Total leukocyte count ( TLC ) TC 270 170
139 Total leukocyte count ( TLC ) - Transplant KT-TLC 200 160
140 Urine For Eosinophils UFE 440 260
141 Urine protein electrophoresis URIELECTRO 3150 1900
142 Von Willebrand factor VONWILL 6600 3900
143 Von Willebrand Ristocetin Cofactor activity VWRCA 8400 6700
144 Comprehensive Myeloma Panel - Haematology HCOMP 10000 8500
B2 - microglobulin - Hematology HB2M
Immunofixation electrophoresis - serum IMMUNOS
Serum Freelight Chain Assay SFLCA
Serum protein electrophoresis ( SPE ) PROELECT
Total Immunoglobulins (including IgG, IgA and IgM) - Hematology HTOTIMMU
145 Thromobophilia Panel ( Molecular + Coagulant assays ) ( THROMMH 18500 16000

Mutations of Factor V ( leiden ), Prothrombin, MTHFR
genes, Proteins C, Protein S, AT III, APCR, Lupus
Anticoagulant, Anti phospholipid antibody )
Anticardiolipin antibodies ( ACA ) - IgM ACLM
Anticardiolipin antibodies ( ACA ) - IgG ACLG
Antithrombin functional assay (Haematology) ANTITHROH
B2 Glycoprotein 1 ( GPI ) IgG ELISA B2IGG
B2 Glycoprotein 1 ( GPI ) IgM ELISA B2IGM
dRVVT screen dRVVT confirm LACC
Factor V ( Leiden ) Gene mutations - Molecular Haematology FVLGMMH
Factor V Leiden ( APC-R) FVLEDN
MTHFR ( C677T ) Gene Polymorphism - Molecular Haematology MTHFRGMMH
Protein C functional assay PROTEINC
Protein S functional assay PROTEINS
Prothrombin ( G20210A ) Gene Mutation - Molecular Haematology PGMMH
Thromobophilia Panel ( Molecular + Coagulant assays ) ( Mutations of THROMMHLO

Factor V ( leiden ), Prothrombin, MTHFR genes, Proteins C, Protein S, AT III,
APCR, Lupus Anticoagulant, Anti phospholipid antibody ) - Label Only
146 Von Willebrand factor & Von Willebrand Ristocetin VONWOS 13000 9000
Cofactor activity
Von Willebrand factor VONWILL
Von Willebrand Ristocetin Cofactor activity VWRCA
Histopathology Laboratory Charges

CAT 1/CAT2 CAT3
1 Biopsy ( Extra large ) - WITH Barcode BIOX 4010 2400
2 Biopsy ( Large ) - WITH Barcode BIOL 2780 1670
3 Biopsy ( Medium ) - WITH Barcode BIOM 2120 1260
45
4 1 pathology slide for issue to patient - NO Barcode FPSR 290 290
5 1 pathology slide for issue to patient (2nd time) - NO PSIP21 440 440
Barcode
6 2 pathology slides for issue to patient - NO Barcode FPSR2 440 440
7 2 pathology slides for issue to patient (2nd time) - NO PSIP22 710 710
Barcode
8 3 pathology slides for issue to patient - NO Barcode PSIP3 610 610
Barcode
Barcode
Barcode
Barcode
16 ANA , ASMA , ALKMA and AMA - WITH Barcode ANASMALKMA 5060 3030
17 ANA , ASMA and ALKMA - WITH Barcode ANASMALK 4230 2540
18 ANA with titration ANAWTIT 3930 2360
19 ANCA - WITH Barcode ANCA 1120 670
20 Anti liver & kidney microsomal antibody ( ALKMA ) - ALKMA 1560 940
WITH Barcode
21 Anti mitochondrial antibody ( AMA ) - WITH Barcode AMA 1340 800
22 Anti nuclear antibodies ( ANA ) - WITH Barcode HANA 1340 800
23 Anti nuclear antibodies ( ANA ) and Anti parietal cell ANAAPOA 2060 1230
antibody ( APCA ) - WITH Barcode
24 Anti nuclear antibodies ( ANA ) and Anti smooth ANASMA 2060 1230
muscle antibody ( ASMA ) - WITH Barcode
25 Anti nuclear antibodies ( ANA ) and Anti thyroid ANAATA 1770 1070
antibodies ( ATA ) - WITH Barcode
26 Anti parietal cell antibody ( APCA ) - WITH Barcode APOA 1340 800
27 Anti PLA2R antibody by indrect immunofluorescene PLA2R 6680 4010
28 Anti smooth muscle antibody ( ASMA ) - WITH ASMA 1340 800
Barcode
29 Anti thyroid antibodies ( ATA )- WITH Barcode ATA 1340 800
(Histopathology)
30 ASMA , ALKMA and AMA - WITH Barcode SMALKMA 2780 1670
31 Bile Duct Brushing for malignant cells - Cytology MCBILE 990 600
32 Biopsy ( Small ) - WITH Barcode BIOS 1400 840
33 Biopsy medium with IF study with 7 IF markers with BIOIMM7 6680 4010
barcodes
34 Biopsy Medium with Immuno fluroscent study - WITH BIOIMM 5570 3340
Barcode
35 Block For Patient BFP 980 980
36 Bronchial washing/BAL/ET secretions for malignant MCBRO 1240 780
cells - Cytology
37 CSF for malignant cells - Cytology MCCSF 820 490
38 Cyst Fluid for malignant cells - Cytology MCCYST 820 490
39 Cytology of aspirate /any smear for cytology WITH FNACN 1120 670
Barcode
40 DSDNA - WITH Barcode DSDNA 1120 670
46
41 Enzyme Histochemistry - Each additional enzyme ENZHISE 1400 840
stain - Histopathology
42 Enzyme Histochemistry - One enzyme stain - ENZHIS 2480 1490
Histopathology
43 FNAC Cytology of aspirate (DONE IN PATHOLOGY ASFNAC 1980 1190
LAB) WITH Barcode
44 FNAC for Endoscopic ultrasound specimen ( EUSFNAC MCEUS 3390 2030
) - Cytology
45 Frozen section (including subsequent paraffin FSECTPS 2120 1260
processing) ( 1 to 2 samples)- WITH Barcode
46 Frozen section (including subsequent paraffin FSECTPSB 3000 1810
47 Frozen section (including subsequent paraffin FSECTPSC 4670 2810
48 Frozen section (including subsequent paraffin FSECTPSC7 6900 4140
processing) ( 7 or more samples) - WITH barcode
49 HPV-DNA ( High Risk ) Cervical Sample HPVDNAH 3250 1980
50 IHC 10 markers and above / ADD ON without barcode IHS10H 15590 9350
51 IHC 10 markers and above with barcode IHS10 15590 9350
52 IHC 7 markers / ADD ON without barcode IHS7H 11800 7080
53 IHC 7 markers with barcode IHS7 11800 7080
54 IHC 8 Markers - With Barcode IHC8 11570 6950
55 IHC 8 markers - Without Barcode IHC8H 11570 6950
56 IHC 9 markers / ADD ON without barcode IHS9H 13140 7880
57 IHC 9 markers with barcode IHS9 13140 7880
58 Immuno fluroscent staining ( 1 stain ) - WITH Barcode IFS1 1110 660
59 Immuno fluroscent staining ( 2 stains ) - WITH IFS2 1890 1510
Barcode
Barcode
Barcode
Barcode
63 Immuno histochemistry ADD ON staining ( IHISTCHEM1C 1710 1030
Cytopathology ) - 1 stain NO Barcode
Cytopathology ) - 2 stains NO Barcode
66 Immuno histochemistry ADD ON staining ( IHS4C 6200 3720
67 Immuno histochemistry ADD ON staining ( IHISTCHEM1H 2120 1260
Histopathology ) - 1 stain - NO Barcode
Histopathology ) - 2 stains - NO Barcode
70 Immuno histochemistry ADD ON staining ( IHS4H 6520 3910
71 Immuno histochemistry staining ( 1 stain ) WITH IHISTCHEM 2010 1200
barcode
72 Immuno histochemistry staining ( 2 stain ) - WITH IHISTCHEM2 4010 2400
Barcode
47
73 Immuno histochemistry staining ( 3 stain ) - WITH IHISTCHEM3 5670 3410
Barcode
74 Immuno histochemistry staining ( 4 stains ) WITH IHS4 6460 3880
barcode
75 Immuno histochemistry staining ( 5 stain ) WITHOUT IHS5H 7790 4670
barcode
76 Immuno histochemistry staining ( 5 stain ) WITH IHS5 9130 5480
barcode
77 Microwave processing for rapid diagnosis (small MPRD 4460 2670
biopsies)
78 One to two stained histopathology slide(s) from FPS1 840 840
outside for opinion - WITH Barcode
79 PAP smear / Hormonal smear / Vault smear / Cervical PAPS 600 360
smear WITH Barcode
80 Paraffin Blocks / Unstained slides received from PBUSM3 2120 1260
outside (more than 3) - WITH Barcode
81 Paraffin Blocks / Unstained slides received from PBUS 1670 1000
outside (up to 3) - WITH Barcode
82 Pleural / Ascitic / Pericardial / Peritoneal wash /any MCPLE 990 600
other fluid for malignant cells - Cytology
83 Remaining of frozen tissue ( Extra Large ) - NO REMXLARGE 4230 2540
Barcode
84 Remaining of frozen tissue ( Large ) - NO Barcode REMLARGE 2780 2010
85 Remaining of frozen tissue ( Medium ) - NO Barcode REMMEDIUM 2120 1260
86 Remaining of frozen tissue ( Small ) - NO Barcode REMSMALL 1400 840
87 Six and more stained histopathology slide(s) from FPS6 1670 1670
88 Sputum for malignant cells - Cytology MCSPU 820 490
89 Stained pathology slide (s) from outside for opinion ( STPHCY3 850 850
Cytopathology ) - More than 2 WITH Barcode
90 Stained pathology slide (s) from outside for opinion ( STPHCY2 500 500
Cytopathology ) - Up to 2 WITH Barcode
91 Three to five stained histopathology slide(s) from FPS3-5 1110 1110
92 Trans bronchial needle aspiration ( TBNA ) Reporting MCTBNA 1240 780
for malignant cells - Cytology
93 Ultrasound/CT guided FNAC Reporting for malignant MCFNAC 1690 1020
cells - Cytology
94 Urine for malignant cells ( 1 sample ) - Cytology MCURI 820 490
95 Urine for malignant cells ( 3 samples ) - Cytology MCURI3 2240 1360
96 Vaginal / cervical cytology by liquid base cytology ( LBC 1260 770
LBC )
Microbiology Laboratory Charges

CAT 1/CAT2 CAT3
1 (OPD case only) AFB culture and sensitivity - LJ AFBCULTASP 2070 1240
Method ( Aspirate )
2 (OPD case only) AFB culture and sensitivity - LJ AFBCULTASPF 2070 1240
Method ( Aspiration fluid )
3 (OPD case only) AFB culture and sensitivity - LJ AFBCULTBLF 2070 1240
Method ( Blister fluid )
48
4 (OPD case only) AFB culture and sensitivity - LJ AFBCULTBRW 2070 1240
Method ( Bronchial washing )
5 (OPD case only) AFB culture and sensitivity - LJ AFBCULTBRL 2070 1240
Method ( Bronchoalveolar lavage )
6 (OPD case only) AFB culture and sensitivity - LJ AFBCULTCIF 2070 1240
Method ( Chest irrigation fluid )
7 (OPD case only) AFB culture and sensitivity - LJ AFBCULTCSF 2070 1240
Method ( CSF )
8 (OPD case only) AFB culture and sensitivity - LJ AFBCULTDRF 2070 1240
Method ( Drainage fluid )
9 (OPD case only) AFB culture and sensitivity - LJ AFBCULET 2070 1240
Method ( ET Secretion )
10 (OPD case only) AFB culture and sensitivity - LJ AFBCULTGTA 2070 1240
Method ( Gastric aspirate )
11 (OPD case only) AFB culture and sensitivity - LJ AFBCULT 2070 1240
Method ( Miscellaneous )
12 (OPD case only) AFB culture and sensitivity - LJ AFBCULTMTV 2070 1240
Method ( Mitral valve )
13 (OPD case only) AFB culture and sensitivity - LJ AFBCULTPDF 2070 1240
Method ( P.D. fluid )
14 (OPD case only) AFB culture and sensitivity - LJ AFBCULTPCF 2070 1240
Method ( Pericardial fluid )
15 (OPD case only) AFB culture and sensitivity - LJ AFBCULTPNF 2070 1240
Method ( Peritoneal fluid )
16 (OPD case only) AFB culture and sensitivity - LJ AFBCULTPLF 2070 1240
Method ( Pleural fluid )
17 (OPD case only) AFB culture and sensitivity - LJ AFBCULTPUS 2070 1240
Method ( Pus )
18 (OPD case only) AFB culture and sensitivity - LJ AFBCULTRVF 2070 1240
Method ( Romovac fluid )
19 (OPD case only) AFB culture and sensitivity - LJ AFBCULTSPM 2070 1240
Method ( Sputum )
20 (OPD case only) AFB culture and sensitivity - LJ AFPCULTSTL 2070 1240
Method ( Stool )
21 (OPD case only) AFB culture and sensitivity - LJ AFBCULTSYF 2070 1240
Method ( Synovial fluid )
22 (OPD case only) AFB culture and sensitivity - LJ AFBCULTTIS 2070 1240
Method ( Tissue )
23 (OPD case only) AFB culture and sensitivity - LJ AFBCULTURI 2070 1240
Method ( Urine )
24 Active Hepatitis B profile AHBP 6890 4140
25 Adenovirus Quantitative real time PCR (BAL) AVQBAL 6970 4500
26 Adenovirus Quantitative real time PCR (BLOOD) AVQBLD 6970 4500
27 Adenovirus Quantitative real time PCR (MIS) AVQMIS 6970 4500
28 Adenovirus Quantitative real time PCR (NASAL SWAB) AVQNALS 6970 4500
29 Adenovirus Quantitative real time PCR (THROAT AVQTHS 6970 4500
SWAB)
30 Aerobic blood culture and sensitivity AEROBLD 910 550
31 Albert staining ( C. diphtheria ) ALBSTCDT 490 290
32 Anaerobic culture ( Mitral valve ) ANAECULTMIV 2070 1240
33 Anaerobic culture ( P. D. fluid ) ANAECULTPDF 2070 1240
34 Anaerobic culture ( Pericardial fluid ) ANAECULTPEF 2070 1240
35 Anaerobic culture ( Peritoneal fluid ) ANAECULTPRF 2070 1240
36 Anaerobic culture ( Pleural fluid ) ANAECULTPLF 2070 1240
49
37 Anaerobic culture ( PUS ) ANAECULTPUS 2070 1240
38 Anaerobic culture ( Tissue ) ANAECULTTIS 2070 1240
39 Anaerobic culture ( Aspiration fluid ) ANAECULTASPF 2070 1240
40 Anaerobic culture ( CSF ) ANAECULTCSF 2070 1240
41 Anaerobic culture ( Drainage fluid ) ANAECULTDRF 2070 1240
42 Anaerobic culture ( Miscellaneous ) ANAECULT 2070 1240
43 Anaerobic culture ( Synovial Fluid ) ACSSF 2070 1240
44 Anaerobic culture ( Urine ) ANAECULTURN 2070 1240
45 Anaerobic culture and sensitivity ( Aspirate ) ANAECULTASP 2070 1240
46 Anti CCP ( Immunoscan R A ) ANTICPP 2320 1400
47 Anti HAV - IgM ( hepatitis A virus serology ) HAVT 1630 980
48 Anti HBc - IgM ( hepatitis B virus serology ) ANTIHBC 1810 1090
49 Anti HBeAg serology ANTIHBE 1970 1190
50 Anti HEV - IgM ( hepatitis E virus serology ) HEVT 2320 1400
51 Anti yeast sensitivity ( Blood ) CANDIFBLD 1500 900
52 Anti yeast sensitivity ( Bone marrow ) CANDIFBOM 1500 900
53 Anti yeast sensitivity ( Bronchial washing ) CANDIFBRW 1500 900
54 Anti yeast sensitivity ( Bronchoalveolar lavage ) CANDIFBRL 1500 900
55 Anti yeast sensitivity ( CSF ) CANDIFCSF 1500 900
56 Anti yeast sensitivity ( Drain Fluid ) CANDIDRA 1500 900
57 Anti yeast sensitivity ( E. T. secretion ) CANDIFETS 1500 900
58 Anti yeast sensitivity ( Miscellaneous ) CANDIF 1500 900
59 Anti yeast sensitivity ( P.D. fluid ) CANDIFPDF 1500 900
60 Anti yeast sensitivity ( Pericardial fluid ) CANDIFPEF 1500 900
61 Anti yeast sensitivity ( Peritoneal fluid ) CANDIFPRF 1500 900
62 Anti yeast sensitivity ( Pleural fluid ) CANDIFPLF 1500 900
63 Anti yeast sensitivity ( Pus ) CANDIFPUS 1500 900
64 Anti yeast sensitivity ( Sputum ) CANDIFSPU 1500 900
65 Anti yeast sensitivity ( Tissue ) CANDIFTIS 1500 900
66 Anti yeast sensitivity ( Urine ) CANDIFURN 1500 900
67 Antibody titre serology for HBsAg ANTIHBSAG 820 490
68 Antistreptolyson O titre ASO 1300 790
69 BacT/Alert aerobic culture ( Aspirate ) AERBTA+B-ASP 2310 1400
70 BacT/Alert aerobic culture ( Blood ) AERBTA+B-BLD 2310 1400
71 BacT/Alert aerobic culture ( Bone Marrow ) AERBTA+B-BM 2310 1400
72 BacT/Alert aerobic culture ( Bronchial washing ) AERBTA+B-BRO 2310 1400
73 BacT/Alert aerobic culture ( CSF ) AERBTACSF 2310 1400
74 BacT/Alert aerobic culture ( Drainage fluid ) AERBTA+B-DRA 2310 1400
75 BacT/Alert aerobic culture ( Miscellaneous ) AERBTA+B 2310 1400
76 BacT/Alert aerobic culture ( P.D. fluid ) AERBTA+B-PDF 2310 1400
77 BacT/Alert aerobic culture ( Pericardial fluid ) AERBTA+B-PEC 2310 1400
78 BacT/Alert aerobic culture ( Peritoneal fluid ) AERBTA+B-PET 2310 1400
79 BacT/Alert aerobic culture ( Pleural fluid ) AERBTA+B-PLE 2310 1400
80 BacT/Alert aerobic culture ( Pus ) AERBTA+B-PUS 2310 1400
81 BacT/Alert aerobic culture ( Synovial fluid ) AERBTA+B-SYN 2310 1400
82 BacT/Alert anaerobic culture ( Aspirate ) ANABTA+BASP 2310 1400
83 BacT/Alert anaerobic culture ( Aspiration fluid ) ANABTA+BASF 2310 1400
84 BacT/Alert anaerobic culture ( Blood ) ANABTA+BBLD 2310 1400
85 BacT/Alert anaerobic culture ( Bone Marrow) ANABTA+BBON 2310 1400
86 BacT/Alert anaerobic culture ( CSF ) ANABTA+BCSF 2310 1400
87 BacT/Alert anaerobic culture ( Miscellaneous ) ANABTA+B 2310 1400
88 BacT/Alert anaerobic culture ( P. D. fluid ) ANABTA+BPDF 2310 1400
89 BacT/Alert anaerobic culture ( Pericardial fluid ) ANABTA+BPER 2310 1400
90 BacT/Alert anaerobic culture ( Peritoneal fluid ) ANABTA+BPEF 2310 1400
50
91 BacT/Alert anaerobic culture ( Pleural fluid ) ANABTA+BPLE 2310 1400
92 BacT/Alert anaerobic culture ( Pus ) ANABTA+BPUS 2310 1400
93 BacT/Alert anaerobic culture ( Tissue ) ANABTA+BTIS 2310 1400
94 BacT/Alert anaerobic culture ( Urine ) ANABTA+BURI 2310 1400
95 BK Polyomavirus Quantitative real time PCR (BLOOD) BKPQBLD 7320 4390
96 BK Polyomavirus Quantitative real time PCR (CSF) BKPQCSF 7320 4390
97 BK Polyomavirus Quantitative real time PCR (MISC) BKPQMIS 7320 4390
98 BK Polyomavirus Quantitative real time PCR (URINE) BKPQURI 7320 4390
99 Brucella antibody assay BAS 700 420
100 C - Reactive protein ( CRP ) CRP 930 570
101 CAPD Fluid Microscopy ( Cell count + Gram Stain + CAPDFCUL 650 390
KOH )
102 Charges for screening tests for blood donor BLOODDS 4790(Cat 1D)/3830 (2) /2880 (3)
103 Chikungunya & Dengue Real Time Qualitative PCR CDRTPCQ 3370 3370
104 Chikungunya Real Time Qualitative PCR CRTQPCR 1580 1580
105 Clostridium Difficile toxin A & B CDTAB 2110 1270
106 CMV antibody IgG CMVAG 820 490
107 CMV antibody IgM CMVAM 770 460
108 CMV avidity IgG CMVAVIGG 1000 600
109 CMV Quantitative Real Time PCR - Microbiology CMVQRTP 6000 4500
110 Cryptococcus antigen test ( Cryptola ) - Blood CDT 2320 1400
111 Cryptococcus antigen test ( Cryptola ) - CSF CDTCSF 2320 1400
112 CSF bacterial antigen test for meningitis causing CSFBATM 3050 1830
organsims
113 CSF VDRL VDRLCSF 350 210
114 Cysticercosis antibody test ( ELISA ) CYSTICER 1600 1000
115 Dengue antibody serology (IgM) DENGU 670 670
116 Dengue Duo spot plus test ( IgG / IgM / NS - 1 ) DDSTPLIGGIGM 2500 1500
117 Dengue Duo spot test ( IgG / IgM ) DDSTIGGIGM 2200 1320
118 Dengue NS 1 Antigen Assay DENGUNS1 630 630
119 Dengue Real Time PCR DENREATPC 1690 1690
120 Direct Fluorescent staining for AFB ( Aspirate ) FLUOREAFBASP 1000 600
121 Direct Fluorescent staining for AFB ( Aspirate ) FLUOREAFBASPN 630 630
Northern Railway
122 Direct Fluorescent staining for AFB ( Aspiration fluid ) FLUOREAFBASPF 1000 600
123 Direct Fluorescent staining for AFB ( Aspiration FLUOREAFBASPS 1000 600
smears )
124 Direct Fluorescent staining for AFB ( Bone marrow ) FLUOREAFBBOM 1000 600
125 Direct Fluorescent staining for AFB ( Bronchial FLUOREAFBBRW 1000 600
washing )
126 Direct Fluorescent staining for AFB ( Bronchoalveolar FLUOREAFBBRL 1000 600
lavage )
127 Direct Fluorescent staining for AFB ( Chest irrigatin FLUOREAFBCIF 1000 600
fluid )
128 Direct Fluorescent staining for AFB ( CSF ) FLUOREAFBCSF 1000 600
129 Direct Fluorescent staining for AFB ( Drainage fluid ) FLUOREAFBDRF 1000 600
130 Direct Fluorescent staining for AFB ( E. T. secretion ) FLUOREAFBETS 1000 600
131 Direct Fluorescent Staining for AFB ( Gastrtric FLUOREAFBGAS 1000 600
aspirate )
132 Direct Fluorescent staining for AFB ( Miscellaneous ) FLUOREAFB 1000 600
133 Direct Fluorescent staining for AFB ( P. D. fluid ) FLUOREAFBPDF 1000 600
134 Direct Fluorescent staining for AFB ( Pericardial fluid ) FLUOREAFBPEF 1000 600
135 Direct Fluorescent staining for AFB ( Peritoneal fluid ) FLUOREAFBPRF 1000 600
136 Direct Fluorescent staining for AFB ( Pleural fluid ) FLUOREAFBPLF 1000 600
51
137 Direct Fluorescent staining for AFB ( PUS ) FLUOREAFBPUS 1000 600
138 Direct Fluorescent staining for AFB ( Sputum ) FLUOREAFBSPU 1000 600
139 Direct Fluorescent staining for AFB ( Stool ) FLUOREAFBSTO 1000 600
140 Direct Fluorescent staining for AFB ( Synovial fluid ) FLUOREAFBSYF 1000 600
141 Direct Fluorescent staining for AFB ( Tissue ) FLUOREAFBTIS 1000 600
142 Direct Fluorescent staining for AFB ( Urine ) FLUOREAFBURN 1000 600
143 E histolytica antibody test (IgG) - Amoebic serology IGGEHIST 1480 890
144 EBV Quantitative Real Time PCR EBQRTP 7320 5240
145 Echinococcus antibody test ( ELISA ) - Hydatid ECHINOIGG 1330 800
serology
146 ELISA for Chikungunya IgM EFCI 630 630
147 Enterovirus real time PCR (Microbiology) ERTN 7820 5000
148 Fungal culture ( Aspiration fluid ) FUNGCULTAPF 1190 710
149 Fungal culture ( Blister fluid ) FUNGCULTBTF 1190 710
150 Fungal culture ( Bronchial washing ) FUNGCULTBRW 1190 710
151 Fungal culture ( Bronchoalveolar lavage ) FUNGCULTBRL 1190 710
152 Fungal culture ( CSF ) FUNGCULTCSF 1190 710
153 Fungal culture ( Drainage fluid ) FUNGCULTDRF 1190 710
154 Fungal culture ( E. T. secretion ) FUNGCULTETS 1190 710
155 Fungal culture ( Faecal fluid ) FUNGCULTFLF 1190 710
156 Fungal culture ( Hair ) FUNGCULTHAIR 1190 710
157 Fungal culture ( Miscellaneous ) FUNGCULT 1190 710
158 Fungal culture ( Nail ) FUNGCULTNAIL 1190 710
159 Fungal culture ( P. D. fluid ) FUNGCULTPDF 1190 710
160 Fungal culture ( Percardial fluid ) FUNGCULTPCF 1190 710
161 Fungal culture ( Peritoneal fluid ) FUNGCULTPTF 1190 710
162 Fungal culture ( Pleural fluid ) FUNGCULTPLF 1190 710
163 Fungal culture ( PUS ) FUNGCULTPUS 1190 710
164 Fungal culture ( Skin scrapings ) FUNGCULTSKIN 1190 710
165 Fungal culture ( Sputum ) FUNGCULTSPU 1190 710
166 Fungal culture ( Stool ) FUNGCULTSTL 1190 710
167 Fungal culture ( Synovial fluid ) FUNGCULTSYF 1190 710
168 Fungal culture ( Tissue ) FUNGCULTTIS 1190 710
169 Fungal culture ( Urine ) FUNGCULTURN 1190 710
170 Fungal culture by Bact Alert ( Blood ) FUNGCULBLD 2310 1400
171 Fungal culture by Bact Alert ( Bone Marrow ) FUNGCULBONE 2310 1400
172 Fungal smear - India ink preparation for cryptococcus INDINK 320 190
173 Fungal smear - KOH preparation ( Ascitic fluid ) KOHMEFATF 280 170
174 Fungal smear - KOH preparation for fungus ( Aspirate KOHMEFASP 280 170
)
175 Fungal smear - KOH preparation for fungus ( KOHMEFAPS 280 170
Aspiration fluid )
176 Fungal smear - KOH preparation for fungus ( Blister KOHMEFBLF 280 170
fluid )
177 Fungal smear - KOH preparation for fungus ( Bone KOHMEFBMW 280 170
marrow )
178 Fungal smear - KOH preparation for fungus ( KOHMEFBRW 280 170
Bronchial washing )
52
179 Fungal smear - KOH preparation for fungus ( KOHMEFBRL 280 170
Bronchoalveolar lavage )
180 Fungal smear - KOH preparation for fungus ( Chest KOHMEFCIF 280 170
irrigation fluid )
181 Fungal smear - KOH preparation for fungus ( Chest KOHMEFCWS 280 170
wound swab )
182 Fungal smear - KOH preparation for fungus ( Drainage KOHMEFDRF 280 170
fluid )
183 Fungal smear - KOH preparation for fungus ( E.T. KOHMEFETS 280 170
secretion )
184 Fungal smear - KOH preparation for fungus ( Ear swab KOHMEFERS 280 170
)
185 Fungal smear - KOH preparation for fungus ( Eye KOHMEFEYS 280 170
swab )
186 Fungal smear - KOH preparation for fungus ( Gastric KOHMEFGTS 280 170
aspirate )
187 Fungal smear - KOH preparation for fungus ( Hair ) KOHMEFHAIR 280 170
188 Fungal smear - KOH preparation for fungus ( KOHMEFLYS 280 170
Laryngeal swab )
189 Fungal smear - KOH preparation for fungus ( KOHMEF 280 170
Miscellaneous )
190 Fungal smear - KOH preparation for fungus ( Nail ) KOHMEFNAIL 280 170
191 Fungal smear - KOH preparation for fungus ( P.D. fluid KOHMEFPDF 280 170
)
192 Fungal smear - KOH preparation for fungus ( KOHMEFPCF 280 170
Pericardial fluid )
193 Fungal smear - KOH preparation for fungus ( KOHMEFPTF 280 170
Peritoneal fluid )
194 Fungal smear - KOH preparation for fungus ( Pleural KOHMEFPLF 280 170
fluid )
195 Fungal smear - KOH preparation for fungus ( Pus ) KOHMEFPUS 280 170
196 Fungal smear - KOH preparation for fungus ( KOHMEFRVF 280 170
Romovac fluid )
197 Fungal smear - KOH preparation for fungus ( Skin KOHMEFSKIN 280 170
scrapings )
198 Fungal smear - KOH preparation for fungus ( Sputum ) KOHMEFSPU 280 170
199 Fungal smear - KOH preparation for fungus ( Stool ) KOHMEFSTOOL 280 170
200 Fungal smear - KOH preparation for fungus ( Synovial KOHMEFSYF 280 170
fluid )
201 Fungal smear - KOH preparation for fungus ( Tissue ) KOHMEFTIS 280 170
202 Fungal smear - KOH preparation for fungus ( Urine ) KOHMEFURN 280 170
203 Fungal smear - KOH preparation for fungus ( Vaginal KOHMEFVGS 280 170
swab )
204 Galactomannam test for aspergillus PAG 2180 1300
205 Gen Probe for T.B. TBGENPROBE 4610 3750
206 Giemsa stain ( Aspiration smears ) - Inclusion bodies GIEMSAASP 320 190
in CMV or herpes
207 Giemsa stain ( Blister fluid ) - Inclusion bodies in CMV GIEMSABLF 320 190
or herpes
208 Giemsa stain ( Bronchial washing ) - PCP / Inclusion GIEMSABRW 320 190
bodies in CMV or herpes
209 Giemsa stain ( E.T. secretion ) - PCP GIEMSAETS 320 190
210 Giemsa stain ( Miscellaneous ) - Inclusion bodies in GIEMSA 320 190
CMV or herpes
53
211 Giemsa stain ( Sputum ) - PCP GIEMSASPU 320 190
212 Giemsa stain ( Tissue ) - Inclusion bodies in CMV or GIEMSATIS 320 190
herpes
213 Gram stain ( Aortic valve ) GRMSTAINAOV 320 190
214 Gram stain ( Ascitic fluid) GRMSTAINASC 320 190
215 Gram stain ( Aspirate) GRMSTAINASE 320 190
216 Gram stain ( Aspiration fluid ) GRMSTAINASF 320 190
217 Gram stain ( Aspiration smears) GRMSTAINASP 320 190
218 Gram stain ( Blister fluid ) GRMSTAINBLF 320 190
219 Gram stain ( Bronchial washing ) GRMSTAINBRW 320 190
220 Gram stain ( Bronchoalveolar lavage ) GRMSTAINBVL 320 190
221 Gram stain ( Chest irrigation fluid ) GRMSTAINCIF 320 190
222 Gram stain ( CSF ) GRMSTAINCSF 320 190
223 Gram stain ( CT guided aspirate ) GRMSTAINCTGA 320 190
224 Gram stain ( Drainage fluid ) GRMSTAINDRF 320 190
225 Gram stain ( E.T. secretion ) RCULTUREETS 320 190
226 Gram stain ( Laryngeal swab ) GRMSTAINLAS 320 190
227 Gram stain ( Miscellaneous ) GRMSTAIN 320 190
228 Gram stain ( P.D. fluid ) GRMSTAINPDF 320 190
229 Gram stain ( Pericardial fluid ) GRMSTAINPEF 320 190
230 Gram stain ( Peritoneal fluid ) GRMSTAINPER 320 190
231 Gram stain ( Pleural fluid ) GRMSTAINPLF 320 190
232 Gram stain ( Pus ) GRMSTAINPUS 320 190
233 Gram stain ( Romovac fluid ) GRMSTAINROF 320 190
234 Gram stain ( Semen ) GRMSTAINSEM 320 190
235 Gram stain ( Sputum ) GRMSTAINSPU 320 190
236 Gram stain ( Stool ) GRMSTAINSTO 320 190
237 Gram stain ( Throat swab ) GRMSTAINTHS 320 190
238 Gram stain ( Tissue ) GRMSTAINTIS 320 190
239 Gram stain ( Urine ) GRMSTAINURN 320 190
240 Gram stain ( Vaginal swab / High vaginal swab ) GRMSTAINVAS 320 190
241 Gram stain ( Venticular fluid ) GRMSTAINVEF 320 190
242 Gram stain ( Wound swab ) GRMSTAINWOS 320 190
243 Group B Streptococci Screening GBSS 1110 660
244 H1N1 / 09 SWINE FLU Qualitative Real Time PCR H1N1 4730 3920
245 Hanging Drop examination ( Stool ) HDROP 270 170
246 HBeAg for hepatitis B HBE 1950 1170
247 HBsAg ( Australia antigen ) HBSAG 820 490
248 HBsAg ( Australia antigen ) ( Dialysis ) DHBSAG 410 410
249 HBsAG SPOT HBSAGSPOT 1410 840
250 HBV Monitor ( Quantitative ) HBVM 9000 6000
251 HBV Qualitative HBVQ 6000 4000
252 HCV Monitor ( Quantitative ) HCVM 10000 6500
253 HCV Qualitative HCVQ 6000 4000
254 HCV Spot test HCVSPOT 1630 980
255 Hepatitis B core specific antibody ( total ) HEPBCSAT 1410 840
256 Hepatitis C virus serology antibody test HCV 1090 650
257 Hepatitis C virus serology antibody test ( Dialysis ) DHCV 540 540
258 Hepatitis E Virus Quantitative Real Time PCR HENRNA 7000
259 Herpes antibody ( IgG ) - Blood HERPAN 1000 620
260 Herpes antibody ( IgG ) - CSF HERPANCSF 1000 620
261 Herpes antibody ( IgM ) - Blood HERPA 1000 620
262 Herpes antibody ( IgM ) - CSF HERPACSF 1000 620
263 HIC Screen Blood Culture Aerobic HICBCA 2320 1400
54
264 HIC Screen Endotracheal secretion culture HICESC 1300 790
265 HIC Screen Stool Culture HICST 1300 790
266 HIC Screen Urine Culture HICUC 1190 710
267 HIV - 1 QUANTITATIVE TEST HIV1Q 8200 5490
268 HIV antibody test HIV 820 490
269 HIV antibody test ( Dialysis ) DHIV 410 410
270 HIV Spot test HIVSPOT 1080 650
271 HSV 1 & 2 and VZV real time PCR (CSF) HSVCSF 9470 5680
272 HSV 1 & 2 real time PCR (BLOOD) HSVBLD 8500 5000
273 HSV 1 & 2 real time PCR (MIS) HSVMIS 8500 5000
274 IgG4 Serum Levels IGG4 3370 2250
275 JC Polyomavirus Qualitative real time PCR (BLOOD) JCVQBLD 7000 6000
276 JC Polyomavirus Qualitative real time PCR (CSF) JCVQCSF 7000 6000
277 JC Polyomavirus Qualitative real time PCR (MIS) JCVQMIS 7000 6000
278 JC Polyomavirus Qualitative real time PCR (URINE) JCVQURI 7000 6000
279 Kidney Transplant Urine Routine Microscopy KTURMCRO 50 30
280 Kinyoun Stain ( Nocardia / Cryptospordium ) - KINYOUNBRW 450 270
Bronchial washing
281 Kinyoun Stain ( Nocardia / Cryptospordium ) - KINYOUNBRO 450 270
Bronchoalvcolar lavage
282 Kinyoun Stain ( Nocardia / Cryptospordium ) - E.T. KINYOUNETS 450 270
Secretion
283 Kinyoun Stain ( Nocardia / Cryptospordium ) - Other KINYOUN 450 270
fluids (NOT FOR CSF)
284 Kinyoun Stain ( Nocardia / Cryptospordium ) - Pleural KINYOUNPLF 450 270
fluid
285 Kinyoun Stain ( Nocardia / Cryptospordium ) - Pus KINYOUNPUS 450 270
286 Kinyoun Stain ( Nocardia / Cryptospordium ) - Sputum KINYOUNSPU 450 270
287 Kinyoun Stain ( Nocardia / Cryptospordium ) - Stool KINYOUNSTO 450 270
288 Legionella urinary antigen test LUAT 1500 900
289 Leptospira IgM LEPTOIGM 1100 700
290 Mantoux test MONTOUX 210 130
291 Modified ZN stain ( M. leprae ) - Slit smears nasal ZNMLEPNASAL 440 260
septum
292 Modified ZN stain ( M. leprae ) - Slit smears skin ZNMLEPSKIN 440 260
293 Monospot test MSPOT 690 420
294 Pneumocystis carinii Immunoflourescent PCI 2320 1400
295 Quantiferon Gold QUQNGOLD 5000 4000
296 Rapid AFB culture - (BacT/ALERT 3D) + Accuprobe AFB4DRUGBLD 8330 5830
identification and sensitivity 4 drugs BLOOD -
Streptomycin, Isoniazid, Rifampicin and Ethambutol
(SIRE)
297 Rapid AFB culture ( BacT/Alert 3D ) with accuprobe RAPIDWITHOUTSEN 2110 1480
identification without sensitivity
298 Rapid AFB culture ( BacT/Alert 3D ) with accuprobe RAPIDWITHOUTSEN 1480 1480
identification without sensitivity Northern Railway
299 Rapid AFB culture (BacT/ALERT 3D) + Accuprobe AFB10DRUGBLD 15000 10000
identification and sensitivity 10 drugs BLOOD - SIRE ,
Ofloxacin, Amikacin, kanamycin, Capreomycin, PAS
and D- Cycloserine
300 Rapid anti mycobacteria sensitivity 2nd line , Single MTBSINGLE 3560 3160
drug sensitivity ( MTB )
55
301 Rapid anti mycobacterial sensitivity 2nd line, 6 drugs - RAP6DRUG 7410 5570
Ofloxacin, Amikacin, kanamycin, Capreomycin, PAS
and D- Cycloserine
302 Rapid antimycobacterial sensitivity to 4 drugs (SIRE) RAS4D 5930 4950
303 Rapid Biofire Gastrointestinal Panel RBGP 15000 13000
304 Rapid Biofire Meningitis / Encephalitis Panel RBFM 15000 13000
305 Rapid Biofire Positive Blood Culture Panel RBFP 13940 11760
306 Rapid Biofire Respiratory Panel RBFR 15000 13000
307 Rapid Gene Xpert Influenza A/H1N1/B PCR RGXI 7380 4430
308 Respiratory - panel (Real Time Qualitative PCR) RESPIRATORY 22 13130 10500
309 Rheumatoid factor - RF ( blood ) RF 820 490
310 Rheumatoid factor - RF ( Synovial fluid ) RFSF 820 490
311 Rota Virus Antigen Test RVAT 1350 820
312 Routine culture and sensitivity ( Ascitic fluid ) RCULTUREASF 1000 600
313 Routine culture and sensitivity ( Aspiration fluid ) RCULTUREASP 1000 600
314 Routine culture and sensitivity ( Blister fluid ) RCULTUREBLF 1000 600
315 Routine culture and sensitivity ( Bone marrow ) RCULTUREBOM 1000 600
316 Routine culture and sensitivity ( Bronchial washing ) RCULTUREBRW 1000 600
317 Routine culture and sensitivity ( Bronchoalveolar RCULTUREBRL 1000 600
lavage )
318 Routine culture and sensitivity ( Chest irrigation fluid RCULTURECIF 1000 600
)
319 Routine culture and sensitivity ( CSF ) RCULTURECSF 1000 600
320 Routine culture and sensitivity ( CT guided aspirate ) RCULTURECTG 1000 600
321 Routine culture and sensitivity ( Drain tip ) RCULTUREDRT 1000 600
322 Routine culture and sensitivity ( Drainage fluid ) RCULTUREDRF 1400 840
323 Routine culture and sensitivity ( Ear swab ) RCULTUREESW 1000 600
324 Routine Culture and Sensitivity ( Endotracheal RCULTUREES 1400 840
Secretion )
325 Routine culture and sensitivity ( Eye swab ) RCULTUREEYS 1000 600
326 Routine culture and sensitivity ( Faecal fluid ) RCULTUREFAF 1000 600
327 Routine culture and sensitivity ( Line tip ) RCULTURELIT 1000 600
328 Routine culture and sensitivity ( Miscellaneous ) RCULTURE 1000 600
329 Routine culture and sensitivity ( Nail ) RCULTURENAIL 1000 600
330 Routine culture and sensitivity ( P.D. fluid ) RCULTUREPDF 1000 600
331 Routine culture and sensitivity ( Pericardial fluid ) RCULTUREPEF 1000 600
332 Routine culture and sensitivity ( Peritoneal fluid ) RCULTUREPER 1000 600
333 Routine culture and sensitivity ( Pleural fluid ) RCULTUREPLF 1000 600
334 Routine culture and sensitivity ( Pus ) RCULTUREPUS 1000 600
335 Routine culture and sensitivity ( Romovac fluid ) RCULTUREROF 1000 600
336 Routine culture and sensitivity ( Semen ) RCULTURESEM 1000 600
337 Routine culture and sensitivity ( Skin scraping swab ) RCULTURESKS 1000 600
338 Routine culture and sensitivity ( Sputum ) RCULTURESPU 1000 600
339 Routine culture and sensitivity ( Stool ) RCULTURESTO 1000 600
340 Routine culture and sensitivity ( Throat swab ) RCULTURETHS 1000 600
341 Routine culture and sensitivity ( Tissue ) RCULTURETIS 1000 600
342 Routine culture and sensitivity ( Vaginal swab ) RCULTUREVAS 1000 600
343 Routine culture and sensitivity ( Venticular fluid ) RCULTUREVEF 1000 600
344 Routine culture and sensitivity ( Wound swab ) RCULTUREWOS 1400 840
345 RPR VDRL 350 210
346 Rubella antibody serology ( IgG ) - Blood RUBVAG 1240 740
347 Rubella antibody serology ( IgG ) - CSF RUBVAGCSF 1240 740
348 Rubella antibody serology ( IgM ) - Blood RUBVAM 1240 740
349 Rubella antibody serology ( IgM ) - CSF RUBVAMCSF 1240 740
56
350 Rubella IgG Avidity Test RUBEAV 1500 900
351 Scrub Typhus IgM Elisa STIGM 2750 1650
352 Serum complement C-3 (Nephelometric method) C3 1110 660
353 Serum complement C-4 (Nephelometric method) C4 1110 660
354 Stool examination ( Routine / Microscopy ) STOOLRE 150 110
355 Stool Examination for Parasites ( Conc. Method ) SEFP 250 150
356 Stool fat globules STOOLFG 150 110
357 Stool Occult blood STOB 210 130
358 Stool pH STPH 140 90
359 Stool reducing substance STRED 150 110
360 SUPPLEMENTARY Direct Fluorescent staining for AFB FLUREAF 0 0
( Bronchoalveolar lavage )
361 TB - Xpert MTB / Rif TBXPERT 4070 3400
362 TB-HAINS Genotypic test MTB/INH,Rif TBHAINS 3400 2720
363 TORCH complex IgG serology ( Blood ) TORCHPROG 2320 1400
364 TORCH complex IgG serology ( CSF ) TORCHPROGCSF 2320 1400
365 TORCH complex IgM serology ( Blood ) TORCHPROM 2320 1400
366 TORCH complex IgM serology ( CSF ) TORCHPROMCSF 2320 1400
367 Toxoplasma antibody serology ( IgG ) TOXOPLAG 1300 790
368 Toxoplasma antibody serology ( IgM ) TOXOPLAM 1300 790
369 Toxoplasma avidity ( IgG ) TOXOAVIGG 1000 600
370 Treponema pallidum haemagglutination test ( TPHA ) TPHA 690 420
- Blood
371 Treponema pallidum haemagglutination test ( TPHA ) TPHACSF 690 420
- CSF
372 Typhi Dot Assay ( IgG ) TDAIGG 680 420
373 Typhi Dot Assay ( IgM ) TDAIGM 680 420
374 Urine culture URNCULT 1000 600
375 Urine culture ( Kidney Transplant ) KT-URNCULT 630 630
376 Urine culture ( Liver Transplant ) LT-URNCU 630 630
377 Urine Pregnancy test ( Beta HCG ) - Microbiology PREG.TST 500 300
378 VZV IgG VZVIGG 1600 1130
379 VZV Real time PCR VZV 8500 5000
380 Weil - felix Test WFELIX 860 510
381 Wet mount examination ( Ameobic liver abcess ) WETMEALA 290 180
382 Wet mount examination ( Aspirate for scolicls / WETMEASH 290 180
hooklets )
383 Wet mount examination ( Miscellaneous ) WETMEMIS 290 180
384 Wet mount examination ( Stool / faecal fluid ) WETME 290 180
385 Widal test for Typhoid WIDAL 500 300
386 ZN staining for A.F.B. ( Aortic Valve ) AFBSNAVE 440 260
387 ZN staining for A.F.B. ( Aspirate ) AFBSNASP 440 260
388 ZN staining for A.F.B. ( Aspiration Fluid ) AFBSNASF 440 260
389 ZN staining for A.F.B. ( Body Fluid ) AFBSNBFD 440 260
390 ZN staining for A.F.B. ( Bronchial Washing ) AFBSNBRW 440 260
391 ZN staining for A.F.B. ( Bronchoalveolar Lavage ) AFBSNBRO 440 260
392 ZN staining for A.F.B. ( CAPD Fluid ) AFBSNCAP 440 260
393 ZN staining for A.F.B. ( Chest Irrigation Fluid ) AFBSNCHE 440 260
394 ZN staining for A.F.B. ( CSF ) AFBSNCSF 440 260
395 ZN staining for A.F.B. ( Drainage Fluid ) AFBSNDRA 440 260
396 ZN staining for A.F.B. ( E.T. Secretion ) AFBSNETS 440 260
397 ZN staining for A.F.B. ( Gastric Aspirate ) AFBSNGAS 440 260
398 ZN staining for A.F.B. ( Miscellaneous ) AFBSN 440 260
399 ZN staining for A.F.B. ( Mitral Valve ) AFBSNMIT 440 260
57
400 ZN staining for A.F.B. ( P.D. Fluid ) AFBSNPDF 440 260
401 ZN staining for A.F.B. ( Pericardial Fluid ) AFBSNPER 440 260
402 ZN staining for A.F.B. ( Peritoneal Fluid ) AFBSNPEF 440 260
403 ZN staining for A.F.B. ( Pleural Fluid ) AFBSNPLE 440 260
404 ZN staining for A.F.B. ( Pus ) AFBSNPUS 440 260
405 ZN staining for A.F.B. ( Sputum ) AFBSNSPU 440 260
406 ZN staining for A.F.B. ( Synovial Fluid ) AFBSNSYN 440 260
407 ZN staining for A.F.B. ( Tissue ) AFBSNTIS 440 260
408 ZN staining for A.F.B. ( Urine ) AFBSNURI 440 260
409 Rapid AFB culture ( BacT/ALERT 3D) + Accuprobe AFB10DRUGOS 18740 14570
identification and sensitivity 10 drugs + DF - SIRE ,
Ofloxacin, Amikacin, kanamycin, Capreomycin, PAS and
D- Cycloserine
Direct Fluorscence Staining for AFB DIRFLU
Rapid AFB culture (BacT/ALERT 3D) + Accuprobe identification and AFB10DRUG

sensitivity 10 drugs - SIRE , Ofloxacin, Amikacin, kanamycin, Capreomycin,
PAS and D- Cycloserine
410 Rapid AFB culture ( BacT/ALERT 3D) + Accuprobe AFB4DRUG 8330 5830
identification and sensitivity 4 drugs + DF - Streptomycin,
Isoniazid, Rifampicin and Ethambutol (SIRE)
Direct Fluorscence Staining for AFB DIRFLU
Rapid AFB culture (BacT/ALERT 3D) + Accuprobe identification and AFB4DRUG

sensitivity 4 drugs - Streptomycin, Isoniazid, Rifampicin and Ethambutol
(SIRE)
411 CAPD Fluid Package ( Cell count + Gram Stain + KOH + CAPDFCUL 4190 2520
Culture Senstivity )
CAPD fluid culture/ABST RCULTURECAPD
CAPD Fluid Microscopy ( Cell count + Gram Stain + KOH ) CAPDFCUL
412 CMV antibody IgG & IgM CMVAGAM 2750 1650

CMV antibody IgG CMVAG
CMV antibody IgM CMVAM
413 Enterically transmitted hepatitis profile ( IgM HAV, IgM ENTHEP 3160 1900
HEV )
Anti HAV - IgM ( hepatitis A virus serology ) HAVT
Anti HEV - IgM ( hepatitis E virus serology ) HEVT
414 Herpes antibody ( IgG & IgM ) - Blood HERPANGM 2750 1650
Herpes antibody ( IgG ) - Blood HERPAN
Herpes antibody ( IgM ) - Blood HERPA
415 Herpes antibody ( IgG & IgM ) - CSF HERPANGMCSF 2750 1650
Herpes antibody ( IgG ) - CSF HERPANCSF
Herpes antibody ( IgM ) - CSF HERPACSF
416 Rubella antibody serology ( IgG & IgM) - Blood RUBVAGM 2750 1650
Rubella antibody serology ( IgG ) - Blood RUBVAG
Rubella antibody serology ( IgM ) - Blood RUBVAM
417 Rubella antibody serology ( IgG & IgM) - CSF RUBVAGMCSF 2750 1650
Rubella antibody serology ( IgG ) - CSF RUBVAGCSF
Rubella antibody serology ( IgM ) - CSF RUBVAMCSF
418 Stool microbiology workup ( Culture, Wetmount, Kinyoun STWORK 1270 770
)
Kinyoun Stain ( Nocardia / Cryptospordium ) - Stool KINYOUNSTO
Routine culture and sensitivity ( Stool ) RCULTURESTO
Wet mount examination ( Stool / faecal fluid ) WETME
419 TORCH complex IgG & IgM serology ( CSF ) TORCHPRCSF

TORCH complex IgG serology ( CSF ) TORCHPROGCSF 2320 1400
TORCH complex IgM serology ( CSF ) TORCHPROMCSF 2320 1400
420 TORCH complex IgG & IgM serology ( Blood ) TORCHPROGM 6260 3750
TORCH complex IgG serology ( Blood ) TORCHPROG
58
TORCH complex IgM serology ( Blood ) TORCHPROM
421 Toxoplasma antibody serology ( IgG & IgM ) TOXOPLAGM 2110 1270
Toxoplasma antibody serology ( IgG ) TOXOPLAG
Toxoplasma antibody serology ( IgM ) TOXOPLAM
422 VIRAL MARKER ( ACUTE HEPATITIS PANEL) VIRAHEP 3570 2140

Anti HAV - IgM ( hepatitis A virus serology ) HAVT
HBsAg ( Australia antigen ) HBSAG
Hepatitis E Virus Quantitative Real Time PCR HENRNA
423 VIRAL MARKER (CHRONIC HEPATITIS SCREEN PANEL) VIRCHGAS 1440 860
Hepatitis C virus serology antibody test HCV
424 VIRAL MARKER (DIALYSIS) VIRDIA 1350 1350

HBsAg ( Australia antigen ) ( Dialysis ) DHBSAG
Hepatitis C virus serology antibody test ( Dialysis ) DHCV
HIV antibody test ( Dialysis ) DHIV
425 VIRAL MARKER - HBV PANEL (HBSAG PROFILE) VIRHBSAG 12340 7400
Anti HBc - IgM ( hepatitis B virus serology ) ANTIHBC
HBeAg for hepatitis B HBE
HBV Qualitative HBVQ
426 VIRAL MARKER(NON PREGNANT / GASTRO) VIRNONP 2050 1230

HIV antibody test HIV
427 VIRAL MARKER (PREGNANT PANEL) VIRP 4590 2750

RPR VDRL
Rubella antibody serology ( IgG ) - Blood RUBVAG
Rubella antibody serology ( IgM ) - Blood RUBVAM
428 VIRAL MARKER (PAED. THAL ASSEEMIA) VIRPTHAL 2050 1230

429 Viral marker profile (Transplant) VMP 2180 2180

CMV antibody IgG CMVAG
CMV antibody IgM CMVAM
Molecular Haematology Laboratory Charges

CAT 1/CAT2 CAT3
1 ALL Translocation Panel ATPMH 6900 5800
2 AML PCR Panel (Any 4) AMLMH 8800 7500
3 AML1 - ETO Translocation ( Molecular Haematogy ) AML1 7000 4500
4 BCR - ABL Qualitative ( Molecular Haematology ) MMBCRABL 6500 4000
5 BCR - ABL Quantitative ( Molecular Haematology ) BCRABL 8500 7500
6 CALR Mutation (Type 1 and Type2) CALRMH 6200 4650
7 Composite Thrombophilia Mutation Panel CTMPMH 7700 5800
8 Factor V ( Leiden ) Gene mutations - Molecular FVLGMMH 5200 3400
Haematology
59
9 FIP1L1-PDGFRA Rearrangement FIP1L1 5100 5100
10 FLT3 Mutation ( D835 & IDT ) ( Molecular FLTMH 6000 4000
Haemtology )
11 Inversion 16 translocation ( Molecular Haemtology ) INVERSIONMH 7000 4500
12 JAK-2 mutation ( Molecular Haematology ) MMPCR 6500 4500
13 MPL mutation MPLMMH 4200 3200
14 MPN Reflex Panel MPNMH 8700 7600
15 MTHFR ( C677T ) Gene Polymorphism - Molecular MTHFRGMMH 3800 2280
Haematology
16 Prothrombin ( G20210A ) Gene Mutation - Molecular PGMMH 3800 2280
Haematology
17 Qualitative Reverse Transcriptase PCR (RT-PCR) for MMPMLRARA 6500 4000
PML-RARA ( Molecular Haematology Laboratory )
18 Qualitative Reverse Transcriptase PCR (RT-PCR) for MMTELAML1 6500 4000
TEL-AML1 ( Molecular Haematology Laboratory )
19 TPMT Genotyping ( Molecular Hematology ) TGMH 5700 4300
Research Lab Charges

CAT 1/CAT2 CAT3
1 Soluble interleukin-2 receptor (SIL2R) SIL2R 4820 3530
Special Order Sets

CAT 1/CAT2 CAT3
1 Liver recipient preoperative workup LIVRECPOWU
$$ Alpha feto protein - AFP ( Serum / Amniotic fluid ) BAFP 800 650
24 Hours Urine Protein (Excludes Albumin) 24URINPROT
300 180
24 Hours Urine Sodium 24US 200 120
Anti mitochondrial antibody ( AMA ) - WITH Barcode AMA
1340 800
Anti nuclear antibodies ( ANA ) and Anti smooth muscle antibody ( ASMA ) ANASMA 2060 1230
- WITH Barcode
Anti-p ANCA ( anti - MPO ) AANCA-AM 1950 1170
APTT ( Activated partial thromboplastin time ) APTT
700 420
BacT/Alert aerobic culture ( Blood ) AERBTA+B-BLD 2310 1400
Blood group - ABO + Rh(D) BGROUP
520 310
BUN BUN 160 100
CA 19-9 CA199
1300 800
Calcium CALC 220 130
CBC - Complete blood count CBC 450 270
CCR - Creatinine Clearance CCR
500 300
CEA ( Carcino-Embryonic Antigen ) CEA 850 550
Ceruloplasmin (Serum) BCPL
1250 1000
CMV antibody IgG CMVAG 820 490
CMV antibody IgM CMVAM 770 460
Electrocardiogram ( ECG ) ECG
400 300
Ferritin FERI 900 540
Fibrinogen (Quantitative) FIBEST
1400 840
Glucose Random GLUR 120 80
820 490
1090 650
HIV antibody test HIV 820 490
60
LFT - Liver Function Test ( Hepatic Profile ) HEPA 1350 800
Magnesium SMAG
300 180
Prothrombin time ( PT ) Haematology Lab PT 420 250
RPR VDRL 350 210
Serum Creatinine CREA 180 110
Serum Iron IRON 400 240
Serum Iron Binding Capacity ( TIBC ) TIBC
500 300
Sodium + Potassium + Chlorides + Bicarbonate SPC 700 420
Spirometery SPIROM
1800 1100
Thyroid Profile ( T3, T4, TSH ) T3T4TSH 1240 1240
Transferrin TF
700 420
Ultrasound lower abdomen / pelvis LA 1500 880
Ultrasound upper abdomen & doppler study ABDO 3800 2280
Urine culture URNCULT
1000 600
Urine examination ( Routine / Microscopy ) URINERE 280 170
Xray chest PA ( CXR ) CHPA
520 310
MRI Charges

CAT 1/CAT2 CAT3
1 Ankylosing Spondylosis Screening Package - for 2 ASSP2 7000 7000
parts
2 Ankylosing Spondylosis Screening Package - for 3 ASSP3 9800 9800
parts
3 Breast MRI - MRI Dept.Charges BRMRI 12200 12200
4 Contrast enhanced MRI brain MRICEMRIB 14600 14600
5 MR Venography Neck ( Plain ) MRIMRVNP 9000 9000
6 MR Venography Neck with contrast ( double dose ) MRIMRVNCDD 20000 20000
7 MR Venography Neck with contrast ( single dose ) MRIMRVNCSD 14600 14600
8 MRI 3D ( Extra ) MRI3D 9800 9800
9 MRI add on anaesthesia MRIADDANAES 4500 4500
10 MRI add on charges for CD MRICD 700 700
11 MRI add on double dose contrast MRISODDC 11300 11300
12 MRI add on extended study MRIAOES 5500 5500
13 MRI add on extra film charges MRIEXTFILM 500 500
14 MRI add on scout both ankles MRIAOSBA 9000 9000
15 MRI add on scout both arms MRIAOSBF 9000 9000
16 MRI add on scout both feet MRIAOSFO 9000 9000
17 MRI add on scout both knee joints MRIAOSBKJ 9000 9000
18 MRI add on scout both lower legs MRIAOSLLB 9000 9000
19 MRI add on scout both shoulders MRIAOSSBS 9000 9000
20 MRI add on scout both thighs MRIAOSTB 9000 9000
21 MRI add on scout brain MRIAOSB 5000 5000
22 MRI add on scout cervical spine MRIAOSCS 5000 5000
23 MRI add on scout dorsal/thoracic spine MRIAOSDTS 5000 5000
24 MRI add on scout hip joints MRIAOSHJ 5000 5000
25 MRI add on scout left ankle MRIAOSLA 5000 5000
26 MRI add on scout left arm MRIAOSRUA 5000 5000
27 MRI add on scout left feet MRIAOSF 5000 5000
28 MRI add on scout left knee joint MRIAOSLKJ 5000 5000
29 MRI add on scout left lower leg MRIAOSLL 5000 5000
30 MRI add on scout left shoulder MRIAOSLS 5000 5000
61
31 MRI add on scout left thigh MRIAOST 5000 5000
32 MRI add on scout lumbo-sacral spine MRIAOSLSS 5000 5000
33 MRI add on scout of neck MRISNK 5000 5000
34 MRI add on scout of wrist MRISWR 5000 5000
35 MRI add on scout orbit MRIAOSO 5000 5000
36 MRI add on scout right ankle MRIAOSRA 5000 5000
37 MRI add on scout right arm MRIAOSRF 5000 5000
38 MRI add on scout right feet MRIAOSFR 5000 5000
39 MRI add on scout right knee joint MRIAOSRKJ 5000 5000
40 MRI add on scout right lower leg MRIAOSLLR 5000 5000
41 MRI add on scout right shoulder MRIAOSRS 5000 5000
42 MRI add on scout right thigh MRIAOSTR 5000 5000
43 MRI add on scout sacro-iliac joints MRIAOSSIJ 5000 5000
44 MRI add on single dose contrast MRIAOSDC 5600 5600
45 MRI angiography both forearms MRASFB 19500 19500
46 MRI angiography both forearms (double dose MRASFDDCB 32000 32000
contrast)
47 MRI angiography both lower legs MRABLL 9800 9800
48 MRI angiography both lower legs (double dose MRABLLDDC 16000 16000
contrast)
49 MRI angiography both thighs MRABT 9800 9800
50 MRI angiography both thighs (double dose contrast) MRABTDDC 16000 16000
51 MRI angiography both upper arms MRASUAB 19500 19500
52 MRI angiography both upper arms (double dose MRASUADDCB 32000 32000
contrast)
53 MRI angiography left forearm MRASFL 9800 9800
54 MRI angiography left forearm (double dose contrast) MRASFDDCL 16000 16000
55 MRI angiography left upper arm MRASUA 9800 9800
56 MRI angiography left upper arm (double dose MRASUADDC 16000 16000
contrast)
57 MRI angiography lower abdomen / pelvis MRALAP 9800 9800
58 MRI angiography lower abdomen / pelvis (double MRALAPDDC 16000 16000
dose contrast)
59 MRI angiography lower thorax MRALT 9800 9800
60 MRI angiography lower thorax (double dose contrast) MRALTDDC 16000 16000
61 MRI Angiography Peripheral With Contrast ( Single MRIANGIO 16000 16000
Part )
62 MRI angiography right forearm MRASFR 9800 9800
63 MRI angiography right forearm (double dose MRASFDDCR 16000 16000
contrast)
64 MRI angiography right upper arm MRASUAR 9800 9800
65 MRI angiography right upper arm (double dose MRASUADDCR 16000 16000
contrast)
66 MRI angiography upper abdomen MRAUA 9800 9800
67 MRI angiography upper abdomen (double dose MRAUADDC 16000 16000
contrast)
68 MRI angiography upper thorax MRAUT 9800 9800
69 MRI angiography upper thorax (double dose contrast) MRAUTDDC 16000 16000
70 MRI Arthography one Shoulder MRIATRHO 19500 19500
71 MRI Arthography one Wrist MRIARW 19500 19500
72 MRI Arthrography MRIARTH 19500 19500
73 MRI both ankles MRIA 19500 19500
74 MRI both ankles (contrast) MRBAC 25700 25700
75 MRI both elbows MRIESB 19500 19500
62
76 MRI both elbows (contrast) MRSECB 25700 25700
77 MRI both forearm (contrast) MRSCFCB 25700 25700
78 MRI both forearms MRFB 19500 19500
79 MRI both hand MRSHB 19500 19500
80 MRI both hand (contrast) MRSHCB 25700 25700
81 MRI both knee joints MRBNJ 19500 19500
82 MRI both knee joints (contrast) MRBNJC 25700 25700
83 MRI both shoulders MRISBS 19500 19500
84 MRI both shoulders (contrast) MRSSCB 25700 25700
85 MRI both wrist MRIWB 19500 19500
86 MRI both wrist (contrast) MRIWBC 25700 25700
87 MRI brachial plexus MRBP 9800 9800
88 MRI brachial plexus (contrast) MRBPC 16000 16000
89 MRI Brachial Plexus + Cervical Spine MRIBRCER 16000 16000
90 MRI brain MRIBRAIN 9000 9000
91 MRI brain (angiography) MRIBANGIO 9000 9000
92 MRI brain (venography) MRIBVEN 9000 9000
93 MRI Brain + Diffusion MRIBRDIF 13700 13700
94 MRI Brain + Diffusion + Perfusion + Contrast MRIBRDIPECON 28300 28300
95 MRI Brain + Dynamic CSF Flow Studies MRIBRDY 13000 13000
96 MRI Brain + Functional MRIBRFUN 14500 14500
97 MRI Brain + Orbits MRIBRORB 13700 13700
98 MRI Brain + Perfusion + Contrast MRIBRPERCON 19500 19500
99 MRI Brain + Sella MRIBRSELLA 13700 13700
100 MRI Brain + Spectroscopy MRIBRSP 13700 13700
101 MRI Brain Cisternography MRIBRCIS 13700 13700
102 MRI brain epilepsy protocol MRIBEP 11500 11500
103 MRI Cardiac Package Plain MRICARPKPL 16000 16000
104 MRI cervical spine MRICS 9000 9000
105 MRI cervical spine (contrast) MRCSC 16000 16000
106 MRI Contrast For Cardiac MRICONCAR 9000 9000
107 MRI Diffusion Weighted MRIDFW 5000 5000
108 MRI dorsal / thoracic spine MRIDS 9000 9000
109 MRI dorsal / thoracic spine (contrast) MRDTSC 16000 16000
110 MRI Dynamic CSF study MRIDCSF 9000 9000
111 MRI ear MRIEAR 9800 9800
112 MRI Ear with contrast MRIEWC 16000 16000
113 MRI face MRIFACE 9800 9800
114 MRI Face with contrast MRIFWC 16000 16000
115 MRI feet MRBF 19500 19500
116 MRI feet (contrast) MRBFC 25700 25700
117 MRI Foetus MRIFOETUS 9800 9800
118 MRI foot MRF 9800 9800
119 MRI foot (contrast) MRFC 16000 16000
120 MRI hip joints MRIHJ 9800 9800
121 MRI hip joints (contrast) MRHJC 16000 16000
122 MRI KUB MRIKUB 15300 15300
123 MRI left ankle MRSAL 9800 9800
124 MRI left ankle (contrast) MRSACL 16000 16000
125 MRI left elbow MRIESL 9800 9800
126 MRI left elbow (contrast) MRSECL 16000 16000
127 MRI left forearm MRFL 9800 9800
128 MRI left forearm (contrast) MRSCFCL 16000 16000
129 MRI left hand MRSHL 9800 9800
63
130 MRI left hand (contrast) MRSHCL 16000 16000
131 MRI left knee joint MRIKJSL 9800 9800
132 MRI left knee joint (contrast) MRSKJCL 16000 16000
133 MRI left shoulder MRISL 9800 9800
134 MRI left shoulder (contrast) MRSSCL 16000 16000
135 MRI left upper arm MRSUAL 9800 9800
136 MRI left upper arm (contrast) MRSUACL 16000 16000
137 MRI left wrist MRIWL 9800 9800
138 MRI left wrist (contrast) MRSWCL 16000 16000
139 MRI Liver Transplant Package MRILIVPK 24000 24000
140 MRI lower abdomen / pelvis MRLAP 9800 9800
141 MRI lower abdomen / pelvis (contrast) MRLAPC 16000 16000
142 MRI lower legs MRLL 9800 9800
143 MRI lower legs (contrast) MRLLC 16000 16000
144 MRI lumbar plexus MRLP 9800 9800
145 MRI lumbar plexus (contrast) MRLPC 16000 16000
146 MRI lumbo-sacral spine MRILSS 9000 9000
147 MRI lumbo-sacral spine (contrast) MRLSSC 16000 16000
148 MRI mammogram both breasts MRMBB 14500 14500
149 MRI mammogram both breasts (contrast) MRMBBC 20500 20500
150 MRI MRCP MRIMRCP 9800 9800
151 MRI neck MRINECK 9800 9800
152 MRI neck carotid angiography MRIENCKANGIO 9000 9000
153 MRI neck carotid angiography (double dose contrast) MRINADD 14500 14500
154 MRI neck with contrast MRINECKC 16000 16000
155 MRI Oncology Package MRIONCOPK 35000 35000
156 MRI orbit MRIORBIT 9800 9800
157 MRI orbit with (contrast) MRIORBITWC 16000 16000
158 MRI para nasal sinuses ( PNS ) MRPNS 9800 9800
159 MRI para nasal sinuses ( PNS with contrast) MRPNSWC 16000 16000
160 MRI Parametric Map MRIPARA 3300 3300
161 MRI pelvis MRIP 9800 9800
162 MRI pelvis with contrast MRIPWC 16000 16000
163 MRI perineum MRP 9800 9800
164 MRI perineum (contrast) MRPC 16000 16000
165 MRI pituitary fossa/sella MRIPFS 9000 9000
166 MRI pituitary fossa/sella contrast MRIPFSC 16000 16000
167 MRI Prostate Package ( Contrast ) MRIPROSPK 34500 34500
168 MRI Pyelography MRIPYE 4500 4500
169 MRI renal angiography MRIRA(CE-S) 9800 9800
170 MRI renal angiography (double dose contrast) MRIRA(CE-D) 16000 16000
171 MRI right ankle MRSAR 9800 9800
172 MRI right ankle (contrast) MRSACR 16000 16000
173 MRI right elbow MRIESR 9800 9800
174 MRI right elbow (contrast) MRSECR 16000 16000
175 MRI right forearm MRFR 9800 9800
176 MRI right forearm (contrast) MRSCFCR 16000 16000
177 MRI right hand MRSHR 9800 9800
178 MRI right hand (contrast) MRSHCR 16000 16000
179 MRI right knee joint MRIKJSR 9800 9800
180 MRI right knee joint (contrast) MRSKJCR 16000 16000
181 MRI right shoulder MRISR 9800 9800
182 MRI right shoulder (contrast) MRSSCR 16000 16000
183 MRI right upper arm MRSUAR 9800 9800
64
184 MRI right upper arm (contrast) MRSUACR 16000 16000
185 MRI right wrist MRIWR 9800 9800
186 MRI right wrist (contrast) MRSWCRL 16000 16000
187 MRI sacro-iliac joints MRISIJ 9800 9800
188 MRI sacro-iliac joints (contrast) MRSIJC 16000 16000
189 MRI screening of brain & MRA MRISB 12100 12100
190 MRI Screening of Lower abdomen MRISLAB 4500 4500
191 MRI Screening of upper abdomen MRISUAB 4500 4500
192 MRI screening with contrast MRISC 9800 9800
193 MRI screening without contrast MRISWC 4500 4500
194 MRI Spectroscopy MRISPE 9800 9800
195 MRI Spine screening MRISPSC 4500 4500
196 MRI Thalassemia Package MRITHALPK 0 0
197 MRI Thalassemia Protocol MRITHALPR 5600 5600
198 MRI thigh MRT 9800 9800
199 MRI thigh (contrast) MRTC 16000 16000
200 MRI thorax MRITHORAX 9800 9800
201 MRI thorax (contrast) MRTHOC 16000 16000
202 MRI TM joint/temporo-mandibular joint MRITMJTMJ 9800 9800
203 MRI TM joint/temporo-mandibular joint contrast MRITMJTMJC 16000 16000
204 MRI Tractography MRITRAC 3600 3600
205 MRI Triple Phase Upper Abdomen with Contrast MRITPUAWC 16000 16000
206 MRI upper abdomen MRIUA 9800 9800
207 MRI upper abdomen (contrast) MRUAC 16000 16000
208 MRI upper abdomen with MRCP MRUAMRCP 16000 16000
209 MRI Urography MRIUROY 15300 15300
210 MRI venography both forearm MRVSFB 19500 0
19500
211 MRI venography both forearm (double dose contrast) MRVSFDDCB 32000 32000
212 MRI venography both lower legs MRVBLL 9800 9800
213 MRI venography both lower legs (double dose MRVBLLDDC 16000 16000
contrast)
214 MRI venography both thighs MRVBT 9800 9800
215 MRI venography both thighs (double dose contrast) MRVBTDDC 16000 16000
216 MRI venography both upper arm MRVSUAB 19500 19500
217 MRI venography both upper arm (double dose MRVSUADDCB 32000 32000
contrast)
218 MRI venography left forearm MRVSFL 9800 9800
219 MRI venography left forearm (double dose contrast) MRVSFDDCL 16000 16000
220 MRI venography left upper arm MRVSUAL 9800 9800
221 MRI venography left upper arm (double dose MRVSUADDCL 16000 16000
contrast)
222 MRI venography lower abdomen / pelvis MRVLAP 9800 9800
223 MRI venography lower abdomen / pelvis (double MRVLAPDDC 16000 16000
dose contrast)
224 MRI venography lower thorax MRVLT 9800 9800
225 MRI venography lower thorax (double dose contrast) MRVLTDDC 16000 16000
226 MRI venography right forearm MRVSFR 9800 9800
227 MRI venography right forearm (double dose contrast) MRVSFDDCR 16000 16000
228 MRI venography right upper arm MRVSUAR 9800 9800
229 MRI venography right upper arm (double dose MRVSUADDCR 16000 16000
contrast)
230 MRI venography upper abdomen MRVUA 9800 9800
231 MRI venography upper abdomen (double dose MRVUADDC 16000 16000
contrast)
65
232 MRI venography upper thorax MRVUTHO 9800 9800
233 MRI venography upper thorax (double dose contrast) MRVUTHODDC 16000 16000
234 MRI whole abdomen MRIWHAB 19500 19500
235 MRI whole abdomen with contrast MRIWAWC 25700 25700
236 MRI Whole Body MRIWHBD 26700 26700
237 MRI Whole Body Angio ( Plain ) MRIWHBDANGIO 26700 26700
238 MRI Whole Body Diffusion MRIWHBDIF 13500 13500
MRI Charges

CAT 1/CAT2 CAT3
1 Biopsy under guidance of ultrasound / CT / MRI fusion BIOCTMRIOS
Biopsy under guidance of ultrasound / CT / MRI fusion - Ultrasonologist fee UBUGCTMRIDF 2090 0/1250
Biopsy under guidance of ultrasound / CT / MRI fusion - Ultrasound dept. UBUGCTMRIDC
2090 2090
charges
2 Breast MRI + Tomosynthesis Charges BRMRIOS

Breast MRI - MRI Dept.Charges BRMRI
12200 12200
Tomosynthesis Charges - Mammography Dept.Charges TOMOMAM 6500 3900
3 MRI BRAIN + MRA BRAIN MRIMRA 10890 10890
MRI brain MRIBRAIN
MRI brain (angiography) MRIBANGIO
4 MRI BRAIN + MRA BRAIN + MRV BRAIN MRIMRAMRV 14520 14520

MRI brain MRIBRAIN
MRI brain (angiography) MRIBANGIO
MRI brain (venography) MRIBVEN
5 MRI NECK + MRA NECK MRIMRANECK 10290 10290

MRI neck MRINECK
MRI neck carotid angiography MRIENCKANGIO
6 MRI UPPER ABDOMEN + MRCP MRIMRCP 10290 10290

MRI MRCP MRIMRCP
MRI upper abdomen MRIUA
7 MRI BRAIN + MRV BRAIN MRIMRV 10290 10290

MRI brain MRIBRAIN
MRI brain (venography) MRIBVEN
MRI Charges ADD ON

CAT 1/CAT2 CAT3
1 Total Intra Venous Sedation ( TIVS ) - MRI/CT TIVSOPDOS
Anaeshesia consumables used in MRI/CT for TIVS TIVSMC 1500 1500
Total Intra Venous Sedation ( TIVS ) - MRI/CT TIVSOPD
2670 2670
Neonatology Test

CAT 1/CAT2 CAT3
1 NEONATOLOGY FUNCTIONAL ECHO ( TEST + DOCTOR FEE ) NEOFEOS 2990 1880
2 NEONATOLOGY ULTRASOUND (TEST+DOCTOR FEE) NEOULTRAOS 2250 1350
66
Nephrology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
928 AVADDH ACUTE VASCULAR ACCESS FOR
OS DIALYSIS (DOCTOR FEE +
HOSPITAL CHARGES)
ACADAHC Acute vascular access for dialysis - 1940 1940 970 780 580
Additional hospital charges
AVADDF Acute vascular access for dialysis - Doctor 19400 19400 9700 7760 5820
fees
929 CADKIDD Cadaveric Kidney Donation
OS (Bench Surgery) - Doctor fee +
Hospital charges
CADKDHC Cadaveric kidney donation (Bench Surgery) - 2800
CADKDF Cadaveric kidney donation (Bench Surgery) - 28000
Doctor fee
930 CAPD1WD CAPD 1 week daycase training
COS (Doctor fee + Hospital charges)
CAPD1WDCDF CAPD 1 week daycase training - doctor fee 17350
CAPD1WDCHC CAPD 1 week daycase training - hospital 1740
charges
931 CAPDTDH CAPD training (doctor charges
COS + hospital service charges)
CAPDAHC CAPD training - Additional hospital charges 1990 1590 1190
CAPDDF CAPD training - Doctor fees 19850 15880 11910
932 CRRTPPD CRRT - PLANNING AND
CHOS MONITORING (DOCTOR FEE +
HOSPITAL CHARGES)
CRRTPMDF CRRT - planning and monitoring - Doctor fee 16000 16000 8000 6400 4800
CRRTPMAHC CRRT - planning and monitoring - hospital 1600 1600 800 640 480
charges
933 HAEM48S Haemodialysis charges for
OS Daycare patients (Doctor +
Hospital + Kit charges) 4008S
HEMODIALDO Haemodialysis - amount given to doctor 770
CCH
HEMODIALKIT Haemodialysis - kit charges 300
CH
HAEPC48S Haemodialysis package charges 4008S 2570
HAEHOS4SN Haemodialysis procedure (4008S) - Hospital 1800
charges
934 HAEMDH Haemodialysis charges for
OS INPATIENTS 4008S ( Doctor +
Hospital )
CCH
HAEHOS4SN Haemodialysis procedure (4008S) - Hospital 1800
charges
935 HAEMIPD Haemodialysis charges for
HOS INPATIENTS 5008S ( Doctor +
Hospital )
CCH
HAEHC8S Haemodialysis procedure (5008S) - hospital 2330
charges
67
936 HAEMPAC Haemodialysis charges for
8SOS Daycare patients (Doctor +
Hospital + Kit charges) 5008S
BLBINAV $$BLOODLINE AV SET (TUBING) 5008S 238
DIAFLSL $$DIALYSER FX60 HIGH FLUX SINGLE USE 467
CCH
CH
HAEOCHS Haemodialysis package charges 5008S 3100
HAEHC8S Haemodialysis procedure (5008S) - hospital 2330
charges
937 HEMODIA Haemodialysis ( emergency )
LEORDSET charges for daycare patient (all
charges)
CH
HEMODIALEP Haemodialysis (emergency) package 4730
C charges
HEMOEDF Haemodialysis Emergency - amount given to 1370 1370
doctor
HEEHC Haemodialysis procedure emergency - 3360 3360
hospital charges
938 IJCSBOS Internal jugular ( IJ ) catheter /
subclavion catheter insertion
in Dialysis Room (Doctor fee +
Hospital Charges)
IJCATHC Internal jugular ( IJ ) catheter / subclavion 1600 1600 800 640 480
catheter insertion in Dialysis Room -
Hospital Charges
IJCSCATDF Internal jugular ( IJ ) catheter / subclavion 16000 16000 8000 6400 4800
catheter insertion in Dialysis Room ( Doctor
Fee )
939 INJOS Charges for giving injection
(I/V infusion - Vancomycin,
Solumedrol, Endoxan ) in
Dialysis Room ( Doctor Fee +
Hospital charges)
CHINJHC Charges for giving injection (I/V infusion - 270
Vancomycin, Solumedrol, Endoxan ) in
Dialysis Room - Hospital Charges
INJDF Charges for giving injection (I/V infusion - 560
Vancomycin, Solumedrol, Endoxan ) in
Dialysis Room ( Doctor Fee )
940 IPDDHCH PERITONEAL DIALYSIS -
OS INTERMITTENT (DOCTOR FEE +
HOSPITAL CHARGES)
IPDAHC Intermittent peritoneal dialysis - Additional 1610 1610 810 640 480
hospital charges
IPDDF Intermittent peritoneal dialysis - Doctor fees 16100 16100 8050 6440 4830
941 KTPSOS KTP Surcharge ( Surgeon +
Hospital + Anastheist )
KTPSA KTP Surcharge - Anasthesist fee 2780
KTPSH KTP Surcharge - Hospital charges 5550
KTPSS KTP Surcharge - Surgeon Fee 5550
942 ONHOS Online Haemodialysis (Doctor
fee + Hospital Charges + kit
charges)
AVSET $$ AV SET ONLINE 530
BIBAG $$ Bibag 960 gm 215
CH
68
HEDFON Online Haemodialysis - amount given to 680
doctor
HHCON Online Haemodialysis - Hospital Charges 1800
HEPPCON Online Haemodialysis package charges 2480
943 PLPEROS Pleural / Peritoneal tapping in
Dialysis Room ( Doctor Fee +
Hospital charges)
PLEPERHC Pleural / Peritoneal tapping in Dialysis Room 560
- Hospital Charges
PTAPPERDF Pleural / Peritoneal tapping in Dialysis Room 2760 2760 2760 2760
( Doctor Fee )
944 SLEEDDHC SLEDD - PLANNING AND
HOS MONITORING CHARGES
(DOCTOR FEE + HOSPITAL
CHARGES)
SLEDDAHC SLEDD - Planning and monitoring charges by 1600 1600 800 640 480
nephrologist - Additional hospital charges
SLEDDNDF SLEDD - Planning and monitoring charges 16000 16000 8000 6400 4800
for Nephrologist - Doctor fee
KBSET Kidney biopsy set usage charges 410
41 KBDHCHO KIDNEY BIOPSY (DOCTOR FEE +

S HOSPITAL CHARGES)
KBHC Kidney biopsy - Additional hospital charges 1680 1680 840 670 500
KBDF Kidney biopsy - Doctor fees 16800 16800 8400 6720 5040
AV Fistula package
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
AV Fistula AV Fistula 21000
Package Includes :
 Day Care Bed charges
 Medicines & Consumables upto Rs. 1688/-
 Anaesthesia Charges & OT Charges
 Professional Fees of Consultant
Package Excludes :
 Cross references other than Nephrologist.
 All investigations, medicines, and consumables over & above included in the package
Dialysis machine usage charges

All Category
Cat 1B Suite
Cat 1A-Pre/
Single Bed
2 Bedded
4 Bedded
Casualty
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1 CRRTMPD CRRT - use of machine (per day) 6070

2 SLEDDMPD SLEDD - Use of machine (per day) 6070
69
Access Procedures For Dialysis
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1 OP2911 Acute vascular access for dialysis ( in OT ) 21340 10670 8540 6400
2 AVFISSF AV Fistula - Surgen Fee
3 OP3397 Basilic vein transposition in OT 64020 32010 25610 19210
4 OP0240 Brachio - basilic loop AV graft for haemodialysis 42660 21330 17060 12800
5 OP0242 Brachio - basilic straight ( above elbow ) AV graft for 42660 21330 17060 12800
haemodialysis
6 OP0239 Brachio - cephalic loop AV graft for haemodialysis 42660 21330 17060 12800
7 OP0241 Brachio - cephalic straight ( above elbow ) AV graft for 42660 21330 17060 12800
haemodialysis
8 OP0245 Brachio AV fistula at elbow for haemodialysis 30700 15350 12280 9210
9 OP0443 CAPD placement ( laparosopic ) 25900 12950 10360 7770
10 OP1080 CAPD placement ( open ) 25900 12950 10360 7770
11 OP0448 CAPD removal & placement ( laparosopic ) 33960 16980 13580 10190
12 OP0445 CAPD removal & placement ( open ) 33960 16980 13580 10190
13 OP0447 CAPD removal ( laparosopic ) 16240 8120 6500 4870
14 OP0444 CAPD removal ( open ) 16240 8120 6500 4870
15 OP0446 CAPD revision ( laparosopic ) 12960 6480 5180 3890
16 OP0449 CAPD revision ( open ) 12960 6480 5180 3890
17 OP0437 Conversion of arteriovenous ( AV ) shunt to 30700 15350 12280 9210
arteriovenous ( AV ) fistula
18 OP0440 Creation of arteriovenous ( AV ) fistula at axillary 38800 19400 15520 11640
artery
19 OP0433 Creation of arteriovenous ( AV ) fistula at elbow ( 38800 19400 15520 11640
brachial artery )
20 OP1077 Creation of arteriovenous ( AV ) fistula at wrist ( radial 38800 19400 15520 11640
artery )
21 OP4205 GSV translocation for AV access 64020 32010 25610 19210
22 OP0320 Ligation of ruptured AV fistula 16240 8120 6500 4870
23 OP0319 Ligation of ruptured AV graft 21340 10670 8540 6400
24 OP0436 Placement of arteriovenous ( AV ) shunt at ankle ( 21340 10670 8540 6400
posterior tibial artery )
25 OP1078 Placement of arteriovenous ( AV ) shunt at wrist ( 21340 10670 8540 6400
radial artery )
26 OP0243 Radio - basilic straight ( below elbow ) AV graft for 42660 21330 17060 12800
haemodialysis
27 OP0244 Radio - cephalic straight ( below elbow ) AV graft for 42660 21330 17060 12800
haemodialysis
28 OP4204 Repair of A.V.Fistula aneurysm 43660 21830 17460 13100
29 OP0441 Revision of arteriovenous ( AV ) fistula at axillary 16240 8120 6500 4870
artery
30 OP0435 Revision of arteriovenous ( AV ) fistula at elbow ( 16240 8120 6500 4870
brachial artery )
31 OP0434 Revision of arteriovenous ( AV ) fistula at wrist ( radial 16240 8120 6500 4870
artery )
32 OP0439 Revision of arteriovenous ( AV ) shunt at ankle ( 10660 5330 4260 3200
33 OP0438 Revision of arteriovenous ( AV ) shunt at wrist ( radial 10660 5330 4260 3200
artery )
34 OP1083 Vascular prosthetic graft in forearm 48520 24260 19410 14560
35 OP0526 Vascular prosthetic graft in thigh 48520 24260 19410 14560
36 OP0525 Vascular prosthetic graft in upper arm 48520 24260 19410 14560
70
ECG Charges

CAT 1/CAT2 CAT3
1 Electrocardiogram ( ECG ) ECG 400 300
Echo Lab Charges

CAT 1/CAT2 CAT3
1 Ambulatory B.P. Monitoring for 24 Hrs. ( Echo ) AMBPMONIT 3600 2400
2 Carotid doppler (ECHO ROOM) CARODOP 3800 2700
3 Dobutamine stress echo (Echo Department) DECHO 6400 4800
4 Echocardiogram with Doppler ( Echo ) ECHODOP 3600 2600
5 Echocardiography with Bubble / Saline contrast ECBSC 4600 3600
6 Fetal cardiac assessment ( Echo ) FECHO 4030 2420
7 Holter test (cardiac lab) ( Echo ) HOLTER 3600 2600
8 Portable Echo Additional Charges ECHO_BS 1200 700
9 Stress Echo (Echo Deparment) SECHOOS 5900 4200
10 Tilt table test ( Cardiology ) ( Echo ) TILT 6000 4000
11 Transoeophageal - Echocardiography / Multiplane TEE 6500 3900
TEE ( Echo )
12 Treadmill test ( TMT) TMT 3400 2600
13 V-Scan Screening Echo SCRECHO 850 850
14 Dobutamine Stress Echo with Contrast DOBUSECHOWD
Contrast for Echocardiography COFOEC 3000 3000
Dobutamine stress echo (Echo Department) DECHO
6400 4800
15 Echocardiogram with Doppler ( with Contrast ) ECHODOPWD
Contrast for Echocardiography COFOEC
3000 3000
Echocardiogram with Doppler ( Contrast charged extra) ECHODOPWD 3600 2600
16 Stress Echo with Contrast SECHOSETWD 8900 7200
Contrast for Echocardiography COFOEC
Stress Echo (Echo Deparment) SECHOOS
Echo Lab Contrast Charges

CAT 1/CAT2 CAT3
1 Contrast for Echocardiography COFOEC 3000 3000
EEG/EMG lab charges

CAT 1/CAT2 CAT3
1 Bedside EEG (less than 1 hr) EEG_BS 3860 2310
2 Bedside EMG EMG_BS 5590 3360
3 Bedside EMG & NCV EMGNCV_BS 9020 5410
4 Bedside Evoked Potential - Auditory ( AEP / BAER / AUDIT_BS 4300 2570
BERA )
5 Bedside Evoked Potential - Somatosensory ( SSEP ) EVOPOTSSEP_BS 4300 2570
6 Bedside Evoked Potential - Visual ( VEP / VER ) VISUAL_BS 4300 2570
71
7 Bedside NCV / NCS ( Nerve conduction velocity / NCV_BS 4710 2820
study )
8 Bedside Repetitive nerve stimulation / Decremental REPNERSTI_BS 4300 2570
response ( RNST )
9 Botox injection under EMG control BIEMGC 1100 670
10 EEG EEG 2570 1550
11 Electroretinography ERG 3230 1940
12 EMG EMG 3860 2310
13 EMG / NCV EMGNCV 7290 4380
14 Evoked Potential - Auditory ( AEP / BAER / BERA ) AUDIT 3220 1940
15 Evoked potential - P300 EVOPOTP300 2930 1760
16 Evoked Potential - Somatosensory EVOPOTSSEP 3450 2070
17 Evoked Potential - Visual ( VEP / VER ) VISUAL 3220 1940
18 Long term bedside EEG ( 6 - 24 hrs ) LTEEG24H 8870 5320
19 Long term video EEG (6 to 24 hrs) - charges for video LTVEEG 10640 6380
recording
20 NCV / NCS ( Nerve conduction velocity / study ) NCV 3660 2200
21 Overnight Video EEG for 12 hour - Lab Charges ONVEEG12LAB 9680 5810
22 Repetitive nerve stimulation / Decremental response REPNERSTI 3220 1940
( RNST )
23 Short term bedside EEG ( 1 - 6 hrs ) STEEG6H 5310 3180
24 Short term video EEG monitoring (less than 6 hrs) VMT 5310 3180
25 Sleep deprivation EEG SDEEG 3450 2070
26 DIAGNOSTIC SLEEP STUDIES WITH OVERNIGHT VIDEO DSSWONVEEGOS
EEG(LABORATRY CHARGES + DOCTOR CHARGES)
Diagnostic sleep studies with overnight video EEG - Doctor fee DSSWONVEEGDF
11550 6930
Diagnostic sleep studies with overnight video EEG - Test charges DSSWONVEEG 9320 5590
27 Electrocorticography ECOGOS
Electrocorticography - charges for procedure ECOGPC 17710 10630
Electrocorticography - Doctor Fee ECOGDF
8870 5320
28 Intraoperative Neurophysiology monitoring INOPMONOS
Intraoperative Neurophysiology monitoring - Charges for procedure INOPMONPC 17710 10630
Intraoperative Neurophysiology monitoring - Doctor Fee INOPMONDF
8870 5320
29 Overnight Video EEG for 12 hours -(LABORATORY ONVEEG12OS
CHARGES + DOCTOR CHARGES)
Overnight Video EEG for 12 hour - Lab Charges ONVEEG12LAB 9680 5810
Overnight Video EEG for 12 hours - Doctor Fee ONVEEG12D
2420 1450
Note: for EMG procedures Rs. 250/- will be charged in addition to EMG charges for disposable needles.
Paediatric cardiac sciences lab charges

CAT 1/CAT2 CAT3
1 Ambulatory B.P. Monitoring for 24 Hrs. ( Paediatric AMBPMONITPS 2640 1840
Cardiac Sciences )
2 Echocardiogram with Doppler ( Paedtriatric Cardiac ECHODOPPS 2660 1670
Sciences )
3 Electrocardiogram ECG ( Paedtriatric Cardiac ECGPS 310 190
Sciences )
4 Fetal Cardiac Assessment ( Paedtriatric Cardiac FECHOPS 3660 2420
Sciences )
5 Holter Test ( Paedtriatric Cardiac Sciences ) HOLTERPS 2640 1840
6 Review Echo for LV Function RELVF 1000 600
7 Review Follow up Fetal Echo RFEH 2000 1200
72
8 Tilt Table Test ( Paediatric Cardiac Sciences ) TILTPS 5570 3340
9 Transoeophageal Echocardiography / Multiplane TEE TEEPSD 5570 3340
( Paedtriatric Cardiac Sciences )
Nuclear Imaging Charges

CAT 1/CAT2 CAT3
1 99m Tc Thyroid Scan TH1 4750 4750
2 Blood Pool Study For GI Bleed GT1 7000 7000
3 Bone Scan SS 5500 5500
4 Brain SPECT ( Epilepsy Protocol ) SPECT 16000 16000
5 Captopril DTPA Study For Screening of Renal HT GS4 8500 8500
6 DEXA bone densitometry with IVA BD5 2610 2610
7 DEXA Hip And Spine bone densitometry BD1 3500 3500
8 DEXA Single Site bone densitometry BD4 2250 2250
9 DEXA Three Site bone densitometry BD2 4000 4000
10 DEXA Three Sites ( Thalassemia Patient ) BD2TP 2250 2250
11 DEXA Whole Body BD3 4500 4500
12 DEXA Whole Body Fat Assessment BD6 4700 4700
13 Direct Radionucleotide Cystogram with uroflometery GS6 5750 5750
( DRCG )
14 DMSA renal scan GS5 5750 5750
15 DTPA Scan GS1 5750 5750
16 Dynamic Sailo Scintigrapgy DSCIN 10000 10000
17 ECD Brain SPECT ECDB 11000 11000
18 Gastric Emptying ( Liquid ) GEL 4500 4500
19 Gastric Emptying ( Solid ) GES 4500 4500
20 Gastric Emptying ( Solid and Liquid ) GESL 6500 6500
21 Gastro Esophageal Reflux Study ( GER ) GT2 4500 4500
22 Gated Stress Myocardial Perusion Study CVS1 13000 13000
23 GER and swallow GT4 5500 5500
24 GFR by sample Method GS2 4000 4000
25 Hepatobiliary Scan GT5 6500 6500
26 Hepatosplenic Scan HTSS 4500 4500
27 HMPAO Brain SPECT B1 12000 12000
28 I-131 MIBG Scan (MIBG isotope charges extra) TI2 11000 11000
29 I-131 Uptake and Scan TH2 4500 4500
30 I-131 Whole Body Scan TH3 6000 6000
31 Leukocyte scan for Infection II1 21000 21000
32 Lung Perfusion RES3 4700 4700
33 Lung Ventilation RES2 4700 4700
34 Lung Ventilation & Perfusion RES1 8500 8500
35 Lung Ventilation, Perfusion and Venography VQ 11500 11500
36 Lymphagiography CVS3 6000 6000
37 Meckel Study GT6 4500 4500
38 Parathyroid Scan TI4 9000 9000
39 Radionuclide cisternnography for CSF Leak - Scan B2 7500 7500
charges
40 Radionuclide Peritoneography RNPG 6000 6000
41 RBC Scan ( Heat Denatured ) RBCSC 6000 6000
42 Renal transplant evaluation GS7 5000 5000
43 Rest Myocardial Perfusion Imaging ( MPI ) RMPI 6500 6500
73
44 Resting MUGA CVS5 5000 5000
45 Scintimammography SMGPY 6000 6000
46 Sentinel Node SENN 3450 3450
47 SPECT Bone Scan SS2 4600 4600
48 Spect for Brain Tumor recurrence GHA B4 9000 9000
49 Spect for Brain Tumor recurrence MIBI B5 9500 9500
50 Stress MUGA CVS4 5500 5500
51 Swallow Study SWAS 2200 2200
52 Tecktroyd Scan (technetium octreotide scan) TECKTROYD 57480 57480
53 Testicular Scan GS8 4500 4500
54 Trodat + FDG PET Brain TROPS 15680 15680
55 TRODAT BRAIN TRODAT2 21000 21000
56 TRODAT BRAIN PET TRODAT1 15680 15680
57 Venography CVS2 5250 5250
58 Yttrium (Medicine Cost Only) RS1 16720 16720
59 Yttrium shunt analysis planner and spect Ytt1 6000 6000
Nuclear Medicine Laboratory Charges

CAT 1/CAT2 CAT3
1 17-OHP (Progesterone) (Nuclear ) - 1 Sample 17OHP 750 750
2 17-OHP (Progesterone) (Nuclear ) - 2 Samples 17OHP2 1510 1510
3 25-OH VIT D Level (Nuclear RIA) 25OHVIT 1710 1710
4 Anti - TG ( Thyroid Antibody ) - Nuclear Medicine TG 580 580
5 Anti - TPO ( Thyroid Antibody ) - Nuclear Medicine TPO 640 640
6 C - Peptide Test PEPTIDE 640 640
7 Chromogranin A NCA 6720 6720
8 Cyclosporin Level ( C0 and C2 ) CYCLOSPORINC 2010 2010
9 Cyclosporin Level ( C2 ) CYCLOSPC2 1240 1240
10 Cyclosporin Level ( CO ) CYCLOSPCO 1240 1240
11 Free T3 T3 430 430
12 Free T3 / Free T4 T3T4 880 880
13 Free T4 T4 440 440
14 Free T4 / TSH T4TSH 880 880
15 Growth Hormone (HGH) ( Nuclear RIA ) GHORMONE 760 760
16 Growth Hormone Stimulation Test ( Clonidine ) ( GHORMONES 3140 3140
Nuclear RIA )
17 IGF 1 (Nuclear Medicine) IGF1 2750 2750
18 IGF BP3 (Nuclear Medicine) IGFBP3 2750 2750
19 Insulin Estimation (5 Samples) INSULINC 1800 1800
20 Insulin Level - Fasting INSULINLF 390 390
21 Insulin Level - PP INSULIPP 410 410
22 Insulin Level - Random INSULINLR 410 410
23 Insulin Level ( Fasting + PP ) INSULINFPP 800 800
24 Insulin Level ( Fasting, 1 hourly and 2 hourly ) INSULINF12 1320 1320
25 Neonatal TSH TSHN 290 290
26 Neuron Specific Enolase (NSE) NMNSE 1500 1500
27 PTH Level PTH 1270 1270
28 Renin Levels RENIN 4200 4200
29 Testesterone (Free) TESTF 1760 1760
30 Testesterone (Total) TESTT 690 690
31 Thyroglobulin assay THGLOA 3990 3990
32 Thyroid Antibodies - Nuclear Medicine TANTIBODIES 1240 1240
74
33 Thyroid Profile ( T3, T4, TSH ) T3T4TSH 1240 1240
34 TSH (Nuclear) TSH 410 410
35 Thyroid profile ( T3 , T4 , TSH ) with Anti - TPO THYTPO
Anti - TPO ( Thyroid Antibody ) - Nuclear Medicine TPO 640 640
Thyroid Profile ( T3, T4, TSH ) T3T4TSH
1240 1240
Nuclear Medicine Therapy Charges

CAT 1/CAT2 CAT3
1 10-20 mCi TH5 11000 11000
2 High Dose I-131 Therapy TH6 16000 16000
3 I-131 Theraphy for thyrotoxicosis upto 10mCi TH4 8000 8000
4 Samarium Therapy for Bone Pain Palliation STFBPP 13790 13790
5 Strontium 89 Therapy Bone Metastasis SS6 89660 89660
6 Theraspheres/Sirspheres THENUC 783750 783750
Nuclear Imaging
CAT 1/CAT2 CAT3
1 FDG PET CT Cardiac plain CPCTPOS
FDG isotope charges F18FDGISO
10500 10500
FDG PET CT Cardiac plain (FDG isotope charges extra) CPCTP 6500 6500
2 FDG PET CT Angiography Whole Body with Contrast ( FOR PCTAWBCOS
COMPANY PATIENTS )
10500 10500
FDG PET CT Angiography Whole Body with Contrast (FDG isotope charges PCTAWBC 18500 18500
extra)
3 FDG PET CT Brain plain PCTBPos

10500 10500
FDG PET CT Brain plain (FDG isotope charges extra) PCTBP 3500 3500
4 FDG PET CT Brain plain with Contrast PCTBWCOS
FDG isotope charges F18FDGISO 10500 10500
FDG PET CT Brain plain with Contrast (FDG isotope charges extra) PCTBWC 5500 5500
5 Whole body PET CT scan with TRODAT brain (With PCTTROBROS
Contrast)
Whole body PET CT Scan with TRODAT brain (With Contrast) PCTTROBR 28500 28500
6 Whole body PET CT Scan with TRODAT brain (Plain) PCTTROBRPOS
Whole body PET CT Scan with TRODAT brain (Plain) PCTTROBRP
24500 24500
7 FDG PET CT Whole Body Plain PCTWBPOS
10500 10500
FDG PET CT Whole Body Plain (FDG isotope charges extra) PCTWBP 10500 10500
8 FDG PET CT Whole Body with Contrast PETCTWBOS
10500 10500
FDG PET CT Whole Body with Contrast (FDG isotope charges extra) PCTWBC 13500 13500
PET CT scan

CAT 1/CAT2 CAT3
1 DOTONOC isotope charges DOTONOC 31350 31350
2 Extra additional CD ( Nuclear ) EADDCDNU 420 420
75
3 Extra additional color film ( Nuclear ) EADDCFNU 420 420
4 Extra additional film ( Nuclear ) EADDNU 420 420
5 F-18 isotope charges F18ISO 5621 5621
6 F-18 PET Bone scan with whole body contrast HRFBSWEC 13500 13500
enhanced CT (F-18 isotope charges extra)
7 FDG isotope charges F18FDGISO 10500 10500
8 FDG PET CT Angiography Brain with Contrast (FDG PCTABWC 8998 8998
isotope charges extra)
9 FDG PET CT Angiography Whole Body with Contrast PCTAWBC 18500 18500
(FDG isotope charges extra)
10 FDG PET CT Myocardial Viability and Perfusion study CPCTMVPSP 10120 10120
plain (FDG isotope charges extra)
11 FDG PET CT Myocardial viability and Perfusion with PCTMVPAWC 16874 16874
CT Coronary Angiography with Contrast (FDG isotope
charges extra)
12 Gallium Whole body PET scan GWBPET 30000 30000
13 Human Serum Albumin (HSA) HSA 11000 11000
14 MIBG isotope charges MIBGC 22000 22000
15 MIBG isotope charges ( Routine ) MIBGPET 10450 10450
16 PET CT - Regional somatostatin ( DOTANOC ) receptor DOTANOC 8180 8180
imaging ( regional )
17 PET CT - Whole body somatostatin receptor imaging ( PCTSRI 15340 15340
DOTONOC isotope charges extra)
18 PET CT BRAIN AND DAT SCAN PTBDS 25000 25000
19 PET CT guided procedure PETBIOPSY 9200 9200
20 Pet CT Scan whole body (Sarcoidosis) PCWB 28000 28000
21 PET Whole Body Sweep PWBS 3070 3070
22 PSMA PET CT Whole Body Plain PSMAPET 22000 22000
23 PSMA PET CT Whole Body with Contrast PSMPETC 25560 25560
24 Urgent PET CT Brain scan with TRODAT Brain PCTBWT 38000 38000
25 Visipaque contrast charges for PET CT PETVC 1050 1050
26 Whole body PET CT Scan with TRODAT brain (With PCTTROBR 28500 28500
Contrast)
Allergy Tests

CAT 1/CAT2 CAT3
1 Aeroallergen ( Respiratory ) Common Panel - Skin Prick AERESCOMOS
Aeroallergen ( Respiratory ) Common Panel AERESCOM 5060 3030
Aeroallergen ( Respiratory ) Common Panel - Hospital Charges AERESCOMH
1680 1010
2 Aeroallergen ( Respiratory ) Comprehensive Panel - Skin AERESCPOS
Prick
Aeroallergen ( Respiratory ) Comprehensive Panel AERESCP 8430 5050
Aeroallergen ( Respiratory ) Comprehensive Panel - Hospital Charges AERESCPH
2800 1690
3 Food Allergy Common Panel - Skin Prick ALLCOMOS
Food Allergy Common Panel ALLCOM 3360 2030
Food Allergy Common Panel - Hospital Charges ALLCOMHOSP
1120 670
4 Food Allergy Comprehensive Panel - Skin Prick ALLCOMPOS
Food Allergey Comprehensive Panel ALLCOMPR
7580 4550
Food Allergy Comprehnsive Panel - Hospital Charges ALLCOMPHOSP 2520 1520
76
Fetal Medicine Charges

CAT 1/CAT2 CAT3
1 AMNIO DRAINAGE AMNIODR 5000 3000
2 FETAL REDUCTION QUADRUPLETS FETALRED 25000 15000
3 Portable ultrasound hospital service charges ( Fetal FETAL_BS 950 580
Medicine )
4 Ultrasound 3 D Reconstruction of face 3DRF 5780 3470
5 Ultrasound Amino infusion AMINOINF 4940 3150
6 Ultrasound AVI & Doppler only UAVID 1790 1180
7 Ultrasound bio-physical scoring BPSC 950 580
8 Ultrasound BPS with doppler + AVI BPSDOP 1890 1160
9 Ultrasound colour doppler Fetal echo with 4 D UFED4 4040 2430
10 Ultrasound colour doppler Fetal echo with doppler UFED 3470 2080
11 Ultrasound colour doppler Twins UTDS 3890 2310
12 Ultrasound colour doppler Twins with growth scan UCDTGS 5250 3150
13 Ultrasound CVS chorionic villus sampling UCVS 10500 7880
14 Ultrasound CVS chorionic villus sampling ( UCVSTS 6300 4730
Thalassemia society patient )
15 Ultrasound Evaluation of AVI / Scar thickness / UEAVI 840 500
presentation / placental localisation
16 Ultrasound fetal blood sampling UFBS 13650 8610
17 Ultrasound fetal For cardiac activity UFCA 840 530
18 Ultrasound fetal Portable charges for fetal medicine UFPCH 1000 630
19 Ultrasound fetal reduction in Fetal Medicine Dept FRED 17330 10400
20 Ultrasound fetal skin sampling (Fetal medicine FETALSKIN 4520 2730
charges)
21 Ultrasound fetal Triplet BPS UFTRBPS 1580 950
22 Ultrasound fetal Triplet BPS - colour Doppler UFTRBPSCD 4830 2900
23 Ultrasound fetal Triplet Growth scan UFTRGS 3890 2330
24 Ultrasound fetal Triplet Growth scan Doppler flows UFTRGSDF 6090 3680
25 Ultrasound fetal Triplet Level II - Doppler flows UFTRLII 6090 3680
26 Ultrasound fetal Triplet MCA / UA / Umblical / UFTRMCA 2100 1260
uterine artery
27 Ultrasound fetal Twin anamoly scan - doppler flows UFTACDF 5780 3470
28 Ultrasound fetal Twin biophysical score UFTBPS 1580 950
29 Ultrasound fetal Twin Genetic sonogram UFTGS 3990 2420
30 Ultrasound fetal Twin MCA/UA/Umblical/uterine UFTMCA 1580 950
artery-Doppler
31 Ultrasound fetal urine sampling FETALURI 6300 3780
32 Ultrasound for Genetic Sonogram (16-18 weeks) UANEU 2630 1580
33 Ultrasound guided Aminocentesis (Twins) FETAMINOTWIN 9450 6300
34 Ultrasound guided amniocentesis UGAMINO 6300 4200
35 Ultrasound guided Amniocentesis and UGAAF 8400 5040
Amnioinfusiuon
36 Ultrasound guided CVS (Twins) FETCVSTWIN 12600 8400
37 Ultrasound Intrauterine transfusion INTRATRA 19950 12600
38 Ultrasound obstetric growth scan + colour doppler OBSTDOP 4410 2730
flow study + AVI
39 Ultrasound Obstetric Intervention OBSINTER 7350 4410
40 Ultrasound obstetrics - MCA / UA / Umblical / Uterine FETOBSMCAUA 1580 950
artery - Doppler
41 Ultrasound obstetrics - Mid trimester anomaly scan FETMTAS 4200 2520
(MTAS / Level II / TIFFA) with Doppler
77
42 Ultrasound obstetrics - Miscellaneous FETOBSMIS 1370 840
43 ULTRASOUND OBSTETRICS - NUCHAL SCAN WITH UONSUAD 3150 1890
UTERINE ARTERY DOPPLER
44 Ultrasound obstetrics - viability / dating scan ( upto UO10 1580 950
10 weeks )
45 ULTRASOUND OBSTETRICS WITH DETAILED STUDY UODFKS 3890 2470
OF FETAL KUB (KIDNEYS-SIZES, PELVICALYCED
DILATATION, CORTICAL THICKNESS, URETERS AND
URINARY BLADDER) SINGLETON
46 ULTRASOUND OBSTETRICS WITH MATERNAL UOWMK 2100 1260
KIDNEYS
47 Ultrasound obstetrics ( Twins ) ( After 18 weeks UOT 3150 1890
without Level II )
48 Ultrasound obstetrics (Triplets) - Level II / MTAS / FETOBSTRI 5460 3310
TIFFA
49 Ultrasound obstetrics Dating + cervical length UTDCL 1260 790
50 Ultrasound obstetrics growth scan ( 26 weeks till UOGS26 2100 1260
term )
51 Ultrasound obstetrics Quadruplets NT Scan UTQTMT 4940 2960
52 Ultrasound obstetrics Triplet Dating cardiac activity UTTRIDCA 2210 1320
53 Ultrasound obstetrics Triplet extended screening UTTRIEX 4410 2730
54 Ultrasound obstetrics Twins AVI Doppler UTTWAVID 2210 1370
55 Ultrasound obstetrics Twins Dating cardiac activity UTTWDCA 1840 1100
56 Ultrasound obstetrics Twins extended screening UTTWEX 3990 2420
57 Ultrasound placental biopsy ULPLABIO 10500 7350
Ultrasound Charges

CAT 1/CAT2 CAT3
1 Breasr FNAC under ultrasound guidance - Ultrasound UFNACULC 1650 990
Department Charges
2 Intussusception Reduction ULINR 3500 2100
3 LIVER TRANSPLANT PACKAGE - Ultrasound charges LTRULT
4 Portable ultrasound hospital service charges ULTRA_BS 1100 670

(Ultrasound Dept)
5 Ultrasound 3D / 4D upper abdomen lower abdomen U3DUA 4200 2520
6 Ultrasound Transplant kidney with scrotum (with ULKWISCR 3100 1840
colour doppler)
7 Ultrasound Transplant kidney with scrotum (without ULKWSCR 2100 1250
colour doppler)
8 Ultrasound whole abdomen with scrotum ULWBWSCR 3500 2100
9 Ultrasound & colour doppler of transplanted kidney KT 1850 1090
10 Ultrasound breast SPB 2200 1320
11 Ultrasound carotid doppler UCARODOP 3220 1940
12 Ultrasound colour doppler eye UEYE 1680 1010
13 Ultrasound colour doppler follicle monitoring (single CDS 650 390
day)
14 Ultrasound colour doppler orthosonography UOSONO 2090 1250
15 Ultrasound colour doppler renal artery RENAL 3500 2100
16 Ultrasound colour doppler thyroid THYROID 1960 1180
17 Ultrasound colour doppler vessel / vein mapping / VLM 1210 730
marking
18 Ultrasound Elastography - Breast ULELASB 2000 1220
78
19 Ultrasound Elastography - Liver ULELASLIV 2000 1670
20 Ultrasound Elastography - Prostate ULELASPRRO 2000 1220
21 Ultrasound Elastography - Scrotum ULELASSCR 2000 1220
22 Ultrasound Elastography - Thyroid ULELASTTHY 2000 1220
23 Ultrasound Extra Film Charges ULTEF 500 500
24 Ultrasound follicle monitoring ( single day ) UFMSD 500 300
25 Ultrasound follicle study full FSF 2300 1380
26 Ultrasound for detection of ascitis UFDA 600 360
27 Ultrasound for detection of pleural effusion ULDPE 600 360
28 Ultrasound for residual urine RU 450 270
29 Ultrasound for undescended testis UUT 1890 1130
30 Ultrasound for Uterine Fibroid Mapping ULUFM 1700 1020
31 Ultrasound guidance charges for Ascites / Effusion UASCUINT 1300 780
tapping ( interventional)
32 Ultrasound guidance charges for FNAC / Biopsy ( UFNACINT 1300 780
interventional)
33 Ultrasound gynae with colour doppler UGCD 2100 1250
34 Ultrasound joints UJTS 2500 1500
35 Ultrasound KUB KUB 1600 960
36 Ultrasound KUB + doppler scrotum ( without TRS ) UKUBDS 2800 1670
37 Ultrasound KUB + pelvis ( Female ) UKUBPF 2100 1260
38 Ultrasound KUB + prostate ( TRUS ) KUBP 2100 1260
39 Ultrasound KUB + prostate + scrotum (without KUBPROSC 2600 1560
doppler)
40 Ultrasound KUB + prostate + TRS + doppler scrotum UKUBPTRS 3500 2100
41 Ultrasound KUB + residual urine KUBRU 1600 960
42 Ultrasound lower abdomen / pelvis LA 1500 880
43 Ultrasound monitoring ( PICU / ICU / OT ) UMBOT 380 380
44 Ultrasound musculoskeletal system UMUSCU 2600 1560
45 Ultrasound Neck UNECK 1700 1020
46 Ultrasound neurosonography ( cranial ultrasound in SPN 1350 800
babies )
47 Ultrasound of a focal swelling FOCALSW 840 510
48 Ultrasound pelvis with colour doppler GCD 2250 1340
49 Ultrasound penile colour doppler PLD 3100 1840
50 Ultrasound peripheral arterial colour doppler both PBLU 5900 3520
arms
51 Ultrasound peripheral arterial colour doppler both PBLL 5900 3520
legs
52 Ultrasound peripheral arterial colour doppler left arm PLA 3800 2270
53 Ultrasound peripheral arterial colour doppler left leg PLL 3800 2270
54 Ultrasound peripheral arterial colour doppler right PRA 3800 2270
arm
55 Ultrasound peripheral arterial colour doppler right leg PRL 3800 2270
56 Ultrasound scrotum ULTRASCROT 1550 920
57 Ultrasound scrotum with colour doppler OSONO 2400 1430
58 Ultrasound small parts ULSMP 1500 900
59 Ultrasound thorax SPCH 1110 670
60 Ultrasound thyroid SPT 1500 900
61 Ultrasound transplant ( graft ) kidney (without TK 700 420
doppler)
62 Ultrasound transrectal + pelvis ultrasound (Male) TRUS 1500 880
63 Ultrasound upper abdomen UA 1600 960
64 Ultrasound upper abdomen & doppler study ABDO 3800 2280
79
65 Ultrasound venous colour doppler both arms PBLUV 6290 3770
66 Ultrasound venous colour doppler both legs PBLLV 6290 3770
67 Ultrasound venous colour doppler left arm PLAV 3770 2270
68 Ultrasound venous colour doppler left leg PLLV 3770 2270
69 Ultrasound venous colour doppler neck PNV 2450 1470
70 Ultrasound venous colour doppler right arm PRAV 3770 2270
71 Ultrasound venous colour doppler right leg PRLV 3770 2270
72 Ultrasound whole abdomen & pelvis ( Adult ) WA 2500 1500
73 Ultrasound whole abdomen & pelvis (age less than 12 WA12 1700 1020
years)
74 Ultrasound whole abdomen with TRUS UWAWTRUS 2800 1670
Ultrasound Monitoring charges ( M Turbo - Anaesthesia ) UMANMT 400 400
Ultrasound Monitoring charges ( GE - Anaesthesia ) UMANGE 650 650
Ultrasound Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1123 ABRFNAC Ultrasound guided Breast
ODOS FNAC outside the department
ABRFNACODD Ultrasound guided Breast FNAC outside the 2090 2090 1060 2090 910
F department - Doctor fee
AFNACOD Ultrasound guided FNAC outside the 2090 2090 1060 2090 2090
department ( Ultrasound dept charges )
1124 ABRFNAC Ultrasound guided Breast
OS FNAC in the department
ABRFNACDF Ultrasound guided Breast FNAC in the 1530 1530 760 1650 990
department - Doctor fee
AFNAC Ultrasound guided FNAC in the department ( 1530 1530 760 1650 990
Ultrasound dept charges )
1125 AFNACOD Ultrasound guided FNAC
OS outside the department
AFNACODDF Ultrasound guided FNAC outside the 2090 2090 1060 2090
department - ultrasonologist fee
AFNACOD Ultrasound guided FNAC outside the 2090 2090 1060 2090 2090
1126 AFNACOS Ultrasound guided FNAC in the
department
AFNACDF Ultrasound guided FNAC in the department - 1530 1530 760 1530
ultrasonologist fee
AFNAC Ultrasound guided FNAC in the department ( 1530 1530 760 1650 990
1127 CUBTAOS Contrast Ultrasound for Blunt
Trauma abdomen
CUBTADC Contrast Ultrasound for Blunt Trauma 7500 7500 4500 7500 4500
abdomen - U/S dept. charges
CUBTADF Contrast Ultrasound for Blunt Trauma 1500 1500 900 1500 900
abdomen - Ultrasonologist fee
1128 ENDOBRO ENDOBRONCHIAL
ULOS ULTRASOUND - (DOCTOR FEE +
HOSPITAL CHARGES +
DISPOSABLES CHARGES +
CYTOLOGY CHARGES)
ENDOBROULH Endobronchial Ultrasound - Hospital 8840 8840 4420 3540 2650 4420 2650
C charges
ENDOBROULD Endobronchial Ultrasound - Doctor Fee 22140 22140 11070 8860 6640 11070 6640
F
80
ENDOBROPAC Endobronchial Ultrasound - For PACS - NOT
S FOR BILLING PURPOSE
ENDOBRONUL Endobronchial Ultrasound - Package 46840 46840 23420 18740 14050 23420 14050
TAPC charges
1129 FRUOS Fetal Reduction by Ultrasound
Dept
FRUDF Fetal Reduction by Ultrasound Dept - Doctor 8800 8800 4750
Fee
FRUUD Fetal Reduction by Ultrasound Dept - 8800 8800 4750
Ultrasound Deptt. Charges
1130 SALSONO Salpingo sonography
OS
USALSODF Salpingo sonography - Ultrasonologist fee 1400 1400 840 1400
USALSODC Salpingo sonography - Ultrasound dept. 1400 1400 840 1400 1400
charges
1131 SKINMAR Ultrasound skin marking for
KOS lesion
SKINMARKDF Ultrasound skin marking for lesion - 1100 1100 660 1100 660
ultrasonologist fee
SKINMARK Ultrasound skin marking for lesion ( 1100 1100 660 1100 660
1132 UADOS Ultrasound diagnostic needle
aspiration for Ascitis
UADDF Ultrasound diagnostic needle aspiration for 1000 1000 600 1000
Ascitis - ultrasonologist fee
UAD Ultrasound diagnostic needle aspiration for 1000 1000 600 1000 1000
Ascitis ( Ultrasound dept charges )
1133 UAEOS Ultrasound guided aspiration
in the department
UAEDF Ultrasound guided aspiration in the 1550 1550 930 1550
department - ultrasonologist fee
UAE Ultrasound guided aspiration in the 1550 1550 930 1550 1550
1134 UAODOS Ultrasound guided aspiration
outside the U/S department
UAODDF Ultrasound guided aspiration outside the 2100 2100 1260 2100
U/S department - ultrasonologist fee
UAOD Ultrasound guided aspiration outside the 2100 2100 1260 2100 2100
U/S department ( Ultrasound dept charges )
1135 UGBHWP Ultrasound guided breast hook
OS wire placement
UGBHWPDC Ultrasound guided breast hook wire 5000 3000
placement - Dept. charges
UGBHWPDF Ultrasound guided breast hook wire 2500 1500
placement - Doctor fee
1136 UGLAAOD Ultrasound guided liver
OS abscess aspiration (outside
dept.)
UGLAAODDC Ultrasound guided liver abscess aspiration 2250 2250 1350 2250 2250
(outside dept.) - Dept. charges
UGLAAODDF Ultrasound guided liver abscess aspiration 2250 2250 1350 2250
(outside dept.) - Doctor fee
1137 UGLAAOS Ultrasound guided liver
abscess aspiration
UGLAADC Ultrasound guided liver abscess aspiration - 1820 1820 920 1820 1820
Dept. charges
UGLAADF Ultrasound guided liver abscess aspiration - 1820 1820 920 1820
Doctor fee
1138 UGLBODO Ultrasound guided liver biopsy
S (outside the dept.)
UGLBODDC Ultrasound guided liver biopsy (outside the 2240 2240 1110 2240 2240
dept.) - Dept. charges
UGLBODDF Ultrasound guided liver biopsy (outside the 2240 2240 1110 2240
dept.) - Doctor fee
1139 UGLBOS Ultrasound guided liver biopsy
81
UGLBDC Ultrasound guided liver biopsy - Dept. 1820 1820 1210 1820 1820
charges
UGLBDF Ultrasound guided liver biopsy - Doctor fee 1820 1820 1210 1820
1140 UGMTPOS Ultrasound guided MTP
UGMTPDF Ultrasound guided MTP - ultrasonologist fee 2200 2200 1320 2200
UGMTP Ultrasound guided MTP ( Ultrasound dept 2200 2200 1320 2200 2200
charges )
1141 UGOCAOS Ultrasound guided ovarian cyst
aspiration
UGOCADC Ultrasound guided ovarian cyst aspiration - 2200 2200 1320 2200 2200
Dept. charges
UGOCADF Ultrasound guided ovarian cyst aspiration - 2200 2200 1320 2200 1000
Doctor fee
1142 UGPAOD Ultrasound guided perigraft
OS aspiration (outside the dept.)
UGPAODDC Ultrasound guided perigraft aspiration 1410 1410 970 1410 1410
(outside the dept.) - Dept. charges
UGPAODDF Ultrasound guided perigraft aspiration 1410 1410 970 1410
(outside the dept.) - Doctor fee
1143 UGPAOS Ultrasound guided perigraft
aspiration
UGPADC Ultrasound guided perigraft aspiration - 1100 1100 660 1100 1100 1100
Dept. charges
UGPADF Ultrasound guided perigraft aspiration - 1100 1100 660 1100
Doctor fee
1144 UGPBOS Ultrasound guided transrectal
prostatic aspiration / biopsy
UGPBDF Ultrasound guided transrectal prostatic 2420 2420 1210 2420
aspiration / biopsy - ultrasonologist fee
UGPB Ultrasound guided transrectal prostatic 2420 2420 1210 2420 2420
aspiration / biopsy ( Ultrasound dept
charges )
1145 UGRBOD Ultrasound guided renal biopsy
OS
UGRBDC Ultrasound guided renal biopsy - Dept. 1800 1440 1080 1800 1800
charges
UGRBDF Ultrasound guided renal biopsy - Doctor fee 1800 1440 1080 1800
1146 UGRBOS Ultrasound guided renal biopsy
(Outside dept.)
UGRBODDC Ultrasound guided renal biopsy (Outside 2100 2100 1260 2100 2100
dept.) - Dept. charges
UGRBODDF Ultrasound guided renal biopsy (Outside 2100 2100 1260 2100
dept.) - Doctor fee
1147 UGTAFAO Ultrasound guided therapeutic
S aspiration for ascitis
UGTAFADC Ultrasound guided therapeutic aspiration 1850 1850 1110 1850 1850
for ascitis - Dept. charges
UGTAFADF Ultrasound guided therapeutic aspiration 1850 1850 1110 1850
for ascitis - Doctor fee
1148 UGTAFPF Ultrasound guided therapeutic
OS aspiration for pleural fluid
UGTAFPFDC Ultrasound guided therapeutic aspiration 1900 1900 1140 1900 1900
for pleural fluid - Dept. charges
UGTAFPFDF Ultrasound guided therapeutic aspiration 1900 1900 1140 1900
for pleural fluid - Doctor fee
1149 ULBRCBO Breast core biopsy under
S Ultrasound guidance
ULBRSCB Breast core biopsy under Ultrasound 2500 1500
guidance - Ultrasonologist fee
ULBRCBDF Breast core biopsy under Ultrasound 2500 1500
guidance - Ultrasound Deptt. Charges
1150 ULCON Contrast ultrasound
CULTRA Contrast Ultrasound - Ultrasonologist fee 1500 1500 900 1500
CONULHC Contrast ultrasound - Ultrasound dept. 7500 7500 4500 7500 4500
charges
1151 ULGYNOS Contrast ultrasound Gynae
82
ULGYNDF Contrast Ultrasound Gynae - Ultrasonologist 1500 1500 900 1500
fee
ULGYNDC Contrast Ultrasound Gynae - Ultrasound 7500 7500 4500 7500 4500
dept. charges
1152 ULHEPLTO Contrast Ultrasound Hepatic
S artery for liver transplant
ULHALIVDF Contrast Ultrasound Hepatic artery for liver 1500 1500 900 1500
transplant - Ultrasonologist fee
ULHALIVDC Contrast Ultrasound hepatic artery for liver 7500 7500 4500 7500 4500
transplant - Ultrasound dept. charges
1153 ULKIDOS Contrast ultrasound Kidney
ULKIDDF Contrast ultrasound Kidney - Ultrasonologist 1500 1500 900 1500
fee
ULKIDDC Contrast ultrasound Kidney - Ultrasound 7500 7500 4500 7500 4500
dept. charges
1154 ULLIVOS Contrast ultrasound Liver
ULLIVDF Contrast Ultrasound Liver - Ultrasonologist 1500 1500 900 1500
fee
ULLIVDC Contrast ultrasound Liver - Ultrasound dept. 7500 7500 4500 7500 4500
charges
1155 ULOESOS Contrast ultrasound
Oesophagus
ULOESDF Contrast Ultrasound Oesophagus - 1500 1500 900 1500
Ultrasonologist fee
ULOESDC Contrast ultrasound Oesophagus - 3500 3500 2100 3500 2100
Ultrasound dept. charges
1156 ULPROOS Contrast ultrasound Prostate
ULPRODF Contrast Ultrasound Prostate - 1500 1500 900 1500
Ultrasonologist fee
ULPRODC Contrast ultrasound Prostate - Ultrasound 7500 7500 4500 7500 4500
dept. charges
1157 ULRFAOS Contrast ultrasound charges
for Radio frequency ablation
ULRFADF Contrast ultrasound charges for Radio 3500 3500 2100 3500
frequency ablation - Ultrasonologist fee
ULRFADC Contrast ultrasound charges for Radio 13980 13980 8390 13980 8390
frequency ablation - Ultrasound dept.
charges
1158 ULSPLOS Contrast ultrasound Spleen
ULSPLDF Contrast Ultrasound Spleen - Ultrasonologist 1500 1500 900 1500
fee
ULSPLDC Contrast Ultrasound Spleen - Ultrasound 7500 7500 4500 7500 4500
dept. charges
1159 ULTHYOS Contrast ultrasound Thyoid
ULTHYDF Contrast Ultrasound Thyroid - 1500 1500 900 1500 850
Ultrasonologist fee
ULTHYDC Contrast ultrasound Thyroid - Ultrasound 7500 7500 4500 7500 4500
dept. charges
1160 ULUVROS Contrast Ultrasound for U V
Reflux
ULUVRDF Contrast Ultrasound for UV reflux - 1500 1500 900 1500
Ultrasonologist fee
ULUVRDC Contrast Ultrasound for UV reflux - 3500 3500 2100 3500 2100
Ultrasound dept. charges
1161 USAVFC Ultrasound guided venous
mapping for I/J catheter
insertion and A.V Fistula
creation
USAVFDF Ultrasound guided venous mapping for I/J 600
catheter insertion and A.V Fistula creation -
Doctor Fee
USAVFHS Ultrasound guided venous mapping for I/J 600
catheter insertion and A.V Fistula creation -
Machine Charges
1162 USBRSTBP Ultrasound guided breast
SYOS biopsy
USBRSTBPSYD Ultrasound guided breast biopsy - 1680 1680 840 1680
F ultrasonologist fee
83
USBRSTBPSY Ultrasound guided breast biopsy ( 1680 1680 840 1680 1680
1163 USSKBRO Ultrasound skin marking for
T lesion in OT
SKINMARKOT Ultrasound skin marking for lesion in OT - 2200 2200 1320 2200 1320
Ultrasonologist fee
SKINMARKOT Ultrasound skin marking for lesion in OT - 2200 2200 1320 2200 1320
US Ultrasound dept charges
X-Ray Charges

CAT 1/CAT2 CAT3
1 Additional charge for BEDSIDE portable X-ray done in XRAY_BS 580 350
WARD/Recovery
2 Additional Xray Contrast AXCONTRAST 150 150
3 Additional Xray film charges for vascular / neuro lab XFCVAS 400 (Cat 1)/ 310 (2)/ 210 (3)
4 Additional Xray gastrographin contrast (100 ml) AXGC100 1300 1300
7 Additional Xray ionic contrast (20 ml) AXIC20 320 320
8 Additional Xray non-ionic contrast (10 ml) AXNIC10 480 480
12 B/L Ankle Mortice View - Xray XRAYAMV 520 310
13 B/L Femur Oblique view- Xray XRAYBLFOV 1010 610
14 B/L Forearm Oblique view - Xray XRAYBLFROV 1010 610
15 B/L Hip Joint Outlet & Inlet views- Xray XRAYHINV 2000 1200
16 B/L Humerus Oblique view - Xray XRAYBLHOV 1010 610
17 B/L Knees Merchant View - Xray XRAYBL 520 310
18 B/L Knees Tunnel View - Xray XRAYBLT 520 310
19 B/L Legs Oblique view- Xray XRAYBLOV 1010 610
20 B/L Shoulder True AP View - Xray XRAYBLSTAPV 520 310
21 Base of Skull - Xray XRAYBSK 520 310
22 Both lower limb length measurement by Xray LOWLIMB 2660 2660
23 Breast ductography / galactography ( excluding dye BDG 3910 3910
charges )
24 Clinch fist view (AP) XRAYFV 520 310
25 Clinch fist view (B/L) XRAYFVBL 520 310
26 Clinch fist View (Lat.) XRAYFVLT 520 310
27 Digital image in CD XRAYCD 220 130
28 Duplicate film (each film) XRAYDF 300 300
29 Enface view of scapula (B/L) XRAYSCBL 1010 610
30 Enface view of scapula (Lt.) XRAYSCLT 520 310
31 Enface view of scapula (Rt.) XRAYSCR 520 310
32 Foetogram AP / Lat. - Xray XRAYFOAPL 1010 610
33 For OT ONLY - Additional charge for portable X-ray BOTPX 2500 1500
done in OT
34 Frog Leg View XRAYLV 520 310
35 Intra oral Xray IORAL 240 140
36 Lt. Ankle Mortice View- Xray XRAYLTAMV 520 310
37 Lt. Femur Oblique view Xray XRAYLFV 520 310
38 Lt. Forearm Oblique view - Xray XRAYLFROV 520 310
39 Lt. Hip Joint Outlet & Inlet views- Xray XRAYHLINV 1010 610
84
40 Lt. Humerus Oblique view - Xray XRAYLTHOV 520 310
41 Lt. Knee Merchant View - Xray XRAYLTFNEE 520 310
42 Lt. Knee Tunnel View - Xray XRAYLFTV 520 310
43 Lt. Legs Oblique view- Xray XRAYLFOV 520 310
44 Lt. Shoulder True AP View - Xray XRAYLFTSTAPV 520 310
45 Lumbosacral Spine - Lateral view in lying down LUMSLD 520 310
position
46 Lumbosacral Spine - Lateral view in sitting position LUMST 520 310
47 Lumbosacral spine AP in sitting position - XRAY XRAYAP 520 310
48 Lumbosacral spine AP/ Lat. In sitting position - Xray XRAYAPLAT 1010 610
49 Lumbosacral spine Lat. In sitting position - Xray XRAYLAT 520 310
50 OPG Xray OPG 720 430
51 Pericatheteric RGU - Dye charges XRAYRGUDY 250 250
52 Rt. Ankle Mortice View - Xray XRAYRTAMV 520 310
53 Rt. Femur Oblique view - Xray XRAYRFV 520 310
54 Rt. Forearm Oblique view - Xray XRAYRTOV 520 310
55 Rt. Hip Joint Outlet & Inlet views- Xray XRAYHRINV 1010 610
56 Rt. Humerus Oblique view- Xray XRAYRTHOV 520 310
57 Rt. Knee Merchant View - Xray XRAYRTKNEE 520 310
58 Rt. Knee Tunnel View - Xray XRAYRTV 520 310
59 Rt. Legs Oblique view- Xray XRAYRFOV 520 310
60 Rt. Shoulder True AP View- Xray XRAYRSTAP 520 310
61 Stentogram Dye charges - Xray XRAYDYE 250 250
62 Xray abdomen AP erect AMENAPE 520 310
63 Xray abdomen AP erect & supine AMENAPES 1010 610
64 Xray abdomen AP supine AMENAPS 520 310
65 Xray abdomen AP view for pancreatic calcification AMENAPPC 520 310
66 Xray abdomen for foreign body localisation AMENFBL 520 310
67 Xray abdomen lateral (bilateral) AMENLB 1010 610
68 Xray abdomen lateral (L) AMENLL 520 310
69 Xray abdomen lateral (R) AMENLR 520 310
70 Xray abdomen left lateral decubitus AMENDB 520 310
71 Xray abdomen oblique for GB area AMENPOGB 520 310
72 Xray abdomen renal area (bilateral) AMENRAB 520 310
73 Xray abdomen renal area (L) AMENRAL 520 310
74 Xray abdomen renal area (R) AMENRAR 520 310
75 Xray abdomen right lateral decubitus AMENDBRT 520 310
76 Xray abdomen urinary bladder area erect AMENUBER 520 310
77 Xray abdomen urinary bladder area supine (AP) AMENUBSP 520 310
78 Xray acromio clavicular joint (bilateral) ACJAPRB 1010 610
79 Xray acromio clavicular joint (L) ACJAPL 520 310
80 Xray acromio clavicular joint (R) ACJAPR 520 310
81 Xray ankle AP & lateral (bilateral) ANKAPLTRB 1010 610
82 Xray ankle AP & lateral (L) ANKAPLTL 520 310
83 Xray ankle AP & lateral (R) ANKAPLTR 520 310
84 Xray ankle AP & stress view (bilateral) ANKAPSVB 1010 610
85 Xray ankle AP & stress view (L) ANKAPSVL 520 310
86 Xray ankle AP & stress view (R) ANKAPSVR 520 310
87 Xray ankle AP (bilateral) ANKAPB 520 310
88 Xray ankle AP (L) ANKAPL 520 310
89 Xray ankle AP (R) ANKAPR 520 310
90 Xray ankle lateral (bilateral) ANKLB 520 310
91 Xray ankle lateral (L) ANKLL 520 310
92 Xray ankle lateral (R) ANKLR 520 310
85
93 Xray ankle oblique (bilateral) ANKOBB 520 310
94 Xray ankle oblique (L) ANKOBL 520 310
95 Xray ankle oblique (R) ANKOBR 520 310
96 Xray ankle stress view (bilateral) ANKSVB 520 310
97 Xray ankle stress view (L) ANKSVL 520 310
98 Xray ankle stress view (R) ANKSVR 520 310
99 Xray arm / humerus AP & lateral (bilateral) ARAPLTB 2000 1200
100 Xray arm / humerus AP & lateral (L) ARAPLTL 1010 610
101 Xray arm / humerus AP & lateral (R) ARAPLTR 1010 610
102 Xray arm / humerus AP & lateral with elbow ARAPLEB 2000 1200
(bilateral)
103 Xray arm / humerus AP & lateral with elbow (L) ARAPLEL 1010 610
104 Xray arm / humerus AP & lateral with elbow (R) ARAPLER 1010 610
105 Xray arm / humerus AP & lateral with shoulder ARAPLSB 2000 1200
(bilateral)
106 Xray arm / humerus AP & lateral with shoulder (L) ARAPLSL 1010 610
107 Xray arm / humerus AP & lateral with shoulder (R) ARAPLSR 1010 610
108 Xray arm / humerus AP (bilateral) ARAPB 1010 610
109 Xray arm / humerus AP (L) ARAPL 520 310
110 Xray arm / humerus AP (R) ARAPR 520 310
111 Xray arm / humerus AP with elbow (bilateral) ARAPELB 1010 610
112 Xray arm / humerus AP with elbow (L) ARAPELL 520 310
113 Xray arm / humerus AP with elbow (R) ARAPELR 520 310
114 Xray arm / humerus AP with shoulder (bilateral) ARAPSHB 1010 610
115 Xray arm / humerus AP with shoulder (L) ARAPSHL 520 310
116 Xray arm / humerus AP with shoulder (R) ARAPSHR 520 310
117 Xray arm / humerus lateral (bilateral) ARLTB 1010 610
118 Xray arm / humerus lateral (L) ARLTL 520 310
119 Xray arm / humerus lateral (R) ARLTR 520 310
120 Xray arm / humerus lateral with elbow (bilateral) ARLTELB 1010 610
121 Xray arm / humerus lateral with elbow (L) ARLTELL 520 310
122 Xray arm / humerus lateral with elbow (R) ARLTELR 520 310
123 Xray arm / humerus lateral with shoulder (bilateral) ARLTSHB 1010 610
124 Xray arm / humerus lateral with shoulder (L) ARLTSHL 520 310
125 Xray arm / humerus lateral with shoulder (R) ARLTSHR 520 310
126 Xray arm for foreign body localisation (bilateral) ARFBLB 1010 610
127 Xray arm for foreign body localisation (L) ARFBLL 520 310
128 Xray arm for foreign body localisation (R) ARFBLR 520 310
129 Xray aspiration biopsy under image intensifier ABUIIF 3910 2340
130 Xray barium swallow + barium meal (upper GI) BSBMUGI 4870 2930
131 Xray Bilateral lower limb length AP & Lateral (Digital) XBLLLAPLD 2660 2660
132 Xray Bilateral lower limb length AP (Digital) XBLLLAPD 1770 1770
133 Xray Bilateral lower limb length Lateral (Digital) XBLLLLD 1770 1770
134 Xray both lower limbs complete (bilateral) - children BLLBC 520 310
135 Xray breast specimen radiography BRSRAD 1180 700
136 Xray bronchogram (bilateral) BRONCBS 7280 4540
137 Xray bronchogram (L) BRONCSSL 4800 2830
138 Xray bronchogram (R) BRONCSSR 4800 2830
139 Xray calcaneum axial & lateral (bilateral) CALAXLB 1010 610
140 Xray calcaneum axial & lateral (L) CALAXLL 520 310
141 Xray calcaneum axial & lateral (R) CALAXLR 520 310
142 Xray calcaneum axial (bilateral) CALAXB 520 310
143 Xray calcaneum axial (L) CALAXL 520 310
144 Xray calcaneum axial (R) CALAXR 520 310
86
145 Xray calcaneum lateral (bilateral) CALLTB 520 310
146 Xray calcaneum lateral (L) CALLTL 520 310
147 Xray calcaneum lateral (R) CALLTR 520 310
148 Xray cephalogram CEPGRAM 720 430
149 Xray cervical spine (lateral) in extension CSPRE 520 310
150 Xray cervical spine (lateral) in flexion CSPLF 520 310
151 Xray cervical spine AP & lateral view CSAPLTV 1010 610
152 Xray cervical spine AP view CSPAP 520 310
153 Xray cervical spine in flexion, extension & neutral CSPFEFC 1490 890
154 Xray cervical spine lateral for cranio-vertebrae CSPLCV 520 310
junction
155 Xray cervical spine lateral view CSPL 520 310
156 Xray cervical spine oblique (bilateral) CSPOB 1010 610
157 Xray cervical spine oblique (L) CSPOL 520 310
158 Xray cervical spine oblique (R) CSPOR 520 310
159 Xray cervical spine open mouth for CV junction CSPOM 520 310
160 Xray cervico-dorsal spine AP & lateral view CDSAPLV 1010 610
161 Xray cervico-dorsal spine AP & swimmers view CDSAPSV 520 310
162 Xray cervico-dorsal spine AP view CDSPAP 520 310
163 Xray cervico-dorsal spine lateral view CDSPL 520 310
164 Xray cervico-dorsal spine swimmers view CDSPSW 520 310
165 Xray check procedure post biliary dilatation CPPBDIL 5310 5310
166 Xray chest AP CHAP 520 310
167 Xray chest AP for ribs bucky film CHAPR 520 310
168 Xray chest apicogram CHAPGM 520 310
169 Xray chest decubitus (L) CHDBL 520 310
170 Xray chest decubitus (R) CHDBR 520 310
171 Xray chest fluroscopy CHFL 1070 640
172 Xray chest for foreign body localisation CHFBL 1070 640
173 Xray chest lateral (L) CHLATL 520 310
174 Xray chest lateral (R) CHLATR 520 310
175 Xray chest oblique (L) CHOBQL 520 310
176 Xray chest oblique (R) CHOBQR 520 310
177 Xray chest PA & lateral (L) CHPALTL 1010 610
178 Xray chest PA & lateral (R) CHPALTR 1010 610
179 Xray chest PA ( CXR ) CHPA 520 310
180 Xray chest PA penetrating CHPAPL 520 310
181 Xray clavicle AP view (bilateral) CLALAPB 1010 610
182 Xray clavicle AP view (L) CLALAPL 520 310
183 Xray clavicle AP view (R) CLALAPR 520 310
184 Xray coccyx AP COAP 520 310
185 Xray coccyx AP & lateral COAPLT 1010 610
186 Xray coccyx lateral COL 520 310
187 Xray dental Xray each film DTXRAYF 240 140
188 Xray dorsal lumbar spine AP & lateral view DLSAPLTV 1010 610
189 Xray dorsal lumbar spine AP view DLSLAPV 520 310
190 Xray dorsal lumbar spine lateral view DLSLTV 520 310
191 Xray dorsal spine AP & lateral view DSAPLTV 1010 610
192 Xray dorsal spine AP view DSPAP 520 310
193 Xray dorsal spine lateral view DSPL 520 310
194 Xray dorsal spine oblique view (L) DSOBLL 520 310
195 Xray dorsal spine oblique view (R) DROBLR 520 310
196 Xray Duplicate Film (Per Film) XDFPF 300 300
197 Xray ear pinna - soft tissue (bilateral) EARPSTB 1010 610
87
198 Xray ear pinna - soft tissue (L) EARPSTL 520 310
199 Xray ear pinna - soft tissue (R) EARPSTR 520 310
200 Xray elbow AP & lateral (bilateral) ELBAPLB 1010 610
201 Xray elbow AP & lateral (L) ELBAPLL 520 310
202 Xray elbow AP & lateral (R) ELBAPLR 520 310
203 Xray elbow AP (bilateral) ELBAPBIL 520 310
204 Xray elbow AP (L) ELBAPL 520 310
205 Xray elbow AP (R) ELBAPR 520 310
206 Xray elbow lateral (bilateral) ELBLTB 520 310
207 Xray elbow lateral (L) ELBLTL 520 310
208 Xray elbow lateral (R) ELBLTR 520 310
209 Xray ERCP ERCP 3540 2120
210 Xray ERCP with papillotomy (includes one ampoule ERCPWPT 4620 2770
ionic contrast)
211 Xray ERCP with papilotomy & dormia basketing of ERCPPDB 4620 2770
stone
212 Xray ERCP with stenting ERCPST 4250 2550
213 Xray ethmoid sinus (bilateral) ETHSB 520 310
214 Xray ethmoid sinus (L) ETHSL 520 310
215 Xray ethmoid sinus (R) ETHSR 520 310
216 Xray feet (bilateral) AP FTAP 520 310
217 Xray feet (bilateral) AP & lateral FTBAPLT 1010 610
218 Xray feet (bilateral) AP & oblique FTBAPOB 1010 610
219 Xray feet (bilateral) lateral FTLAT 520 310
220 Xray feet (bilateral) oblique FTBOBL 520 310
221 Xray feet for arch lateral (bilateral) FTALTB 520 310
222 Xray femur (including hip joint) AP & lateral (bilateral) FRHJAPLTB 2000 1200
223 Xray femur (including hip joint) AP & lateral (L) FRHJAPLTL 1010 610
224 Xray femur (including hip joint) AP & lateral (R) FRHJAPLTR 1010 610
225 Xray femur (including hip joint) AP (bilateral) FRHJAPBIL 1010 610
226 Xray femur (including hip joint) AP (L) FRHJAPL 520 310
227 Xray femur (including hip joint) AP (R) FRHJAPR 520 310
228 Xray femur (including hip joint) lateral (bilateral) FRHJLTBIL 1010 610
229 Xray femur (including hip joint) lateral (L) FRHJLTL 520 310
230 Xray femur (including hip joint) lateral (R) FRHJLTR 520 310
231 Xray femur (including knee joint) AP & lateral FRKJAPLTB 2000 1200
(bilateral)
232 Xray femur (including knee joint) AP & lateral (L) FRKJAPLTL 1010 610
233 Xray femur (including knee joint) AP & lateral (R) FRKJAPLTR 1010 610
234 Xray femur (including knee joint) AP (bilateral) FRKJAPBIL 1010 610
235 Xray femur (including knee joint) AP (L) FRKJAPL 520 310
236 Xray femur (including knee joint) AP (R) FRKJAPR 520 310
237 Xray femur (including knee joint) lateral (bilateral) FRKJLTB 1010 610
238 Xray femur (including knee joint) lateral (L) FRKJLTL 520 310
239 Xray femur (including knee joint) lateral (R) FRKJLTR 520 310
240 Xray femur AP & lateral (bilateral) THAPLFB 2000 1200
241 Xray femur AP & lateral (L) THAPLFL 1010 610
242 Xray femur AP & lateral (R) THAPLFR 1010 610
243 Xray femur AP (bilateral) FEAPB 1010 610
244 Xray femur AP (L) FEAPLT 520 310
245 Xray femur AP (R) FEAPRT 520 310
246 Xray femur lateral (bilateral) FELAB 1010 610
247 Xray femur lateral (L) FELALT 520 310
248 Xray femur lateral (R) FELART 520 310
88
249 Xray first carpo metacarpal joint (bilateral) FTCMJB 520 310
250 Xray first carpo metacarpal joint (L) FTCMJL 520 310
251 Xray first carpo metacarpal joint (R) FTCMJR 520 310
252 Xray floor of orbit (bilateral) FLORBB 520 310
253 Xray floor of orbit (L) FLORBL 520 310
254 Xray floor of orbit (R) FLORBR 520 310
255 Xray Foetogram INTOGRMF 520 310
256 Xray foot AP & lateral (L) FTAPLL 520 310
257 Xray foot AP & lateral (R) FTAPLR 520 310
258 Xray foot AP & oblique (L) FTAPOBL 520 310
259 Xray foot AP & oblique (R) FTAPOBR 520 310
260 Xray foot AP (L) FOOTAPL 520 310
261 Xray foot AP (R) FOOTAPR 520 310
262 Xray foot AP , Lateral & oblique (Bilateral) FAPLTOBB 1490 890
263 Xray foot AP , Lateral & oblique (L) FAPLTOBL 1010 610
264 Xray foot AP , Lateral & oblique (R) FAPLTOBR 1010 610
265 Xray foot for arch lateral (L) FTAHLTL 520 310
266 Xray foot for arch lateral (R) FTAHLTR 520 310
267 Xray foot for foreign body localisation (bilateral) FOTFBLB 520 310
268 Xray foot for foreign body localisation (L) FOTFBLL 520 310
269 Xray foot for foreign body localisation (R) FOTFBLR 520 310
270 Xray foot lateral (L) FOTLTL 520 310
271 Xray foot lateral (R) FOTLTR 520 310
272 Xray foot oblique (L) FOTOBL 520 310
273 Xray foot oblique (R) FOTOBR 520 310
274 Xray for foreign body in orbit (bilateral) FFBORBB 520 310
275 Xray for foreign body in orbit (L) FFBORBL 520 310
276 Xray for foreign body in orbit (R) FFBORBR 520 310
277 Xray forearm AP & lateral (bilateral) FAPLB 1010 610
278 Xray forearm AP & lateral (L) FAPLL 520 310
279 Xray forearm AP & lateral (R) FAPLR 520 310
280 Xray forearm AP (bilateral) FARMAPB 520 310
281 Xray forearm AP (L) FARMAPL 520 310
282 Xray forearm AP (R) FARMAPR 520 310
283 Xray forearm for foreign body localisation (bilateral) FARMFBLB 520 310
284 Xray forearm for foreign body localisation (L) FARMFBLL 520 310
285 Xray forearm for foreign body localisation (R) FARMFBLR 520 310
286 Xray forearm for soft tissue AP & lateral (bilateral) FSTAPB 1010 610
287 Xray forearm for soft tissue AP & lateral (L) FSTAPL 520 310
288 Xray forearm for soft tissue AP & lateral (R) FSTAPR 520 310
289 Xray forearm with elbow AP & lateral (bilateral) FAEALB 1010 610
290 Xray forearm with elbow AP & lateral (L) FAEALL 520 310
291 Xray forearm with elbow AP & lateral (R) FAEALR 520 310
292 Xray forearm with wrist AP & lateral (bilateral) FWAPLB 1010 610
293 Xray forearm with wrist AP & lateral (L) FWAPLL 520 310
294 Xray forearm with wrist AP & lateral (R) FWAPLR 520 310
295 Xray hand - soft tissue AP view (bilateral) HDSTAPB 520 310
296 Xray hand - soft tissue AP view (L) HDSTAPL 520 310
297 Xray hand - soft tissue AP view (R) HDSTAPR 520 310
298 Xray hand ( ball catcher view ) HBRA 520 310
299 Xray hand AP & Lateral (bilateral) HAPLTB 1010 610
300 Xray hand AP & Lateral (L) HAPLTL 520 310
301 Xray hand AP & Lateral (R) HAPLTR 520 310
302 Xray hand AP & oblique (bilateral) HLOBLB 1010 610
89
303 Xray hand AP & oblique (L) HLOBLL 520 310
304 Xray hand AP & oblique (R) HLOBLR 520 310
305 Xray hand AP (bilateral) HPOBL 520 310
306 Xray hand AP (L) HPA 520 310
307 Xray hand AP (R) HPAL 520 310
308 Xray hand AP , Lateral & oblique (bilateral) HAPLTOBB 1010 610
309 Xray hand AP , Lateral & oblique (L) HAPLTOBL 1010 610
310 Xray hand AP , Lateral & oblique (R) HAPLTOBR 1010 610
311 Xray hand for foreign body localisation (bilateral) HDFBLB 520 310
312 Xray hand for foreign body localisation (L) HDFBLL 520 310
313 Xray hand for foreign body localisation (R) HDFBLR 520 310
314 Xray hand lateral (bilateral) HDLTB 520 310
315 Xray hand lateral (L) HLATL 520 310
316 Xray hand lateral (R) HLATR 520 310
317 Xray hand oblique (bilateral) HOBLB 520 310
318 Xray hand oblique (L) HOBLL 520 310
319 Xray hand oblique (R) HOBLR 520 310
320 Xray hand ulnar deviation (for scaphoid) (bilateral) HDUDSB 520 310
321 Xray hand ulnar deviation (for scaphoid) (L) HDUDSL 520 310
322 Xray hand ulnar deviation (for scaphoid) (R) HDUDSR 520 310
323 Xray heel axial (bilateral) HLAXB 520 310
324 Xray heel axial (L) HLAXL 520 310
325 Xray heel axial (R) HLAXR 520 310
326 Xray heel lateral & axial (bilateral) HLLAXB 1010 610
327 Xray heel lateral & axial (L) HLLAXL 520 310
328 Xray heel lateral & axial (R) HLLAXR 520 310
329 Xray heel lateral (bilateral) HLLTB 520 310
330 Xray heel lateral (L) HLLTL 520 310
331 Xray heel lateral (R) HLLTR 520 310
332 Xray heel pads lateral view (bilateral) HLPLTBIL 520 310
333 Xray hip AP & lateral (bilateral) HIPAPLTB 2000 1200
334 Xray hip AP & lateral (L) HIPAPLTL 1010 610
335 Xray hip AP & lateral (R) HIPAPLTR 1010 610
336 Xray hip AP (L) HIPAPL 520 310
337 Xray hip AP (R) HIPAPR 520 310
338 Xray hip for acetabulum AP view (L) HIPAAPL 520 310
339 Xray hip for acetabulum AP view (R) HIPAAPR 520 310
340 Xray hip lateral (bilateral) HIPLTB 1010 610
341 Xray hip lateral (L) HIPLTL 520 310
342 Xray hip lateral (R) HIPLTR 520 310
343 Xray hips for acetabulum AP view (bilateral) HIPAAPB 1010 610
344 Xray hips including thighs (AP view for hip HIPITHB 1010 610
dislocation) - bilateral
345 Xray iliac crest for bone age ( pelvis AP view ) ILCBPAP 520 310
346 Xray index finger AP & lateral (L) IXFRAPLTL 520 310
347 Xray index finger AP & lateral (R) IXFRAPLTR 520 310
348 Xray infantogram INTOGRM 520 310
349 Xray inferior orbital fissure (bilateral) INFORBFB 520 310
350 Xray inferior orbital fissure (L) INFORBFL 520 310
351 Xray inferior orbital fissure (R) INFORBFR 520 310
352 Xray invertogram INVTOGRM 1010 610
353 Xray knee AP & lateral (bilateral) KNAPLTB 1010 610
354 Xray knee AP & lateral (L) KNAPLTL 520 310
355 Xray knee AP & lateral (R) KNAPLTR 520 310
90
356 Xray knee AP (bilateral) KNAPBIL 520 310
357 Xray knee AP (erect) (bilateral) BTKAP 520 310
358 Xray knee AP (erect) (L) LTKAP 520 310
359 Xray knee AP (erect) (R) RTKAP 520 310
360 Xray knee AP (L) KNEEAPL 520 310
361 Xray knee AP (R) KNAPR 520 310
362 Xray knee lateral (bilateral) KNLTBL 520 310
363 Xray knee lateral (L) KNLTL 520 310
364 Xray knee lateral (R) KNLTR 520 310
365 Xray knee skyline (bilateral) KNSKYB 1010 610
366 Xray knee skyline (L) KNSKYL 520 310
367 Xray knee skyline (R) KNSKYR 520 310
368 Xray knee tunnel / axial view (bilateral) KNTAXB 520 310
369 Xray knee tunnel / axial view (L) KNAXL 520 310
370 Xray knee tunnel / axial view (R) KNAXR 520 310
371 Xray KUB AMENKUB 1010 610
372 Xray KUB ( single film ) AMENKUBS 520 310
373 Xray KUB (Child - Age < 12 years) - Single Film XKUBC 520 310
374 Xray left elbow for bone age (AP & lateral view) LELBAPLTV 520 310
375 Xray left hand for bone age (PA view) LTHDBAPA 520 310
376 Xray Left lower limb length AP & Lateral (Digital) XLLLLAPLD 1770 1770
377 Xray Left lower limb length AP (Digital) XLLLLAPD 1070 1070
378 Xray Left lower limb length Lateral (Digital) XLLLLLD 1070 1070
379 Xray leg AP & lateral (bilateral) LEGAPLTB 1010 610
380 Xray leg AP & lateral (L) LEGAPLL 520 310
381 Xray leg AP & lateral (R) LEGAPLR 520 310
382 Xray leg AP & lateral with ankle (bilateral) LEGAPAB 1010 610
383 Xray leg AP & lateral with ankle (L) LEGAPAL 520 310
384 Xray leg AP & lateral with ankle (R) LEGAPAR 520 310
385 Xray leg AP & lateral with knee (bilateral) LEGAPKB 1010 610
386 Xray leg AP & lateral with knee (L) LEGAPKL 520 310
387 Xray leg AP & lateral with knee (R) LEGAPKR 520 310
388 Xray leg AP (bilateral) LEGAPB 520 310
389 Xray leg AP (L) LEGAPL 520 310
390 Xray leg AP (R) LEGAPR 520 310
391 Xray leg AP with ankle (bilateral) LEGAPANKB 520 310
392 Xray leg AP with ankle (L) LEGAPANKL 520 310
393 Xray leg AP with ankle (R) LEGAPANKR 520 310
394 Xray leg AP with knee (bilateral) LEGAPKNEB 520 310
395 Xray leg AP with knee (L) LEGAPKNEL 520 310
396 Xray leg AP with knee (R) LEGAPKNER 520 310
397 Xray leg lateral (bilateral) LEGLTB 520 310
398 Xray leg lateral (L) LEGLTL 520 310
399 Xray leg lateral (R) LEGLTR 520 310
400 Xray leg lateral with ankle (bilateral) LEGLANKB 520 310
401 Xray leg lateral with ankle (L) LEGLANKL 520 310
402 Xray leg lateral with ankle (R) LEGLANKR 520 310
403 Xray leg lateral with knee (bilateral) LEGLKNEB 520 310
404 Xray leg lateral with knee (L) LEGLKNEL 520 310
405 Xray leg lateral with knee (R) LEGLKNER 520 310
406 Xray little finger AP & lateral (L) LITFRAPLTL 520 310
407 Xray little finger AP & lateral (R) LITFRAPLTR 520 310
408 Xray lower leg for foreign body localisation (bilateral) LLEGFBLB 520 310
409 Xray lower leg for foreign body localisation (L) LLEGFBLL 520 310
91
410 Xray lower leg for foreign body localisation (R) LLEGFBLR 520 310
411 Xray lumbar spine AP & lateral view LRSAPLT 1010 610
412 Xray lumbar spine AP erect (Lt & Rt bending) LRSAPLTRT 1010 610
413 Xray lumbar spine AP erect (Lt bending) LSAPELB 520 310
414 Xray lumbar spine AP erect (Rt bending) LSAPERB 520 310
415 Xray lumbar spine AP view LSPAP 520 310
416 Xray lumbar spine lateral erect extension LSPLEPE 520 310
417 Xray lumbar spine lateral erect flexion LSPLEPF 520 310
418 Xray lumbar spine lateral erect flexion & extension LSPLEFE 1010 610
419 Xray lumbar spine lateral view LSPL 520 310
420 Xray lumbar spine oblique (bilateral) LSPOB 1010 610
421 Xray lumbar spine oblique (L) LSPOL 520 310
422 Xray lumbar spine oblique (R) LSPOR 520 310
423 Xray lumbosacral spine AP & lateral view LLSAPLT 1010 610
424 Xray lumbosacral spine AP erect (Lt & Rt bending) LLSAPRT 1010 610
425 Xray lumbosacral spine AP erect (Lt bending) LLSAPLTB 520 310
426 Xray lumbosacral spine AP erect (Rt bending) LLSAPRTB 520 310
427 Xray lumbosacral spine AP view including SI joints LLSAPV 520 310
428 Xray lumbosacral spine lateral erect extension LLSAEEXT 520 310
429 Xray lumbosacral spine lateral erect flexion LLSLTEF 520 310
430 Xray lumbosacral spine lateral erect flexion & LLSLTEFE 1010 610
extension
431 Xray lumbosacral spine lateral view LTSLTV 520 310
432 Xray lumbosacral spine oblique (bilateral) LTSOBLB 1010 610
433 Xray lumbosacral spine oblique (L) LTSOBLL 520 310
434 Xray lumbosacral spine oblique (R) LTSOBLR 520 310
435 Xray lunate (bilateral) LUNB 520 310
436 Xray lunate (L) LUNL 520 310
437 Xray lunate (R) LUNR 520 310
438 Xray mandible AP MABAPPA 520 310
439 Xray mandible oblique (bilateral) MABOBB 1010 610
440 Xray mandible oblique (L) MABOBL 520 310
441 Xray mandible oblique (R) MABOBR 520 310
442 Xray mastoid lateral oblique (bilateral) MASLOB 1010 610
443 Xray mastoid lateral oblique (L) MASLOL 520 310
444 Xray mastoid lateral oblique (R) MASLOR 520 310
445 Xray mastoid stenvers view (bilateral) MASSVB 1010 610
446 Xray mastoid stenvers view (L) MASSTEN 520 310
447 Xray mastoid stenvers view (R) MASSVR 520 310
448 Xray mastoid townes view MASTOW 520 310
449 Xray mastoid view schuller (bilateral) MASVSB 1010 610
450 Xray mastoid view schuller (L) MASVSC 520 310
451 Xray mastoid view schuller (R) MASVSR 520 310
452 Xray middle finger AP & lateral (L) MIDFAPLTL 520 310
453 Xray middle finger AP & lateral (R) MIDFAPLTR 520 310
454 Xray modified stenvers view for cochlear implant ) (L) MODSCIMPL 520 310
455 Xray modified stenvers view for cochlear implant ) (R) MODSCIMPR 520 310
456 Xray myelogram ( cervical ) MYELOC 8500 5100
457 Xray myelogram ( lumbar ) MYELOL 7460 4480
458 Xray nasal bone lateral (bilateral) NASBLTB 520 310
459 Xray nasal bone lateral (L) NASBLL 520 310
460 Xray nasal bone lateral (R) NASBLR 520 310
461 Xray nasopharynx lateral for adenoids NASADE 520 310
462 Xray neck for foreign body localisation NKFBL 520 310
92
463 Xray oesophageal dilatation under fluoroscopy ODUTVC 3540 2120
464 Xray oesophageal dilatation under fluoroscopy + ODUTVEI 3540 2120
endo prosthesis insertion
465 Xray oesophagus for foreign body localisation OFBL 520 310
466 Xray optic foramen (bilateral) OPTFORB 1010 610
467 Xray optic foramen (L) OPTFORL 520 310
468 Xray optic foramen (R) OPTFORR 520 310
469 Xray orbit AP & lateral (bilateral) OBITAPLTB 1490 890
470 Xray orbit AP & lateral (L) ORLTAP 1010 610
471 Xray orbit AP & lateral (R) OBITAPLTR 1010 610
472 Xray orbit AP (bilateral) OBITAPB 520 310
473 Xray orbit AP (L) OBITAPL 520 310
474 Xray orbit AP (R) ORRTAP 520 310
475 Xray orbit caldwel (bilateral) ORBITCB 520 310
476 Xray orbit caldwel (L) ORBITCL 520 310
477 Xray orbit caldwel (R) ORBITCR 520 310
478 Xray orbit for foreign body localisation (bilateral) ORBITFBLB 520 310
479 Xray orbit for foreign body localisation (L) ORBITFBLL 520 310
480 Xray orbit for foreign body localisation (R) ORBITFBLR 520 310
481 Xray orbit lateral (bilateral) ORBITLTB 1010 610
482 Xray orbit lateral (L) ORLTLA 520 310
483 Xray orbit lateral (R) ORRTLA 520 310
484 Xray orbit PA (bilateral) OBITPAB 520 310
485 Xray orbit PA (L) OBITPAL 520 310
486 Xray orbit PA (R) OBITPAR 520 310
487 Xray pacemaking (any procedure under fluoroscopy) PMAPTVF 5850 3510
488 Xray paranasal sinus Waters view PNSWAT 520 310
489 Xray patella PA & lateral (bilateral) PATPALB 1010 610
490 Xray patella PA & lateral (L) PATPALL 520 310
491 Xray patella PA & lateral (R) PATPALR 520 310
492 Xray patella tangential (bilateral) PATTANB 520 310
493 Xray patella tangential (L) PATTANL 520 310
494 Xray patella tangential (R) PATTANR 520 310
495 Xray pelvis AP (including both hips) PELAP 520 310
496 Xray penis ( soft tissue ) PEN 520 310
497 Xray percutaneous biliary baloon dilatation POUSBBD 17710 10630
498 Xray pisiform (bilateral) PISIB 520 310
499 Xray pisiform (L) PISIL 520 310
500 Xray pisiform (R) PISIR 520 310
501 Xray PTC PTC 6200 3720
502 Xray right hypochondrium for gall bladder RHYPOGB 520 310
503 Xray Right lower limb length AP & Lateral (Digital) XRLLLAPLD 1770 1770
504 Xray Right lower limb length AP (Digital) XRLLLAD 1070 1070
505 Xray Right lower limb length Lateral (Digital) XRLLLLD 1070 1070
506 Xray ring finger AP & lateral (L) RGFRAPLTL 520 310
507 Xray ring finger AP & lateral (R) RGFRAPLTR 520 310
508 Xray roof of orbit (bilateral) ROOFOB 520 310
509 Xray roof of orbit (L) ROOFOL 520 310
510 Xray roof of orbit (R) ROOFOR 520 310
511 Xray sacro coccyx spine / junction - AP & Lateral SCSAL 1010 610
512 Xray sacro coccyx spine / junction - lateral SCSL 520 310
513 Xray sacroiliac joint AP (bilateral) SIJTAPB 520 310
514 Xray sacroiliac joint AP (L) SIJTAPL 520 310
515 Xray sacroiliac joint AP (R) SIJTAPR 520 310
93
516 Xray sacroiliac joint oblique (bilateral) SIJTOBB 1010 610
517 Xray sacroiliac joint oblique (L) SIJTOBL 520 310
518 Xray sacroiliac joint oblique (R) SIJTOBR 520 310
519 Xray sacrum AP SSPAP 520 310
520 Xray sacrum AP & lateral SSAPLT 1010 610
521 Xray sacrum lateral SSPL 520 310
522 Xray scapula AP & lateral (bilateral) SCPLAPLB 2000 1200
523 Xray scapula AP & lateral (L) SCPLAPLL 1010 610
524 Xray scapula AP & lateral (R) SCPLAPLR 1010 610
525 Xray scapula AP (bilateral) SCPLAPB 1010 610
526 Xray scapula AP (L) SCPLAPL 520 310
527 Xray scapula AP (R) SCPLAPR 520 310
528 Xray scapula axial (bilateral) SCPAB 1010 610
529 Xray scapula axial (L) SCPAL 520 310
530 Xray scapula axial (R) SCPAR 520 310
531 Xray scapula lateral (bilateral) SCPLB 1010 610
532 Xray scapula lateral (L) SCPLL 520 310
533 Xray scapula lateral (R) SCPLR 520 310
534 Xray scapula Y - view (bilateral) SCPYB 1010 610
535 Xray scapula Y - view (L) SCPYL 520 310
536 Xray scapula Y - view (R) SCPYR 520 310
537 Xray screening fluoroscopy SFLURO 1070 640
538 Xray shoulder AP & lateral (bilateral) SHOAPLTB 2000 1200
539 Xray shoulder AP & lateral (L) SHOAPLTL 1010 610
540 Xray shoulder AP & lateral (R) SHOAPLTR 1010 610
541 Xray shoulder AP (bilateral) SHAPB 1010 610
542 Xray shoulder AP (L) SHAPL 520 310
543 Xray shoulder AP (R) SHAPR 520 310
544 Xray shoulder axial (axillary) (bilateral) SHAXB 1010 610
545 Xray shoulder axial (axillary) (L) SHAXL 520 310
546 Xray shoulder axial (axillary) (R) SHAXR 520 310
547 Xray shoulder lateral (bilateral) SHLATB 1010 610
548 Xray shoulder lateral (L) SHLATL 520 310
549 Xray shoulder lateral (R) SHLATR 520 310
550 Xray shoulder lateral transthoracic (bilateral) SHLTTHB 1010 610
551 Xray shoulder lateral transthoracic (L) SHLTTHL 520 310
552 Xray shoulder lateral transthoracic (R) SHLTTHR 520 310
553 Xray skeletal survey ( extended - 11 films) SKELSE11 5510 3310
554 Xray skeletal survey ( standard - 5 films ) SKELSS5 2500 1500
555 Xray skull AP SKUAP/PA 520 310
556 Xray skull AP & lateral SKUAPLT 1010 610
557 Xray skull AP for styloid process SKUAPSP 520 310
558 Xray skull base / basal view / submento-vertebral SKUBAS 520 310
view
559 Xray skull cone down lateral for sella ( pitutary fossa ) SKUCDS 520 310
560 Xray skull for jugular foramen SKJF 520 310
561 Xray skull lateral (bilateral) SKULB 1010 610
562 Xray skull lateral (L) SKULL 520 310
563 Xray skull lateral (R) SKULR 520 310
564 Xray skull maxilla SKUMAX 520 310
565 Xray skull oblique for optic foramina (bilateral) SKUOOFB 1010 610
566 Xray skull oblique for optic foramina (L) SKUOOFL 520 310
567 Xray skull oblique for optic foramina (R) SKUOOFR 520 310
568 Xray skull occipito-frontal view SKOCCF 520 310
94
569 Xray skull perorbital view SKUPERIV 520 310
570 Xray skull tangential view SKTGV 520 310
571 Xray skull Towne's / fronto-occipital 15 deg SKUTOW 520 310
572 Xray skull Townes / fronto-occipital 20 deg SKUTOW20 520 310
573 Xray skull Townes / fronto-occipital 30 deg SKUTOW30 520 310
574 Xray soft tissue neck AP NAP 520 310
575 Xray soft tissue neck AP & lateral NAPL 1010 610
576 Xray soft tissue neck lateral NLA 520 310
577 Xray soft tissue neck lateral ( adenoids / nasopharynx NLAA 520 310
)
578 Xray sphenoid sinus (lateral) SSINLT 520 310
579 Xray sterno clacicular joint AP (bilateral) STCJAPB 520 310
580 Xray sterno clavicular joint AP (L) STCJAPL 520 310
581 Xray sterno clavicular joint AP (R) STCJAPR 520 310
582 Xray sterno clavicular joint oblique (bilateral) STCJOBB 1010 610
583 Xray sterno clavicular joint oblique (L) STCJOBL 520 310
584 Xray sterno clavicular joint oblique (R) STCJOBR 520 310
585 Xray sternum AP STERAP 520 310
586 Xray sternum lateral STERLT 520 310
587 Xray sternum oblique (L) STEROBL 520 310
588 Xray sternum oblique (R) STEROBR 520 310
589 Xray styloid processes AP STLPAP 520 310
590 Xray submandibular gland area (L) SMABGOL 520 310
591 Xray submandibular gland area (R) SMABGOR 520 310
592 Xray subtalar joint (bilateral) SJB 1010 610
593 Xray subtalar joint (L) SJL 520 310
594 Xray subtalar joint (R) SJR 520 310
595 Xray superior orbital fissure (bilateral) SOFISB 520 310
596 Xray superior orbital fissure (L) SOFISL 520 310
597 Xray superior orbital fissure (R) SOFISR 520 310
598 Xray temporo mandibular joints (closed mouth) TMJCMB 1010 610
(bilateral)
599 Xray temporo mandibular joints (closed mouth) (L) TMJCML 520 310
600 Xray temporo mandibular joints (closed mouth) (R) TMJCMR 520 310
601 Xray temporo mandibular joints (open & closed TMJOCMB 2000 1200
mouth) (bilateral)
602 Xray temporo mandibular joints (open & closed TMJOCML 1010 610
mouth) (L)
603 Xray temporo mandibular joints (open & closed TMJOCMR 1010 610
mouth) (R)
604 Xray temporo mandibular joints (open mouth) TMJOMB 1010 610
(bilateral)
605 Xray temporo mandibular joints (open mouth) (L) TMJOML 520 310
606 Xray temporo mandibular joints (open mouth) (R) TMJOMR 520 310
607 Xray thigh for foreign body localisation (bilateral) THFBLB 1010 610
608 Xray thigh for foreign body localisation (L) THFBLL 520 310
609 Xray thigh for foreign body localisation (R) THFBLR 520 310
610 Xray thigh for soft tissue AP & lateral (bilateral) THSTAPLTB 2000 1200
611 Xray thigh for soft tissue AP & lateral (L) THSTAPLTL 1010 610
612 Xray thigh for soft tissue AP & lateral (R) THSTAPLTR 1010 610
613 Xray thigh for soft tissue AP (bilateral) THSTAPB 1010 610
614 Xray thigh for soft tissue AP (L) THSTAPL 520 310
615 Xray thigh for soft tissue AP (R) THSTAPR 520 310
616 Xray thoracic inlet view THIAP 520 310
95
617 Xray thumb AP & lateral (L) THUAPLTL 520 310
618 Xray thumb AP & lateral (R) THUAPLTR 520 310
619 Xray Thumb AP (bilateral) THUALB 520 310
620 Xray trapezium (bilateral) TZIUB 520 310
621 Xray trapezium (L) TZIUL 520 310
622 Xray trapezium (R) TZIUR 520 310
623 Xray venogram lower limb (bilateral) VENOLLB 8870 5320
624 Xray venogram lower limb (L) VENOLLL 5310 3190
625 Xray venogram lower limb (R) VENOLLR 5310 3190
626 Xray venogram upper limb (bilateral) VENOULB 8870 5320
627 Xray venogram upper limb (L) VENOULL 5310 3190
628 Xray venogram upper limb (R) VENOULR 5310 3190
629 Xray Whole spine digital film AP XWSDAP 1070 1070
630 Xray Whole spine digital film AP & Lateral XWSDAPL 1770 1770
631 Xray Whole spine digital film AP & Lateral (Left XWSDFAPLLB 1770 1770
Bending)
632 Xray Whole spine digital film AP & Lateral (Right XWSDFAPLRB 1770 1770
Bending)
633 Xray Whole spine digital film AP ( Right & Left XWSDFAPLRLB 2660 2660
Bending )
634 Xray Whole spine digital film AP (Left Bending) XWSDFAPLB 1070 1070
635 Xray Whole spine digital film AP (Right Bending) XWSDFAPRB 1070 1070
636 Xray Whole spine digital film Lateral XWSDL 1070 1070
637 Xray wrist and hand for bone age WRHBA 520 310
638 Xray wrist AP & lateral (bilateral) WRPALB 1010 610
639 Xray wrist AP & lateral (L) WRPALL 520 310
640 Xray wrist AP & lateral (R) WRPALR 520 310
641 Xray wrist AP & oblique (bilateral) WRAPLATB 520 310
642 Xray wrist AP & oblique (L) WRAPLATL 520 310
643 Xray wrist AP & oblique (R) WRAPLATR 520 310
644 Xray wrist AP (bilateral) WRPAB 520 310
645 Xray wrist AP (L) WRPAL 520 310
646 Xray wrist AP (R) WRPAR 520 310
647 Xray wrist AP, lateral & oblique (bilateral) WRAPLOBB 1490 890
648 Xray wrist AP, lateral & oblique (L) WRAPLOBL 1010 610
649 Xray wrist AP, lateral & oblique (R) WRAPLOBR 1010 610
650 Xray wrist carpal tunnel (bilateral) WRCTNLB 520 310
651 Xray wrist carpal tunnel (L) WRCTNLL 520 310
652 Xray wrist carpal tunnel (R) WRCTNLR 520 310
653 Xray wrist lateral (bilateral) WRLATB 520 310
654 Xray wrist lateral (L) WRLATL 520 310
655 Xray wrist lateral (R) WRLATR 520 310
656 Xray zygomatic arch base ZYGABAS 520 310
657 Xray zygomatic arch oblique tangential ZYGAOBLT 520 310
658 Xray zygomatic arch Townes ZYGATOW 520 310
659 Xray barium enema (double contrast) BEDCON
Xray barium dye Charges ( Rs. 320 ) BEDCONDYE 320 320
Xray barium enema (double contrast) BEDCON
5510 3310
660 Xray barium enema BELBOW
Xray barium dye Charges ( Rs. 320 ) BEDCONDYE
320 320
Xray barium enema BELBOW 4260 2550
661 Xray barium meal follow through BHFT
Xray barium dye Charges BHFTDYE
150 150
Xray barium meal follow through BHFT 3740 2240
96
662 Xray barium meal upper GI BMUGIT
150 150
Xray barium meal upper GI BMUGIT 3110 1870
663 Xray barium swallow for foreign body localisation BSFBL
Xray barium dye Charges BHFTDYE 150 150
Xray barium swallow for foreign body localisation BSFBL
2150 1290
664 Xray barium swallow (for heart) with fluoroscopy BSHFLS
Xray barium swallow (for heart) with fluoroscopy BSHFLS
2150 1290
665 Xray barium distal cologram COLOD
Xray barium distal cologram COLOD
2150 1290
Xray barium distal cologram ( dye Charges ) COLODDYE 150 150
666 Xray gastrografin cologram COLOG
Xray gastrografin cologram COLOG
2830 1690
Xray gastrografin dye Charges - 3 Ampoules ( Rs. 1000) GASTAMP1000 1000 1000
667 Xray Colonic transit time COLOTTOS
Xray Colonic transit time COLTT 3910 2340
668 Xray penile cavernosogram CONG
Xray gastrografin dye Charges - Vial ( Rs. 900 ) GAST2DYE 900 900
Xray penile cavernosogram CONG
4260 2550
669 Xray barium upper GI and follow through CUGITAF
150 150
Xray barium upper GI and follow through CUGITAF
5510 3310
670 Xray Cystouretherogram - Adult (MCU) CYSTAOS
Xray Cystouretherogram - Adult (MCU) CYSTA
4400 2640
Xray gastrografin dye Charges - Vial ( Rs. 750 ) GASTA 750 750
671 Xray Cystogram - Child (<10 years) (MCU) CYSTOCCOS
Xray Cystogram - Child (<10 years) (MCU) CYSTOCC 4400 2640
Xray Gastrografin dye charges (Rs 250) CYSTODCC 250 250
672 Xray Cystouretherogram - Child (<10 years) (MCU) CYSTOCOS
Xray Cystouretherogram - Child (<10 years) (MCU) CYSTOC 4400 2640
Xray Gastrografin dye charges (Rs 250) CYSTODCC
250 250
673 Xray cystogram - Adult ( MCU ) CYSTOGAOS
Xray cystogram - Adult ( MCU ) CYSTOGA 4400 2640
Xray gastrografin dye Charges - Vial ( Rs. 750 ) GASTA
750 750
674 Xray Dacrocystogram DACROOS
Xray Dacrocystogram DACROCYS
2500 1500
Xray gastrografin dye charges - Ampoule ( Rs. 250) COLOGDYE250 250 250
675 Xray Defaecography DAFGRAOS
Xray Barium paste charges ( Rs. 250 ) BARPAST
250 250
Xray Defaecography DEFAGRA 6740 4050
676 Xray Distal cologram with RGU ( Gastrografin ) DISRGUGASOS
Xray Distal cologram with RGU ( Gastrografin ) DISCOLORGUGAS 3540 2120
Xray gastrografin dye Charges - Vial ( Rs. 750 ) GASTA
750 750
677 Xray gastric band adjustment under image intensifier GASBANDOS
Xray Gastric band adjustment under image intensifier GASBAND 1960 1180
Xray gastrografin dye charges - Ampoule ( Rs. 250) COLOGDYE250
250 250
678 Xray gastrografin upper GI GAST
Xray gastrografin dye Charges - 3 Ampoules ( Rs. 1250 ) COLOGDYE
1250 1250
Xray gastrografin upper GI GAST 3990 2400
679 Xray gastrografin follow through GAST3
Xray gastrografin dye Charges - 3 Ampoules ( Rs. 1000) GASTAMP1000
1000 1000
Xray gastrografin follow through GAST3 3740 2240
97
680 Xray gastrografin upper GI & follow through GAST4
Xray gastrografin dye Charges - 3 Ampoules ( Rs. 1000) GASTAMP1000
1000 1000
Xray gastrografin upper GI & follow through GAST4 5850 3510
681 Xray gastrografin enema GASTENE
Xray gastrografin dye Charges - 3 Ampoules ( Rs. 1250 ) COLOGDYE 1250 1250
Xray gastrografin enema GASTENE 4260 2550
682 Xray genitogram GENT
Xray genitogram GENT
3000 1800
683 Xray hysterosalpingogram ( HSG ) HSG
Xray gastrografin dye charges - Ampoule ( Rs. 500 ) BDGDYE500
500 500
Xray hysterosalpingogram ( HSG ) HSG 3540 2150
684 Xray Ileostogram with barium ILEOBAROS
150 150
Xray Ileostogram with barium ILEOBAR 2220 1330
685 Xray Ileostogram with gastrografin ILEOGASOS
Xray gastrografin dye Charges - Vial ( Rs. 500 ) GAST500 500 500
Xray Ileostogram with gastrografin ILEOGAS 3910 2340
686 Xray IVP (non-ionic contrast) IVPA
Xray IVP (non-ionic contrast) IVPA 3900 2340
Xray IVP (non-ionic contrast) ( dye Charges ) IVPADYE
1050 1050
687 Xray IVP (non-ionic contrast) child IVPC2
Xray IVP (non-ionic contrast) child IVPC2
3350 2010
Xray IVP (non-ionic contrast) child ( dye Charges ) IVPC2DYE
500 500
688 Xray Loopogram with barium LOOPOBAROS
150 150
Xray Loopogram with Barium LOOPOGRAM 2220 1330
689 Xray Loopogram with gastrografin LOOPOGASOS
Xray Loopogram with Gastrografin LOOPOGAS 3540 2120
690 Lumbosacral Spine - Sitting & Lying Position LUMSTOS
Lumbosacral Spine - Lateral view in lying down position LUMSLD 520 310
Lumbosacral Spine - Lateral view in sitting position LUMST
520 310
691 Xray nephrostogram (bilateral) NEPB
Xray nephrostogram (bilateral) NEPB
5150 3090
692 Xray nephrostogram (L) NEPL
250 250
Xray nephrostogram (L) NEPL 3740 2240
693 Xray nephrostogram (R) NEPR
250 250
Xray nephrostogram (R) NEPR 3740 2240
694 Xray barium swallow OPBSLOW
Xray barium swallow OPBSLOW
2150 1290
695 Xray pouchogram (with barium) POUWBAR
Xray gastrografin dye charges - Ampoule ( Rs. 320 ) BDGDYE 320 320
Xray pouchogram (with barium) POUWBAR
2150 1290
696 Xray pouchogram (with gastrografin) POUWGAS
Xray gastrografin dye Charges - Vial ( Rs. 500 ) GAST500
500 500
Xray pouchogram (with gastrografin) POUWGAS 2150 1290
697 Xray PTBD gram PTBDGRAM
Xray gastrografin dye charges - Ampoule ( Rs. 320 ) BDGDYE
320 320
Xray PTBD gram PTBDGRAM 3540 2120
98
698 Xray RGP in Xray department RGPIDM
250 250
Xray RGP in Xray department RGPIDM 3540 2120
699 Xray RGP in OT RGPIOT
Xray gastrografin dye Charges - Vial ( Rs. 900 ) GAST2DYE
900 900
Xray RGP in OT RGPIOT 4620 2770
700 Xray RGU RGU
Xray RGU RGU
3740 2240
701 Xray small bowel barium enema ( enteroclysis ) SBBEMA
150 150
Xray small bowel barium enema ( enteroclysis ) SBBEMA 7280 4370
702 Stereotactic Core Biopsy (Mammographic Guidance) SCBMGOS
Stereotactic Core Biopsy (Mammographic Guidance) - Doctor Fee SCBMG
4000 4000
Stereotactic Core Biopsy (Mammographic Guidance) - Hospital Charges SCBMGHC 14000 14000
703 Xray parotid sialogram (bilateral) SIALBS
Xray parotid sialogram (bilateral) SIALBS 3100 1860
704 Xray parotid sialogram (R) SIALOR
Xray parotid sialogram (R) SIALOR
1770 1070
705 Xray parotid sialogram (L) SIALOS
250 250
Xray parotid sialogram (L) SIALOS
1770 1070
706 Xray sinogram / fistulogram SINOG
250 250
Xray sinogram / fistulogram SINOG 2310 1390
707 Xray submandibular sialogram (bilateral) SMABSB
Xray submandibular sialogram (bilateral) SMABSB 3100 1860
708 Xray submandibular sialogram (L) SMABSL
Xray submandibular sialogram (L) SMABSL
1770 1070
709 Xray submandibular sialogram (R) SMABSR
Xray submandibular sialogram (R) SMABSR
1770 1070
710 Xray T - tube cholangiogram TTCG
250 250
Xray T - tube cholangiogram TTCG 2940 1760
711 Ultrasound Guided Core Breast Biopsy UGCBBOS
Ultrasound Guided Core Breast Biopsy - Doctors Fee UGCBB
2000 2000
Ultrasound Guided Core Breast Biopsy - Hospital Charges UGCBMHC 6000 6000
712 Vacuum Assisted Breast Biopsy under Mammographic VABBMGOS
Guidance
Vacuum Assisted Breast Biopsy under Mammographic Guidance - Doctor VABBMG 5000 5000
Fee
Vacuum Assisted Breast Biopsy under Mammographic Guidance - Hospital VABBMGHC 35000 35000
Charges
713 Vacuum Assisted Breast Biopsy under Ultrasound VABBUGOS

Guidance
Vacuum Assisted Breast Biopsy under Ultrasound Guidance - Doctor Fee VABBUG 5000 5000
Vacuum Assisted Breast Biopsy under Ultrasound Guidance - Hospital VABBUGHC 30000 30000
Charges
714 Xray VP shuntogram VENOVPS

Xray VP shuntogram VENOVPS
3300 1980
99
715 Xray Distal Cologram ( Barium + Gastrografin ) XDCBGOS
150 150
Xray Distal Cologram ( Barium + Gastrografin ) XDCBG 3540 2120
Xray Gastrografin dye charges (Rs 250) CYSTODCC 250 250
716 Xray gastrografin swallow (Adult) XGSAOS
Xray Gastrografin (Adult) dye charges XGSADC 500 500
Xray gastrografin swallow (Adult) XGSA 1960 1170
717 Xray Gastrografin Swallow (Child - < 12 Years) XGSCOS
250 250
Xray Gastrografin Swallow (Child - < 12 Years) XGSC 1960 1170
718 Xray IVP non-ionic contrast with lasix challenge XNILCOS
Xray IVP (non-ionic contrast) ( dye Charges ) IVPADYE 1050 1050
Xray IVP non-ionic contrast with lasix challenge XNILC 4950 3300
719 Pericatheteric RGU( including dye charges ) - XRAY XRAYRGOS
Pericatheteric RGU - Dye charges XRAYRGUDY 250 250
Pericatheteric RGU - Xray XRAYRGU
3740 2240
720 Stentogram ( including dye charges ) XRAYSCOS
Stentogram Dye charges - Xray XRAYDYE 250 250
Stentogram charges - Xray XRAYSC
2940 1760
X-Ray Mammography Charges

CAT 1/CAT2 CAT3
1 ADD ON 3D MAMMOGRAPHY CHARGES ADDMAMOG 2750 1650
2 Breast FNAC under Radiological guidance - Radiology BFNACDF 2500
Dept. Charges
3 Breast Ultrasound ( Radiology ) BRERAD 2200 1350
4 Extra DVD / CD + films upto 5 in number + Duplicate EXTRAMEMO
report
5 Extra Film beyond 5 films EXTFILMB
6 Mammographic hook wire localisation HWLOCAL 7500 2000

7 Mammographic hook wire localizatio ( Hook wire and MAHWL 2000 2000
film charges only)
8 Radiological evaluation of collection REVACOL 510 510
9 Radiological evaluation of stent patency REVASTPT 510 510
10 Radiological guidance charges for FNAC / Biopsy ( RDFNACINT 600 600
interventional) - Dept Charges
11 Specimen Mammography MAMMSM 1500 900
12 Tomosynthesis Charges - Mammography TOMOMAM 6500 3900
Dept.Charges
13 Breast FNAC under Radiological guidance BFNACOS
Breast FNAC under Radiological guidance - Radiologist fee BFNACRF
2500
Breast FNAC under Radiological guidance - Radiology Dept. Charges BFNACDF 2500
14 Breast core biopsy under radiological guidance BRBIOS
Breast core biopsy under radiological guidance - Radiologist fee BRBIORF
3000
Breast core biopsy under radiological guidance - Radiology Dept. Charges BRBIOHC 5000 3000
15 Hook wire localisation under radiological guidance HKWLOS
Hook wire localisation under radiological guidance - Radiologist fee HKWLRF 3000 1800
Hook wire localisation under radiological guidance - Radiology Dept. fee HKWLHC 7000 4200
16 Breast Tomosynthesis (3D Mammography) - Left Breast MAMMBT3DLOS
only
Breast Tomosynthesis (3D Mammography) - Left Breast only MAMMBT3DL 3250 1950
Breast Ultrasound ( Mammography ) BRULTMAM
100
17 Breast Tomosynthesis ( 3D Mammography ) - Bilateral MAMMBT3DOS
Breast Tomosynthesis (3D Mammography) MAMMBT3D
6500 3900
18 Breast Tomosynthesis (3D Mammography) - Right Breast MAMMBT3DROS

only
Breast Tomosynthesis (3D Mammography) - Right Breast only MAMMBT3DR
3250 1950
19 Mammography - Bilateral MAMMOBL

Mammography (bilateral) ( Xray dept charges ) MAMMOP 3750 2250

20 Mammography ( Left ) MAMMOLTOS
Mammography ( Left ) ( Xray dept charges ) MAMMOPL

1850 1100
21 Mammography ( Right ) MAMMORTOS
Mammography (R) ( Xray dept charges ) MAMMOPR 1850 1100

22 Comprehensive Left breast imaging package bilateral (2D MM2D3DLMOS
+ 3D Left Mammogram + Breast MRI)
Comprehensive Left breast imaging package bilateral (2D + 3D Left MM2D3DRM 12000 12000
Mammogram + Breast MRI) - MRI Department Charges
Comprehensive Left breast imaging package bilateral (2D + 3D Left MM2D3DLM 3000 1800
Mammogram + Breast MRI) - X-Ray Department Charges
23 Comprehensive breast imaging package bilateral (2D + 3D MMCOBR2D3DOS

Mammography + Breast MRI)
Comprehensive breast imaging package bilateral (2D + 3D Mammography MMCOBR2D3DMRI 12000 12000
+ Breast MRI) - MRI Department Charges
Comprehensive breast imaging package bilateral (2D + 3D Mammography MMCOBR2D3D
6500 3900
+ Breast MRI) - X-Ray Department Charges
24 Comprehensive Right breast imaging package bilateral MMCOBR2D3DRO

(2D + 3D Right Mammogram + Breast MRI)
Comprehensive Right breast imaging package bilateral (2D + 3D Right MM2D3DRMRI

12000 12000
Mammogram + Breast MRI) - MRI Department Charges
Comprehensive Right breast imaging package bilateral (2D + 3D Right MMCOBR2D3DR 3000 1800
Mammogram + Breast MRI) - X-Ray Department Charges
25 Radiological skin marking for lesion RAFSMAROS

Radiological skin marking for lesion - Radiologist fee RAFSMARDF 1500 900
Radiological skin marking for lesion - Radiology Dept. Charges RAFSMARHC
1500 900
26 Radiological skin marking for lesion in OT RAFSMOTOS
Radiological skin marking for lesion in OT - Radiologist fee RAFSMOTDF 3000 1800
Radiological skin marking for lesion in OT - Radiology Dept. Charges RAFSMOTHC
3000 1800
27 Radiological guidance charges for Ascites / Effusion RASCUINTOS
tapping / Drainage ( interventional)
Radiological guidance charges for Ascites / Effusion tapping / Drainage ( RASCUINT 600 600
interventional) - Dept. Charges
Radiological guidance charges for Ascites / Effusion tapping / Drainage ( RASCUINTRF
500 500
interventional) - Radiologist fee
28 Radiological guidance charges for FNAC / Biopsy ( RDFNACINTOS

interventional)
Radiological guidance charges for FNAC / Biopsy ( interventional) - Dept RDFNACINT 600 600
Charges
Radiological guidance charges for FNAC / Biopsy ( interventional) - RDFNACINTRF
500 500
Radiologist Fee
Respiratory & Chest Medicine Lab Charges

CAT 1/CAT2 CAT3
101
1 Pulmonary rehabilitation program PULREHP 1400 1400
2 Spirometery SPIROM 1800 1100
3 Spirometery + Diffusion studies DIFSTUD 2540 1530
4 Spirometery + Lung Volume + Diffusion studies SPIRLD 2540 1530
5 Spirometry with Reversibility ( Drugs ) SPIROMD 1800 1100
Urodynamic doctor procedure charges

CAT 1/CAT2 CAT3
1 SPC - Procedure Charges UROSPHC 9450 5670
2 Tesa - Procedure Charges UROTESADF 4730 2840
3 Urodynamics Lab OPD - CMG UROCMG 2000 1200
4 Urodynamics Lab OPD - EMG + CMG UROEMGCMG 2800 1680
5 Urodynamics Lab OPD - EMGU UROPEMGU 400 240
6 Urodynamics Lab OPD - UFM UROPROUFM 800 480
7 Urodynamics Lab OPD - UFM + EMG + CMG UROUECMG 3200 1920
8 Urodynamics Lab OPD - UPP UROUPP 490 300
Urodynamic test charges

CAT 1/CAT2 CAT3
1 Complete Urodynamic Study ( Uroflowmetery , UROCOMPLETE 4000 2400
Cystometrography and UPP )
2 Electromyography ( EMG ) urinary sphincter EMGU 600 360
3 Urethral profile pressure ( UPP ) UPP 1000 600
4 Uroflowmetery ( UFM ) UFM 1000 600
5 Voiding cystometery VOIDCYST 2000 1200
6 Water cystometrography ( CMG ) CMG 2500 1500
7 Water cystometrography ( CMG ) with WATCYST 3300 1980
Electrmyography ( EMG )
URODYNAMICS PROCEDURES
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
CATHMOS Catheterization with
instillation of any medicine -
Urodynamics
CATHMHC Catheterization with instillation of any 650 650 330 260 200 330 2160
medicine - Hospital Charges
CATHMDF Catheterization with instillation of any 6540 6540 3270 2620 1960 3270
medicine - Procedure Charges
CATHOS Catheterization - Urodynamics
CATHHC Catheterization - Hospital Charges 470 470 240 190 140 240 1560
CATHDF Catheterization - Procedure Charges ( OPD ) 4720 4720 2360 1890 1420 2360
102
CESOS Cyst Excision - Urodynamics
CESHC Cyst Excision - Hospital Charges 910 910 460 360 270 460 3000
CESDF Cyst Excision - Procedure Charges 9080 9080 4540 3630 2720 4540
DMAJOS Dressing Major - Urodynamics
DMAJHC Dressing Major - Hospital Charges 360 360 180 150 110 180 1200
DMAJDF Dressing Major - Procedure Charges (OPD) 3640 3640 1820 1460 1090 1820
DMOS Dressing Minor - Urodynamics
DMINHC Dressing Minor - Hospital Charges 180 180 90 70 60 90 600

DMDF Dressing Minor - Procedure Charges (OPD) 1820 1820 910 730 550 910
FREOS Frenuloplasty - Urodynamics
FREHC Frenuloplasty - Hospital Charges 730 730 360 290 220 360 2400
FREDF Frenuloplasty - Procedure Charges 7280 7280 3640 2910 2180 3640
NSBWOS Bladder wash with catheter

removal - Urodynamics
BWHC Bladder wash with catheter removal - 360 180 150 110 180 1200
Hospital Charges
NSBWDF Bladder wash with catheter removal - 3640 3640 1820 1460 1090 1820
Procedure Charges
PBIOOS Prostate Biopsy - Urodynamics
PBIOHC Prostate Biopsy - Hospital Charges 910 910 460 360 270 460 3000
PBIODF Prostate Biopsy - Procedure Charges (OPD) 9080 9080 4540 3630 2720 4540
SUPBIOOS Superficial Biopsy -

Urodynamics
SUPBIOHC Superficial Biopsy - Hospital Charges 650 650 330 260 200 330 2160
SUPBIODF Superficial Biopsy - Procedure Charges 6540 6540 3270 2620 1960 3270
TBIOOS Testicular Biopsy -

Urodynamics
TBIOHC Testicular Biopsy - Hospital Charges 1090 1090 550 440 330 550 3600
TBIODF Testicular Biopsy - Procedure Charges 10900 10900 5450 4360 3270 5450
UDILOS Urethral Dilatation -

Urodynamics
UDILHC Urethral Dilatation - Hospital Charges 910 910 460 360 270 460 3000
UDILDF Urethral Dilatation - Procedure Charges 9080 9080 4540 3630 2720 4540
(OPD)
UROSPCO SPC - Urodynamics

S
UROSPCHC SPC - Hospital Charges 1890 1890 950 760 570 950 6240
UROSPHC SPC - Procedure Charges 18900 18900 9450 7560 9450
UROTESA Tesa - Urodynamics

OS
UROTESA Tesa - Hospital Charges 950 950 470 380 280 470 3120
UROTESADF Tesa - Procedure Charges 9460 9460 4730 3780 2840 4730
Other Special Care Charges

Premium/
2 Bedded
4 Bedded
Cat-1D
POPD/
All Cat
GOPD
Single
Cat-2
Cat-3
Suite

1 ATEBJMOTAC All teeth extractions (both jaws) For Minor OT ( 3700
Anaesthetists Charges )
103
2 ABJMOTAC Alveolectomy (Both jaws) For Minor OT ( 2310
3 ASJNMOTAC Alveolectomy (one jaws) For Minor OT ( 1300
4 ALPMOTAC Alveoloplasty For Minor OT ( Anaesthetists Charges 1290
)
5 ALPDMANCH Anaesthetists charges for Argon laser 690
photocoagulation ( single sitting ) for diabetic
maculopathy - Doctor fees
6 CRDFICGANCH Anaesthetists charges for Combined retinal digital 670
fluorescein & indocyanine green ( ICG ) imaging
angiography
7 ANADENTAL Anaesthetists charges for dental procedures 2910
8 RDFIANCH Anaesthetists charges for Retinal digital 320
flurorescein imaging angiography
9 RDICGANCH Anaesthetists charges for Retinal digital 440
indocyanine green ( ICG ) imaging angiography
10 YAGANCH Anaesthetists charges for YAG laser 700
photocoagulation - Doctor fees
11 ANDLANA Anal Dilatation For Minor OT ( Anaesthetists 870
Charges )
12 ABLDAF Angiography of B/L Dorsolumbar Spinal Radicular 13860 6930 5540 4160
Arteries - Anasthetist fee
13 AULAC Apicectomy (Under LA) For Minor OT ( 1850
14 AFDFAC Archbar fixation dentoalveolar fracture segment 1390
For Minor OT ( Anaesthetists Charges )
15 BASCAN Balloon Angioplasty & Stenting in Cervical 41580 20790 16630 12470
ICA/Vertebral - Anasthetist Fee
16 BACEDAN Balloon Assisted Coil Embolization of a 46200 23100 18480 13860
Direct/Indirect Cavernous Fistula - Anasthetist fee
17 BAVAC Brachio AV fistula at elbow for hemodialysis - 2420
Anaesthetists Charges
18 CSTLACSMF Cataract Surgery MULTIFOCAL TORIC LENS - 3020
Anaesthetist Charges
19 CSTLACSY Cataract Surgery SYMFONY LENS - Anaesthetist 3780
Charges
20 CSTLACSYT Cataract Surgery SYMFONY TORIC LENS - 4160
Anaesthetist Charges
21 CTZANA Catheterization For Minor OT ( Anaesthetists 520
Charges )
22 CIRETDAC Caval Interruption using retrievable device - Doctor 15960 7980 6380 3990
Anaesthesia Charges
23 CCMANA Circumcision For Minor OT ( Anaesthetists Charges 1560
)
24 CARAVFAC Conversion of arteriovenous (AV) shunt to 2420
arteriovenous (AV) fistula - Anaesthetists Charges
25 CAREVFBAC Creation of arteriovenous (AV) Fistula at elbow ( 3060
Brachial artery ) - Anaesthetists Charges
26 CAREVFWBAC Creation of arteriovenous (AV) Fistula at wrist ( 3060
Radial Artery ) - Anaesthetists Charges
27 CAREVFAC Creation of arteriovenous (AV) Fistula at axillary 3060
artery - Anaesthetists Charges
28 CTANGA CT ( Anaesthesia Charges ) - GA 5000
29 CTANSB CT ( Anaesthesia Charges ) - Standby 2500
30 DENIMPAC Dental Implant (first stage) For Minor OT ( 9220
31 DNTANSB Dental OPD ( Anaesthesia Charges ) - GA 4500
32 DBFMNA Diagnostic Bronchoscopy For Minor OT ( 1930
104
33 DBWBNA Diagnostic Bronchoscopy with Biopsy ( 2810
34 DISTMJAC Dislocation of TMJ For Minor OT ( Anaesthetists 1160
Charges )
35 DOSANA Dorsal Slit For Minor OT ( Anaesthetists Charges ) 1220
36 DREMA Dressing (minor) For Minor OT ( Anaesthetists 520
Charges )
37 DCDRA Dressing change/drain removal For Minor OT 440
(Anaesthetists Charges)
38 ELRBA Ear lobe repair BL For Minor OT ( Anaesthetists 1040
Charges )
39 ELRUA Ear lobe repair UL For Minor OT ( Anaesthetists 700
Charges )
40 ESPFDNA Embolization of Spinal Pial/dural Fistula - 46200 23100 18480 13860
Anasthetist fee
41 ENDOBYAC Endoluminal bypass - Doctor Anaesthesia Charges 15960 7980 6380 3990
42 ANAANAF Endoscopy submucosal dissection - Anaesthetists 53550 26780 21420 16070
Fee
43 ENTOANSB ENT OPD ( Anaesthesia Charges ) - GA 2500
44 EXPFAC Excision of pericoronal flap For Minor OT ( 910
45 EXBIMAC Excisional biospy For Minor OT ( Anaesthetists 1390
Charges )
46 EYEANGA Eye OPD ( Anaesthesia Charges ) - GA 2000
47 EYEANSB Eye OPD ( Anaesthesia Charges ) - Standby 1500
48 FLDIMTAC Flap Division and Inset For Minor OT ( Anaesthetists 2980
Charges)
49 FLMTAC Flap Large For Minor OT ( Anaesthetists Charges ) 4960
50 FSMTAC Flap Small For Minor OT ( Anaesthetists Charge) 4140
51 FSBQAC Flap surgery with bone graft (per quadrant) For 1850
Minor OT ( Anaesthetists Charges )
52 FDPIANA Flow Divertor Placement for Intracranial Aneurysm 55440 27720 22180 16630
- Anasthetist fee
53 FOASA Foam Sclerotherapy For Minor OT ( Anaesthetists 3470
Charges )
54 FLAMOTAC Fracture mandible open reduction under LA (Cost 6920
of plates & screws etc.) For Minor OT (
55 FRMOTAC Frenectomy For Minor OT ( Anaesthetists Charges ) 990
56 FNPANA Frenuloplasty For Minor OT ( Anaesthetists Charges 780
)
57 GASPROPOEM Gastroenterology Procedures Poem - Anasthetist 56230 28110 22490 16870
Fee
58 GINPMOTAC Gingivoplasty For Minor OT ( Anaesthetists 1390
Charges )
59 HYBAC Hybrid Procedure- Anaesthetist Charge 24650 23870 19950 16030
60 ICCPLNA ICD insertion for complex effusion/pneumothorax 1930
61 ICDSMNA ICD insertion for simple effusion/pneumothorax 830
62 IBSMOTAC Impaction (Bony/soft tissue) For Minor OT ( 2610
63 ICVADPAC Implantable Central Venous Access Device 5000 2500 2010 1250
Placement - Doctor Anaesthesia Charges
64 INADMA Incision and drainage (major) For Minor OT ( 1390
65 INADA Incision and drainage (Minor) For Minor OT ( 700
66 INDMOTAC Incision and drainage For Minor OT( Anaesthetists 920
Charges )
105
67 IDLANA Incision and Drainage of Multiple/ Large Superficial 1390
Abscess For Minor OT ( Anaesthetists Charges )
68 IDSANA Incision And Drainage of Small/Superficial Abscess 700
69 IMFMOTAC Inter - Maxillary fixation with archbar For Minor 3230
OT( Anaesthetists Charges )
70 IAVDNA Intracranial Angioplasty for Vasaspasm - 27720 13860 11090 8320
Anasthetist fee
71 IVMECNA Intracranial AVM Embolization (Complex) - 55440 27720 22180 16630
Anasthetist fee
72 IAELNA Intracranial AVM Embolization using Liquid Embolic 46200 23100 18480 13860
material - Anasthetist fee
73 ISRNA Intracranial Stenting in Stroke Revascularization - 46200 23100 18480 13860
Anasthetist fee
74 JFMOTAC Jaw fracture closed reduction For Minor OT( 3700
75 KTPSA KTP Surcharge - Anasthesist fee 2780
76 LIVHIAF Liver Transplant High - Anaesthetist Charges 105000
77 LIVTANF Liver Transplant Low - Anaesthetist Charges 75000
78 LINNRAF Liver Transplant Normal Risk - Anaesthetist Charges 90000
79 LNBMN Lymph Node Biopsy For Minor OT ( Anaesthetists 830
Charges )
80 MADMANA Major Debridement For Minor OT ( Anaesthetists 1740
Charges )
81 MTANA Meatotomy For Minor OT ( Anaesthetists Charges ) 730
82 MINIMPAC Mini implant for anchorage (per implant) For Minor 2770
83 MINDA Minor debridement For Minor OT ( Anaesthetists 870
Charges )
84 MRIANGA MRI ( Anaesthesia Charges ) - GA 5000
85 MRIANSB MRI ( Anaesthesia Charges ) - Standby 2500
86 NEDLAA Needle aspiration For Minor OT (Anaesthetists 440
Charges )
87 NERBLAC Nerve block in Neuralgias For Minor OT ( 1390
88 ORANCAC Oro antral communication closure For Minor OT ( 6460
89 PETANGA PET ( Anaesthesia Charges ) - GA 5000
90 PETANSB PET ( Anaesthesia Charges ) - Standby 3000
91 PTBANA Prostatic Trucut Biopsy For Minor OT ( 700
92 RFCHTVOAC Recanalization for Chronic Total Vascular Occlusion 13970 6990 5590 3500
- Doctor Anaesthesia Charges
93 RIOHAN Reduction of Irreducible Obstructed Hernia For 4340
94 RSPANA Reduction of Stomal Prolapsed For Minor OT ( 2610
95 RATMOTAC Reimplantation of avulsed tooth For Minor OT( 1220
96 RCIDAC Removal of Caval Interruption Device - Doctor 5990 3000 2400 1500
Anaesthesia Charges
97 RPMLAAC Removal of plates of mandible and maxilla (Under 3700
LA) For Minor OT( Anaesthetists Charges )
98 SCMOTAC Scaling full mouth For Minor OT ( Anaesthetists 990
Charges )
99 SSFTNA Secondary Suturing For Minor OT ( Anaesthetists 1100
Charges )
100 SVCAAC Six Vessel Cerabral Angiogram - Anasthetist Fee 11550 5780 4620 3470
101 SKGMTAC Skin Grafting For Minor OT ( Anaesthetists Charges 3310
)
106
102 SMSKGRAA Small Skin Grafting For Minor OT ( Anaesthetists 3310
Charges )
103 STSEA Soft tissue swelling excision for Minor OT 2430
(Anaesthetists Charges )
104 SPTCANA SPC (Suprapubic Trocar Cystostomy) For Minor OT ( 2090
105 SPREMOTAC Splint Removal For Minor OT ( Anaesthetists 610
Charges )
106 SACEAN Stent Assisted Coil Embolization of Intracranial ICA 46200 23100 18480 13860
Aneurysm - Anasthetist fee
107 SUBCURAC Subgingival scaling & curretage full mouth For 1390
Minor OT (Anaesthetists Charges)
108 SUEXTAC Surgical extraction of tooth For Minor OT 1380
109 SUTREA Suture removal For Minor OT (Anaesthetists 440
Charges)
110 SMLANA Suturing of Medium Lacerations (Large) For Minor 2430
OT ( Anaesthetists Charges )
111 SSLANA Suturing of Small Lacerations For Minor OT ( 1390
112 TCBANA Teslicular Biopsy For Minor OT ( Anaesthetists 1040
Charges )
113 THHYD Therapeutic Hypothermia for 24-48 hrs - Doctor 20000 10000 8000 6000
Fee
114 CATPAAC TPA - Cataract - Anaesthetist Charges
115 TUEXAC Tumour Excision For Minor OT (Anaesthetists 4610
Charges)
116 UMANGE Ultrasound Monitoring charges ( GE - Anaesthesia ) 650
117 UMANMT Ultrasound Monitoring charges ( M Turbo - 400
Anaesthesia )
118 URCANA Uretheral Catheterization For Minor OT ( 520
119 UCADANA Urethral Calibration and Dilatation For Minor OT ( 700
120 URDLA Urethral dilatation For Minor OT (Anaesthetists 870
Charges)
121 VAMSNA VAC Application For Minor OT ( Anaesthetists 550
Charges )
122 VENSAPBAC Venography guided laser assisted saphenous vein 17460 8740 6990 4370
closure (B/L) - Doctor Anaesthesia Charges
123 VENSAPAC Venography guided laser assisted saphenous vein 13970 6990 5590 3500
closure (U/L) - Doctor Anaesthesia Charges
124 WDMTN Wound Debridement For Minor OT ( Anaesthetists 550
Charges )
125 YSBAN Y-Stenting in a Basilar Top Aneurysm - Anasthetist 55440 27720 22180 16630
fee
Dental Charges
SNo Code Description POPD GOPD

1 BASIDT Bar Supported Implant Dentures 550000 550000
2 BASLDSJ Bar Supported Implant Dentures / Single Jaw 300000 300000
3 DALVPLS1 Cat- 1 - Alveoloplasty 2200 1460
4 DCERLAM1 Cat- 1 - Ceramic laminate 5860 5140
5 DCOMPVEN1 Cat- 1 - Composite veneers 2210 2210
6 DCOVUCST1 Cat- 1 - Core build up ( casting ) 2210 2210
107
7 DCOVUPREF1 Cat- 1 - Core build up ( prefab ) 1470 750
8 DSPREMO1 Cat- 1 - Splint Removal 1460 1460
9 DATEXT-1 Cat- 1 - All teeth extractions (both jaws) 11720 8790
10 DABJAW-1 Cat- 1 - Alveolectomy (both jaws) 7330 5850
11 DAOJAW-1 Cat- 1 - Alveolectomy (one jaws) 3660 2930
12 DARCT-1 Cat- 1 - Apexification + Root canal treatment ( RCT ) 3660 3330
13 DAPISUR-1 Cat- 1 - Apical Surgery for tooth preservation 15000 12500
14 DAULA-1 Cat- 1 - Apicectomy ( Under LA ) 5850 4390
15 DAPICE-1 Cat- 1 - Apicectomy (Endodontics) 5850 3990
16 DAPAT-1 Cat- 1 - Apicectomy per additional tooth 2200
17 DAFDDS-1 Cat- 1 - Archbar fixation dentoalveolar fracture segment 4390 2930
18 DARTMJ-1 Cat- 1 - Arthocentesis of TMJ 7330 5450
19 DBP-1 Cat- 1 - Bite plate 4400 2940
20 DBT-1 Cat- 1 - Bleaching of teeth 7330 7330
21 DCPD-1 Cat- 1 - Cast partial dentures (metal casting) 8790 6600
22 CSPT-1 Cat- 1 - Cavity sealant (per tooth) 940 940
23 CCPV-1 Cat- 1 - Chemical cauterisation (per visit) 750 590
24 DCULAR-1 Cat- 1 - Closure of upper & lower anterior spaces + 27820 17580
retainers
25 DENCDUL-1 Cat- 1 - Complete denture upper and lower (both) 17580 13180
26 DENCDUOL-1 Cat- 1 - Complete denture upper or lower (either one) 8790 7330
27 DSFMOUL Cat- 1 - Complete Scaling Lower Arch 2200
28 DSFMOUU Cat- 1 - Complete Scaling Upper Arch 2200
29 DCFILL-1 Cat- 1 - Composite filling 2200 2000
30 DCOSFILL-1 Cat- 1 - Cosmetic Filling 3000 3000
31 DCBC-1 Cat- 1 - Crown / Bridge per unit (ceramic) 6600 5140
32 DCBM-1 Cat- 1 - Crown / Bridge per unit (metal) 4400 2940
33 DCBP-1 Cat- 1 - Crown / Bridge per unit (Procera) 19970
34 DCURRE-1 Cat- 1 - Curettage (per quadrant) 3660 1330
35 DCYSTMAR-1 Cat- 1 - Cyst Enucleation / Marsupialisation 11720 5850
36 DDIFS-1-C Cat- 1 - Dental implant ( complete ) 66550 48400
37 DDIFS-1 Cat- 1 - Dental implant (first stage) 29280 11720
38 DDIMP2-1 Cat- 1 - Dental implant (second stage) 14640 10250
39 DIWC Cat- 1 - Dental Implant with Crown 66550
40 DDTMJ-1 Cat- 1 - Dislocation of TMJ 3660 3030
41 DENEMAX1 Cat- 1 - E-Max Crown 15000 10000
42 DENMELPLASTY Cat- 1 - Enameloplasty 1500 1000
43 DEPF-1 Cat- 1 - Excision of pericoronal flap 1460 1460
44 DEB-1 Cat- 1 - Excisional biopsy 4390 2340
45 DRPTO-1 Cat- 1 - Extraction (per tooth) 740 590
46 DEFDTO-1 Cat- 1 - Extraction of fractured / decayed tooth 1460 880
47 DFCS-1 Cat- 1 - Fabrication of Circummandibular splint 5860 4840
48 DFMASK-1 Cat- 1 - Face mask 10250 9530
49 DFAGI-1 Cat- 1 - Filling amalgam / Glass ionomer 2240 1600
50 DFFOCJ-1 Cat- 1 - Fixed Functional Appliance for Orthopedic 43920
correction of JAW
51 DFOCERN-1 Cat- 1 - Fixed Orthodontics ( Ceramic Braces ) - First 21970 14640
installment
52 DFOCERS-1 Cat- 1 - Fixed Orthodontics ( Ceramic Braces ) - 2940 2570
Subsequent installment
53 DFOCER-1 Cat- 1 - Fixed orthodontics (ceramic braces) - Full amount 51250 49670
54 DFOSSN-1 Cat- 1 - Fixed orthodontics (steel braces) - First installment 14640 14640
108
55 DFOSS-1 Cat- 1 - Fixed orthodontics (steel braces) - Full amount 39930 36610
56 DFOSSS-1 Cat- 1 - Fixed orthodontics (steel braces) - Subsequent 2570 2210
installment
57 DFRLB-1 Cat- 1 - Fixed Retainers ( Lingual Bonded ) 7330
58 DFOPFM-1 Cat- 1 - Flap operation (full mouth) 14640 13180
59 DFOPQ-1 Cat- 1 - Flap operation (per quadrant) 4390 3660
60 DFSBG-1 Cat- 1 - Flap surgery with bone graft (per quadrant) 5850 5850
61 DFAPP-1 Cat- 1 - Fluoride application 1180 1180
62 DFMORLA-1 Cat- 1 - Fracture mandible open reduction under LA ( Cost 21970 18150
of Plates & screws etc. )
63 DFRENE-1 Cat- 1 - Frenectomy 2200 1180
64 DGTOMY-1 Cat- 1 - Gingivectomy (per quadrant) 3660 2930
65 DGPLASTY-1 Cat- 1 - Gingivoplasty (per quadrant) 4390 3660
66 DHBA-1 Cat- 1 - Habit Breaking appliance 8790
67 DIMPACT-1 Cat- 1 - Impaction (Bony / soft tissue) 7330 6660
68 DIPW-1 Cat- 1 - Implant Prosthetic work up Stage 2 and Stage 3 35000 25000
69 DIDRAIN-1 Cat- 1 - Incision and drainage 2930 2340
70 DIBIOP-1 Cat- 1 - Incisional biopsy 2200 1180
71 DIMFA-1 Cat- 1 - Inter - maxillary fixation with archbar 10250 8790
72 DIWSPIL-1 Cat- 1 - Interdental wiring + splinting (per quadrant) 4390 4390
73 DIAINJ-1 Cat- 1 - Intra articular injection 1180 1180
74 DIFF-1 Cat- 1 - Iodoform Dressing for CYST 590 530
75 DJFCR-1 Cat- 1 - Jaw fracture closed reduction 11720 10990
76 DLFREN-1 Cat- 1 - Lingual frenectomy 2200 1770
77 DENCDULL-1 Cat- 1 - Lucitone Denture 24630 24630
78 DMFCC-1 Cat- 1 - Metal free ceramic crown 10250 8790
79 DMIA-1 Cat- 1 - Mini - implant for anchorage (per implant) 8790 7330
80 DMFA-1 Cat- 1 - Myfunctional Appliance - Twin Block 9080 7260
81 DNBN-1 Cat- 1 - Nerve block in Neuralgias 4390 3630
82 DOBTU-1 Cat- 1 - Obturators 11720 10990
83 DOPER-1 Cat- 1 - Operculectomy 1460 1460
84 DOACC-1 Cat- 1 - Oro antral communication closure 20490
85 DPDAC-1 Cat- 1 - Partial dentures (acrylic) 2940 2660
86 DATD-1 Cat- 1 - per additional tooth in denture 750 590
87 DPIOSMF-1 Cat- 1 - Placentrax Inj for OSMF 1180
88 DPOS-1 Cat- 1 - Planning Orthognathic Surgery 7870 7260
89 DPLCENE-1 Cat- 1 - Porcelain laminate veneers 5860 5140
90 DPPSOCPN-1 Cat- 1 - Pre & post surgical orthodontics for cleft palate - 17580 14640
First installment
91 DPPSOCP-1 Cat- 1 - Pre & post surgical orthodontics for cleft palate - 32220 29280
Full amount
92 DPPSOCPS-1 Cat- 1 - Pre & post surgical orthodontics for cleft palate - 1470 3670
93 DPSOSN-1 Cat- 1 - Pre & post surgical orthodontics for orthognathic 23430 20500
surgery - First installment
94 DPSOS-1 Cat- 1 - Pre & post surgical orthodontics for orthognathic 36610 41000
surgery - Full amount
95 DPSOSS-1 Cat- 1 - Pre & post surgical orthodontics for orthognathic 2210 2570
surgery - Subsequent installment
96 DPUCAP-1 Cat- 1 - Pulp capping 2240 1330
97 DPULPO-1 Cat- 1 - Pulpotomy 1460 1460
98 DRME-1 Cat- 1 - Rapid maxillary expansion ( RME ) 10250 9530
109
99 DRCB-1 Cat- 1 - Recementation of crown / bridge 890 590
100 DRAT-1 Cat- 1 - Reimplantation of avulsed tooth 2930 2930
101 DREDENT-1 Cat- 1 - Relining of denture 890 890
102 DRORTHON-1 Cat- 1 - Removable orthodontics - First installment 14640 14640
103 DRORTHO-1 Cat- 1 - Removable orthodontics - Full amount 23430 23430
104 DRORTHOS-1 Cat- 1 - Removable orthodontics - Subsequent installment 1470 1470
105 DRFW-1 Cat- 1 - Removal of Frontosuspension wiring 5850
106 DROCBU-1 Cat- 1 - Removal of old crown/bridge/unit 740
107 DRPMMLA-1 Cat- 1 - Removal of plates of mandible and maxilla ( Under 11720
LA )
108 DRDENT-1 Cat- 1 - Repair of dentures 890 530
109 DRRBA-1 Cat- 1 - Retainers replacement (both arches) 2940 2210
110 DRRPA-1 Cat- 1 - Retainers replacement (per arch) 1470 1110
111 DRCTANT-1 Cat- 1 - Root canal treatment ( RCT ) - anterior 3660 2930
112 DRCTPOS-1 Cat- 1 - Root canal treatment ( RCT ) - posterior 5850 3990
113 DRCAPIC-1 Cat- 1 - Root canal with Apicectomy 7330 5850
114 DSFMOU-1 Cat- 1 - Scaling full mouth 2200 2000
115 DSMEA-1 Cat- 1 - Slow Maxillary Expansion Appliance 7330
116 DSMAINT-1 Cat- 1 - Space maintainers 3670 3670
117 DSMODEL-1 Cat- 1 - Study model 450 390
118 DSSCFM-1 Cat- 1 - Subgingival scaling & curretage full mouth 4390 3660
119 DSETO-1 Cat- 1 - Surgical extraction of tooth 2930 2930
120 DSREMO-1 Cat- 1 - Suture removal 1460 1030
121 DENTEMP-1 Cat- 1 - Temporarization Placement of Permanent Crown 1500 1000
122 DTMJP-1 Cat- 1 - TMJ Physiotherapy 750
123 DTINLY-1 Cat- 1 - Tooth inlay 2210 2210
124 DTEXCI-1 Cat- 1 - Tumour excision 14640 8790
125 DVOSPL-1 Cat- 1 - Vacuum formed occlusal splint 4400 3670
126 FPD3 Cat- 1 - Velaplast (Flexible Partial Dentures)- Upto 3 10000 7000
missing teeth to be replaced
127 FPD6 Cat- 1 - Velaplast (Flexible Partial Dentures) - Upto 6 15000 12000
128 FPD9 Cat- 1 - Velaplast (Flexible Partial Dentures) - Upto or 18000 15000
more than 9 missing teeth to be replaced
129 DZCFULA-1 Cat- 1 - Zygonatic Complex Fracture under LA 14640
130 DACR-1 Cat- 1-Acrylic Crown 5000 3000
131 DAGFTPU-1 Cat- 1-Allograft Per Unit 15000
132 DAPISURS-1 Cat- 1-Apical Surgery for tooth preservation subsequent 3000 1500
tooth
133 DBPEX-1 Cat- 1-Bone Preserving Dental Extraction 5000 3000
134 DCAEX-1 Cat- 1-Canine Exposure 12500 10000
135 DCERON-1 Cat- 1-Ceramic Onlay 20000 15000
136 COSINVISCB-1 Cat- 1-Clear Aligners Complicated Both 350000
137 COSINVISCS-1 Cat- 1-Clear Aligners Complicated Single 200000
138 COSINVISSB-1 Cat- 1-Clear Aligners Simple Both 175000
139 COSINVISSS-1 Cat- 1-Clear Aligners Simple Single 150000
140 DREBOND-1 Cat- 1-Crown Rebonding 3000 2750
141 DRECEM-1 Cat- 1-Crown Recementation 1500 750
142 CUTOCR-1 Cat- 1-Cutting Out Old Crown 2500 1750
143 DISTASG-1 Cat- 1-Deep Impaction 15000 10000
144 DEMAXV-1 Cat- 1-E Max Veneer/ Crown 25000 20000
145 DFLAP-1 Cat- 1-Flap Surgery per Segment 5000 3500
110
146 DLASE-1 Cat- 1-Laser Surgery 12500
147 DMEMBL-1 Cat- 1-Membrane Large 20000
148 DMEMBM-1 Cat- 1-Membrane Medium 15000
149 DMEMBS-1 Cat- 1-Membrane Small 10000
150 DLPDEN3-1 Cat- 1-Partial Denture Lucitone upto 3 Teeth 8500 6500
153 DPIEZ-1 Cat- 1-Piezo Surgery 12500
154 DPOST-1 Cat- 1-Post and Core 3000 2000
155 DRISATS-1 Cat- 1-Reimplantation and Cosmetic splinting of Avulsed 5500 2500
Subsequent Tooth
156 DRISAT-1 Cat- 1-Reimplantation and Cosmetic splinting of Avulsed 15000 12500
Tooth
157 SIRCT-1 Cat- 1-Single Sitting RCT 10000
158 DTAC-1 Cat- 1-Tacs 1500
159 DITEX4F-1 Cat- 1-Teeth Express on 4 Implants First Stage Per Arch 150000 130000
160 DITEX4S-1 Cat- 1-Teeth Express on 4 Implants Second Stage Per Arch 150000 130000
161 DITEX6F-1 Cat- 1-Teeth Express on 6 Implants First Stage Per Arch 200000 175000
162 DITEX6S-1 Cat- 1-Teeth Express on 6 Implants Second Stage Per Arch 250000 225000
163 DORTHTR-1 Cat-1-Orthodontic Trainer 12000 10000
164 PITFISRE-1 Cat-1-Pit and Fissure Sealant 1800 1500
165 CLEGNESD Clear Aligners Double 150000
166 CLEGNES Clear Aligners Single 120000
167 CULHIDR Complete ( U / L ) Hybrid Implant Dentures 750000 750000
168 CDWPLA Complete Denture With Implant Location 225000 225000
169 DLOSJA Denture with Implant Locators / Single Jaw 130000 130000
170 DSLLPA Direct Sinus Lift For Implant Placement 25000 25000
171 DRVGRAD DRVG - Dental Radiovision Graphy 250 150
172 GRAPC Graft ( Per CC ) 7000 7000
173 HYIDRS Hybrid Implant Dentures / Single Jaw 375000 375000
174 IMCTDISG Impaction ( Distoangular ) 10000 10000
175 ISLFTP Indirect Sinus Lift For Implant Placement 10000 10000
176 LACLASRE LANAP (Laser Assisted New Attachment Procedure) - per 7500 4500
quadrant
177 LACAEX Laser Canine Exposure 5000 3500
178 LACROQUA Laser Crown Lengthening (per Quadrant) 7500 5000
179 LACROLE Laser Crown Lengthening (per Tooth) 2000 2000
180 LASDISMO Laser Disinfection ( Full Mouth ) 10000 7500
181 LAFRETO Laser Frenectomy 7500 5000
182 LAGITOMX Laser Gingivectomy (per Quadrant) 7500 5000
183 LAGINTH Laser Gingivectomy (per Tooth) 2000 1500
184 LAGUMBLE Laser Gum Bleaching (per Quadrant) 10000 6000
185 LAPHRA Laser Physiotherapy 6 Sittings 5000 3000
186 LASERMAJ Laser Surgery Major 10000 7500
187 LASESUR Laser Surgery Minor 5000 3500
188 LASEFULL Laser Whitening ( Full Mouth ) 20000 15000
189 LASEWHI Laser Whitening (per Tooth) 2000 2000
190 LADC1 Local Anaesthesia Category 1 - Dental 200 150
191 MEFOT Metal Free ONLAY / Tooth 15000 15000
192 PITFISRE Pit and Fissure Sealants (per Tooth) 1800 1500
193 RETNTCT Retreatment RCT 8000 8000
194 SEALICEBA Self Ligating Ceramic Braces 80000 70000
111
195 SELIBRAS Self Ligating Metal Braces 65000 55000
196 SIRCT Single Sitting RCT 10000 10000
197 SUTREMO Suture Removal For Dental 1000 1000
198 VSTDESJ Valplast Denture / Single Jaw 18000 18000
199 NGA Night Guard Appliance ( Dental )

NGA Cat- 1 - Dental Night Guard Appliance
3670
DENLAB150 Dental Lab Charges Rs - 210
210 210
200 DCERLAM2 Cat- 2 - Ceramic laminate 3600
201 DCOMPVEN2 Cat- 2 - Composite veneers 1550
202 DCOVUCST2 Cat- 2 - Core build up ( casting ) 1550
203 DCOVUPREF2 Cat- 2 - Core build up ( prefab ) 530
204 DSPREMO2 Cat- 2 - Splint Removal 1030
205 DATEXT-2 Cat- 2 - All teeth extractions (both jaws) 6160
206 DABJAW-2 Cat- 2 - Alveolectomy (both jaws) 4100
207 DAOJAW-2 Cat- 2 - Alveolectomy (one jaws) 2060
208 DALVPLS2 Cat- 2- Alveoloplasty 1030
209 DARCT-2 Cat- 2 - Apexification + Root canal treatment ( RCT ) 2060
210 DAPISUR-2 Cat- 2 - Apical Surgery for tooth preservation 11500
211 DAULA-2 Cat- 2 - Apicectomy ( Under LA ) 3090
212 DAPICE-2 Cat- 2 - Apicectomy (Endodontics) 2570
213 DAPAT-2 Cat- 2 - Apicectomy per additional tooth 1030
214 DAFDDS-2 Cat- 2 - Archbar fixation dentoalveolar fracture segment 2060
215 DBP-2 Cat- 2 - Bite plate 2060
216 DBT-2 Cat- 2 - Bleaching of teeth 5140
217 DCPD-2 Cat- 2 - Cast partial dentures (metal casting) 4630
218 CSPT-2 Cat- 2 - Cavity sealant (per tooth) 530
219 CCPV-2 Cat- 2 - Chemical cauterisation (per visit) 430
220 DCULAR-2 Cat- 2 - Closure of upper & lower anterior spaces + 12310
retainers
221 DENCDUL-2 Cat- 2 - Complete denture upper and lower (both) 9240
222 DENCDUOL-2 Cat- 2 - Complete denture upper or lower (either one) 5140
223 DCFILL-2 Cat- 2 - Composite filling 1030
224 DCBC-2 Cat- 2 - Crown / Bridge per unit (ceramic) 3600
225 DCBM-2 Cat- 2 - Crown / Bridge per unit (metal) 2060
226 DCURRE-2 Cat- 2 - Curettage (per quadrant) 530
227 DCYSTMAR-2 Cat- 2 - Cyst Enucleation / Marsupialisation 4100
228 DDIFS-2-C Cat- 2 - Dental implant ( complete ) 24200
229 DDIFS-2 Cat- 2 - Dental implant (first stage) 8210
230 DDIMP3-2 Cat- 2 - Dental implant (second stage) 7190
231 NGA-2 Cat- 2 - Dental Night Guard Appliance 2570
232 DENMELPLASTY Cat- 2 - Enameloplasty 1500 750
233 DEPF-2 Cat- 2 - Excision of pericoronal flap 1030
234 DEB-2 Cat- 2 - Excisional biopsy 1650
235 DRPTO-2 Cat- 2 - Extraction (per tooth) 430
236 DEFDTO-2 Cat- 2 - Extraction of fractured / decayed tooth 630
237 DFMASK-2 Cat- 2 - Face mask 6680
238 DFAGI-2 Cat- 2 - Filling amalgam / Glass ionomer 530
239 DFOCERN-2 Cat- 2 - Fixed Orthodontics ( Ceramic Braces ) - First 11430
installment
240 DFOCERS-2 Cat- 2 - Fixed Orthodontics ( Ceramic Braces ) - 590
241 DFOCER-2 Cat- 2 - Fixed orthodontics (ceramic braces) - Full amount 35820
112
242 DFOSSN-2 Cat- 2 - Fixed orthodontics (steel braces) - First installment 11430
243 DFOSS-2 Cat- 2 - Fixed orthodontics (steel braces) - Full amount 24610
244 DFOSSS-2 Cat- 2 - Fixed orthodontics (steel braces) - Subsequent 1660
installment
245 DFOPFM-2 Cat- 2 - Flap operation (full mouth) 9240
246 DFOPQ-2 Cat- 2 - Flap operation (per quadrant) 2570
247 DFSBG-2 Cat- 2 - Flap surgery with bone graft (per quadrant) 4100
248 DFAPP-2 Cat- 2 - Fluoride application 830
249 DFRENE-2 Cat- 2 - Frenectomy 830
250 DGTOMY-2 Cat- 2 - Gingivectomy (per quadrant) 2060
251 DGPLASTY-2 Cat- 2 - Gingivoplasty (per quadrant) 2570
252 DIMPACT-2 Cat- 2 - Impaction (Bony / soft tissue) 3090
253 DIDRAIN-2 Cat- 2 - Incision and drainage 1650
254 DIBIOP-2 Cat- 2 - Incisional biopsy 830
255 DIMFA-2 Cat- 2 - Inter - maxillary fixation with archbar 6160
256 DIWSPIL-2 Cat- 2 - Interdental wiring + splinting (per quadrant) 3090
257 DIAINJ-2 Cat- 2 - Intra articular injection 830
258 DJFCR-2 Cat- 2 - Jaw fracture closed reduction 7700
259 DLFREN-2 Cat- 2 - Lingual frenectomy 1240
260 DMFCC-2 Cat- 2 - Metal free ceramic crown 6160
261 DMIA-2 Cat- 2 - Mini - implant for anchorage (per implant) 5140
262 DMFA-2 Cat- 2 - Myfunctional Appliance - Twin Block 5450
263 DOBTU-2 Cat- 2 - Obturators 7700
264 DOPER-2 Cat- 2 - Operculectomy 1030
265 DPDAC-2 Cat- 2 - Partial dentures (acrylic) 1550
266 DATD-2 Cat- 2 - per additional tooth in denture 430
267 DPOS-2 Cat- 2 - Planning Orthognathic Surgery 4840
268 DPLCENE-2 Cat- 2 - Porcelain laminate veneers 3600
269 DPPSOCPN-2 Cat- 2 - Pre & post surgical orthodontics for cleft palate - 10250
First installment
270 DPPSOCP-2 Cat- 2 - Pre & post surgical orthodontics for cleft palate - 20500
Full amount
271 DPPSOCPS-2 Cat- 2 - Pre & post surgical orthodontics for cleft palate - 2570
272 DPSOSN-2 Cat- 2 - Pre & post surgical orthodontics for orthognathic 15530
273 DPSOS-2 Cat- 2 - Pre & post surgical orthodontics for orthognathic 28710
274 DPSOSS-2 Cat- 2 - Pre & post surgical orthodontics for orthognathic 1660
275 DPUCAP-2 Cat- 2 - Pulp capping 530
276 DPULPO-2 Cat- 2 - Pulpotomy 1030
277 DRME-2 Cat- 2 - Rapid maxillary expansion ( RME ) 6680
278 DRCB-2 Cat- 2 - Recementation of crown / bridge 430
279 DRAT-2 Cat- 2 - Reimplantation of avulsed tooth 2060
280 DREDENT-2 Cat- 2 - Relining of denture 630
281 DRORTHON-2 Cat- 2 - Removable orthodontics - First installment 9820
282 DRORTHO-2 Cat- 2 - Removable orthodontics - Full amount 16410
283 DRORTHOS-2 Cat- 2 - Removable orthodontics - Subsequent installment 1110
284 DRDENT-2 Cat- 2 - Repair of dentures 360
285 DRRBA-2 Cat- 2 - Retainers replacement (both arches) 1550
286 DRRPA-2 Cat- 2 - Retainers replacement (per arch) 780
113
287 DRCTANT-2 Cat- 2 - Root canal treatment ( RCT ) - anterior 1860
288 DRCTPOS-2 Cat- 2 - Root canal treatment ( RCT ) - posterior 2570
289 DRCAPIC-2 Cat- 2 - Root canal with Apicectomy 4100
290 DSFMOU-2 Cat- 2 - Scaling full mouth 530
292 DSMAINT-2 Cat- 2 - Space maintainers 2570
293 DSMODEL-2 Cat- 2 - Study model 280
294 DSSCFM-2 Cat- 2 - Subgingival scaling & curretage full mouth 2570
295 DSETO-2 Cat- 2 - Surgical extraction of tooth 2060
296 DSREMO-2 Cat- 2 - Suture removal 750
297 DENTEMP-2 Cat- 2 - Temporarization Placement of Permanent Crown 750
298 DTINLY-2 Cat- 2 - Tooth inlay 1550
299 DTEXCI-2 Cat- 2 - Tumour excision 6160
300 DVOSPL-2 Cat- 2 - Vacuum formed occlusal splint 2570
301 FPD3-2 Cat- 2 - Velaplast (Flexible Partial Dentures)- Upto 3 4900
302 FPD6-2 Cat- 2 - Velaplast (Flexible Partial Dentures) - Upto 6 8400
303 FPD9-2 Cat- 2 - Velaplast (Flexible Partial Dentures) - Upto or 10500
304 DACR-2 Cat- 2-Acrylic Crown 1650
305 DAPISURS-2 Cat- 2-Apical Surgery for tooth preservation subsequent 750
tooth
306 DBPEX-2 Cat- 2-Bone Preserving Dental Extraction 1650
307 DCAEX-2 Cat- 2-Canine Exposure 7500
308 DCERON-2 Cat- 2-Ceramic Onlay 12500
309 DCOSFILL-2 Cat- 2-Cosmetic Filling 2000
310 DREBOND-2 Cat- 2-Crown Rebonding 2500
311 DRECEM-2 Cat- 2-Crown Recementation 550
312 CUTOCR-2 Cat- 2-Cutting Out Old Crown 1550
313 DISTASG-2 Cat- 2-Deep Impaction 7500
314 DEMAXV-2 Cat- 2-E Max Veneer/ Crown 15000
315 DFLAP-2 Cat- 2-Flap Surgery per Segment 2550
316 DORTHTR-2 Cat- 2-Orthodontic Trainer 7500
317 DLPDEN3-2 Cat- 2-Partial Denture Lucitone upto 3 Teeth 5500
320 PITFISRE-2 Cat- 2-Pit and Fissure Sealant 1000
321 DPOST-2 Cat- 2-Post and Core 1500
322 DRISATS-2 Cat- 2-Reimplantation and Cosmetic splinting of Avulsed 1550
Subsequent Tooth
323 DRISAT-2 Cat- 2-Reimplantation and Cosmetic splinting of Avulsed 11500
Tooth
324 DITEX4F-2 Cat- 2-Teeth Express on 4 Implants First Stage Per Arch 125000
325 DITEX4S-2 Cat- 2-Teeth Express on 4 Implants Second Stage Per Arch 125000
326 DITEX6F-2 Cat- 2-Teeth Express on 6 Implants First Stage Per Arch 150000
327 DITEX6S-2 Cat- 2-Teeth Express on 6 Implants Second Stage Per Arch 220000
328 LADC2 Local Anaesthesia Category 2 - Dental 100
329 DCERLAM3 Cat- 3 - Ceramic laminate 1550
330 DCOMPVEN3 Cat- 3 - Composite veneers 670
331 DAPISUR-3 Cat- 3 - Apical Surgery for tooth preservation 900
332 DBP-3 Cat- 3 - Bite plate 890
114
333 DBT-3 Cat- 3 - Bleaching of teeth 2210
334 DCPD-3 Cat- 3 - Cast partial dentures (metal casting) 1990
335 DCULAR-3 Cat- 3 - Closure of upper & lower anterior spaces + 5280
retainers
336 DENCDUL-3 Cat- 3 - Complete denture upper and lower (both) 3960
337 DENCDUOL-3 Cat- 3 - Complete denture upper or lower (either one) 2210
338 DENCOSCL-3 Cat- 3 - Cosmetic Cleaning & Polishing 500
339 DCOSFILL-3 Cat- 3 - Cosmetic Filling 700
340 DCOSPRES-3 Cat- 3 - Cosmetic Preservation of Tooth 900
341 DCBC-3 Cat- 3 - Crown / Bridge per unit (ceramic) 1550
342 DCBM-3 Cat- 3 - Crown / Bridge per unit (metal) 890
343 DDIFS-3 Cat- 3 - Dental implant (first stage) 3510
344 DDIMP4-3 Cat- 3 - Dental implant (second stage) 3090
345 NGA-3 Cat- 3 - Dental Night Guard Appliance 1110
346 DFMASK-3 Cat- 3 - Face mask 2860
347 DFOCERN-3 Cat- 3 - Fixed Orthodontics ( Ceramic Braces ) - First 5860
installment
348 DFOCER-3 Cat- 3 - Fixed orthodontics (ceramic braces) - Full amount 15370
349 DFOSSN-3 Cat- 3 - Fixed orthodontics (steel braces) - First installment 5860
350 DFOSS-3 Cat- 3 - Fixed orthodontics (steel braces) - Full amount 10560
351 DFOSSS-3 Cat- 3 - Fixed orthodontics (steel braces) - Subsequent 590
installment
352 DMFCC-3 Cat- 3 - Metal free ceramic crown 2640
353 DMIA-3 Cat- 3 - Mini - implant for anchorage (per implant) 2210
354 DMFA-3 Cat- 3 - Myfunctional Appliance - Twin Block 3030
355 DOBTU-3 Cat- 3 - Obturators 3310
356 DPDAC-3 Cat- 3 - Partial dentures (acrylic) 670
357 DATD-3 Cat- 3 - per additional tooth in denture 190
358 DPLCENE-3 Cat- 3 - Porcelain laminate veneers 1550
359 DPPSOCPN-3 Cat- 3 - Pre & post surgical orthodontics for cleft palate - 5860
First installment
360 DPPSOCP-3 Cat- 3 - Pre & post surgical orthodontics for cleft palate - 8790
Full amount
361 DPPSOCPS-3 Cat- 3 - Pre & post surgical orthodontics for cleft palate - 750
362 DPSOSN-3 Cat- 3 - Pre & post surgical orthodontics for orthognathic 7620
363 DPSOS-3 Cat- 3 - Pre & post surgical orthodontics for orthognathic 12310
364 DPSOSS-3 Cat- 3 - Pre & post surgical orthodontics for orthognathic 590
365 DRME-3 Cat- 3 - Rapid maxillary expansion ( RME ) 2860
366 DRCB-3 Cat- 3 - Recementation of crown / bridge 190
367 DREDENT-3 Cat- 3 - Relining of denture 280
368 DRORTHON-3 Cat- 3 - Removable orthodontics - First installment 4400
369 DRORTHO-3 Cat- 3 - Removable orthodontics - Full amount 7040
370 DRORTHOS-3 Cat- 3 - Removable orthodontics - Subsequent installment 450
371 DRDENT-3 Cat- 3 - Repair of dentures 170
372 DRRBA-3 Cat- 3 - Retainers replacement (both arches) 670
373 DRRPA-3 Cat- 3 - Retainers replacement (per arch) 340
375 DSMAINT-3 Cat- 3 - Space maintainers 1110
376 DSMODEL-3 Cat- 3 - Study model 120
115
377 DENTEMP-3 Cat- 3 - Temporarization Placement of Permanent Crown 530
378 DVOSPL-3 Cat- 3 - Vacuum formed occlusal splint 1110
379 FPD3-3 Cat- 3 - Velaplast (Flexible Partial Dentures)- Upto 3 2100
380 FPD6-3 Cat- 3 - Velaplast (Flexible Partial Dentures) - Upto 6 3600
381 FPD9-3 Cat- 3 - Velaplast (Flexible Partial Dentures) - Upto or 4500
382 DACR-3 Cat- 3-Acrylic Crown 1250
383 DAPISURS-3 Cat- 3-Apical Surgery for tooth preservation subsequent 250
tooth
384 DBPEX-3 Cat- 3-Bone Preserving Dental Extraction 0
385 DCAEX-3 Cat- 3-Canine Exposure 0
386 DRECEM-3 Cat- 3-Crown Recementation 190
387 CUTOCR-3 Cat- 3-Cutting Out Old Crown 300
388 DEMAXV-3 Cat- 3-E Max Veneer/ Crown 0
389 DEMPLSTY-3 Cat- 3-Enameloplasty 200
393 PITFISRE-3 Cat- 3-Pit and Fissure Sealant 300
394 DPOST-3 Cat- 3-Post and Core 250
395 DRISATS-3 Cat- 3-Reimplantation and Cosmetic splinting of Avulsed 300
Subsequent Tooth
396 DRISAT-3 Cat- 3-Reimplantation and Cosmetic splinting of Avulsed 750
Tooth
397 LADC3 Local Anaesthesia Category 3 - Dental 70
398 CERBR7000 Ceramic Braces Rs - 10250 10250
399 DENLAB1000 Dental Lab Charges Rs - 1330 1330 1330
405 DENLAB2000 Dental Lab Charges Velaplast Rs - 2300 2300 2300
Dental Procedures All Category

Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
BMSDHC BILIARY MICROLITH STUDY
OS (DOCTOR FEE + HOSPITAL
CHARGES)
BMSHC Biliary microlith study - Additional hospital 6200 6200 3100 2490 1860
charges
BMSDF Biliary microlith study - Doctor fee 17730 17730 8870 7100 5320
BMSHCPACS Biliary microlith study - For PACS - NOT FOR
BILLING PURPOSE
BTDFHCO BEHAVIOUR THERAPY ( 50

S MINUTE SESSION ) (DOCTOR
FEE + HOSPITAL CHARGES)
BET Behaviour therapy ( 50 minute session ) - 1610 1610 800 640 480 800 410
Doctor Fee
116
BETPSC Behaviour therapy ( 50 minute session ) - 420 420 210 170 130 210 110
hospital charges
CSPTOS Dental - Cavity sealant (per

tooth)- INPATIENT Doctor &
Hospital charges
CSPTHC Dental - Cavity sealant (per tooth) - Hospital 180 180 90 70 50
Charges
CSPT-1 Dental Category 1 - Cavity sealant (per 940 940
tooth)
DABJOS Dental - Alveolectomy (both

jaws)- INPATIENT Doctor &
Hospital charges
DABJHC Dental - Alveolectomy (both jaws) - Hospital 1470 1470 740 590 440
Charges
DABJAW-1 Dental Category 1 - Alveolectomy (both 7330 5850
jaws)
DAFDOS Dental - Archbar fixation

dentoalveolar fracture
segment- INPATIENT Doctor &
Hospital charges
DAFDHC Dental - Archbar fixation dentoalveolar 900 900 450 360 270
fracture segment - Hospital Charges
DAFDDS-1 Dental Category 1 - Archbar fixation 4390 2930
dentoalveolar fracture segment
DALVOS Dental - Alveoloplasty-
INPATIENT Doctor & Hospital
charges
DALVHC Dental - Alveoloplasty - Hospital Charges 460 460 230 190 140
DALVPLS1 Dental Category 1 - Alveoloplasty 2200 1460
DAOJOS Dental - Alveolectomy (one

jaws)- INPATIENT Doctor &
Hospital charges
DAOJHC Dental - Alveolectomy (one jaws) - Hospital 750 750 370 300 220
Charges
DAOJAW-1 Dental Category 1 - Alveolectomy (one jaws) 3660 2930
DAPAOS Dental - Apicectomy per

additional tooth- INPATIENT
Doctor & Hospital charges
DAPAHC Dental - Apicectomy per additional tooth - 460 460 230 190 140
Hospital Charges
DAPAT-1 Dental Category 1 - Apicectomy per 2200
additional tooth
DAPIOS Dental - Apicectomy

(Endodontics)- INPATIENT
DAPIHC Dental - Apicectomy (Endodontics) - Hospital 1190 1190 590 470 350
Charges
DAPICE-1 Dental Category 1 - Apicectomy 5850 3990
(Endodontics)
DARCOS Dental - Apexification + Root
canal treatment ( RCT )-
charges
DARCHC Dental - Apexification + Root canal 750 750 370 300 220
treatment ( RCT ) - Hospital Charges
DARCT-1 Dental Category 1 - Apexification + Root 3660 3330
canal treatment ( RCT )
DARTOS Dental - Arthocentesis of TMJ-

charges
DARTHC Dental - Arthocentesis of TMJ - Hospital 1470 1470 740 590 440
Charges
DARTMJ-1 Dental Category 1 - Arthocentesis of TMJ 7330 5450
117
DATEOS Dental - All teeth extractions
(both jaws)- INPATIENT Doctor
& Hospital charges
DATEHC Dental - All teeth extractions (both jaws) - 2350 2350 1180 950 710
Hospital Charges
DATEXT-1 Dental OPD Category 1 - All teeth 11720 8790
extractions (both jaws)
DAULOS Dental - Apicectomy ( Under
LA )- INPATIENT Doctor &
Hospital charges
DAULHC Dental - Apicectomy ( Under LA ) - Hospital 1190 1190 590 470 350
Charges
DAULA-1 Dental Category 1 - Apicectomy ( Under LA ) 5850 4390
DCFIOS Dental - Composite filling-

charges
DCFIHC Dental - Composite filling - Hospital Charges 460 460 230 190 140
DCFILL-1 Dental Category 1 - Composite filling 2200 2000
DCUROS Dental - Curettage (per

quadrant)- INPATIENT Doctor
& Hospital charges
DCURHC Dental - Curettage (per quadrant) - Hospital 750 750 370 300 220
Charges
DCURRE-1 Dental Category 1 - Curettage (per 3660 1330
quadrant)
DCYSOS Dental - Cyst Enucleation /

Marsupialisation- INPATIENT
DCYSTMAR-1 Dental OPD Category 1 - Cyst Enucleation / 11720 5850
Marsupialisation
DDIFCOS Dental - Dental implant (
complete )- INPATIENT Doctor
& Hospital charges
DDIFCHC Dental - Dental implant ( complete ) - 8780 8780 4390 3510 2630
Hospital Charges
DDIFS-1-C Dental OPD Category 1 - Dental implant ( 66550 48400
complete )
DDIFOS Dental - Dental implant (first

stage)- INPATIENT Doctor &
Hospital charges
DDIFHC Dental - Dental implant (first stage) - 5850 5850 2930 2340 1760
Hospital Charges
DDIFS-1 Dental OPD Category 1 - Dental implant 29280 11720
(first stage)
DDIMOS Dental - Dental implant

(second stage)- INPATIENT
DDIMHC Dental - Dental implant (second stage) - 2930 2930 1460 1170 880
Hospital Charges
DDIMP2-1 Dental OPD Category 1 - Dental implant 14640 10250
(second stage)
DDTMOS Dental - Dislocation of TMJ-

charges
DDTMHC Dental - Dislocation of TMJ - Hospital 750 750 370 300 220
Charges
DDTMJ-1 Dental Category 1 - Dislocation of TMJ 3660 3030
DEB-OS Dental - Excisional biopsy-

charges
DEB-HC Dental - Excisional biopsy - Hospital Charges 900 900 450 360 270
118
DEB-1 Dental OPD Category 1 - Excisional biopsy 4390 2340
DEFDOS Dental - Extraction of fractured

/ decayed tooth- INPATIENT
DEFDHC Dental - Extraction of fractured / decayed 310 310 150 120 90
tooth - Hospital Charges
DEFDTO-1 Dental OPD Category 1 - Extraction of 1460 880
fractured / decayed tooth
DEIPDHC DENTAL EXTRACTION (

OS INPATIENT ) (DOCTOR FEE +
HOSPITAL CHARGES)
DEAHC Dental extraction ( inpatient ) - Additional 130 130 70 60 40
hospital charges
DEDF Dental extraction ( inpatient ) - Doctor fee 1190 1190 590 470 350
DEPFOS Dental - Excision of pericoronal

flap- INPATIENT Doctor &
Hospital charges
DEPFHC Dental - Excision of pericoronal flap - 310 310 150 120 90
Hospital Charges
DEPF-1 Dental OPD Category 1 - Excision of 1460 1460
pericoronal flap
DFAGOS Dental - Filling amalgam /

Glass ionomer- INPATIENT
DFAGHC Dental - Filling amalgam / Glass ionomer - 220 220 110 90 70
Hospital Charges
DFAGI-1 Dental Category 1 - Filling amalgam / Glass 2240 1600
ionomer
DFAPOS Dental - Fluoride application-

charges
DFAPHC Dental - Fluoride application - Hospital 240 240 120 100 70
Charges
DFAPP-1 Dental Category 1 - Fluoride application 1180 1180
DFMOOS Dental - Fracture mandible

open reduction under LA-
charges
DFMOHC Dental - Fracture mandible open reduction 4400 4400 2200 1760 1320
under LA - Hospital Charges
DFMORLA-1 Dental Category 1 - Fracture mandible open 21970 18150
reduction under LA ( Cost of Plates & screws
etc. )
DFOPFOS Dental - Flap operation (full

mouth)- INPATIENT Doctor &
Hospital charges
DFOPFHC Dental - Flap operation (full mouth) - 2930 2930 1460 1170 880
Hospital Charges
DFOPFM-1 Dental OPD Category 1 - Flap operation (full 14640 13180
mouth)
DFOPOS Dental - Flap operation (per

& Hospital charges
DFOPHC Dental - Flap operation (per quadrant) - 900 900 450 360 270
Hospital Charges
DFOPQ-1 Dental OPD Category 1 - Flap operation (per 4390 3660
quadrant)
DFREOS Dental - Frenectomy-

charges
DFREHC Dental - Frenectomy - Hospital Charges 460 460 230 190 140
DFRENE-1 Dental OPD Category 1 - Frenectomy 2200 1180
119
DFSBOS Dental - Flap surgery with bone
graft (per quadrant)-
charges
DFSBHC Dental - Flap surgery with bone graft (per 1190 1190 590 470 350
quadrant) - Hospital Charges
DFSBG-1 Dental OPD Category 1 - Flap surgery with 5850 5850
bone graft (per quadrant)
DGPLOS Dental - Gingivoplasty (per

& Hospital charges
DGPLHC Dental - Gingivoplasty (per quadrant) - 900 900 450 360 270
Hospital Charges
DGPLASTY-1 Dental OPD Category 1 - Gingivoplasty (per 4390 3660
quadrant)
DGTOOS Dental - Gingivectomy (per

& Hospital charges
DGTOHC Dental - Gingivectomy (per quadrant) - 750 750 370 300 220
Hospital Charges
DGTOMY-1 Dental OPD Category 1 - Gingivectomy (per 3660 2930
quadrant)
DIAIOS Dental - Intra articular

injection- INPATIENT Doctor &
Hospital charges
DIAIHC Dental - Intra articular injection - Hospital 240 240 120 100 70
Charges
DIAINJ-1 Dental OPD Category 1 - Intra articular 1180 1180
injection
DIBIOS Dental - Incisional biopsy-

charges
DIBIHC Dental - Incisional biopsy - Hospital Charges 460 460 230 190 140
DIBIOP-1 Dental OPD Category 1 - Incisional biopsy 2200 1180
DIDROS Dental - Incision and drainage-

charges
DIDRHC Dental - Incision and drainage - Hospital 620 620 310 240 190
Charges
DIDRAIN-1 Dental OPD Category 1 - Incision and 2930 2340
drainage
DIFFOS Dental - Iodoform Dressing for

CYST- INPATIENT Doctor &
Hospital charges
DIFFHC Dental - Iodoform Dressing for CYST - 130 130 70 60 40
Hospital Charges
DIFF-1 Dental Category 1 - Iodoform Dressing for 590 530
CYST
DIMFOS Dental - Inter - maxillary
fixation with archbar-
charges
DIMFHC Dental - Inter - maxillary fixation with 2070 2070 1030 830 620
archbar - Hospital Charges
DIMFA-1 Dental Category 1 - Inter - maxillary fixation 10250 8790
with archbar
DIMPOS Dental - Impaction (Bony / soft

tissue)- INPATIENT Doctor &
Hospital charges
DIMPHC Dental - Impaction (Bony / soft tissue) - 1470 1470 740 590 440
Hospital Charges
DIMPACT-1 Dental OPD Category 1 - Impaction (Bony / 7330 6660
soft tissue)
120
DIWSOS Dental - Interdental wiring +
splinting (per quadrant)-
charges
DIWSHC Dental - Interdental wiring + splinting (per 900 900 450 360 270
quadrant) - Hospital Charges
DIWSPIL-1 Dental OPD Category 1 - Interdental wiring 4390 4390
+ splinting (per quadrant)
DJFCOS Dental - Jaw fracture closed

reduction- INPATIENT Doctor &
Hospital charges
DJFCHC Dental - Jaw fracture closed reduction - 2350 2350 1180 950 710
Hospital Charges
DJFCR-1 Dental OPD Category 1 - Jaw fracture closed 11720 10990
reduction
DLFROS Dental - Lingual frenectomy-

charges
DLFRHC Dental - Lingual frenectomy - Hospital 460 460 230 190 140
Charges
DLFREN-1 Dental OPD Category 1 - Lingual frenectomy 2200 1770
DMIAOS Dental - Mini - implant for

anchorage (per implant)-
charges
DMIAHC Dental - Mini - implant for anchorage (per 1760 1760 880 700 530
implant) - Hospital Charges
DMIA-1 Dental OPD Category 1 - Mini - implant for 8790 7330
anchorage (per implant)
DNBNOS Dental - Nerve block in
Neuralgias- INPATIENT Doctor
& Hospital charges
DNBNHC Dental - Nerve block in Neuralgias - Hospital 900 900 450 360 270
Charges
DNBN-1 Dental Category 1 - Nerve block in 4390 3630
Neuralgias
DOACOS Dental - Oro antral
communication closure -
charges
DOACHC Dental - Oro antral communication closure - 4110 4110 2060 1650 1240
Hospital Charges
DOACC-1 Dental Category 1 - Oro antral 20490
communication closure
DOBTOS Dental - Obturators-

charges
DOBTHC Dental - Obturators - Hospital Charges 2350 2350 1180 950 710
DOBTU-1 Dental Category 1 - Obturators 11720 10990
DOPEOS Dental - Operculectomy-

charges
DOPEHC Dental - Operculectomy - Hospital Charges 310 310 150 120 90
DOPER-1 Dental Category 1 - Operculectomy 1460 1460
DPIOOS Dental - Placentrax Inj for

OSMF- INPATIENT Doctor &
Hospital charges
DPIOHC Dental - Placentrax Inj for OSMF - Hospital 240 240 120 100 70
Charges
DPIOSMF-1 Dental Category 1 - Placentrax Inj for OSMF 1180
121
DPUCOS Dental - Pulp capping-
charges
DPUCHC Dental - Pulp capping - Hospital Charges 220 220 110 90 70
DPUCAP-1 Dental Category 1 - Pulp capping 2240 1330
DPULOS Dental - Pulpotomy-

charges
DPULHC Dental - Pulpotomy - Hospital Charges 310 310 150 120 90
DPULPO-1 Dental Category 1 - Pulpotomy 1460 1460
DRATOS Dental - Reimplantation of

avulsed tooth- INPATIENT
DRATHC Dental - Reimplantation of avulsed tooth - 620 620 310 240 190
Hospital Charges
DRAT-1 Dental OPD Category 1 - Reimplantation of 2930 2930
avulsed tooth
DRCAOS Dental - Root canal with
Apicectomy- INPATIENT Doctor
& Hospital charges
DRCAHC Dental - Root canal with Apicectomy - 1470 1470 740 590 440
Hospital Charges
DRCAPIC-1 Dental Category 1 - Root canal with 7330 5850
Apicectomy
DRCTFOS Dental - Root canal treatment (

RCT ) - anterior- INPATIENT
DRCTFHC Dental - Root canal treatment ( RCT ) - 750 750 370 300 220
anterior - Hospital Charges
DRCTANT-1 Dental Category 1 - Root canal treatment ( 3660 2930
RCT ) - anterior
DRCTOS Dental - Root canal treatment (

RCT ) - posterior- INPATIENT
DRCTHC Dental - Root canal treatment ( RCT ) - 1190 1190 590 470 350
posterior - Hospital Charges
DRCTPOS-1 Dental Category 1 - Root canal treatment ( 5850 3990
RCT ) - posterior
DRFWOS Dental - Removal of

Frontosuspension wiring-
charges
DRFWHC Dental - Removal of Frontosuspension 1190 1190 590 470 350
wiring - Hospital Charges
DRFW-1 Dental Category 1 - Removal of 5850
Frontosuspension wiring
DROCOS Dental - Removal of old
crown/bridge/unit- INPATIENT
DROCHC Dental - Removal of old crown/bridge/unit - 180 180 90 70 50
Hospital Charges
DROCBU-1 Dental Category 1 - Removal of old 740
crown/bridge/unit
DRPMOS Dental - Removal of plates of

mandible and maxilla ( Under
LA )- INPATIENT Doctor &
Hospital charges
DRPMHC Dental - Removal of plates of mandible and 2350 2350 1180 950 590
maxilla ( Under LA ) - Hospital Charges
DRPMMLA-1 Dental Category 1 - Removal of plates of 11720
mandible and maxilla ( Under LA )
122
DRPTOS Dental - Extraction (per tooth)-
charges
DRPTHC Dental - Extraction (per tooth) - Hospital 180 180 90 70 50
Charges
DRPTO-1 Dental OPD Category 1 - Extraction (per 740 590
tooth)
DSETOS Dental - Surgical extraction of
tooth- INPATIENT Doctor &
Hospital charges
DSETHC Dental - Surgical extraction of tooth - 620 620 310 240 190
Hospital Charges
DSETO-1 Dental OPD Category 1 - Surgical extraction 2930 2930
of tooth
DSFMOS Dental - Scaling full mouth-
charges
DSFMHC Dental - Scaling full mouth - Hospital 460 460 230 190 140
Charges
DSFMOU-1 Dental Category 1 - Scaling full mouth 2200 2000
DSPROS Dental - Splint Removal-

charges
DSPRHC Dental - Splint Removal - Hospital Charges 310 310 150 120 90
DSPREMO1 Dental Category 1 - Splint Removal 1460 1460
DSREOS Dental - Suture removal-

charges
DSREHC Dental - Suture removal - Hospital Charges 180 180 90 70 50
DSREMO-1 Dental OPD Category 1 - Suture removal 1460 1030
DSSCOS Dental - Subgingival scaling &

curretage full mouth-
charges
DSSCHC Dental - Subgingival scaling & curretage full 900 900 450 360 270
mouth - Hospital Charges
DSSCFM-1 Dental Category 1 - Subgingival scaling & 4390 3660
curretage full mouth
DTEXOS Dental - Tumour excision-

charges
DTEXHC Dental - Tumour excision - Hospital Charges 2930 2930 1460 1170 880
DTEXCI-1 Dental OPD Category 1 - Tumour excision 14640 8790
DZCFOS Dental - Zygonatic Complex

Fracture under LA- INPATIENT
DZCFHC Dental - Zygonatic Complex Fracture under 2930 2930 1460 1170 880
LA - Hospital Charges
DZCFULA-1 Dental Category 1 - Zygonatic Complex 14640
Fracture under LA
Dermatology Procedure Charges
Code Description POPD GOPD

SKINCP Skin - Corn paring 700 420
SKINCML Skin Cauterisation - Multiple lesions 2380 1430
SKINCSL Skin Cauterisation - Single lesion 1470 880
SKINCTL Skin Cauterisation - Two lesions 2420 1450
123
SKINCRML Skin Cryosurgery - Multiple Lesions 4200 2520
SKINCRSL Skin Cryosurgery - Single Lesion 1680 1010
SKINCRTL Skin Cryosurgery - Two Lesions 2630 1580
SKINGSP Skin OPD - Gram Stain procedure 420 250
SKINIIP Skin OPD - Intralesional injection procedure 700 420
SKINKPP Skin OPD - KOH preparation procedure 500 300
SKINPUVA Skin OPD - PUVA Therapy 420 250
SKINBP Skin OPD - Skin biopsy procedure 2940 1760
SKINSPTP Skin OPD - Skin patch testing procedure 2100 1260
SKINSPTPAC Skin OPD - Skin patch testing procedure - charges for 110 70
additional antigen
SKINSMAFB Skin OPD - Slit smear for AFB procedure 840 500
SKINTACML Skin OPD - Trichloacetia acid cauterisation - Multiple 3150 1890
lesions
SKINTACSL Skin OPD - Trichloacetia acid cauterisation - Single lesion 740 440
SKINTACTL Skin OPD - Trichloacetia acid cauterisation - Two lesions 1470 880
SKINSFP Skin OPD scraping for fungus procedure 320 190
ENT Procedure Charges
Code Description POPD GOPD

IMPED Impedance Audiometry 650 400
NASENDO Nasal Endoscopy 1900 1100
PTDHS Position Testing ( Dix - Hallpike / Head - Shaking ) GOPD 350
AUDIOM Pure tone audiometry ( PTA ) 600 350
RPEM Re-Position ( Epley's ) Manouvere GOPD 600
ENT Therapy Charges

Cat-1D Single/
Cat-2 Beded
Premium/
4 Bedded
GOPD
POPD
Cat-3
Suite
Code Description
STHER Speech Therapy (per sitting) 580 560 340 560 340
SPEECHC Speech Therapy per 10 Session - Hospital 4970 2980 4970 2980
Charges
SPSINHC Speech Therapy specialised for singers - 1660 1000 1660 1000
Hospital Charges
ENTINHC Tinnitus retraining therapy - Hospital Charges 560 340 560 340
ENT charges
Code Description POPD GOPD ALL CAT

DCHFENT Dressing charges for ENT 270
EUMCH Examination under microscope charges 290
TTCCH Tracheostomy tube change charges 710
ENGHC Videonystagmography (VNG)(Hospital Fee) 3310 3310
ENT Procedures
124
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
ASEHOS Speech Assessment (
Endoscopic Laryngology &
Stroboscopy ) - ( Doctor fee +
Hospital Share )
ASEDF Speech Assessment ( Endoscopic 3310
Laryngology & Stroboscopy ) - Doctor fee
ASEHC Speech Assessment ( Endoscopic 2200 3300
Laryngology & Stroboscopy ) - Hospital
Share
ASSRDH Auditory Steady State

Response( ASSR )(DOCTOR FEE
+ HOSPITAL CHARGES)
ASSR Auditory Steady State Response ( ASSR ) - 4330 2600
Doctor fee
ASSRHA Auditory Steady State Response ( ASSR ) - 870 520
hospital amount
DBHLDH Detailed BERA for hearing

loss(DOCTOR FEE + HOSPITAL
CHARGES)
DBHL Detailed BERA for hearing loss - Doctor fee 2780 1670
DBHLHA Detailed BERA for hearing loss- hospital 560 330
amount
DPOAEDH Distortion Product Otoacoustic

Emisssion( DPOAE )(DOCTOR
DPOAE Distortion Product Otoacoustic Emisssion ( 1240 740
DPOAE ) - Doctor fee
DPOAEHA Distortion Product Otoacoustic Emisssion ( 250 150
DPOAE ) - hospital amount
ELDHOS Endoscopic Laryngology

(Doctor fee + Hospital Share)
ELDF Endoscopic Laryngology - Doctor fee 2210
SAELSH Endoscopic Laryngology - Hospital Share 1110 1990
ENGOS Videonystagmography (VNG)

(Doctor fee + Hospital fee)
ENGDF Videonystagmography (VNG) (Doctor Fee) 4970 4970 4140 3310 2480 3310
ENGHC Videonystagmography (VNG)(Hospital Fee) 4970 4970 4140 3310 2480 3310 3310
ENTBIOP ENT Biopsy (Doctor fee +

OS Hospital Charges)
ENTBIOPDF ENT Biopsy - Doctor fee 5000
ENTBIOPHC ENT Biopsy - Hospital Charges 2500 4500
ENTINJPO ENT Injection Botox / Steroid

S (Doctor fee + Hospital Charges)
ENTINJPDF ENT Injection Botox / Steroid - Doctor fee 4000
ENTINJPHC ENT Injection Botox / Steroid - Hospital fee 2000 3600
ENTOPDA ENT Augmentation

UGOS Laryngoplasty (Doctor fee +
Hospital Charges)
ENTOPDAUGD ENT Augmentation Laryngoplasty - Doctor 6000
F fee
ENTOPDAUGH ENT Augmentation Laryngoplasty - Hospital 3000 5400
C Charges
ENTOPDS ENT Stricture Dilatation

TRICOS (Doctor fee + Hospital Charges)
125
ENTOPDSTRIC ENT Stricture Dilatation - Doctor fee 8000
DF
ENTOPDSTRIC ENT Stricture Dilatation - Hosital Charges 4000 7200
HC
ENTOPDT ENT - Diagnostic TNE (Doctor

NEOS fee + Hospital Charges)
ENTOPDTNED ENT - Diagnostic TNE - Doctor fee 3000
F
ENTOPDTNEH ENT - Diagnostic TNE - Hospital Charges 1500 2700
C
ENTOPPN ENT OPD - Posterior Nasal

OS Packing (Doctor fee + Hospital
charges)
ENTOPPNDF ENT OPD - Posterior Nasal Packing - Doctor 5450
fee
ENTOPPNHC ENT OPD - Posterior Nasal Packing - 550
Hospital Charges
ENTSKINP ENT - Adult Skin Prick Test

ROS (Doctor Fee + Hospital
Charges)
ENTSKINDF ENT - Adult Skin Prick Test - Doctor Charge 2000 2000
ENTSKIN ENT - Adult Skin Prick Test - Hospital Charge 1500 1500
OTOESDH OTO-ACOUSTIC EMISSION TEST

CHOS FOR NEWBORN BABIES
CHARGES)
OETNBDF OTO-acoustic emission test for newborn 940 940 470 380 280
babies - Doctor fee
OETNBHC OTO-acoustic emission test for newborn 500 500 250 200 150
babies - Hospital charges
VAOS VOICE ANALYSIS
VACDC Voice analysis - Clinical doctor charges 2900 1440
VAHC Voice analysis - Hospital Charges 5780 2900
VASPC Voice analysis - Speech pathologists charges 2900 1440
Hospital Charges
Bedside procedure charges

All Category
Cat 1B Suite
Cat 1A-Pre/
Single Bed
2 Bedded
Casualty
Cat-1D
4 Bed
Cat-2
Cat-3

1 ALTEST Allergy testing in casualty / Prick testing for ant 100 90
2 ANINFCH Antibiotic infusion charges 340 270
3 BCCHC Baby care charges ( while baby is with mother i 1020 1020 820 610
4 DRESSCAS Dressing in casualty 240 220
5 HIDORFEOS HIGH DOSE CHEMOTHERAPY AND RESCUE - Ho 22370 11190 8950 6710
6 ICPHC ICP Monitoring Charges (Hospital charges) 2500 1250 1000 750
7 INJADMCH Injection administration charges 120 120
8 RYLETI Ryle's tube insertion in casualty 250 220
9 STSUTREM Stitch / Suture removal 250 220
10 STREMDRESS Suture removal / Dressings / Stent removal in D 180
11 TRACH Tracheostomy tube changing charges in casual 340 270
12 URCATH Urinary Foley's catheterisation in casualty 270
126
KTP Charges
13 KTPCHA KTP Service Charges 10680 5340 4010 2680 4850
Resuscitation charges
14 NEWBRNRES Resuscitation charges of newborn baby followi 5070 2540 1910 1280
15 NEWBRNRES Resuscitation charges of newborn baby followi 4010 2020 1520 1010
Bedside procedure charges (Glucometry)

GLUCH Glucometry test charges ( Also order stock item with this ) 90 50
Dressing set charges

ASPSER Aspiration set usage charges 380
BGAMJEER Big Gamjee Roll 120
BMSET Bone marrow set usage charges 400
DRESSET Dressing set usage charges 200
EYESET Eye set usage charges 420
GAMJEEP Gamjee Pad 20
GAMJEER Gamjee Roll 80
GAUZEP Gauze Pack ( packet of 5) 30
ICDBOTTLE Intercostal chest tube ( ICD ) bottle charges 400
KBSET Kidney biopsy set usage charges 410
LBSET Liver biopsy set usage charges 400
LPSET Lumbar puncture set usage charges 400
MAJDSET Major dressing set usage charges 290
MYELOSET Myelogram set usage charges 400
PEXTRSET Paediatric exchange transfusion set usage charges 400
PDSET Peritoneal dialysis ( PD ) set usage charges 400
TROCSET Trocar and cannula set usage charges 1880
CATHSET Urinary catheteristion set 400
Dressing set charges (CVP line)

COSET Cut open ( venesection ) / suturing set usage charges 400
Dressing set charges (in package)

ANGIOSET Angiogram set usage charges 380
Dressing set charges (Tracheostomy)

TRACSET Tracheostomy set usage charges 400
Hospital charges
ALPTRDL ALPHA TRACELL DELUX CHARGES 450
ALPTRA ALPHA TRACELL CHARGES 250
ALPXC ALPHA XCELL CHARGES 450
APAC Angiography Pool Account 2100
127
ACAC Angioplasty combo a/c 3150
AULG AUTOLOGIC CHARGES 510
ECMOHC ECMO - Maintenance Charges Per Day (Cardiac surgery) 11580
INTERCH Interpreter charges 1390
KTPSH KTP Surcharge - Hospital charges 5550
LCLL Laser Charges for Lesion ( Large ) 5090
LCLS Laser Charges for Lesion ( Small Size ) 2550
LCLM Laser Charges for Lesions ( Midium Size ) 3820
NIM NIMBUS CHARGES 640
PLASAC Plaster Application / Removal 210 210
SECARHC Screening Echo Cardiology - Hospital Charges 1070
UROSPCHC SPC - Hospital Charges 950 6240
SUPAR SUPAR TEST CHARGES 640
LAVDMC Temporary LVAD - Maintenance Charges Per Day 11580
UROTESA Tesa - Hospital Charges 470 3120
USAVFHS Ultrasound guided venous mapping for I/J catheter insertion 600
and A.V Fistula creation - Machine Charges
Hospital Charges CIC

HCCIC Home Collection Sample Charges 110
Hospital charges for Diabetic Foot Clinic

BIOTHES Biothesiometery 250
DIFOMIPOP Diabetic foot - minor outpatient procedure (hospital charges) 1300 1300 1300
RHC
TOEBRAIND Toe Brachial Index 250 250
Hospital charges for haemodialysis

HDFHC Online Hemodiafiltration (HDF) (5008S) - Hospital Charges 3680 3680
PLEXHD Plasma exchange procedure by cell separator (Dialysis) 21000 21000
Hospital service charges for thalassemia patient

IPRTH Hospital service charges for thalassemia patients 700
MRD Charges

MRDFEE Correction - MRD Record 1000
MRDCHG MRD Charges 500 (IP)
200 (DC)
Stoma care charges

STOMCARE Stoma care charge 220
CHRG
STOMAC3 Stoma care charges ( Complex ) 410
STOMAC1 Stoma care charges ( Easy ) 180
STOMAC4 Stoma care charges ( Extra Complex ) 590
STOMAC2 Stoma care charges ( Normal ) 340
128
Operations
Access Procedures For Dialysis
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1 OP2911 Acute vascular access for dialysis ( in OT ) 21340 10670 8540 6400
2 AVFISSF AV Fistula - Surgen Fee
3 OP3397 Basilic vein transposition in OT 64020 32010 25610 19210
4 OP0240 Brachio - basilic loop AV graft for haemodialysis 42660 21330 17060 12800
5 OP0242 Brachio - basilic straight ( above elbow ) AV graft for 42660 21330 17060 12800
haemodialysis
6 OP0239 Brachio - cephalic loop AV graft for haemodialysis 42660 21330 17060 12800
7 OP0241 Brachio - cephalic straight ( above elbow ) AV graft for 42660 21330 17060 12800
haemodialysis
8 OP0245 Brachio AV fistula at elbow for haemodialysis 30700 15350 12280 9210
9 OP0443 CAPD placement ( laparosopic ) 25900 12950 10360 7770
10 OP1080 CAPD placement ( open ) 25900 12950 10360 7770
11 OP0448 CAPD removal & placement ( laparosopic ) 33960 16980 13580 10190
12 OP0445 CAPD removal & placement ( open ) 33960 16980 13580 10190
13 OP0447 CAPD removal ( laparosopic ) 16240 8120 6500 4870
14 OP0444 CAPD removal ( open ) 16240 8120 6500 4870
15 OP0446 CAPD revision ( laparosopic ) 12960 6480 5180 3890
16 OP0449 CAPD revision ( open ) 12960 6480 5180 3890
17 OP0437 Conversion of arteriovenous ( AV ) shunt to 30700 15350 12280 9210
arteriovenous ( AV ) fistula
18 OP0440 Creation of arteriovenous ( AV ) fistula at axillary 38800 19400 15520 11640
artery
19 OP0433 Creation of arteriovenous ( AV ) fistula at elbow ( 38800 19400 15520 11640
brachial artery )
20 OP1077 Creation of arteriovenous ( AV ) fistula at wrist ( radial 38800 19400 15520 11640
artery )
21 OP4205 GSV translocation for AV access 64020 32010 25610 19210
22 OP0320 Ligation of ruptured AV fistula 16240 8120 6500 4870
23 OP0319 Ligation of ruptured AV graft 21340 10670 8540 6400
24 OP0436 Placement of arteriovenous ( AV ) shunt at ankle ( 21340 10670 8540 6400
25 OP1078 Placement of arteriovenous ( AV ) shunt at wrist ( 21340 10670 8540 6400
radial artery )
26 OP0243 Radio - basilic straight ( below elbow ) AV graft for 42660 21330 17060 12800
haemodialysis
27 OP0244 Radio - cephalic straight ( below elbow ) AV graft for 42660 21330 17060 12800
haemodialysis
28 OP4204 Repair of A.V.Fistula aneurysm 43660 21830 17460 13100
29 OP0441 Revision of arteriovenous ( AV ) fistula at axillary 16240 8120 6500 4870
artery
30 OP0435 Revision of arteriovenous ( AV ) fistula at elbow ( 16240 8120 6500 4870
brachial artery )
31 OP0434 Revision of arteriovenous ( AV ) fistula at wrist ( radial 16240 8120 6500 4870
artery )
32 OP0439 Revision of arteriovenous ( AV ) shunt at ankle ( 10660 5330 4260 3200
33 OP0438 Revision of arteriovenous ( AV ) shunt at wrist ( radial 10660 5330 4260 3200
artery )
129
34 OP1083 Vascular prosthetic graft in forearm 48520 24260 19410 14560
35 OP0526 Vascular prosthetic graft in thigh 48520 24260 19410 14560
36 OP0525 Vascular prosthetic graft in upper arm 48520 24260 19410 14560
Aesthetic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
37 OP1305 Abdominoplasty 121280 60640 48510 36380
38 OP1303 Abdominoplasty with limited incision 97020 48510 38810 29110
39 OP1304 Abdominoplasty with liposuction 145540 72770 58220 43660
40 OP2996 Belt Lipectomy 183900 91950 73560 55170
41 OP3082 Bilateral face dimple construction ( dimploplasty ) 84900 42450 33960 25470
42 OP3007 Botox / Fillers 33760 16880 13500 10130
43 OP1803 Brachioplasty / arm lift 112480 56240 44990 33740
44 OP0842 Brow / forehead lift 148360 74180 59340 44510
45 OP1804 Buttock implant 116900 58450 46760 35070
46 OP4383 Buttock Lift 133420 66710 53370 40030
47 OP1802 Calf implant 107880 53940 43150 32360
48 OP0840 Centralisation of chin 98880 49440 39550 29660
49 OP0083 Chemical peel of face 84380 42190 33750 25310
50 OP0060 Chin augmentation - multiple sliding osteotomies ( 102500 51250 41000 30750
Genioplasty )
51 OP0061 Chin augmentation - osteotomy with bone graft ( 116900 58450 46760 35070
Genioplasty )
52 OP1320 Chin augmentation - prosthetic / allograft ( 98880 49440 39550 29660
Genioplasty )
53 OP0059 Chin augmentation - single sliding osteotomy ( 80860 40430 32340 24260
Genioplasty )
54 OP0826 Chin reduction 112480 56240 44990 33740
55 OP4382 Circumferential Body Lift 200100 100050 80040 60030
56 OP3423 Contouring of bones of the face - multiple Bones 97020 48510 38810 29110
57 OP3422 Contouring of bones of the face - single Bone 60640 30320 24260 18190
58 OP1364 Correction / revision of face scars - single 48580 24290 19430 14570
59 OP3060 Correction / revision of two face scars 65440 32720 26180 19630
60 OP3431 Correction of complex scar - large 101260 50630 40500 30380
61 OP3430 Correction of complex scar - medium 67500 33750 27000 20250
62 OP3429 Correction of complex scar - small 50640 25320 20260 15190
63 OP1798 Correction of congenital ear lobule deformity 67500 33750 27000 20250
64 OP4368 Correction of Contour Deformity Face (Fat, Implant, 64020 32010 25610 19210
Flap) - Minor
65 OP4369 Correction of Contour Deformity Face (Fat, Implant, 106720 53360 42690 32020
Flap)-Majorlip
66 OP3005 Correction of multiple facial scars 81820 40910 32730 24550
67 OP1588 Corrective rhinoplasty - augmentation with bone graft 101260 50630 40500 30380
68 OP1587 Corrective rhinoplasty - augmentation with cartilage 101260 50630 40500 30380
69 OP1586 Corrective rhinoplasty - augmentation with implant 77640 38820 31060 23290
70 OP3310 Corrective rhinoplasty - complete 159160 79580 63660 47750
71 OP1584 Corrective rhinoplasty - nasal tip 67500 33750 27000 20250
72 OP1593 Corrective rhinoplasty - reduction 105660 52830 42260 31700
73 OP1580 Corrective rhinoplasty - with septoplasty 118160 59080 47260 35450
74 OP1594 Corrective rhinoplasty for crooked / deviated nose 134980 67490 53990 40490
130
75 OP1315 Cosmetic blepharoplasty ( four lids ) 101260 50630 40500 30380
76 OP0135 Cosmetic blepharoplasty ( one lid ) 45060 22530 18020 13520
77 OP0136 Cosmetic blepharoplasty ( three lids ) 64280 32140 25710 19280
78 OP0058 Cosmetic blepharoplasty ( two lids ) 62320 31160 24930 18700
79 OP1095 Dermabrasion 89940 44970 35980 26980
80 OP1336 Dermabrasion full face 89940 44970 35980 26980
81 OP1337 Dermabrasion partial face 62980 31490 25190 18890
82 OP1345 Ear lobule repair - bilateral 18200 9100 7280 5460
83 OP1344 Ear lobule repair - unilateral 12140 6070 4860 3640
84 OP3077 Ear lobule repair with cartilage graft 73640 36820 29460 22090
85 OP1350 Endoscopic brow / forehead lift 148360 74180 59340 44510
86 OP1349 Endoscopic face lift 202300 101150 80920 60690
87 OP1363 Eyebrow graft 74240 37120 29700 22270
88 OP0138 Eyelash graft 74240 37120 29700 22270
89 OP0841 Face lift - classic operations 134980 67490 53990 40490
90 OP1767 Face lift - facial suspension 89940 44970 35980 26980
91 OP1789 Face lift - mid face 101260 50630 40500 30380
92 OP1766 Face lift - minimum scar 118160 59080 47260 35450
93 OP1790 Face lift - with SMAS 151900 75950 60760 45570
94 OP4459 Fat grafting ( Non cosmetic ) 60640 30320 24260 18190
95 OP3326 Genital labioplasty 79680 39840 31870 23900
96 OP4226 Hair transplant other then scalp (Large) 176080 88040 70430 52820
97 OP4227 Hair transplant other then scalp (Medium) 132060 66030 52820 39620
98 OP4228 Hair transplant other then scalp (Small) 58700 29350 23480 17610
99 OP0814 Hair transplantation - major 297000 148500 118800 89100
100 OP0813 Hair transplantation - medium 222740 111370 89100 66820
101 OP0812 Hair transplantation - minor 148520 74260 59410 44560
102 OP3329 Hymenoplasty 79680 39840 31870 23900
103 OP4821 Implant Removal Face 50000 25000 20000 15000
104 OP1769 Intralesional injection (in OT) 12020 6010 4810 3610
105 OP4495 Laser Resurfacing - Large 97020 48510 38810 29110
106 OP4496 Laser Resurfacing - Medium 72760 36380 29100 21830
107 OP4497 Laser Resurfacing - Small 48520 24260 19410 14560
108 OP2969 Lateral canthoplasty 33760 16880 13500 10130
109 OP3078 Lip reconstruction with multiple flaps 122640 61320 49060 36790
110 OP3079 Lip reconstruction with single flap 114480 57240 45790 34340
111 OP1770 Lip reduction 49500 24750 19800 14850
112 OP1768 Lipo-injection - major 101260 50630 40500 30380
113 OP3081 Lipoinjection - medium 84380 42190 33750 25310
114 OP1771 Lipo-injection - minor 67500 33750 27000 20250
115 OP1774 Liposuction - large 98880 49440 39550 29660
116 OP3080 Liposuction - medium 69540 34770 27820 20860
117 OP1776 Liposuction - small 49500 24750 19800 14850
118 OP4817 Liposuction ( Non-Cosmetic ) 62500 31250 25000 18750
119 OP4491 Liposuction (Multiple Areas) 145540 72770 58220 43660
120 OP1805 Malar / cheek implant 98880 49440 39550 29660
121 OP3084 Malar reduction 106320 53160 42530 31900
122 OP4215 Medial Canthoplasty 58700 29350 23480 17610
123 OP3062 Midline etching 60760 30380 24300 18230
124 OP3037 Neo - umbiloplasty 89940 44970 35980 26980
125 OP0084 Otoplasty for bat ears ( bilateral ) 101260 50630 40500 30380
126 OP1343 Otoplasty for bat ears ( unilateral ) 67500 33750 27000 20250
127 OP3341 Penile augumentation 132580 66290 53030 39770
128 OP3000 Penile lengthening procedure 122640 61320 49060 36790
131
129 OP4454 PRP injection Full face 24260 12130 9700 7280
130 OP4457 PRP injection hair or scar removal 12140 6070 4860 3640
131 OP4455 PRP Medium 12140 6070 4860 3640
132 OP4456 PRP Small 7280 3640 2910 2180
133 OP3036 Radiofrequency excision of moles - multiple 60760 30380 24300 18230
134 OP3038 Radiofrequency excision of moles - single 40960 20480 16380 12290
135 OP1801 Reverse abdominoplasty / torsoplasty 134900 67450 53960 40470
136 OP1800 Reverse thigh lift 134900 67450 53960 40470
137 OP3350 Scar revision of trunk of extremity ( large ) 72760 36380 29100 21830
138 OP3351 Scar revision of trunk of extremity ( medium ) 60640 30320 24260 18190
139 OP3352 Scar revision of trunk of extremity ( small ) 48520 24260 19410 14560
140 OP3075 Thighplasty 130800 65400 52320 39240
141 OP1797 Thread lift 98880 49440 39550 29660
142 OP3063 Transverse etching ( abdominal ) 81820 40910 32730 24550
143 OP3353 Umbilical reconstruction 79680 39840 31870 23900
144 OP1796 Umblicoplasty 67500 33750 27000 20250
145 OP3083 Unilateral face dimple construction ( dimploplasty ) 50640 25320 20260 15190
146 OP3066 Upper body lift 163480 81740 65390 49040
147 OP4472 Vaginal Rejuvenation (Laser) 48520 24260 19410 14560
148 OP4473 Vaginal Rejuvenation (Surgical) 72760 36380 29100 21830
149 OP4465 Xanthelasma Bilateral / Both Eyelid 45000 22500 18000 13500
150 OP4464 Xanthelasma Single 35000 17500 14000 10500
Amputations And Disarticulations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
151 OP1816 Amputation / disarticulation of finger(s) 28360 14180 11340 8510
152 OP0250 Amputation / disarticulation of toe(s) 28360 14180 11340 8510
153 OP0467 Amputation of hand ( carpal level ) 61440 30720 24580 18430
154 OP0256 Amputation of hand ( metacarpal level ) 61440 30720 24580 18430
155 OP0253 Amputation of lower limb - above knee 85080 42540 34030 25520
156 OP0252 Amputation of lower limb - below knee 85080 42540 34030 25520
157 OP0258 Amputation of upper limb ( above elbow ) 85080 42540 34030 25520
158 OP0257 Amputation of upper limb ( below elbow ) 85080 42540 34030 25520
159 OP1808 Chopart's amputation ( mid - tarsal ) 51500 25750 20600 15450
160 OP1811 Disarticulation at the level of ankle 60840 30420 24340 18250
161 OP1810 Disarticulation at the level of knee 60840 30420 24340 18250
162 OP1817 Disarticulation of elbow joint 60840 30420 24340 18250
163 OP1812 Disarticulation of hip joint 99240 49620 39700 29770
164 OP1818 Disarticulation of shoulder joint 99240 49620 39700 29770
165 OP1815 Disarticulation of wrist joint 55820 27910 22330 16750
166 OP4154 Forefoot excisional arthroplasty (Multiple) 96600 48300 38640 28980
167 OP4153 Forefoot excisional arthroplasty (Single) 64400 32200 25760 19320
168 OP2994 Forequarter amputation 113400 56700 45360 34020
169 OP1813 Hind Quarter disarticulation 113400 56700 45360 34020
170 OP1809 Lisfranc ampuation ( tarso - metatarsal ) 69460 34730 27780 20840
171 OP3033 Ray excision of digit 46300 23150 18520 13890
172 OP0254 Revision of amputation stump 63820 31910 25530 19150
173 OP0469 Syme's amputation 60840 30420 24340 18250
Ano-rectal Operations
132
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
174 OP1025 Anal sphincter repair after injury 90380 45190 36150 27110
175 OP1242 Anal transposition 67760 33880 27100 20330
176 OP1243 Anoplasty 59600 29800 23840 17880
177 OP1033 Anoplasty for imperforate anus with low opening 59600 29800 23840 17880
178 OP3360 Band ligation of haemorrhoids ( in OT ) 15280 7640 6110 4580
179 OP1029 Excision / laying open of fistula in ano ( high level ) 67760 33880 27100 20330
with or without seton
180 OP1030 Excision / laying open of fistula in ano ( low level ) 54200 27100 21680 16260
181 OP1031 Haemorrhoidectomy 54200 27100 21680 16260
182 OP3359 Injection sclerotherapy of haemorrhoids / piles ( in OT 15280 7640 6110 4580
)
183 OP1037 Lateral sphincterotomy or fissurectomy 49720 24860 19890 14920
184 OP1276 PSARP - complete 93100 46550 37240 27930
185 OP1277 PSARP - limited 66240 33120 26500 19870
186 OP1281 Rectal myomectomy 36200 18100 14480 10860
187 OP1282 Rectal polyp excision 16540 8270 6620 4960
188 OP0029 Rectal prolapse repair - Delormes rectopexy 103900 51950 41560 31170
189 OP0030 Rectal prolapse repair abdominal ( open technique ) 103900 51950 41560 31170
190 OP1076 Seton removal / laying open of residual fistula-in-ano 31620 15810 12650 9490
191 OP0689 Stapled haemorrhoidectomy 54200 27100 21680 16260
192 OP1038 Thiersch’s wiring 31620 15810 12650 9490
193 OP1280 Trans-anal rectal biopsy 22660 11330 9060 6800
Aortic Aneurysm Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

194 OP4209 Aortic Aneurysm fenestrated stent grafting 784420 392210 313770 235330
195 OP4825 Application and Monitoring of Digital Chest Suction 15620 7810 6250 4690
Machine
196 OP4832 Carinal tumour resection and anastomosis 281260 140630 112500 84380
197 OP3367 Chest wall repair in OT 184880 92440 73950 55460
198 OP4208 Complex endovascular repair of aortic aneurysm 560300 280150 224120 168090
199 OP0091 Elective infra renal abdominal aortic aneurysm repair - 229720 114860 91890 68920
aorto bifemoral bypass graft
aorto bi-iliac bypass graft
aorto uni-iliac uni-femoral bypass graft
tube graft
203 OP0088 Elective supra renal abdominal aortic aneurysm repair 229720 114860 91890 68920
- aorto bifemoral bypass graft
- aorto bi-iliac bypass graft
- tube graft
206 OP0315 Elective thoracic aortic aneurysm repair 229720 114860 91890 68920
207 OP4824 Empyema decortication with rib resection 187500 93750 75000 56250
208 OP4822 Empyema Grade I 125000 62500 50000 37500
133
209 OP4823 Empyema II 156260 78130 62500 46878
210 OP4207 Endovascular repair of aortic aneurysm 392200 196100 156880 117660
211 OP4850 Hemithorax Mass (Complex) 281260 140630 112500 84380
212 OP4826 ICD Removal 15620 7810 6250 4690
213 OP4851 Intraoperative repair of diapragm 78120 39060 31250 23440
214 OP4833 lobectomy 125000 62500 50000 37500
215 OP4835 Open Adhesiolysis 51260 25630 20500 15380
216 OP4839 Open Bilobectomy 260260 130130 104100 78080
217 OP4852 Open Bullectomy 187040 93520 74820 56110
218 OP4828 Open Cyst Excision 93760 46880 37500 28130
219 OP4843 Open drainage of mediastinal collection 62500 31250 25000 18750
220 OP4841 Open Excision of complex mediastinal mass 281260 140630 112500 84380
221 OP4837 Open Hematoma Evacuation 93760 46880 37500 28130
222 OP4845 Open metastasectomy 93760 46880 37500 28130
223 OP4846 Open Pleurectomy 78120 39060 31250 23440
224 OP4849 Open repair of pericardial defect 46880 23440 18750 14060
225 OP4829 Robotic Excision of bronchogenic cyst 156260 78130 62500 46880
226 OP4830 Robotic excision of complex intra-thoracic cyst 306260 153130 122500 91880
227 OP4831 Robotic Thymectomy for small thymoma/MG 181260 90630 72500 54380
228 OP0086 Ruptured infra renal abdominal aortic aneurysm 280140 140070 112060 84040
repair - aorto bifemoral bypass graft
repair - aorto bi-iliac bypass graft
repair - aorto uni-iliac uni-femoral bypass graft
repair - tube graft
232 OP0105 Ruptured supra renal abdominal aortic aneurysm 280140 140070 112060 84040
repair - aorto bi-iliac bypass graft
repair - aorto-bifemoral bypass graft
repair - tube graft
235 OP4834 Thoracoscopic Adhesiolysis 78120 39060 31250 23440
236 OP4836 Thoracoscopic Hematoma Evacuation 125000 62500 50000 37500
237 OP4844 Thoracoscopic metastasectomy 118760 59380 47500 35630
238 OP4840 Tracheal Resection & Reconstruction (complex) 250000 125000 100000 75000
239 OP4838 VATS Bilobectomy 312500 156250 125000 93750
240 OP4827 VATS Cyst Excision 125000 62500 50000 37500
241 OP4842 VATS drainage of mediastinal collection 78120 39060 31250 23440
242 OP4847 VATS Pleurectomy 109380 54690 43750 32810
243 OP4848 VATS repair of pericardial defect 62500 31250 25000 18750
Appendicular Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

244 OP1013 Appendicectomy 59600 29800 23840 17880
245 OP1014 Appendicular abscess drainage 67760 33880 27100 20330
246 OP1268 Laparoscopic appendicectomy 59600 29800 23840 17880
Arthrodesis
134
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
247 OP3253 Arthrodesis ( hip ) 77880 38940 31150 23360
248 OP3254 Arthrodesis ( SI Joints ) 77880 38940 31150 23360
249 OP1980 Arthrodesis ankle 77880 38940 31150 23360
250 OP1981 Arthrodesis foot - Bachelor's / Green Grice 59120 29560 23650 17740
251 OP1983 Arthrodesis knee joint 77880 38940 31150 23360
252 OP1984 Arthrodesis of elbow joint 77880 38940 31150 23360
253 OP1989 Arthrodesis of hand & foot bone(s) 63260 31630 25300 18980
254 OP1982 Arthrodesis of shoulder joint 77880 38940 31150 23360
255 OP1985 Arthrodesis of wrist joint 77880 38940 31150 23360
256 OP4142 Calcaneo-cuboid arthrodesis 81760 40880 32700 24530
257 OP4338 Joint Arthrogram 50940 25470 20380 15280
258 OP4339 Joint Arthrotomy with debridement 101880 50940 40750 30560
259 OP1979 Lambrinudi / Triple Arthrodesis of ankle 77880 38940 31150 23360
260 OP4349 Large Joint Arthrodesis 106980 53490 42790 32090
261 OP4144 MTP Joint fusion 57500 28750 23000 17250
262 OP4140 Subtalar fusion / arthrodesis 70820 35410 28330 21250
263 OP4141 Talonavicular arthrodesis 81760 40880 32700 24530
264 OP4337 Triple Arthrodesis (Adult) 106980 53490 42790 32090
Arthroscopic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
265 OP4247 Arthoroscopic biceps tenodesis 67380 33690 26950 20210
266 OP4243 Arthoroscopic PASTA repair 66160 33080 26460 19850
267 OP4244 Arthoroscopic subscapularis repair 58600 29300 23440 17580
268 OP2150 Arthroscopic ACL and PCL reconstruction of knee 148160 74080 59260 44450
269 OP4578 Arthroscopic ACL and PCL Reconstruction single stage 202860 101430 81140 60860
( Two site graft )
270 OP4253 Arthroscopic ACL avulsion fracture fixation 99580 49790 39830 29870
271 OP4576 Arthroscopic ACL Ganglion cyst Decompression 88200 44100 35280 26460
272 OP2151 Arthroscopic ACL reconstruction of knee ( arthroscopy 110480 55240 44190 33140
with single site tendon graft )
273 OP2152 Arthroscopic arthrodesis of ankle 77880 38940 31150 23360
274 OP2153 Arthroscopic arthrofibrolysis of elbow 77880 38940 31150 23360
275 OP2154 Arthroscopic arthrofibrolysis of hip 77880 38940 31150 23360
276 OP2155 Arthroscopic arthrofibrolysis of knee 77880 38940 31150 23360
277 OP2156 Arthroscopic arthrofibrolysis of shoulder 77880 38940 31150 23360
278 OP2157 Arthroscopic arthrofibrolysis of wrist 77880 38940 31150 23360
279 OP4254 Arthroscopic Bankart's Repair (Soft Tissue) 103340 51670 41340 31000
280 OP4560 Arthroscopic Biceps Tenodesis 132300 66150 52920 39690
281 OP4258 Arthroscopic Bony Bankart's Repair 108380 54190 43350 32510
282 OP4246 Arthroscopic capsulorrhaphy 67380 33690 26950 20210
283 OP2158 Arthroscopic carpal repair of wrist 72760 36380 29100 21830
284 OP2159 Arthroscopic debridement of ankle 72760 36380 29100 21830
285 OP2160 Arthroscopic debridement of elbow 72760 36380 29100 21830
286 OP2161 Arthroscopic debridement of hip 72760 36380 29100 21830
287 OP2162 Arthroscopic debridement of knee 72760 36380 29100 21830
288 OP2163 Arthroscopic debridement of shoulder 72760 36380 29100 21830
135
289 OP2164 Arthroscopic debridement of wrist 72760 36380 29100 21830
290 OP2165 Arthroscopic diagnostic arthroscopy of ankle 34060 17030 13620 10220
291 OP4245 Arthroscopic global labrum repair (A-P) - Anterior - 96660 48330 38660 29000
Posterior
292 OP2166 Arthroscopic impingement release of ankle 72760 36380 29100 21830
293 OP4572 Arthroscopic labral cyst decompression 99220 49610 39690 29770
294 OP2167 Arthroscopic lateral collateral ligament reconstruction 72760 36380 29100 21830
of knee
295 OP2168 Arthroscopic lateral release of knee 72760 36380 29100 21830
296 OP2169 Arthroscopic lavage of ankle 34060 17030 13620 10220
297 OP2170 Arthroscopic lavage of knee 34060 17030 13620 10220
298 OP2171 Arthroscopic loose body removal from ankle 72760 36380 29100 21830
299 OP2172 Arthroscopic loose body removal from elbow 72760 36380 29100 21830
300 OP2173 Arthroscopic loose body removal from hip 72760 36380 29100 21830
301 OP2174 Arthroscopic loose body removal from knee 72760 36380 29100 21830
302 OP2175 Arthroscopic loose body removal from shoulder 72760 36380 29100 21830
303 OP2176 Arthroscopic loose body removal from wrist 72760 36380 29100 21830
304 OP2177 Arthroscopic medial collateral ligament reconstruction 72760 36380 29100 21830
of knee
305 OP2179 Arthroscopic meniscal repair of knee 72760 36380 29100 21830
306 OP4575 Arthroscopic Meniscus repair with implant 99220 49610 39690 29770
307 OP4251 Arthroscopic microfracture of OCD 66160 33080 26460 19850
308 OP2180 Arthroscopic osteoarticular transport / mosaic plasty 72760 36380 29100 21830
of knee
309 OP4571 Arthroscopic Partial Meniscectomy - Discoid Meniscus 121280 60640 48510 36380
310 OP2181 Arthroscopic partial meniscectomy of knee 72760 36380 29100 21830
311 OP2182 Arthroscopic patellar stabilisation 72760 36380 29100 21830
312 OP2183 Arthroscopic PCL avulsion fixation of knee 80220 40110 32090 24070
313 OP2184 Arthroscopic PCL reconstruction of knee ( arthroscopy 148160 74080 59260 44450
with two site tendon graft )
314 OP4577 Arthroscopic PCL Reconstruction with implants 148840 74420 59540 44650
315 OP2185 Arthroscopic posterolateral corner repair of knee 72760 36380 29100 21830
316 OP2186 Arthroscopic release of frozen shoulder 72760 36380 29100 21830
317 OP4570 Arthroscopic release of impingment of ankle 121280 60640 48510 36380
318 OP4569 Arthroscopic release of tennis elbow 110260 55130 44100 33080
319 OP4579 Arthroscopic Remplissage Shoulder 99220 49610 39690 29770
320 OP4563 Arthroscopic repair of posterior labrum 121280 60640 48510 36380
321 OP4574 Arthroscopic Revision - ACL Reconstruction 143320 71660 57330 43000
322 OP2187 Arthroscopic rotator cuff repair of shoulder 72760 36380 29100 21830
323 OP4256 Arthroscopic Rotator Cuff Repair with Anchors 108380 54190 43350 32510
(Double Row)
324 OP4255 Arthroscopic Rotator Cuff Repair with Anchors (Single 103340 51670 41340 31000
Row)
325 OP4257 Arthroscopic Rotator Cuff Repair with Biceps 108380 54190 43350 32510
Tenotomy
326 OP2188 Arthroscopic SLAP lesion repair of shoulder 72760 36380 29100 21830
327 OP2189 Arthroscopic stabilisation of shoulder for Recurrent 94480 47240 37790 28340
dislocation
328 OP2190 Arthroscopic subacromial decompression / 72760 36380 29100 21830
acromioplasty of shoulder
329 OP4259 Arthroscopic Superior Labrum Repair 103340 51670 41340 31000
330 OP2191 Arthroscopic synovectomy of ankle 72760 36380 29100 21830
331 OP2192 Arthroscopic synovectomy of elbow 72760 36380 29100 21830
332 OP2193 Arthroscopic synovectomy of hip 72760 36380 29100 21830
333 OP2194 Arthroscopic synovectomy of knee 72760 36380 29100 21830
334 OP2195 Arthroscopic synovectomy of shoulder 72760 36380 29100 21830
136
335 OP2196 Arthroscopic synovectomy of wrist 72760 36380 29100 21830
336 OP2198 Arthroscopic tibial plateau reconstruction of knee 72760 36380 29100 21830
337 OP2199 Arthroscopic tibial spine fixation of knee 72760 36380 29100 21830
338 OP2197 Arthroscopic triangular fibro-cartilage ( TFC ) repair of 72760 36380 29100 21830
wrist
339 OP4573 Arthroscpic Para Meniscal Cyst Decompression 121280 60640 48510 36380
340 OP4557 Arthrscopic both Meniscus Partial Meniscectomy 121280 60640 48510 36380
341 OP4567 Comlex Ligament Reconstruction - Single 143320 71660 57330 43000
342 OP4568 Complex Ligamant Reconstrcuction - Multiple 187420 93710 74970 56230
343 OP2200 Diagnostic arthroscopy of elbow 34060 17030 13620 10220
344 OP2201 Diagnostic arthroscopy of hip 34060 17030 13620 10220
345 OP2202 Diagnostic arthroscopy of knee 34060 17030 13620 10220
346 OP2203 Diagnostic arthroscopy of shoulder 34060 17030 13620 10220
347 OP2204 Diagnostic arthroscopy of wrist 34060 17030 13620 10220
348 OP4301 MPFL Reconstruction for Recurrent Dislocation Patella 103340 51670 41340 31000
349 OP4562 Open Biceps Tenodesis 110260 55130 44100 33080
350 OP4302 Open Fixation of Intra - Articular Osteochondral 103340 51670 41340 31000
Fragment
351 OP4565 Open LCL Reconstruction 143320 71660 57330 43000
352 OP4561 Open LCL Repair 121280 60640 48510 36380
353 OP4559 Open MCL Reconstrction 121280 60640 48510 36380
354 OP4558 Open MCL repair 99220 49610 39690 29770
355 OP4300 Open PCL Avulsion + Fixation 109520 54760 43810 32860
356 OP4564 Open release of tennis elbow 11020 5510 4410 3310
357 OP4566 Open release of tennis elbow with fixation 143320 71660 57330 43000
Bedsore Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

358 OP0042 Coccygeal bedsore excision with flap closure 111600 55800 44640 33480
359 OP1310 Coccygeal bedsore excision with primary closure 94400 47200 37760 28320
360 OP3424 Debridement of bedsore 34740 17370 13900 10420
361 OP0049 Ischial bedsore excision with myocutaneous / muscle 100000 50000 40000 30000
flap closure ( unilateral )
362 OP0047 Ischial bedsore excision with primary closure ( 75000 37500 30000 22500
unilateral )
363 OP0048 Ischial bedsore excision with skin grafting ( unilateral ) 87500 43750 35000 26250
364 OP0037 Other bedsore excision with myocutaneous flap 100000 50000 40000 30000
closure
365 OP0033 Other bedsore excision with primary closure 75000 37500 30000 22500
366 OP0036 Other bedsore excision with skin flap closure 87500 43750 35000 26250
367 OP0034 Other bedsore excision with skin grafting 87500 43750 35000 26250
368 OP0045 Sacral bedsore excision with myocutaneous flap 100000 50000 40000 30000
closure
369 OP0043 Sacral bedsore excision with primary closure 75000 37500 30000 22500
370 OP0044 Sacral bedsore excision with skin flap closure 87500 43750 35000 26250
371 OP0046 Sacral bedsore excision with skin grafting 87500 43750 35000 26250
372 OP0035 Trochanteric bedsore excision with myocutaneous flap 100000 50000 40000 30000
closure ( unilateral )
373 OP0050 Trochanteric bedsore excision with primary closure ( 75000 37500 30000 22500
unilateral )
374 OP0020 Trochanteric bedsore excision with skin flap closure ( 87500 43750 35000 26250
unilateral )
137
375 OP0032 Trochanteric bedsore excision with skin grafting ( 87500 43750 35000 26250
unilateral )
Bone Tumour Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
376 OP2007 Curettage and bone grafting - long bones 74500 37250 29800 22350
377 OP2006 Curettage and bone grafting - small bones 49400 24700 19760 14820
378 OP2001 Excision of large exostosis 49400 24700 19760 14820
379 OP2003 Excision of large tumours ( without bone grafting ) - 74500 37250 29800 22350
long bones
380 OP2005 Excision of large tumours + reconstruction with 173780 86890 69510 52130
custom prosthesis
381 OP2002 Excision of large tumours with bone grafting - long 81300 40650 32520 24390
bones
382 OP2004 Excision of large tumours with bone grafting with 96860 48430 38740 29060
fixation for long bones
383 OP2000 Excision of small exostosis 24880 12440 9950 7460
Breast Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
384 OP3308 Augmentation mammoplasty by fat grafting 169500 84750 67800 50850
385 OP1772 Augmentation mammoplasty by implant 108380 54190 43350 32510
386 OP4476 Bilateral Mastectomy with free nipple graft 115780 57890 46310 34730
387 OP2821 Breast abscess drainage 20340 10170 8140 6100
388 OP4718 Breast Conservation Surgery with SLNB 91000 45500 36400 27300
389 OP4719 Breast Conservation Surgery with SLNB with axillary 98000 49000 39200 29400
clearance
390 OP1777 Breast lift / mastopexy 117400 58700 46960 35220
391 OP2873 Breast lumpectomy - large 42940 21470 17180 12880
392 OP1023 Breast lumpectomy - small 31620 15810 12650 9490
393 OP0602 Breast lumpectomy with axillary clearance ( BCS ) 90380 45190 36150 27110
394 OP2868 Breast lumpectomy with axillary sampling 67760 33880 27100 20330
395 OP2869 Breast lumpectomy with sentinal lymph node biopsy 67760 33880 27100 20330
396 OP2833 Breast reconstruction using free flap 225700 112850 90280 67710
397 OP2832 Breast reconstruction using implant 135500 67750 54200 40650
398 OP2829 Breast reconstruction using latisimus dorsi muscle 162540 81270 65020 48760
399 OP2830 Breast reconstruction using rectus abdominis muscle 180600 90300 72240 54180
400 OP3085 Breast reconstruction with DIEP flap 205220 102610 82090 61570
401 OP1806 Correction of inverted nipple - unilateral 108380 54190 43350 32510
402 OP1807 Correction of inverted nipples - bilateral 135500 67750 54200 40650
403 OP2971 Endoscopic breast lump excision 37080 18540 14830 11120
404 OP1781 Endoscopic gynaecomastia excision - bilateral 108380 54190 43350 32510
405 OP1788 Endoscopic gynaecomastia excision - unilateral 72280 36140 28910 21680
406 OP1018 Excision of breast lump under ultrasound guidance 42940 21470 17180 12880
407 OP1787 Excision of supernumerary / accessory breast - 108380 54190 43350 32510
bilateral
408 OP1775 Excision of supernumerary / accessory breast - 72280 36140 28910 21680
unilateral
138
409 OP0599 Gynaecomastia excision - unilateral 80000 40000 32000 24000
410 OP4715 Gynecomastia - Large 105000 52500 42000 31500
411 OP4714 Gynecomastia - Medium 84000 42000 33600 25200
412 OP4713 Gynecomastia - Small 63000 31500 25200 18900
413 OP4381 Mastectomy For Gender Identify Disorder 89140 44570 35660 26740
414 OP1024 Micodochotomy & removal of papilloma in breast 45280 22640 18110 13580
duct
415 OP0603 Needle localisation biopsy of breast mass / lump 54200 27100 21680 16260
416 OP1792 Nipple reconstruction - bilateral 100260 50130 40100 30080
417 OP1791 Nipple reconstruction - unilateral 66880 33440 26750 20060
418 OP1778 Peri-areolar breast lift / mastopexy 99340 49670 39740 29800
419 OP1022 Radical / modified radical mastectomy 90380 45190 36150 27110
420 OP4720 Radical / Modified Radical Mastectomy with SLNB 91000 45500 36400 27300
421 OP4721 Radical / Modified Radical Mastectomy with SLNB 98000 49000 39200 29400
with axillary clearance
422 OP2828 Radical / modified radical mastectomy with 90380 45190 36150 27110
supraclavicular lymph node clearance
423 OP1773 Reduction mammoplasty - bilateral 149020 74510 59610 44710
424 OP1786 Reduction mammoplasty - unilateral 99340 49670 39740 29800
425 OP2831 Removal of breast implant 90380 45190 36150 27110
426 OP1021 Simple mastectomy 56540 28270 22620 16960
427 OP2871 Simple mastectomy with axillary sampling 67760 33880 27100 20330
428 OP2870 Simple mastectomy with sentinal lymph node biopsy 67760 33880 27100 20330
Cardiac Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

429 OP0410 Aortic arch replacement
430 OP0366 Aortic valve repair
431 OP0365 Aortic valve replacement
432 OP0367 Aortic valve replacement + Tricuspid valve repair
433 OP0407 Ascending aorta replacement
434 OP0371 Atrial septal defect ( ASD ) closure
435 OP0383 Atrio-ventricular canal defect repair
436 OP0406 Bentall's Procedure ( aortic root replacement )
437 OP3236 Bidirectional glen shunt
438 CABGDO CABG (off pump) - amount given to surgeon from
within package
439 OP3232 Cardiac clot excision
OP0411 Cardiac myxoma excision
Within Package
440
441 OP3231 Cardiac tumor excision
442 OP3235 Central shunt ( aorto pulmonary shunt )
443 CHSDOC Closed heart surgery - amount given to cardiac
surgeon from within the package
444 OP0387 Closed mitral valvotomy
445 OP4581 Complex CABG
446 OP0384 Congenital aneurysm of the sinus of Valsalva repair
447 OP0385 Congenital aortic stenosis repair
448 OP0386 Congenital mitral valve repair
449 OP0382 Cor Triatriatum repair
450 OP0392 Coronary artery bypass surgery OFF pump
451 OP0391 Coronary artery bypass surgery ON pump
139
452 OP3239 DOR procedure
453 OP4505 ECMO Initiation Charges - Cardiac Surgery 194480 97240 77790 58340
454 OP3365 Epicardial pacemaker Explantation in OT 84060 42030 33620 25220
455 OP3364 Epicardial pacemaker Implantation in OT 80060 40030 32020 24020
456 OP3233 Fontan's procedure
457 HRPDC High risk ADD ON for cardiac surgery - amount given
to surgeon from within the package
458 HPSF Hybrid procedure - amount given to surgeon within
package
459 IABPDPC IABP - ADD ON for cardiac surgery - Doctor operation
charges
460 OP0378 Intracardiac repair of aorto-pulmonary window
461 OP0376 Intracardiac repair of Ebstein's malformation
462 OP0373 Intracardiac repair of tetrology of Fallots Within Package
463 OP0380 Intracardiac repair of total anomalous pulmonary
venous connection
464 OP0377 Intracardiac repair of truncus arteriosus
465 OP0374 Intracardiac repair of ventricular septal defect ( VSD )
+ pulmonary stenosis ( PS )
466 OP0408 Left ventricular (cardiac) aneurysm repair
467 OP0413 Maze procedure for atrial fibrillation
468 OP0368 Mitral valve repair
469 OP0393 Mitral valve replacement
470 OP3242 Omentoplasty for sternal closure

471 OHDOC Open Heart Surgery/CABG (On Pump) - amount given
to cardiac surgeon from within the package
472 PCHSL1E Paediatric Closed Heart Surgery Level One - Prof. fee (
In case of Emergency Surgery )
473 PCHSL1 Paediatric Closed Heart Surgery Level One - Paeds
Card Sciences charges
474 PCHSL3E Paediatric Closed Heart Surgery Level Three - Prof. fee
( In case of Emergency Surgery )
475 PCHSL3 Paediatric Closed Heart Surgery Level Three - Paeds
476 PCHSL2E Paediatric Closed Heart Surgery Level Two - Prof. fee (
477 PCHSL2 Paediatric Closed Heart Surgery Level Two - Paeds
478 POHSL1 Paediatric Open Heart Surgery Level One - Prof. fee (
479 POHSL1 Paediatric Open Heart Surgery Level One - Paeds Card
Sciences charges
480 POHSL3 Paediatric Open Heart Surgery Level Three - Prof. fee (
481 POHSL3 Paediatric Open Heart Surgery Level Three - Paeds
482 POHSL2 Paediatric Open Heart Surgery Level Two - Prof. fee (
483 POHSL2 Paediatric Open Heart Surgery Level Two - Paeds Card
Sciences charges
484 OP0388 Patent ductus arteriosus (PDA) closure
485 OP0389 Pericardiectomy
486 OP3244 Pericardiostomy Within Package
487 OP4504 Permanent LVAD - Cardiac Surgery 1389160 694580 555660 416750
488 OP0409 Post infarction venticular septal defect repair Within Package
140
489 OP3366 Premie PDA clipping in OT 168080 84040 67230 50420
490 OP3237 Pulmonary artery banding
491 OP3238 Pulmonary valvotomy
492 OP3230 Redo aortic valve replacement
493 OP3240 Redo coronary artery bypass surgery OFF pump
494 OP3241 Redo coronary artery bypass surgery ON pump
Within Package
495 OP3229 Redo mitral valve replacement
496 OP0412 Repair of cardiac injury
497 OP0390 Repair of coarctation of the aorta
498 OP3243 Sternectomy
499 OP3234 Systemic pulmonary shunt ( BT shunt )
500 OP4503 Temporary LVAD Initiation Charge - Cardiac Surgery 463060 231530 185220 138920
501 OP0369 Tricuspid valve repair
502 OP0370 Tricuspid valve replacement Within Package
503 OP0372 Ventricular septal defect ( VSD ) closure
Cardiology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
504 OP0680 Aortic aneurysm stent grafting
505 OP1301 ASD device closure Within Package
506 OP0642 Bi-ventricular pacing ( Heart failure device )
507 OP0659 Check coronary angiography ( CAG ) - femoral route
508 OP0660 Check coronary angiography ( CAG ) - radial route
509 OP0650 Coronary angiography ( CAG ) - femoral route
510 OP0651 Coronary angiography ( CAG ) - radial route
511 OP0652 Coronary angioplasty via femoral route - elective
512 OP0662 Coronary angioplasty via femoral route - primary, for
cardiogenic shock
513 OP0653 Coronary angioplasty via femoral route - primary,
routine
514 OP0654 Coronary angioplasty via femoral route - rescue
515 OP0655 Coronary angioplasty via femoral route for re-stenosis
516 OP0656 Coronary angioplasty via radial route - elective
517 OP0661 Coronary angioplasty via radial route - primary, for
cardiogenic shock
518 OP0663 Coronary angioplasty via radial route - primary,
routine Within Package
519 OP0657 Coronary angioplasty via radial route - rescue
520 OP0658 Coronary angioplasty via radial route for re-stenosis
521 OP0667 Coronary angioplasty with directional atherectomy
522 OP0666 Coronary angioplasty with rotablation ( rotational
atherectomy )
523 OP0647 Electrophysiology study - major ( EP )
524 OP0648 Electrophysiology study - minor ( EP )
525 OP0665 Implantable cardioverter defibrilator ( ICD )
implantation - combo device
implantation - dual chamber device
implantation - single chamber device
528 OP0649 Intra aortic balloon pump insertion ( IABP )
529 ASDPCS Paediatric ASD Device - Paeds Card Sciences charges
141
530 PASDEM Paediatric ASD Device - Prof. Fee ( In case of
Emergency )
531 PBSEPPC Paediatric Balloon Septostomy - Paeds Card Sciences
charges
532 PBSEMC Paediatric Balloon Septostomy - Prof. Fee ( In case of
Emergency )
533 CAPC Paediatric Cardiac angiography - Paeds Card Sciences
charges
534 PCAEMC Paediatric Cardiac angiography - Prof. Fee ( In case of
Emergency )
535 CCEPC Paediatric Cardiac coil Embolisation - Paeds Card
Sciences charges
536 PCCEMC Paediatric Cardiac coil Embolisation - Prof. Fee ( In
case of Emergency )
537 PDAPF Paediatric PDA Device - Paeds Card Sciences charges
538 PPDAEM Paediatric PDA Device - Prof. Fee ( In case of
Emergency )
539 PVALPC Paediatric Valvuloplasty - Paeds Card Sciences charges
540 PVEMCH Paediatric Valvuloplasty - Prof. Fee ( In case of
Emergency )
541 OP1300 PDA device closure
542 OP0639 Pericardiocentesis
543 OP0676 Peripheral embolisation
544 OP0643 Permanent pacemaker insertion - dual chamber ( PPI )
545 OP0644 Permanent pacemaker insertion - single chamber ( PPI
)
546 OP0646 Radio-frequency ablation ( RFA )
547 OP0645 Sinus node recovery time analysis ( SNRT )
548 OP0640 Temporary pacemaker insertion
549 OP0677 Valvuloplasty - aortic
550 OP1302 Valvuloplasty - mitral Within Package
551 OP0679 Valvuloplasty - pulmonary
552 OP0678 Valvuloplasty - tricuspid
Cleft Lip And Palate Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

553 OP1585 Cleft lip nose rhinoplasty - complete 96660 48330 38660 29000
554 OP1583 Cleft lip nose rhinoplasty - nasal tip 80560 40280 32220 24170
555 OP1323 Cleft lip repair - bilateral complete 98080 49040 39230 29420
556 OP1576 Cleft lip repair - bilateral incomplete 88200 44100 35280 26460
557 OP0062 Cleft lip repair - unilateral complete 94400 47200 37760 28320
558 OP1577 Cleft lip repair - unilateral incomplete 77260 38630 30900 23180
559 OP1247 Cleft palate repair - complete 115780 57890 46310 34730
560 OP1248 Cleft palate repair - posterior 92620 46310 37050 27790
561 OP4305 PALATAL IMPLANT (SET OF 3) 42020 21010 16810 12610
562 OP4306 PALATAL IMPLANT (SET OF 5) 56020 28010 22410 16810
563 OP0041 Palatal re-repair / lengthening 92620 46310 37050 27790
564 OP1307 Repair of palatal fistula with alveolar bone grafting 137240 68620 54900 41170
565 OP0038 Repair of palatal fistula with buccal flap 111600 55800 44640 33480
566 OP1578 Repair of palatal fistula with free flap 197360 98680 78940 59210
567 OP0040 Repair of palatal fistula with local flap 128780 64390 51510 38630
568 OP0039 Repair of palatal fistula with tongue flap - first stage 102980 51490 41190 30890
142
569 OP1579 Repair of palatal fistula with tongue flap - second 77260 38630 30900 23180
stage
570 OP1581 Revision of lip repair 94400 47200 37760 28320
571 OP1582 Revision of lip repair and Alveolar bone grafting 128780 64390 51510 38630
Closed Reduction And Internal Fixation
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
572 OP1890 Closed Ender's nailing for fracture shaft femur 98300 49150 39320 29490
573 OP1888 Closed Ender's nailing for fracture tibia 98300 49150 39320 29490
574 OP1887 Closed interlock nailing for fracture tibia 98300 49150 39320 29490
575 OP1889 Closed interlocking nailing for fracture shaft femur 98300 49150 39320 29490
576 OP3260 Closed nailing humerus 88340 44170 35340 26500
577 OP2993 Closed percutaneous screw fixation for neck of 57560 28780 23020 17270
humerus
578 OP1886 Closed percutaneous screw fixation for tibial plateau 52220 26110 20890 15670
fracture
579 OP1893 Closed reduction fracture distal radius with K-wire 28280 14140 11310 8480
fixation
580 OP1896 Closed reduction fracture neck humerus with K-wire 55560 27780 22220 16670
fixation
581 OP1895 Closed reduction fracture supracondylar humerus 55560 27780 22220 16670
with K-wire fixation
582 OP3065 Closed reduction of ankle 21960 10980 8780 6590
583 OP3045 Closed reduction of elbow 21960 10980 8780 6590
584 OP4131 Closed reduction of femur 19960 9980 7980 5990
585 OP4128 Closed reduction of forearm bones 19960 9980 7980 5990
586 OP3447 Closed reduction of fracture of metacarpal / phalynx 30820 15410 12330 9250
587 OP3057 Closed reduction of hip 21960 10980 8780 6590
588 OP4130 Closed reduction of humerus 19960 9980 7980 5990
589 OP4133 Closed reduction of IP / MP Joints 19960 9980 7980 5990
590 OP4129 Closed reduction of leg bones 19960 9980 7980 5990
591 OP3058 Closed reduction of shoulder 21960 10980 8780 6590
592 OP3055 Closed reduction of wrist 21960 10980 8780 6590
593 OP1894 K-wire fixation for fracture radial styloid 28280 14140 11310 8480
594 OP3263 Nailing of radius and ulna 88340 44170 35340 26500
Dental OT Day Care

Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

595 OP4780 Dental-Deep Impaction 15000
596 OP3094 Alveolectomy ( both jaws ) in OT 16180 8090 6470 4850 8090
597 OP3095 Alveolectomy ( one jaws ) in OT 8080 4040 3230 2420 4040
598 OP3096 Alveoloplasty in OT 4880 2440 1950 1460 2440
599 OP3099 Apicectomy ( per tooth ) in OT 12920 6460 5170 3880 6460
600 OP4086 Archbar fixation dentoalveolar fracture per segement 9700 4850 3880 2910 4850
- Dental
601 OP3102 Arthocentesis of TMJ in OT 16180 8090 6470 4850 8090
602 OP3103 Cavity sealant ( per tooth ) in OT 2080 1040 830 620 1040
603 OP4114 Ceramic laminate - Dental 12920 6460 5170 3880 6460
143
604 OP3105 Chemical cauterisation in OT 1660 830 660 500 830
605 OP3130 Circum-mandibular splint removal in OT 3240 1620 1300 970 1620
606 OP3104 Composite filling in OT 4880 2440 1950 1460 2440
607 OP4110 Composite veneers - Dental 4880 2440 1950 1460 2440
608 OP4109 Core build up (prefab) - Dental 3240 1620 1300 970 1620
609 OP4108 Core buildup (casting) - Dental 4880 2440 1950 1460 2440
610 OP4117 Crown / Bridge per unit (procera) - Dental 44040 22020 17620 13210 22020
611 OP4116 Crown/Bridge per unit (metal) - Dental 9700 4850 3880 2910 4850
612 OP4115 Crown/Bridge per unit (PFM) - Dental 14560 7280 5820 4370 7280
613 OP4124 Curettage (Per quadrant) - Dental 8080 4040 3230 2420 4040
614 OP3136 Dental Implant in OT 146740 73370 58700 44020 73370
615 OP4787 Dental-Acrylic Crown 5000
616 OP4793 Dental-Allograft Per Unit 15000
617 OP4765 Dental-Apical Surgery for tooth preservation 15000
618 OP4766 Dental-Apical Surgery for tooth preservation 3000
subsequent tooth
619 OP4774 Dental-Bone Preserving Dental Extraction 5000
620 OP4768 Dental-Canine Exposure 12500
621 OP4791 Dental-Ceramic Onlay 20000
622 OP4804 Dental-Clear Aligners Complicated Both 350000
623 OP4803 Dental-Clear Aligners Complicated Single 200000
624 OP4802 Dental-Clear Aligners Simple Both 175000
625 OP4801 Dental-Clear Aligners Simple Single 150000
626 OP4786 Dental-Cosmetic Filling 3000
627 OP4789 Dental-Crown Rebonding 3000
628 OP4788 Dental-Crown Recementation 1500
629 OP4792 Dental-Cutting Out Old Crown 2500
630 OP4782 Dental-Cyst Enucleation/Marsupialisation 12500
631 OP4767 Dental-E Max Veneer/ Crown 25000
632 OP4779 Dental-Enameloplasty 1500
633 OP4784 Dental-Flap Surgery per Segment 5000
634 OP4800 Dental-Laser Surgery 12500
635 OP4796 Dental-Membrane Large 20000
636 OP4795 Dental-Membrane Medium 15000
637 OP4794 Dental-Membrane Small 10000
638 OP4781 Dental-Orthodontic Trainer 12000
639 OP4771 Dental-Partial Denture Lucitone upto 3 Teeth 8500
642 OP4799 Dental-Piezo Surgery 12500
643 OP4785 Dental-Pit and Fissure Sealant 1800
644 OP4783 Dental-Post and Core 3000
645 OP4770 Dental-Reimplantation and Cosmetic splinting of 5500
Avulsed Subsequent Tooth
646 OP4769 Dental-Reimplantation and Cosmetic splinting of 15000
Avulsed Tooth
647 OP4790 Dental-Single Sitting RCT 10000
648 OP4797 Dental-Tacs 1500
649 OP4777 Dental-Teeth Express on 4 Implants First Stage Per 150000
Arch
650 OP4778 Dental-Teeth Express on 4 Implants Second Stage Per 150000
Arch
651 OP4775 Dental-Teeth Express on 6 Implants First Stage Per 200000
Arch
652 OP4776 Dental-Teeth Express on 6 Implants Second Stage Per 250000
Arch
144
653 OP4798 Dental-Temporary Crown 1000
654 OP4087 Dislocation of TMJ - Dental 8080 4040 3230 2420 4040
655 OP3132 Elevation of zygomatic complex fracture in OT 32280 16140 12910 9680 16140
656 OP4098 Excisional biopsy - Dental 9700 4850 3880 2910 4850
657 OP4097 Extraction- All Teeth- Both Jaws - Dental 25860 12930 10340 7760 12930
658 OP4099 Extraction of fractured/decayed tooth - Dental 3240 1620 1300 970 1620
659 OP3147 Extraction of impacted tooth in OT 16180 8090 6470 4850 8090
660 OP4088 Fabrication of Circummandibular splint - Dental 12920 6460 5170 3880 6460
661 OP3110 Filling amalgam / Glass ionomer in OT 4940 2470 1980 1480 2470
662 OP3142 Flap operation ( per quadrant ) in OT 9700 4850 3880 2910 4850
663 OP4125 Flap operation (full arch) - Dental 32280 16140 12910 9680 16140
664 OP3143 Flap surgery with bone graft ( per quadrant ) in OT 12920 6460 5170 3880 6460
665 OP4112 Fluoride application per arch - Dental 2600 1300 1040 780 1300
666 OP4089 Fracture mandible open reduction (cost of plates & 48440 24220 19380 14530 24220
screws extra ) - Dental
667 OP4100 Frenectomy - Dental 4880 2440 1950 1460 2440
668 OP3145 Gingivectomy ( per quadrant ) in OT 8080 4040 3230 2420 4040
669 OP3146 Gingivoplasty ( per quadrant ) in OT 9700 4850 3880 2910 4850
670 OP4126 Implant Surgery First Stage) - Dental 64560 32280 25820 19370 32280
671 OP4127 Implant Surgery Second Stage - Dental 32280 16140 12910 9680 16140
672 OP4102 Incision & drainage - Dental 6480 3240 2590 1940 3240
673 OP4101 Incisional biopsy - Dental 4880 2440 1950 1460 2440
674 OP4103 Inta articular injection - Dental 2600 1300 1040 780 1300
675 OP3150 Interdental wiring + splinting ( per quadrant ) in OT 9700 4850 3880 2910 4850
676 OP4090 Inter-maxillary fixation with archbar - Dental 22600 11300 9040 6780 11300
677 OP4091 Iodoform Dressing - Dental 1300 650 520 390 650
678 OP4104 Jaw fracture closed reduction - Dental 25860 12930 10340 7760 12930
679 OP4118 Metal Free ceramic crown - Dental 22600 11300 9040 6780 11300
680 OP3154 Mini implant for anchorage ( per implant ) in OT 19380 9690 7750 5810 9690
681 OP4092 Nerve block in Neuralgias - Dental 9700 4850 3880 2910 4850
682 OP3116 Obturator for cleft palate in OT 25860 12930 10340 7760 12930
683 OP4093 Operculectomy - Dental 3240 1620 1300 970 1620
684 OP4094 Oro antral communication closure - Dental 45220 22610 18090 13570 22610
685 OP3119 Placentrax injection for OSMF in OT 2600 1300 1040 780 1300
686 OP3121 Pulp capping in OT 4940 2470 1980 1480 2470
687 OP3122 Pulpotomy in OT 3240 1620 1300 970 1620
688 OP4122 Rapid maxillary expansion (RME) - Dental 22600 11300 9040 6780 11300
689 OP4119 Recementation of crown /bridge per unit - Dental 1960 980 780 590 980
690 OP3155 Reimplantation of avulsed tooth in OT 6480 3240 2590 1940 3240
691 OP4120 Relining of Denture - Dental 1960 980 780 590 980
692 OP3123 Removal of Fronto-suspension wiring in OT 12920 6460 5170 3880 6460
693 OP4121 Removal of old crown/ bridge per unit - Dental 1660 830 660 500 830
694 OP4095 Removal of plates of mandible and maxilla - Dental 25860 12930 10340 7760 12930
695 OP3125 Removal of plates of mandible and maxilla in OT 25860 12930 10340 7760 12930
696 OP3126 Root canal treatment ( RCT ) - anterior in OT 8080 4040 3230 2420 4040
697 OP3127 Root canal treatment ( RCT ) - posterior in OT 12920 6460 5170 3880 6460
698 OP3129 Scaling full mouth in OT 4880 2440 1950 1460 2440
699 OP3140 Simple extraction of tooth in OT 1660 830 660 500 830
700 OP4123 Space maintainers - Dental 8080 4040 3230 2420 4040
701 OP4107 Splint removal - Dental 3240 1620 1300 970 1620
702 OP3131 Subgingival scaling & curretage full mouth in OT 9700 4850 3880 2910 4850
703 OP3156 Surgical extraction of tooth in OT 6480 3240 2590 1940 3240
704 OP4105 Suture removal - Dental 3240 1620 1300 970 1620
705 OP4096 TMJ Physiotherapy - Dental 1660 830 660 500 830
706 OP4111 Tooth inlay - Dental 4880 2440 1950 1460 2440
145
707 OP4106 Tumour excision - Dental 32280 16140 12910 9680 16140
Endocrine Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
708 OP0540 Endoscopic hemi-thyroidectomy / lobectomy 61640 30820 24660 18490
709 OP0542 Endoscopic parathyroidectomy 99340 49670 39740 29800
710 OP0541 Endoscopic subtotal thyroidectomy 99340 49670 39740 29800
711 OP1043 Excision of lingual thyroid 45280 22640 18110 13580
712 OP1044 Excision of thyroglossal cyst 45280 22640 18110 13580
713 OP1272 Excision of thyroglossal fistula / sinus 45280 22640 18110 13580
714 OP4722 Hemithyroidectomy (size <5 cms) 64540 32270 25820 19360
715 OP4724 Hemithyroidectomy (size >10 cms) 84000 42000 33600 25200
716 OP4723 Hemithyroidectomy (size 5 - 10 cms) 73500 36750 29400 22050
717 OP1051 Hemi-thyroidectomy / lobectomy 67760 33880 27100 20330
718 OP4388 Laparoscopic Adrenalectomy 140100 70050 56040 42030
719 OP0567 Laparoscopic adrenalectomy ( transabdominal ) 108380 54190 43350 32510
720 OP4389 Open Adrenalectomy 127340 63670 50940 38200
721 OP0627 Parathyroidectomy - multiple glands 90380 45190 36150 27110
722 OP0626 Parathyroidectomy - multiple glands & reimplantation 90380 45190 36150 27110
in muscle
723 OP1045 Parathyroidectomy - single gland 90380 45190 36150 27110
724 OP0568 Retroperitoneoscopic adrenalectomy 99340 49670 39740 29800
725 OP4537 Robotic Adrenalectomy 166760 83380 66700 50030
726 OP1011 Subtotal adrenalectomy 119620 59810 47850 35890
727 OP0806 Subtotal thyroidectomy 67760 33880 27100 20330
728 OP0628 Thyroid isthmectomy 67760 33880 27100 20330
729 OP1012 Total adrenalectomy 135500 67750 54200 40650
730 OP1050 Total thyroidectomy 90380 45190 36150 27110
731 OP4727 Total Thyroidectomy - Large (>10 cms) 112000 56000 44800 33600
732 OP4726 Total Thyroidectomy - Medium (5-10 cms) 98000 49000 39200 29400
733 OP4725 Total Thyroidectomy - Small (<5 cms) 86060 43030 34420 25820
734 OP2874 Total thyroidectomy with sternotomy for retrosternal 135500 67750 54200 40650
goiter
Ent
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

735 OP0988 Adenoidectomy 22800 11400 9120 6840
736 OP0960 Adeno-tonsillectomy 43520 21760 17410 13060
737 OP4588 Advanced Schwannomas and Hemangiomas of the 157500 78750 63000 47250
Facial Nerve
738 OP0996 Antral puncture & wash - bilateral 16480 8240 6590 4940
739 OP0405 Antral puncture & wash - unilateral 9980 4990 3990 2990
740 OP4585 Arytenoidectomy 57760 28880 22000 17330
741 OP3470 Augmentation laryngeal surgery 53400 26700 21360 16020
742 OP4587 Aural Atresia Recanalization 86620 43310 34650 25990
743 OP3466 Aural Meatoplasty 36220 18110 14490 10870
744 OP4580 BAHA 78760 39380 31500 23630
146
745 OP4596 Bleeding Polypus Septum Removal 18380 9190 7350 5510
746 OP0962 Caldwel Luc's operation - bilateral 39880 19940 15950 11960
747 OP0978 Caldwel Luc's operation - unilateral 26320 13160 10530 7900
748 OP0922 Choanal atresia repair 112900 56450 45160 33870
749 OP3496 Coblation / radiofrequency channeling anterior and 36220 18110 14490 10870
posterior tonsillar pillar
750 OP3497 Coblation / radiofrequency channeling base of tongue 36220 18110 14490 10870
751 OP3495 Coblation / radiofrequency channeling of soft palate 36220 18110 14490 10870
752 OP4603 Coblation Assisted Inferior Turbinate Reduction 26260 13130 10500 7880
753 OP4325 COBLATION ENDOSCOPIC ADENOIDECTOMY 50940 25470 20380 15280
754 OP4703 Coblation Lingual Tonsillectomy 39380 19690 15750 11810
755 OP3492 Coblation tonsillectomy 39800 19900 15920 11940
756 OP4706 Collaural Fistula 52500 26250 21000 15750
757 OP0938 Cortical mastoidectomy 61420 30710 24570 18430
758 OP4607 Crico Thyroid Approximation 39380 19690 15750 11810
759 OP4589 Debridement for Malignant Otitis Externa 84000 42000 33600 25200
760 OP0914 Decompression of endolymphatic sac 102640 51320 41060 30790
761 OP0999 Diagnostic nasal endoscopy 7400 3700 2960 2220
762 OP0756 Dilatation of hypopharynx 22800 11400 9120 6840
763 OP0990 Direct laryngoscopy 22800 11400 9120 6840
764 OP3472 DRAF I - bilateral 53160 26580 21260 15950
765 OP3471 DRAF I - unilateral 36220 18110 14490 10870
766 OP3474 DRAF II - bilateral 71680 35840 28670 21500
767 OP3473 DRAF II - unilateral 53160 26580 21260 15950
768 OP3475 DRAF III 102640 51320 41060 30790
769 OP4085 Emergency foreign body removal by rigid 80140 40070 32060 24040
bronchoscope with optical forceps
770 OP0975 Endoscopic adenoidectomy 33080 16540 13230 9920
771 OP0966 Endoscopic antrostomy - bilateral 24720 12360 9890 7420
772 OP0402 Endoscopic antrostomy - unilateral 16480 8240 6590 4940
773 OP3476 Endoscopic clivus resection of lesion / approach 107280 53640 42910 32180
774 OP0959 Endoscopic DCR 41700 20850 16680 12510
775 OP0972 Endoscopic frontal recess clearance of disease - 31620 15810 12650 9490
bilateral
776 OP0982 Endoscopic frontal recess clearance of disease - 26320 13160 10530 7900
unilateral
777 OP0971 Endoscopic maxillary clearance of disease - bilateral 31620 15810 12650 9490
778 OP0981 Endoscopic maxillary clearance of disease - unilateral 26320 13160 10530 7900
779 OP0989 Endoscopic maxillary clearance of disease ( canine 31620 15810 12650 9490
fossa approach ) - bilateral
780 OP0404 Endoscopic maxillary clearance of disease ( canine 20960 10480 8380 6290
fossa approach ) - unilateral
781 OP3485 Endoscopic nasal + sinus Debridment for invasive 77040 38520 30820 23110
fungal sinusitis - bilateral
782 OP3484 Endoscopic nasal + sinus Debridment for invasive 61640 30820 24660 18490
fungal sinusitis - unilateral
783 OP0994 Endoscopic nasal biopsy 17240 8620 6900 5170
784 OP0920 Endoscopic orbital decompression 112900 56450 45160 33870
785 OP0919 Endoscopic pan sinus surgery - bilateral 112900 56450 45160 33870
786 OP0398 Endoscopic pan sinus surgery - unilateral 78860 39430 31540 23660
787 OP3488 Endoscopic Septoplasty 37880 18940 15150 11360
788 OP3398 Endoscopic transnasal medial maxillectomy 188720 94360 75490 56620
789 OP0954 Endoscopy and surgical decannulation of 22800 11400 9120 6840
tracheostomy
790 OP0985 Endoscopy, decannulation & strapping of 22800 11400 9120 6840
tracheostomy
147
791 OP0998 Examination under microscopy (ENT) 7400 3700 2960 2220
792 OP0908 Excision of acoustic neuroma - translabrynthine 147760 73880 59100 44330
approach
793 OP0909 Excision of glomus jugulare tumour 147760 73880 59100 44330
794 OP0947 Excision of laryngeal papilloma 58760 29380 23500 17630
795 OP0951 Excision of palatal mass 58760 29380 23500 17630
796 OP1401 Excision of pharyngeal diverticulum 78860 39430 31540 23660
797 OP1358 Excision of pharyngeal pouch and cricopharyngeal 78860 39430 31540 23660
myotomy
798 OP0965 Excision of tumour of external auditory canal 33080 16540 13230 9920
799 OP4420 Exploratory Tympanotomy 32240 16120 12900 9670
800 OP0934 External ethmoidectomy - bilateral 78860 39430 31540 23660
801 OP0943 External ethmoidectomy - unilateral 58760 29380 23500 17630
802 OP0918 External osteoplastic frontal sinus surgery 112900 56450 45160 33870
803 OP4701 Feminizing Thyroplasty 91880 45940 36750 27560
804 OP0941 FESS - bilateral 61420 30710 24570 18430
805 OP0955 FESS - unilateral 41700 20850 16680 12510
806 OP0928 FESS ( extended ) - bilateral 82440 41220 32980 24730
807 OP0940 FESS ( extended ) - unilateral 61420 30710 24570 18430
808 OP0969 FESS ( minimal ) - bilateral 41700 20850 16680 12510
809 OP0957 FESS ( minimal ) - unilateral 33080 16540 13230 9920
810 OP2958 FESS revision surgery - bilateral 45480 22740 18190 13640
811 OP2960 FESS revision surgery - unilateral 36100 18050 14440 10830
812 OP1000 Fibreoptic laryngoscopy 7740 3870 3100 2320
813 OP0898 Foreign body ear removal 10440 5220 4180 3130
814 OP0899 Foreign body nose removal 10440 5220 4180 3130
815 OP3478 Frontal ostium balloon sinuplasty-bilateral 53160 26580 21260 15950
816 OP3477 Frontal ostium bBalloon sinuplasty-unilateral 36220 18110 14490 10870
817 OP3498 Hyoid bone suspension 71680 35840 28670 21500
818 OP0991 Hypopharyngoscopy 22800 11400 9120 6840
819 OP0902 Incision and drainage of Ludwigs angina 51500 25750 20600 15450
820 OP4605 Injection Laryngoplasty - Fat 31500 15750 12600 9450
821 OP4705 Intratympanic Injection 10500 5250 4200 3150
822 OP4608 Laryngeal Drop 26260 13130 10500 7880
823 OP4702 Laryngeal T-tube Placement 52500 26250 21000 15750
824 OP0948 Laryngeal web excision 53400 26700 21360 16020
825 OP0945 Laryngofissure & repair 61420 30710 24570 18430
826 OP3494 Laser / coblation / radiofrequency assisted 71680 35840 28670 21500
uvulopalatoplasty
827 OP3468 Laser / coblation excision of laryngeal papilloma 71680 35840 28670 21500
828 OP3469 Laser / coblation MLS decortication 71680 35840 28670 21500
829 OP3493 Laser / coblation resection of midline base of tongue 48340 24170 19340 14500
830 OP4591 Laser Assisted Resurfacing of Buccal Mucosa 26260 13130 10500 7880
831 OP3467 Laser MLS 53400 26700 21360 16020
832 OP4609 Laser Stapedotomy 78760 39380 31500 23630
833 OP3183 Laser Tonsillectomy 50860 25430 20340 15260
834 OP0897 Major vessel ligation for epistaxis 61640 30820 24660 18490
835 OP0927 Mastoidectomy with cavity obliteration 78860 39430 31540 23660
836 OP3480 Maxillary ostium balloon sinuplasty-bilateral 53160 26580 21260 15950
837 OP3479 Maxillary ostium balloon sinuplasty-unilateral 36220 18110 14490 10870
838 OP0949 Microlaryngoscopic ( MLS ) decortication 58760 29380 23500 17630
839 OP0968 Microlaryngoscopic ( MLS ) excision of nodule / polyp 33080 16540 13230 9920
840 OP0980 Microlaryngoscopy ( MLS ) & biopsy 27480 13740 10990 8240
841 OP0964 MLS radiofrequency biopsy of mass (ENT) 33080 16540 13230 9920
148
842 OP0953 MLS radiofrequency excision of mass / nodule / polyp 41700 20850 16680 12510
(ENT)
843 OP0925 Modified radical mastoidectomy 82440 41220 32980 24730
844 OP0937 Myringoplasty 58760 29380 23500 17630
845 OP3462 Myringotomy - bilateral 20720 10360 8290 6220
846 OP3463 Myringotomy - unilateral 15680 7840 6270 4700
847 OP0986 Myringotomy with grommet - bilateral 32240 16120 12900 9670
848 OP0997 Myringotomy with grommet - unilateral 16120 8060 6450 4840
849 OP3465 Myringotomy with T-Tube insertion - unilateral 37880 18940 15150 11360
850 OP3464 Myringotomy with T-Tube insertion- bilateral 39740 19870 15900 11920
851 OP0894 Nasal anterior & posterior (both) packing 20860 10430 8340 6260
852 OP0896 Nasal anterior packing 8660 4330 3460 2600
853 OP0893 Nasal endoscopic cautery 26000 13000 10400 7800
854 OP0895 Nasal posterior packing 15720 7860 6290 4720
855 OP0903 Nasal septal abscess drainage 10440 5220 4180 3130
856 OP0976 Nasal septoplasty 27480 13740 10990 8240
857 OP0958 Nasal septoplasty + submucosal diathermy 41700 20850 16680 12510
858 OP3487 Nasal septoplasty-Complex 37880 18940 15150 11360
859 OP4599 Nasal Septum Perforation Closure (Local Flap) 39380 19690 15750 11810
860 OP3483 Nasal spacer plate placement 20160 10080 8060 6050
861 OP3491 Nasal valve correction - bilateral 36220 18110 14490 10870
862 OP3490 Nasal valve correction - unilateral 23920 11960 9570 7180
863 OP4700 Nasolabilal Cyst Excision 47260 23630 18900 14180
864 OP0702 Oral excisional biopsy 19800 9900 7920 5940
865 OP1001 Oral incisional biopsy 10000 5000 4000 3000
866 OP0932 Ossiculoplasty 78860 39430 31540 23660
867 OP0973 Pan-endoscopy (ENT) 33080 16540 13230 9920
868 OP0900 Parapharyngeal abscess drainage 27480 13740 10990 8240
869 OP4582 Parapharyngeal Tumour Excision 65620 32810 26250 19690
870 OP4763 Parotid Gland Combined Approach 62500 31250 25000 18750
871 OP3486 Partial septectomy 36220 18110 14490 10870
872 OP4084 Pediatric Tracheotomy with superior tracheal flap 61640 30820 24660 18490
873 OP0935 Pharyngeal diverticulum excision 78860 39430 31540 23660
874 OP4704 Pinna Seroma Drainage 26260 13130 10500 7880
875 OP4594 Plunging Ranula Excision 47260 23630 18900 14180
876 OP4592 Posterior Cordectomy and Arytenoidectomy 65620 32810 26250 19690
877 OP0961 Pre-auricular sinus excision - bilateral 41700 20850 16680 12510
878 OP0979 Pre-auricular sinus excision - unilateral 27480 13740 10990 8240
879 OP4583 Quincy Incision and Drainage 21000 10500 8400 6300
880 OP0926 Radical mastoidectomy 82440 41220 32980 24730
881 OP0963 Radiofrequency excision of mass in nose 39880 19940 15950 11960
882 OP0974 Radiofrequency nose submucosal diathermy 31620 15810 12650 9490
883 OP0984 Radiofrequency turbinate reduction 26320 13160 10530 7900
884 OP4584 Ranula Marsupialisation 31500 15750 12600 9450
885 OP1285 Release of tongue tie / frenuloplasty 13780 6890 5510 4130
886 OP2962 Repair of CSF otorrhea 102700 51350 41080 30810
887 OP0950 Repair of oro-antral fistula with flap 58760 29380 23500 17630
888 OP0983 Retropharyngeal abscess drainage 27480 13740 10990 8240
889 OP2968 Revision mastoidectomy 85860 42930 34340 25760
890 OP2961 Revision tympanoplasty 82160 41080 32860 24650
891 OP4597 Rhinolith Removal 13120 6560 5250 3940
892 OP4598 Rhinosporidiosis Excision 65620 32810 26250 19690
893 OP4000 SEPTAL FRAMEWORK SURGERY 92460 46230 36980 27740
894 OP3482 Sphenoid ostium balloon sinuplasty-bilateral 53160 26580 21260 15950
895 OP3481 Sphenoid ostium balloon sinuplasty-unilateral 36220 18110 14490 10870
149
896 OP0942 Sphenoidotomy - bilateral 58760 29380 23500 17630
897 OP0956 Sphenoidotomy - unilateral 39880 19940 15950 11960
898 OP3489 Spurectomy 23920 11960 9570 7180
899 OP0931 Stapedectomy 82440 41220 32980 24730
900 OP0802 Stomaplasty ( tracheal ) 24720 12360 9890 7420
901 OP0944 Styloidectomy - bilateral 58760 29380 23500 17630
902 OP0967 Styloidectomy - unilateral 31620 15810 12650 9490
903 OP4762 Submandibular Gland Combined approach 50000 25000 20000 15000
904 OP0952 Submucosal uvulo-palato-pharyngo-plasty by 39880 19940 15950 11960
radiofrequency ( UPPP )
905 OP0987 Surgical turbinate reduction - bilateral 21800 10900 8720 6540
906 OP0403 Surgical turbinate reduction - unilateral 16480 8240 6590 4940
907 OP0946 Thyroplasty - type 1 58760 29380 23500 17630
911 OP0977 Tonsillectomy 32240 16120 12900 9670
912 OP4604 Tonsillotomy 26260 13130 10500 7880
913 OP0917 Tracheal reconstruction 112900 56450 45160 33870
914 OP4593 Tracheal Stoma Closure (Tracheo cutaneous fistula 31500 15750 12600 9450
closure)
915 OP0799 Tracheo-oesophageal puncture 17240 8620 6900 5170
916 OP0798 Tracheo-oesophageal valve insertion 21580 10790 8630 6470
917 OP0889 Tracheostomy ( open ) - elective 31400 15700 12560 9420
918 OP0890 Tracheostomy ( open ) - emergency 36560 18280 14620 10970
919 OP0394 Tracheostomy ( percutaneous ) - elective 30060 15030 12020 9020
920 OP0395 Tracheostomy ( percutaneous ) - emergency 34920 17460 13970 10480
921 OP4707 Tracheostomy Site Bleeding re-exploration 39380 19690 15750 11810
922 OP4601 Trans Tymapanic BERA - Bilateral 23620 11810 9450 7090
923 OP4600 Trans Tymapanic BERA - Unilateral 13120 6560 5250 3940
924 OP0929 Trans-nasal vidian neurectomy - bilateral 88260 44130 35300 26480
925 OP0939 Trans-nasal vidian neurectomy - unilateral 58760 29380 23500 17630
926 OP0734 Triple endoscopy ( laryngoscopy, tracheoscopy & 41140 20570 16460 12340
oesophagoscopy )
927 OP0933 Tympanoplasty 78860 39430 31540 23660
928 OP0936 Uvulo-palato-pharyngo-plasty ( UPPP ) 33080 16540 13230 9920
929 OP4595 Vallecular Cyst Excision 39380 19690 15750 11810
930 OP4606 Vocal Fold Injection - Fillers/Steroid 21000 10500 8400 6300
931 OP4326 Z-PLATAPLASTY 81500 40750 32600 24450
External Fixators
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

932 OP1957 Ankle / foot deformity correction using JESS fixator 141640 70820 56660 42490
933 OP1909 Ankle arthrodesis using Ilizarov fixator 81440 40720 32580 24430
934 OP3456 Application of Ilizarov & Hexapod/Ortho-SUV frame 128860 64430 51540 38660
935 OP4448 ATFL/CFL ankle reconstruction 111140 55570 44460 33340
936 OP1917 Bone transport femur using Ilizarov fixator 81440 40720 32580 24430
937 OP1933 Bone transport femur using Orthofix fixator 81440 40720 32580 24430
938 OP1918 Bone transport tibia using Ilizarov fixator 81440 40720 32580 24430
939 OP1938 Bone transport tibia using Orthofix fixator 81440 40720 32580 24430
940 OP4451 Capitullum or coronoid fracture fixation / excision 55560 27780 22220 16670
150
941 OP4444 Change of wires / screws 19440 9720 7780 5830
942 OP2845 Closed ankle / foot fracture fixation using JESS fixator 81440 40720 32580 24430
943 OP1921 Closed elbow fracture fixation using Ilizarov fixator 81440 40720 32580 24430
944 OP1902 Closed femoral condyle fracture using Ilizarov fixator 81440 40720 32580 24430
945 OP2837 Closed femoral shaft fracture fixation using Ilizarov 81440 40720 32580 24430
fixator
946 OP1922 Closed forearm fracture fixation using Ilizarov fixator 81440 40720 32580 24430
947 OP2847 Closed forearm fracture fixation using JESS fixator 81440 40720 32580 24430
948 OP1919 Closed fracture dislocation shoulder fixation using 81440 40720 32580 24430
Ilizarov fixator
949 OP1930 Closed fracture femur fixation using Orthofix fixator 81440 40720 32580 24430
950 OP1944 Closed fracture forearm fixation using Orthofix fixator 81440 40720 32580 24430
951 OP2851 Closed fracture humerus fixation using Orthofix fixator 81440 40720 32580 24430
952 OP2848 Closed fracture metacarpal and phalanges fixation 89700 44850 35880 26910
using JESS fixator
953 OP1934 Closed fracture tibia fixation using Orthofix fixator 81440 40720 32580 24430
954 OP1950 Closed fracture wrist joint fixation using Orthofix 81440 40720 32580 24430
fixator
955 OP1920 Closed humerus fracture fixation using Ilizarov fixator 81440 40720 32580 24430
956 OP4450 Closed reduction of fractur with percutaneous fixation 55560 27780 22220 16670
with screw / wire
957 OP1905 Closed tibial plafond and ankle fracture fixation using 81440 40720 32580 24430
Ilizarov fixator
958 OP1903 Closed tibial plateau fracture fixation using Ilizarov 81440 40720 32580 24430
fixator
959 OP1904 Closed tibial shaft fracture fixation using Ilizarov 81440 40720 32580 24430
fixator
960 OP1923 Closed wrist fracture fixation using Ilizarov fixator 81440 40720 32580 24430
961 OP2849 Closed wrist fracture fixation using JESS fixator 34060 17030 13620 10220
962 OP4453 Complex joint reconstruction using external fixator 120400 60200 48160 36120
963 OP4443 Complex trauma fixation using external fixator / 81040 40520 32420 24310
K-wire
964 OP1955 Contractures fingers release using JESS fixator 155780 77890 62310 46730
965 OP3262 Corticotomy - long bones 77880 38940 31150 23360
966 OP1899 Cross leg fixaton in flap surgery using Universal 75560 37780 30220 22670
External Fixator
967 OP1910 Deformity correction femur using Ilizarov fixator 81440 40720 32580 24430
968 OP1932 Deformity correction femur using Orthofix fixator 81440 40720 32580 24430
969 OP1912 Deformity correction foot and ankle using Ilizarov 81440 40720 32580 24430
fixator
970 OP1942 Deformity correction foot using Orthofix fixator 81440 40720 32580 24430
971 OP1949 Deformity correction forearm bones using Orthofix 81440 40720 32580 24430
fixator
972 OP1925 Deformity correction forearm using Ilizarov fixator 81440 40720 32580 24430
973 OP1924 Deformity correction humerus using Ilizarov fixator 81440 40720 32580 24430
974 OP1948 Deformity correction humerus using Orthofix fixator 81440 40720 32580 24430
975 OP1954 Deformity correction of wrist using JESS fixator 89700 44850 35880 26910
976 OP1911 Deformity correction tibia using Ilizarov fixator 81440 40720 32580 24430
977 OP1937 Deformity correction tibia using Orthofix fixator 81440 40720 32580 24430
978 OP1926 Deformity correction wrist using Ilizarov fixator 81440 40720 32580 24430
979 OP2865 External fixation for closed fracture femur using 56740 28370 22700 17020
Universal External Fixator
980 OP2867 External fixation for closed fracture forearm using 56740 28370 22700 17020
981 OP2866 External fixation for closed fracture humerus using 56740 28370 22700 17020
982 OP2864 External fixation for closed fracture tibia using 56740 28370 22700 17020
151
983 OP1897 External fixation for open fracture femur using 56740 28370 22700 17020
984 OP2859 External fixation for open fracture forearm using 56740 28370 22700 17020
985 OP2860 External fixation for open fracture humerus using 56740 28370 22700 17020
986 OP2861 External fixation for open fracture tibia using 56740 28370 22700 17020
987 OP1900 External fixator application for fracture pelvis using 56740 28370 22700 17020
988 OP1913 Femoral lengthening using Ilizarov fixator 81440 40720 32580 24430
989 OP1940 High tibial osteotomy ( HTO ) of tibia with Orthofix 81440 40720 32580 24430
990 OP1931 Infected non-union femur fixation using Orthofix 81440 40720 32580 24430
fixator
991 OP2855 Infected non-union tibia fixation using Orthofix fixator 81440 40720 32580 24430
992 OP1908 Knee arthrodesis using Ilizarov fixator 81440 40720 32580 24430
993 OP1915 Knee contracture release using Ilizarov fixator 81440 40720 32580 24430
994 OP1935 Lenghtening femur using Orthofix fixator 81440 40720 32580 24430
995 OP1939 Lenghtening tibia using Orthofix fixator 81440 40720 32580 24430
996 OP1945 Lengthening humerus using Orthofix fixator 81440 40720 32580 24430
997 OP1947 Lengthening metacarpals / phalanges hand using 81440 40720 32580 24430
Orthofix fixator
998 OP1941 Lengthening metatarsals and foot bones using 81440 40720 32580 24430
Orthofix fixator
999 OP1956 Lengthening of metacarpals & phalanges using JESS 89700 44850 35880 26910
fixator
1000 OP1958 Lengthening of metatarsal using JESS fixator 37140 18570 14860 11140
1001 OP1946 Lenthening forearm ( radius or ulna ) using Orthofix 81440 40720 32580 24430
fixator
1002 OP4446 Lower limb tendon tenodesis 111140 55570 44460 33340
1003 OP2854 Non-infected non-union femur fixation using Orthofix 81440 40720 32580 24430
fixator
1004 OP1936 Non-infected non-union tibia fixation using Orthofix 81440 40720 32580 24430
fixator
1005 OP2834 Non-union femur fixation using Ilizarov fixator ( 81440 40720 32580 24430
Infected )
1006 OP1927 Non-union femur fixation using Ilizarov fixator ( 81440 40720 32580 24430
Non-infected )
1007 OP3457 Only application of Hexapod/Ortho-SUV frame on 35440 17720 14180 10630
already applied Ilizarov fixator
1008 OP2846 Open ankle / foot fracture fixation using JESS fixator 81440 40720 32580 24430
1009 OP2835 Open elbow fracture fixation using Ilizarov fixator 81440 40720 32580 24430
1010 OP2836 Open femoral condyle fracture using Ilizarov fixator 81440 40720 32580 24430
1011 OP1901 Open femoral shaft fracture fixation using Ilizarov 81440 40720 32580 24430
fixator
1012 OP2838 Open forearm fracture fixation using Ilizarov fixator 81440 40720 32580 24430
1013 OP1951 Open forearm fracture fixation using JESS fixator 81440 40720 32580 24430
1014 OP2839 Open fracture dislocation shoulder fixation using 81440 40720 32580 24430
Ilizarov fixator
1015 OP2850 Open fracture femur fixation using Orthofix fixator 81440 40720 32580 24430
1016 OP2856 Open fracture forearm fixation using Orthofix fixator 81440 40720 32580 24430
1017 OP1943 Open fracture humerus fixation using Orthofix fixator 81440 40720 32580 24430
1018 OP1953 Open fracture metacarpal and phalanges fixation 34060 17030 13620 10220
using JESS fixator
1019 OP2852 Open fracture tibia fixation using Orthofix fixator 81440 40720 32580 24430
1020 OP2853 Open fracture wrist joint fixation using Orthofix fixator 81440 40720 32580 24430
1021 OP2840 Open humerus fracture fixation using Ilizarov fixator 81440 40720 32580 24430
152
1022 OP4449 Open reduction of fracture with screw / K-wire 69460 34730 27780 20840
fixation
1023 OP2841 Open tibial plafond and ankle fracture fixation using 81440 40720 32580 24430
Ilizarov fixator
1024 OP2842 Open tibial plateau fracture fixation using Ilizarov 92620 46310 37050 27790
fixator
1025 OP2843 Open tibial shaft fracture fixation using Ilizarov fixator 81440 40720 32580 24430
1026 OP2844 Open wrist fracture fixation using Ilizarov fixator 81440 40720 32580 24430
1027 OP1952 Open wrist fracture fixation using JESS fixator 38680 19340 15470 11600
1028 OP1929 Osteotomy hip using Orthofix fixator 81440 40720 32580 24430
1029 OP4447 Patellar tendon reconstruction/repair 111140 55570 44460 33340
1030 OP4452 Pelvic repositioning osteotomy 120400 60200 48160 36120
1031 OP1914 Tibial lengthening using Ilizarov fixator 81440 40720 32580 24430
1032 OP1898 Transarticular external fixation of ankle using 56740 28370 22700 17020
1033 OP2863 Transarticular external fixation of knee using Universal 56740 28370 22700 17020
External Fixator
1034 OP2862 Transarticular external fixation of wrist using Universal 56740 28370 22700 17020
External Fixator
1035 OP4445 Upper limb tendon tenodesis 111140 55570 44460 33340
Eye And Eyelid Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1036 OP4498 AC Formation 4560 2280 1820 1370
1037 OP0414 Aminotic membrane transplant of cornea 62400 31200 24960 18720
1038 OP1235 Antenor chamber paracentesis 3480 1740 1390 1040
1039 OP2327 Anti VEGF injection (per eye) - Surgeon fee Within package
1040 OP4500 Biopsy ( Conjunctival / Eyelid / Ocular Surface ) 15160 7580 6060 4550
1041 OP2898 Blepharoplasty lower lid for ectropion ( both eyes ) 68860 34430 27540 20660
1042 OP2897 Blepharoplasty lower lid for ectropion ( single eye ) 43120 21560 17250 12940
1043 OP0134 Blepharoplasty lower lid for entropion ( both eyes ) 68860 34430 27540 20660
1044 OP0133 Blepharoplasty lower lid for entropion ( single eye ) 43120 21560 17250 12940
1045 OP2896 Blepharoplasty upper lid for ectropion ( both eyes ) 68860 34430 27540 20660
1046 OP2895 Blepharoplasty upper lid for ectropion ( single eye ) 43120 21560 17250 12940
1047 OP0132 Blepharoplasty upper lid for entropion ( both eyes ) 68860 34430 27540 20660
1048 OP0131 Blepharoplasty upper lid for entropion ( single eye ) 43120 21560 17250 12940
1049 OP0130 Blepharoplasty, with grafting, lower lid for ectropion ( 86080 43040 34430 25820
both eyes )
1050 OP0129 Blepharoplasty, with grafting, lower lid for ectropion ( 58100 29050 23240 17430
single eye )
1051 OP0128 Blepharoplasty, with grafting, upper lid for ectropion ( 86080 43040 34430 25820
both eyes )
1052 OP0127 Blepharoplasty, with grafting, upper lid for ectropion ( 58100 29050 23240 17430
single eye )
1053 OP1238 Buckle removal 5960 2980 2380 1790
1054 OP1189 Conjunctival flap creation 16220 8110 6490 4870
1055 OP0904 Corneal foreign body removal - deep 21640 10820 8660 6490
1056 OP1190 Corneal foreign body removal - superficial 7840 3920 3140 2350
1057 OP1191 Corneal grafting 80520 40260 32210 24160
1058 OP1192 Cyclocryopexy 9880 4940 3950 2960
1059 OP1193 Dacryocystorhinostomy / cystectomy 46040 23020 18420 13810
1060 OP1200 Enucleation of eye ( with implant) 51580 25790 20630 15470
153
1061 OP1199 Enucleation of eye ( without implant ) 28020 14010 11210 8410
1062 OP0430 Epicanthus & telecanthus correction 73140 36570 29260 21940
1063 OP1201 Epicanthus correction 36580 18290 14630 10970
1064 OP0021 Evisceration of eye ( with implant ) 51580 25790 20630 15470
1065 OP1202 Evisceration of eye ( without implant ) 28020 14010 11210 8410
1066 OP1204 Exenteration of orbit 73140 36570 29260 21940
1067 OP1203 Eye examination under GA 4840 2420 1940 1450
1068 OP0137 Eye lid reconstruction ( multiple lids ) 92460 46230 36980 27740
1069 OP1362 Eye lid reconstruction ( one lid ) 40120 20060 16050 12040
1070 OP0416 Fascia lata sling surgery (Eye) 81700 40850 32680 24510
1071 OP1188 Incision and drainage of chalazion 4840 2420 1940 1450
1072 OP1205 Intraocular foreign body removal 67140 33570 26860 20140
1073 OP1206 Intraocular lens implant (THIS IS NOT A CATARACT 60240 30120 24100 18070
OPERATION)
1074 OP1207 Intraocular surgery of anterior segment for glaucoma 53840 26920 21540 16150
1075 OP0022 Intraocular surgery of anterior segment for secondary 53840 26920 21540 16150
IOL
1076 OP1234 Intravitreal injection 4800 2400 1920 1440
1077 OP1194 Lacrimal abscess drainage 7140 3570 2860 2140
1078 OP1208 Lensectomy 67140 33570 26860 20140
1079 OP1195 Lid abscess drainage 7140 3570 2860 2140
1080 OP4499 Lid Cyst / Benign Mass Excision 18200 9100 7280 5460
1081 OP1197 Lid entropion correction - both eyes 49720 24860 19890 14920
1082 OP2899 Lid entropion correction - single eye 33120 16560 13250 9940
1083 OP1209 Lid tumour excision & repair ( WITHOUT grafting or 40120 20060 16050 12040
flaps )
1084 OP1210 Lid tumour excision & repair with skin / mucosal 62400 31200 24960 18720
grafting or flap construction
1085 OP0415 Limbal stem cell transplant (eye) 62400 31200 24960 18720
1086 MICSSF Micro Incision Cataract Surgery ( including high Within package
viscosity visco elastic ) - Surgeon's fees
1087 OP1223 Orbital abscess drainage 25900 12950 10360 7770
1088 OP1211 Orbitotomy 80520 40260 32210 24160
1089 OP3023 Phaco-emulsification cataract operation (without IOL) 54760 27380 21900 16430
- NOT FOR DAYCARE
1090 OP1233 Pneumatic retinopexy 31340 15670 12540 9400
1091 OP1213 Probing and syringing of naso-lacrimal duct 7840 3920 3140 2350
1092 OP1214 Probing and syringing of naso-lacrimal duct with 25900 12950 10360 7770
inferior turbinate infracture
1093 OP1232 Prophylactic retinal detachment surgery ( buckling 23540 11770 9420 7060
procedure )
1094 OP1216 Pterygium surgery ( with grafting ) 34040 17020 13620 10210
1095 OP1215 Pterygium surgery ( without grafting ) 12260 6130 4900 3680
1096 OP1217 Ptosis surgery 49500 24750 19800 14850
1097 OP1237 Reinjection of silicone oil 19660 9830 7860 5900
1098 OP1218 Repair of lacrimal canaliculi 53840 26920 21540 16150
1099 OP1220 Repair of lid coloboma 40120 20060 16050 12040
1100 OP1219 Repair of lid coloboma with skin / mucosal grafting or 62400 31200 24960 18720
flap construction
1101 OP1221 Repair of lid injuries 41800 20900 16720 12540
1102 OP1222 Repair of lid injuries with flaps or grafts 62400 31200 24960 18720
1103 OP1212 Repair of perforating injury of eyeball 53840 26920 21540 16150
1104 OP1224 Retinal detachment surgery 61020 30510 24410 18310
1105 OP1225 Retinocryopexy 23540 11770 9420 7060
1106 OP1236 Silicone oil removal 15700 7850 6280 4710
1107 OP1226 Squint horizontal muscle surgery 51580 25790 20630 15470
154
1108 OP1227 Squint vertical muscle surgery 67140 33570 26860 20140
1109 OP1228 Symblephron release ( WITHOUT grafting ) 25900 12950 10360 7770
1110 OP1229 Symblephron release with grafting 50380 25190 20150 15110
1111 OP1230 Tarsorrhaphy 13800 6900 5520 4140
1112 OP1799 Tarsorrhaphy release 4840 2420 1940 1450
1113 OP1231 Vitrectomy 61020 30510 24410 18310
Foot Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1114 OP4151 Ankle ligament reconstruction 100420 50210 40170 30130
1115 OP4150 Ankle ligament repair 66160 33080 26460 19850
1116 OP4331 Extensive CTEV Release 96760 48380 38700 29030
1117 OP4332 Medial CTEV Release 68780 34390 27510 20630
1118 OP4333 Posterior CTEV Release 68780 34390 27510 20630
1119 OP4149 Tarsal tunnel release 51500 25750 20600 15450
1120 OP4148 Tibialis post tendon release 51500 25750 20600 15450
Gastro-duodenal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1121 OP4540 Bariatric Surgery Super Obese ( BMI > 50 ) 222100 111050 88840 66630
1122 OP1009 Closure of perforated duodenal ulcer 89700 44850 35880 26910
1123 OP0027 Closure of perforated gastric ulcer 89700 44850 35880 26910
1124 OP3392 Delayed gastric pull-up 135580 67790 54230 40670
1125 OP1003 Gastro-jejunostomy (without vagotomy) 99340 49670 39740 29800
1126 OP1004 Gastrostomy 63260 31630 25300 18980
1127 OP1005 Highly selective vagotomy 70860 35430 28340 21260
1128 OP3391 Laparoscopic distal gastrectomy with Bilroth 1 237280 118640 94910 71180
reconstruction
1129 OP3368 Laparoscopic distal gastrectomy with Roux-en-Y 189820 94910 75930 56950
gastrojejunostomy
1130 OP0564 Laparoscopic duodenal perforation closure 99340 49670 39740 29800
1131 OP3027 Laparoscopic gastrectomy 107500 53750 43000 32250
1132 OP0688 Laparoscopic gastric perforation closure 99340 49670 39740 29800
1133 OP0560 Laparoscopic gastro - jejunostomy ( GJ ) 103800 51900 41520 31140
1134 OP0634 Laparoscopic gastrostomy 63260 31630 25300 18980
1135 OP3369 Laparoscopic pyloromyotomy 81400 40700 32560 24420
1136 OP3370 Laparoscopic pyloroplasty 81400 40700 32560 24420
1137 OP3375 Laparoscopic total gastrectomy with with roux-en-Y 271200 135600 108480 81360
oesophagojejunostomy
1138 OP0636 Laparoscopic truncal vagotomy & gastro - jejunostomy 118060 59030 47220 35420
1139 OP3377 Laparoscopic truncal vagotomy and pyloroplasty 135580 67790 54230 40670
1140 OP1402 Partial / subtotal gastrectomy 88700 44350 35480 26610
1141 OP1279 Pyloromotomy for pyloric stenosis 59940 29970 23980 17980
1142 OP1404 Radical gastrectomy 112020 56010 44810 33610
1143 OP4538 Revisional Bariatric Surgery 222100 111050 88840 66630
1144 OP4534 Robotic Sleeve Gastrectomy 222100 111050 88840 66630
1145 OP4529 Single Incision Sleeve Gastrectomy 222100 111050 88840 66630
155
1146 OP1403 Total gastrectomy 138700 69350 55480 41610
1147 OP1010 Truncal vagotomy & gastro - jejunostomy 103800 51900 41520 31140
1148 OP0635 Truncal vagotomy & pyloroplasty 112900 56450 45160 33870
General Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1149 OP2016 Aspiration of ganglion with local / steroid injection 6520 3260 2610 1960
1150 OP2317 Aspiration of hematoma 6520 3260 2610 1960
1151 OP1299 Central venous access in neonate 33000 16500 13200 9900
1152 OP3024 Central venous line insertion in OT 10360 5180 4140 3110
1153 OP1328 Debridement ( large ) in OT 30500 15250 12200 9150
1154 OP1329 Debridement ( medium ) in OT 20320 10160 8130 6100
1155 OP1330 Debridement ( small ) in OT 15240 7620 6100 4570
1156 OP3311 Debridement of crush avulsion injury of extremity 63820 31910 25530 19150
1157 OP4812 Debridement of Diabetc Foot - Major 37500 18750 15000 11250
1158 OP0318 Debridement of foot - forefoot / heel 53060 26530 21220 15920
1159 OP0317 Debridement of foot - toes 29760 14880 11900 8930
1160 OP0544 Diagnostic laparoscopy ( with or without biopsy ) 36140 18070 14460 10840
1161 OP3164 Drainage of abdominal wall haematoma 44680 22340 17870 13400
1162 OP2046 Drainage of paravertebral abscess 35760 17880 14300 10730
1163 OP2047 Drainage of psoas abscess 35760 17880 14300 10730
1164 OP0140 Excision of Bartholin's cyst 24880 12440 9950 7460
1165 OP4327 Excision of Bony Tumour with Reconstruction & 173300 86650 69320 51990
Fixation
1166 OP1072 Excision of carbuncle 74380 37190 29750 22310
1167 OP2020 Excision of ganglion 38120 19060 15250 11440
1168 OP0248 Excision of haemangioma - extremities / trunk (5 - 10 76240 38120 30500 22870
cm)
1169 OP0355 Excision of haemangioma - extremities / trunk (less 66960 33480 26780 20090
than 5 cm)
1170 OP0249 Excision of haemangioma - extremities / trunk (more 109020 54510 43610 32710
than 10 cm)
1171 OP0354 Excision of haemangioma - face (less than 2 cm) 66960 33480 26780 20090
1172 OP0247 Excision of haemangioma - face (more than 2 cm) 109020 54510 43610 32710
1173 OP1073 Excision of large superficial soft tissue mass / tumour - 63540 31770 25420 19060
Excluding neuroma or ganglion
1174 OP2318 Excision of medium size superficial soft tissue mass / 50820 25410 20330 15250
tumour - Excluding neuroma or ganglion
1175 OP2970 Excision of multiple cysts 50820 25410 20330 15250
1176 OP3073 Excision of pilonidal sinus with flap cover 112700 56350 45080 33810
1177 OP1027 Excision of pilonidal sinus with primary closure 63540 31770 25420 19060
1178 OP1028 Excision of pilonidal sinus without primary closure 50820 25410 20330 15250
1179 OP1275 Excision of preauricular tags 25420 12710 10170 7630
1180 OP3035 Excision of sinus ( soft tissue ) 27180 13590 10870 8150
1181 OP1075 Excision of small superficial soft tissue mass / tumour - 38120 19060 15250 11440
Excluding neuroma or ganglion
1182 OP1256 Exomphalos ( omphalocele ) repair 125960 62980 50380 37790
1183 OP1002 Exploratory laparotomy ( including small biopsy ) 51900 25950 20760 15570
1184 OP0111 Gastroschisis repair 125960 62980 50380 37790
1185 OP1736 Glomus tumour excision 46140 23070 18460 13840
1186 OP3361 Incision & drainage of MULTIPLE deep abscesses 37200 18600 14880 11160
1187 OP0601 Incision and drainage of large / deep abscess 22340 11170 8940 6700
156
1188 OP0901 Incision and drainage of small / superficial abscess 10980 5490 4390 3290
1189 OP1034 Ischorectal abscess drainage 62040 31020 24820 18610
1190 OP1267 Laparoscopic division of intra-abdominal adhesions / 81780 40890 32710 24530
bands ( adhesiolysis )
1191 OP0546 Laparoscopic drainage of intra-abdominal collection 81780 40890 32710 24530
1192 OP3054 Laparoscopic removal of infected mesh (following 81160 40580 32460 24350
hernia repair)
1193 OP0562 Laparoscopic splenectomy 113940 56970 45580 34180
1194 OP2901 Laparotomy and division of intra-abdominal adhesions 84200 42100 33680 25260
/ bands
1195 OP1139 Marsupialization of Bartholin's cyst 18120 9060 7250 5440
1196 OP1006 Mesenteric cyst excision 74380 37190 29750 22310
1197 OP4143 MTP Joint debridement 54060 27030 21620 16220
1198 OP0518 Muscle biopsy 17940 8970 7180 5380
1199 OP0117 Neuroblastoma excision 127120 63560 50850 38140
1200 OP1007 Omentectomy 74380 37190 29750 22310
1201 OP3363 Paediatric vascular cut down ( venesection ) in OT 37200 18600 14880 11160
1202 OP1035 Perianal abscess drainage 49700 24850 19880 14910
1203 OP3450 Preauricular tag excision - complex 50760 25380 20300 15230
1204 OP3449 Preauricular tag excision - simple 33820 16910 13530 10150
1205 OP4816 Removal of Soft Tissue / Lipoma - Multiple 87500 43750 35000 26250
1206 OP4815 Removal of Soft Tissue / Lipoma - Single 37500 18750 15000 11250
1207 OP3348 Repair of complex lacerated wound 50820 25410 20330 15250
1208 OP1144 Resuturing of abdomen 73420 36710 29370 22030
1209 OP1394 Retroperitoneal drainage of abscess 71640 35820 28660 21490
1210 OP1008 Retroperitoneal tumour excision 108820 54410 43530 32650
1211 OP2010 Secondary wound closure ( suturing ) 73420 36710 29370 22030
1212 OP4805 Secondary wound closure (Small Wound) 30000 15000 12000 9000
1213 OP0593 Splenectomy ( open ) 119220 59610 47690 35770
1214 OP0905 Suturing of large lacerated wound 38120 19060 15250 11440
1215 OP0906 Suturing of small lacerated wound 25420 12710 10170 7630
1216 OP4146 Tendoachilles debridement 84820 42410 33930 25450
1217 OP4145 Tendoachilles decompression 56500 28250 22600 16950
1218 OP4312 Umbilectomy with/ without entering peritoneal cavity 75460 37730 30180 22640
(umbilical exploration / PVID)
1219 OP1298 Venesection 26580 13290 10630 7970
1220 OP2319 Wide excision of superficial tumour ( trunk / limbs ) 74380 37190 29750 22310
1221 OP1294 Wilms’ tumour excision 127120 63560 50850 38140
Hand Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1222 OP4385 Anastomosis by Vein Graft in Reimplantation ( 127340 63670 50940 38200
Multiple )
1223 OP4384 Anastomosis by Vein Graft in Reimplantation ( Single ) 76400 38200 30560 22920
1224 OP1612 AO plating for fracture distal phalynx 68720 34360 27490 20620
1225 OP1613 AO plating for fracture middle phalynx 68720 34360 27490 20620
1226 OP1614 AO plating for fracture proximal phalynx 68720 34360 27490 20620
1227 OP1615 AO plating for metacarpal fracture 68720 34360 27490 20620
1228 OP1325 Burns contracture release - multiple fingers / 128780 64390 51510 38630
extensive
1229 OP1326 Burns contracture release - one finger / toe / minor 85860 42930 34340 25760
157
1230 OP2304 Burns contracture release - two fingers / toes / 102980 51490 41190 30890
medium
1231 OP1763 Button hole deformity correction - multiple fingers 128780 64390 51510 38630
1232 OP1764 Button hole deformity correction - single finger 85860 42930 34340 25760
1233 OP1765 Button hole deformity correction - two fingers 107360 53680 42940 32210
1234 OP1663 Closed reduction of fracture scaphoid 60100 30050 24040 18030
1235 OP4336 Complex Foot Reconstruction / Hand 114620 57310 45850 34390
1236 OP1605 Composite grafting for finger tip injuries 64420 32210 25770 19330
1237 OP4467 Contracture Hand - Moderate 92620 46310 37050 27790
1238 OP4468 Contracture Hand - Severe 127340 63670 50940 38200
1239 OP4466 Contracture Hand - Simple 57880 28940 23150 17360
1240 OP2307 Contracture release for camptodactyly - multiple 98740 49370 39500 29620
fingers
1241 OP2305 Contracture release for camptodactyly - single finger 43020 21510 17210 12910
1242 OP2306 Contracture release for camptodactyly - two fingers 64420 32210 25770 19330
1243 OP2310 Contracture release with tendon transfer for 137240 68620 54900 41170
camptodactyly - multiple fingers
camptodactyly - single finger
camptodactyly - two fingers
1246 OP0420 Correction of complex bifid thumb ( Wassal type 1 ) 64420 32210 25770 19330
1252 OP1654 Correction of Mallet finger 60100 30050 24040 18030
1253 OP1655 Correction of Mallet finger - extensor tendon repair 102980 51490 41190 30890
1254 OP1656 Correction of Mallet finger - tendon repair with 107360 53680 42940 32210
K-wiring
1255 OP0844 Correction of simple bifid thumb / finger 47260 23630 18900 14180
1256 OP1311 Correction of simple bifid toe 47260 23630 18900 14180
1257 OP1600 Cross finger flap for finger tip injuries 85860 42930 34340 25760
1258 OP1670 Debridement for hand injuries 43020 21510 17210 12910
1259 OP1702 Debulking for macrodactyly 62500 31250 25000 18750
1260 OP1616 Distractor / JESS application for fracture distal phalynx 45000 22500 18000 13500
1261 OP1617 Distractor / JESS application for fracture middle 45000 22500 18000 13500
phalynx
1262 OP1618 Distractor / JESS application for fracture proximal 45000 22500 18000 13500
phalynx
1263 OP1619 Distractor / JESS application for metacarpal fracture 45000 22500 18000 13500
1264 OP1602 Dorsal dermodesis for nail bed injuries 68720 34360 27490 20620
1265 OP1596 Drainage of subungual haematoma 25880 12940 10350 7760
1266 OP4469 Dupuytren's Contracture - Mild 46300 23150 18520 13890
1267 OP4470 Dupuytren's Contracture - Moderate 69460 34730 27780 20840
1268 OP4471 Dupuytren's Contracture - Severe 92620 46310 37050 27790
1269 OP1683 Excision of extra digit (excluding thumb) 30000 15000 12000 9000
1270 OP4807 Excision of extra digit (Excluding thumb) Complex 60000 30000 24000 18000
1271 OP4806 Excision of extra digit (Excluding thumb) Simple 45000 22500 18000 13500
1272 OP0419 Excision of extra digit with ligament reconstruction 85860 42930 34340 25760
(excluding thumb)
1273 OP4372 Excision of glomus tumor finger 76400 38200 30560 22920
1274 OP1635 Extensor tendon repair ( Zone 1) 50000 25000 20000 15000
1275 OP1636 Extensor tendon repair ( Zone 2) - single tendon 50000 25000 20000 15000
1276 OP1640 Extensor tendon repair ( Zone 2) - two tendons 70000 35000 28000 21000
158
1277 OP1639 Extensor tendon repair ( Zone 3) - multiple tendons 107360 53680 42940 32210
1289 OP1699 First web release for cleft hand 85860 42930 34340 25760
1290 OP1620 Flexor tendon repair ( Zone 1) 68720 34360 27490 20620
1291 OP1621 Flexor tendon repair ( Zone 2) - single tendon 50000 25000 20000 15000
1292 OP1625 Flexor tendon repair ( Zone 2) - two tendons 70000 35000 28000 21000
1293 OP1624 Flexor tendon repair ( Zone 3) - multiple tendons 107360 53680 42940 32210
1305 OP1734 Free microvascular joint transfer 188740 94370 75500 56620
1306 OP1706 Free phalangeal / bone transfer for brachydactyly 85860 42930 34340 25760
1307 OP1604 Full thickness skin grafting for finger tip injuries 50000 25000 20000 15000
1308 OP1679 Groin / abdominal flap cover for hand injuries - large ( 102980 51490 41190 30890
multiple flaps )
single flap )
two flaps )
1311 OP1678 Groin / abdominal flap cover for hand injuries - 85860 42930 34340 25760
medium ( multiple flaps )
medium ( single flap )
medium ( two flaps )
1314 OP1677 Groin / abdominal flap cover for hand injuries - small ( 68720 34360 27490 20620
multiple flaps )
single flap )
two flaps )
1317 OP1760 Hand abscess drainage 30000 15000 12000 9000
1318 OP1606 Homodigital flap for finger tip injuries 85860 42930 34340 25760
1319 OP1750 Incision and drainage for flexor tenosynovitis 43020 21510 17210 12910
1320 OP1608 K - wire fixation for fracture distal phalynx 51500 25750 20600 15450
1321 OP1609 K - wire fixation for fracture middle phalynx 51500 25750 20600 15450
1322 OP1610 K - wire fixation for fracture proximal phalynx 51500 25750 20600 15450
1323 OP1611 K - wire fixation for metacarpal fracture 64420 32210 25770 19330
159
1324 OP0470 Krukenberg's operation 85860 42930 34340 25760
1325 OP1664 K-wire fixation of fracture scaphoid 64420 32210 25770 19330
1326 OP1697 Ligament reconstruction for hypoplastic thumb 85860 42930 34340 25760
1327 OP4235 Mini Plate for fracture phalanx 58600 29300 23440 17580
1328 OP3071 Nail bed reconstruction - multiple fingers 124860 62430 49940 37460
1329 OP3008 Nail bed reconstruction - single finger 70280 35140 28110 21080
1330 OP3072 Nail bed reconstruction - two fingers 97560 48780 39020 29270
1331 OP2302 Nail bed repair - multiple 57880 28940 23150 17360
1332 OP1595 Nail bed repair - single 34740 17370 13900 10420
1333 OP2303 Nail bed repair - two nail beds 46300 23150 18520 13890
1334 OP1599 Oblique triangular flap for finger tip injuries 85860 42930 34340 25760
1335 OP1680 On-top plasty / pollicization 137240 68620 54900 41170
1336 OP1669 Open reduction and ligament repair of wrist 85860 42930 34340 25760
1337 OP1666 ORIF and bone grafting for non-union of scaphoid 85860 42930 34340 25760
1338 OP1667 ORIF and vascularised bone grafting for non-union of 171640 85820 68660 51490
scaphoid
1339 OP4487 Orthoplastic Reconstruction Thumb/Finger 115780 57890 46310 34730
1340 OP1747 Osteotomy for metacarpal malunion 85860 42930 34340 25760
1341 OP1748 Osteotomy for phalangeal malunion 85860 42930 34340 25760
1342 OP1698 Pollicization for hypoplastic thumb 163020 81510 65210 48910
1343 OP3438 Primary tendon repair by tendon graft 80560 40280 32220 24170
1344 OP1668 Proximal row carpectomy 85860 42930 34340 25760
1345 OP1684 Radial club hand - centralisation / radialisation 81520 40760 32610 24460
1346 OP1686 Radial club hand - distractor / external fixator 60100 30050 24040 18030
application
1347 OP1685 Radial club hand - free epiphysis / fibula transfer 197360 98680 78940 59210
1348 OP1682 Radial club hand - osteotomy of ulna 128780 64390 51510 38630
1349 OP1742 Radial collateral ligament reconstruction of thumb 85860 42930 34340 25760
1350 OP1744 Radial collateral ligament repair of thumb 68720 34360 27490 20620
1351 OP1703 Ray resection for macrodactyly 102980 51490 41190 30890
1352 OP1759 Release of first extensor compartment 43020 21510 17210 12910
1353 OP1607 Reverse dermal cross finger flap for finger tip injuries 85860 42930 34340 25760
1354 OP1665 Screw fixation of fracture scaphoid 60100 30050 24040 18030
1355 OP1597 Shortening and closure of finger stump 37500 18750 15000 11250
1356 OP1700 Snow - Littler's procedure for cleft hand 128780 64390 51510 38630
1357 OP1603 Split skin grafting for finger tip injuries 45000 22500 18000 13500
1358 OP1756 Swan neck deformity correction - multiple fingers 107360 53680 42940 32210
1359 OP1754 Swan neck deformity correction - single finger 85860 42930 34340 25760
1360 OP1755 Swan neck deformity correction - two fingers 94400 47200 37760 28320
1361 OP1708 Syndactyly release - complex 128780 64390 51510 38630
1362 OP1288 Syndactyly release - simple 85860 42930 34340 25760
1363 OP1652 Tendon grafting - stage 1 81520 40760 32610 24460
1364 OP1653 Tendon grafting - stage 2 102980 51490 41190 30890
1365 OP1650 Tenolysis of flexor / extensor tendons - single 51500 25750 20600 15450
1366 OP1601 Thenar flap for finger tip injuries 62500 31250 25000 18750
1367 OP1701 Toe transfer - great toe 197360 98680 78940 59210
1368 OP1740 Toe transfer - second toe 197360 98680 78940 59210
1369 OP1749 Trigger finger release 34740 17370 13900 10420
1370 OP1741 Ulnar collateral ligament reconstruction of thumb 85860 42930 34340 25760
1371 OP1743 Ulnar collateral ligament repair of thumb 68720 34360 27490 20620
1372 OP1598 V - Y advancement flap for finger tip injuries 85860 42930 34340 25760
1373 OP1752 Wrist synovectomy 66160 33080 26460 19850
1374 OP1746 Zimmer splint application for multiple fingers 64420 32210 25770 19330
1375 OP1745 Zimmer splint application for one finger 64420 32210 25770 19330
160
Head And Neck Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1376 OP0733 Buccal mucosal radical excision 65740 32870 26300 19720
1377 OP0911 Commando operation 147760 73880 59100 44330
1378 OP0736 Composite oral resection - large 131320 65660 52530 39400
1379 OP0735 Composite oral resection - small 98520 49260 39410 29560
1380 OP0766 Cordectomy - larynx 82160 41080 32860 24650
1381 OP4313 Cystic hygroma (major) 70040 35020 28020 21010
1382 OP4314 Cystic hygroma (minor) 56020 28010 22410 16810
1383 OP2957 Endoscopic nasal mass excision 93360 46680 37340 28010
1384 OP0115 Excision of branchial cyst / fistula ( bilateral ) 61640 30820 24660 18490
1385 OP0114 Excision of branchial cyst / fistula ( unilateral ) 41140 20570 16460 12340
1386 OP1319 Excision of carcinoma cheek 103800 51900 41520 31140
1387 OP2963 Excision of nasopharyngeal angiofibroma - big 130620 65310 52250 39190
1388 OP2964 Excision of nasopharyngeal angiofibroma - small 93360 46680 37340 28010
1389 OP2966 Excision of nasopharyngeal angiofibroma with 167920 83960 67170 50380
intracranial extension
1390 OP4590 Excision of Sinus in neck 39380 19690 15750 11810
1391 OP0763 Extended laryngo-pharyngectomy 164180 82090 65670 49250
1392 OP0780 Extended maxillectomy 139500 69750 55800 41850
1393 OP0785 Extended neck dissection 139500 69750 55800 41850
1394 OP0803 Extra-cranial skull base resection 180540 90270 72220 54160
1395 OP1046 Glossectomy - partial 65740 32870 26300 19720
1396 OP0737 Glossectomy - subtotal 82160 41080 32860 24650
1397 OP0738 Glossectomy - total 98520 49260 39410 29560
1398 OP0797 Head and neck repair - complex 65740 32870 26300 19720
1399 OP0796 Head and neck repair - simple 32900 16450 13160 9870
1400 OP0776 Hypopharyngeal laser resection - large 90300 45150 36120 27090
1401 OP0775 Hypopharyngeal laser resection - medium 65740 32870 26300 19720
1402 OP0774 Hypopharyngeal laser resection - small 41140 20570 16460 12340
1403 OP0753 Infra - temporal fossa resection 147760 73880 59100 44330
1404 OP4221 Inter Maxillary Fixation 28040 14020 11220 8410
1405 OP0773 Laryngeal laser resection - large 82160 41080 32860 24650
1406 OP0772 Laryngeal laser resection - medium 57500 28750 23000 17250
1407 OP0771 Laryngeal laser resection - small 41140 20570 16460 12340
1408 OP0762 Laryngectomy with partial pharyngectomy 131320 65660 52530 39400
1409 OP0912 Laryngo-pharyngectomy 147760 73880 59100 44330
1410 OP0782 Laryngoscopic excision of tumours - large 65740 32870 26300 19720
1411 OP0781 Laryngoscopic excision of tumours - small 32900 16450 13160 9870
1412 OP0758 Local head and neck flap - large 82160 41080 32860 24650
1413 OP3070 Local head and neck flap - medium 67220 33610 26890 20170
1414 OP0757 Local head and neck flap - small 57500 28750 23000 17250
1415 OP4217 Mandibular Distraction Stage-I 70040 35020 28020 21010
1416 OP4218 mandibular Distraction Stage-II 28040 14020 11220 8410
1417 OP0777 Mandibulectomy - marginal 57500 28750 23000 17250
1418 OP0778 Mandibulectomy - segmental 82160 41080 32860 24650
1419 OP0779 Mandibulotomy 65740 32870 26300 19720
1420 OP4219 Maxillary Distractor Stage - I 70040 35020 28020 21010
1421 OP4220 Maxillary Distractor Stage - II 28040 14020 11220 8410
1422 OP0784 Modified neck dissection 123160 61580 49260 36950
1423 OP0761 Near total laryngectomy 123160 61580 49260 36950
161
1424 OP0787 Neck mass excision - complex 49240 24620 19700 14770
1425 OP0786 Neck mass excision - simple 24720 12360 9890 7420
1426 OP0755 Oral laser resection - large 123160 61580 49260 36950
1427 OP0759 Oral laser resection - medium 98520 49260 39410 29560
1428 OP0754 Oral laser resection - small 65740 32870 26300 19720
1429 OP0789 Oral lesion excision - complex 65740 32870 26300 19720
1430 OP0788 Oral lesion excision - simple 32900 16450 13160 9870
1431 OP0770 Oropharyngeal laser resection - large 139500 69750 55800 41850
1432 OP0769 Oropharyngeal laser resection - medium 114940 57470 45980 34480
1433 OP0768 Oropharyngeal laser resection - small 82160 41080 32860 24650
1434 OP0760 Other partial laryngectomy 82160 41080 32860 24650
1435 OP0795 Parapharyngeal space excision 114940 57470 45980 34480
1436 OP0910 Partial maxillectomy 82160 41080 32860 24650
1437 OP0794 Pedicled flap for head and neck - major 98520 49260 39410 29560
1438 OP0764 Pedicled flap for head and neck - medium 73920 36960 29570 22180
1439 OP0792 Pedicled flap for head and neck - minor 49240 24620 19700 14770
1440 OP0993 Pharyngeal fistula repair - simple without flap 49240 24620 19700 14770
1441 OP2959 Pharyngeal fistula repair with flap 89600 44800 35840 26880
1442 OP2967 Pharyngeal flap 89600 44800 35840 26880
1443 OP0767 Pharyngeal repair 73920 36960 29570 22180
1444 OP2965 Pharyngoplasty 89600 44800 35840 26880
1445 OP0793 Pharyngotomy 82160 41080 32860 24650
1446 OP0791 Photo-dynamic therapy ( PDT ) for head and neck - 123160 61580 49260 36950
complex
1447 OP0790 Photo-dynamic therapy ( PDT ) for head and neck - 82160 41080 32860 24650
simple
1448 OP1047 Radical neck dissection 106740 53370 42700 32020
1449 OP0783 Selective neck dissection 90300 45150 36120 27090
1450 OP0800 Skin graft for head and neck - large 69800 34900 27920 20940
1451 OP0801 Skin graft for head and neck - small 41140 20570 16460 12340
1452 OP0913 Supra-cricoid partial laryngectomy 123160 61580 49260 36950
1453 OP0924 Total laryngectomy 114940 57470 45980 34480
1454 OP0923 Total maxillectomy 114940 57470 45980 34480
1455 OP0807 Trans-cervical base of tongue resection 98520 49260 39410 29560
1456 OP0396 Vertical partial laryngectomy 98520 49260 39410 29560
1457 OP0809 Wide excision of lesion in head and neck - major 106740 53370 42700 32020
1458 OP0808 Wide excision of lesion in head and neck - minor 65700 32850 26280 19710
Hepato-bilio-pancreatic Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1459 OP1368 Cholecystectomy 94840 47420 37940 28450
1460 OP1015 Cholecystectomy and choledocholithotomy ( open ) 108640 54320 43460 32590
1461 OP1386 Distal pancreatectomy & pancreatico-jejunostomy 119200 59600 47680 35760
1462 OP1371 Excision of cholangiocarcinoma 124620 62310 49850 37390
1463 OP1370 Excision of choledochal cyst and hepatico-jejunostomy 124620 62310 49850 37390
1464 OP1389 Frey's procedure 155760 77880 62300 46730
1465 OP1016 Hepatico - jejunostomy ( open ) 119420 59710 47770 35830
1466 OP1274 Hepatico porto-enterostomy ( Kasai's operation ) 151960 75980 60780 45590
1467 OP1387 Insulinoma excision 119200 59600 47680 35760
1468 OP4413 Laparoscopic Assisted Distal pancreatectomy 277340 138670 110940 83200
1469 OP4414 Laparoscopic Assisted Hepatico Jejunostomy 246520 123260 98610 73960
162
1470 OP4415 Laparoscopic Assisted Lateral Pancreatico- 286160 143080 114460 85850
Jejunostomy
1471 OP0554 Laparoscopic cholecystectomy 99340 49670 39740 29800
1472 OP0549 Laparoscopic cholecystectomy and 114240 57120 45700 34270
choledocholithotomy ( CBD exploration )
1473 OP0555 Laparoscopic cholecystectomy with 114240 57120 45700 34270
choledochoduodenostomy
1474 OP3393 Laparoscopic cholecystectomy with intra-operative 115260 57630 46100 34580
cholangiogram
1475 OP0565 Laparoscopic cysto - gastrostomy 103800 51900 41520 31140
1476 OP0566 Laparoscopic cysto - jejunostomy 103800 51900 41520 31140
1477 OP0563 Laparoscopic deroofing of non-hydatid liver cyst 103800 51900 41520 31140
1478 OP3031 Laparoscopic distal pancreatectomy 129900 64950 51960 38970
1479 OP0588 Laparoscopic drainage of liver abscess drainage 103800 51900 41520 31140
1480 OP1391 Laparoscopic drainage of pseudopancreatic cyst 99340 49670 39740 29800
1481 OP0591 Laparoscopic excision of choledochal cyst and 129820 64910 51930 38950
hepatico-jejunostomy
1482 OP0550 Laparoscopic hepatico - jejunostomy 129820 64910 51930 38950
1483 OP3032 Laparoscopic Peustow's operation 107360 53680 42940 32210
1484 OP3371 Laparoscopic repair of CBD injury 101700 50850 40680 30510
1485 OP3030 Laparoscopic Whipple's operation 179140 89570 71660 53740
1486 OP4412 Laparoscopic Whipples procedure 308180 154090 123270 92450
1487 OP1390 Laparotomy and drainage of pseudopancreatic cyst 72940 36470 29180 21880
1488 OP1388 Lateral pancreatico-jejunostomy 114240 57120 45700 34270
1489 OP1375 Left hepatectomy 135500 67750 54200 40650
1490 OP1067 Left liver lobectomy 146280 73140 58510 43880
1491 OP1377 Liver abscess drainage (open) 77620 38810 31050 23290
1492 OP1372 Liver resection with excision of CBD 194960 97480 77980 58490
1493 OP1393 Necrosectomy and drainage of pancreatic abscess 103800 51900 41520 31140
1494 OP0732 Open deroofing / excision of non-hydatid liver cyst 77620 38810 31050 23290
1495 OP1376 Partial liver resection ( lateral segmentectomy ) 87680 43840 35070 26300
1496 OP1017 Primary repair of common hepatic or bile duct ( CBD ) 66120 33060 26450 19840
1497 OP4311 Pseudo pancreatic cyst - cystogastrostomy 76400 38200 30560 22920
1498 OP1369 Radical cholecystectomy ( liver bed excision with bile 123160 61580 49260 36950
duct excision + lymph nodal dissection )
1499 OP0119 Radical cholecystectomy ( lymph nodal dissection + 123160 61580 49260 36950
liver bed excision WITHOUT bile duct excision )
resection of segment 4B & 5 with bile duct excision )
right tri-segmentectomy with bile duct excision )
1502 OP4539 Revisional Cholecystectomy Surgery 118260 59130 47300 35480
1503 OP1374 Right hepatectomy 162560 81280 65020 48770
1504 OP1373 Right hepatic trisegmentectomy 200320 100160 80130 60100
1505 OP4417 Robotic Assisted Distal pancreatectomy 332820 166410 133130 99850
1506 OP4419 Robotic Assisted Hepatico-Jejunostomy 258840 129420 103540 77650
1507 OP4418 Robotic Assisted Lateral Pancreatico- Jejunostomy 343420 171710 137370 103030
1508 OP4416 Robotic Assisted Whipples procedure 369820 184910 147930 110950
1509 OP1392 Roux-en-Y cystojejunostomy ( open ) 101960 50980 40780 30590
1510 OP4528 Single Incision Laparoscopic Cholecystectomy 118260 59130 47300 35480
1511 OP1385 Whipple's procedure 184880 92440 73950 55460
Hernia Operations
163
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1512 OP0681 Bassini repair of inguinal hernia with mesh ( bilateral ) 85800 42900 34320 25740
1513 OP0682 Bassini repair of inguinal hernia with mesh ( unilateral 76740 38370 30700 23020
)
1514 OP0600 Incisional hernia repair with abdominoplasty 147780 73890 59110 44330
1515 OP1057 Inguinal herniotomy ( bilateral ) 61000 30500 24400 18300
1516 OP1058 Inguinal herniotomy ( unilateral ) 54200 27100 21680 16260
1517 OP2941 Inguinal herniotomy in Neonates ( bilateral ) 67060 33530 26820 20120
1518 OP2940 Inguinal herniotomy in Neonates ( unilateral ) 45280 22640 18110 13580
1519 OP1097 Laparoscopic epigastric hernia repair - transabdominal 72280 36140 28910 21680
intra-peritoneal onlay mesh
1520 OP0426 Laparoscopic epigastric hernia repair - transabdominal 72280 36140 28910 21680
pre-peritoneal inlay mesh
1521 OP1101 Laparoscopic incisional hernia repair - transabdominal 113340 56670 45340 34000
intraperitoneal onlay mesh
1522 OP0535 Laparoscopic inguinal herniotomy - bilateral 57380 28690 22950 17210
1523 OP0534 Laparoscopic inguinal herniotomy - unilateral 49720 24860 19890 14920
1524 OP0598 Laparoscopic lumbar hernia repair 103900 51950 41560 31170
1525 OP1103 Laparoscopic repair of diaphragmatic hernia 263320 131660 105330 79000
1526 OP1102 Laparoscopic spigelian hernia repair - transabdominal 103900 51950 41560 31170
1527 OP0531 Laparoscopic total extra-peritoneal mesh repair of 103900 51950 41560 31170
femoral hernia ( TEP ) - bilateral
femoral hernia ( TEP ) - unilateral
inguinal hernia ( TEP ) - bilateral
inguinal hernia ( TEP ) - unilateral
obturator hernia ( TEP ) - bilateral
obturator hernia ( TEP ) - unilateral
Recurrent inguinal hernia ( TEP ) - bilateral
Recurrent inguinal hernia ( TEP ) - unilateral
1535 OP1098 Laparoscopic umbilical hernia repair - transabdominal 82200 41100 32880 24660
1536 OP0427 Laparoscopic umbilical hernia repair - transabdominal 82200 41100 32880 24660
pre-peritoneal inlay mesh
1537 OP1099 Laparoscopic ventral hernia ( others ) 89620 44810 35850 26890
1538 OP4001 Laproscopic Diaphragmatic rupture repair 263320 131660 105330 79000
1539 OP1059 Mesh repair of inguinal hernia ( bilateral ) 94840 47420 37940 28450
1540 OP1060 Mesh repair of inguinal hernia ( unilateral ) 79100 39550 31640 23730
1541 OP1283 Mesh repair of Recurrent inguinal hernia ( bilateral ) 99340 49670 39740 29800
1542 OP1284 Mesh repair of Recurrent inguinal hernia ( unilateral ) 85800 42900 34320 25740
1543 OP3380 Open incisional hernia repair with component 237280 118640 94910 71180
separation with flap advancement and mesh
placement
1544 OP3026 Open removal of infected mesh (following hernia 61640 30820 24660 18490
repair)
1545 OP1053 Open repair of epigastric hernia with mesh 65500 32750 26200 19650
1546 OP0684 Open repair of epigastric hernia without mesh 65500 32750 26200 19650
164
1547 OP1054 Open repair of femoral hernia 72280 36140 28910 21680
1548 OP1055 Open repair of incisional hernia ( first repair ) with 99140 49570 39660 29740
mesh
1549 OP1056 Open repair of incisional hernia ( first repair ) without 89700 44850 35880 26910
mesh
1550 OP0025 Open repair of lumbar hernia 103900 51950 41560 31170
1551 OP0024 Open repair of obturator hernia 103900 51950 41560 31170
1552 OP1062 Open repair of Recurrent incisional hernia with mesh 113340 56670 45340 34000
1553 OP1287 Repair of congenital diaphragmatic hernia 134000 67000 53600 40200
1554 OP2942 Repair of Recurrent inguinal hernia without mesh ( 99340 49670 39740 29800
bilateral )
1555 OP2943 Repair of Recurrent inguinal hernia without mesh ( 85800 42900 34320 25740
unilateral )
1556 OP1425 Repair of traumatic diaphragmatic hernia ( open ) 219460 109730 87780 65840
1557 OP1291 Repair of umbilical hernia with mesh ( open ) 99340 49670 39740 29800
1558 OP0683 Repair of umbilical hernia without mesh ( open ) 74500 37250 29800 22350
1559 OP1065 Repair of ventral hernia (not umbilical or epigastric) 99340 49670 39740 29800
with mesh
1560 OP1064 Repair of ventral hernia (not umbilical or epigastric) 74500 37250 29800 22350
without mesh
1561 OP4536 Robotic Hiatus Hernia Repair 118260 59130 47300 35480
1562 OP4535 Robotic RYGB 222100 111050 88840 66630
1563 OP4533 Single Incision IPOM 97840 48920 39140 29350
1564 OP4532 Single Incision TEP ( Bilateral ) 123720 61860 49490 37120
1565 OP4531 Single Incision TEP ( Unilateral ) 103800 51900 41520 31140
1566 OP1061 Spigelian hernia repair 103900 51950 41560 31170
1567 OP0431 Strangulated incisional hernia repair ( open technique 108640 54320 43460 32590
)
1568 OP1063 Strangulated non-incisional ventral hernia repair ( 103900 51950 41560 31170
open technique)
1569 OP1306 Ventral hernia repair with abdominoplasty 135500 67750 54200 40650
Hydatid Cyst Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1570 OP1378 Excision or drainage of hydatid cyst of liver (open) 114240 57120 45700 34270
1571 OP0589 Excision or drainage of intraperitoneal hydatid cyst 114240 57120 45700 34270
1572 OP1379 Laparoscopic excision or drainage of hydatid cyst of 99340 49670 39740 29800
liver
1573 OP1066 Laparoscopic excision or drainage of intraperitoneal 99340 49670 39740 29800
hydatid cyst
Intestinal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1574 OP1406 Abdominoperineal resection ( APR ) - open 123280 61640 49310 36980
1575 OP1026 Anterior resection of rectum ( open ) 123280 61640 49310 36980
1576 OP1405 Anterior resection with total mesorectal excision ( 112020 56010 44810 33610
TME ) - open
1577 OP2947 Bishop Koop ileostomy in Neonates 72280 36140 28910 21680
1578 OP1296 Closure of colostomy 54200 27100 21680 16260
165
1579 OP0118 Closure of ileostomy 54200 27100 21680 16260
1580 OP1398 Colonic interposition 103800 51900 41520 31140
1581 OP1250 Colostomy and colonic biopsy 72280 36140 28910 21680
1582 OP3394 Delayed colon interpostion 169500 84750 67800 50850
1583 OP1507 Duhamel's abdomino-perineal pull through resection 99340 49670 39740 29800
with colo-anal anastomosis for Hirschprung's disease
1584 OP4308 Duodenal atresia/annular pancreas( 81500 40750 32600 24450
dudenodudenostomy/dudenojejunostomy)
1585 OP2950 End colostomy in Neonates 72280 36140 28910 21680
1586 OP0101 End ileostomy 56540 28270 22620 16960
1587 OP2949 End ileostomy in Neonates 72280 36140 28910 21680
1588 OP4307 Gastro-jejunostomy and pyloroplasty 73880 36940 29550 22160
1589 OP1266 Imaging guided hydrostatic reduction of 45280 22640 18110 13580
intussusception
1590 OP0026 Jejunostomy / feeding jejunostomy 63260 31630 25300 18980
1591 OP4395 Laparoscoic Sigmoid colectomy with colo-colic 215720 107860 86290 64720
anastmosis
1592 OP4397 Laparoscopic Abdomino-perineal resection with 277340 138670 110940 83200
permanent Colostomy
1593 OP4396 Laparoscopic Anterior Resection with TME with 246520 123260 98610 73960
Colorectal anastmosis with/without diverting stoma
1594 OP0552 Laparoscopic anterior resection with total mesorectal 125600 62800 50240 37680
excision ( TME )
1595 OP0553 Laparoscopic assisted abdominoperineal resection ( 125600 62800 50240 37680
APR )
1596 OP0551 Laparoscopic assisted left hemicolectomy 103800 51900 41520 31140
1597 OP0592 Laparoscopic assisted right hemicolectomy 103800 51900 41520 31140
1598 OP2903 Laparoscopic closure of intestinal perforation 99340 49670 39740 29800
1599 OP4391 Laparoscopic Left hemicolectomy with Colo-Colic 215720 107860 86290 64720
Anastmosis with/without Diverting Stoma
1600 OP3093 Laparoscopic Meckel's diverticulectomy 64480 32240 25790 19340
1601 OP3028 Laparoscopic proctocolectomy 134380 67190 53750 40310
1602 OP4393 Laparoscopic Procto-colectomy with diverting 246520 123260 98610 73960
Ileostomy
1603 OP1505 Laparoscopic pull through for Hirschprung's disease 103900 51950 41560 31170
1604 OP0561 Laparoscopic rectopexy 119420 59710 47770 35830
1605 OP4394 Laparoscopic Restorative Procto-colectomy with/ 308180 154090 123270 92450
without diverting Ileostomy
1606 OP4390 Laparoscopic Right hemicolectomy with 215720 107860 86290 64720
Ileo-Transverse Anastmosis with/without Diverting
Stoma
1607 OP4399 Laparoscopic Sigmoid Colectomy with Colo-Rectal 246520 123260 98610 73960
Anastmosis with diverting loop ileostomy
1608 OP4398 Laparoscopic Sigmoid Colectomy with Hartman's 215720 107860 86290 64720
Procedure
1609 OP0545 Laparoscopic small bowel resection 103800 51900 41520 31140
1610 OP3029 Laparoscopic total colectomy 134380 67190 53750 40310
1611 OP4400 Laparoscopic Total Colectomy For IBD/Cancer 246520 123260 98610 73960
1612 OP4392 Laparoscopic Total Colectomy with Ileo- Rectal 246520 123260 98610 73960
anastmosis
1613 OP1070 Laparotomy & bowel resection for intussusception 78840 39420 31540 23650
1614 OP2902 Laparotomy & closure of intestinal perforation 72280 36140 28910 21680
1615 OP1265 Laparotomy & reduction of intussusception 72280 36140 28910 21680
1616 OP1297 Laparotomy for correction of intestinal malrotation 63260 31630 25300 18980
1617 OP0432 Left hemicolectomy ( open ) 103800 51900 41520 31140
1618 OP2952 Loop colostomy in Neonates 72280 36140 28910 21680
1619 OP0001 Loop ileostomy 56540 28270 22620 16960
1620 OP2951 Loop ileostomy in Neonates 72280 36140 28910 21680
166
1621 OP4310 Meckel's diverticulum (open) 56020 28010 22410 16810
1622 OP4309 Mesentric cyst excision 53480 26740 21390 16040
1623 OP2948 Miculicz operation in Neonates 72280 36140 28910 21680
1624 OP1508 Modified Soave's abdomino-perineal pull through 103900 51950 41560 31170
resection with colo-anal anastomosis for total colonic
Hirschprung's disease
1625 OP1271 Multiple intestinal resection and anastomosis 118060 59030 47220 35420
1626 OP2946 Multiple intestinal resection and anastomosis in 119420 59710 47770 35830
Neonates
1627 OP1409 Proctocolectomy ( open ) 113340 56670 45340 34000
1628 OP4324 PSARP + laparotomy for anorectal malformation 101880 50940 40750 30560
1629 OP1412 Rectal prolapse repair with mesh ( laproscopic ) 100980 50490 40390 30290
1630 OP1411 Rectal prolapse repair with mesh ( open ) 67060 33530 26820 20120
1631 OP2953 Resection of band of Ladd 81740 40870 32700 24520
1632 OP1410 Restorative proctocolectomy 155760 77880 62300 46730
1633 OP1407 Right hemicolectomy ( open ) 108640 54320 43460 32590
1634 OP4409 Robotic Assisted Total Colectomy For IBD/Cancer 295840 147920 118340 88750
1635 OP4408 Robotic Assisted Abdomino-perineal resection with 332820 166410 133130 99850
permanent Colostomy
1636 OP4407 Robotic Assisted Anterior Resection with TME with 295840 147920 118340 88750
Colorectal anastmosis with/without diverting stoma
1637 OP4402 Robotic Assisted Left hemicolectomy with Colo-colic 258840 129420 103540 77650
Anastmosis with/without Diverting Stoma
1638 OP4404 Robotic Assisted Procto-colectomy with diverting 295840 147920 118340 88750
Ileostomy
1639 OP4405 Robotic Assisted Restorative Procto-colectomy with/ 369820 184910 147930 110950
without diverting Ileostomy
1640 OP4401 Robotic Assisted Right hemicolectomy with 258840 129420 103540 77650
Ileo-Transverse Anastmosis with/without Diverting
Stoma
1641 OP4406 Robotic Assisted Sigmoid colectomy with Colo-Colic 258840 129420 103540 77650
anastmosis
1642 OP4411 Robotic Assisted Sigmoid Colectomy with Colo-Rectal 295840 147920 118340 88750
Anastmosis with diverting loop ileostomy
1643 OP4410 Robotic Assisted Sigmoid Colectomy with Hartman's 258840 129420 103540 77650
Procedure
1644 OP4403 Robotic Assisted Total Colectomy with Ileo- Rectal 295840 147920 118340 88750
anastmosis
1645 OP1036 Sigmoid / descending colectomy ( open ) 113340 56670 45340 34000
1646 OP0100 Sigmoid end colostomy 56540 28270 22620 16960
1647 OP1249 Sigmoid loop colostomy 56540 28270 22620 16960
1648 OP1041 Sigmoid resection for volvulus of colon 108640 54320 43460 32590
1649 OP1042 Simple untwisting for volvulus of colon 70860 35430 28340 21260
1650 OP1071 Single intestinal resection and anastomosis 61640 30820 24660 18490
1651 OP2945 Single intestinal resection and anastomosis in 81740 40870 32700 24520
Neonates
1652 OP3010 Small bowel transplant recipient operation(Normal / 129440 64720 51780 38830
Early)
1653 OP1278 Soave's abdomino-perineal pull through resection 103900 51950 41560 31170
1654 OP1408 Subtotal colectomy ( open ) 113340 56670 45340 34000
1655 OP1506 Swenson's abdomino-perineal pull through resection 103900 51950 41560 31170
1656 OP0587 Transabdominal rectopexy ( open ) 108640 54320 43460 32590
1657 OP1032 Trans-anal pull through for Hirschprung's disease 103900 51950 41560 31170
1658 OP1039 Transverse colectomy ( open ) 108640 54320 43460 32590
1659 OP0099 Transverse colostomy 103900 51950 41560 31170
1660 OP1040 Tube caecostomy 45280 22640 18110 13580
167
Kidney Transplantation
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1661 OP1081 Donor nephrectomy ( open ) 78380 39190 31350 23510
1662 OP0450 Laparoscopic donor nephrectomy 100740 50370 40300 30220
1663 OP0528 Laparoscopic internal drainage of post renal 56020 28010 22410 16810
transplant lymphocele
1664 OP0442 Native nephro-ureterectomy of prospective / 93360 46680 37340 28010
operated renal transplant patient - bilateral
1665 OP1079 Native nephro-ureterectomy of prospective / 63440 31720 25380 19030
operated renal transplant patient - unilateral
1666 OP0524 Nephrectomy of transplanted kidney 82040 41020 32820 24610
1667 OP1084 Post renal transplant lymphocele aspiration / drain 56020 28010 22410 16810
insertion in OT
1668 OP0527 Post renal transplant lymphocele internal drainage ( 56020 28010 22410 16810
open procedure )
1669 OP1082 Renal transplant recipient surgery 138700 69350 55480 41610
1670 OP0523 Rexploration & drainage of collection following renal 56020 28010 22410 16810
transplant recipient surgery
1671 OP0456 Rexploration following renal transplant recipient 56020 28010 22410 16810
surgery for acute graft rejection
surgery for chronic graft rejection
surgery for graft dysfunction
surgery for haemorrhage
surgery for thrombosis
surgery for urinary leaks
surgery for urinary obstruction
Liver Transplant Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1678 OP0616 Extended left lateral segment orthotopic liver
transplantation
1679 OP0610 Extended left lateral segmentectomy of liver donor
1680 OP0608 Extended right hepatectomy of liver donor
1681 OP0613 Extended right lobe orthotopic liver transplantation
1682 OP0607 Left hepatectomy of liver donor
1683 OP0606 Left hepatectomy with caudate lobe, of liver donor
Within Package
1684 OP0615 Left lateral segment orthotopic liver transplantation
1685 OP0609 Left lateral segmentectomy of liver donor
1686 OP0618 Left lobe + caudate lobe orthotopic liver
transplantation
1687 OP0614 Left lobe orthotopic liver transplantation
1688 LINHIDC Liver Transplant High Risk - Doctors operation charges
1689 LIVTDOC Liver Transplant Low - Doctors operation charges
168
1690 LIVNOR Liver Transplant Normal Risk - Doctors operation
charges
1691 LTSDOC Liver transplant surgery ( adult ) Normal/Early -
recipient - amount given to surgeon from within the
package
1692 LTSCDO Liver transplant surgery (child) - recipient - amount
given to surgeon from within the package
1693 OP0625 Monosegment orthotopic liver transplantation
1694 OP0843 Re-exploration of liver donor
1695 OP0619 Re-exploration of liver recipient and control of
bleeding
1696 OP0624 Re-exploration of liver recipient and excision of
hepatic artery pseudoaneurysm
1697 OP0623 Re-exploration of liver recipient and hepatic artery
reconstruction
1698 OP0622 Re-exploration of liver recipient and portal vein
thrombectomy
1699 OP0621 Re-exploration of liver recipient and repair of cut
surface leak
1700 OP0620 Re-exploration of liver recipient and revised biliary
reconstruction
1701 OP0605 Right hepatectomy of liver donor
1702 OP0612 Right lobe orthotopic liver transplantation
1703 OP0611 Whole graft orthotopic liver transplantation
Lymphadenectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1704 OP2822 Axillary clearance for breast carcinoma 90380 45190 36150 27110
1705 OP2823 Axillary sampling for breast disease 90380 45190 36150 27110
1706 OP2824 Axillary sentinal lymph node biopsy 36200 18100 14480 10860
1707 OP0543 Endoscopic axillary lymph node sampling 36200 18100 14480 10860
1708 OP0687 Ilio-inguinal lymph nodal block dissection - bilateral 101660 50830 40660 30500
1709 OP0686 Ilio-inguinal lymph nodal block dissection - unilateral 67760 33880 27100 20330
1710 OP4166 Ilioinguinal lymphadenectomy ( Bilateral ) 168080 84040 67230 50420
1711 OP4165 Ilioinguinal lymphadenectomy ( Unilateral ) 112060 56030 44820 33620
1712 OP2875 Inguinal lymph nodal block dissection - bilateral 101660 50830 40660 30500
1713 OP2876 Inguinal lymph nodal block dissection - unilateral 67760 33880 27100 20330
1714 OP3395 Laparoscopic abdominal lymphadenectomy 115260 57630 46100 34580
1715 OP1074 Lymph node biopsy 22660 11330 9060 6800
1716 OP0765 Paratracheal lymph nodal dissection 86760 43380 34700 26030
1717 OP2878 Pelvic lymph nodal block dissection 90380 45190 36150 27110
1718 OP0017 Retroperitoneal lymphadenectomy for malignancy ( 112900 56450 45160 33870
RPLND )
1719 OP4386 RPLND Bilateral 152820 76410 61130 45850
1720 OP4387 RPLND Unilateral 101880 50940 40750 30560
1721 OP4729 Superficial Inguinal Lymph Nodal Dissection - Bilateral 84000 42000 33600 25200
1722 OP4728 Superficial Inguinal Lymph Nodal Dissection - 52500 26250 21000 15750
Unilateral
1723 OP3383 Thoracic lymphadenectomy (open) 101700 50850 40680 30510
1724 OP3386 Thoracoscopic lymphadenectomy 101700 50850 40680 30510
Medicines
169
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1725 OP4492 Incisional Hernia Repair with Component Separation 162080 81040 64830 48620
1726 OP4490 Release of Tongue Tie with Z plasty 46300 23150 18520 13890
1727 OP4458 Suturing of Multiple lacerated wound 57880 28940 23150 17360
Miscellaneous Orthopaedics Procedures
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1728 OP2011 Above-knee / Above-elbow plaster cast application 11420 5710 4570 3430
1729 OP2982 Application of skeletal traction 11220 5610 4490 3370
1730 OP3255 Arthrotomy for septic arthritis 51640 25820 20660 15490
1731 OP2015 Aspiration of hemarthrosis 6180 3090 2470 1850
1732 OP2012 Below-knee / Below-elbow plaster cast application 8520 4260 3410 2560
1733 OP2991 Bone grafting / Allograft / Bone subsitute - Long bone 54140 27070 21660 16240
1734 OP2992 Bone grafting / Allograft / Bone subsitute - Short bone 35240 17620 14100 10570
1735 OP3061 Capsulotomy of elbow 65660 32830 26260 19700
1736 OP3053 Capsulotomy of metatarsophalyngeal ( MP ) joints 60160 30080 24060 18050
1737 OP3052 Capsulotomy of metatarsophalyngeal + 65660 32830 26260 19700
interphalyngeal ( MP & IP ) joints
1738 OP3261 Closed tendo-achilles tenotomy 24480 12240 9790 7340
1739 OP2987 Core decompression hip 60160 30080 24060 18050
1740 OP2985 Core decompression hip + bone grafting 77320 38660 30930 23200
1741 OP1973 Curettage, drainage & debridement for osteomyelitis 36420 18210 14570 10930
1742 OP1976 DeQuervein's release 25900 12950 10360 7770
1743 OP2984 Egger's Operation 60160 30080 24060 18050
1744 OP2983 Epiphyseal Drilling 51640 25820 20660 15490
1745 OP2974 Epiphysiodesis 60160 30080 24060 18050
1746 OP4318 Examination under general anaesthesia 12740 6370 5100 3820
1747 OP2027 Fasciotomy - Upper / Lower limb 41560 20780 16620 12470
1748 OP3042 Halo pelvis application 43060 21530 17220 12920
1749 OP2986 Halo vest application 25900 12950 10360 7770
1750 OP2022 Ingrowing toe nail excision 34740 17370 13900 10420
1751 OP2014 Intra-articular injections 6180 3090 2470 1850
1752 OP4317 Large procedure (Misc) - Paed 42020 21010 16810 12610
1753 OP2017 Local hydrocortisone infiltration 6180 3090 2470 1850
1754 OP2990 Manipulation of club foot 11220 5610 4490 3370
1755 OP2029 Manipulation of frozen shoulder joint under GA 19900 9950 7960 5970
1756 OP2018 Manipulation of joints with hydrocortisone infiltration 10940 5470 4380 3280
1757 OP2030 Manipulation of stiff knee under GA 19900 9950 7960 5970
1758 OP4316 Medium procedure (Misc) - Paed 28040 14020 11220 8410
1759 OP2981 Needle biopsy of bone / soft tissue, in OT 21580 10790 8630 6470
1760 OP2975 Open adductor tenotomy 43060 21530 17220 12920
1761 OP2976 Open adductor tenotomy with obturator neurectomy 60160 30080 24060 18050
1762 OP2989 Open Bone Biopsy 15480 7740 6190 4640
1763 OP3265 Open synovectomy ( ankle ) 72760 36380 29100 21830
1764 OP3266 Open synovectomy ( elbow ) 72760 36380 29100 21830
1765 OP3267 Open synovectomy ( Hip ) 72760 36380 29100 21830
1766 OP3268 Open synovectomy ( knee ) 72760 36380 29100 21830
170
1767 OP3269 Open synovectomy ( small joints of foot ) 72760 36380 29100 21830
1768 OP3270 Open synovectomy ( small joints of hand ) 72760 36380 29100 21830
1769 OP3381 Partial claviculectomy 56740 28370 22700 17020
1770 OP3382 Partial manubriectomy 56740 28370 22700 17020
1771 OP1840 Partial patellectomy 59240 29620 23700 17770
1772 OP4350 Periarticular Soft Tissue Reconstruction 76400 38200 30560 22920
1773 OP1974 Posteromedial release for CTEV 61820 30910 24730 18550
1774 OP2900 Removal of deep foreign body - limbs or trunk 41560 20780 16620 12470
1775 OP2025 Removal of superficial foreign body - limbs or trunk 23700 11850 9480 7110
1776 OP1972 Sequestrectomy + saurcerisation (major) for 56680 28340 22670 17000
osteomyelitis
1777 OP1971 Sequestrectomy + saurcerisation (minor) for 25900 12950 10360 7770
osteomyelitis
1778 OP4315 Small procedure (Misc) -Paed 14000 7000 5600 4200
1779 OP1978 Souter's / Yount's contracture release for polio 52000 26000 20800 15600
1780 OP2013 Spica plaster cast application in OT 19080 9540 7630 5720
1781 OP2977 Subcutaneous Adductor Tenotomy 24480 12240 9790 7340
1782 OP2028 Synovial biopsy 15480 7740 6190 4640
1783 OP1841 Total patellectomy 59240 29620 23700 17770
1784 OP1977 Trigger thumb / finger release 34740 17370 13900 10420
Miscellaneous Vascular Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1785 OP0417 Carotid body tumour excision 117400 58700 46960 35220
1786 OP0418 Internal iliac artery ligation 36140 18070 14460 10840
1787 OP2918 Pseudoaneurysm repair 72240 36120 28900 21670
1788 OP3022 Stem cell therapy for limb ischaemia 82160 41080 32860 24650
1789 OP0316 Temporal artery biopsy 24660 12330 9860 7400
Morbid Obesity Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1790 OP0536 Laparoscopic adjustable gastric banding 112900 56450 45160 33870
1791 OP0539 Laparoscopic bilio-pancreatic diversion 205200 102600 82080 61560
1792 OP0547 Laparoscopic gastric band removal 41140 20570 16460 12340
1793 OP0537 Laparoscopic Roux-en-Y gastric bypass 186560 93280 74620 55970
1794 OP0538 Laparoscopic sleeve gastrectomy 186560 93280 74620 55970
1795 OP4530 Single Incision RYGB 222100 111050 88840 66630
Nerve Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1796 OP1710 Anterior transposition of ulnar nerve 79460 39730 31780 23840
1797 OP2178 Arthroscopic median nerve decompression 54200 27100 21680 16260
1798 OP1312 Brachial plexus exploration & nerve repair 138920 69460 55570 41680
171
1799 OP1313 Brachial plexus exploration & nerve transfer / 162080 81040 64830 48620
neurotization
1800 OP1314 Brachial plexus exploration with nerve grafting 180600 90300 72240 54180
1801 OP1112 Brachial plexus repair - neurolysis 138920 69460 55570 41680
1802 OP3257 Carpal tunnel release (open) without synovectomy 54200 27100 21680 16260
1803 OP1705 Carpal tunnel release operation with Guyon's canal 54200 27100 21680 16260
release
1804 OP1704 Carpal tunnel release operation with opponensplasty 135500 67750 54200 40650
1805 OP1712 Carpal tunnel release operation with synovectomy 75000 37500 30000 22500
1806 OP1707 Cubital tunnel release 54200 27100 21680 16260
1807 OP1716 Digital nerve grafting 69460 34730 27780 20840
1808 OP1713 Digital nerve repair 50000 25000 20000 15000
1809 OP0921 Endoscopic optic nerve decompression 124220 62110 49690 37270
1810 OP1722 Excision of neuroma - major nerve 117400 58700 46960 35220
1811 OP1721 Excision of neuroma - minor nerve 81320 40660 32530 24400
1812 OP3433 Exploration (alone) for brachial plexus injury 69460 34730 27780 20840
1813 OP0930 Facial nerve decompression - vertical / tympanic 162540 81270 65020 48760
segment
1814 OP0915 Facial nerve decompression complete ( vertical + 162540 81270 65020 48760
horizontal segment )
1815 OP1176 Laparoscopic presacral neurectomy 90380 45190 36150 27110
1816 OP1720 Median nerve grafting 144440 72220 57780 43330
1817 OP1715 Median nerve repair 99340 49670 39740 29800
1818 OP1107 Micro-surgical decompression of 5th cranial nerve ( 162540 81270 65020 48760
trigeminal )
1819 OP0479 Micro-surgical decompression of 7th cranial nerve ( 162540 81270 65020 48760
facial )
1820 OP3335 Miscellaneous nerve grafting ( complex ) 121000 60500 48400 36300
1821 OP3336 Miscellaneous nerve grafting ( simple ) 72740 36370 29100 21820
1822 OP1123 Nerve biopsy 16340 8170 6540 4900
1823 OP2300 Nerve exploration + neurolysis for median nerve 79460 39730 31780 23840
1824 OP2301 Nerve exploration + neurolysis for radial nerve 79460 39730 31780 23840
1825 OP1968 Nerve exploration + neurolysis for ulnar nerve 79460 39730 31780 23840
1826 OP4225 Neurolysis for major nerve 84060 42030 33620 25220
1827 OP1966 Neurolysis of lateral popliteal nerve 100000 50000 40000 30000
1828 OP1969 Other nerve repair 90380 45190 36150 27110
1829 OP1090 Peripheral neurectomy ( maxilla / mandible ) 43900 21950 17560 13170
1830 OP4708 Peroneal Nerve Repair ( Direct ) 94500 47250 37800 28350
1831 OP4709 Peroneal Nerve Repair ( with nerve graft ) 126000 63000 50400 37800
1832 OP1719 Radial nerve grafting 135500 67750 54200 40650
1833 OP1717 Radial nerve repair 108380 54190 43350 32510
1834 OP3271 Sciatic nerve exploration 79460 39730 31780 23840
1835 OP3448 Sciatic nerve exploration and repair 112060 56030 44820 33620
1836 OP4240 Sciatic Nerve repair (with nerve graft) 140100 70050 56040 42030
1837 OP0907 Total facial nerve decompression upto geniculate 162540 81270 65020 48760
ganglion
1838 OP0397 Total facial nerve repair 162540 81270 65020 48760
1839 OP1718 Ulnar nerve grafting 135500 67750 54200 40650
1840 OP1714 Ulnar nerve repair 108380 54190 43350 32510
Neurosurgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

172
1841 OP1124 Application of skull traction 16320 8160 6530 4900
1842 OP1126 Brain abscess tapping 103900 51950 41560 31170
1843 OP1120 Chronic subdural haematoma tapping 144440 72220 57780 43330
1844 OP1122 Cisternal puncture 15880 7940 6350 4760
1845 OP1104 Clipping of aneurysm of anterior communicating 210800 105400 84320 63240
artery of brain
1846 OP0198 Clipping of aneurysm of anterior inferior cerebellar 210800 105400 84320 63240
artery
1847 OP0005 Clipping of aneurysm of basilar artery of brain 210800 105400 84320 63240
1848 OP0192 Clipping of aneurysm of carotid bifurcation 210800 105400 84320 63240
1849 OP0191 Clipping of aneurysm of distal anterior cerebral artery 210800 105400 84320 63240
1850 OP0195 Clipping of aneurysm of distal extracranial internal 210800 105400 84320 63240
carotid artery
1851 OP0004 Clipping of aneurysm of internal carotid artery 210800 105400 84320 63240
1852 OP0008 Clipping of aneurysm of middle cerebral artery 210800 105400 84320 63240
bifurcation
1853 OP0200 Clipping of aneurysm of middle cerebral artery cortical 210800 105400 84320 63240
branches
1854 OP0199 Clipping of aneurysm of middle cerebral artery 210800 105400 84320 63240
trifurcation
1855 OP0197 Clipping of aneurysm of posterior cerebral artery 210800 105400 84320 63240
1856 OP0003 Clipping of aneurysm of posterior communicating 210800 105400 84320 63240
artery of brain
1857 OP0196 Clipping of aneurysm of superior cerebellar artery 210800 105400 84320 63240
1858 OP0006 Clipping of aneurysm of vertebral artery 210800 105400 84320 63240
1859 OP0007 Clipping of aneurysm of vertebro basilar artery 210800 105400 84320 63240
1860 OP0193 Clipping of clinoidal / para-clinoidal region aneurysm 210800 105400 84320 63240
1861 OP3216 Clipping of complex aneurysm of anterior 261040 130520 104420 78310
communicating artery of brain
1862 OP3213 Clipping of complex aneurysm of anterior inferior 261040 130520 104420 78310
cerebellar artery
1863 OP3204 Clipping of complex aneurysm of basilar artery of 261040 130520 104420 78310
brain
1864 OP3209 Clipping of complex aneurysm of carotid bifurcation 261040 130520 104420 78310
1865 OP3208 Clipping of complex aneurysm of distal anterior 261040 130520 104420 78310
cerebral artery
1866 OP3210 Clipping of complex aneurysm of distal extracranial 261040 130520 104420 78310
internal carotid artery
1867 OP3203 Clipping of complex aneurysm of internal carotid 261040 130520 104420 78310
artery
1868 OP3207 Clipping of complex aneurysm of middle cerebral 261040 130520 104420 78310
artery bifurcation
artery cortical branches
artery trifurcation
1871 OP3212 Clipping of complex aneurysm of posterior cerebral 261040 130520 104420 78310
artery
1872 OP3202 Clipping of complex aneurysm of posterior 261040 130520 104420 78310
communicating artery of brain
1873 OP3211 Clipping of complex aneurysm of superior cerebellar 261040 130520 104420 78310
artery
1874 OP3205 Clipping of complex aneurysm of vertebral artery 261040 130520 104420 78310
1875 OP3206 Clipping of complex aneurysm of vertebro basilar 261040 130520 104420 78310
artery
1876 OP0194 Clipping of ophthalmic artery aneurysm 210800 105400 84320 63240
1877 OP0496 Cranioplasty with artificial bone cement / prosthetic 203560 101780 81420 61070
implant
1878 OP0495 Cranioplasty with reposition of bone flap 203560 101780 81420 61070
173
1879 OP1105 Craniotomy for acute / subacute subdural 163800 81900 65520 49140
haematomas
1880 OP3410 Craniotomy for bleed in anterior cranial fossa ( ACF ) 261040 130520 104420 78310
1881 OP1128 Craniotomy for brain abscess excision 178740 89370 71500 53620
1882 OP0482 Craniotomy for brain stem tumours 203560 101780 81420 61070
1883 OP0483 Craniotomy for cerebellar brain tumours 203560 101780 81420 61070
1884 OP0488 Craniotomy for cerebello-pontine angle tumours 210800 105400 84320 63240
1885 OP0471 Craniotomy for chronic subdural haematomas 144440 72220 57780 43330
1886 OP0484 Craniotomy for clival / petrous region tumours 210800 105400 84320 63240
1887 OP3413 Craniotomy for complex intra ventricular tumor 261040 130520 104420 78310
1888 OP3404 Craniotomy for complex Parenchyma Brain tumors 261040 130520 104420 78310
1889 OP0487 Craniotomy for convexity meningiomas of brain 178740 89370 71500 53620
1890 OP1111 Craniotomy for CSF rhinorrhoea repair 188720 94360 75490 56620
1891 OP0475 Craniotomy for decompression of malignant infarcts ( 178740 89370 71500 53620
supra-tentorial )
1892 OP0473 Craniotomy for depressed fracture of skull 163800 81900 65520 49140
1893 OP0474 Craniotomy for extradural haematomas 163800 81900 65520 49140
1894 OP3405 Craniotomy for intra cerebral bleed 178740 89370 71500 53620
1895 OP0480 Craniotomy for intraventricular brain tumours 178740 89370 71500 53620
1896 OP3221 Craniotomy for large cerebello-pontine angle tumours 261040 130520 104420 78310
1897 OP3218 Craniotomy for large clival / petrous region tumours 261040 130520 104420 78310
1898 OP3402 Craniotomy for large Convexity Meningioma of brain 261040 130520 104420 78310
1899 OP3406 Craniotomy for large intra cerebral bleed 261040 130520 104420 78310
1900 OP3217 Craniotomy for large pineal region tumours 261040 130520 104420 78310
1901 OP3400 Craniotomy for Large posterior fossa tumor 261040 130520 104420 78310
1902 OP3220 Craniotomy for large sellar / parasellar tumours 261040 130520 104420 78310
1903 OP3219 Craniotomy for large skull base tumours 261040 130520 104420 78310
1904 OP3403 Craniotomy for Parasaggital Meningioma of brain 261040 130520 104420 78310
1905 OP1109 Craniotomy for parenchymal brain tumours 178740 89370 71500 53620
1906 OP0472 Craniotomy for parenchymal contusions of brain 163840 81920 65540 49150
1907 OP0481 Craniotomy for pineal region tumours 210800 105400 84320 63240
1908 OP0491 Craniotomy for posterior fossa ( infra-tentorial ) 203560 101780 81420 61070
infarcts
1909 OP0490 Craniotomy for posterior fossa haematomas 203560 101780 81420 61070
1910 OP0489 Craniotomy for posterior fossa tumours 203560 101780 81420 61070
1911 OP0486 Craniotomy for sellar / parasellar tumours 210800 105400 84320 63240
1912 OP3399 Craniotomy for Severe Brain injury 261040 130520 104420 78310
1913 OP0485 Craniotomy for skull base tumours 210800 105400 84320 63240
1914 OP0716 Craniotomy for subtemporal decompression of 178740 89370 71500 53620
infective disorders
1915 OP4501 Deep Brain Stimulation (DBS) 347300 173650 138920 104190
1916 OP0493 Endoscopic CSF rhinorrhoea repair 188720 94360 75490 56620
1917 OP3396 Endoscopic Skull Base Tumor Surgery 210800 105400 84320 63240
1918 OP1129 Endoscopic third ventriculostomy ( ETV ) 158880 79440 63550 47660
1919 OP3408 Endoscopic VP shunt 144440 72220 57780 43330
1920 OP0009 Excision of AVM of anterior mesial temporal region of 210800 105400 84320 63240
brain
1921 OP0206 Excision of AVM of basal ganglion of brain 210800 105400 84320 63240
1922 OP0203 Excision of AVM of medial frontal region of brain 210800 105400 84320 63240
1923 OP0201 Excision of AVM of medial occipital region of brain 210800 105400 84320 63240
1924 OP0202 Excision of AVM of medial parietal region of brain 210800 105400 84320 63240
1925 OP0011 Excision of AVM of medial trigonal region of brain 210800 105400 84320 63240
1926 OP0207 Excision of AVM of posterior fossa of brain ( cerebellar 210800 105400 84320 63240
)
1927 OP0211 Excision of AVM of posterior fossa of brain ( CPA ) 210800 105400 84320 63240
174
1928 OP0210 Excision of AVM of posterior fossa of brain ( 210800 105400 84320 63240
flocculo-nodular )
1929 OP0209 Excision of AVM of posterior fossa of brain ( 210800 105400 84320 63240
para-median )
1930 OP0208 Excision of AVM of posterior fossa of brain ( vermian ) 210800 105400 84320 63240
1931 OP0010 Excision of AVM of posterior mesial temporal region 210800 105400 84320 63240
of brain
1932 OP0204 Excision of AVM of thalamo-caudate region of brain 210800 105400 84320 63240
1933 OP0205 Excision of AVM of third ventricular region of brain 210800 105400 84320 63240
1934 OP0213 Excision of brain stem AVM ( mid-brain ) 210800 105400 84320 63240
1935 OP0212 Excision of brain stem AVM ( pontine ) 210800 105400 84320 63240
1936 OP3201 Excision of complex AVM of brain 261040 130520 104420 78310
1937 OP3196 External lumbar drain 44800 22400 17920 13440
1938 OP3222 External ventricular drainage 59660 29830 23860 17900
1939 OP4764 ICP Monitoring Placement 33340 16670 13340 10000
1940 OP1121 Lumbar puncture in OT 11020 5510 4410 3310
1941 OP3411 Microscopic 3rd ventriculostomy 158220 79110 63290 47470
1942 OP3401 Mini craniotomy for Subdural Hematoma 178740 89370 71500 53620
1943 OP0514 Revision of ventriculoperitoneal ( VP ) shunt 86920 43460 34770 26080
1944 OP0519 Stereotactic aspiration of intracerebral abscess 144440 72220 57780 43330
1945 OP0520 Stereotactic biopsy of brain tumours / lesions 178740 89370 71500 53620
1946 OP1127 Stereotactic evacuation of intracerebral haematoma 169340 84670 67740 50800
1947 OP0521 Stereotactic surgery for movement disorders 210800 105400 84320 63240
1948 OP1116 Syringomyelia shunt surgery 144440 72220 57780 43330
1949 OP0515 Thecoperitoneal ( TP ) shunt 86920 43460 34770 26080
1950 OP1110 Trans-sphenoidal pituitary decompression surgery ( 196600 98300 78640 58980
endoscopic )
1951 OP0492 Trans-sphenoidal pituitary decompression surgery ( 178740 89370 71500 53620
microscopic )
1952 OP1125 Ventricular puncture ( brain ) 19880 9940 7950 5960
1953 OP3195 Ventricular reservoir placement 59660 29830 23860 17900
1954 OP3159 Ventricular Tapping - done in OT 18080 9040 7230 5420
1955 OP0516 Ventriculoatrial ( VA ) shunt 86920 43460 34770 26080
1956 OP1118 Ventriculoperitoneal ( VP ) shunt 86920 43460 34770 26080
1957 OP0513 Ventriculoperitoneal ( VP ) shunt with external 86920 43460 34770 26080
ventricular drainage
Obstetrics & Gynaecology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1958 OP1130 Abdominal hysterectomy ( TAH ) ( level 1 ) 95380 47690 38150 27310
1959 OP0096 Abdominal hysterectomy ( TAH ) in patient with 115560 57780 46220 33100
previous pelvic surgery ( level 2 )
1960 OP0095 Abdominal hysterectomy ( TAH ) with pelvic floor 115560 57780 46220 33100
repair ( level 2 )
1961 OP1131 Abdominal sterilisation / Post partum ligation / 13700 6850 5480 3920
tubectomy
1962 OP0013 Anterior & posterior colporraphy (AP repair) 50320 25160 20130 14410
1963 OP3161 Anterior Colporraphy 40740 20370 16300 11670
1964 OP1132 Aspiration of ovarian cyst under ultrasound guidance 11420 5710 4570 3270
(in OT)
1965 OP0012 Aspiration of peritoneal collection under ultrasound 11420 5710 4570 3270
guidance
175
1966 OP3162 Caesarean hysterectomy 110020 55010 44010 31510
1967 OP1133 Caesarean section ( LSCS ) 59540 29770 23820 17050
1968 OP3173 Cautery of vaginal vault granuloma 4320 2160 1730 1240
1969 OP3160 Cervical encirclage 36700 18350 14680 10510
1970 OP3251 Cervical polypectomy 7720 3860 3090 2210
1971 OP3163 Cold knife cone biopsy of cervix 28540 14270 11420 8170
1972 OP1183 Colposcopy 4320 2160 1730 1240
1973 OP1185 Colposcopy with cervical biopsy ( LEEP ) & 11580 5790 4630 3310
cauterisation
1974 OP0144 Diagnostic hysteroscopy 19100 9550 7640 5470
1975 OP1167 Diagnostic laparoscopy & hysteroscopy 38540 19270 15420 11040
1976 OP3174 Dialation & curettage of uterus ( D&C ) 13700 6850 5480 3920
1977 OP1154 Drainage of vulval haematoma following delivery 41540 20770 16620 11890
1978 OP1135 End to end fallopian tubal recanalisation / 85400 42700 34160 24460
anastomosis - bilateral
1979 OP0023 End to end fallopian tubal recanalisation / 74080 37040 29630 21210
anastomosis - unilateral
1980 OP0015 Episiotomy repair - secondary suturing in OT 20400 10200 8160 5840
1981 OP0014 Episiotomy repair in OT - primary repair 20400 10200 8160 5840
1982 OP3168 Excision of endometrial scar 40740 20370 16300 11670
1983 OP3169 Excision of vaginal wall cyst 40740 20370 16300 11670
1984 OP3182 Fetal reduction (in OT)
1985 OP3165 Foreign body removal from vagina 24460 12230 9780 7010
1986 OP1134 Forthergill / Manchester repair of uterine prolapse 55360 27680 22140 15850
1987 OP0139 Forthergill / Manchester repair of uterine prolapse 69140 34570 27660 19800
WITH tubal ligation
1988 OP1137 Hematocolpos drainage / colpotomy 40740 20370 16300 11670
1989 OP1161 Hysteroscopic division of thick synechiae 54360 27180 21740 15570
1990 OP1157 Hysteroscopic division of thin synechiae 23780 11890 9510 6810
1991 OP1163 Hysteroscopic metroplasty 54360 27180 21740 15570
1992 OP1162 Hysteroscopic myomectomy ( less than 3 cm) 40840 20420 16340 11690
1993 OP1166 Hysteroscopic myomectomy ( more than 3 cm ) 66300 33150 26520 18990
1994 OP1158 Hysteroscopic polypectomy 24220 12110 9690 6940
1995 OP1159 Hysteroscopic removal of IUCD 23780 11890 9510 6810
1996 OP1160 Hysteroscopic removal of retained products of 40080 20040 16030 11480
conception
1997 OP1164 Hysteroscopic resection of uterine septum 54360 27180 21740 15570
1998 OP1165 Hysteroscopic trans-cervical resection of 65140 32570 26060 18650
endometrium ( TCRE )
1999 OP1138 Hysterotomy 66740 33370 26700 19120
2000 OP1172 Laparoscopic adhesiolysis & hysteroscopy 85140 42570 34060 24380
2001 OP3166 Laparoscopic assisted vaginal hysterectomy ( LAVH ) ( 103120 51560 41250 29530
Uterus < 14 week )
2002 OP3167 Laparoscopic assisted vaginal hysterectomy (LAVH ) ( 123560 61780 49420 35380
Uterus < 14 week ) or with previous pelvic surgery
2003 OP3178 Laparoscopic colposacropexy 91300 45650 36520 26150
2004 OP3176 Laparoscopic excision of board ligament leaves 74000 37000 29600 21190
2005 OP3250 Laparoscopic excision of broad ligament leaves 81440 40720 32580 23320
2006 OP1179 Laparoscopic fallopian tubal recanalisation 94960 47480 37980 27190
2007 OP0110 Laparoscopic milking for ectopic pregnancy 81440 40720 32580 23320
2008 OP1177 Laparoscopic myomectomy ( for fibroid less than 3 cm 99260 49630 39700 28430
)
2009 OP0094 Laparoscopic myomectomy ( for fibroid more than 3 113480 56740 45390 32500
cm )
2010 OP1180 Laparoscopic neo-vagina creation 94960 47480 37980 27190
2011 OP0108 Laparoscopic ovarian cystectomy 81440 40720 32580 23320
176
2012 OP2904 Laparoscopic repair of rectovaginal fistula ( RVF ) 55360 27680 22140 15850
2013 OP1143 Laparoscopic repair of Recurrent rectovaginal fistula ( 75440 37720 30180 21600
RVF )
2014 OP1175 Laparoscopic salpingectomy 82940 41470 33180 23750
2015 OP3177 Laparoscopic salpingo-oopherectomy 74000 37000 29600 21190
2016 OP0109 Laparoscopic salpingostomy 82940 41470 33180 23750
2017 OP3175 Laparoscopic surgery for tubo - ovarian torsion 74000 37000 29600 21190
2018 OP1178 Laparoscopic uterine cornual excision 94960 47480 37980 27190
2019 OP3417 Laparoscopic uterine suspension 100620 50310 40250 28820
2020 OP3179 Laparoscopic vesico-vaginal ( VVF ) repair 95060 47530 38020 27220
2021 OP3181 Laparoscopic Wertheims ( radical ) hysterectomy 165940 82970 66380 47520
2022 OP1173 Laparoscopy & hysteroscopy with fimbrioplasty / 81440 40720 32580 23320
neosalpingostomy
2023 OP1171 Laparoscopy & hysteroscopy with LUNA 65140 32570 26060 18650
2024 OP1169 Laparoscopy & hysteroscopy with ovarian biopsy 48920 24460 19570 14010
2025 OP1168 Laparoscopy & hysteroscopy with ovarian drilling 48920 24460 19570 14010
2026 OP1170 Laparoscopy & hysteroscopy with tubal canulation 65140 32570 26060 18650
2027 OP0092 Laparoscopy with hysteroscopic cornual 65140 32570 26060 18650
catheterisation
2028 OP0018 Laparoscopy with ovarian biopsy 48920 24460 19570 14010
2029 OP3170 LeFort operation for uterine prolapse 48920 24460 19570 14010
2030 OP3171 Manual removal of placenta 20400 10200 8160 5840
2031 OP1140 Mid trimester abortion 38520 19260 15410 11030
2032 OP1184 MTP - Medical termination of pregnancy 13700 6850 5480 3920
2033 OP1141 MTP with laparoscopic sterilisation 20320 10160 8130 5820
2034 OP1142 MTP with minilap sterilisation 20320 10160 8130 5820
2035 OP3252 Non descent vaginal hysterectomy ( NDVH ) 95380 47690 38150 27310
2036 OP3416 Non descent vaginal hysterectomy ( NDVH ) for 105200 52600 42080 30130
uterus > 12 weeks
2037 OP3415 Non descent vaginal hysterectomy ( NDVH ) + bilateral 105200 52600 42080 30130
salphingo oopherectomy ( BSO )
2038 OP1186 Normal delivery in OT 59540 29770 23820 17050
2039 OP0142 Ovarian cystectomy / oopherectomy ( open technique 54360 27180 21740 15570
)
2040 OP1136 Pelvic examination under anaesthesia and aspiration ( 13700 6850 5480 3920
EUA )
2041 OP1146 Perineal tear repair ( CPT repair ) 62220 31110 24890 17810
2042 OP3247 Perineorraphy 13980 6990 5590 4000
2043 OP1151 Radical hysterectomy for malignancy / Wertheim’s 165080 82540 66030 47270
hysterectomy
2044 OP2877 Radical hysterectomy for malignancy / Wertheim’s 165200 82600 66080 47300
hysterectomy + Cyto-reductive surgery for ovarian
cancer
2045 OP2906 Repair of rectovaginal fistula ( RVF ) 48300 24150 19320 13830
2046 OP2905 Repair of Recurrent rectovaginal fistula ( RVF ) 60280 30140 24110 17260
2047 OP2907 Repair of Recurrent vesico-vaginal fistula - abdominal 75440 37720 30180 21600
approach
2048 OP2908 Repair of Recurrent vesico-vaginal fistula - vaginal 75440 37720 30180 21600
approach
2049 OP1482 Repair of vesico-vaginal fistula - abdominal approach 94940 47470 37980 27190
2050 OP1483 Repair of vesico-vaginal fistula - vaginal approach 94940 47470 37980 27190
2051 OP3068 Repair of vesico-vaginal fistula ( VVF ) with flap cover 137040 68520 54820 39240
2052 OP3172 Repositioning on inverted uterus ( uterine inversion ) 20400 10200 8160 5840
2053 OP0141 Salpingectomy ( open technique ) 54360 27180 21740 15570
2054 OP1145 Salpingo-oophrectomy ( open technique ) 54360 27180 21740 15570
2055 OP1153 Simple vulvectomy 82980 41490 33190 23770
2056 OP1155 Suturing of vaginal / vulval tears 13980 6990 5590 4000
177
2057 OP1147 Total ( radical ) vulvectomy with dissection of nodes 124480 62240 49790 35650
2058 OP1182 Total laparoscopic hysterectomy ( TLH ) in case of 136160 68080 54460 38990
previous pelvic surgery or intraabdominal adhesions
(excluding-tubal-ligation-surgery)
2059 OP0093 Total laparoscopic hysterectomy of uterus less than 14 113480 56740 45390 32500
weeks ( TLH )
2060 OP1181 Total laparoscopic hysterectomy of uterus more than 136160 68080 54460 38990
14 weeks ( TLH )
2061 OP3249 Trachelectomy ( uterine cervix excision ) 155100 77550 62040 44420
2062 OP3248 Trachelorrhaphy ( uterine cervix repair ) 61160 30580 24460 17510
2063 OP1156 Uterine myomectomy 91240 45620 36500 26120
2064 OP0016 Vaginal hysterectomy & repair 91240 45620 36500 26120
2065 OP0143 Vaginal vault prolapse repair / vault suspension ( 89580 44790 35830 25660
abdominal approach )
2066 OP1149 Vaginal vault prolapse repair / vault suspension ( 89580 44790 35830 25660
vaginal approach )
2067 OP1292 Vaginoplasty 124320 62160 49730 35600
2068 OP1148 Vaginoplasty for vaginal agenesis 124320 62160 49730 35600
2069 OP1150 Ventrisuspension of the uterus ( open technique ) 54360 27180 21740 15570
2070 OP1152 Vulval biopsy 11740 5870 4700 3370
178
Oesophageal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2071 OP1251 Complete correction of oesophageal atresia and TEF 145360 72680 58140 43610
2072 OP0970 Dilatation of oesophageal - first stage 22660 11330 9060 6800
2073 OP0992 Dilatation of oesophageal - subsequent stage 15880 7940 6350 4760
2074 OP1399 Enucleation of leiomyoma of oesophagus ( 262360 131180 104940 78710
transthoracic )
2075 OP1396 Ivor Lewis oesophagectomy 154080 77040 61630 46220
2076 OP0558 Laparoscopic fundoplication ( Dor's ) & hiatus hernia 99340 49670 39740 29800
repair
2077 OP0556 Laparoscopic fundoplication ( Nissen ) & hiatus hernia 99340 49670 39740 29800
repair
2078 OP0557 Laparoscopic fundoplication ( Toupet's ) & hiatus 99340 49670 39740 29800
hernia repair
2079 OP4080 Laparoscopic fundoplication for GERD 169500 84750 67800 50850
2080 OP0630 Laparoscopic oesophageal cardiomyotomy 157400 78700 62960 47220
2081 OP0559 Laparoscopic placement of magnetic oesophageal 45280 22640 18110 13580
sphincter
2082 OP3372 Laparoscopic repair of giant paraesophageal hiatus 169500 84750 67800 50850
hernia with fundoplication
2083 OP3373 Laparoscopic repair of giant paraesophageal hiatus 135580 67790 54230 40670
hernia without fundoplication
2084 OP3374 Laparoscopic repair of recurrent hiatus hernia / redo 257620 128810 103050 77290
fundoplication
2085 OP3376 Laparoscopic transhiatal oesophagectomy with gastric 271200 135600 108480 81360
pull-up
2086 OP1424 Ligation of oesophagus 88980 44490 35590 26690
2087 OP1397 Mc-Keown oesophagectomy 169500 84750 67800 50850
2088 OP2944 Nissen fundoplication & hiatus hernia repair 103800 51900 41520 31140
2089 OP1400 Oesophageal cardiomyotomy 131160 65580 52460 39350
2090 OP4083 Oesophageal Perforation repair 131160 65580 52460 39350
2091 OP0028 Oesophageal stricturoplasty 88980 44490 35590 26690
2092 OP3378 Oesophagectomy with colon interpostion (abdomen 271200 135600 108480 81360
and chest incision for oesophagectomy)
2093 OP3379 Oesophagectomy with colonic interpostion (abdomen, 338980 169490 135590 101690
chest and neck oesophagectomy)
2094 OP1255 Oesophagostomy 66240 33120 26500 19870
2095 OP1413 Removal of foreign body oesophagus by flexible 33060 16530 13220 9920
oesophagoscope
2096 OP0892 Removal of foreign body oesophagus by rigid 22660 11330 9060 6800
oesophagoscope
2097 OP3384 Thoracoscopic and laparoscopic oesophagectomy with 305080 152540 122030 91520
gastric pull-up (chest anastomosis)
2098 OP3385 Thoracoscopic and laparoscopic oesophagectomy with 338980 169490 135590 101690
gastric pull-up (neck anastomosis)
2099 OP3387 Trans hiatal oesophagectomy with colonic 237280 118640 94910 71180
interpostion
2100 OP3388 Trans thoracic fundoplication 149160 74580 59660 44750
2101 OP3389 Trans thoracic redo fundoplicaton 237280 118640 94910 71180
2102 OP1381 Transaction of oesophagus and EEA stapling 88980 44490 35590 26690
2103 OP1395 Transhiatal oesophagectomy 107880 53940 43150 32360
2104 OP3390 VATS enuceation of oesophageal tumors 135580 67790 54230 40670
2105 OP4055 VATS Enucleation of leiomyoma of esophagus 314800 157400 125920 94440
179
Onco Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2106 OP4322 Saccrococcygel teratoma - External 71320 35660 28530 21400
2107 OP4323 Saccrococcygel teratoma - with intra- pelvic extension 89140 44570 35660 26740
Oncology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2108 OP2910 Bone marrow / stem cell transplantation (if done in 205200 102600 82080 61560
OT)
2109 OP3025 Bone marrow harvesting procedure (if done in OT) 45240 22620 18100 13570
Open Reduction And Internal Fixation
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2110 OP4334 Ankle Bimalleolar Fixation with Syndesmosis screw 122240 61120 48900 36670
2111 OP1824 Calcaneal pin insertion 12360 6180 4940 3710
2112 OP4345 Complex Fracture Fixation with Ilizarov 122240 61120 48900 36670
2113 OP4344 Complex Fracture Fixation with Nailing 122240 61120 48900 36670
2114 OP4343 Complex Fracture Fixation with Plating 122240 61120 48900 36670
2115 OP4348 Complex Joint Reconstruction with Ilizarov 132420 66210 52970 39730
2116 OP4347 Complex Joint Reconstruction with Nailing 132420 66210 52970 39730
2117 OP4346 Complex Joint Reconstruction with Plating 132420 66210 52970 39730
2118 OP1845 Condylar plate fixation for supracondylar fracture 94420 47210 37770 28330
femur
2119 OP1848 DCS fixation for subtrochanteric fracture femur 94420 47210 37770 28330
2120 OP1844 DCS fixation for supracondylar fracture femur 94420 47210 37770 28330
2121 OP1846 DHS fixation for intertrochanteric fracture femur 94420 47210 37770 28330
2122 OP4134 Fixation of radial head 74040 37020 29620 22210
2123 OP4136 Fixation of tibial tuberosity 58500 29250 23400 17550
2124 OP1860 K-wire fixation for fracture metacarpal / phalanx 29580 14790 11830 8870
2125 OP1819 K-wire fixation for fracture metatarsal / phalanx 27260 13630 10900 8180
2126 OP1876 Lateral condyle fixation for fracture humerus 59240 29620 23700 17770
2127 OP1875 Medial condyle fixation for fracture humerus 59240 29620 23700 17770
2128 OP4138 Mid tarsal joint plate fixation 85820 42910 34330 25750
2129 OP1859 Mini plate fixation for fracture metacarpals 41340 20670 16540 12400
2130 OP1822 Mini plate fixation for fracture metatarsals 39740 19870 15900 11920
2131 OP1861 Multiple K-wire fixation for fracture metacarpals / 44340 22170 17740 13300
phalanges
2132 OP1820 Multiple K-wire fixation for fracture metatarsals / 36080 18040 14430 10820
phalanges
2133 OP1847 Multiple screw fixation for fracture neck of femur 94420 47210 37770 28330
2134 OP4328 Non-Union of Long Bones - ORIF with Bone Grafting 122240 61120 48900 36670
2135 OP4250 Open ACI tansplant (Autologous Chondrocyte Implant) 100420 50210 40170 30130
2136 OP1863 Open reduction + K-wire fixation for carpal dislocation 41340 20670 16540 12400
180
2137 OP1879 Open reduction fracture medial epicondyle + K-wire 56680 28340 22670 17000
fixation / screw
2138 OP1883 Open reduction fracture neck humerus + fibular 108520 54260 43410 32560
grafting
2139 OP1882 Open reduction fracture neck humerus + plate fixation 81440 40720 32580 24430
2140 OP4329 Open Reduction of Dislocated Large Joint 96760 48380 38700 29030
2141 OP3264 Open Reduction of dislocated MP Joint of thumb / 77880 38940 31150 23360
finger
2142 OP1877 Open reduction supracondylar fracture humerus with 59240 29620 23700 17770
K-wire fixation
2143 OP4341 ORIF Metacarpal / Metatarsal 106980 53490 42790 32090
2144 OP4330 Osteochondral Fracture Fixation 122240 61120 48900 36670
2145 OP1855 Osteosynthesis anterior pillar / wall of acetabulum 166600 83300 66640 49980
(Screw / Plate)
2146 OP1854 Osteosynthesis posterior pillar / wall of acetabulum 166600 83300 66640 49980
(screw / Plate)
2147 OP1849 PFN for subtrochanteric fracture femur 92340 46170 36940 27700
2148 OP1829 Plating / nail fixation for fracture lateral malleolus 64360 32180 25740 19310
2149 OP1885 Plating for fracture clavicle 59240 29620 23700 17770
2150 OP1842 Plating for fracture femur 94420 47210 37770 28330
2151 OP1851 Plating for fracture femur with bone grafting 108520 54260 43410 32560
2152 OP1835 Plating for fracture fibula 59240 29620 23700 17770
2153 OP1880 Plating for fracture humerus 94420 47210 37770 28330
2154 OP1881 Plating for fracture humerus + bone grafting 108520 54260 43410 32560
2155 OP1832 Plating for fracture lateral tibial condyle 81440 40720 32580 24430
2156 OP1830 Plating for fracture medial & lateral tibial condyles 81440 40720 32580 24430
2157 OP1831 Plating for fracture medial tibial condyle 81440 40720 32580 24430
2158 OP1836 Plating for fracture shaft of tibia 94420 47210 37770 28330
2159 OP1837 Plating for fracture shaft tibia + bone grafting 108520 54260 43410 32560
2160 OP1834 Plating for fracture tibial plafond 81440 40720 32580 24430
2161 OP1856 Plating for pubic symphysis fracture 166600 83300 66640 49980
2162 OP1867 Plating for radius & ulna fracture 81440 40720 32580 24430
2163 OP1865 Plating for radius fracture 59240 29620 23700 17770
2164 OP1858 Plating for SI joint disruption - bilateral 134520 67260 53810 40360
2165 OP1857 Plating for SI joint disruption - unilateral 134520 67260 53810 40360
2166 OP1866 Plating for ulna fracture 59240 29620 23700 17770
2167 OP1871 Plating of fracture radius & ulna + bone grafting 103820 51910 41530 31150
2168 OP1870 Plating of fracture radius + bone grafting 82720 41360 33090 24820
2169 OP2892 Plating of fracture ulna + bone grafting 82720 41360 33090 24820
2170 OP4137 Plating of ilium 85820 42910 34330 25750
2171 OP1823 Reconstruction plate fixation for fracture calcaneum 94420 47210 37770 28330
2172 OP3190 Sacral fracture - open reduction and fixation ( ORIF ) 116940 58470 46780 35080
2173 OP3191 Sacral fracture - percutaneous fixation 116940 58470 46780 35080
2174 OP1821 Screw fixation for fracture 5th metatarsal base 36420 18210 14570 10930
2175 OP1853 Screw fixation for fracture head femur 94420 47210 37770 28330
2176 OP1862 Screw fixation for fracture scaphoid 61820 30910 24730 18550
2177 OP1838 Screw fixation for fracture tibial spine 81440 40720 32580 24430
2178 OP4147 Screw fixation navicular / calcaneum 56180 28090 22470 16850
2179 OP4135 Screw fixation patella 53820 26910 21530 16150
2180 OP4252 Stem cell transplant in knee/shoulder/hip 64420 32210 25770 19330
2181 OP1850 Supracondylar nail for supracondylar fracture femur 92340 46170 36940 27700
2182 OP4340 Surgery for Recurrent Shoulder Dislocation 106980 53490 42790 32090
2183 OP1864 T-buttress plate fixation for fracture distal radius 61820 30910 24730 18550
2184 OP1839 Tension band wiring / encirclage wiring for fracture 59240 29620 23700 17770
patella
181
2185 OP1828 Tension band wiring / malleolar screw for fracture 64360 32180 25740 19310
medial malleolus
medial malleolus & plating lateral malleolus
medial malleolus & plating lateral malleolus with
screw fixation distal tibia
2188 OP1843 Tension band wiring for fracture greater trochanter 59240 29620 23700 17770
2189 OP1884 Tension band wiring for fracture lateral end clavicle 59240 29620 23700 17770
2190 OP1872 Tension band wiring proximal ulna / screw fixation for 61820 30910 24730 18550
fracture ulna
2191 OP4335 Tillaux Fracture ORIF 106980 53490 42790 32090
2192 OP1874 Ulnar osteotomy + coronoid fixation 59240 29620 23700 17770
2193 OP1873 Ulnar osteotomy + fixation of intercondylar femur 102800 51400 41120 30840
humerus - both pillars
Operations For Dislocations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2194 OP1990 Close reduction acromio-clavicular joint with K-wire 26880 13440 10750 8060
fixation
2195 OP1891 Closed reduction fracture or dislocation carpal / wrist 26040 13020 10420 7810
with K-wire fixation
2196 OP3459 Dislocation Foot - Closed reduction 23680 11840 9470 7100
2197 OP4248 Open latarjet with coracoid 100420 50210 40170 30130
2198 OP4249 Open latarjet with iliac crest 108380 54190 43350 32510
2199 OP1991 Open reduction acromio-clavicular joint with tension 59240 29620 23700 17770
band wiring
2200 OP1995 Open reduction for dislocation of carpal / wrist joint 56180 28090 22470 16850
2201 OP3460 Open reduction for dislocation of tarsal bones 51500 25750 20600 15450
2202 OP1996 Open reduction for dislocation shoulder 79380 39690 31750 23810
2203 OP1994 Open reduction for elbow joint dislocation 76040 38020 30420 22810
2204 OP1992 Open reduction for hip joint dislocation 79380 39690 31750 23810
2205 OP1993 Open reduction for knee joint dislocation 79380 39690 31750 23810
2206 OP3458 Open reduction of ankle joint 85820 42910 34330 25750
2207 OP1998 Open repair for Recurrent dislocation of elbow joint 103820 51910 41530 31150
2208 OP1999 Open repair for Recurrent dislocation of patella 103820 51910 41530 31150
2209 OP1997 Open repair for Recurrent dislocation of shoulder 103820 51910 41530 31150
Operations For Portal Hypertension

OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2210 OP1384 Distal splenorenal shunt ( Warren shunt ) 98740 49370 39500 29620
2211 OP1382 Interposition mesocaval shunt - synthetic graft 171640 85820 68660 51490
2212 OP0828 Interposition mesocaval shunt - vein graft 171640 85820 68660 51490
2213 OP0827 Portacaval shunt 98740 49370 39500 29620
2214 OP1383 Proximal lienorenal shunt 98740 49370 39500 29620
2215 OP1380 Sub-cardiac porta-azygos disconnection & 93360 46680 37340 28010
devascularization
182
Orthognathic Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2216 OP0019 Alveolar bone grafting 85860 42930 34340 25760
2217 OP0171 Alveolar fracture - closed reduction 34400 17200 13760 10320
2218 OP0172 Alveolar fracture - open reduction 51500 25750 20600 15450
2219 OP1309 Arch bar application 43020 21510 17210 12910
2220 OP1308 Arch bar removal 17360 8680 6940 5210
2221 OP0706 Bilateral sagittal split osteotomy - advancement 171640 85820 68660 51490
2222 OP0705 Bilateral sagittal split osteotomy - setback 171640 85820 68660 51490
2223 OP4321 Clitorovaginoplasty for CAH 96760 48380 38700 29030
2224 OP1096 Dental Category 1 - All teeth extraction (single jaw) in 15980 7990 6390 4790
OT
2225 OP0709 Dental OPD category 2 - All teeth extraction (single 11200 5600 4480 3360
jaw)
2226 OP0152 Frontal sinus fracture ( complicated ) - open reduction 85860 42930 34340 25760
( ORIF )
2227 OP0151 Frontal sinus fracture ( simple ) - open reduction 72940 36470 29180 21880
2228 OP0829 Full mouth periodontal flap surgery 38640 19320 15460 11590
2229 OP0080 Jaw cyst excision - simple / unilocular 34400 17200 13760 10320
2230 OP0081 Jaw cyst or tumour - radical resection 68720 34360 27490 20620
2231 OP1335 Jaw cyst or tumour excision and bone grafting 85860 42930 34340 25760
2232 OP0082 Jaw cyst or tumour resection and reconstruction of 188740 94370 75500 56620
jaw with free fibula flap
2233 OP0707 LeFort I osteotomy with advancement 171640 85820 68660 51490
2234 OP0079 LeFort I osteotomy with application of distractor 171640 85820 68660 51490
2235 OP1093 LeFort I osteotomy with impaction / intrusion 171640 85820 68660 51490
2236 OP0069 LeFort III ( extracranial ) advancement 214500 107250 85800 64350
2237 OP0070 LeFort III ( intracranial ) advancement - monobloc 214500 107250 85800 64350
2238 OP0169 LeFort III complicated fracture - open reduction ( ORIF 137240 68620 54900 41170
)
2239 OP0168 LeFort III fracture - open reduction ( ORIF ) 118060 59030 47220 35420
2240 OP0170 LeFort III fracture ( complicated ) - open reduction + 154500 77250 61800 46350
bone graft ( ORIF )
2241 OP0078 LeFort III osteotomy with application of distractor 214500 107250 85800 64350
2242 OP0071 LeFort III with Lefort I advancement 257420 128710 102970 77230
2243 OP4380 Malar palate removal Multiple 101880 50940 40750 30560
2244 OP4379 Malar palate removal Single 76400 38200 30560 22920
2245 OP0177 Mandible condylar fracture - open reduction 85860 42930 34340 25760
2246 OP4374 Mandible Distraction 127340 63670 50940 38200
2247 OP0176 Mandible fracture ( complicated ) - open reduction ( 85860 42930 34340 25760
ORIF )
2248 OP0173 Mandible fracture - closed reduction 46360 23180 18540 13910
2249 OP0175 Mandible fracture - open reduction ( ORIF ) 73000 36500 29200 21900
2250 OP0174 Mandible fracture - percutaneous reduction / external 73000 36500 29200 21900
fixation
2251 OP4376 Mandible palate removal Multiple 101880 50940 40750 30560
2252 OP4375 Mandible palate removal Single 76400 38200 30560 22920
2253 OP0187 Mandible reconstruction with bone graft 73000 36500 29200 21900
2254 OP0185 Mandible reconstruction with bone plate 73000 36500 29200 21900
2255 OP0188 Mandible reconstruction with free fibular flap 188740 94370 75500 56620
2256 OP0186 Mandible reconstruction with implant 85860 42930 34340 25760
183
2257 OP3332 Manual reduction of temporomandibular ( TM ) joint 30360 15180 12140 9110
dislocation under GA
2258 OP0164 Maxillary LeFort I fracture - closed reduction 46360 23180 18540 13910
2259 OP0165 Maxillary LeFort I fracture - open reduction ( ORIF ) 72940 36470 29180 21880
2260 OP0166 Maxillary LeFort I fracture ( complicated ) - open 85860 42930 34340 25760
reduction ( ORIF )
2261 OP0167 Maxillary LeFort I fracture ( complicated ) - open 102980 51490 41190 30890
reduction + bone graft ( ORIF )
2262 OP4378 Maxillary palate removal Multiple 101880 50940 40750 30560
2263 OP4377 Maxillary palate removal Single 76400 38200 30560 22920
2264 OP0190 Maxillary reconstruction ( complicated ) with bone 85860 42930 34340 25760
graft
2265 OP0189 Maxillary reconstruction without bone graft 68720 34360 27490 20620
2266 OP1085 Maxillo - mandibular cyst enucleation / 60100 30050 24040 18030
marsupialisation
2267 OP0146 Nasal bone fracture - closed reduction with 48340 24170 19340 14500
manipulation / stabilisation
2268 OP0145 Nasal bone fracture - closed reduction without 45080 22540 18030 13520
manipulation
2269 OP0147 Nasal bone fracture ( complicated ) - open reduction ( 85860 42930 34340 25760
ORIF )
2270 OP0148 Nasal bone fracture ( simple ) - open reduction 73000 36500 29200 21900
2271 OP0150 Naso-ethmoid fracture - open reduction with fixation ( 85860 42930 34340 25760
ORIF )
2272 OP0149 Naso-ethmoid fracture - open reduction without 73000 36500 29200 21900
fixation
2273 OP0155 Naso-maxillary complicated fracture ( LeFort II ) - open 137240 68620 54900 41170
reduction ( ORIF )
2274 OP0156 Naso-maxillary complicated fracture ( LeFort II ) - open 154500 77250 61800 46350
reduction ( ORIF ) + bone graft
2275 OP0153 Naso-maxillary fracture ( LeFort II ) - closed reduction 51500 25750 20600 15450
2276 OP0154 Naso-maxillary fracture ( LeFort II ) - open reduction ( 118060 59030 47220 35420
ORIF )
2277 OP0159 Open reduction and internal fixation ( ORIF ) of malar 73000 36500 29200 21900
fracture
2278 OP3338 Open reduction and internal fixation of tripod fracture 101260 50630 40500 30380
of zygoma
2279 OP1094 Oral submucous cyst excision 34400 17200 13760 10320
2280 OP0708 Oral submucous cyst marsupialisation 30100 15050 12040 9030
2281 OP0160 Orbital blow out fracture - open reduction + alloplastic 73000 36500 29200 21900
implant
2282 OP0161 Orbital blow out fracture - open reduction + bone 85860 42930 34340 25760
graft
2283 OP0163 Orbital complicated fracture - open reduction 85860 42930 34340 25760
2284 OP0162 Orbital simple fracture - open reduction 73000 36500 29200 21900
2285 OP0157 Percutaneous reduction of malar fracture 51500 25750 20600 15450
2286 OP1091 Repair of oro-antral fistula 75140 37570 30060 22540
2287 OP0548 Root canal filling + apicoectomy 17240 8620 6900 5170
2288 OP1089 Segmental mandibular osteotomy ( multiple ) 128780 64390 51510 38630
2289 OP2909 Segmental mandibular osteotomy ( single ) 102980 51490 41190 30890
2290 OP1092 Segmental maxillary osteotomy ( multiple ) 128780 64390 51510 38630
2291 OP0704 Segmental maxillary osteotomy ( single ) 102980 51490 41190 30890
2292 OP1087 Surgical disimpaction for impacted canine / 36560 18280 14620 10970
supernumerary tooth
2293 OP0703 Surgical disimpaction of all four impacted molars 60100 30050 24040 18030
2294 OP1088 Surgical disimpaction of two impacted molars 30100 15050 12040 9030
2295 OP0178 TM joint dislocation - closed reduction 45080 22540 18030 13520
2296 OP0180 TM joint dislocation - open reduction 73000 36500 29200 21900
184
2297 OP0179 TM joint dislocation ( complicated ) - closed reduction 85860 42930 34340 25760
/ IMF ( arch bars )
2298 OP0158 Zygomatic arch fracture - open reduction 73000 36500 29200 21900
Orthopaedic Implant Removal
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2299 OP3256 Broken nail removal from long bones 51500 25750 20600 15450
2300 OP3258 Cemented implant removal ( hip ) 51500 25750 20600 15450
2301 OP3259 Cemented implant removal ( knee ) 51500 25750 20600 15450
2302 OP2040 External fixator removal from long bones 17520 8760 7010 5260
2303 OP2038 Implant removal from ankle 35580 17790 14230 10670
2304 OP2979 Implant removal from large joint ( Hip, Knee, Shoudler 40800 20400 16320 12240
)
2305 OP3040 Implant removal from spine 37420 18710 14970 11230
2306 OP2034 Multiple K-wire removal 20620 10310 8250 6190
2307 OP2031 Nail removal from long bones 23420 11710 9370 7030
2308 OP2037 Plate removal both bones forearm - radius and ulna 35580 17790 14230 10670
2309 OP2036 Plate removal forearm bones - Radius / Ulna 32700 16350 13080 9810
2310 OP2035 Plate removal from long bones 37100 18550 14840 11130
2311 OP2042 Removal of cross leg external fixator 17520 8760 7010 5260
2312 OP2043 Removal of pelvis external fixator 17520 8760 7010 5260
2313 OP2032 Screw removal for dynamisation 21560 10780 8620 6470
2314 OP2033 Single K-wire removal 8700 4350 3480 2610
2315 OP3274 Tension band wire removal from medial / lateral 17520 8760 7010 5260
malleolus
2316 OP2039 Tension band wiring removal from patella / olecranon 17520 8760 7010 5260
2317 OP2041 Transarticular external fixator removal 21560 10780 8620 6470
Osteotomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2318 OP2883 Abduction ( valgus ) osteotomy of hip 99340 49670 39740 29800
2319 OP2081 Cervical substraction osteotomy 129120 64560 51650 38740
2320 OP2082 Cervical substraction osteotomy + anterior procedure 129120 64560 51650 38740
2321 OP2881 Chiari osteotomy of hip 99340 49670 39740 29800
2322 OP1724 Derotation osteotomy for humerus 77880 38940 31150 23360
2323 OP2887 Distal radial osteotomy for malunited Colles' fracture 67720 33860 27090 20320
2324 OP2083 Dorsal substraction osteotomy 129120 64560 51650 38740
2325 OP2084 Dorsal substraction osteotomy + anterior procedure 129120 64560 51650 38740
2326 OP2889 Drawyer's calcaneal osteotomy 59120 29560 23650 17740
2327 OP2879 Emslie Trillat advancement of patellar tendon 74500 37250 29800 22350
2328 OP1868 Excision of head of radius 56680 28340 22670 17000
2329 OP2888 Excision of lower end of ulna ( Darrach's procedure ) 54200 27100 21680 16260
2330 OP4152 Hallux valgus correction / osteotomy 57500 28750 23000 17250
2331 OP1987 High tibial osteotomy ( HTO ) of tibia - Coventry 77880 38940 31150 23360
2332 OP1986 Innominate osteotomy of hip 99340 49670 39740 29800
2333 OP2890 Keller's procedure for hallux valgus 37980 18990 15190 11390
185
2334 OP2884 Lateral closed wedge osteotomy for cubitus varus of 66120 33060 26450 19840
elbow
2335 OP2886 Lateral closed wedge osteotomy for genu valgum 77880 38940 31150 23360
2336 OP2085 Lumbar substraction osteotomy 129120 64560 51650 38740
2337 OP2086 Lumbar substraction osteotomy + anterior procedure 129120 64560 51650 38740
2338 OP1711 Medial epicondylectomy 63260 31630 25300 18980
2339 OP2885 Medial open wedge osteotomy for genu valgum 77880 38940 31150 23360
2340 OP1988 Osteotomy of hand / foot + K-wire fixation 37980 18990 15190 11390
2341 OP4342 Osteotomy of Long Bone with Fixation 132420 66210 52970 39730
2342 OP2880 Salter innominate osteotomy 120400 60200 48160 36120
2343 OP2891 Supramalleolar osteotomy of lower end of tibia / 77880 38940 31150 23360
fibula
2344 OP2882 Varus derotation osteotomy of hip 99340 49670 39740 29800
Packages
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2345 CSMLSF Cataract Surgery MULTI FOCAL LENS ( Restor &
Technis Multifocal ) - Surgeon's fees
2346 CSTLSFS Cataract Surgery MULTIFOCAL TORIC LENS - Surgeon's
fees
2347 CSPCHSF Cataract Surgery Package - GOPD -card holders ( with
Indian foldable lens) - Surgeon's fees
2348 CSPSF Cataract Surgery Package with foldable IOL - Surgeon's
fees
2349 CSPNSF Cataract Surgery Package with non - foldable IOL -
Surgeon's fees
2350 CSPWSF Cataract Surgery Package without IOL - Surgeon's fees
2351 CSTLSFS Cataract Surgery SYMFONY LENS - Surgeon's fees
2352 CSTLSFS Cataract Surgery SYMFONY TORIC LENS - Surgeon's
fees
2353 CSTLSF Cataract Surgery TORIC LENS - Surgeon's fees
2354 CIPBWR Cochlear implantation Bilateral (with audiology) -
Surgeon Fee
Within Package
2355 CIPBWO Cochlear Implantation Bilateral (Without Audiology) -
Surgeon Fee
2356 CIWPLSF Cochlear Implantation with Audiology Post Lingual
Deaf Child/Adult - Surgeon Fees
2357 CIPWOS Cochlear Implantation With Audiology Pre Lingual
Deaf Child - Surgeon Fees
2358 CIPWSF Cochlear Implantation Without Audiology - Surgeon
Fees
2359 COCSF Colposcopy & Cautery (Surgeon Fees For Day Care)
2360 COLEEPS Colposcopy & LEEP (Surgeon Fees for Day Care)
2361 CHDCSF Colposcopy Hysteroscopy and D & C (Surgeon fees for
Day care)
2362 CHLEEPS Colposcopy Hysteroscopy and LEEP (Surgeon fees for
Day care)
2363 DHDCSF Diagnostic Hysteroscopy with D&C (Surgeon Fees for
Day Care )
2364 MTPSF MTP (Surgeon fees for Day care)
2365 OP4423 Position Testing ( Dix - Hallpike / Head - Shaking ) 4860 2430 1940 1460
2366 OP4424 Re-Position ( Epley's ) Manouvere 9700 4850 3880 2910
186
Pain Control Procedures
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2368 OP2935 Celiac plexus local anaesthetic block 15760 7880 6300 4730
2369 OP0845 Celiac plexus neurolytic/USG block 19680 9840 7870 5900
2370 OP0888 Combined spinal and epidural block 11280 5640 4510 3380
2371 OP0846 Continuous plexus block 11820 5910 4730 3550
2372 OP2925 Continuous stellate ganglion local anaesthetic block 13120 6560 5250 3940
2373 OP4759 Disc fix 52500 26250 21000 15750
2374 OP0847 Electronic PCA pump installation in OT 9980 4990 3990 2990
2375 OP4554 Endoscopic Dissectomy 26460 13230 10580 7940
2376 OP2937 Epidural adhesioniolysis 15760 7880 6300 4730
2377 OP0849 Epidural block ( Caudal ) 10500 5250 4200 3150
2378 OP0850 Epidural block ( Cervical ) 13120 6560 5250 3940
2379 OP0848 Epidural block ( Lumbar ) 7480 3740 2990 2240
2380 OP0851 Epidural block ( Thoracic ) 9080 4540 3630 2720
2381 OP2938 Epidurography 11140 5570 4460 3340
2382 OP2939 Epiduroscopy ( with epidurography ) 18780 9390 7510 5630
2383 OP2063 Facet joint block 10500 5250 4200 3150
2384 OP4735 Facet joint block - Bilateral 13120 6560 5250 3940
2385 OP0852 Facet joint block by radiofrequency ablation 11820 5910 4730 3550
2386 OP4736 Facet joint block by RFA - Bilateral 13120 6560 5250 3940
2387 OP2926 Ganglion impar local anaesthetic block 15760 7880 6300 4730
2388 OP0853 Ganglion impar neurolytic/USGG block 19680 9840 7870 5900
2389 OP0854 Gasserian gangalion neurolytic/ Radiofrequency 11280 5640 4510 3380
anlation block
2390 OP0856 Gasserian ganglion radiofrequency ablation 19680 9840 7870 5900
2391 OP0855 Gasserian ganglion/ local anaesthetic infiltration 7480 3740 2990 2240
block
2392 OP4552 Genicular Nerve R.F. 17060 8530 6820 5120
2393 OP4748 Genicular Nerve R.F. - B/L 19680 9840 7870 5900
2394 OP0857 Glossopharyngeal nerve local anaesthetic infiltration 15760 7880 6300 4730
block
2395 OP2929 Glossopharyngeal nerve neurolytic block 9400 4700 3760 2820
2396 OP2930 Glossopharyngeal nerve radio-frequency block 18380 9190 7350 5510
2397 OP2936 Hypogastric plexus local anaesthetic block 15760 7880 6300 4730
2398 OP0858 Hypogastric plexus neurolytic/USG block 19680 9840 7870 5900
2399 OP0859 Infra-orbital nerve local anaesthetic infiltration block 10500 5250 4200 3150
2400 OP0860 Infra-orbital nerve neurolytic block 7480 3740 2990 2240
2401 OP2934 Infra-orbital nerve radio-frequency block 13120 6560 5250 3940
2402 OP0861 Intercostal nerve local anaesthetic block 15760 7880 6300 4730
2403 OP2927 Intercostal nerve neurolytic block 7480 3740 2990 2240
2404 OP2928 Intercostal nerve radio-frequency block 19680 9840 7870 5900
2405 OP0862 Intrathecal / epidural neurolysis 11280 5640 4510 3380
2406 OP4747 Knee injection - B/L 14440 7220 5780 4330
2407 OP4746 Knee injection - U/L 13120 6560 5250 3940
2408 OP0863 Local anaesthetic infiltration into scar / trigger point 10500 5250 4200 3150
for pain relief
2409 OP4761 Lumbar Drain placement in OT 9180 4590 3670 2750
2410 OP0887 Lumbar puncture Drain for CSF 7480 3740 2990 2240
2411 OP0864 Lumbar sympathetic block 15760 7880 6300 4730
187
2412 OP0865 Lumbar sympathetic radiofrequency ablation 19680 9840 7870 5900
2413 OP0866 Mandibular nerve local anaesthetic infiltration block 10500 5250 4200 3150
2414 OP0867 Mandibular nerve neurolytic block 7480 3740 2990 2240
2415 OP2931 Mandibular nerve radio-frequency block 13120 6560 5250 3940
2416 OP0868 Maxillary nerve local anaesthetic infiltration block 7480 3740 2990 2240
2417 OP0869 Maxillary nerve neurolytic block 7480 3740 2990 2240
2418 OP2932 Maxillary nerve radio-frequency block 11280 5640 4510 3380
2419 OP0870 Mechanical infusor ( Baxter ) pump installation in OT 6160 3080 2460 1850
2420 OP0871 Mechanical intrathecal pump installation in OT 18780 9390 7510 5630
2421 OP0872 Mental nerve local anaesthetic infiltration block 10500 5250 4200 3150
2422 OP0873 Mental nerve neurolytic block 7480 3740 2990 2240
2423 OP2064 Nerve block 7480 3740 2990 2240
2424 OP2065 Nerve root block 9400 4700 3760 2820
2425 OP4749 Occipital Nerve - Local Infiltration 10500 5250 4200 3150
2426 OP4750 Occipital Nerve - Radiofrequency/USG Ablation 13120 6560 5250 3940
2427 OP4556 Ozone Therapy 8960 4480 3580 2690
2428 OP4758 Paravertebral - Bilateral 18380 9190 7350 5510
2429 OP0875 Para-vertebral local anaesthetic infiltration block 15760 7880 6300 4730
2430 OP4752 Penile Nerve / Lateral Cutaneous / Genital Femora 13120 6560 5250 3940
Radiofrequency / USG Ablation
2431 OP4751 Penile Nerve / Lateral Cutaneous / Genital Femoral - 10500 5250 4200 3150
Local Infiltration
2432 OP4502 Percutaneous Discectomy 78760 39380 31500 23630
2433 OP0876 Programmable intrathecal pump installation in OT 26260 13130 10500 7880
2434 OP4760 Programmable intrathecal pump installation in OT - 52500 26250 21000 15750
Permanent
2435 OP4553 PRP Therapy 19680 9840 7870 5900
2436 OP0877 Psoas compartment local anaesthetic infiltration block 5640 2820 2260 1690
2437 OP4555 Rami Communicans Radiofrequency 13120 6560 5250 3940
2438 OP4743 Rami Communicans Radiofrequency - U/L, B/L 15760 7880 6300 4730
2439 OP4742 Ramus Communicans local infiltration - B/L 11820 5910 4730 3550
2440 OP4741 Ramus Communicans local infiltration - U/L, B/L 10500 5250 4200 3150
2441 OP4740 S. I. Joint R. F. - B/L 15760 7880 6300 4730
2442 OP4739 S. I. Joint R. F. / USG 13120 6560 5250 3940
2443 OP0878 Sacroiliac joint injection block 10500 5250 4200 3150
2444 OP4738 Sacroiliac joint injection block - Bilateral 11820 5910 4730 3550
2445 OP4745 Shoulder injection - B/L 11820 5910 4730 3550
2446 OP4744 Shoulder injection - U/L 10500 5250 4200 3150
2447 OP2922 Spheno-palatine ganglion local anaesthetic block 13120 6560 5250 3940
2448 OP2923 Spheno-palatine ganglion radiofrequency block 15760 7880 6300 4730
2449 OP0880 Spinal cord stimulation implant ( permanent ) 52500 26250 21000 15750
2450 OP0881 Spinal cord stimulation implant ( temporary ) 26260 13130 10500 7880
2451 OP2924 Stellate ganglion local anaesthetic block 15760 7880 6300 4730
2452 OP0882 Stellate ganglion neurolytic block 11280 5640 4510 3380
2453 OP0883 Stellate ganglion radiofrequency/USG ablation 19680 9840 7870 5900
2454 OP0884 Supra-orbital nerve local anaesthetic infiltration block 10500 5250 4200 3150
2455 OP0885 Supra-orbital nerve neurolytic block 13120 6560 5250 3940
2456 OP2933 Supra-orbital nerve radio-frequency block 13120 6560 5250 3940
2457 OP4756 Supra-scapular - Local Infiltration 10500 5250 4200 3150
2458 OP4757 Supra-scapular - Radiofrequency Ablation 13120 6560 5250 3940
2459 OP0886 Trans-foraminal block 10500 5250 4200 3150
2460 OP4737 Trans-foraminal block - Bilateral 13120 6560 5250 3940
2461 OP4755 Trigger point - Radiofrequency Ablation 13120 6560 5250 3940
2462 OP4754 Trochlear Nerve - Local Infiltration 10500 5250 4200 3150
2463 OP4753 Trochlear Nerve - Radiofrequency Ablation 13120 6560 5250 3940
188
2464 OP4549 Ultrasound Guided Block For Postop Pain Relief 10500 5250 4200 3150
Intracostal & Paravertebral
Sciatico Femoral
2467 OP4548 Ultrasound Guided Block For Postop Pain Relief TAP 6560 3280 2620 1970
Block
Peripheral Aneurysm Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2468 OP0303 Brachial aneurysm repair using reversed vein graft 173700 86850 69480 52110
2469 OP0302 Brachial aneurysm repair using synthetic graft 173700 86850 69480 52110
2470 OP0304 Brachial pseudo - aneurysm repair using reversed vein 173700 86850 69480 52110
graft
2471 OP4206 Complex peripheral aneurysm repair 229720 114860 91890 68920
2472 OP0294 Femoral aneurysm repair using reversed vein graft 173700 86850 69480 52110
2473 OP0293 Femoral aneurysm repair using synthetic graft 173700 86850 69480 52110
2474 OP0295 Femoral pseudo - aneurysm repair using reversed vein 173700 86850 69480 52110
graft
2475 OP0300 Iliac aneurysm repair using reversed vein graft 173700 86850 69480 52110
2476 OP0299 Iliac aneurysm repair using synthetic graft 173700 86850 69480 52110
2477 OP0301 Iliac pseudo - aneurysm repair using reversed vein 173700 86850 69480 52110
graft
2478 OP0297 Popliteal aneurysm repair using reversed vein graft 173700 86850 69480 52110
2479 OP0296 Popliteal aneurysm repair using synthetic graft 173700 86850 69480 52110
2480 OP0298 Popliteal pseudo - aneurysm repair using reversed 173700 86850 69480 52110
vein graft
2481 OP0306 Subclavian aneurysm repair using reversed vein graft 173700 86850 69480 52110
2482 OP0305 Subclavian aneurysm repair using synthetic graft 173700 86850 69480 52110
2483 OP0307 Subclavian pseudo - aneurysm repair using reversed 144440 72220 57780 43330
vein graft
2484 OP3020 Ultrasound guided thrombin injection for aneurysm 173700 86850 69480 52110
repair
Peripheral Angioplasty
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2485 OP0720 Femoral angioplasty in OT - brachial route 20620 10310 8250 6190
2486 OP0696 Femoral angioplasty in OT - femoral route 20620 10310 8250 6190
2487 OP0731 Femoral subintimal angioplasty in OT ( antegrade ) - 20620 10310 8250 6190
femoral route
2488 OP0726 Femoral subintimal angioplasty in OT ( retrograde ) - 20620 10310 8250 6190
femoral route
2489 OP0701 Iliac angioplasty in OT - brachial route 20620 10310 8250 6190
2490 OP0695 Iliac angioplasty in OT - femoral route 20620 10310 8250 6190
189
Plastic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2491 OP4545 Abdomen Wall Reconstruction 101080 50540 40430 30320
2492 OP3087 ALT perforator free flap 204340 102170 81740 61300
2493 OP4524 Apronectomy 144380 72190 57750 43310
2494 OP4239 Bi-paddle PMC 117400 58700 46960 35220
2495 OP4214 Bi-Pedicle flap 44040 22020 17620 13210
2496 OP4362 Botox Injection in Brachial Plexus 40020 20010 16010 12010
2497 OP4359 Burn Contracture Release of Axilla 106720 53360 42690 32020
2498 OP4358 Burn Contracture Release of Elbow 106720 53360 42690 32020
2499 OP4361 Burn Contracture Release of Groin 106720 53360 42690 32020
2500 OP4360 Burn Contracture Release of Knee 106720 53360 42690 32020
2501 OP1318 Burn wound dressing ( large ) 45060 22530 18020 13520
2502 OP1317 Burn wound dressing ( medium ) 27040 13520 10820 8110
2503 OP1316 Burn wound dressing ( minor ) 18060 9030 7220 5420
2504 OP3357 Collagen dressing in OT ( large ) 53080 26540 21230 15920
2505 OP3356 Collagen dressing in OT ( medium ) 39760 19880 15900 11930
2506 OP3309 Collagen dressing in OT ( small ) 26600 13300 10640 7980
2507 OP0065 Composite graft ( large ) - plastic surgery 84380 42190 33750 25310
2508 OP0064 Composite graft ( medium ) - plastic surgery 67500 33750 27000 20250
2509 OP1324 Composite graft ( small ) - plastic surgery 50640 25320 20260 15190
2510 OP4521 Contouring of Mandible Angle 101080 50540 40430 30320
2511 OP1795 Contracture release of lips 89940 44970 35980 26980
2512 OP1794 Contracture release of neck 125900 62950 50360 37770
2513 OP3425 Correction of Binder's Syndrome 101260 50630 40500 30380
2514 OP0810 Correction of macrostomia 40460 20230 16180 12140
2515 OP0811 Correction of microstomia 71980 35990 28790 21590
2516 OP0072 Cranioplasty with bone graft 134900 67450 53960 40470
2517 OP0066 Craniostenosis ( multiple cranial sutures ) - 188320 94160 75330 56500
reconstruction of cranial vault
2518 OP0067 Craniostenosis ( multiple cranial sutures ) - 239700 119850 95880 71910
reconstruction of cranial vault & bone grafting
2519 OP1327 Craniostenosis ( single cranial suture ) - reconstruction 161860 80930 64740 48560
of cranial vault
2520 OP0068 Craniostenosis ( single cranial suture ) - reconstruction 179840 89920 71940 53950
of cranial vault & bone grafting
2521 OP3437 Cross leg flap 84380 42190 33750 25310
2522 OP0063 Cross lip pedicle flap ( Abbe Estlander ) 89940 44970 35980 26980
2523 OP3312 Debulking of large flap 42520 21260 17010 12760
2524 OP3313 Debulking of small flap 26600 13300 10640 7980
2525 OP4353 Deep – (Biopsy) 53360 26680 21340 16010
2526 OP1331 Delay of flap 24840 12420 9940 7450
2527 OP3314 Deltopectoral flap 106080 53040 42430 31820
2528 OP1338 Dermofat graft – large 60740 30370 24300 18220
2529 OP1339 Dermofat graft – small 36040 18020 14420 10810
2530 OP4482 Digital Vessel Repair 72760 36380 29100 21830
2531 OP3315 Distally based fasciocutaneous flap 84900 42450 33960 25470
2532 OP3316 Division and insetting of flap - single stage ( large ) 63740 31870 25500 19120
2533 OP3317 Division and insetting of flap - single stage ( medium ) 45000 22500 18000 13500
2534 OP3318 Division and insetting of flap - single stage ( small ) 32500 16250 13000 9750
2535 OP3432 Division of flap 25340 12670 10140 7600
190
2536 OP4489 Dressing (Extra Large) 24260 12130 9700 7280
2537 OP1340 Dressing in OT major 18200 9100 7280 5460
2538 OP1341 Dressing in OT medium 14560 7280 5820 4370
2539 OP1342 Dressing in OT minor / suture removal 9700 4850 3880 2910
2540 OP0823 Ear lobule reconstruction - bilateral 16940 8470 6780 5080
2541 OP0824 Ear lobule reconstruction - unilateral 11360 5680 4540 3410
2542 OP4494 Ear Lobule Repair with Contilage Graft 36400 18200 14560 10920
2543 OP1346 Ear reconstruction 1st stage – cartilage implantation 134900 67450 53960 40470
2544 OP1347 Ear reconstruction 2nd stage – release and graft 74200 37100 29680 22260
2545 OP1348 Ear reconstruction 3rd stage / touching and revisions 60740 30370 24300 18220
2546 OP0822 Ear reconstruction using tissue expander ( bilateral ) 202300 101150 80920 60690
2547 OP0821 Ear reconstruction using tissue expander ( unilateral ) 134900 67450 53960 40470
2548 OP3319 Excision and repair of hidradenitus suppurativa 79680 39840 31870 23900
2549 OP3320 Excision and skin grafting of hidradenitus suppurativa 132580 66290 53030 39770
2550 OP0123 Excision of extremity lesion with Z-plasty or other 60740 30370 24300 18220
adjacent tissue transfer
2551 OP0125 Excision of hand or foot lesion with Z-plasty or other 60740 30370 24300 18220
2552 OP1357 Excision of head and neck lesion with Z-plasty or other 60740 30370 24300 18220
2553 OP0825 Excision of keloid ear lobule 71980 35990 28790 21590
2554 OP4732 Excision of Large Size Pelvic Soft Tissue Tumor (>10 98000 49000 39200 29400
cms)
2555 OP4731 Excision of Medium Size Pelvic Soft Tissue Tumor (5 - 77000 38500 30800 23100
10 cms)
2556 OP0124 Excision of scalp lesion with Z-plasty or other adjacent 60740 30370 24300 18220
tissue transfer
2557 OP1351 Excision of scar / lesion / wound and skin grafting - 112480 56240 44990 33740
major
medium
minor
2560 OP1785 Excision of skin lesion - extremities / trunk (5 - 10 cm) 89940 44970 35980 26980
2561 OP1784 Excision of skin lesion - extremities / trunk (less than 5 67500 33750 27000 20250
cm)
2562 OP1779 Excision of skin lesion - extremities / trunk (more than 112480 56240 44990 33740
10 cm)
2563 OP1780 Excision of skin lesion - face (less than 2 cm) 53940 26970 21580 16180
2564 OP1793 Excision of skin lesion - face (more than 2 cm) 80940 40470 32380 24280
2565 OP4730 Excision of Small Size Pelvic Soft Tissue Tumor (<5 56000 28000 22400 16800
cms)
2566 OP0122 Excision of trunk lesion with Z-plasty or other adjacent 60740 30370 24300 18220
tissue transfer
2567 OP0126 Expander insertion - multiple 80000 40000 32000 24000
2568 OP1359 Expander insertion - single 60640 30320 24260 18190
2569 OP3006 Expander insertion ( more than 2 ) 134980 67490 53990 40490
2570 OP1360 Expander removal & contouring - multiple 151900 75950 60760 45570
2571 OP1361 Expander removal & contouring - single 118160 59080 47260 35450
2572 OP3321 Eyebrow reconstruction with flap 79680 39840 31870 23900
2573 OP4484 Face Reanimation FFMT 181920 90960 72770 54580
2574 OP4485 Face Reanimation Muscle Flap 121280 60640 48510 36380
2575 OP4222 Face Swelling (Large) 73380 36690 29350 22010
2576 OP4223 Face Swelling (Medium) 58700 29350 23480 17610
2577 OP4224 Face Swelling (Small) 44040 22020 17620 13210
2578 OP0077 Facial bi-partition for hyperteleorism 269660 134830 107860 80900
2579 OP4483 Facial Nerve Cross Nerve Graft 121280 60640 48510 36380
191
2580 OP4367 Facial Reanimation (Baby Sitting Procedure) 133420 66710 53370 40030
2581 OP4366 Facial Reanimation by cross face nerve graft 133420 66710 53370 40030
2582 OP4363 Facial Reanimation by local muscle transfer – 1 Muscle 80060 40030 32020 24020
2583 OP4364 Facial Reanimation by local muscle transfer – 2 Muscle 106720 53360 42690 32020
2584 OP3067 Fibular osteocutaneous free flap for long bones 204340 102170 81740 61300
2585 OP1332 Flap insetting ( large ) 53940 26970 21580 16180
2586 OP1333 Flap insetting ( small ) 36040 18020 14420 10810
2587 OP4811 Flap insetting (Medim) 37500 18750 15000 11250
2588 OP3322 Foucher flap 95460 47730 38180 28640
2589 OP4486 Free Functional Muscle Transfer 169780 84890 67910 50930
2590 OP3003 Free Perforator flap transfer 204340 102170 81740 61300
2591 OP3323 Full thickness skin graft ( large ) 106080 53040 42430 31820
2592 OP3324 Full thickness skin graft ( medium ) 79680 39840 31870 23900
2593 OP3325 Full thickness skin graft ( small ) 53080 26540 21230 15920
2594 OP3436 Gastrocnemius / Soleus muscle flap 84380 42190 33750 25310
2595 OP4474 Gender Reassignment Surgery Female to Male 169780 84890 67910 50930
2596 OP4475 Gender Reassignment Surgery Male to Female 145540 72770 58220 43660
2597 OP3327 Gracilis flap ( free ) 212260 106130 84900 63680
2598 OP3328 Gracilis flap ( pedicled ) 106080 53040 42430 31820
2599 OP3076 Groin perforator free flap 204340 102170 81740 61300
2600 OP4238 Head & neck reconstruction (Complex) 102740 51370 41100 30820
2601 OP4237 Head & neck reconstruction (Simple) 58700 29350 23480 17610
2602 OP4236 Hepatic artery anastomosis 72760 36380 29100 21830
2603 OP4544 Hernia Repair with Abdominal Wall Reconstruction 173260 86630 69300 51980
2604 OP3074 Iliac crest osteocutaneous free flap 204340 102170 81740 61300
2605 OP3330 Latissimus dorsi ( LD ) free flap 194600 97300 77840 58380
2606 OP4370 LD Pedicle Flap 106720 53360 42690 32020
2607 OP4371 LD Pedicle flap with implant for breast reconsrtruction 133420 66710 53370 40030
2608 OP3331 Littler flap 100000 50000 40000 30000
2609 OP3428 Local Advancement flap - large 101260 50630 40500 30380
2610 OP3427 Local Advancement flap - medium 67500 33750 27000 20250
2611 OP3426 Local Advancement flap - small 50640 25320 20260 15190
2612 OP1737 Local transposition flap - large 78720 39360 31490 23620
2613 OP1739 Local transposition flap - medium 74200 37100 29680 22260
2614 OP1709 Local transposition flap - small 53940 26970 21580 16180
2615 OP3009 Lymphaticovenous shunt 122640 61320 49060 36790
2616 OP3333 Medial plantar artery flap ( neurovascular free flap ) 265280 132640 106110 79580
2617 OP3334 Medial plantar artery flap ( pedicled ) 106080 53040 42430 31820
2618 OP0820 Medpore ear reconstruction ( bilateral ) 269660 134830 107860 80900
2619 OP0815 Medpore ear reconstruction ( unilateral ) 179840 89920 71940 53950
2620 OP4546 Nasal Framework Correction 101080 50540 40430 30320
2621 OP3337 Nasolabial flap 63740 31870 25500 19120
2622 OP3001 Neurovascular island Flap - Free 204340 102170 81740 61300
2623 OP3002 Neurovascular island Flap - Pedicle 122640 61320 49060 36790
2624 OP4354 Oberlin Nerve Transfer 133420 66710 53370 40030
2625 OP0074 Orbital repositioning for hyperteleorism - extracranial 269660 134830 107860 80900
& intracranial approach
& intracranial approach with bone graft
approach
approach with bone graft
2629 OP0819 Otoplasty for acquired ear deformity ( bilateral ) 72760 36380 29100 21830
2630 OP0818 Otoplasty for acquired ear deformity ( unilateral ) 48520 24260 19410 14560
192
2631 OP0817 Otoplasty for lop ears ( bilateral ) 84900 42450 33960 25470
2632 OP0816 Otoplasty for lop ears ( unilateral ) 72760 36380 29100 21830
2633 OP4541 Panniculectomy 57760 28880 23100 17330
2634 OP4231 Partial Ear Reconstruction 73380 36690 29350 22010
2635 OP3339 Pectoralis major myocutaneous flap 106080 53040 42430 31820
2636 OP4373 Pedicle ALT flap 133420 66710 53370 40030
2637 OP0466 Pedicle flap cover of amputation stump 89940 44970 35980 26980
2638 OP4216 Pedicle LD for breast 88060 44030 35220 26420
2639 OP4814 Pedicled ALT Flap 125000 62500 50000 37500
2640 OP4213 Pedicled Gastronimius Flap 73380 36690 29350 22010
2641 OP3358 Pedicled perforator flap ( large ) 95460 47730 38180 28640
2642 OP3340 Pedicled perforator flap ( small ) 63740 31870 25500 19120
2643 OP4230 Penile reconstruction (Free flap) 205440 102720 82180 61630
2644 OP4229 Penile reconstruction (Pedicle flap) 146740 73370 58700 44020
2645 OP4522 Post Traumatic Ear Reconstruction Simple 57760 28880 23100 17330
2646 OP4523 Post Traumatic Ear Reconstruction Complex 115500 57750 46200 34650
2647 OP3342 Posterior interosseus artery flap 84900 42450 33960 25470
2648 OP1735 Radial artery forearm free flap 130360 65180 52140 39110
2649 OP3343 Radial artery forearm pedicled flap 95460 47730 38180 28640
2650 OP4478 Radial/Ulnar Artery Repair 72760 36380 29100 21830
2651 OP3344 Reconstruction by Limberg flap ( large ) 79680 39840 31870 23900
2652 OP3345 Reconstruction by Limberg flap ( small ) 53080 26540 21230 15920
2653 OP1592 Reconstructive rhinoplasty - forehead flap ( single 101260 50630 40500 30380
stage )
2654 OP1590 Reconstructive rhinoplasty - forehead flap ( stage One 84380 42190 33750 25310
of two stages )
2655 OP1591 Reconstructive rhinoplasty - forehead flap ( stage Two 50640 25320 20260 15190
of two stages )
2656 OP3346 Rectus abdominis flap ( free ) 212260 106130 84900 63680
2657 OP3347 Rectus abdominis flap ( pedicled ) 106080 53040 42430 31820
2658 OP3349 Reverse sural artery flap 95460 47730 38180 28640
2659 OP4820 Skin and Soft Tissue Biopsy - Large 25000 12500 10000 7500
2660 OP4819 Skin and Soft Tissue Biopsy - Medium 20000 10000 8000 6000
2661 OP4818 Skin and Soft Tissue Biopsy - Small 15000 7500 6000 4500
2662 OP4547 Skin biopsy 14440 7220 5780 4330
2663 OP2009 Skin grafting - major 76460 38230 30580 22940
2664 OP2008 Skin grafting - minor 40460 20230 16180 12140
2665 OP4355 Somsak Nerve Transfer 133420 66710 53370 40030
2666 OP2999 Split skin grafting - medium 61400 30700 24560 18420
2667 OP1964 Sternomastoid release - unipolar 39560 19780 15820 11870
2668 OP3014 Sternomastoid release Bipolar 81820 40910 32730 24550
2669 OP4813 Supercharging of tissue/flapintestine 112500 56250 45000 33750
2670 OP4352 Superficial – (Biopsy) 32020 16010 12810 9610
2671 OP4477 Sural Nerve graft 60640 30320 24260 18190
2672 OP4543 Surgical Wound Closure - Complex ( By Plastic Surgery 115500 57750 46200 34650
Technique)
2673 OP4542 Surgical Wound Closure - Simple ( By Plastic Surgery 57760 28880 23100 17330
Technique)
2674 OP4488 Suture Removal In Day Care 1830
2675 OP3420 Tangential excision of burn wound - large 84380 42190 33750 25310
2676 OP3419 Tangential excision of burn wound - medium 67500 33750 27000 20250
2677 OP3418 Tangential excision of burn wound - small 50640 25320 20260 15190
2678 OP1738 Thoracic pedicle flap 89940 44970 35980 26980
2679 OP4232 Tube Flap Reconstruction (Large) 73380 36690 29350 22010
2680 OP4233 Tube Flap Reconstruction (Medium) 58700 29350 23480 17610
193
2681 OP4234 Tube Flap Reconstruction (Small) 44040 22020 17620 13210
2682 OP1733 Ulnar artery forearm free flap 130360 65180 52140 39110
2683 OP3421 Vaccum assisted wound closure ( VAC ) application 27000 13500 10800 8100
2684 OP4810 Vaccum assisted wound closure ( VAC ) application - 25000 12500 10000 7500
Large
Medium
Small
2687 OP4481 Vascular Malformation Excision - Large 121280 60640 48510 36380
2688 OP4480 Vascular Malformation Excision - Medium 84900 42450 33960 25470
2689 OP4479 Vascular Malformation Excision - Small 60640 30320 24260 18190
2690 OP0464 V-Y flap cover of amputation stump 67500 33750 27000 20250
2691 OP4711 Webspace Contrature Release + local flap 67200 33600 26880 20160
2692 OP4710 Webspace Contrature Release + Z Plasty 54600 27300 21840 16380
2693 OP4712 Webspace Contrature Release with distal flap 88200 44100 35280 26460
2694 OP3354 Z-plasty repair of scar ( multiple ) 79680 39840 31870 23900
2695 OP3355 Z-plasty repair of scar ( single ) 36400 18200 14560 10920
Primary Arthroplasty
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2696 OP4139 Ankle joint replacement 129300 64650 51720 38790
2697 OP1540 Bipolar hip hemiarthroplasty - cemented 94000 47000 37600 28200
2698 OP1541 Bipolar hip hemiarthroplasty - non cemented 94000 47000 37600 28200
2699 OP1542 Bipolar shoulder hemiarthroplasty - cemented 94000 47000 37600 28200
2700 OP1543 Bipolar shoulder hemiarthroplasty - non cemented 94000 47000 37600 28200
2701 OP4132 Closed reduction of Bipolar / THR 19040 9520 7620 5710
2702 OP1526 Computer assisted total knee replacement - cemented 142260 71130 56900 42680
2703 OP1527 Computer assisted total knee replacement - hybrid 142260 71130 56900 42680
2704 OP1528 Computer assisted total knee replacement - non 142260 71130 56900 42680
cemented
2705 OP3051 Excision arthroplasty of elbow 54960 27480 21980 16490
2706 OP1510 Finger joint replacement - per joint 64700 32350 25880 19410
2707 OP1572 Finger joint replacement - three joints or more 97040 48520 38820 29110
2708 OP1509 Finger joint replacement - two joints 97040 48520 38820 29110
2709 OP2997 Gap / implant arthroplasty 94060 47030 37620 28220
2710 OP2980 Girdle Stone Arthroplasty 47140 23570 18860 14140
2711 OP1523 Minimally invasive total hip replacement - cemented 142260 71130 56900 42680
2712 OP1524 Minimally invasive total hip replacement - hybrid 142260 71130 56900 42680
2713 OP1525 Minimally invasive total hip replacement - non 142260 71130 56900 42680
cemented
2714 OP1529 Minimally invasive total knee replacement - cemented 142260 71130 56900 42680
2715 OP1530 Minimally invasive total knee replacement - hybrid 142260 71130 56900 42680
2716 OP1531 Minimally invasive total knee replacement - non 142260 71130 56900 42680
cemented
2717 OP1511 Patellofemoral arthroplasty - cemented 64700 32350 25880 19410
2718 OP1512 Patellofemoral arthroplasty - non cemented 64700 32350 25880 19410
2719 OP3092 Patelloplasty with patellar surface replacement 98020 49010 39210 29410
2720 OP2988 THR with acetabuloplasty 150860 75430 60340 45260
2721 OP0183 TM joint ankylosis - arthroplasty + allograft 103440 51720 41380 31030
2722 OP0184 TM joint ankylosis - arthroplasty + prosthetic joint 103440 51720 41380 31030
replacement
194
2723 OP0181 TM joint ankylosis - condylectomy / interposition gap 103440 51720 41380 31030
arthroplasty
2724 OP0182 TM joint ankylosis - gap arthroplasty 103440 51720 41380 31030
2725 OP1514 Toe Joint Replacement - single joint 64700 32350 25880 19410
2726 OP1513 Toe Joint Replacement - three or more joints 97040 48520 38820 29110
2727 OP2820 Toe Joint Replacement - two joints 97040 48520 38820 29110
2728 OP1515 Total elbow replacement - cemented 142260 71130 56900 42680
2729 OP1516 Total elbow replacement - hybrid 142260 71130 56900 42680
2730 OP1517 Total elbow replacement - non cemented 142260 71130 56900 42680
2731 OP1518 Total hip replacement - cemented 142260 71130 56900 42680
2732 OP1519 Total hip replacement - hybrid 142260 71130 56900 42680
2733 OP1520 Total hip replacement - non cemented 142260 71130 56900 42680
2734 OP1521 Total hip replacement - non cemented stem - metal on 142260 71130 56900 42680
metal
2735 OP1522 Total hip replacement - resurfacing - metal on metal 142260 71130 56900 42680
2736 OP3050 Total Hip Replacement with acetabular reconstruction 150860 75430 60340 45260
- cemented ( Primary )
- uncemented ( Primary )
2738 OP1532 Total knee replacement - cemented 142260 71130 56900 42680
2739 OP1533 Total knee replacement - hybrid 142260 71130 56900 42680
2740 OP1534 Total knee replacement - non cemented 142260 71130 56900 42680
2741 OP3046 Total Knee Replacement with tibial condyle 150860 75430 60340 45260
reconstruction ( Primary )
2742 OP1535 Total shoulder replacement - cemented 142260 71130 56900 42680
2743 OP1536 Total shoulder replacement - hybrid 142260 71130 56900 42680
2744 OP1537 Total shoulder replacement - non cemented 142260 71130 56900 42680
2745 OP1538 Unicondylar knee replacement - cemented 142260 71130 56900 42680
2746 OP1539 Unicondylar knee replacement - non cemented 142260 71130 56900 42680
2747 OP1544 Unipolar hip hemiarthroplasty - cemented 94000 47000 37600 28200
2748 OP1545 Unipolar hip hemiarthroplasty - non cemented 94000 47000 37600 28200
2749 OP1546 Unipolar shoulder hemiarthroplasty - cemented 94000 47000 37600 28200
2750 OP1574 Vascularised Joint Replacement - multiple joints 129320 64660 51730 38800
2751 OP1573 Vascularised Joint Replacement - single joint 107780 53890 43110 32330
Procedures
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2752 OP4421 Beside Decannulation of Tracheostomy 15280 7640 6110 4580
2753 OP4422 Endo - Laryngoscopy ( Bedside ) 7640 3820 3060 2290
2754 OP4303 Tonsillar Fossa Hemostasis 15280 7640 6110 4580
Psychiatry
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2764 OP1366 Modified ECT (electro convulsive therapy) 9320 4660 3730 2800
2765 OP1367 Narco analysis 10340 5170 4140 3100
Reimplantation Revascularisation Operations

195
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2766 OP3435 Exploration for reimplantation - arm / forearm 61640 30820 24660 18490
2767 OP3434 Exploration for reimplantation - single digit 46240 23120 18500 13870
2768 OP0741 Reimplantation of ear 205200 102600 82080 61560
2769 OP0830 Reimplantation of finger - single 150000 75000 60000 45000
2770 OP1694 Reimplantation of fingers - four or more fingers 250000 125000 100000 75000
2771 OP1693 Reimplantation of fingers - three fingers 187500 93750 75000 56250
2772 OP0831 Reimplantation of fingers - two fingers 127340 63670 50940 38200
2773 OP0748 Reimplantation of lip 205200 102600 82080 61560
2774 OP0832 Reimplantation of lower limb at ankle level 250000 125000 100000 75000
2775 OP0833 Reimplantation of lower limb at lower leg level 250000 125000 100000 75000
2776 OP0747 Reimplantation of nose 205200 102600 82080 61560
2777 OP0742 Reimplantation of penis 205200 102600 82080 61560
2778 OP0749 Reimplantation of scalp 205200 102600 82080 61560
2779 OP0743 Reimplantation of testis 205200 102600 82080 61560
2780 OP0836 Reimplantation of upper limb at forearm level 250000 125000 100000 75000
2781 OP0837 Reimplantation of upper limb at palm level 250000 125000 100000 75000
2782 OP0838 Reimplantation of upper limb at upper arm level 250000 125000 100000 75000
2783 OP0839 Reimplantation of upper limb at wrist level 250000 125000 100000 75000
2784 OP4717 Reimplantation Single Finger (Crush avulsed with vein 168000 84000 67200 50400
graft)
2785 OP0718 Revascularisation of finger - single 69460 34730 27780 20840
2786 OP0739 Revascularisation of fingers - four or more fingers 138920 69460 55570 41680
2787 OP1696 Revascularisation of fingers - three fingers 115780 57890 46310 34730
2788 OP1695 Revascularisation of fingers - two fingers 92620 46310 37050 27790
2789 OP0750 Revascularisation of lower limb at ankle level 123160 61580 49260 36950
2790 OP0751 Revascularisation of lower limb at lower leg level 123160 61580 49260 36950
2791 OP0752 Revascularisation of lower limb at thigh level 123160 61580 49260 36950
2792 OP0745 Revascularisation of upper limb at forearm level 123160 61580 49260 36950
2793 OP0746 Revascularisation of upper limb at palm level 123160 61580 49260 36950
2794 OP0744 Revascularisation of upper limb at upper arm level 123160 61580 49260 36950
2795 OP0740 Revascularisation of upper limb at wrist level 123160 61580 49260 36950
Revision Arthroplasty
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2796 OP1562 Computer assisted total knee Replacement - 165880 82940 66350 49760
Cemented ( Revision arthroplasty )
2797 OP1563 Computer assisted Total Knee Replacement - Hybrid ( 165880 82940 66350 49760
Revision arthroplasty )
2798 OP1564 Computer assisted Total Knee Replacement - non 165880 82940 66350 49760
cemented ( Revision arthroplasty )
2799 OP1549 Patellofemoral Arthroplasty - Cemented ( Revision 64700 32350 25880 19410
arthroplasty )
2800 OP1550 Patellofemoral Arthroplasty - non cemented ( Revision 64700 32350 25880 19410
arthroplasty )
2801 OP1551 Total Elbow Replacement - Cemented ( Revision 165880 82940 66350 49760
arthroplasty )
196
2802 OP1552 Total Elbow Replacement - Hybrid ( Revision 165880 82940 66350 49760
arthroplasty )
2803 OP1553 Total Elbow Replacement - non cemented ( Revision 165880 82940 66350 49760
arthroplasty )
2804 OP1554 Total Hip Replacement - Cemented ( Revision 165880 82940 66350 49760
arthroplasty )
2805 OP1555 Total Hip Replacement - Hybrid ( Revision arthroplasty 165880 82940 66350 49760
)
2806 OP1556 Total Hip Replacement - non cemented ( Revision 165880 82940 66350 49760
arthroplasty )
2807 OP1557 Total Hip Replacement - non cemented stem - Metal 165880 82940 66350 49760
on metal ( Revision arthroplasty )
2808 OP1558 Total Hip Replacement - Resurfacing - Metal on metal 165880 82940 66350 49760
( Revision arthroplasty )
- cemented ( Revision )
- uncemented ( Revision )
2811 OP1559 Total Hip Replacement with acetabuloplasty / Femoral 165880 82940 66350 49760
reconstruction - Cemented ( Revision arthroplasty )
reconstruction - Hybrid ( Revision arthroplasty )
reconstruction - non cemented ( Revision arthroplasty
)
2814 OP1565 Total Knee Replacement - Cemented ( Revision 165880 82940 66350 49760
arthroplasty )
2815 OP1566 Total Knee Replacement - Hybrid ( Revision 165880 82940 66350 49760
arthroplasty )
2816 OP1567 Total Knee Replacement - non cemented ( Revision 165880 82940 66350 49760
arthroplasty )
2817 OP3043 Total Knee Replacement with tibial condyle 150860 75430 60340 45260
reconstruction ( Revision )
2818 OP1568 Total Shoulder Replacement - Cemented ( Revision 165880 82940 66350 49760
arthroplasty )
2819 OP1569 Total Shoulder Replacement - Hybrid ( Revision 165880 82940 66350 49760
arthroplasty )
2820 OP1570 Total Shoulder Replacement - non cemented ( 165880 82940 66350 49760
2821 OP1547 Unicondylar Knee Replacement - Cemented ( Revision 165880 82940 66350 49760
arthroplasty )
2822 OP1548 Unicondylar Knee Replacement - non cemented ( 165880 82940 66350 49760
Salivary Gland Operations

OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2823 OP0629 Excision of sublingual gland tumour 45280 22640 18110 13580
2824 OP1048 Excision of submandidular gland / tumour 45280 22640 18110 13580
2825 OP0805 Extended parotidectomy 121860 60930 48740 36560
2826 OP3506 Sialoendoscopy: Parotid duct diagnostic - bilateral 28740 14370 11500 8620
2827 OP3505 Sialoendoscopy: Parotid duct diagnostic - unilateral 20160 10080 8060 6050
2828 OP3508 Sialoendoscopy: Parotid duct dillatation - bilateral 28740 14370 11500 8620
2829 OP3507 Sialoendoscopy: Parotid duct dillatation - unilateral 20160 10080 8060 6050
2830 OP3511 Sialoendoscopy: Parotid duct multiple calculi removal 36220 18110 14490 10870
simple
197
2831 OP3510 Sialoendoscopy: Parotid duct single calculi removal 28740 14370 11500 8620
simple
2832 OP3509 Sialoendoscopy: Parotid duct stenting 19580 9790 7830 5870
2833 OP3500 Sialoendoscopy: Submandibular duct diagnostic - 28740 14370 11500 8620
bilateral
2834 OP3499 Sialoendoscopy: Submandibular duct diagnostic - 20160 10080 8060 6050
unilateral
2835 OP3502 Sialoendoscopy: Submandibular duct dialatation - 28740 14370 11500 8620
bilateral
2836 OP3501 Sialoendoscopy: Submandibular duct dialatation - 20160 10080 8060 6050
unilateral
2837 OP3504 Sialoendoscopy: Submandibular duct multiple calculi 36220 18110 14490 10870
removal simple
2838 OP3503 Sialoendoscopy: Submandibular duct single calculi 28740 14370 11500 8620
removal simple
2839 OP0995 Submandibular duct calculus removal 45280 22640 18110 13580
2840 OP1049 Superficial parotidectomy 90380 45190 36150 27110
2841 OP0631 Superficial parotidectomy for Recurrent tumour 90380 45190 36150 27110
2842 OP0804 Total parotidectomy 121860 60930 48740 36560
2843 OP1052 Total parotidectomy ( nerve preserving ) 121860 60930 48740 36560
2844 OP0031 Total parotidectomy ( with nerve grafting ) 162540 81270 65020 48760
2845 OP0632 Total parotidectomy for Recurrent tumour ( nerve 121860 60930 48740 36560
preserving )
2846 OP0633 Total parotidectomy for Recurrent tumour ( with 162540 81270 65020 48760
nerve grafting )
Small Bowel Transplant Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2847 OP3362 Small bowel transplant donor operation Within Package
Spinal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2848 OP2055 Anterior and posterior fusion for vertebral deformity 203200 101600 81280 60960
correction
2849 OP2056 Anterior and posterior fusion with instrumentation for 212420 106210 84970 63730
vertebral deformity correction
2850 OP3414 Anterior cervical corpectomy for DPLL 210800 105400 84320 63240
2851 OP3412 Anterior cervical corpectomy with stabilization and 210800 105400 84320 63240
instrumentation
2852 OP2087 Anterior cervical discectomy - Multiple Level 171580 85790 68630 51470
2853 OP2088 Anterior cervical discectomy - Single Level 162540 81270 65020 48760
2854 OP0501 Anterior cervical discectomy with instrumentation / 180600 90300 72240 54180
bone grafting
2855 OP2129 Anterior decompression + anterior interbody fusion of 180600 90300 72240 54180
lumbar spine
2856 OP2138 Anterior decompression + Fusion + Anterior 180600 90300 72240 54180
instrumentation of lumbar spine
2857 OP2137 Anterior decompression + posterior decompression + 203200 101600 81280 60960
fusion + instrumentation of lumbar spine
2858 OP2057 Anterior fusion for vertebral deformity correction 171580 85790 68630 51470
198
2859 OP2058 Anterior fusion with instrumentation for vertebral 171580 85790 68630 51470
deformity correction
2860 OP2134 Anterolateral decompression + Fusion + anterior 180600 90300 72240 54180
instrumentation of dorsal / thoracic spine
2861 OP2139 Anterolateral decompression + Fusion + anterior 180600 90300 72240 54180
2862 OP2135 Anterolateral decompression + Fusion + Posterior 203200 101600 81280 60960
instrumentation of dorsal / thoracic spine
2863 OP2140 Anterolateral decompression + Fusion + Posterior 203200 101600 81280 60960
2864 OP2094 Anterolateral decompression of Dorsal spine 171580 85790 68630 51470
2865 OP2107 Anterolateral decompression of Lumbar Spine 130940 65470 52380 39280
2866 OP2045 Aspiration of spinal abscess 7480 3740 2990 2240
2867 OP2079 Bone grafting for spinal dysraphism 86920 43460 34770 26080
2868 OP2089 Cervical decompression laminectomy - multiple levels 162540 81270 65020 48760
2869 OP2090 Cervical decompression laminectomy - single level 162540 81270 65020 48760
2870 OP0500 Cervical laminoplasty with instrumentation / bone 171580 85790 68630 51470
graft
2871 OP2048 Cervical vertebral corpectomy 171580 85790 68630 51470
2872 OP4525 COCCYX Manipulation Under GA 33080 16540 13230 9920
2873 OP3192 Coccyxdectomy 111880 55940 44750 33560
2874 OP2059 Convex epiphysiodesis of the curve for vertebral 171580 85790 68630 51470
2875 OP2060 Costoplasty of rib hump for vertebral deformity 108380 54190 43350 32510
correction
2876 OP3451 Debridement spine 29580 14790 11830 8870
2877 OP2066 Discogram 18120 9060 7250 5440
2878 OP2095 Dorsal / thoracic discectomy - Microscopic ( 1 level ) 144440 72220 57780 43330
2879 OP2096 Dorsal / thoracic discectomy - Microscopic ( 2 levels ) 162540 81270 65020 48760
2880 OP2097 Dorsal / thoracic discectomy - Microscopic ( More 162540 81270 65020 48760
than 2 levels )
2881 OP2103 Dorsal / thoracic laminoplasty with instrumentation 171580 85790 68630 51470
2882 OP2098 Dorsal / thoracic lamintectomy and discectomy - Open 162540 81270 65020 48760
( 1 level )
( 2 levels )
( More than 2 levels )
2885 OP2049 Dorsal / thoracic vertebral corpectomy 171580 85790 68630 51470
2886 OP0507 Endoscopic laminectomy + discectomy for lumbar disc 144000 72000 57600 43200
prolapse
2887 OP3223 Endoscopic lumbar laminotomy - Multiple Levels 178740 89370 71500 53620
2888 OP3197 Endoscopic Lumbar laminotomy + Fenestration + 178740 89370 71500 53620
facetectomy - Multiple Levels
2889 OP3198 Endoscopic Lumbar laminotomy + Fenestration + 158880 79440 63550 47660
facetectomy - Single Level
2890 OP3199 Endoscopic Lumbar laminotomy and Fenestration - 178740 89370 71500 53620
Multiple levels
2891 OP3200 Endoscopic Lumbar laminotomy and Fenestration - 158880 79440 63550 47660
Single Level
2892 OP3305 Endoscopic spinal decompression 242420 121210 96970 72730
2893 OP3302 Endoscopic spinal fenestration with bilateral 186880 93440 74750 56060
foraminotomy
2894 OP3304 Endoscopic spinal fenestration with discectomy & 216260 108130 86500 64880
bilateral foraminotomy
2895 OP3303 Endoscopic spinal fenestration with discectomy & 205100 102550 82040 61530
foraminotomy
2896 OP3301 Endoscopic spinal fenestration with foraminotomy 166220 83110 66490 49870
2897 OP2143 Excision of extradural spinal cord tumour 171580 85790 68630 51470
199
2898 OP2144 Excision of intradural spinal cord tumour 171580 85790 68630 51470
2899 OP2145 Excision of intramedullary spinal cord tumour 180600 90300 72240 54180
2900 OP3407 Excision of large spinal tumor with duraplasty 261040 130520 104420 78310
2901 OP2973 Excision of spinal AVM 191580 95790 76630 57470
2902 OP3409 Foramen magnum decompression and duraplasty 203560 101780 81420 61070
2903 OP3452 Growing rods 155940 77970 62380 46780
2904 OP3453 Growing rods distraction 37420 18710 14970 11230
2905 OP2051 Kyphoplasty of the kyphotic vertebra 56520 28260 22610 16960
2906 OP0477 Laminectomy & decompression for extradural bony 171580 85790 68630 51470
spinal tumours
2907 OP0478 Laminectomy & decompression for extradural soft 171580 85790 68630 51470
tissue spinal tumours
2908 OP1106 Laminectomy & decompression for intradural, 171580 85790 68630 51470
extramedullary spinal tumours
2909 OP0476 Laminectomy & decompression for intradural, 180600 90300 72240 54180
intramedullary spinal tumours
2910 OP0506 Laminectomy / discectomy for lumbar disc prolapse ( 130940 65470 52380 39280
microscopic )
2911 OP1115 Laminectomy / discectomy for lumbar disc prolapse ( 130940 65470 52380 39280
open )
2912 OP2108 Lumbar discectomy - Endoscopic ( 1 level ) 144000 72000 57600 43200
2913 OP2109 Lumbar discectomy - Endoscopic ( 2 levels ) 144000 72000 57600 43200
2914 OP2110 Lumbar discectomy - Endoscopic ( More than 2 levels ) 144000 72000 57600 43200
2915 OP2111 Lumbar discectomy - Microscopic ( 1 level ) 130940 65470 52380 39280
2916 OP2112 Lumbar discectomy - Microscopic ( 2 levels ) 130940 65470 52380 39280
2917 OP2113 Lumbar discectomy - Microscopic ( More than 2 levels 130940 65470 52380 39280
)
2918 OP2116 Lumbar interspinous fenestration - Multiple Levels 162540 81270 65020 48760
2919 OP2117 Lumbar interspinous fenestration - Single Level 130940 65470 52380 39280
2920 OP2106 Lumbar laminectomy - Multiple Levels 162540 81270 65020 48760
2921 OP2118 Lumbar laminectomy - Single Level 130940 65470 52380 39280
2922 OP2126 Lumbar laminectomy and discectomy - Open ( 1 level ) 130940 65470 52380 39280
2923 OP2114 Lumbar laminectomy and discectomy - Open ( 2 levels 130940 65470 52380 39280
)
2924 OP2115 Lumbar laminectomy and discectomy - Open ( More 171580 85790 68630 51470
than 2 levels )
2925 OP2119 Lumbar laminoplasty 130940 65470 52380 39280
2926 OP2120 Lumbar laminotomy - Multiple Levels 162540 81270 65020 48760
2927 OP2122 Lumbar laminotomy + Fenestration + facetectomy - 162540 81270 65020 48760
Multiple Levels
2928 OP2123 Lumbar laminotomy + Fenestration + facetectomy - 144440 72220 57780 43330
Single Level
2929 OP2124 Lumbar laminotomy and Fenestration - Multiple levels 162540 81270 65020 48760
2930 OP2125 Lumbar laminotomy and Fenestration - Single Level 144440 72220 57780 43330
2931 OP2050 Lumbar vertebral corpectomy 180600 90300 72240 54180
2932 OP2955 Non fusion surgery of lumbar spine ( Diam spacer 130940 65470 52380 39280
insertion )
2933 OP3056 Occipito-cervical fusion ( posterior only ) 156040 78020 62420 46810
2934 OP3091 Open biopsy of spine 24740 12370 9900 7420
2935 OP3193 Percutaneous fixation of dorsal spine 171580 85790 68630 51470
2936 OP3194 Percutaneous fixation of lumbar spine 171580 85790 68630 51470
2937 OP2091 Posterior cervical foraminotomy - Multiple Levels 171580 85790 68630 51470
2938 OP2092 Posterior cervical foraminotomy - Single Level 162540 81270 65020 48760
2939 OP2093 Posterior cervical laminoplasty 171580 85790 68630 51470
2940 OP2131 Posterior decompression + anterior interbody fusion 180600 90300 72240 54180
of lumbar spine
200
2941 OP2136 Posterior decompression + fusion + instrumentation of 180600 90300 72240 54180
dorsal / thoracic spine
2942 OP2142 Posterior decompression and posterolateral fusion + 180600 90300 72240 54180
2943 OP2133 Posterior decompression and posterolateral fusion of 180600 90300 72240 54180
lumbar Spine
2944 OP2141 Posterior decompression and transforaminal 180600 90300 72240 54180
interbody fusion + instrumentation of lumbar spine
2945 OP2132 Posterior decompression and transforaminal 180600 90300 72240 54180
Interbody fusion of Lumbar Spine
2946 OP2104 Posterior decompression of dorsal Spine - Multiple 171580 85790 68630 51470
levels
2947 OP2105 Posterior decompression of dorsal Spine - Single level 162540 81270 65020 48760
2948 OP2128 Posterior decompression of dorsal Spine and fusion 171580 85790 68630 51470
2949 OP2061 Posterior fusion for vertebral deformity correction 171580 85790 68630 51470
2950 OP2062 Posterior fusion with instrumentation for vertebral 197060 98530 78820 59120
2951 OP0714 Repair of diastometomyelia ( spinal dysraphism ) 86920 43460 34770 26080
2952 OP0712 Repair of lipo - meningomyelocele ( spinal dysraphism 86920 43460 34770 26080
)
2953 OP0711 Repair of lipo - meningomyelocele with untethering of 131400 65700 52560 39420
cord ( spinal dysraphism )
2954 OP0713 Repair of meningocele ( spinal dysraphism ) 86900 43450 34760 26070
2955 OP1117 Repair of meningomyelocele ( spinal dysraphism ) 87380 43690 34950 26210
2956 OP0512 Repair of meningomyelocele with untethering of cord 163840 81920 65540 49150
& excision of intradural lipoma ( spinal dysraphism )
2957 OP0511 Repair of meningomyelocele with untethering of cord 131400 65700 52560 39420
( spinal dysraphism )
2958 OP2972 Repair of spinal arteriovenous fistula 191580 95790 76630 57470
2959 OP0715 Repair of sub-occipital meningomyelocele ( spinal 86920 43460 34770 26080
dysraphism )
2960 OP2074 Revision spine surgery - Instrumentated 189560 94780 75820 56870
2961 OP2075 Revision spine surgery - non-instrumentated 180600 90300 72240 54180
2962 OP3306 Revision surgery for cervical disc 169500 84750 67800 50850
2963 OP3307 Revision surgery for lumbar disc 169500 84750 67800 50850
2964 OP0497 Spinal decompression with pedicle screw fixation ( 180600 90300 72240 54180
instrumentation )
2965 OP1113 Spinal decompression with sublaminar wiring ( 180600 90300 72240 54180
instrumentation )
2966 OP2067 Total cervical disc replacement 180600 90300 72240 54180
2967 OP2146 Total cervical spondylectomy 203200 101600 81280 60960
2968 OP2147 Total dorsal spondylectomy 203200 101600 81280 60960
2969 OP2068 Total lumbar disc replacement 203200 101600 81280 60960
2970 OP2148 Total lumbar spondylectomy 203200 101600 81280 60960
2971 OP0505 Transabdominal anterolateral spinal decompression 180600 90300 72240 54180
with instrumentation / bone grafting
2972 OP3228 Transoral decompression and posterior fusion of 261040 130520 104420 78310
cranio-vertebral junction
2973 OP1108 Trans-oral odontoid removal 171580 85790 68630 51470
2974 OP2956 Trans-oral odontoid removal with posterior 203200 101600 81280 60960
instrumentation
2975 OP3041 Transpedicular biopsy of spine 24740 12370 9900 7420
2976 OP0504 Transthoracic anterolateral spinal decompression with 180600 90300 72240 54180
instrumentation / bone grafting
2977 OP0710 Untethering of cord ( spinal dysraphism ) 131400 65700 52560 39420
2978 OP3187 Vertebral corporectomy and fusion for OPLL 223740 111870 89500 67120
2979 OP3188 Vertebral Nucleoplasty ( cervical ) 74600 37300 29840 22380
2980 OP3189 Vertebral Nucleoplasty ( lumbar ) 74600 37300 29840 22380
201
2981 OP3454 Vertebral Transforaminal endoscopy 162480 81240 64990 48740
2982 OP3455 Vertebral Transforaminal foraminoplasty 162480 81240 64990 48740
2983 OP2052 Vertebroplasty of kyphotic vertebra 56520 28260 22610 16960
Sympathectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2984 OP0259 Cervical sympathectomy - open 73000 36500 29200 21900
2985 OP0260 Cervical sympathectomy - thoracoscopic 205960 102980 82380 61790
2986 OP3044 Dorsal sympathectomy - open 66380 33190 26550 19910
2987 OP0292 Laparoscopic lumbar sympathectomy 68720 34360 27490 20620
2988 OP0291 Lumbar sympathectomy - open 51500 25750 20600 15450
2989 OP0583 Thoracoscopic dorsal sympathectomy 68720 34360 27490 20620
Tendon / Muscle Transfers
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2990 OP1725 David Chuangs muscle transfer procedure 188800 94400 75520 56640
2991 OP1731 Functioning free muscle transfer - Gracilis muscle 283160 141580 113260 84950
2992 OP1732 Functioning free muscle transfer - Latisimus dorsi 283160 141580 113260 84950
muscle
2993 OP1730 Pedicle latisimus dorsi transfer 141640 70820 56660 42490
2994 OP1660 Tendon transfer for median nerve injuries - multiple 92620 46310 37050 27790
2995 OP1659 Tendon transfer for median nerve injuries - single ( 69460 34730 27780 20840
opponensplasty )
2996 OP3059 Tendon transfer for polio 60160 30080 24060 18050
2997 OP1658 Tendon transfer for radial nerve injuries - multiple 92620 46310 37050 27790
2998 OP1657 Tendon transfer for radial nerve injuries - single 69460 34730 27780 20840
2999 OP1662 Tendon transfer for ulnar nerve injuries - multiple 92620 46310 37050 27790
3000 OP1661 Tendon transfer for ulnar nerve injuries - single 69460 34730 27780 20840
3001 OP1962 Tendon transfer of tibialis posterior to dorsum of foot 56680 28340 22670 17000
3002 OP1727 Trapezius muscle transfer 141640 70820 56660 42490
3003 OP3069 Trapezius transfer 137380 68690 54950 41210
3004 OP1726 Triceps to biceps muscle transfer 141640 70820 56660 42490
Tendon Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

3005 OP1965 Quadriceplasty 80720 40360 32290 24220
3006 OP1286 Release of torticollis ( sterno-mastoid tenotomy ) 57880 28940 23150 17360
3007 OP3272 Tendo-achilles reconstruction 88900 44450 35560 26670
3008 OP3273 Tendo-achilles repair 77880 38940 31150 23360
3009 OP1963 Tendo-Achillles ( TA ) lengthening 45360 22680 18140 13610
3010 OP1651 Tenolysis of flexor / extensor tendons - multiple 113320 56660 45330 34000
Thoracic Surgery
202
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
3011 OP4527 Allied Assistance - Major 110260 55130 44100 33080
3012 OP4526 Allied Assistance - Minor 55120 27560 22050 16540
3013 OP4515 Bronchial Sleeve Resection & Repair 226220 113110 90490 67870
3014 OP4022 Bronchoplasty fistula closure 238480 119240 95390 71540
3015 OP4304 Bullet injury - retrival of bullet and reconstruction face 299060 149530 119620 89720
/ head and neck
3016 OP4044 Cervical Mediastinoscopy 79360 39680 31740 23810
3017 OP0261 Cervical rib excision 179080 89540 71630 53720
3018 OP1414 Chest ( pleural ) aspiration in OT 11560 5780 4620 3470
3019 OP4076 Chest tube insertion & Pleurodesis 39220 19610 15690 11770
3020 OP4010 Chest wall tumour resection (with rib resection) and 152860 76430 61140 45860
chest wall reconstruction (Methyl methacrylate plate)
chest wall reconstruction (Prolene mesh + Large
Muscle flap
chest wall reconstruction (Prolene mesh + Medium
Muscle flap
chest wall reconstruction (Prolene mesh + Small
Muscle flap
chest wall reconstruction (Prolene mesh)
3025 OP4008 Chest wall window for empyema thoracis 179080 89540 71630 53720
3026 OP4025 Clamshell Thoracotomy 99980 49990 39990 29990
3027 OP1254 Decortication for empyema thoracis 90300 45150 36120 27090
3028 OP1245 Diagnostic bronchoscopy ( with or without biopsy ) 22400 11200 8960 6720
3029 OP0576 Diagnostic thoracoscopy and drainage 32900 16450 13160 9870
3030 OP0575 Diagnostic thoracoscopy with biopsy 41140 20570 16460 12340
3031 OP4026 Emergency Thoracotomy for Chest Trauma 125980 62990 50390 37790
3032 OP4030 Esophageal Exclusion in Chest Trauma 138960 69480 55580 41690
3033 OP1417 Excision of cervical rib / scalenotomy 61620 30810 24650 18490
3034 OP2825 Excision of chest wall tumour (excluding ribs) 125080 62540 50030 37520
3035 OP2826 Excision of chest wall tumour (including ribs) 90300 45150 36120 27090
3036 OP0594 Excision of mediastinal tumour ( open ) 114940 57470 45980 34480
3037 OP4081 Flexible fiber optic bronchoscopy (with or without 16800 8400 6720 5040
biopsy)
3038 OP1246 Foreign body removal by flexible bronchoscope 28740 14370 11500 8620
3039 OP0891 Foreign body removal by rigid bronchoscope 44840 22420 17940 13450
3040 OP4019 Harvesting of muscle pedicled graft & reinforcement 179080 89540 71630 53720
of Bronchial stump
3041 OP4027 Intercostal Block 19960 9980 7980 5990
3042 OP1415 Intercostal chest tube insertion ( ICD ) in OT 40320 20160 16130 12100
3043 OP4028 IVC Tumour Resection 238480 119240 95390 71540
3044 OP4042 Lung volume reduction surgery 219200 109600 87680 65760
3045 OP4029 Median Sternotomy 199460 99730 79780 59840
3046 OP4035 Open carinal pneumonectomy 308180 154090 123270 92450
3047 OP4002 Open Diaphragmatic eventration/hernia repair 199460 99730 79780 59840
3048 OP4519 Open Diaphragmatic Plication 146420 73210 58570 43930
3049 OP4051 Open excision of invasive Anterior Mediastinal mass 314800 157400 125920 94440
(including Thymoma) with lung resection and vascular
repair.
203
(including Thymoma) with lung resection.
(including Thymoma) with pericardiectomy
(including Thymoma) with vascular repair.
3053 OP4516 Open Excision of Large Hemithorax Mass 256220 128110 102490 76870
3054 OP4047 Open excision of non-invasive Anterior Mediastinal 238480 119240 95390 71540
mass (including Thymoma)
3055 OP4036 Open Extrapleural Pneumonectomy in Mesothelioma 238480 119240 95390 71540
3056 OP4039 Open Lobectomy + Mediastinal LN dissection 278840 139420 111540 83650
3057 OP4079 Open Lobectomy in life threatening hemoptysis 268500 134250 107400 80550
3058 OP1419 Open lung biopsy 99980 49990 39990 29990
3059 OP4034 Open lung cyst surgery 249220 124610 99690 74770
3060 OP4053 Open PMT excision with rib resection 262340 131170 104940 78700
3061 OP4052 Open PMT excision without rib resection 238480 119240 95390 71540
3062 OP4037 Open Pneumonectomy + Mediastinal LN dissection 298280 149140 119310 89480
3063 OP4041 Open segmental resection of bronchial tumour 238480 119240 95390 71540
3064 OP4038 Open Sleeve lobectomy 278840 139420 111540 83650
3065 OP4056 Open Tracheo-esophageal fistula repair 199460 99730 79780 59840
3066 OP4031 Pleroperitoneal Shunt 119240 59620 47700 35770
3067 OP1426 Pleural biopsy 42740 21370 17100 12820
3068 OP4517 Pleurocutaneous Window 84180 42090 33670 25250
3069 OP1430 Pleurodesis 9120 4560 3650 2740
3070 OP4032 Posterolateral Thoracotomy 99980 49990 39990 29990
3071 OP4043 Pulmonary AVM 251020 125510 100410 75310
3072 OP1421 Rib resection & drainage of collection 61620 30810 24650 18490
3073 OP4074 Rigid bronchoscopy + Bronchial stenosis dilation 44840 22420 17940 13450
3074 OP4075 Rigid bronchoscopy + Debulking of tracheo-bronchial 56020 28010 22410 16810
tumor
3075 OP4073 Rigid bronchoscopy + tracheal stenosis dilation 44840 22420 17940 13450
3076 OP4069 Robotic Cardiomyotomy for Achalasia Cardia 155040 77520 62020 46510
3077 OP4060 Robotic Diaphragmatic eventration/hernia repair 259300 129650 103720 77790
3078 OP4068 Robotic Enucleation of leiomyoma of esophagus 310020 155010 124010 93010
3079 OP4067 Robotic esophagectomy + Gastric pull-up with neck 338980 169490 135590 101690
anastomosis
3080 OP4065 Robotic excision of Anterior mediastinal tumour 310020 155010 124010 93010
3081 OP4510 Robotic Excision of Invasive Anterior Mediastinal Mass 311140 155570 124460 93340
or Thymoma
or Thymoma with Lung & Pericardial Resection
or Thymoma with Lung Resection
or Thymoma with Pericardial & Lung Resection +
Vascular Repair
or Thymoma with Pericardial Resection
3086 OP4062 Robotic lobectomy 329540 164770 131820 98860
3087 OP4063 Robotic mediastinal LN sampling 129940 64970 51980 38980
3088 OP4066 Robotic PMT excision 310020 155010 124010 93010
3089 OP4061 Robotic pneumonectomy 329540 164770 131820 98860
3090 OP4064 Robotic Radical thymectomy for MG or 310020 155010 124010 93010
small/non-invasive Thymoma
3091 OP4023 Sinus Excision Chest 79360 39680 31740 23810
204
3092 OP4016 Sternal Resection Partial with (reconstruction Prolene 285700 142850 114280 85710
Mesh &/or Methyl Methacrylate plate) with Muscle
flap
3093 OP4015 Sternal Resection Partial with Methyl methacrylate 215720 107860 86290 64720
plate reconstruction
3094 OP4014 Sternal Resection Partial with Prolene mesh 196120 98060 78450 58840
reconstruction
3095 OP4018 Sternal Resection Total with reconstruction (Prolene 341740 170870 136700 102520
Mesh &/or Methyl methacrylate plate) with Muscle
flap reconstruction
3096 OP4082 Sternal Resection Total with Methyl methacrylate 277340 138670 110940 83200
plate reconstruction
3097 OP4017 Sternal Resection Total with Prolene Mesh 252140 126070 100860 75640
reconstruction
3098 OP1289 Thoracic pneumonectomy 110040 55020 44020 33010
3099 OP4020 Thoracoplasty 138960 69480 55580 41690
3100 OP4506 Thoracoscopic Blebectomy 91520 45760 36610 27460
3101 OP0577 Thoracoscopic decortication 303900 151950 121560 91170
3102 OP0596 Thoracoscopic excision of bronchogenic cyst of lung 299060 149530 119620 89720
3103 OP0581 Thoracoscopic fenestration of pericardium for 70040 35020 28020 21010
pericardial effusion
3104 OP0578 Thoracoscopic lobectomy 304180 152090 121670 91250
3105 OP0579 Thoracoscopic lung nodule excision 90300 45150 36120 27090
3106 OP0580 Thoracoscopic mediastinal lymph node biopsy 99980 49990 39990 29990
3107 OP1429 Thoracoscopic mediastinal tumour excision 286160 143080 114460 85850
3108 OP0582 Thoracoscopic pneumonectomy 304180 152090 121670 91250
3109 OP0590 Thoracoscopic removal of hydatid cyst of lung 299060 149530 119620 89720
3110 OP0595 Thoracoscopic segmental resection of lung 146280 73140 58510 43880
3111 OP4509 Thoracoscopic Segmentectomy 237940 118970 95180 71380
3112 OP0584 Thoracoscopic thymectomy 116560 58280 46620 34970
3113 OP4507 Thoracoscopic Wedge Resection 54920 27460 21970 16480
3114 OP1416 Thoracotomy & decortication of lung 253240 126620 101300 75970
3115 OP1427 Thoracotomy & evacuation of hematoma 65700 32850 26280 19710
3116 OP1428 Thoracotomy & lobectomy 253480 126740 101390 76040
3117 OP1418 Thoracotomy & mediastinal lymph node biopsy 41140 20570 16460 12340
3118 OP4021 Thoracotomy & Pericardial window construction 149240 74620 59700 44770
3119 OP1420 Thoracotomy & pneumonectomy 253480 126740 101390 76040
3120 OP0458 Thoracotomy & segmental resection of lung 121900 60950 48760 36570
3121 OP0463 Thoracotomy and excision of bronchogenic cyst of 249220 124610 99690 74770
lung
3122 OP0462 Thoracotomy and excision of dermoid cyst of lung 98520 49260 39410 29560
3123 OP0461 Thoracotomy and excision of hydatid cyst of lung 249220 124610 99690 74770
3124 OP0459 Thoracotomy and re-exploration for bleeding 90300 45150 36120 27090
3125 OP1422 Thoracotomy for anterolateral decompression 98520 49260 39410 29560
3126 OP0460 Thoracotomy for penetrating injury chest 119240 59620 47700 35770
3127 OP0457 Thoracotomy, pleurectomy & excision of 179080 89540 71630 53720
emphysematous bullae
3128 OP3034 Thoroscopic lung bullectomy 214880 107440 85950 64460
3129 OP1423 Thymectomy ( open ) 238480 119240 95390 71540
3130 OP4071 Tracheal stenosis - resection + EEA 224120 112060 89650 67240
3131 OP4072 Tracheal tumour - resection + EEA 246520 123260 98610 73960
3132 OP4070 Tracheotomy and Foreign body removal 41280 20640 16510 12380
3133 OP4058 Transaxillary First Rib Resection in Thoracic Outlet 179080 89540 71630 53720
Syndrome
3134 OP4045 VATS biopsy of mediastinal mass 99980 49990 39990 29990
3135 OP4508 VATS Debridement of Empyema Thoracic 109800 54900 43920 32940
3136 OP4518 VATS Diaphragmatic Plication 208640 104320 83460 62590
205
3137 OP4003 VATS Diaphragmatic rupture repair 239380 119690 95750 71810
3138 OP4024 VATS ligation of Thoracic duct for Chylothorax 249220 124610 99690 74770
3139 OP4040 VATS Lobectomy + Mediastinal LN dissection 334620 167310 133850 100390
3140 OP4033 VATS lung biopsy 99980 49990 39990 29990
3141 OP4004 VATS Pleural Biopsy (under GA) 56020 28010 22410 16810
3142 OP4077 VATS Pleural Biopsy (under LA) 50420 25210 20170 15130
3143 OP4007 VATS Pleurodesis (Mechanical/Talc) 61640 30820 24660 18490
3144 OP4005 VATS pleurodesis (under GA) 61640 30820 24660 18490
3145 OP4078 VATS pleurodesis (under LA) 56020 28010 22410 16810
3146 OP4054 VATS PMT excision 286160 143080 114460 85850
3147 OP4046 VATS Radical thymectomy for MG or 286160 143080 114460 85850
small/non-invasive Thymoma
3148 OP4006 VATS removal of foreign body chest 299060 149530 119620 89720
3149 OP4059 VATS resection of Cervical rib for Thoracic outlet 214880 107440 85950 64460
syndrome
3150 OP4057 VATS Tracheo-esophageal fistula repair 239380 119690 95750 71810
3151 OP4319 VATS/ thoracoscopic drainage of empyema - Paed 91680 45840 36670 27500
3152 OP4520 Video Assisted Mediastinoscopic Lymphadenectomy 219620 109810 87850 65890
Urology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
3153 OP1489 Augmentation cystoplasty 130940 65470 52380 39280
3154 OP2316 Auto-augmentation cystoplasty 120020 60010 48010 36010
3155 OP1431 Balloon dialation of ureter 33900 16950 13560 10170
3156 OP4429 Balloon Dilatation of PUJ 41680 20840 16670 12500
3157 OP0097 Bladder diverticulectomy ( bilateral ) 110800 55400 44320 33240
3158 OP1244 Bladder diverticulectomy ( unilateral ) 73920 36960 29570 22180
3159 OP4182 Bladder Injury repair 39220 19610 15690 11770
3160 OP1432 Bladder neck incision ( BNI ) 51400 25700 20560 15420
3161 OP4427 Bladder Rupture Repair Major 37040 18520 14820 11110
3162 OP4428 Bladder Rupture Repair Minor 19980 9990 7990 5990
3163 OP4173 Boari Flap Repair 126060 63030 50420 37820
3164 OP4441 Botulinum Toxin Injection Bladder 48100 24050 19240 14430
3165 OP3019 Change of PCN tube 18780 9390 7510 5630
3166 OP1262 Chordee correction 57880 28940 23150 17360
3167 OP1434 Circumcision 23640 11820 9460 7090
3168 OP3018 Closure of ureterostomy 18780 9390 7510 5630
3169 OP1435 Closure of urethral fistula 50420 25210 20170 15130
3170 OP0359 Corporo-cavernosal penile shunt 27300 13650 10920 8190
3171 OP1438 Cystocopy with retrograde catheterisation - bilateral 26320 13160 10530 7900
3172 OP1437 Cystocopy with retrograde ureteric catheterisation - 21400 10700 8560 6420
unilateral
3173 OP1440 Cystoscopic stent removal 14440 7220 5780 4330
3174 OP1253 Cystoscopy 14920 7460 5970 4480
3175 OP1252 Cystoscopy and fulguration of posterior uretheral 60200 30100 24080 18060
valves
3176 OP1436 Cystoscopy with bladder biopsy 21400 10700 8560 6420
3177 OP4183 Cystoscopy with Clot Evacuation 22400 11200 8960 6720
3178 OP4178 Cystoscopy with Retrograde pyelography - RGP ( 44840 22420 17940 13450
Bilateral )
3179 OP4177 Cystoscopy with Retrograde pyelography - RGP ( 22400 11200 8960 6720
Unilateral )
206
3180 OP1290 De-torsion and fixation of involved testis 45240 22620 18100 13570
3181 OP4179 Diagnostic Ureteroscopy 33620 16810 13450 10090
3182 OP1441 Dilatation of stricture urethra 15280 7640 6110 4580
3183 OP1485 Dismembered pyeloplasty ( Anderson Hynes ) 123020 61510 49210 36910
3184 OP3017 Dorsal slit of prepuce 18780 9390 7510 5630
3185 OP1443 Double J stent placement in ureter - bilateral 47680 23840 19070 14300
3186 OP1442 Double J stent placement in ureter - unilateral 29900 14950 11960 8970
3187 OP1257 Ectopic vesicae - bladder turn in 95720 47860 38290 28720
3188 OP2314 Endoincision of ureteric stricture 51400 25700 20560 15420
3189 OP2315 Endopyelotomy 63240 31620 25300 18970
3190 OP1444 Endoscopic removal of stone in bladder - 50940 25470 20380 15280
Cystolitholapaxy
3191 OP1446 Endoscopic teflon injection - bilateral 51400 25700 20560 15420
3192 OP1445 Endoscopic teflon injection - unilateral 32760 16380 13100 9830
3193 OP4167 Epididymectomy 39940 19970 15980 11980
3194 OP1487 Epispadias reconstruction / repair 84060 42030 33620 25220
3195 OP0263 Epispadias with ectopic vesicae - complete repair 140100 70050 56040 42030
3196 OP1488 Extended pyelolithotomy ( Gil Vernet ) 120020 60010 48010 36010
3197 OP4168 Fournier's Gangrene 56020 28010 22410 16810
3198 OP4160 Fracture Penis repair 112060 56030 44820 33620
3199 OP4162 Graft repair of Peyronies Disease 105440 52720 42180 31630
3200 OP1258 Hemi-nephroureterectomy ( open ) 114080 57040 45630 34220
3201 OP4170 High Orchidectomy 56020 28010 22410 16810
3202 OP4425 Hormonal Therapy injection for Cancer Prostate 6960 3480 2780 2090
3203 OP1496 Hydrocele sac eversion / excision - bilateral 47480 23740 18990 14240
3204 OP1497 Hydrocele sac eversion / excision - unilateral 33680 16840 13470 10100
3205 OP1263 Hypospadias MAGPI 46300 23150 18520 13890
3206 OP1261 Hypospadias second stage correction 81320 40660 32530 24400
3207 OP4426 Impacted Foley's Removal 9260 4630 3700 2780
3208 OP0358 Laparoscopic excision of bladder diverticulum 65740 32870 26300 19720
3209 OP0268 Laparoscopic lymphatic disconnection for chyluria 87860 43930 35140 26360
3210 OP0362 Laparoscopic partial cystectomy 84060 42030 33620 25220
3211 OP0266 Laparoscopic pyeloplasty 123020 61510 49210 36910
3212 OP0361 Laparoscopic radical cystectomy 154080 77040 61630 46220
3213 OP0270 Laparoscopic radical prostatectomy 161100 80550 64440 48330
3214 OP0357 Laparoscopic renal cyst de-roofing 82160 41080 32860 24650
3215 OP0570 Laparoscopic transperitoneal simple nephrectomy 102500 51250 41000 30750
3216 OP0267 Laparoscopic ureteric re-implantation 102500 51250 41000 30750
3217 OP0573 Laparoscopic varicocelectomy - bilateral 54200 27100 21680 16260
3218 OP0574 Laparoscopic varicocelectomy - unilateral 39420 19710 15770 11830
3219 OP1174 Laparoscopic ventri-suspension ( Burch's 84060 42030 33620 25220
colposuspension )
3220 OP0356 Laparoscopic, transperitoneal partial nephrectomy 131820 65910 52730 39550
3221 OP0269 Laparoscopic, transperitoneal radical nephrectomy 112060 56030 44820 33620
3222 OP4433 Lumber Sinus Excision 111140 55570 44460 33340
3223 OP3180 Marshalls Marchetti Kantz ( MMK ) Open 61640 30820 24660 18490
colposuspension
3224 OP4586 Mitomycin C intilation 5080 2540 2030 1520
3225 OP4320 Mitrofanoff's (appendicovesicostomy) 86580 43290 34630 25970
3226 OP1462 Nephrectomy ( open ) 84580 42290 33830 25370
3227 OP0264 Nephrolithotomy 74520 37260 29810 22360
3228 OP0116 Nephro-pyelolithotomy 74520 37260 29810 22360
3229 OP4155 Nephroureterectomy 131820 65910 52730 39550
3230 OP4430 Nesbit Procedure greater than 2cm 32420 16210 12970 9730
3231 OP1461 Open pyelolithotomy 73920 36960 29570 22180
207
3232 OP1273 Optical internal uretherotomy ( OIU ) 51400 25700 20560 15420
3233 OP1451 Orchidectomy - bilateral 51400 25700 20560 15420
3234 OP1452 Orchidectomy - unilateral 43960 21980 17580 13190
3235 OP1453 Orchidopexy for undescended testis - bilateral 65740 32870 26300 19720
3236 OP1454 Orchidopexy for undescended testis - unilateral 51400 25700 20560 15420
3237 OP1456 Palomo’s operation for varicocele - unilateral 31400 15700 12560 9420
3238 OP1455 Palomos operation for varicocele - bilateral 43960 21980 17580 13190
3239 OP4442 Para Phimosis Reduction 9260 4630 3700 2780
3240 OP0363 Partial amputation of penis 46900 23450 18760 14070
3241 OP1491 Partial nephrectomy ( open ) 125500 62750 50200 37650
3242 OP1486 PCNL 100740 50370 40300 30220
3243 OP1460 PCNL ( second stage ) 50400 25200 20160 15120
3244 OP2313 Penile frenuloplasty 11700 5850 4680 3510
3245 OP4159 Penile Implant 140100 70050 56040 42030
3246 OP1498 Penile venous ligation 54520 27260 21810 16360
3247 OP1458 Percutaneous nephrostomy ( PCN ) 36140 18070 14460 10840
3248 OP4431 Peri Nephric Abscess Drainage Open 92620 46310 37050 27790
3249 OP4432 Peri Nephric Abscess Drainage Pigtail like PCN 32860 16430 13140 9860
3250 OP1459 Perineal urethrostomy 33620 16810 13450 10090
3251 OP0262 Photo vaporisation of prostate ( Laser prostatectomy ) 84060 42030 33620 25220
3252 OP4161 Plication for Peyronies Disease 72820 36410 29130 21850
3253 OP1295 Prepucioplasty 23640 11820 9460 7090
3254 OP4164 Priapism ( Major ) 84060 42030 33620 25220
3255 OP4163 Priapism ( Minor ) 67220 33610 26890 20170
3256 OP0265 Prophylactic orchidopexy for prevention of torsion 39420 19710 15770 11830
3257 OP4184 Radical Cystectomy with Neobladder 190380 95190 76150 57110
3258 OP1495 Radical cystectomy with urinary diversion 161100 80550 64440 48330
3259 OP1490 Radical nephrectomy ( open ) 117160 58580 46860 35150
3260 OP1472 Reimplantation of ureter ( ureteroneocystostomy ) - 98040 49020 39220 29410
unilateral
3261 OP0098 Reimplantation of ureter ( ureteroneocystostomy ) 112060 56030 44820 33620
with bladder diverticulectomy - unilateral
3262 OP1492 Reimplantation of ureters ( ureteroneocystostomy ) - 140100 70050 56040 42030
bilateral
3263 OP0002 Reimplantation of ureters ( ureteroneocystostomy ) 154080 77040 61630 46220
with bladder diverticulectomy - bilateral
3264 OP0113 Repair of distal hypospadias - single stage correction 92620 46310 37050 27790
3265 OP1259 Repair of hypospadias with large fistula 57880 28940 23150 17360
3266 OP0112 Repair of hypospadias with multiple fistulae 69460 34730 27780 20840
3267 OP1260 Repair of hypospadias with small fistula 46300 23150 18520 13890
3268 OP1264 Repair of proximal hypospadias - single stage 132160 66080 52860 39650
correction
3269 OP4175 Retrograde intrarenal surgery ( RIRS ) for Kidney 101880 50940 40750 30560
3270 OP4174 Retrograde intrarenal surgery ( RIRS ) for ureter 76400 38200 30560 22920
3271 OP0572 Retroperitoneoscopic ureterolithotomy 77980 38990 31190 23390
3272 OP1447 Scrotal exploration 36140 18070 14460 10840
3273 OP4172 Scrotal Sebaceous Cysts 44840 22420 17940 13450
3274 OP4169 Scrotoplasty 56020 28010 22410 16810
3275 OP1463 Seminal vasiculogram ( SVG ) 22660 11330 9060 6800
3276 OP1464 Seminal vasiculogram ( SVG ) + Vasoepididymal 73920 36960 29570 22180
anastomosis ( VEA ) - bilateral
3277 OP1465 Seminal vasiculogram ( SVG ) + Vasoepididymal 51400 25700 20560 15420
anastomosis ( VEA ) - unilateral
3278 OP4176 Stage II Ureterenoscopy ( URS ) 33620 16810 13450 10090
3279 OP3090 Subinguinal varicocelectomy - bilateral 53740 26870 21500 16120
3280 OP3089 Subinguinal varicocelectomy - unilateral 39160 19580 15660 11750
208
3281 OP1439 Suprapubic cystolithotomy 39420 19710 15770 11830
3282 OP1468 Suprapubic trocar cystostomy ( SPC ) 30060 15030 12020 9020
3283 OP1187 Tension free vaginal tape insertion ( TVT ) for urinary 43020 21510 17210 12910
incontinence
3284 OP1466 Testicular biopsy 15280 7640 6110 4580
3285 OP4171 Testicular Implant 56020 28010 22410 16810
3286 OP0364 Total amputation of penis 98740 49370 39500 29620
3287 OP1069 Total amputation of penis with block dissection – 164180 82090 65670 49250
bilateral
3288 OP1068 Total amputation of penis with block dissection – 110800 55400 44320 33240
unilateral
3289 OP1467 Transurethral resection of bladder tumour ( TURBT ) 84060 42030 33620 25220
3290 OP0360 Trucut prostatic biopsy in OT 9540 4770 3820 2860
3291 OP1469 TURP 84060 42030 33620 25220
3292 OP1470 TURP & TUR(BT) 112060 56030 44820 33620
3293 OP1471 TURP + cystolithotripsy ( CLT ) 112060 56030 44820 33620
3294 OP4156 Ureterocalicostomy 126060 63030 50420 37820
3295 OP4434 Ureterocoele Incision U/L 46300 23150 18520 13890
3296 OP1478 Ureterolithotomy 65740 32870 26300 19720
3297 OP1493 Ureterolysis for retroperitoneal fibrosis ( IRPF ) - 120020 60010 48010 36010
bilateral
3298 OP1474 Ureterolysis for retroperitoneal fibrosis ( IRPF ) - 90300 45150 36120 27090
unilateral
3299 OP1475 Ureteroscopic removal of stone ( URS ) 71320 35660 28530 21400
3300 OP4435 Ureteroscopy Biopsy 45260 22630 18100 13580
3301 OP1269 Uretheral meatal dilatation 8260 4130 3300 2480
3302 OP1448 Uretheral meatoplasty 15600 7800 6240 4680
3303 OP1270 Uretheral meatotomy 10380 5190 4150 3110
3304 OP1476 Uretheroplasty - first stage 50420 25210 20170 15130
3305 OP1477 Uretheroplasty - second stage 56020 28010 22410 16810
3306 OP4438 Urethral Caruncle 23160 11580 9260 6950
3307 OP4439 Urethral Diverticulum 23160 11580 9260 6950
3308 OP4440 Urethrectomy 23160 11580 9260 6950
3309 OP1494 Urethroplasty - single stage procedure 109100 54550 43640 32730
3310 OP4158 Urethroplasty for PIDD 140100 70050 56040 42030
3311 OP4436 Urethroplasty I Stage 21300 10650 8520 6390
3312 OP4437 Urethroplasty II Stage 22620 11310 9050 6790
3313 OP4157 Urethroplasty with Buccal Mucosa 140100 70050 56040 42030
3314 OP1433 Urinary catheterisation 9140 4570 3660 2740
3315 OP1479 Vasectomy 9720 4860 3890 2920
3316 OP1480 Vasectomy reversal - bilateral 92620 46310 37050 27790
3317 OP1481 Vasectomy reversal - unilateral 69460 34730 27780 20840
3318 OP1293 Vesicostomy 30080 15040 12030 9020
3319 OP4180 Vesicovaginal Repair ( Abdominal approach ) 112060 56030 44820 33620
3320 OP4181 Vesicovaginal Repair ( Vaginal approach ) 112060 56030 44820 33620
Varicose Vein Operations

OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

3321 OP4211 Endovenous ablation of varicose veins - Bilateral 179300 89650 71720 53790
3322 OP4210 Endovenous ablation of varicose veins - Unilateral 156900 78450 62760 47070
3323 OP3461 Foam sclerotherapy for varicose veins 56020 28010 22410 16810
209
3324 OP2912 High ligation, stripping & multiple avulsions for LSV 76840 38420 30740 23050
varicose veins - bilateral
3325 OP0286 High ligation, stripping & multiple avulsions for LSV 67720 33860 27090 20320
varicose veins - unilateral
3326 OP2913 High ligation, stripping & multiple avulsions for 76840 38420 30740 23050
Recurrent LSV varicose veins - bilateral
3327 OP0289 High ligation, stripping & multiple avulsions for 67720 33860 27090 20320
Recurrent LSV varicose veins - unilateral
3328 OP3246 Laser ablation of varicose veins in OT (Bilateral) 179300 89650 71720 53790
3329 OP3245 Laser ablation of varicose veins in OT (Unilateral) 156900 78450 62760 47070
3330 OP2916 Multiple avulsions for varicose veins - bilateral 76840 38420 30740 23050
3331 OP0288 Multiple avulsions for varicose veins - unilateral 67720 33860 27090 20320
3332 OP2914 Sapheno - popliteal junction ligation for Recurrent SSV 76840 38420 30740 23050
varicose veins - bilateral
3333 OP0290 Sapheno - popliteal junction ligation for Recurrent SSV 67720 33860 27090 20320
varicose veins - unilateral
3334 OP2915 Sapheno - popliteal junction ligation for SSV varicose 76840 38420 30740 23050
veins - bilateral
3335 OP0287 Sapheno - popliteal junction ligation for SSV varicose 67720 33860 27090 20320
veins - unilateral
Vascular Access Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
3336 OP0308 Chemoport insertion 42020 21010 16810 12610
3337 OP0309 Chemoport removal 28040 14020 11220 8410
3338 OP4203 Duplex guided central venous line insertion 19600 9800 7840 5880
3339 OP0310 Hickman line insertion 42020 21010 16810 12610
3340 OP0311 Permacath placement / insertion 42020 21010 16810 12610
Vascular Bypass Grafting
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

3341 OP0218 Aorto - Bifemoral bypass using synthetic graft 173700 86850 69480 52110
3342 OP2917 Aorto - femoral bypass using synthetic graft 173700 86850 69480 52110
3343 OP0231 Axillary - brachial bypass using synthetic graft 135480 67740 54190 40640
3344 OP0232 Carotid - axillary bypass using synthetic graft 144440 72220 57780 43330
3345 OP4189 Carotid carotid bypass using synthetic graft 173700 86850 69480 52110
3346 OP4188 Carotid subclavian bypass using synthetic graft 173700 86850 69480 52110
3347 OP0220 Common iliac - bifemoral bypass graft 135480 67740 54190 40640
3348 OP0219 Common iliac - bilateral external iliac bypass graft 135480 67740 54190 40640
3349 OP4186 Complex aorto bifemoral bypass 229720 114860 91890 68920
3350 OP4185 Complex aorto femoral bypass 229720 114860 91890 68920
3351 OP4190 Complex axillo distal bypass 229720 114860 91890 68920
3352 OP4191 Complex Femoro - popliteal ( above knee ) bypass 229720 114860 91890 68920
using reversed LSV
3353 OP4192 Complex Femoro - popliteal ( below knee ) bypass 229720 114860 91890 68920
using reversed LSV
3354 OP4193 Complex Femoro - popliteal above knee bypass using 229720 114860 91890 68920
synthetic graft
210
3355 OP4194 Complex Femoro - popliteal above knee bypass using 229720 114860 91890 68920
synthetic graft intervening vein collar
3356 OP4196 Complex iliodistal bypass 229720 114860 91890 68920
3357 OP0223 External iliac - common femoral bypass graft 144440 72220 57780 43330
3358 OP0224 Extra - anatomical (extra-peritoneal) femoro - femoral 173700 86850 69480 52110
bypass graft
3359 OP0237 Extra - anatomical axillo - bifemoral bypass using 135480 67740 54190 40640
synthetic graft
3360 OP0238 Extra - anatomical axillo - femoral bypass using 135480 67740 54190 40640
synthetic graft
3361 OP0236 Extra - anatomical bilateral axillo - femoral bypass 135480 67740 54190 40640
using synthetic graft
3362 OP0235 Extra - anatomical bilateral subclavian - femoral 135480 67740 54190 40640
bypass using synthetic graft
3363 OP0233 Extra - anatomical subclavian - bifemoral bypass using 135480 67740 54190 40640
synthetic graft
3364 OP0234 Extra - anatomical subclavian - femoral bypass using 135480 67740 54190 40640
synthetic graft
3365 OP1504 Femoro - popliteal ( above knee ) bypass using 173700 86850 69480 52110
reversed LSV
3366 OP0214 Femoro - popliteal ( below knee ) bypass using 173700 86850 69480 52110
reversed LSV
3367 OP0225 Femoro - popliteal above knee bypass using synthetic 173700 86850 69480 52110
graft
3368 OP0226 Femoro - popliteal above knee bypass using synthetic 173700 86850 69480 52110
graft intervening vein collar
3369 OP0227 Femoro - popliteal below knee bypass using synthetic 173700 86850 69480 52110
graft
3370 OP0228 Femoro - popliteal below knee bypass using synthetic 173700 86850 69480 52110
graft intervening vein collar
3371 OP4195 Femoro distal bypass 229720 114860 91890 68920
3372 OP3021 Graft thrombectomy 117180 58590 46870 35150
3373 OP0585 Laparoscopic assisted aorto-distal vascular 90300 45150 36120 27090
anastomosis
3374 OP0586 Laparoscopic assisted ilio-distal vascular anastomosis 90300 45150 36120 27090
3375 OP0217 Popliteal - anterior tibial bypass using reversed LSV 144440 72220 57780 43330
3376 OP0216 Popliteal - posterior tibial bypass using reversed LSV 144440 72220 57780 43330
3377 OP0313 Re-exploration for bleeding at vascular anastomotic 36140 18070 14460 10840
site
3378 OP0312 Removal of infected graft 43140 21570 17260 12940
3379 OP0222 Retroperitoneal, common iliac to common femoral 135480 67740 54190 40640
bypass graft
3380 OP0221 Retroperitoneal, common iliac to external iliac bypass 135480 67740 54190 40640
graft
3381 OP4187 Robotic aortic bypass 361360 180680 144540 108410
3382 OP0215 SFA - popliteal bypass using reversed LSV 144440 72220 57780 43330
3383 OP0230 Subclavian - brachial bypass using synthetic graft 135480 67740 54190 40640
3384 OP0229 Subclavian - subclavian cross neck bypass using 173700 86850 69480 52110
synthetic graft
Vascular Embolectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

3385 OP0351 Brachial embolectomy - primary closure 173700 86850 69480 52110
3386 OP0352 Brachial embolectomy - PTFE patch closure 173700 86850 69480 52110
211
3387 OP0353 Brachial embolectomy - vein patch closure 173700 86850 69480 52110
3388 OP4199 Brachial embolectomy with endarterectomy 229720 114860 91890 68920
3389 OP2920 Femoral embolectomy - primary closure ( bilateral ) 235320 117660 94130 70600
3390 OP0345 Femoral embolectomy - primary closure ( unilateral ) 173700 86850 69480 52110
3391 OP2919 Femoral embolectomy - PTFE patch closure ( bilateral ) 235320 117660 94130 70600
3392 OP0346 Femoral embolectomy - PTFE patch closure ( unilateral 173700 86850 69480 52110
)
3393 OP2921 Femoral embolectomy - vein patch closure ( bilateral ) 235320 117660 94130 70600
3394 OP0347 Femoral embolectomy - vein patch closure ( unilateral 173700 86850 69480 52110
)
3395 OP4200 Femoral embolectomy with endarterectomy 229720 114860 91890 68920
3396 OP4212 Fluoroscopic guided peripheral embolectomy 173700 86850 69480 52110
3397 OP4241 Fluoroscopic guided peripheral embolectomy with 229720 114860 91890 68920
endarterectomy
3398 OP0348 Popliteal embolectomy - primary closure 173700 86850 69480 52110
3399 OP0349 Popliteal embolectomy - PTFE patch closure 173700 86850 69480 52110
3400 OP0350 Popliteal embolectomy - vein patch closure 173700 86850 69480 52110
3401 OP4201 Popliteal embolectomy with endarterectomy 229720 114860 91890 68920
Vascular Endarterectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
3402 OP0282 Brachial endarterectomy with PTFE patch plasty 156900 78450 62760 47070
3403 OP0283 Brachial endarterectomy with vein patch plasty 196120 98060 78450 58840
3404 CEPDC Carotid endarterectomy ADD ON for cardiac surgery - Within Package
amount given to surgeon from within the package
3405 OP0271 Carotid endarterectomy with primary closure 196120 98060 78450 58840
3406 OP0246 Carotid endarterectomy with PTFE patch plasty 196120 98060 78450 58840
3407 OP0272 Eversion carotid endarterectomy 156900 78450 62760 47070
3408 OP0276 Femoral endarterectomy with PTFE patch plasty 156900 78450 62760 47070
3409 OP0277 Femoral endarterectomy with vein patch plasty 156900 78450 62760 47070
3410 OP4197 Graft exploration and endarterectomy 173700 86850 69480 52110
3411 OP0275 Iliac endarterectomy with PTFE patch plasty 156900 78450 62760 47070
3412 OP0280 Popliteal endarterectomy with PTFE patch plasty 156900 78450 62760 47070
3413 OP0281 Popliteal endarterectomy with vein patch plasty 156900 78450 62760 47070
3414 OP0278 SFA endarterectomy with PTFE patch plasty 156900 78450 62760 47070
3415 OP0279 SFA endarterectomy with vein patch plasty 156900 78450 62760 47070
3416 OP0284 Subclavian endarterectomy with PTFE patch plasty 156900 78450 62760 47070
3417 OP0285 Subclavian endarterectomy with vein patch plasty 156900 78450 62760 47070
Vascular Injury Repair

OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

3418 OP3446 Anterior tibial artery / vein repair by vein graft - large 84060 42030 33620 25220
defect
3419 OP3445 Anterior tibial artery / vein repair by vein graft - small 56020 28010 22410 16810
defect
3420 OP0274 Carotid artery repair (post traumatic) - primary 173700 86850 69480 52110
closure
3421 OP0273 Carotid artery repair (post traumatic) using PTFE patch 173700 86850 69480 52110
212
3422 OP4198 Explantation of infected graft with vascular repair 173700 86850 69480 52110
3423 OP0330 Exploration & repair of axillary arterial injury - primary 173700 86850 69480 52110
repair
3424 OP0332 Exploration & repair of axillary arterial injury - using 229720 114860 91890 68920
vein graft
3425 OP0331 Exploration & repair of axillary arterial injury - using 173700 86850 69480 52110
vein patch
3426 OP0333 Exploration & repair of brachial arterial injury - 173700 86850 69480 52110
primary repair
3427 OP0335 Exploration & repair of brachial arterial injury - using 173700 86850 69480 52110
vein graft
3428 OP0334 Exploration & repair of brachial arterial injury - using 173700 86850 69480 52110
vein patch
3429 OP0342 Exploration & repair of carotid arterial injury - primary 173700 86850 69480 52110
repair
3430 OP0344 Exploration & repair of carotid arterial injury - using 173700 86850 69480 52110
vein graft
3431 OP0343 Exploration & repair of carotid arterial injury - using 173700 86850 69480 52110
vein patch
3432 OP0324 Exploration & repair of femoral arterial injury - 173700 86850 69480 52110
primary repair
3433 OP0326 Exploration & repair of femoral arterial injury - using 229720 114860 91890 68920
vein graft
3434 OP0325 Exploration & repair of femoral arterial injury - using 173700 86850 69480 52110
vein patch
3435 OP0321 Exploration & repair of iliac arterial injury - primary 173700 86850 69480 52110
repair
3436 OP0323 Exploration & repair of iliac arterial injury - using vein 229720 114860 91890 68920
graft
3437 OP0322 Exploration & repair of iliac arterial injury - using vein 173700 86850 69480 52110
patch
3438 OP0327 Exploration & repair of popliteal arterial injury - 173700 86850 69480 52110
primary repair
3439 OP0329 Exploration & repair of popliteal arterial injury - using 229720 114860 91890 68920
vein graft
3440 OP0328 Exploration & repair of popliteal arterial injury - using 173700 86850 69480 52110
vein patch
3441 OP0336 Exploration & repair of radial arterial injury - primary 173700 86850 69480 52110
repair
3442 OP0338 Exploration & repair of radial arterial injury - using 229720 114860 91890 68920
vein graft
3443 OP0337 Exploration & repair of radial arterial injury - using 173700 86850 69480 52110
vein patch
3444 OP0339 Exploration & repair of subclavian arterial injury - 173700 86850 69480 52110
primary repair
using vein graft
using vein patch
3447 OP0314 Exploration and ligation for bleeding due to traumatic 42020 21010 16810 12610
(unnamed) arterial injury
3448 OP3440 Other artery / vein repair by vein graft - large defect 84060 42030 33620 25220
3449 OP3439 Other artery / vein repair by vein graft - small defect 56020 28010 22410 16810
3450 OP3444 Posterior tibial artery / vein repair by vein graft - large 84060 42030 33620 25220
defect
3451 OP3443 Posterior tibial artery / vein repair by vein graft - small 56020 28010 22410 16810
defect
3452 OP3442 Ulnar artery / vein repair by vein graft - large defect 84060 42030 33620 25220
3453 OP3441 Ulnar artery / vein repair by vein graft - small defect 56020 28010 22410 16810
3454 OP4202 Vascular repair for hemostasis 140100 70050 56040 42030
213
Vertebral Fusion
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
3455 OP2069 C1 - C2 vertebral fusion 171580 85790 68630 51470
3456 OP2070 C1 - C2 vertebral screw fixation 171580 85790 68630 51470
3457 OP2071 Odontoid screw fixation 171580 85790 68630 51470
3458 OP2073 Posterior cervico - occipital vertebral fusion 189560 94780 75820 56870
3459 OP2072 Trans-oral odontoid screw and posterior fixation 178740 89370 71500 53620
Ophthalmology Procedure Charges
SNo Code Description POPD GOPD

1 AUTOPERID Automated Perimetery ( Double eyed patient ) 2150 1290
2 AUTOPERIO Automated Perimetery ( One eyed patient ) 1080 650
3 BIBLBI Botox Injection Blepharospasam - Bilateral 8250 4950
4 BIBLUNI Botox Injection Blepharospasam - Unilateral 5500 3300
5 BOIEBI Botox Injection Epiphora - Bilateral 4130 2480
6 BOIEUNI Botox Injection Epiphora - Unilateral 2750 1650
7 BISTPBI Botox Injection Squint/Lid retraction/ Four inducing temporary P 4130 2480
8 BISTPUNI Botox Injection Squint/Lid retraction/ Four inducing temporary P 2750 1650
9 DIARETSCR Diabetic retiniopathy screening in OPD 230 140
10 ULTRASOAB Eye Ultrasonography A & B scan 1970 1180
11 ULTRASOB Eye Ultrasonography B scan 1180 700
12 ULTRASONA Eye Ultrasonography Biometeric A scan 790 470
13 HOSSS Lee's screen charting 740 440
14 ORTHOE Orthoptic exercise 90 60
15 RORTHO Refraction and Orthoptic checkup 90 60
Physiotherapy
Gym Charges
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Suite

1 GYM Gym charges for 1 month 2310 2310 2310 2310 2310 2310
Physiotherapy Inpatient Procedures

Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Suite

2 BSIP Balance System ( Inpatient Physiotherapy ) 920 700 460 460 550 330
3 BUSIP Biodex Unweighing System ( Inpatient 920 780 460 460
Physiotherapy )
214
4 EMGBIOIP EMG Biofeedback ( Inpatient Physiotherapy 920 780 460 460
)
5 GTIP Gait Trainer ( Inpatient Physiotherapy ) 920 780 460 460
6 MOTOMED Motomed 780 610 300 300 460 270
7 PYCPMEIP Physiotherapy - continuous passive 850 460 390 390
mobilisation exercises ( CPM ) - for
inpatients
8 PYESTIP Physiotherapy - electrical stimulation 850 460 390 390
therapy - for inpatients
9 PYECLTIP Physiotherapy - electronic cervical / lumbar 850 460 390 390
traction - for inpatients
10 PYELIP Physiotherapy - exercise ( long ) - for 920 610 460 460
inpatients
11 PYESIP Physiotherapy - exercise ( short ) - for 780 390 300 300
inpatients
12 PYITIP Physiotherapy - interferential therapy - for 780 460 390 390
inpatients
13 PYLTIP Physiotherapy - laser therapy - for 780 460 390 390
inpatients
14 PYLWDIP Physiotherapy - long wave diathermy - for 780 460 390 390
inpatients
15 PYMPDIP Physiotherapy - microwave / pulsed 780 460 390 390
diathermy - for inpatients
16 PYMHPCIP Physiotherapy - moist hot packs / 610 300 240 240
cryotherapy - for inpatients
17 PYTMIDT Physiotherapy - more than 3 modalities ( 10 7380 4420
days package ) - outpatients
18 PY3MIP Physiotherapy - more than three modalities 1240 920 460 460
- for inpatients
19 PYPWBIP Physiotherapy - paraffin wax bath - for 610 300 240 240
inpatients
20 PYSWDIP Physiotherapy - short wave diathermy - for 610 300 240 240
inpatients
21 PYTTTIP Physiotherapy - tilt table therapy - for 700 460 390 390
inpatients
22 PYUTIP Physiotherapy - ultrasonic therapy - for 550 300 240 240
inpatients
23 PYPCCD Physiotherapy package charge following 2150 1390 850 850
caesarean delivery / Surgery
24 PYPCND Physiotherapy package charge following 1390 850 610 610
normal delivery
Physiotherapy Opd Tests Charges

Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Suite

25 BSOP7 Balance System ( Outpatient Physiotherapy 3840 2310
) - 7 Visits
26 BSOP1 Balance System ( Outpatient Physiotherapy 610 370
) - Single Visit
27 BUSOP14 Biodex Unweighing System ( Outpatient 7700 4610
Physiotherapy ) - 14 Visits
215
Physiotherapy ) - Single Visit
31 CMPOP30 CPM ( Outpatient ) - 30 Visits 7700 4610
32 CMPOP14 CPM ( Outpatient Physiotherapy ) - 14 Visits 4610 2760
33 CMPOP7 CPM ( Outpatient Physiotherapy ) - 7 Visits 2310 1390
34 CMPOP1 CPM ( Outpatient Physiotherapy ) - Single 390 240
Visit
35 EMGBIOOP EMG Biofeedback ( Outpatient 7700 4610
14 Physiotherapy ) - 14 Visits
1 Physiotherapy ) - Single Visit
39 PHYS10 Excercise-Short case Package - (10 day 3400 2100
package)
40 PHYS5 Excercise-Short case Package - (5 day 1740 1080
package)
41 GTOP14 Gait Trainer ( Outpatient Physiotherapy ) - 7700 4610
14 Visits
30 Visits
43 GTOP7 Gait Trainer ( Outpatient Physiotherapy ) - 7 3840 2310
Visits
Single Visit
45 PHYTAPE Kineso Taping 270 160
46 CAOTH Occupational Therapy - Consultation and 920 550 300 300 550 330
Asssessment
47 LEXOTHE Occupational Therapy - Long Exercise 920 780 460 460 610 370
48 SEXOTHE Occupational Therapy - Short Exercise 780 390 240 240 390 240
49 PHYANC4 Physiotheraphy Antenatal Classes ( 4 Visits ) 1400 1400
50 PHYANC1 Physiotheraphy Antenatal Classes ( Per Visit 390 390
)
51 PYCASOP Physiotherapy - consultation and 610 370
assessment charges - outpatients
52 PY3MOP Physiotherapy - more than three modalities 850 500
- outpatients
53 PHYELOPD Physiotherapy exercise (long) - outpatients 610 370
54 PHYESOPD Physiotherapy exercise (short) - outpatients 390 240
55 PHYFSMOD Physiotherapy first & second modality - 550 330
outpatients
56 PHYFSMOD Physiotherapy first & second modality ( 10 4610 2760
10 day package ) - outpatients
57 PHYFMOD Physiotherapy first modality - outpatients 300 190
58 PHYFMOD1 Physiotherapy first modality ( 10 day 2770 1660
0 package ) - outpatients
59 PHYFSTMO Physiotherapy first, second & third modality 780 460
D - outpatients
216
60 PHYFSTMO Physiotherapy first, second & third modality 5920 3560
D10 ( 10 day package ) - outpatients
61 PHYCBCOS Physiotherapy charges for Care of back clinic
PHYCONCBC Physiotherapy Care of back clinic - consultant charges 550
PHYCHA Physiotherapy speciality clinic - department charges
550 390
62 PHYHCOS Physiotherapy charges for Hand clinic
PHYCONHC Physiotherapy Hand Clinic - consultant charges
550
PHYCHA Physiotherapy speciality clinic - department charges 550 390
63 PHYSPCLCH Physiotherapy charges for Rheumatoid arthritis
clinic
PHYCON Physiotherapy - Rheumatoid arthritis clinic - consultant
550
charges
PHYCHA Physiotherapy speciality clinic - department charges 550 390
Physiotherapy Package
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Suite
64 PHYELOPD1 Physiotherapy exercise (long) - outpatients 5690 3420
0 - ( 10 day package )
65 PHYELOPD5 Physiotherapy exercise (long) - outpatients 2920 1750
- ( 5 day package )
Health Check-up Program
Comprehensive Cardiac Check-up

SNo Code Description HCP1
HCP-CCC Comprehensive Cardiac Check-up with TMT & ECHO ( Package ) 4600
BGROUPEHC Blood group - ABO + Rh(D) for HCP BUN BUN
CBCDLC Complete blood count ( CBC ) with Differential leukocyte count ( DLC ) HCP4 Comprehensive Cardiac Check-up
ECHODOP Echocardiogram with Doppler ( Echo ) ECG Electrocardiogram ( ECG )
ESR Erythrocyte sedimentation rate ( ESR ) GLUF Glucose F
GLUP Glucose PP
HEPA LFT - Liver Function Test ( Hepatic Profile ) LIPP Lipid Profile
CREA Serum Creatinine
TMT Treadmill test ( TMT)

WA Ultrasound whole abdomen & pelvis ( Adult ) URIA Uric Acid
URINERE Urine examination ( Routine / Microscopy ) CHPA Xray chest PA ( CXR )
YTCHC YOGA - Training charges for health Checkup patients
SNo Code Description HCP

31 ADDEHCCOMP Add on for EHC - Comprehensive Breast Imaging Package - Complete
EHCCOMPLETE Add on for Eexecutive Health - Complete 1540
MBRANGS BRCA 1 and 2 gene analysis (BY NGS) 33080
BRULTMAM Breast Ultrasound ( Mammography )
MMCOBR2D3DMRI Comprehensive breast imaging package bilateral (2D + 3D Mammography + Breast MRI) - MRI 12600
MMCOBR2D3D Comprehensive breast imaging package bilateral (2D + 3D Mammography + Breast MRI) - X-Ray 3780
32 ADDEHCTOMO Add on for EHC - Tomosynthesis ( 2D + 3D Mammography ) - Advanced
ADDEHC2D3DM Add on for EHC - Advanced 1100
217
MAMMBT3D Breast Tomosynthesis (3D Mammography) 3780
33 ADDR2DMOS Add on for EHC - Routine (2D Mammography) - Basic

ADDEHC Add on for EHC - Basic 560
MAMMOP Mammography (bilateral) ( Xray dept charges ) 2210

34 EHCCOMPOS Add on for EHC - Comprehensive Breast Imaging Package
ADDEHC2D3DM Ad dd on for EHC – Advanced 1100
BRULTMAM MMCOBR2D3DMRI Breast Ultrasound ( Mammography )
MMCOBR2D3D Comprehensive breast imaging package bilateral (2D + 3D Mammography + Breast MRI) - MRI Comprehensive breast imaging
12600
package bilateral (2D + 3D Mammography + Breast MRI) - X-Ray
3780
39 EHCHYPEROS HYPERTENSION PROFILE - EXECUTIVE HEALTH CHECKUP 7310

CBC CBC - Complete blood count
ECHODOP Echocardiogram with Doppler ( Echo )
EHCHP EHC - Hypertension profile
ECHPATHC EHC - Patient handling charges
ECG Electrocardiogram ( ECG )
GTT6 Glucose F + Glucose PP ( 75 g Glucose )
LIPP Lipid Profile
RENPP Renal Biochemical Profile - Complete
WA Ultrasound whole abdomen & pelvis ( Adult )
42 EHCINFOS EHC - INFECTION SCREENING 4210

EHCIS EHC - Infection Screening
HBSAG HBsAg ( Australia antigen )
HCV Hepatitis C virus serology antibody test
HIV HIV antibody test
RCULTUREVAS Routine culture and sensitivity ( Vaginal swab )
VDRL RPR
URINERE Urine examination ( Routine / Microscopy )
43 EHCLUNGOS PULMONARY (CHEST) CHECK UP - EXECUTIVE HEALTH CHECKUP 11010

SGPT ALT / SGPT
SGOT AST / SGOT
BUN BUN
CBCDLC Complete blood count ( CBC ) with Differential leukocyte count ( DLC )
EHCLH EHC - Lungs & Heart Check ups
IGE Immunoglobulin E ( IgE )
SPIROM Spirometery
STOOLRE Stool examination ( Routine / Microscopy )
T3T4TSH Thyroid Profile ( T3, T4, TSH )
CHOL Total Cholesterol
218
CHAP Xray chest AP
PNSWAT Xray paranasal sinus Waters view
44 EHCMIGROS HEADACHE/MIGRANE - EXECUTIVE HEALTH CHECKUP 6030

CTHP CT head (plain)
EHCHMIG EHC - Headache/Migrane
RENPI Renal Biochemical Profile - Basic (BUN,Creat,Ca,PO,4,Na,K,Bicarbonate)
TSH TSH (Nuclear)
VB12 Vitamin B 12 ( B12 )
45 EHCNEUROS NEUROPATHY PROFILE- EXECUTIVE HEALTH CHECKUP 7110

EHCNEUP EHC - Neuropathy Profile
GLYCOHA Glycosylated Haemoglobin ( HbA1c )
HEPA LFT - Liver Function Test ( Hepatic Profile )
NCV NCV / NCS ( Nerve conduction velocity / study )
48 EHCOBOS EHC- Screening for obesity 10220

PEPTIDE C - Peptide Test
EHCSCOB EHC - Obesity
INSULINFPP Insulin Level ( Fasting + PP )
LIPP Lipid Profile
FSH Serum FSH ( Random )
LH Serum LH ( Random )
SPROLAC Serum Prolactin
URIA Uric Acid
49 EHCOSTEOS EHC - OSTEOPOROSIS PLAN 11310

25OHVIT 25-OH VIT D Level (Nuclear RIA)
ALKP Alkaline Phosphatase ( ALP )
ANTICPP Anti CCP ( Immunoscan R A )
CALC Calcium
HS CRP ( HS ) High Sensitivity C-Reactive Protein
BD2 DEXA Three Site bone densitometry
EHCOSP EHC - Osteoporosis Plan
HMYT Homocysteine
PHOS Phosphorus
URIA Uric Acid
219
50 EHCPLSOS EHC -POLYCYSTIC OVARIAN SYNDROME/ACNE 9330
DHEAS Dehydroepiandrosterone Sulfate ( DHEA-S )
EHCPOSA EHC - Polycystic Ovarian Syndrome/Acne
LIPP Lipid Profile
TESTF Testesterone (Free)
TESTT Testesterone (Total)
51 EHCPREPACOB EHC - PRE/PAC OBESITY SURGERY 23310

PEPTIDE C - Peptide Test
CPST Coagulation profile screening (PT / APTT/ TT / CBC / PS )
EHCPREPOBSUR EHC - Preop/Pac obesity surgery
FERI Ferritin
FACID Folic Acid
HBSAG HBsAg ( Australia antigen )
HCV Hepatitis C virus serology antibody test
HIV HIV antibody test
INSULINFPP Insulin Level ( Fasting + PP )
LIPP Lipid Profile
IRON Serum Iron
LH Serum LH ( Random )
SPIROM Spirometery
SECHOOS Stress Echo (Echo Deparment)
URIA Uric Acid
CHAP Xray chest AP
54 EHCVITPOS EHC - VITAMIN PROFILE 4260

EHCVTP EHC - Vitamin Profile
FACID Folic Acid
56 HCPBJFOS HCP - BONE & JOINT CONSULTATION FEMALE 10540

220
HANA Anti nuclear antibodies ( ANA ) - WITH Barcode
CALC Calcium
EHCBJC EHC - Bone & Joint Consultation
PHOS Phosphorus
PTH PTH Level
RF Rheumatoid factor - RF ( blood )
URIA Uric Acid
57 HCPBJMOS HCP - BONE & JOINT CONSULTATION MALE 9280

CALC Calcium
EHCBJC EHC - Bone & Joint Consultation EHC
ECHPATHC - Patient handling charges
PHOS Phosphorus
PTH RF PTH Level
T3T4TSH Rheumatoid factor - RF ( blood )
URIA Thyroid Profile ( T3, T4, TSH )

Uric Acid
58 HCP-CC Executive Health Check-up with TMT ( Package ) 4850

BGROUPEHC Blood group - ABO + Rh(D) for HCP
BUN BUN
ESR Erythrocyte sedimentation rate ( ESR )
HCP3 Executive Health Check-up
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
URIA Uric Acid
CHPA Xray chest PA ( CXR )
59 HCPMENOPOS HCP - MENOPAUSAL PLAN 20600

CA125 CA 125
CALC Calcium
BD2 DEXA Three Site bone densitometry
EHCMENP EHC - Menopausal Plan
221
GLUR Glucose Random
MAMMOP Mammography (bilateral) ( Xray dept charges )
PHOS Phosphorus
OESTR Serum Oestradiol ( E2 ) - Random
LBC Vaginal / cervical cytology by liquid base cytology ( LBC )
60 HCPMHCOS HCP - MALE HEALTH CHECKUP 14350

BUN BUN
EHCMHC EHC - Male health profile
FACID Folic Acid
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
SMAG Magnesium
PROST Prostatic Specific Antigen ( PSA )
SPIROM Spirometery
STOB Stool Occult blood
WA URIA Ultrasound whole abdomen & pelvis ( Adult )
URINERE Uric Acid
VB12 Urine examination ( Routine / Microscopy )
HCP1 Vitamin B 12 ( B12 )
CHPA Whole Body Check-up
YTCHC Xray chest PA ( CXR )
YOGA - Training charges for health Checkup patients
61 HCPTHYOS HCP - THYROID PLAN 5200

EHCTHY EHC - Thyroid Plan
T3T4 Free T3 / Free T4
TANTIBODIES Thyroid Antibodies - Nuclear Medicine
TSH TSH (Nuclear)
SPT Ultrasound thyroid
62 HCPWOMENOS HCP - HEALTH CHECKS FOR WOMEN 11370

CA125 CA 125
222
EHCHCWOM EHC - Health checks for women
HPVDNAH HPV-DNA ( High Risk ) Cervical Sample
LIPP Lipid Profile
CHAP Xray chest AP
Pre Employment Check-up

63 HCP-PRC Pre employment checkup ( Package ) 880
GLUR Glucose Random
HCP6 Pre Employment Check-up

URINERE Urine examination ( Routine / Microscopy ) CHPA
Xray chest PA ( CXR )
Routine Medical Check-up
65 HCP-RMC Routine Medical Check-up ( Package ) 1660

BUN BUN
GLUF Glucose F
GLUP Glucose PP
HCP2 Routine Medical Check-up
Sr. Citizen Health Check-up

66 HCP-SRC Sr. Citizen Health Check-up ( Package for male ) 2980
BUN BUN
GLUF Glucose F
GLUP Glucose PP
223
HCP5 Sr. Citizen Health Check-up
URIA Uric Acid
67 HCP-SRCF Sr. Citizen Health Check-up ( Package for female ) 3420

BGROUPEHC Blood group - ABO + Rh(D) for HCP BUN
BUN
CBCDLC Complete blood count ( CBC ) with Differential leukocyte count ( DLC ) ECG
Electrocardiogram ( ECG )
ESR Erythrocyte sedimentation rate ( ESR ) GLUF
Glucose F
GLUP Glucose PP
HCP5 Sr. Citizen Health Check-up

WA Ultrasound whole abdomen & pelvis ( Adult ) URIA
Uric Acid
LBC Vaginal / cervical cytology by liquid base cytology ( LBC ) CHPA
Xray chest PA ( CXR )
Whole Body Check-up

70 HCP-WBCF Whole body check-up with TMTand ECHO ( Package for female ) 8820
BUN BUN
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
SPIROM Spirometery
URIA Uric Acid
HCP1 Whole Body Check-up
71 HCP-WBCM Whole body check-up with TMT and ECHO ( Package for male ) 9820
BUN BUN
224
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
SPIROM Spirometery
URIA Uric Acid
URINERE Urine examination ( Routine / Microscopy ) HCP1
Whole Body Check-up

Miscellaneous Charges
Ambulance charges
SNo Code Description POPD GOPD All Cate Cat-1

1 CADCONCT Cardiac ambulance - doctor charge (credited to hospital) 8820
- Outside NCT limits
2 CADCWNCT Cardiac ambulance - doctor charge (credited to hospital) 1760
- Within NCT limits
3 NCPAONCT Neonatologist's charges for accompanying patient in 10500
ambulance - outside NCT limits
4 NCPAWNCT Neonatologist's charges for accompanying patient in 7070
ambulance - within NCT limits
5 PNCAPA Paediatrician / Neonatologist charges for accompanying 36700
patient in aeroplane
6 PCAPAONCT Paediatrician's charges for accompanying patient in 10500
ambulance - Outside NCT limits
7 PCAPAWNCT Paediatrician's charges for accompanying patient in 7070
ambulance - Within NCT limits
Diet Consultation Charges

8 DIET Diet Chart 340 60 340
9 DIETVC Dietician Visit Charges Cat 1D 220
Cat 2 180
Cat 3 130
Duplicate Bill Charges

10 DUPBILL Duplicate bill charges 30 30 50
11 DUPBILLPRI Duplicate bill charges for Private OPD (Rs. 20) 20
Laboratory Consultation charges

225
12 BLCON Biochemistry consultation charges 1680
13 HLCON Haematology consultation charges 1680
14 MLCON Microbiology consultation charges 1260
NST charges
15 NSTFV NST ( first visit ) 270
16 NSTSV NST ( subsequent visit ) 220
OPD Card charges

17 GOPDCFREE Free General OPD card 0 0
18 POPDCFREE Free Private OPD Card 0 0
19 GOPDC General OPD registration (Rs.20) 20
20 GOPDSCONS General OPD Sticker alone ( NO CHARGE ) 0
21 HOMCARD Homeopathy opd registration charges (Registration 50
ONLY)
OPD Registration

22 HVCH Homeopathy Visit Charges Rs. 30 30
Other Charges

23 PARINFGUID Parent information guide NNU 120
Smart Card Registration Charges

24 GOPDCN General OPD registration (Rs. 100) for NEW cases 100
25 SMARTREG Smart Card Registration Charges 150
26 SMARTSTICK Smart Card Sticker Only 25
ER
Telephone charges

27 TCP Telephone charges from patients 5
Dialysis machine usage charges

All Category
Cat 1B Suite
Cat 1A-Pre/
Single Bed
2 Bedded
4 Bedded
Casualty
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1 CRRTMPD CRRT - use of machine (per day) 6070

2 SLEDDMPD SLEDD - Use of machine (per day) 6070
FOB usage charges

3 FOBCOS Fibre Optic Bronchoscopy ( FOB ) - ( 2550
Equipment Charges + Anaesthesia Fee )
226
AMBUVIDEOS AMBU Videoscope - ( Equipment Charges + 4860
Anaesthesia Charges )
CMACOS C-mac ( Equipment Charges + Anaesthesia Fee ) 1500
Image intensifier usage charges

4 INFCOTH Image intensifier fluroscopy for Ozone 780
Therapy (Rs 780)
5 IINPRP Image intensifier fluroscopy for pain 710
relief procedures in OT (Rs 710)
6 IIPROT Image intensifier fluroscopy in OT other 2210
than pain relief (Rs.2210)
Infusion pump usage charges

7 EPCAPIHC Electronic PCA pump daily use - Hospital 220
Charges
8 PICC Paediatric infusion pump usage charge 1330 670 470 470
Jaundice meter charges

9 JAUNMET Jaundice meter test charges 120
Laser machine usage charges

10 LAMCFC Endovascular Laser Ablation usage 18740
charges (including laser fibre charges)
Medical monitor usage charges

11 CFM Cerebral Brain Functioning 1000 780 490
12 PCRMC Paediatric cardio-respiratory monitor 1660 830 610 440
charges
13 PPOC Paediatric pulse oximetry charges 1330 670 470 350
14 TCO2 Transcutaneous CO2 Monitor 1220 1100 1000
Nebulisation charges
15 PNEBC Nebulisation charges 170 100 170
NIGS usage charges

16 NIGSUCH Navigation image guide system (NIGS) 4080
Usage Charges
Nitric Oxide Therapy

17 NOTHCH Nitric Oxide Therapy Charges with 2760
intensive monitoring
OT machine usage charges

18 KUZA CUSA usage charges in OT 2650 2650
19 ULTCISI Ultracision Charges in OT 1320 1320
20 LMUC Liposuction machine usage charges 1320 1320 1320 660 1320 660
21 OTHOGC Ozone gas machine usage charges 660
22 RFEPCH Radiofrequency equipment procedures 660
charges
Oxygen therapy charges

23 CPAP CPAP / BiPAP usage per night 2650 1320 1320 660
24 POTCIM Paediatric oxygen therapy charges with 1280 640 450 320
intensive monitoring
Patient warmer usage charges

227
25 PWC Patient warmer charges 1000 490 390 270
Phototherapy charges
26 PPTC Paediatric phototherapy charges 1790 890 640 450
Thromboelastography test charges

27 TEGHTC Thromboelastography ( TEG ) + 2430
Heparinase test charges
28 TEGTC Thromboelastography ( TEG ) test 1630
charges
Ureteroscope usage charges

29 FURESCOPE Flexible Ureteroscope usage charges 13790
Ventilator charges
30 BIPAPUCH Bipap usage charges per day - Adult 2820
31 PVCICU Paediatric ventilator usage charges per 2580
day (in PICU / NNU)
32 MICROVEN Ventilator usage charges per day - Adult 2810
TCHR
Bedside Procedure
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
2 AFGEDHC AUTOPSY FOR FOETAL
OS GENETIC EVALUATION
CHARGES)
AFGEDF Autopsy for foetal genetic evaluation - 18640 18640 9320 7460 5590
Doctor fee
AFGEHC Autopsy for foetal genetic evaluation - 1860 1860 930 740 560
hospital charges
3 AKAEPCA Above knee /above elbow
OS plaster cast application (Doctor
fee + Hospital Charges)
AKAEPCADF Above-knee / above-elbow plaster cast 10100 10100 5050 4040 3030 5050 3030
application - Doctor Fees
AKAEPCABSP Above-knee / above-elbow plaster cast 1010 1010 510 400 300 510 300
application - Hospital Charges
4 BBDHCOS BEDSIDE FLEXIBLE
BRONCHOSCOPY (DOCTOR FEE
+ HOSPITAL CHARGES)
BRONHC Bedside bronchoscopy - Additional hospital 1630 1630 810 650 490
charges
BRONDF Bedside bronchoscopy - Doctor fees 16280 16280 8140 6510 4880
5 BEDFIOPL Bedside fibreoptic
AOS laryngoscopy (Doctor fee +
Hospital charges)
OP1000 Fibreoptic laryngoscopy 7740 7740 3870 3100 2320
FIBOPTLARHC Fibreoptic Laryngoscopy - Hospital charges 780 780 390 310 230
6 BIDDHCO BEDSIDE INCISION &
S DRAINAGE (DOCTOR FEE +
HOSPITAL CHARGES)
IDDF Bedside incision & drainage - Doctor fees 12660 12660 6330 5060 3800
228
IDHC Bedside incision & drainage - Additional 1270 1270 630 510 380
hospital charges
7 BKBEPCA Below-knee / Below-elbow
OS plaster cast application -
(Doctor fee + Hospital Charges)
BKBEPCPDF Below-knee / Below-elbow plaster cast 7460 7460 3730 2980 2240
application - Doctor Fees
BKBEPCPBSP Below-knee / Below-elbow plaster cast 760 760 380 300 230
application - Hospital Charges
8 BLIGOS Band ligation of haemorrhoids
( bedside )
BLIGDC Band ligation of haemorrhoids ( bedside ) - 13540 13540 6770 5420 4060
doctor charges
BLIGHC Band ligation of haemorrhoids ( bedside ) - 1360 1360 680 540 410
Hospital charges
9 BMADHC BONE MARROW ASPIRATION
CHARGES)
BMAHC Bone marrow aspiration - Additional 710 710 350 280 210
hospital charges
BMADF Bone marrow aspiration - Doctor fees 7080 7080 3540 2830 2120
10 BMBADH BONE MARROW BIOPSY +
COS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
BMBAHC Bone marrow biopsy & aspiration - 1270 1270 630 510 380
BMBADF Bone marrow biopsy & aspiration - Doctor 12660 12660 6330 5060 3800
fees
11 BMBDHC BONE MARROW BIOPSY
CHARGES)
BMBHC Bone marrow biopsy - Additional hospital 930 930 470 370 280
charges
BMBDF Bone marrow biopsy - Doctor fees 9320 9320 4660 3730 2800
12 BOmAHA Bone marrow harvesting
ROS (Doctor fee + Hospital charges)
BOMARHARD Bone marrow harvesting - doctor fee (if 49220 49220 24610 19690 14770
F done bedside)
BOMAHARHC Bone marrow harvesting - hospital charges 4920 4920 2460 1970 1480
(if done bedside)
13 BOMATRB Bone Marrow Transplantation
EDOS (Doctor fee + Hospital Charges)
BOMATRBED Bone marrow transplantation procedure - 223740 223740 111870 89500 67120
doctor fee (if done bedside)
BOMATRHC Bone marrow transplantation procedure - 22370 22370 11190 8950 6710
hospital charges (if done bedside)
14 BSSDHCO BED SIDE SUTURING (DOCTOR
S FEE + HOSPITAL CHARGES)
BSSDF Bed side suturing - Doctor fees 6160 6160 3080 2460 1850
BSSHC Bed side suturing - Hospital Charges 600 600 300 240 180
15 BWDLOS Burn wound dressing LARGE -
Bedside Procedure
OP1318 Burn wound dressing ( large ) 45060 45060 22530 18020 13520
BWDLBSP Burn wound dressing large - Bedside 4100 4100 2050 1640 1230
charges
16 BWDMIO Burn wound dressing MINOR -
S Bedside Procedure
OP1316 Burn wound dressing ( minor ) 18060 18060 9030 7220 5420
BWDMIBSP Burn wound dressing minor - Bedside 1640 1640 820 660 490
charges
17 BWDMOS Burn wound dressing MEDIUM
- Bedside Procedure
OP1317 Burn wound dressing ( medium ) 27040 27040 13520 10820 8110
229
BWDMBSP Burn wound dressing medium - Bedside 2460 2460 1230 980 740
charges
18 CENTDIAL ICU-Central Venous
OS Line/Dialysis Catheter
Insertion - (Doctor Fee+
Hospital Charges)
CENTDIALDF ICU-Central Venous Line/Dialysis Catheter 20000 20000 10000 8000 6000
Insertion - Doctor Fee
CENTDIALHC ICU-Central Venous Line/Dialysis Catheter 2000 2000 1000 800 600
Insertion - Hospital Charges
19 COMDHC CARDIAC OUTPUT
OS MONITORING BY THORACIC
BIO-IMPEDANCE METHOD
CHARGES)
COMTBIDF Cardiac output monitoring by thoracic 21280 21280 10640 8510 6380
bio-impedance method - Doctor fee
COMTBIHC Cardiac output monitoring by thoracic 2130 2130 1060 850 640
bio-impedance method - hospital charges
20 CVLIDFHC CENTRAL VENOUS LINE
OS INSERTION (DOCTOR FEE +
HOSPITAL CHARGES)
CVLIHC Central venous line insertion - Additional 1120 1120 560 450 340
hospital charges
CVLIDF Central venous line insertion - Doctor fees 11180 11180 5590 4470 3350
USCCVLI Central Venous Line Insertion - Ultrasound 220
Machine Usage Charges
21 DEBLARW Debridement ( large ) in ward
DOS (Doctor fee + Hospital charges)
DEBRIDEMEN Debridement ( large ) in ward - hospital 2720 2720 1360 1090 820
TLH charges
DEBRIDEMEN Debridement ( large ) in ward - doctor fee 27220 27220 13610 10890 8170
TL
22 DEBMED Debridement ( medium ) in
WDOS ward (Doctor fee + Hospital
Charges)
DEBRIDEMEN Debridement ( medium ) in ward - doctor 18100 18100 9050 7240 5430
TM fee
DEBRIDEMEN Debridement ( medium ) in ward - hospital 1810 1810 910 720 540
TMH charges
23 DEBSMW Debridement ( small ) in ward
D (Doctor fee + Hospital charges)
DEBRIDEMEN Debridement ( small ) in ward - doctor fee 8920 8920 4460 3570 2680
T
DEBRIDEMEN Debridement ( small ) in ward - hospital 890 890 450 360 270
TS charges
24 DMDFHC DRESSING IN WARD /
HOS DRESSING ROOM ( MAJOR )
CHARGES)
DWDMJAHC Dressing in ward / dressing room ( Major ) - 1160 1160 580 470 350
DWDMJDF Dressing in ward / dressing room ( Major ) - 11640 11640 5820 4660 3490
Doctor fee
25 DMIPDHC DRESSING IN WARD /
OS DRESSING ROOM (DOCTOR FEE
+ HOSPITAL CHARGES)
DWDMIAHC Dressing in ward / dressing room - 640 640 320 260 190
DWDMIDF Dressing in ward / dressing room - Doctor 6400 6400 3200 2560 1920
fee
26 DOCHERE HIGH DOSE CHEMOTHERAPY
OS AND RESCUE (Doctor fee +
Hospital Charges)
230
DOREDOCF HIGH DOSE CHEMOTHERAPY AND RESCUE - 223740 223740 111870 89500 67120
Doctor Fee
HIDORFEOS HIGH DOSE CHEMOTHERAPY AND RESCUE - 22370 22370 11190 8950 6710
Hospital Charges
27 DSSPCHD Diagnostic Sleep Studies
HCOS (Laboratory charges +
Professional charges)
DSSDF Diagnostic sleep studies - Doctor fee 18640 18640 9320 7460 5590
DSSTC Diagnostic sleep studies test charges 15280 15280 7640 6110 4580
28 ECMODOS ECMO DIALY charges
ECMOPLSDDF ECMO DAILY charges - Doctors fees 11030 8820 6620
ECMODHC ECMO DAILY charges - Hospital Charges 1100 880 660
29 ECMOPLS ECMO initiation charges
OS (inlcudes PLS circuit & ECMO
cannula)
ECMOPLSDF ECMO initiation charges (includes PLS circuit 55130 44100 33080
and ECMO cannul ) - Doctors fees
ECMOPLSHC ECMO initiation charges (includes PLS circuit 275630 275630 275630
and ECMO cannul ) - Hospital Charges
30 EPANLAB Epidural analgesia for labour
OS patients
EAFLPDF Epidural analgesia for labour patient - 9180 9180 4590 3670 2750
Doctor fees
EAFLPHC Epidural analgesia for labour patient - 920 920 460 370 280
Hospital charges
31 FANCDFH Needle biopsy / FNAC (Doctor
CHOS fee + Hospital charges)
FNACHC FNAC / Needle biopsy - Additional hospital 620 620 310 250 190
charges
FNACDF FNAC / Trucut needle biopsy - Doctor fees 6160 6160 3080 2460 1850
32 HSSTDHC HORMONAL STIMULATION
HOS SUPPRESSION TEST (DOCTOR
HSSTHC Hormonal stimulation suppression test - 590 590 290 230 180
HSSTDF Hormonal stimulation suppression test - 5860 5860 2930 2340 1760
Doctor fees
33 IAIDHCHO INTRA ARTICULAR INJECTIONS
S OF STEROIDS /
HYALURONIDASE INTO SMALL
JOINT (DOCTOR FEE +
HOSPITAL CHARGES)
IAISSJHC Intra articular injections of steroids / 340 340 170 130 100
hyaluronidase into small joint - Additional
hospital charges
IAISSJDF Intra articular injections of steroids / 3360 3360 1680 1340 1010
hyaluronidase into small joint - Doctor fees
34 IAISHDHC INTRA ARTICULAR INJECTIONS
HOS OF STEROIDS /
HYALURONIDASE INTO LARGE
JOINT (DOCTOR FEE +
HOSPITAL CHARGES)
IAISLJHC Intra articular injections of steroids / 560 560 280 220 170
hyaluronidase into large joint - Additional
hospital charges
IAISLJDF Intra articular injections of steroids / 5600 5600 2800 2240 1680
hyaluronidase into large joint - Doctor fees
35 ICDIDHCH INTERCOSTAL CHEST TUBE (
OS ICD ) INSERTION (DOCTOR FEE
+ HOSPITAL CHARGES)
ICDHC Intercostal chest tube ( ICD ) insertion - 1570 1570 780 630 470
231
ICDDF Intercostal chest tube ( ICD ) insertion - 15680 15680 7840 6270 4700
Doctor fees
36 ICDTTCOS ICD / Trachostomy tube
change IN WARD (DOCTOR FEE
+ HOSPITAL CHAGES)
ICDTCDF ICD / Trachostomy tube Change IN WARD 4100 4100 2050 1640 1230
(Doctor fees)
ICDTCHC ICD / Trachostomy tube Change IN WARD 410 410 210 160 120
(Hospital Charges)
37 INJSCLOS Injection sclerotherapy of
haemorrhoids / piles ( bedside)
INSCHDF Injection sclerotherapy of haemorrhoids / 12900 12900 6450 5160 3870
piles ( bedside) - Doctor charges
INJSCLHAHC Injection sclerotherapy of haemorrhoids / 1290 1290 650 520 390
piles ( bedside) - Hospital charges
38 IVPCOS IV / Peripheral cannulation IN
WARD (DOCTOR FEE +
HOSPITAL CHAGES)
IVPCDF IV / Peripheral cannulation IN WARD 3640 3640 1820 1460 1090
(Doctor fees)
IVPCHC IV / Peripheral cannulation IN WARD 360 360 180 150 110
(Hospital Charges)
39 JALDHCOS JOINT ASPIRATION ( LARGE )
CHARGES)
JALHC Joint aspiration ( large ) - Additional 620 620 310 250 190
hospital charges
JALDF Joint aspiration ( large ) - Doctor fees 6160 6160 3080 2460 1850
40 JASDHCH JOINT ASPIRATION ( SMALL )
CHARGES)
JASHC Joint aspiration ( small ) - Additional hospital 400 400 200 160 120
charges
JASDF Joint aspiration ( small ) - Doctor fees 3960 3960 1980 1580 1190
41 KBDHCHO KIDNEY BIOPSY (DOCTOR FEE +
S HOSPITAL CHARGES)
KBHC Kidney biopsy - Additional hospital charges 1680 1680 840 670 500
KBDF Kidney biopsy - Doctor fees 16800 16800 8400 6720 5040
42 LBDHCHO LIVER BIOPSY (DOCTOR FEE +
S HOSPITAL CHARGES)
LBHC Liver biopsy - Additional hospital charges 1470 1470 740 590 440
LBDF Liver biopsy - Doctor fees 14700 14700 7350 5880 4410
43 LPCSFDHC LUMBAR PUNCTURE / CSF
OS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
LPCSFDF Lumbar Puncture / CSF aspiration - Doctor 8920 8920 4460 3570 2680
fees
LPCSFHC Lumbar Puncture / CSF aspiration - hospital 890 890 450 360 270
charges
44 LSBOS Lumbar sympathetic block -
(Doctor fee + Hospital charges)
OP0864 Lumbar sympathetic block 15760 15760 7880 6300 4730
LSBBSP Lumbar sympathetic block - Additional 1580 1580 790 630 470
Hospital Charges
45 MEFOS Manual evacuation of faeces
MEFDF Manual evacuation of faeces - Doctor 12540 12540 6270 5020 3760
charges
MEOFHC Manual evacuation of faeces - Hospital 1250 1250 630 500 380
charges
232
46 MNBDHC MUSCLE / NERVE BIOPSY (
HOS BEDSIDE ) (DOCTOR FEE +
HOSPITAL CHARGES)
MNBAHC Muscle / nerve biopsy ( bedside ) - 1120 1120 560 450 340
MNBDF Muscle / nerve biopsy ( bedside ) - Doctor 11180 11180 5590 4470 3350
fee
47 NMECHOS Neuro Monitoring Charges
NMECH Neuro Monitoring Electrode charges 17420
NMEQCH Neuro Monitoring Euipment charges 1740
48 NOSOS Nitrous Oxide Sedation
NOSCON Nitrous Oxide Sedation - Consumables 1330
NOSDF Nitrous Oxide Sedation - Doctor fee 7460 7460 3730 2980 2240
NOSHC Nitrous Oxide Sedation - Hospital charges 750 750 370 300 220
49 NPDWDH NASAL PACKING ( DONE IN
CHOS WARD ) (DOCTOR FEE +
HOSPITAL CHARGES)
NPAHC Nasal packing ( done in ward ) - Additional 1080 1080 540 430 330
hospital charges
NPDF Nasal packing ( done in ward ) - Doctor fee 10840 10840 5420 4340 3250
50 OIBOS Oral Incisional biospy (bedside)
- Doctor fee + Hospital service
charges
OP1001 Oral incisional biopsy 10000 10000 5000 4000 3000
OIBBSP Oral incisional biopsy - Hospital service 1000 1000 500 400 300
charges
51 OSBGSAM BLOOD GAS SAMPLING
PL (DOCTOR FEE + HOSPITAL
CHARGES)
DOCCHBGSA Charges for taking blood gas sample - 5420 5420 2710 2170 1630
MP doctor charges
BSPCHBGSAM Charges for taking blood gas sample - 540 540 380 220 160
P Hospital charges
52 OSVTAP Ventricular Tapping (bedside
procedure) (DOCTOR FEE +
HOSPITAL CHARGES)
HCVTAP Ventricular Tapping ( Bedside Procedure ) - 1800 1800 900 720 540
Hospital charges
DOCHVTAP Ventricular Tapping ( Bedside Procedure ) 18040 18040 9020 7220 5410
Doctor charges
53 PACCLOS PULMONARY ARTERY
CATHERISATION ( SWAN GANZ
) IN CATH LAB
PACCLC Pulmonary artery catheterisation ( Swan 9310 9310 4660 3720 2790
ganz ) - Cath lab charges
PACDF Pulmonary artery catheterisation ( Swan 19400 19400 9700 7760 5820
Ganz ) - Doctor fee
54 PACOS PULMONARY ARTERY
CATHERISATION ( SWAN GANZ
) - BEDSIDE
PACAHC Pulmonary artery catheterisation ( Swan 1940 1940 970 780 580
Ganz ) - Additional hospital charges
Ganz ) - Doctor fee
55 PASPDHC PERICARDIAL TAPPING /
HOS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
PADF Pericardial aspiration - Doctor fees 10840 10840 5420 4340 3250
PAHC Pericardial aspiration- hospital charges 1080 1080 540 430 330
233
56 PEPCLOS Pocket for endocardial
pacemaker under GA in Cath
lab
PEPCLAF Pocket for endocardial pacemaker under GA 16770 16770 8390 6710 5030
in Cath lab - Anaesthetists charges
PEPCLCF Pocket for endocardial pacemaker under GA 22310 22310 11150 8930 6690
in Cath lab - Cath Lab Charges
PEPCLSF Pocket for endocardial pacemaker under GA 55900 55900 27950 22370 16770
in Cath lab - Surgeon fee
57 PERTDFHC Enzyme therapy infusion (
Doctor Fee + Hospital Charges )
PERTDF Enzyme therapy infusion - Doctor fee 8220 8220 4110 3290 2470
PERTHF Enzyme therapy infusion - Hospital charges 820 820 410 330 250
58 PGHDFHC Growth hormone stimulation
test ( Doctor fee + Hospital
Charges )
PGHDF Growth hormone stimulation test - Doctor 8220 8220 4110 3290 2470 4110 3340
fee
PGHHC Growth hormone stimulation test - Hospital 820 820 410 330 250 410
charges
59 PGSDDFH Glycogen storage disease
C stimulation test ( Doctor fee +
Hospital charges )
PGSDDF Glycogen storage disease stimulation test ( 8220 8220 4110 3290 2470 4110 3340
Doctor fee )
PGSDHC Glycogen storage disease stimulation test ( 820 820 410 330 250 410
Hospital charges )
60 PHLDHCO Phlebotomy (Doctor fee +
S Hospital charges)
PHLHC Phlebotomy - Additional hospital charges 750 750 370 300 220
PHLDF Phlebotomy - Doctor fees 7460 7460 3730 2980 2240
61 PIVGDFHC IVIG therapy ( Doctor fee +
Hospital Charges )
PIVGDF IVIG therapy - Doctor Fee 8220 8220 4110 3290 2470 3180 3340
PIVGHC IVIG therapy - Hospital charges 820 820 410 330 250 320
62 PLEDCHC PLEURODESIS - BEDSIDE
HOS UNDER LA (DOCTOR FEE +
HOSPITAL CHARGES)
PLEHC Pleurodesis - Additional hospital charges 590 590 290 230 180
PLEDF Pleurodesis - Doctor fees 5860 5860 2930 2340 1760
63 PLGAOS Pleurodesis - Bedside under GA
PLGAAF Pleurodesis - Bedside under GA - 1480 1480 740 590 440
Anaesthetists charges
PLGAHF Pleurodesis - Bedside under GA - Hospital 590 590 290 230 180
service charges
PLGASF Pleurodesis - Bedside under GA - Surgeon 5860 5860 2930 2340 1760
fee
64 PMINBOS Pulse monitoring infusion -
Non Biological - (Doctor fee +
Hospital charges)
PMINBDF Pulse monitoring infusion - Non Biological - 6160 6160 3080 2470 1850
Doctor fee
PMINBHC Pulse monitoring infusion - Non Biological - 620 620 310 250 190
Hospital charges
65 PMIOS Pulse monitoring infusion -
Biological - Doctor fee
PMIDF Pulse monitoring infusion - Biological - 17260 17260 8630 6900 5180
Doctor fee
PMIBHC Pulse monitoring infusion - Biological - 1730 1730 860 690 520
Hospital charges
234
66 PPDAOS Premie PDA clipping under GA
- Bedside
PPDAAF Premie PDA clipping - Bedside under GA - 50310 50310 25160 20120 15100
Anaesthetists charges
PPDAHF Premie PDA clipping - Bedside under GA - 16770 16770 8390 6710 5030
Hospital service charges
PPDASF Premie PDA clipping - Bedside under GA - 167710 167710 83850 67080 50320
Surgeon fee
67 PPDFHC Pamidronate infusion ( Doctor
fee + Hospital Charges )
PPDF Pamidronate infusion - Doctor Fee 5260 5260 2630 2100 1580
PPHC Pamidronate infusion - Hospital charges 530 530 260 210 160
68 PULPUSO Pigtail placement under usg
S guidance - PULMONOLOGY
PULPUSGDF Pigtail placement under usg guidance - 15440 15440 7720 6180 4630
Pulmonology Doctor Fee
PULPUSHC Pigtail placement under usg guidance - 1540 1540 770 620 460
Pulmonology Hospital Charges
69 PULULTR Screening ultrasound of thorax
AOS - PULMONOLOGY
PULULTRADF Screening ultrasound of thorax - 2200 2200 1100 880 660
PULULTRAHC Screening ultrasound of thorax - 220 220 110 90 70
70 PULUSGO Intercoastal tube drainge
S under usg guidance -
PULMONOLOGY
PULUSGDF Intercoastal tube drainge under usg 15440 15440 7720 6180 4630
guidance - Pulmonology Doctor Fee
PULUSGHC Intercoastal tube drainge under usg 1540 1540 770 620 460
guidance - Pulmonology Hospital Charges
71 SCRULTD ICU-Screening ultrasound of
VTOS Thorax/DVT - (Doctor Fee +
Hospital charges)
SCRULTDVTDF ICU-Screening ultrasound of Thorax/DVT - 4600 4600 2300 1840 1380
Doctor Fee
SCRULTDVTHC ICU-Screening ultrasound of Thorax/DVT - 460 460 230 190 140
Hospital Charges
72 SKBISHCH SKIN BIOPSY (DOCTOR FEE +
OS HOSPITAL CHARGES)
SBHC Skin biopsy - Additional hospital charges 620 620 310 250 190 310
SBDF Skin biopsy - Doctor fees 6160 6160 3080 2460 1850 3080 1850
73 SPCAOS Spica plaster cast application
SPCABSP Spica plaster cast application in ward - 1760 1760 880 700 530
Bedside Procedure Chargers
SPCADF Spica plaster cast application in ward - 17560 17560 8780 7020 5270
Doctor Fees
74 STADCHC SKULL TRACTION APPLICATION
HOS (DOCTOR FEE + HOSPITAL
CHARGES)
STAAHC Skull traction application - Additional 1630 1630 810 650 490
hospital charges
STADF Skull traction application - Doctor fee 16260 16260 8130 6500 4880
75 TAALVDH Ascites tapping / aspiration
COS done in WARD ( therapeutic ) -
large volume paracentesis
(doctor fee + hospital charges)
TAALVDF Therapeutic ascites aspiration ( large 6620 6620 3310 2650 1990
volume paracentesis ) - Doctor fees
TAALVHC Therapeutic ascites aspiration ( large 660 660 330 270 200
volume paracentesis ) done in WARD -
235
76 TAASVPD Ascites tapping / aspiration -
HCOS small volume paracentesis
(doctor fee + hospital charges)
TAASVHC Therapeutic ascites aspiration ( small 620 620 310 250 190
volume paracentesis ) - Additional hospital
charges
TAASVDF Therapeutic ascites aspiration ( small 6160 6160 3080 2460 1850
77 TARLOCO Target localisation in MRI / CT
S for stereotactic surgery
(Doctor fee + Hospital charges
+ Equipment charges)
STEEQUUSECH Stereotactic equipment usage charges 11890 11890 5940 4760 3570
TARLOCDF Target localisation in MRI / CT for 33580 33580 16790 13430 10070
stereotactic surgery - doctor fee
TARLOCHC Target localisation in MRI / CT for 3360 3360 1680 1340 1010
stereotactic surgery - hospital charges
78 TBDHCHO TRACHEOSTOMY ( BEDSIDE )
S (DOCTOR FEE + HOSPITAL
CHARGES)
TRACDF Tracheostomy ( bedside ) - Doctor fees 36160 36160 18080 14460 10850
TRACHC Tracheostomy ( bedside ) - hospital charges 3620 3620 1810 1450 1090
79 TIVSOPOS Total Intra Venous Sedation (
TIVS ) - OUTPATIENT
TIVSOP Total Intra Venous Sedation ( TIVS ) - 3730 2240
OUTPATIENT
80 TIVSOS Total Intra Venous Sedation (
TIVS ) - (Professional fee +
Hospital charges)
TIVSDF Total Intra Venous Sedation ( TIVS ) - Doctor 7460 7460 3730 2980 2240
fee
TIVSHC Total Intra Venous Sedation ( TIVS ) - 750 750 370 300 220
Hospital Charges
81 TPADCHC THERAPEUTIC PLEURAL FLUID
OS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
TPADF Therapeutic pleural aspiration - Doctor fees 8620 8620 4310 3450 2590
TPFAHC Therapeutic pleural fluid aspiration - 860 860 430 350 260
82 TPNSONS TPN CONSULTATION CHARGES
ULTOS (DOCTOR FEE + HOSPITAL
CHARGES)
TPNHOSCHRG TPN consultation - Additional hospital 360 360 180 150 110
charges
TPNDOCFEE TPN consultation - Doctor fee 3640 3640 1820 1460 1090
83 TRCRNDO Transcranial doppler (doctor
POS fee + hospital charges)
TRCRNDOPDF Transcranial doppler - Doctor charges 7460 7460 3730 2980 2240 3240 1940
TRCRNDOPHC Transcranial doppler - Hospital service 750 750 370 300 220 1630 980
charges
84 UFCINOS Urinary Foleys catheterisation
IN WARD (Docter fee +
Hospital Charges)
UFCIW Urinary foley's catheterisation - Hospital 1000 1000 500 400 300
Charges
UFCINDF Urinary Foley's catheterisation in ward - 9980 9980 4990 3990 2990
Doctor Fees
85 ULTRAICU ICU-Ultrasound guided
OS pigtail/Inter Costal Tube -
(Doctor Fee + Hospital
Charges)
236
ULTRAICUDF ICU-Ultrasound guided pigtail/Inter Costal 16000 16000 8000 6400 4800
Tube - Doctor Fee
ULTRAICUHC ICU-Ultrasound guided pigtail/Inter Costal 1600 1600 800 640 480
Tube - Hospital Charges
86 VACBAS Vaccum assisted wound
closure ( VAC ) application
Bedside Procedure
VACBA Vaccum assisted would closure (VAC) 2700 2700 1350 1080 810
application Bedside Procedure Charges
OP3421 Vaccum assisted wound closure ( VAC ) 27000 27000 13500 10800 8100
application
Bronchoscopy procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
87 AMDHCO ANORECTAL OR OESOPHAGEAL
S MANOMETRY (DOCTOR FEE +
HOSPITAL CHARGES)
AMHC Anorectal manometery - Additional hospital 820 820 410 330 250
charges
AMDF Anorectal manometery - Doctor fees 2060 2060 1030 820 620
88 BRAPCOS Bronchoscopic tumor
debulking ( Cautery / APC ) -
Charges)
BRAPCDF Bronchoscopic tumor debulking ( Cautery / 33080 33080 16540 13230 9920
APC ) - Doctor Fee
BRAPCPACS Bronchoscopic tumor debulking ( Cautery /
APC ) - For PACS - NOT FOR BILLING
PURPOSE
BRAPCHC Bronchoscopic tumor debulking ( Cautery / 13230 13230 6620 5290 3970
APC ) - Hospital Charges
89 BREBUSO Bronchoscopy + EBUS - (Doctor
S Fee + Hospital Charges)
BREBUSDF Bronchoscopy + EBUS - Doctor Fee 29240 29240 14620 11700 8770
BREBUSPACS Bronchoscopy + EBUS - For PACS - NOT FOR
BILLING PURPOSE
BREBUSHC Bronchoscopy + EBUS - Hospital Charges 11700 11700 5850 4680 3510
90 BRFBROS Bronchoscopic foreign body
removal - (Doctor Fee+Hospital
Charges)
BRFBRDF Bronchoscopic foreign body removal - 22860 22860 11430 9140 6860
Doctor Fee
BRFBRPACS Bronchoscopic foreign body removal - For
PACS - NOT FOR BILLING PURPOSE
BRFBRHC Bronchoscopic foreign body removal - 9140 9140 4570 3660 2740
Hospital Charges
91 BRGINJOS Bronchoscopic glue injection -
Charges)
BRGINJDF Bronchoscopic glue injection - Doctor Fee 24000 24000 12000 9600 7200
BRGINJPACS Bronchoscopic glue injection - For PACS -
NOT FOR BILLING PURPOSE
BRGINJHC Bronchoscopic glue injection - Hospital 9600 9600 4800 3840 2880
Charges
92 BRONDHC BRONCHOSCOPY - Done in
OS Endoscopy (DOCTOR FEE +
HOSPITAL CHARGES)
BRONPACS BRONCHOSCOPY - Done in Endoscopy - For
237
BRONDFN Bronchoscopy (Done in endoscopy) - Doctor 14760 14760 7380 5900 4430
fees
BRONENHC Bronchoscopy (Done in endoscopy)- 5900 5900 2950 2360 1770
93 BRTBSDO Tracheal/Bronchial stricture
S dilation - (Doctor Fee +
Hospital Charges)
BRTBSDDF Tracheal/Bronchial stricture dilation - 22860 22860 11430 9140 6860
Doctor Fee
BRTBSDPACS Tracheal/Bronchial stricture dilation - For
BRTBSDHC Tracheal/Bronchial stricture dilation - 9140 9140 4570 3660 2740
Hospital Charges
94 BRTRSTOS Bronchoscopic
tracheal/bronchial stenting -
Charges)
BRTRSTDF Bronchoscopic tracheal/bronchial stenting - 36500 36500 18250 14600 10950
Doctor Fee
BRTRSTPACS Bronchoscopic tracheal/bronchial stenting -
For PACS - NOT FOR BILLING PURPOSE
BRTRSTHC Bronchoscopic tracheal/bronchial stenting - 14600 14600 7300 5840 4380
Hospital Charges
95 DIATHOO Diagnostic Thoracoscopy with
S biopsy in Endoscopy Room -
DTHOR BIO Diagnostic Thoracoscopy with biopsy in 37280 37280 18640 14910 11180
Endoscopy Room Doctor fee
DIATHOPACS Diagnostic Thoracoscopy with biopsy in
Endoscopy Room - For PACS - NOT FOR
BILLING PURPOSE
DIATHORBIOH Diagnostic Thoracoscopy with biopsy in 14910 14910 7460 5960 4470
C Endoscopy Room - Hospital Charges
96 DNSEPOE Diagnostic nasal & sinus
COS endoscopy / postoperative
endoscopic cleaning (Doctor
fee + Hospital charges)
DNSEPOECDF Diagnostic nasal & sinus endoscopy / 4000 4000 2000 1600 1200 2000 1200
postoperative endoscopic cleaning - Doctor
fee
DNSEPOECHC Diagnostic nasal & sinus endoscopy / 200 120
postoperative endoscopic cleaning - hospital
charges
97 EBUSOS EBUS - ( Doctor Fee + Hospital
Charges )
EBUSDF EBUS - Doctor Fee 22140 22140 11070 8860 6640
EBUPACS EBUS - For PACS - NOT FOR BILLING
PURPOSE
EBUSHC EBUS - Hospital Charges 8860 8860 4430 3540 2660
98 IFSTKOS Intrapleural Fibronolysis with
STK ( Doctor fee + Additional
hospital charges )
INSTKA Intrapleural Fibronolysis with STK - 3470 3470 1740 1390 1040
IFSTKD Intrapleural Fibronolysis with STK - Doctor 8680 8680 4340 3470 2600
Fee
99 MADHEO Medical thoracoscopy with
S Adhesiolysis ( Doctor fee +
Additional hospital charges )
MTHADI Medical thoracoscopy with Adhesiolysis - 19410 19410 9700 7760 5820
MADHED Medical thoracoscopy with Adhesiolysis 48520 48520 24260 19410 14560
-Doctor Fee
238
100 MTHDOS Medical thoracoscopy
Diagnostic ( Doctor Fee +
Additional hospital charges )
MCTHA Medical thoracoscopy Diagnostic - 15660 15660 7830 6260 4700
MTHD Medical thoracoscopy Diagnostic - Doctor 39140 39140 19570 15660 11740
Fee
101 PADIADO Pleural aspiration diagnostic (
S Doctor fee + Additional
hospital charges )
PADIAD Pleural aspiration diagnostic - Additional 2120 2120 1060 850 640
hospital charges
PADIADF Pleural aspiration diagnostic - Doctor Fee 5300 5300 2650 2120 1590
102 PNBRONO PNEUMO PROJECT
S BRONCHOSCOPY
PNBRONENPA PNEUMO PROJECT BRONCHOSCOPY - For
CS PACS - NOT FOR BILLING PURPOSE
PNBRONENHC PNEUMO PROJECT BRONCHOSCOPY - 1340
HOSPITAL CHARGES
PNBRONDF PNEUMO PROJECT BRONCHOSCOPY 3350
-DOCTOR PROCEDURE CHARGES
103 REBUSOS Radial EBUS charges - (Doctor
Fee + Hospital Charges)
REBUSDF Radial EBUS charges - Doctor Fee 22140 22140 11070 8860 6640
REBUSHCPACS Radial EBUS charges - For PACS - NOT FOR
BILLING PURPOSE
REBUSHC Radial EBUS charges - Hospital Charges 8860 8860 4430 3540 2660
104 RFAOS Radio frequency ( RF ) ablation
- Gastroenterology (Doctor fee
+ Hospital charges)
RFAHC Radio frequency ablation ( Gastroenterology 12300 12300 6150 4920 3690
) - Additional hospital charges
RFADF Radio frequency ablation ( Gastroenterology 30740 30740 15370 12300 9220
) - Doctor Fee
RFAHCPACS Radio frequency ablation ( Gastroenterology
) - For PACS - NOT FOR BILLING PURPOSE
105 RGBRDOS Rigid Bronchoscopy Diagnostic
- (Doctor Fee + Hospital
Charges)
RGBRDDF Rigid Bronchoscopy Diagnostic - Doctor Fee 22860 22860 11430 9140 6860
RGBRDHCPAC Rigid Bronchoscopy Diagnostic - For PACS -
S NOT FOR BILLING PURPOSE
RGBRDHC Rigid Bronchoscopy Diagnostic - Hospital 9140 9140 4570 3660 2740
Charges
106 RGBRFBR Rigid Bronchoscopy - Foreign
OS body removal - (Doctor Fee +
Hospital Charges)
RGBRFBRDF Rigid Bronchoscopy - Foreign body removal - 31500 31500 15750 12600 9450
Doctor Fee
RGBRFBRPACS Rigid Bronchoscopy - Foreign body removal -
RGBRFBRHC Rigid Bronchoscopy - Foreign body removal - 12600 12600 6300 5040 3780
Hospital Charges
107 RGBRSTT Rigid Bronchoscopy + stenting
DBOS + tumor de-bulking - (Doctor
Fee + Doctor Fee)
RGBRSTTDBPA Rigid Bronchoscopy + stenting + tumor
CS de-bulking - For PACS - NOT FOR BILLING
PURPOSE
RGBRSTTDBHC Rigid Bronchoscopy + stenting + tumor 15760 15760 7880 6300 4730
de-bulking - Hospital Charges
RGBRSTTDBDF Rigid Bronchoscopy = stenting + tumor 39400 39400 19700 15760 11820
de-bulking - Doctor Fee
239
108 RGBRTBS Rigid Bronchoscopy +
TOS tracheal/bronchial stenting -
Charges)
RGBRTBSTDF Rigid Bronchoscopy + tracheal/bronchial 39400 39400 19700 15760 11820
stenting - Doctor Fee
RGBRTBSTPAC Rigid Bronchoscopy + tracheal/bronchial
S stenting - For PACS - NOT FOR BILLING
PURPOSE
RGBRTBSTHC Rigid Bronchoscopy + tracheal/bronchial 15760 15760 7880 6300 4730
stenting - Hospital Charges
109 RGBRTDB Rigid Bronchoscopy + Tumor
OS de-bulking - (Doctor Fee +
Hospital Charges)
RGBRTDBDF Rigid Bronchoscopy + Tumor de-bulking - 30500 30500 15250 12200 9150
Doctor Fee
RGBRTDBPACS Rigid Bronchoscopy + Tumor de-bulking -
RGBRTDBHC Rigid Bronchoscopy + Tumor de-bulking - 12200 12200 6100 4880 3660
Hospital Charges
110 TRANBOS Transjuglar Biopsy
TRANBCC Transjuglar Biopsy - Consumable Charges 18150 18150 9080
TRANBDF Transjuglar Biopsy - Doctor fee 52420 52420 26210 20970 15730
TRANBFC Transjuglar Biopsy - Fluroscopy charges 18340 18340 9170 7340 5500
TRANBPACS Transjuglar Biopsy - For PACS - NOT FOR
BILLING PURPOSE
TRANBHC Transjuglar Biopsy - Hospital charges 20970 20970 10480 8390 6290
Cardiac Procedures
Cardiac rehabilitation charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

112 CARREHCH Cardiac Rehabilitation charges (Rs. 970
970)
113 CREOPPRCIP Cardiac Rehabilitation Heart 670 670 670
Failure Program for inpatients
114 CREOPPROH Cardiac Rehabilitation Heart 4000 4000
F Failure Program for outpatients
115 CREOPPRO1 Cardiac Rehabilitation outpatient 4000 4000
program ( one month )
program ( three month )
program ( two month )
118 CRPACABG Cardiac Rehabilitation Package 2670 2670 2670
after CABG
119 CRPAPTCA Cardiac Rehabilitation Package 1330 1330 1330
after PTCA
120 HYCRECH Hybrid Package rehabilitation 1100
Charge
CARDIAC SURGERY PACKAGE

240
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
121 ENDOBOS Endomyocardial Package
PostHeart Tx - Package
Charges
ENDOPKC Endomyocardial Package - Package 32000
Charges
123 HTPKOS HEART TRANSPLANT PACKAGE
HTPCH Heart Transplant Package Charges 2920000
125 IABPOS IABP INSERTION CARDIOLOGY
( Doctor fee + Hospital Charges
)
IABPPC IABP INSERTION-PACKAGE CHARGES 59000
126 IVUSOS IVUS (Doctor fee + Hospital
Charges )
IVUSPC IVUS - Package Charges 35000
127 LVADOS LVAD / Heart Transplant
Assessment Package
LVADPC LVAD / Heart Transplant Assessment 192000
Package - Package Charges
Heart transplant Package Includes :

 Stay up to 22 days.
 ICCU monitoring charges for 15 days
 Investigations limited to Rs. 209480/-.
 Medicines limited to Rs. 180000/-(including GST)
 Consumables limited to Rs. 130000/-(including GST)
 Blood products limited to Rs. 88200/-
 Professional Fees of Cardiac Surgeon, Cardiologist & Anaesthetist
 IABP. PPI
Package Excludes :
 Nephrology & Dialysis services.
 All investigations, medicines, and consumables over & above the prescribed limit
 All hospital charges for the stay beyond the package stay.
 Stay in ICCU for more than package days will be charged extra per day towards intensive care monitoring (within total package days).
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

111 HRCARDP HIGH RISK ADD ON FOR
OS CARDIAC (PACKAGE CHARGES
+ DOCTOR FEES)
HRADDCSPC High risk ADD ON for cardiac surgery 53000
package charges
Cardiac Surgery Packages - CABG Off Pump

All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
241
130 CABGOAD CABG (OFF PUMP) (PACKAGE
COS CHARGES + ALL DOCTOR FEES)
CABGOFFP CABG (off pump) package charges 444000 417000 378000 327000 253000
Package Includes :
 Stay up to 8 days including ICCU monitoring charges for 5 days
 Investigations limited to Rs. 16210/- in category 3 and Rs. 32410/- in other categories
 Blood Bank crossmatch charges.
 Cardiac Rehabilitation
Package Excludes :
 Cost of valve
 All Blood products.
 Cross references other than Cardiologist during package stay.
 Carotid Endarterectomy – Extra amount will be charged for this procedure, if required.
 Physiotherapy
 Intra-aortic Balloon Pump (IABP) will be charged extra.
 All hospital charges for the stay beyond the package stay of 8 days.
 High Risk Surcharge will be charged extra in high risk cases.
Cardiac Surgery Packages - Closed Heart
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
132 CHSPCDC CLOSED HEART SURGERY
OS (PACKAGE CHARGES + ALL
DOCTOR FEES)
CHSPC Closed heart surgery package charges 243000 232000 200000 180000 142000
Package Includes :
 Stay up to 6 days including ICCU monitoring charges for 4 days.
 In case of reexploration no separate charges for Cardiac Surgeon, Cardioligist & Anaesthetist.
Package Excludes :
 Cost of valve
 All blood products
 Swan Ganz Catheter, continuous cardiac output monitoring, Centrifugal pump
 Physiotherapy
242
Cardiac Surgery Packages - Hybrid Procedure
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
134 HPPROOS HYBRID PROCEDRE PACKAGE
HPPC HYBRID PROCEDURE - PACKAGE CHARGE 595000 560000 505000 446000 360000
Package Includes :
 Consumables limited to Rs. 42000/- (including GST)
 In case of reexploration no separate charges for Cardiac Surgeon, Cardioligist & Anaesthetist.
Package Excludes :
 Cost of valve
 Swan Ganz Catheter, continuous cardiac output monitoring, Centrifugal pump
 Physiotherapy
 High Risk Surcharge will be charged extra iIn high risk cases.
Cardiac Surgery Packages - Open Heart On Pump
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

135 OHSDHCH OPEN HEART SURGERY / CABG
OS (ON PUMP) (PACKAGE
CHARGES + ALL DOCTOR FEES)
OHSPC Open Heart Surgery/CABG (On Pump) 538000 477000 413000 370000 277000
package charges
Package Includes :
 Cardiac Rehabilitation
Package Excludes :
 Cost of valve
243
 Physiotherapy
 Stay in ICCU for more than package days will be charged extra per day towards intensive care monitoring (within total package days)
Cardiology ( Non Package Procedures )
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
137 PPDHCHO PACEMAKER PROGRAMMING
S (PACKAGE CHARGES + DOCTOR
FEE)
PACEPROG Pacemaker Programming package charges 2420 2290 2160 1910 1650
138 TPPDHCH TEMPORARY PACEMAKER
OS PACKAGE CHARGES (PACKAGE
CHARGES + DOCTOR FEE)
TPPC Temporary pacemaker package charges 12200 11690 11180 9150 8390
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Day care
Cat-1D
GOPD
POPD
Cat-2
Cat-3
139 CARWITHI CARDIAC CATHETERISATION
NVOS WITH INVESTIGATION CATH
LAB (PACKAGE CHARGES +
DOCTOR FEE)
CARWITH CARDIAC CATHETERISATION WITH 40000 37000 29500 26000 18500 16000
INVESTIGATION PACKAGE CHARGES
Package includes :
 One day stay (day care stay for day care category)
 Routine Investigations
 Medicines limited to Rs. 1500/- (including GST) and consumables limited to Rs. 1900/- (including GST)
 Professional fees of Cardiologist
Package excludes :
 All expenses for stay beyond the package period.
 Professional charges of other Consultants
 Any other incidental procedures & investigations other than mentioned above.
 Additional medicines & consumables over and above the limit prescribed.
 Nephrology & dialysis charges
140 PEASAOS PERICARDIAL ASPIRATION

(PACKAGE CHARGES + DOCTOR
FEE)
PRTION PERICARDIAL ASPIRATION - Package 40000 40000 32000 27000 25000
charges
Includes Prof fees. and Hospital charges. All other charges towards medicines, medical consumables and investigations will be charged extra at actuals.
Cardiology package charges
244
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
141 FFRPKCH FFR - Packages charges 33600
Includes Prof fees., FFR Equipment charges, medicines limited to Rs. 1700/-, medical consumables limited to Rs. 15500/-.
Cardiology Packages
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Day care
Cat-1D
GOPD
POPD
Cat-2
Cat-3
143 CARCATET CARDIAC CATHETERISATION
IONOS WITHOUT INVESTIGATION
CATH LAB (PACKAGE CHARGES
+ DOCTOR FEE)
CARPACKN CARDIAC CATHETERISATION WITHOUT 33000 31000 23000 20000 15000 14000
INVESTIGATION PACKAGE CHARGES
Package includes :
 One day stay (day care stay for day care category)
Package excludes :
 Any other incidental procedures & investigations.
144 CEAONCS[ CAROTID ENDARTERECTOMY

DCOS ADD ON FOR CARDIAC
SURGERY (PACKAGE CHARGES
+ DOCTOR FEE)
CEADDCS Carotid endarterectomy ADD ON for cardiac 48300
surgery package charges
145 CESMAPD CARDIAC ELECTROPHYSIOLOGY

COS STUDIES (MAJOR) (PACKAGE
CESMPC Cardiac electrophysiology studies (Major) 47000 44800 41700 37600 33200
package charges
Package includes :
 1 night stay including ICCU monitoring charges
 Medicines limited to Rs. 1000/-.(including GST)
Package excludes :
 All expenses for stay beyond the package period and not included above.
 Professional charges of other Consultants.
146 CESMIPDC CARDIAC ELECTROPHYSIOLOGY

OS STUDIES (MINOR) (PACKAGE
245
CELSMPC Cardiac electrophysiology studies (Minor) 29000 28000 26000 23000 22000
package charges
Package includes :
 1 night stay including ICCU monitoring charges
Package excludes :
147 CRAPDCO CARDIAC RADIO FREQUENCY (

S RF ) ABLATION (PACKAGE
CRAPC Cardiac radiofrequency ablation package 126000 116000 106000 90500 85000
charges
Package includes :
 Radio frequency ablation package includes 1 night stay including ICCU monitoring charges.
 Consumables limited to Rs. 8000/-.(including GST)
Package excludes :
 Additional medicines and consumables over and above the limit prescribed.
148 CRAPDCO COMPLEX CARDIAC RADIO

S3D FREQUENCY ( RF ) ABLATION
3D MAPPING (PACKAGE
CRAPC3D Complex cardiac radiofrequency ablation 3D 438000 438000 378000 339000 296000
mapping package charges
Package includes :
 4 night stay including 1 day ICCU monitoring charges
 Medicines limited to Rs. 15000/-, consumables limited to Rs. 150000/-.(including GST)
Package excludes :
149 IABPSPDC IABP - ADD ON FOR CARDIAC

HOS SURGERY (PACKAGE CHARGES
+ DOCTOR FEE)
IABPSPC IABP - ADD ON for cardiac surgery package 57750
charges
Cardiology Packages - ASD / PDA Closure
246
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
150 ASDPDCO ASD / PDA / RSOU/ VSD
S CLOSURE
ASDCPDACPC ASD / PDA / RSOU / VSD DEVICE CLOSURE - 241000 210000 171000 144000 98000
package charges
Package Includes :
 Stay up to two days including 1 day ICCU monitoring charges
 Medical consumables limited to Rs. 19000/-(including GST)
Package Excludes :
 Any additional charges other than included in the package.
 Any other incidental procedures.
Cardiology Packages - Coronary Angiography
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Day care
Cat-1D
GOPD
POPD
Cat-2
Cat-3
151 CAPCDHC CORONARY ANGIOGRAPHY
OS WITHOUT INVESTIGATION
FEE)
CAWOPC Coronary angiography without investigation 33500 30300 22200 19100 14500 13000
package charges
152 CAWIPCH CORONARY ANGIOGRAPHY
DHCOS WITH INVESTIGATION
FEE)
CAWIPC Coronary angiography with investigation 38500 35500 27900 24700 17000 15000
package charges
153 CCAPPDC CHECK CORONARY
HOS ANGIOGRAM (PACKAGE
CCAPC Check coronary angiogram package charges 16940 15130 13200 12100 9680
Package includes :
 One day stay including ICCU monitoring charges.(day care stay for day care category)
Package excludes :
Cardiology Packages - Coronary Angioplasty
247
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
154 CAFRPDH CORONARY ANGIOPLASTY FOR
COS RESTENOSIS (PACKAGE
CAFSPC Coronary angioplasty for restenosis package 112040 103950 98180 90090 76230
charges
155 ECAWSPD ELECTIVE CORONARY
CHOS ANGIOPLASTY (PACKAGE
CHARGES + ALL DOCTOR FEE)
ECAWSPC Elective Coronary Angioplasty Package 221100 205700 172400 144000 127000
Package Includes :
 Stay up to three days including ICCU monitoring charges for one day.
 Cardiac Rehabilitation.
Package Excludes :
 Cost of consumables
 If additional stent is used, prof. fees will be charged extra.
 In complex cases, prof. fees will be charged extra
 Additional investigations other than included in the package.
 Additional medicines and consumables over and above the limit prescribed.
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

156 EOTPCDC EMBOLISATION (PACKAGE
HOS CHARGES + DOCTOR FEE)
ETRHOMPC Embolisation package charges 68400 62200 56400 51300 46600
Package includes Professional fee and Cath Lab charges. Room rent and other charges will be billed at actual
Cardiology Packages - Endomyocardial Biopsy

All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

157 EBOS ENDOMYOCARDIAL BIOPSY
FEE)
EBPC ENDOMYOCARDIAL BIOPSY PACKAGE 68700 64400 61100 55700 46200
CHARGES
Package Includes :
 Stay up to one day including ICCU monitoring charges.
248
Package Excludes :
 Cost of medicines and consumables
Cardiology Packages - Intra Cardiac Implants
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
158 AICDIPDC AICD SINGLE CHAMBER
HOS IMPLANTATION PACKAGE (
AICDIPC AICD SINGLE CHAMBER IMPLANTATION 169000 157000 141000 127000 111000
PACKAGE - Package Charges
Package Includes :
 Stay up to three days including ICCU monitoring charges for two days.
 Medicines limited to Rs. 7500/- (incldg GST)
Package Excludes :
 Medicines over and above limit prescribed in package
159 BPIPCOS BIVENTRICULAR PACEMAKER

IMPLANTATION (PACKAGE
BPIPC BIVENTRICULAR PACEMAKER 208000 192000 165000 149000 127600
IMPLANTATION PACKAGE CHARGES
Package Includes :
 Stay up to five days including ICCU monitoring charges for three days.
Package Excludes :
160 CDAICDIP CRTD PACKAGE ( Doctor Fee +

DCHOS Hospital Charges )
CDAICDIPC CRTD PACKAGE - Package Charges 232000 216000 191000 171000 148000
Package Includes :
 Stay up to five days including ICCU monitoring charges for three days.
Package Excludes :
249
162 DAICDIPD AICD DOUBLE CHAMBER

CHOS IMPLANTATION PACKAGE (
DAICDIPC AICD DOUBLE CHAMBER IMPLANTATION 189000 174000 158000 143000 124000
PACKAGE - Package Charges
Package Includes :
Package Excludes :
164 LRIOS LOOP RECORDER

IMPLANTATION (PACKAGE
LRIPC LOOP RECORDER IMPLANTATION PACKAGE 68700 64400 61100 55700 46200
CHARGES
Package Includes :
 Stay for one day including ICCU monitoring charges.
Package Excludes :
 Cost of medicines and consumables
165 PDCPDHC PACEMAKER - DOUBLE

HOS CHAMBER (PACKAGE CHARGES
+ DOCTOR FEE)
PDCPC Pacemaker - double chamber package 138000 127000 115000 103000 91000
charges
Package Includes :
Package Excludes :
250
166 PGREPOS PG - REPLACEMENT (PACKAGE
PGPC PG Replacement - Package Charges 132000 121000 101000 89000 75000
Package includes :
 Three days stay including ICCU monitoring charges for 1 day
 Medicines limited to Rs. 7500/- (including GST).
Package excludes :
 All Consumables
167 PSCPDHC PACEMAKER - SINGLE

HOS CHAMBER (PACKAGE CHARGES
+ DOCTOR FEE)
PSCPC Pacemaker - single chamber package 137000 126000 106000 94000 80000
charges
Package Includes :
 Stay up to three days including ICCU monitoring charges for one day.
Package Excludes :
Cardiology Packages - IVC Filter Device Insertion
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

168 IVCOS IVC FILTER DEVICE INSERTION
FEES)
IVCPC IVC Filter Device Insertion - Package Charges 145900 145900 73000 58400 43800
Package includes Professional fee and Cath Lab charges. Room rent and other charges will be billed at actual
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

169 RAWIDHC RENAL / PERIPHERAL
HCOS ANGIOGRAPHY PACKAGE
(WITH INVESTIGATIONS)
RAWIPC Renal angiography with investigations 35800 31800 24200 21000 15300
package charges
251
Package includes :
Package excludes :
170 RAWIODH RENAL / PERIPHERAL

CHCOS ANGIOGRAPHY PACKAGE
(WITHOUT INVESTIGATIONS)
RAWOIPC Renal angiography without investigations 31600 26500 19000 15800 12700
package charges
Package includes :
Package excludes :
Cardiology Packages - Rotablator
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

171 ROTDAOS ROTABLATOR / DIRECTIONAL
ATHERECTOMY (PACKAGE
ROTDAPC ROTABLATOR / DIRECTIONAL 82000
ATHERECTOMY-Package Charges
Package includes :
 Consumables limited to Rs. 45000/- (including GST)
Package excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
252
172 THTDFHC CORONARY THROMBOLYTIC
OS THERAPY (DOCTOR FEES +
HOSPITAL CHARGES)
THTDF Coronary Thrombolytic Therapy - Doctor 43400 43400 21700 17360 13020
fees
THTHC CoronaryThrombolytic Therapy - Hospital 4340 4340 2170 1740 1300
charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
173 CVPDCHO CARDIAC VALVOPLASTY (CATH
S LAB) (PACKAGE CHARGES +
DOCTOR FEE)
CVCPC Cardiac valvoplasty (Cath lab) package 119000 107000 98000 94000 80000
charges
Package includes :
 Two days stay including ICCU monitoring charges for 1 day
Package excludes :
CATARACT\OPHTHALMIC SURGERY PACKAGE
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

174 CSMLAOS Cataract Surgery MULTI FOCAL
LENS ( Restor & Technis
Multifocal ) - (PACKAGE
CATMFL Cataract surgery package - Multi Focal Lens 76500
package charges
Note: The above package includes stay in Day care room and includes Surgeon fees, Anaesthetist fees. Nursing care, diet charges,
medicines limited to Rs. 600/-(including GST), consumables limited to Rs. 40000/-(including GST). Cost of additional room rent, special
drugs, special investigations, cost of medicines and consumables over and above the prescribed limit, if any, shall be charged extra at
applicable rates.
175 CSPCHOS Cataract Surgery Package for

GOPD card holders ( with
Indian foldable lens) -
(PACKAGE CHARGES + ALL
DOCTOR FEES)
CSPFINDIOLPC Cataract surgery package ( for GOPD 17800
patients ) - with Indian foldable lense IOL
package charges
253
176 CSPIOLPD CATARACT SURGERY - WITH
COS FOLDABLE IOL (PACKAGE
CSPNIOLPC Cataract surgery package - with foldable IOL 31200
package charges
177 CSPWIOLP CATARACT SURGERY -
DCOS WITHOUT IOL (PACKAGE
CSPFIOLPC Cataract surgery package - without IOL 26500
package charges
178 CSPWNFP CATARACT SURGERY - WITH
DCOS NON-FOLDABLE IOL (PACKAGE
CSPWNFIOLPC Cataract surgery package - with 28500
Non-foldable IOL package charges
Note: The above packages include stay in Day care room and includes Surgeon fees, Anaesthetist fees. Nursing care, diet charges, medicines
limited to Rs. 600/-(including GST) for all packages and consumables limited to Rs. 3000/-(including GST) for Without IOL, Rs. 5000/-(including
GST) for Non Foldable IOL, Rs. 8200/-(including GST) for Foldable IOL and Rs. 3500/- (including GST) for GOPD, Cost of additional room rent,
special drugs, special investigations, cost of medicines and consumables over and above the prescribed limit, if any, shall be charged extra at
applicable rates.
179 CSTLOS Cataract Surgery TORIC LENS -

DOCTOR FEES)
CATTORIC Cataract surgery package - Toric Lens 59000
package charges
applicable rates.
180 CSTLSYOS Cataract Surgery SYMFONY

LENS - (PACKAGE CHARGES +
ALL DOCTOR FEES)
CATTORICSY Cataract surgery package - Symfony Lens 91000
package charges
applicable rates.
181 CSTLSYTM Cataract Surgery MULTIFOCAL

FOS TORIC LENS - (PACKAGE
CATTORICMF Cataract surgery package - Multifocal Toric 99500
Lens package charges
applicable rates.
182 CSTLSYTO Cataract Surgery SYMFONY

S TORIC LENS - (PACKAGE
CATTORICST Cataract surgery package - Symfony Toric 114500
Lens package charges
applicable rates.
254
183 MICSOS Micro Incision Cataract Surgery
( including high viscosity visco
elastic ) - (PACKAGE CHARGES
+ ALL DOCTOR FEES)
MICINCCATPK Micro Incision Cataract Surgery (Including 43500
high viscosity visco elastic) - Package
Charges
Note: The above package includes stay in Day care room and includes Surgeon fees, Anaesthetist fees. Nursing care, diet charges, medicines
limited to Rs. 600/-(including GST) and consumables limited to Rs. 12000/-(including GST). Cost of additional room rent, special drugs, special
investigations, cost of medicines and consumables over and above the prescribed limit, if any, shall be charged extra at applicable rates.
185 AVEGFPC Anti VEGF injection (per eye) - 19870 19870 19870 19870 19870
Package charges
Note: The above package includes stay in Day care room and includes Surgeons fees, Anesthetist fees and Anaesthesia consumables. Cost of
special medicines and consumables, cost of additional room rent, special investigations, shall be charged extra at applicable rates
Cochlear Implantation package - Bilateral
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
198 CIPBWRO COCHLEAR IMPLANTATION
S BILATERAL (WITH AUDIOLOGY-
PACKAGE CHARGES + ALL
DOCTORS FEES
CIPCBS Cochlear implantation Bilateral (with 298000 257000 206000
audiology) - Package Charges
199 CIPBWOR COCHLEAR IMPLANTATION
OS BILATERAL (WITHOUT
Audiology) - PACKAGE
CHARGES + ALL DOCTORS FEES
CIPCBNS Cochlear implantation Bilateral (without 246000 200000 149000
audiology) - Package Charges
Package includes:
1. 3 days stay.
2. Medicines limited to Rs. 1500/-(including GST).
3. Consumables limited to Rs. 6500/-(including GST) and one X-ray mastoid.
4. Professional Fees of Surgeon, Speech Therapist, Anasthetist, Anasthesia and OT Charges.
Package excludes:
1. Cost of implant
2. All hospital charges for the stay beyond the package stay of 3 days
3. Additional medicines and consumables over and above prescribed limit.
4. Any investigations.
5. Professional charges of other Consultants.
Cochlear Implantation - Only Surgery / Revision surgery

All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

200 CIPWROS COCHLEAR IMPLANTATION
OS (WITHOUT AUDIOLOGY) (ONLY
/REVISION SURGERY) -
PACKAGE CHARGES + ALL
DOCTORS FEES
255
CIPCOS Cochlear implantation (Excluding speech 138000 110000 83000
therapy) Only / Revision Surgery - Package
Charges
Package includes:
1. 3 days stay.
3. Consumables limited to Rs. 3500/-(including GST) and one X-ray mastoid.
4. Professional Fees of Surgeon, Anasthetist, Anasthesia and OT Charges.
Package excludes:
1. Cost of implant
Cochlear Implantation - Post Lingual with Rehabilation
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
201 CIPLDDAC COCHLEAR IMPLANTATION
HCOS (WITH AUDIOLOGY)- POST
LINGUAL DEAF CHILD/ADULT
DOCTOR FEES)
CIPLDACPC Cochlear implantation (including speech 150000
therapy) - post lingual deaf adult or child
package charges
Package includes:
1. 3 days stay.
3. Consumables (including X-Ray Mastoids) limited to Rs. 3500/-(including GST).
4. Professional Fees of Surgeon, Speech therapist, Anasthetist, Anasthesia and OT Charges.
Package excludes:
1. Cost of implant
Cochlear Implantation - Pre Lingual with Rehabilation

All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

202 CIPLDDHC COCHLEAR IMPLANTATION
OS (WITH AUDIOLOGY)- PRE
LINGUAL DEAF CHILD
DOCTOR FEES)
CIPLDCPC Cochlear implantation (with audiology) - pre 172000 143000 117000
lingual deaf child package charges
Package includes:
1. 3 days stay.
2. Medicines limited to Rs. 1500/- (including GST).
3. Consumables limited to Rs. 3500/-(including GST).
256
4. Professional Fees of Surgeon, Speech therapist, Anasthetist, Anasthesia and OT Charges
Package excludes:
1. Cost of implant
Paediatric Cardiac Sciences packages
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1092 CAPCOS Paediatric Cardiac angiography
CAPK Paediatric Cardiac angiography - package 77700 68200 50700 34800 25300
charges
Package Includes :
 2 days stay.
 Investigations limited to Rs. 2490/- in cat 3 & Rs. 4990/- in other categories.
 Medicines and consumables limited to Rs. 7700/-(including GST)
Package Excludes :
 Blood Bank charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1093 ASDOS Paediatric ASD Device
ASDPPC Paediatric ASD Device - package charges 239900 207700 168000 140000 92100
1094 ASDPEPD ASD DEVICE CLOSURE
COS (PAEDIATRIC ONLY) (PACKAGE
CHARGE + DOCTOR FEE)
ASDCPDACPC ASD / PDA / RSOU / VSD DEVICE CLOSURE - 241000 210000 171000 144000 98000
package charges
Package Includes :
 2 days stay including Intensive Care for 1 day
 Investigations limited to Rs. 5570/- in cat 3 & Rs. 11120/- in other catagories.
Package Excludes :
 Blod Bank charges
257
PCS Packages - Balloon Septostomy
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1095 PBSEPOS Paediatric Balloon Septostomy
PBSEPC Paediatric Balloon Septostomy - package 124300 108700 93600 79600 67800
charges
Package Includes :
 2 days stay including Intensive Care for 1 day.
Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1096 PCHSL1OS Paediatric Closed Heart
Surgery Level One
PCHSL1P Paediatric Closed Heart Surgery Level One 228000 198000 153000 125000 91000
package charges
Package Includes :
 3 days stay including Intensive Care for 1 day.
Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1097 PCHSL2OS PAEDIATRIC CLOSED HEART
SURGERY LEVEL TWO ( ALL
CHARGES)
PCHSL2P Paediatric Closed Heart Surgery Level Two 330000 286000 235000 192000 135000
package charges
Package Includes :
 7 days stay including Intensive Care for 3 days
258
Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1098 PCHSL3OS Paediatric Closed Heart
Surgery Level Three
PCHSL3P Paediatric Closed Heart Surgery Level Three 460000 402000 313000 262000 197000
package charges
Package Includes :
 9 days stay including Intensive Care for 4 days.
Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1099 CCEPCOS Paediatric Cardiac coil
Embolisation
CCEPPC Paediatric Cardiac coil Embolisation - 97000 84300 75200 58200 38200
package charges
Package Includes :
 1 day stay.
 Investigations limited to Rs. 2710/-in cat 3 & Rs. 5420/- in other catagories.
Package Excludes :
 All hospital charges for the stay beyond the package stay of 1 day.
259
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1100 POHSL1O Paediatric Open Heart Surgery
S Level One
POHSL1P Paediatric Open Heart Surgery Level One 441000 382000 319000 260000 211000
package charges
Package Includes :
 Investigations limited to Rs. 13790/- in cat 3 Rs. 27550/- in other catagories.
Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
S Level Two
POHSL2P Paediatric Open Heart Surgery Level Two 521000 459000 382000 316000 233000
package charges
Package Includes :
Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

S Level Three
POHSL3P Paediatric Open Heart Surgery Level Three 720000 638000 515000 442000 344000
package charges
Package Includes :
 10 days stay including Intensive Care for 5 days.
260
Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1103 PDAOS Paediatric PDA Device
PDAPC Paediatric PDA Device - package charges 185200 161800 132900 95600 58600
Package Includes :
Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1104 PVALOS Paediatric Valvuloplasty
PVALPPC Paediatric Valvuloplasty - package charges 172500 149200 126500 103900 70900
Package Includes :
 Investigations limited to Rs. 4400/- in cat 3 & Rs. 8790/-in other catagories.
 Medicines and consumables limited to Rs. 20200/-(including GST))
Package Excludes :
GYNAECOLOGY PACKAGE
Day Care Package Procedures
S.No. Investigation Limit on medicines & consumables

Total Charges (including GST)
261
1. Colposcopy/Cautery 5300 100
2. Colposcopy/LEEP 9000 700
3. Diagnostic Hyster/D&C 14500 1000
4. Colpo/Hystero/D&C 17000 1000
5. Colpo/Hystero/LEEP 19000 1000
6. MTP 11500 1000
Note: These packages include Surgeon fee, Anasthetist fees, Hospital charges with limits on medicines and consumables as mentioned above.
Charges for investigations and biopsy will be extra.
Liver tranplant package charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
740 LIVHPAC Liver Transplant High Risk - 2259000
recipient package charges
Package includes
Stay up to 21 days for the recipient and 8 days for donor in Single Room and includes 5 days stay in ICU for the recipient and 2 days stay in
ICU for the Donor, Surgeons Fee, Anaesthetist Fee, Anaesthesia, Theater Charges, Gastroentrology Visit Charges, medicines limited to Rs.
285000/- (incldg GST), consumables limited to Rs. 325000/-(incldg GST), investigation limited to Rs. 231000/- and Blood Bank services
limited to Rs. 84000/-.
Package Excludes
All investigations, medicines, consumables, blood bank charges, hospital stay over the limits included in package and all other charges over
and above period of hospital stay. Nephrology related treatment charges, any non liver transplant consultants visit charges and procedure
charges, etc.
741 LIVPACKC Liver Transplant Low Risk - 1668000

Package includes
Stay up to 18 days for the recipient and 7 days for donor in Cat 2 Room and includes 5 days stay in ICU for the recipient and 1 day stay in ICU
for the Donor, Surgeons Fee, Anaesthetist Fee, Anaesthesia, Theater Charges, Gastroentrology Visit Charges, medicines limited to Rs.
270000/-(incldg GST), consumables limited to Rs. 220000/-(incldg GST), investigations limited to Rs. 178500/- and Blood Bank services
limited to Rs. 84000/-.
Package Excludes
charges, etc.
742 LINORPC Liver Transplant Normal Risk - 1965000

Package includes.
Stay up to 18 days for the recipient in Cat 1 room and 7 days for donor in Cat 2 room and includes 5 days stay in ICU for the recipient and 1
day stay in ICU for the Donor, Surgeons Fee, Anaesthetist Fee, Anaesthesia, Theater Charges, Gastroentrology Visit Charges, medicines
limited to Rs. 275000/-(incldg GST), consumables limited to Rs. 250000/-(incldg GST), investigation limited to Rs. 189000/- and Blood Bank
services limited to Rs. 84000/-.
Package Excludes
charges, etc.
262
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
746 LIVPAEDO Liver Transplant Package
S (Paediatrics)
LTPPPC Liver Transplant Package (Paediatrics) - Package 1053000
Charges
Package includes.
Stay up to 23 days for the recipient in Cat 1 room and 6 days for donor in Cat 2 room including 6 days stay in ICU for the recipient and 1 day
stay in ICU for the Donor, Surgeons Fee, Anaesthetist Fee, Anaesthesia, Theater Charges, Gastroentrology Visit Charges
Package Excludes
charges, etc.
Critical Care Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
203 BIPAPINIT BIPAP Initiation (Doctor +
NOS Hospital Charges)
BIPAPINITNDF BIPAP Initiation - Doctor Fee 3460 3460 1730 1380 1040
BIPAPINITNHC BIPAP Initiation - Hospital service charges 340 340 170 140 100
204 BIPAPMO BIPAP Monitoring (Doctor +
BIPAPMONITD BIPAP Monitoring - Doctor Fee 3460 3460 1730 1380 1040
F
BIPAPMONNH BIPAP Monitoring - Hospital service charges 340 340 170 140 100
C
205 COMEVOS Cardiac Output Monitoring By
EV 1000 (Doctor + Hospital
Charges)
COMEV1000D Cardiac output monitoring by EV 1000 - 12130
F doctor fee
COMEVBPC Cardiac output monitoring by EV1000 - 1220
bedside procedure charges
COMEV1000 Cardiac output monitoring by EV1000 - 1820
special equipment charges
206 CPAMOS Cardio-Pulmonary Assessment
and Monitoring by
Ultrasound-(Doctor
Fee+Hospital Charges)
CPAMH Cardio-Pulmonary Assessment and 800
Monitoring by Ultrasound-Additional
Hospital Charges
CPAMD Cardio-Pulmonary Assessment and 16000 16000 8000 6400 4800
Monitoring by Ultrasound-Doctor Fee
CPAMHM Cardio-Pulmonary Assessment and 1200
Monitoring by Ultrasound-Hospital Charges
(Machine usage)
207 NOTOS Nitric Oxide Therapy - (Doctor
NOTDF Nitric Oxide Therapy - Doctor Fee 12600 12600 6300 5040 3780
NOTHC Nitric Oxide Therapy - Hospital Charges 3150
(Machine usage)
263
208 VENTINIT Ventilator Initiation (Doctor +
VENTINITNDF Ventilator Initiation - Doctor Fee 3460 3460 1730 1380 1040
VENTINITNHC Ventilator Initiation - Hospital service 340 340 170 140 100
charges
209 VENTMO Ventilator Monitoring (Doctor
NOS + Hospital Charges)
VENTIMONITD Ventilator Monitoring - Doctor Fee 3460 3460 1730 1380 1040
F
VENTIMONNH Ventilator Monitoring - Hospital service 340 340 170 140 100
C charges
Diabetic foot clinic procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
278 COCADIJO Contact cast application for
DEOS diabetic joint deformity
(OUTPATIENT Doctor +
Hospital Charges )
COCADIJODED Contact cast application for diabetic joint 2320 2320
F deformity (doctor fee)
COCADIJODEH Contact cast application for diabetic joint 2130 2130
C deformity (hospital charges)
279 CONCSTO Contact cast application for
S diabetic joint deformity
(INPATIENT Doctor + Hospital
charges)
COCADIJODED Contact cast application for diabetic joint 2320 2320
F deformity (doctor fee)
COCADIJODEH Contact cast application for diabetic joint 2130 2130
C deformity (hospital charges)
280 DIFOASPR Diabetic foot assessment -
IPOS primary (INPATIENT Doctor +
Hospital charges)
DIFOASPRDF Diabetic foot assessment ( primary 240 240
preventive ) - doctor fee
DIFOASPRHC Diabetic foot assessment (primary) - 540 540
hospital charges
281 DIFOASPR Diabetic foot assessment -
OS primary preventive
(OUTPATIENT Doctor +
Hospital Charges)
DIFOASPRDF Diabetic foot assessment ( primary 240 240
preventive ) - doctor fee
DIFOASPRHC Diabetic foot assessment (primary) - 540 540
hospital charges
282 DIFOASSE Diabetic foot assessment -
OS secondary (OUTPATIENT
Doctor + Hospital Charges )
DIFOASSEDF Diabetic foot assessment (secondary) - 460 460
doctor fee
DIFOASSEHC Diabetic foot assessment (secondary) - 1090 1090
hospital charges
283 DIFODRM Diabetic foot care major
J dressing ( INPATIENT Doctor +
Hospital charges)
DFDRESSMAJ Diabetic foot clinic ( major dressing ) - 850 850
doctor fee
264
DFCMAJHC Diabetic foot clinic ( major dressing ) - 200 200 190
Hospital Charges
284 DIFOMIN Diabetic foot care minor
DROS dressing ( INPATIENT Doctor +
Hospital charges)
DIFMINHC Diabetic foot clinic ( minor dressing ) - 140
bedside procedure charges
DFDRESSMIN Diabetic foot clinic ( minor dressing ) - 490 490
doctor fee
285 DIFOMIP Diabetic foot - minor
OPROS outpatient procedure (Doctor
Fee + Hospital Charges )
DIFOMIPOPRD Diabetic foot - minor outpatient procedure 1090 1090
F (doctor fee)
DIFOMIPOPRH Diabetic foot - minor outpatient procedure 1300 1300 1300
C (hospital charges)
286 DIFOSECO Diabetic foot assessment -
S secondary (INPATIENT Doctor
+ Hospital charges)
DIFOASSEDF Diabetic foot assessment (secondary) - 460 460
doctor fee
DIFOASSEHC Diabetic foot assessment (secondary) - 1090 1090
hospital charges
287 ETIPOS Extensor tenotomy (
INPATIENT Doctor + Hospital
charges)
OUEXTEDF Outpatient extensor tenotomy (doctor fee) 1850 1850
OUEXTEHC Outpatient extensor tenotomy (hospital 1690 1690
charges)
288 FOOPSOS FOOT PRESSURE SCAN
CHARGES)
FOOSCADF Foot scan ( foot pressure analysis ) - Doctor 400 400
fee
FOOSCA Foot scan ( foot pressure analysis ) Hospital 780 780
charges
289 INSHOEPS IN - SHOE PRESSURE SCAN
CHARGES)
INSHOEPCDF In-shoe pressure scan - Doctor fee 620 620
INSHOEPC In-shoe pressure scan - Hospital charges 920 920
290 LSINJOS Liquid silicone heel injection (
INPATIENT Doctor + Hospital
charges)
OULISIINJDF Outpatient liquid silicone heel injection 1850 1850
(doctor fee)
OULISIINJHC Outpatient liquid silicone heel injection 1690 1690
(hospital charges)
291 OUEXTEO Outpatient extensor tenotomy
S (Doctor Fee + Hospital
Charges)
OUEXTEDF Outpatient extensor tenotomy (doctor fee) 1850 1850
OUEXTEHC Outpatient extensor tenotomy (hospital 1690 1690
charges)
292 OULISIINJ Outpatient liquid silicone heel
OS injection (Doctor Fee +
Hospital Charges)
OULISIINJDF Outpatient liquid silicone heel injection 1850 1850
(doctor fee)
OULISIINJHC Outpatient liquid silicone heel injection 1690 1690
(hospital charges)
Diabetology and Endocrinology

265
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
293 ANASDHC AUTONOMIC NEUROPATHY
OS ASSESSMENT SPOT TEST
CHARGES)
ANASTDF Autonomic neuropathy assessment spot test 230
- Doctor fee
ANASTHC Autonomic neuropathy assessment spot test 760 760 380 300 230 380 230
- hospital charges
294 CGMPDH CONTINUOUS GLUCOSE
COS MONITORING - (DOCTOR FEE +
HOSPITAL CHARGES)
CGMSRTDWP Continuous glucose monitoring - real time ( 3680 3680 1840 1470 1100
CGMS-RT ) - doctor fee
CGMSRTAHC Continuous glucose monitoring - real time ( 29360 29360 14680 11740 8810
CGMS-RT ) - hospital charges
Dialysis package charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
295 HEMOFRE5 Online Hemodiafiltration 4000
(Fresenius5008-5)
Doctor procedure charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

296 ADDCOBI Add on package for Audiology & 120000
Speech Therapy Bilateral
297 ADDCUNI Add on package for Audiology & 100000
Speech Therapy Unilateral
298 ABLDS Angiography of B/L Dorsolumbar 69300 69300 34650 27720 20790
Spinal Radicular Arteries - Doctor
Fee
299 ARHEVE AORTIC HEMIARCH REPLACEMENT 70000 70000 35000 28000 21000
300 ACHENT AORTIC ARCHH REPLACEMENT 175000 175000 87500 70000 52500
301 ARRENT AORTIC ROOT REPLACEMENT 227500 227500 113750 91000 68250
302 ARAOHIA AORTIC ROOT, ASCENDING AORTA 367500 367500 183750 147000 110250
AND HEMIARCH REPLACEMENT
303 AOCLX AORTIC VALVE REPAIR COMPLEX 122500 122500 61250 49000 36750
304 AOVSI AORTIC VALVE REPAIR SIMPLE 87500 87500 43750 35000 26250
305 AVRNT AORTIC VALVES REPLACEMENT 70000 70000 35000 28000 21000
306 ASEART ASCENDING AORTAA 122500 122500 61250 49000 36750
REPLACEMENT
307 GEATSDF Ascitic Tab subsequent - Doctor 5520 5520 2760 2210 1660
Fee
308 ABLR ATERIAL BYPASS 105000 105000 52500 42000 31500
LIMA-RIMA/RADIAL
309 ATMAS ATRIAL MAZE PROCEDURE-SINGLE 87500 87500 43750 35000 26250
266
310 SERER ATRIAL SEPTAL DEFECT 35000 35000 17500 14000 10500
REPAIR-DIRECT CLOSURE
311 PREAL ATRIAL SEPTAL DEFECT 52500 52500 26250 21000 15750
REPAIR-PERICARDIAL PATCH
312 RICEAL ATRILA MAZE 140000 140000 70000 56000 42000
PROCEDURE-BIATRIAL
313 AUTISM AUTISM ASSESSMENT 9260 9260 4630 3700 2780
314 BASCD Balloon Angioplasty & Stenting in 207900 207900 103950 83160 62370
Cervical ICA/Vertebral - Doctor Fee
315 BACEDF Balloon Assisted Coil Embolization 231000 231000 115500 92400 69300
of a Direct/Indirect Cavernous
Fistula - Doctor Fee
316 BFNACRF Breast FNAC under Radiological 1580 1580 1580 1580 900 2500
guidance - Radiologist fee
317 BIIR Broken Impacted Implant Removal 55100 55100 27550 22040 16530
318 DIAEXO CARDIAC TUMORR EXCISION 70000 70000 35000 28000 21000
319 CHOCED CHORDAL PROCEDURE 52500 52500 26250 21000 15750
320 CAVRCE COMPLEX AORTIC VALVE 87500 87500 43750 35000 26250
REPLACEMENT
321 CPCIDF Complex Cardiology procedure 10500
charges
322 CNDDF Conduction of normal delivery - 51660 51660 25830 20660 15500
Doctor fee
323 DSC Delayed sternal closure 83340 83340 41670 33340 25000
324 DEBSIDL2 Developmental evaluation using 11020 11020 5510 4410 3310
BSID (<2 years)
325 DEBSIDG2 Developmental evaluation using 14560 14560 7280 5820 4370
BSID (greater than 2 years)
326 DFDRESSMA Diabetic foot clinic ( major dressing 850 850
J ) - doctor fee
327 DFDRESSMI Diabetic foot clinic ( minor dressing 490 490
N ) - doctor fee
328 EDUASS EDUCATIONAL ASSESSMENT 9260 9260 4630 3700 2780
329 ESPFD Embolization of Spinal Pial/dural 231000 231000 115500 92400 69300
Fistula - Doctor Fee
336 EMPR EMERGENCY PROCEDURE 175000 175000 87500 70000 52500
337 ESO Emergency sternal opening 116660 116660 58330 46660 35000
338 EPALNT EPICARDIAL PACING WIRE 175000 175000 87500 70000 52500
IMPLANTATION
339 EPICR EPIGASTRIC HERNIA REPAIR 105000 105000 52500 42000 31500
340 ESMYO EXTENDED SEPTAL MYECTOMY 350000 350000 175000 140000 105000
FOR HOCM
341 EXSTENTCF Extra stent placement 5250
342 FDPIA Flow Divertor Placement for 277200 277200 138600 110880 83160
Intracranial Aneurysm - Doctor Fee
343 FBR Foreign body retrieval 101640 101640 50820 40660 30490
344 GEPOEMDF Gastroenterology Procedures 187420 187420 93710 74970 56230
Poem - Doctor Fee
345 PCD Genetic counseling & 6670
Documentation ( Samples sent
abroad )
346 PRC Genetics report Interpretation & 8000
counseling ( Patients / sample
coming from abroad )
347 PULGPA Guided pleural aspiration 6620 6620 3310 2650 1990
(Diagnostic) Pulmonology Doctor
Fee
348 HSC Hand sewn coil making charges 25410 25410 12710 10160 7620
267
349 DOREDOCF HIGH DOSE CHEMOTHERAPY AND 223740 223740 111870 89500 67120
RESCUE - Doctor Fee
350 IAERTN IABP INSERTION 35000 35000 17500 14000 10500
351 IARVAL IABP REMOVAL 21000 21000 10500 8400 6300
352 IAVDF Intracranial Angioplasty for 138600 138600 69300 55440 41580
Vasaspasm - Doctor Fee
353 IVMEC Intracranial AVM Embolization 277200 277200 138600 110880 83160
(Complex) - Doctor Fee
354 IAELE Intracranial AVM Embolization 231000 231000 115500 92400 69300
using Liquid Embolic material -
Doctor Fee
355 ICPPF Intracranial pressure monitoring 29360 29360 14680 11740 8810
device insertion charges
(Professional fees)
356 ISRDF Intracranial Stenting in Stroke 231000 231000 115500 92400 69300
Revascularization - Doctor Fee
357 IQASS IQ ASSESSMENT 14560 14560 7280 5820 4370
358 ITDF Iron therapy - Doctor fee 1300
359 IMISE ISCHEMIC VENTRICULAR SEPTAL 210000 210000 105000 84000 63000
RUPTURE REPAIR
360 RHSD Joint injection with US guidance - 1800 1800 1800 1800 1800 1500 0
RHS - Subsequent per joint (
Doctors Charges )
361 KTPSS KTP Surcharge - Surgeon Fee 5550
362 LETURE LEAFLET PROCEDURE 52500 52500 26250 21000 15750
363 LTROC LEFT ATRIAL APPENDAGE 35000 35000 17500 14000 10500
OCCLUSION
364 LFTTRO LEFT ATRIAL TROMBUS REMOVAL 28020 28020 14010 11210 8410
365 LEVNE LEFT VENTRICULAR ANEURYSM 210000 210000 105000 84000 63000
REPAIR
366 MECS100 Melanocyte Eidermal Cell 46690
suspension (for covering at max
100 sq. cm)
367 MICS MICS 122500 122500 61250 49000 36750
368 MRAPR MITRAL LEAFLET PRESERVATION 36760 36760 18380 14700 11030
369 MVRP MITRAL VALVEE REPLACEMENT 73500 73500 36750 29400 22050
370 MTP2TRIM MTP in 2nd trimester in Labour 51760 51760 25880 20700 15530
Room - Doctor fee
371 NPPNCDF Neonatologist / paediatrician 7080 7080 3540 2830 2120
post-natal charges following
Caesarean delivery - Doctor fee
372 NPPNNDF Neonatologist / paediatrician 5080 5080 2540 2030 1520
post-natal charges following
normal delivery - Doctor fee
373 NNPNRESCS Neonatologist / paediatrician 5080 5080 2540 2030 1520
DF resuscitation charges following
caesarian delivery - Doctor fee
374 NNPNRESCH Neonatologist / paediatrician 4200 4200 2100 1680 1260
ADF resuscitation charges following
normal delivery - Doctor fee
375 NPCRCCDF Neonatology / paediatric 12160 12160 6080 4860 3650
consultant attendance +
resuscitation charges of newborn
during Caesarean delivery - Doctor
fee
376 NPCRNDDF Neonatology / paediatric 9340 9340 4670 3740 2800
consultant attendance +
resuscitation charges of newborn
during normal delivery - Doctor fee
268
377 NOSOP Nitrous Oxide Sedation for 3550 2130
OUTPATIENT
378 OTRPIP Occupational therapy for 1220 1220 610 490 370
paediatric / rheumatology patients
379 OPPCSSC Off Pump PCS surgical charges 96800 96800 48400 38720 29040
380 OMLST OMENTOPLASTY 175000 175000 87500 70000 52500
381 IAMMV Open excision of invasive Anterior 273000 273000 136500 109200 81900
Mediastinal mass (including
Thymoma) Vascular repair - Add
On
382 IAMML Open excision of invasive Anterior 273000 273000 136500 109200 81900
Thymoma) With lung resection -
Add On
383 IAMMLV Open excision of invasive Anterior 294000 294000 147000 117600 88200
Thymoma) With lung resection and
vascular repair - Add On
384 IAMM Open excision of invasive Anterior 247800 247800 123900 99120 74340
Thymoma) with pericardiectomy -
Add On
385 NIAMM Open excision of non - invasive 226800 226800 113400 90720 68040
Anterior Mediastinal mass
(including Thymoma) - Add On
386 THYOAD Open Thymectomy - Add on 226800 226800 113400 90720 68040
387 OAFSVLDF Outpatient Arterial flow studies in 530 530 530
vascular lab - Doctor fee
388 OVFSVLDF Outpatient venous flow studies in 890
vascular lab - Doctor fee
389 ONVEEG12D Overnight Video EEG for 12 hours - 2420 1450
Doctor Fee
390 OTHDF Ozone Therapy (Doctor fee) 4610
391 PAWVA PACING WIRE REMOVAL 16660 16660 8330 6660 5000
392 PCSBEDSC PCS - Bedside Pleural Sclerosis 5000 5000 2500 2500 1500
393 CHW PCS Chest Wall repair 152460 152460 76230 60980 45740
394 PCSVA2 PCS Procedure Access in Neonate 100000 100000 50000 40000 30000
and Infant
395 PCSVA4 PCS Procedure Complex Surgical 300000 300000 150000 120000 90000
396 PCSVA3 PCS Procedure Pericariocentesis 66660 66660 33330 26660 20000
397 PCSVA1 PCS Procedure Vascular Access 66660 66660 33330 26660 20000
398 GEFNADF Percutaneous USG guided FNA - 6620 6620 3310 2650 1990
Doctor Fee
399 PEDFPSDF Portable Echocardiography ( 1730 1730
Paediatric Cardiac Sciences ) -
Doctor Fees ( If Done Outside
Working Hrs )
400 PEDF Portable echocardiography in 1730
emergency hours - Doctor fees
401 PCDBG Posterior Cervical Discectomy with 163800 163800 81900 65520 49140
Instrumentation / Bone Grafting
402 NEUDBS Programming of DBS (in OT) 36840 36840 18420 14740 11050
403 NEUDBSW Programming of DBS (in Ward) 18420 18420 9210 7370 5530
404 PUMBR PULMONARY 262500 262500 131250 105000 78750
THROMBOENDARTERECTOMY
BOTH SIDE
405 PTHROT PULMONARY 175000 175000 87500 70000 52500
THROMBOENDARTERECTOMY ONE
SIDE
269
406 RASCUINTRF Radiological guidance charges for 500 500 500 500 500 500 500
Ascites / Effusion tapping /
Drainage ( interventional) -
Radiologist fee
407 RDFNACINTR Radiological guidance charges for 500 500 500 500 500 500
F FNAC / Biopsy ( interventional) -
Radiologist Fee
408 RSMS Redo sternotomy / Mini 200000 200000 100000 80000 60000
sternotomy
409 REERY REDO SURGERY 175000 175000 87500 70000 52500
410 REVITEMB Re-Vitrification - Embryologist fee 2760
411 RATYMI RING ANNULOPLASTY-MITRAL 70000 70000 35000 28000 21000
412 SECARDF Screening Echo Cardiology - Doctor 670
Fee
413 SVCAD Six Vessel Cerabral Angiogram - 57760 57760 28880 23100 17330
Doctor fee
414 SACEI Stent Assisted Coil Embolization of 231000 231000 115500 92400 69300
Intracranial ICA Aneurysm - Doctor
Fee
415 STEWL STERNAL WIRE REMOVAL 87500 87500 43750 35000 26250
416 SBEG Suction Blister Epidermal Grafting 33350
(for covering at max 60 sq. cm.)
417 TIVSOPD Total Intra Venous Sedation ( TIVS ) 2670 2670
- MRI/CT
418 TIVSOP Total Intra Venous Sedation ( TIVS ) 3730 2240
- OUTPATIENT
419 TRIPVRER Tricuspid Valve Repair - Add on 70000 70000 35000 28000 21000
420 USEMGHRSD Ultrasound during emergency 3800 3800 1900 1520 1140 1900 1140
F hours (done in U/S room) - doctor
fee
421 USAVFDF Ultrasound guided venous 600
mapping for I/J catheter insertion
and A.V Fistula creation - Doctor
Fee
422 VCCC Valved Conduit Construction 166660 166660 83330 66660 50000
Charges
423 VCAU Vertebral Cement Augmentation 68400 68400 34200 27300 20510
424 ENGDF Videonystagmography (VNG) 4970 4970 4140 3310 2480 3310 0
(Doctor Fee)
425 OWCSTDF Wound care therapy charges FOR 610 610 610
OUTPATIENTS ( Intermittent
pneumatic limb compression ) -
Doctor fee
426 WRETU WOUND RESUTURE 35000 35000 17500 14000 10500
427 YSBAD Y-Stenting in a Basilar Top 277200 277200 138600 110880 83160
Aneurysm - Doctor Fee
Doctor procedure charges (bronchoscopy)

All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

428 UFNACDF Breasr FNAC under ultrasound 1580 950
guidance - Consultant Fee
429 BRGINJDF Bronchoscopic glue injection - 24000 24000 12000 9600 7200
Doctor Fee
430 BRAPCDF Bronchoscopic tumor debulking ( 33080 33080 16540 13230 9920
Cautery / APC ) - Doctor Fee
270
Doctor procedure charges (colonoscopy)
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
431 IFSTKD Intrapleural Fibronolysis with STK - 8680 8680 4340 3470 2600
Doctor Fee
432 MTHD Medical thoracoscopy Diagnostic - 39140 39140 19570 15660 11740
Doctor Fee
433 MADHED Medical thoracoscopy with 48520 48520 24260 19410 14560
Adhesiolysis -Doctor Fee
434 PADIADF Pleural aspiration diagnostic - 5300 5300 2650 2120 1590
Doctor Fee
Gastroenterology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
468 ATDOS Ascitic Tap Diagnostic (Doctor
ATDHC Ascitic Tap Diagnostic - Additional hospital 2100 2100 1050 840 630
charges
ATDDF Ascitic Tap Diagnostic - Doctor Fee 5260 5260 2630 2100 1580
ATDPACS Ascitic Tap Diagnostic - For PACS - NOT FOR
BILLING PURPOSE
469 BATOS Breath Analyser Test
BATDF Breath Analyser Test - Doctor fee 12600 12600 6300 5040 3780
BATPACS Breath Analyser Test - For PACS - NOT FOR
BILLING PURPOSE
BATHC Breath Analyser Test - Hospital charges 5040 5040 2520 2020 1510
BATCH Breath Anlyser Test - Consumable charges 2420 2420 1210 1210 1210
470 BPWLOS BALLOON PLACEMENT FOR
WEIGHT FOR WEIGHT LOSS -
Charges)
BPWLHC BALLOON PLACEMENT FOR WEIGHT FOR 8400 6720 5040
WEIGHT LOSS - Additional Hospital Charges
BPWLDC BALLOON PLACEMENT FOR WEIGHT FOR 21000 16800 12600
WEIGHT LOSS - Doctor Fee
471 BRCOS BALLOON REPLACEMENT (BRT)
CHARGES - (Doctor fee +
Hospital Charges)
BRCHC BALLON REPLACEMENT (BRT) CHARGES - 1260 1010 760
Additional Hospital Charges
BRCDC BALLON REPLACEMENT (BRT) CHARGES - 3150 2520 1890
Doctor Fee
FLCX FLUROSCOPY CHARGES (X-RAY) 1050 1050 1050
472 BRTDSTO Bronchoscoic tumor debulking
S + stenting - (Doctor Fee +
Hospital Charges)
BRTDSTDF Bronchoscoic tumor debulking + stenting - 52500 52500 26250 21000 15750
Doctor Fee
BRTDSTPACS Bronchoscopic tumor debulking + stenting -
BRTDSTHC Bronchoscopic tumor debulking + stenting - 21000 21000 10500 8400 6300
Hospital Charges
271
473 BRWLLOS Bronchoscopic whole lung
lavage - (Doctor Fee + Hospital
Charges)
BRWLLDF Bronchoscopic whole lung lavage - Doctor 52500 52500 26250 21000 15750
Fee
BRWLLPACS Bronchoscopic whole lung lavage - For PACS
- NOT FOR BILLING PURPOSE
BRWLLHC Bronchoscopic whole lung lavage - Hospital 21000 21000 10500 8400 6300
Charges
474 CEDHCOS CAPSULE ENDOSCOPY
CHARGES)
CEHC Capsule endoscopy - Additional hospital 12600 12600 6300 5040 3780
charges
CEDF Capsule endoscopy - Doctor fee 31500 31500 15750 12600 9450
CEPACS Capsule endoscopy - For PACS - NOT FOR
BILLING PURPOSE
475 CLLSDHCO COLONOSCOPY ( LIMITED TO
S LEFT SIDE ) - (DOCTOR FEE +
HOSPITAL CHARGES)
CLSHC Colonoscopy ( limited to left side ) - 4200 4200 2100 1680 1260
CLSDF Colonoscopy ( limited to left side ) - Doctor 10500 10500 5250 4200 3150
fee
CLSDPACS Colonoscopy ( limited to left side ) - For PACS
476 COLOS Colonoscopy done outside
endoscopy suite (Doctor fee +
Hospital Charges)
COLOSHC Colonoscopy done outside endoscopy suite - 7320 7320 3660 2930 2200
COLOS Colonoscopy done outside endoscopy suite - 18300 18300 9150 7320 5490
doctor fee
COLOSPACS Colonoscopy done outside endoscopy suite -
477 CTSTOS Colonic Transit Study - (Doctor
CTSTH Colonic Transit Study - Additional hospital 1000 1000 1000 1000 1000
charges
CTSTD Colonic Transit Study - Doctor Fee 2500 2500 2500 2500 2500
CTSTPACS Colonic Transit Study - For PACS - NOT FOR
BILLING PURPOSE
478 CWDFHC COLONOSCOPY ( WHOLE ) -
CHARGES)
CWHC Colonoscopy ( whole ) - Additional hospital 5880 5880 2940 2350 1760
charges
CWDF Colonoscopy ( whole ) - Doctor fee 14700 14700 7350 5880 4410
CWDPACS Colonoscopy ( whole ) - For PACS - NOT FOR
BILLING PURPOSE
479 DBEBOS Double Balloon Enteroscopy
Both side (Doctor fee +
Hospital charges)
DBEBSHC Double Balloon Enteroscopy Both side - 18480 18480 9240 7390 5540
DBEBSDF Double Balloon Enteroscopy Both side - 46200 46200 23100 18480 13860
Doctor Fee
DBEBSPACS Double Balloon Enteroscopy Both side - For
480 DBESSOS Double Balloon Enteroscopy
Single side (Doctor fee +
Hospital charges)
DBESSHC Double Balloon Enteroscopy Single side - 15120 15120 7560 6050 4540
272
DBESSDF Double Balloon Enteroscopy Single side - 37800 37800 18900 15120 11340
Doctor Fee
DBESSPACS Double Balloon Enteroscopy Single side - For
481 EBDHCHO ENDOSCOPIC BANDING ( FIRST
S SESSION ) (DOCTOR FEE +
HOSPITAL CHARGES)
EBFSHC Endoscopic banding ( first session ) - 8400 8400 4200 3360 2520
EBFSDF Endoscopic banding ( first session ) - Doctor 21000 21000 10500 8400 6300
fee
EBFSPACS Endoscopic banding ( first session ) - For
482 EBSDCHO ENDOSCOPIC BILIARY
S STENTING (DOCTOR FEE +
HOSPITAL CHARGES)
EBSHC Endoscopic biliary stenting - Additional 16800 16800 8400 6720 5040
hospital charges
EBSDF Endoscopic biliary stenting - Doctor fee 42000 42000 21000 16800 12600
EBSPACS Endoscopic biliary stenting - For PACS - NOT
FOR BILLING PURPOSE
483 EBSDHCH ENDOSCOPIC BANDING (
OS SUBSEQUENT SESSION )
CHARGES)
EBSSHC Endoscopic banding ( subsequent session ) - 5880 5880 2940 2350 1760
EBSSDF Endoscopic banding ( subsequent session ) - 14700 14700 7350 5880 4410
Doctor fee
EBSSPACS Endoscopic banding ( subsequent session ) -
484 EBUSTBN EBUS and TBNA ( For Northern
A Railway )
FNANEED $$ FNA Needle 5000
FLUOREAFBAS Direct Fluorescent staining for AFB ( 630
PN Aspirate ) Northern Railway
ENDOBROULN Endobronchial Ultrasound ( Northern 6320
DC Railway ) - Doctor Fee
ENDOBROULN Endobronchial Ultrasound ( Northern 2740
HC Railway ) - Hospital charges
MCEUSN FNAC for Endoscopic ultrasound specimen ( 1520
EUSFNAC ) Northern Railway - Cytology
RAPIDWITHO Rapid AFB culture ( BacT/Alert 3D ) with 1480
UTSENN accuprobe identification without sensitivity
Northern Railway
485 EDNUDFH ENDOSCOPIC ULTRASOUND
CHOS (DOCTOR FEE + HOSPITAL
CHARGES)
EUHC Endoscopic ultrasound - Additional hospital 5040 5040 2520 2020 1510 2520 1510
charges
EUDF Endoscopic ultrasound - Doctor fee 12600 12600 6300 5040 3780 6300 3780
EUHCPACS Endoscopic ultrasound - For PACS - NOT FOR
BILLING PURPOSE
486 EDSDSSD ENDOSCOPIC OESOPHAGEAL
HCHOS STRICTURE DILATATION (
SUBSEQUENT SESSION )
CHARGES)
EOSDSSHC Endoscopic oesophageal stricture dilatation 5040 5040 2520 2020 1510
( subsequent session ) - Additional hospital
charges
EOSDSSDF Endoscopic oesophageal stricture dilatation 12600 12600 6300 5040 3780
( subsequent session ) - Doctor fee
EOSDSSPACS Endoscopic oesophageal stricture dilatation
( subsequent session ) - For PACS - NOT FOR
BILLING PURPOSE
273
487 EEPDFDC ENDOSCOPIC
HOS ENDO-PROSTHESIS
PLACEMENT (DOCTOR FEE +
HOSPITAL CHARGES)
EEPPHC Endoscopic endo-prosthesis placement - 12600 12600 6300 5040 3780
EEPPDF Endoscopic endo-prosthesis placement - 31500 31500 15750 12600 9450
Doctor fee
EEPPACS Endoscopic endo-prosthesis placement - For
488 EFBRDHC ENDOSCOPIC FOREIGN BODY
HOS REMOVAL (DOCTOR FEE +
HOSPITAL CHARGES)
EFBRHC Endoscopic foreign body removal - 10080 10080 5040 4030 3020
EFBRDF Endoscopic foreign body removal - Doctor 25200 25200 12600 10080 7560
fee
EFBRPACS Endoscopic foreign body removal - For PACS
489 EMLDFHC ENDOSCOPIC MECHANICAL
HOS LITHOTROPSY (DOCTOR FEE +
HOSPITAL CHARGES)
EMLHC Endoscopic mechanical lithotropsy - 16800 16800 8400 6720 5040
EMLDF Endoscopic mechanical lithotropsy - Doctor 42000 42000 21000 16800 12600
fee
EMLPACS Endoscopic mechanical lithotropsy - For
490 EMROS Endoscopy Mucosal Resection
EMRHC Endoscopy Mucosal Resection - Additional 21000 21000 10500 8400 6300
hospital charges
EMRDF Endoscopy Mucosal Resection - Doctor Fee 52500 52500 26250 21000 15750
EMRHCPACS Endoscopy Mucosal Resection - For PACS -
491 ENDOBAD Endoscopic banding done
OS outside endoscopy suite
ENDOBAN Endoscopic banding done outside endoscopy 10170 10170 5080 4070 3050
suite - Additional hospital charges
ENDBAOS Endoscopic banding done outside endoscopy 25420 25420 12710 10170 7630
suite - doctor fee
ENDBAPACS Endoscopic banding done outside endoscopy
suite - For PACS - NOT FOR BILLING
PURPOSE
492 ENDOSCL Endoscopic sclerotherapy done
OS outside endoscopy suite
ENDSCLHC Endoscopic sclerotherapy done outside 10170 10170 5080 4070 3050
endoscopy suite - Additional hospital
charges
ENDSCLOS Endoscopic sclerotherapy done outside 25420 25420 12710 10170 7630
endoscopy suite - doctor fee
ENDSCLOSPAC Endoscopic sclerotherapy done outside
S endoscopy suite - For PACS - NOT FOR
BILLING PURPOSE
493 ENTDHCH ENTEROSCOPY (DOCTOR FEE +
OS HOSPITAL CHARGES)
EHC Enteroscopy - Additional hospital charges 8400 8400 4200 3360 2520
EDF Enteroscopy - Doctor fee 21000 21000 10500 8400 6300
EHCPACS Enteroscopy - For PACS - NOT FOR BILLING
PURPOSE
494 ENTEROS Enteroscopy done outside
Hospital Charges)
274
ENTEROHC Enteroscopy done outside endoscopy suite - 11860 11860 5930 4740 3560
ENTEROS Enteroscopy done outside endoscopy suite - 29640 29640 14820 11860 8890
doctor fee
ENTEROSPACS Enteroscopy done outside endoscopy suite -
495 EODADHC ENDOSCOPIC OESOPHAGEAL
HOS DILATATION FOR ACHALASIA
CHARGES)
EODAHC Endoscopic oesophageal dilatation for 10080 10080 5040 4030 3020
achalasia - Additional hospital charges
EODADF Endoscopic oesophageal dilatation for 25200 25200 12600 10080 7560
achalasia - Doctor fee
EODAPACS Endoscopic oesophageal dilatation for
achalasia - For PACS - NOT FOR BILLING
PURPOSE
496 EOSDFSD ENDOSCOPIC OESOPHAGEAL
HCHOS STRICTURE DILATATION ( FIRST
SESSION ) (DOCTOR FEE +
HOSPITAL CHARGES)
EOSDFSHC Endoscopic oesophageal stricture dilatation 8400 8400 4200 3360 2520
( first session ) - Additional hospital charges
EOSDFSDF Endoscopic oesophageal stricture dilatation 21000 21000 10500 8400 6300
( first session ) - Doctor fee
EOSDFSPACS Endoscopic oesophageal stricture dilatation
( first session ) - For PACS - NOT FOR BILLING
PURPOSE
497 EPDHCHO ENDOSCOPIC POLYPECTOMY
S (DOCTOR FEE + HOSPITAL
CHARGES)
EPHC Endoscopic polypectomy - Additional 16800 16800 8400 6720 5040
hospital charges
EPDF Endoscopic polypectomy - Doctor fee 42000 42000 21000 16800 12600
EPHCPACS Endoscopic polypectomy - For PACS - NOT
FOR BILLING PURPOSE
498 EPEPTDHC ENDOSCOPIC PAPILLOTOMY (
HOS EPT ) (DOCTOR FEE + HOSPITAL
CHARGES)
EPTHC Endoscopic papillotomy ( EPT ) - Additional 15120 15120 7560 6050 4540
hospital charges
EPTDF Endoscopic papillotomy ( EPT ) - Doctor fee 37800 37800 18900 15120 11340
EPTPACS Endoscopic papillotomy ( EPT ) - For PACS -
499 EPRTDHC ENDOSCOPIC PLACEMENT OF
HOS RYLES TUBE (DOCTOR FEE +
HOSPITAL CHARGES)
EPRTHC Endoscopic placement of Ryles tube - 4910 4910 2460 1960 1470
EPRTDF Endoscopic placement of Ryles tube - Doctor 12280 12280 6140 4910 3680
fee
500 EPSDFHC ENDOSCOPIC PANCREATIC
HOS STENTING (DOCTOR FEE +
HOSPITAL CHARGES)
EPSHC Endoscopic pancreatic stenting - Additional 16800 16800 8400 6720 5040
hospital charges
EPSDF Endoscopic pancreatic stenting - Doctor fee 42000 42000 21000 16800 12600
501 ERCHDFH ERCP (DOCTOR FEE + HOSPITAL
COS CHARGES)
ERCPHC ERCP - Additional hospital charges 6300 6300 3150 2520 1890
ERCPDF ERCP - Doctor fee 15760 15760 7880 6300 4730
ERCPHCPACS ERCP - For PACS - NOT FOR BILLING
PURPOSE
275
502 ERCPCOS ERCP Cystogastromy (Doctor
ERCPCHC ERCP Cystogastromy - Additional hospital 19320 19320 9660 7730 5800
charges
ERCPCDF ERCP Cystogastromy - Doctor Fee 48300 48300 24150 19320 14490
ERCPCHCPACS ERCP Cystogastromy - For PACS - NOT FOR
BILLING PURPOSE
503 ERCPOS ERCP done outside endoscopy
suite (Doctor fee + Hospital
Charges)
ERCPOSHC ERCP done outside endoscopy suite - 8130 8130 4060 3250 2440
ERCPOS ERCP done outside endoscopy suite - doctor 20320 20320 10160 8130 6100
fee
ERCPOSHCPAC ERCP done outside endoscopy suite - For
S PACS - NOT FOR BILLING PURPOSE
504 ERMDHC OESOPHAGEAL AND RECTAL
OS MANOMETRY (DOCTOR FEE +
HOSPITAL CHARGES)
ERMHC Esophageal and Rectal manometery - 5880 5880 2940 2350 1760
ERMDF Esophageal and Rectal manometery - 14700 14700 7350 5880 4410
Doctor fees
ERMDPACS Esophageal and Rectal manometery - For
505 ESDOS Endoscopy submucosal
dissection (Doctor fee +
Hospital charges)
CCGRAP $$ Co - Grasper 2515
INJTORM $$ Injector Force Max 25G 1442
ITNAM $$ IT Nano 10791
ILYCAP $$ Olympus Cap 1173
SPRACAT $$ Spray Cathetar 1550
ESDHC Endoscopy submucosal dissection - 71400 71400 35700 28560 21420
ANAANAF Endoscopy submucosal dissection - 53550 53550 26780 21420 16070
Anaesthetists Fee
ENDOANAC Endoscopy submucosal dissection - 26780 26780 13390 10710 8030
Anasthesia Consumable
ESDDF Endoscopy submucosal dissection - Doctor 178500 178500 89250 71400 53550
Fee
ESDHCPACS Endoscopy submucosal dissection - For PACS
506 ESFSDHCH ENDOSCOPIC SCLEROTHERAPY
CHARGES)
ESFSHC Endoscopic sclerotherapy - Additional 8150 8150 4080 3260 2440
hospital charges
ESAPC Endoscopic sclerotherapy - APC probe 4000 4000 4000 4000
charges
ESFSDF Endoscopic sclerotherapy - Doctor fee 20380 20380 10190 8150 6110
ESFSDFPACS Endoscopic sclerotherapy - For PACS - NOT
FOR BILLING PURPOSE
507 EUSCOS EUS Coiling - (Doctor Fee +
Hospital Charges)
EUSCPACS EUS Coiling - For PACS - NOT FOR BILLING
PURPOSE
EUSCH EUS Coiling - Additional hospital charges 12600 12600 6300 5040 3780
EUSCD EUS Coiling - Doctor fee 31500 31500 15750 12600 9450
508 EUSGCOS Endoscopic ( EUS ) guided
cystogastromy (Doctor fee +
Hospital charges)
EUSGCHC Endoscopic ( EUS ) guided cystogastromy - 18480 18480 9240 7390 5540
276
EUSGCDF Endoscopic ( EUS ) guided cystogastromy - 46200 46200 23100 18480 13860
Doctor Fee
EUSGPACS Endoscopic ( EUS ) guided cystogastromy -
509 EUSGOS Endoscopic ultrasound ( EUS )
guided celiac block (Doctor fee
+ Hospital charges)
EUSGHC Endoscopic ultrasound ( EUS ) guided celiac 12600 12600 6300 5040 3780
block - Additional hospital charges
EUSGDF Endoscopic ultrasound ( EUS ) guided celiac 31500 31500 15750 12600 9450
block - Doctor Fee
EUSGHCPACS Endoscopic ultrasound ( EUS ) guided celiac
block - For PACS - NOT FOR BILLING
PURPOSE
510 EUTOS Endoultrasound therapeutic
EUTHC Endoultrasound therapeutic - Additional 8400 8400 4200 3360 2520
hospital charges
EUTDF Endoultrasound therapeutic - Doctor Fee 21000 21000 10500 8400 6300
EUTHCPACS Endoultrasound therapeutic - For PACS -
511 FIBSOS FIBROSCAN
FIBSHC Fibroscan - Collection charges (Hospital) 2520 2520 1260 1010 760 1260
FIBSDF Fibroscan - Doctor fee 6300 6300 3150 2520 1890 3150
FIBPAC Fibroscan - For PACS - NOT FOR BILLING
PURPOSE
512 FLXSIGOS Flexible sigmoidoscopy done
outside endoscopy suite
FLEXSIGHC Flexible sigmoidoscopy done outside 3350 3350 1680 1340 1000
endoscopy suite - Additional hospital
charges
FSIGOS Flexible sigmoidoscopy done outside 8380 8380 4190 3350 2510
endoscopy suite - doctor fee
FLEXSIGHCPA Flexible sigmoidoscopy done outside
CS endoscopy suite - For PACS - NOT FOR
BILLING PURPOSE
513 FSDFHCH FLEXIBLE SIGMOIDOSCOPY
CHARGES)
FSHC Flexible sigmoidoscopy - Additional hospital 2780 2780 1390 1110 830
charges
FSDF Flexible sigmoidoscopy - Doctor fee 6940 6940 3470 2780 2080
FSDFHPACS Flexible sigmoidoscopy - For PACS - NOT
FOR BILLING PURPOSE
514 GASBIO4I Gastroenterology Procedures
NOS Biofeedback 4 Session -
Charges)
GASBIO4INHC Gastroenterology Procedures Biofeedback 4 4000
Session - Additional Hospital Charges
GASBIO4INDF Gastroenterology Procedures Biofeedback 4 10000
Session - Doctor Fee
515 GASBIOSI Gastroenterology Procedures
NOS Biofeedback - Single Session
Charges)
GASBIOSINHC Gastroenterology Procedures Biofeedback - 1000
GASBIOSINDF Gastroenterology Procedures Biofeedback - 2500
Doctor Fee
277
516 GASTBRO Gastroenterology Procedures
S Breath Test for H-Pylori
CHARGES)
BREATHIND $$Disposables (Breath Test Indicator) 750
GASTBRHC Gastroenterology Procedures Breath Test 1000
for H-Pylori - Additional Hospital Charges
GASTBRDF Gastroenterology Procedures Breath Test 2500
for H-Pylori - Doctor Fee
517 GEATSOS Ascitic Tab subsequent
CHARGES)
GEATSHC Ascitic Tab subsequent - Additional Hospital 2210 2210 1100 880 660
Charges
GEATSDF Ascitic Tab subsequent - Doctor Fee 5520 5520 2760 2210 1660
518 GEFNAOS Percutaneous USG guided FNA
CHARGES)
GEFNAHC Percutaneous USG guided FNA - Additional 2650 2650 1320 1060 800
Hospital Charges
GEFNADF Percutaneous USG guided FNA - Doctor Fee 6620 6620 3310 2650 1990
519 GEPOEMA Gastroenterology Procedures
OS Poem (DOCTOR FEE +
HOSPITAL CHARGES)
CCGRAP $$ Co - Grasper 2515
FUJICAP $$ Fujinon Cap 1167
INJTORM $$ Injector Force Max 25G 1442
LIPSCAPEM $$ Olympus Cap Poem 587
SPRACAT $$ Spray Cathetar 1550
KNITT $$ TT Knife J 7534
GEPOEMAHC Gastroenterology Procedures Poem - 74970 74970 37480 29990 22490
PROANACHAC Gastroenterology Procedures Poem - 28110 28110 14060 11250 8430
Anasthesia Consumable
GASPROPOEM Gastroenterology Procedures Poem - 56230 56230 28110 22490 16870
Anasthetist Fee
GEPOEMDF Gastroenterology Procedures Poem - Doctor 187420 187420 93710 74970 56230
Fee
520 GSOS GASTROGRAFFIN STUDY -
Charges)
GSHC GASTROGRAFFIN STUDY - Additional 840 670 500
Hospital Charges
GSDC GASTROGRAFFIN STUDY - Doctor Fee 2100 1680 1260
521 HVPGOS HVPG
HVPGCH HVPG - Consumable charges 4250 4250 4250 4250 4250
HVPGDF HVPG - Doctor Fee 14700 14700 7350 5880 4410
HVPGFC HVPG - Fluroscopy charges 4900 4900 2450 1960 1470
HVPGHC HVPG - Hospital charges 1960 1960 980 780 590
HVPGCHPACS HVPGCH - For PACS - NOT FOR BILLING
PURPOSE
522 LACTTOS Gastroenterology Procedures
Lactose Tolerance Test -
Charges)
LACTTDFHC Gastroenterology Procedures Lactose 600
Tolerance Test - Additional Hospital Charges
LACTTDF Gastroenterology Procedures Lactose 1500
Tolerance Test - Doctor Fee
278
523 LBHCHEO LIVER BIOPSY - DONE IN
S ENDOSCOPY (DOCTOR FEE +
HOSPITAL CHARGES)
LBDF Liver biopsy - Doctor fees 14700 14700 7350 5880 4410
LBDPACS Liver biopsy - For PACS - NOT FOR BILLING
PURPOSE
LBEHC Liver biopsy (done in endoscopy) - Additional 5880 5880 2940 2350 1760
hospital charges
524 MAPSSOS Microlith analysis of
pre-supplied samples (Doctor
fee + Hospital Charges)
MAPSSHC Microlith analysis of pre-supplied samples - 950 950 480 380 280
MAPSSDF Microlith analysis of pre-supplied samples - 2380 2380 1190 950 710
Doctor Fee
MAPSSHCPAC Microlith analysis of pre-supplied samples -
S For PACS - NOT FOR BILLING PURPOSE
525 NASJEJFL NASO-JEJUNAL TUBE
UOS INSERTION - FLUROSCOPIC
CHARGES)
NASJEJTUNFLS Naso-jejunal tube insertion ( Fluroscopic ) - 12600 12600 6300 5040 3780
DOC doctor fee
NASJEJTUNFLS Naso-jejunal tune insertion ( Fluroscopic) - 5040 5040 2520 2020 1510
HOS Hospital service charges
526 NASJEJTU NASO-JEJUNAL TUBE
BINSOS INSERTION (DOCTOR FEE +
HOSPITAL SERVICE CHARGES)
NASJEJTUNINS Naso-jejunal tube insertion ( endoscopic ) - 12600 12600 6300 5040 3780
DOC doctor fee
NASJEPACS Naso-jejunal tune insertion ( endoscopic ) -
NASJEJTUNINS Naso-jejunal tune insertion ( endoscopic )- 5040 5040 2520 2020 1510
HOS Hospital service charges
527 NBDDHCH NASO-BILIARY DRAINANGE (
OS NBD ) (DOCTOR FEE +
HOSPITAL CHARGES)
NBDHC Naso-biliary drainange ( NBD ) - Additional 14700 14700 7350 5880 4410
hospital charges
NBDDF Naso-biliary drainange ( NBD ) - Doctor fee 36760 36760 18380 14700 11030
NBDHCPACS Naso-biliary drainange ( NBD ) - For PACS -
528 NFTOS NASOJEJUNAL FEEDING TUBE
REPOSITIONING CHARGES -
Charges)
NFTHC NASOJEJUNAL FEEDING TUBE 1260 1010 760
REPOSITIONING CHARGES - Additional
Hospital Charges
NFTDC NASOJEJUNAL FEEDING TUBE 3150 2520 1890
REPOSITIONING CHARGES - Doctor Fee
529 OPHDHCH OESOPHAGEAL PH
OS MONITORING (DOCTOR FEE +
HOSPITAL CHARGES)
OPMHC Oesophageal pH monitoring - Additional 6720 6720 3360 2690 2020
hospital charges
OPMDF Oesophageal pH monitoring - Doctor fee 16800 16800 8400 6720 5040
OPMHCPACS Oesophageal pH monitoring - For PACS -
530 PBROS PEG/BRT REMOVAL CHARGES -
Charges)
279
PBRHC PEG/BRT REMOVAL CHARGES - Additional 420 340 250
Hospital Charges
PBRDC PEG/BRT REMOVAL CHARGES - Doctor Feee 1050 840 630
531 PEGDHCH PERCUTANEOUS ENDOSCOPIC
OS GASTROSTOMY ( PEG )
CHARGES)
PEGHC Percutaneous endoscopic gastrostomy ( PEG 11760 11760 5880 4700 3530
PEGDF Percutaneous endoscopic gastrostomy ( PEG 29400 29400 14700 11760 8820
) - Doctor fee
PEGHCPACS Percutaneous endoscopic gastrostomy ( PEG
) - For PACS - NOT FOR BILLING PURPOSE
532 SBOWTRA Small bowel transplant
SUROS recipient operation (NORMAL
RISK) (Package charges +
Gastroenterologist fee)
SBTSAGAS Small bowel transplant surgery (Normal / 66000
Early)- amount given to gastroenterology
from within the package
SBTSPCN Small bowel transplant surgery (Normal)- 2365000
533 SBTSPCEO Small bowel transplant
S recipient operation (EARLY
DISCHARGE) (Package charges
+ Gastroenterologist fee)
SBTSPCE Small bowel transplant surgery (Early 2200000
Discharge)- recipient package charges
SBTSAGAS Small bowel transplant surgery (Normal / 66000
Early)- amount given to gastroenterology
from within the package
534 SPGCBOS Spy Glass
Cholangioscopy+Consumables
(Optical Fiber-Spy Scope) -
(Doctor Fee+ Hospital Charges)
- Spybite Biopsy
COFSPY Consumables ( Optical fiber + Spyscope ) 18000
charges
SBBIO Spy bite biopsy charges 6300
SPGCH Spy Glass Cholangioscopy - Additional 13440 13440 6720 5380 4030
hospital charges
SPGCD Spy Glass Cholangioscopy - Doctor Fee 33600 33600 16800 13440 10080
SGXR X-Ray ( Spy Glass ) 4200
535 SPGCLOS Spy Glass
Cholangioscopy+Consumables
(Optical Fiber-Spy Scope) -
(Doctor Fee+Hospital Charges)
- Laser Lithotripsy
COFSPY Consumables ( Optical fiber + Spyscope ) 18000
charges
LASLI Laser Lithotripsy 12600
SPGCH Spy Glass Cholangioscopy - Additional 13440 13440 6720 5380 4030
hospital charges
SPGCD Spy Glass Cholangioscopy - Doctor Fee 33600 33600 16800 13440 10080
SGXR X-Ray ( Spy Glass ) 4200
536 STPDHCH SENGSTAKEN TUBE
OS PLACEMENT (DOCTOR FEE +
HOSPITAL CHARGES)
DTPHC Sengstaken tube placement. - Additional 5880 5880 2940 2350 1760
hospital charges
STPDF Sengstaken tube placement. - Doctor fee 14700 14700 7350 5880 4410
280
537 TAALVHC Ascites tapping / aspiration
ENDOS done in ENDOSCOPY (
therapeutic ) - large volume
paracentesis (doctor fee +
hospital charges)
TAALVDF Therapeutic ascites aspiration ( large 6620 6620 3310 2650 1990
TAALVHCEND Therapeutic ascites aspiration ( large 2400 2400 1200 960
volume paracentesis ) done in ENDOSCOPY
room - Additional hospital charges
538 TJLBEOS Transjuglar liver biopsy (done
in endoscopy) (Doctor fee +
Hospital Charges)
TJLBE Transjuglar liver biopsy (done in endoscopy) 8400 8400 4200 3360 2520
- Additional hospital charges
TJLBEDF Transjuglar liver biopsy (done in endoscopy) 21000 21000 10500 8400 6300
- Doctor Fee
TJLBEPACS Transjuglar liver biopsy (done in endoscopy)
- For PACS - NOT FOR BILLING PURPOSE
539 UGGGIED UPPER GASTROINTESTINAL (
CHOS UGI ) ENDOSCOPY (DOCTOR
UGIPACS Upper gastrointestinal ( UGI ) endoscopy -
UGIHC Upper gastrointestinal ( UGI ) endoscopy - 3780 3780 1890 1510 1140
UGIDF Upper gastrointestinal ( UGI ) endoscopy - 9460 9460 4730 3780 2840
Doctor fee
540 UGIOS Upper gastrointestinal (UGI )
endoscopy done outside
Hospital Charges)
UGIOSHC Upper gastrointestinal (UGI ) endoscopy 4910 4910 2460 1960 1470
done outside endoscopy suite - Additional
hospital charges
UGIOS Upper gastrointestinal (UGI ) endoscopy 12280 12280 6140 4910 3680
done outside endoscopy suite - doctor fee
541 ULTIOS Ultroid Injection - (Doctor Fee
+ Hospital Charges)
ULTIH Ultroid Injection - Additional hospital 6720 6720 3360 2690 2020
charges
ULTID Ultroid Injection - Doctor Fee 16800 16800 8400 6720 5040
ULTIPACS Ultroid Injection - For PACS - NOT FOR
BILLING PURPOSE
542 USCOS USG FOR SIZE OF COLLECTION
/ USG FOR ASCITES - (Doctor
USCHC USG FOR SIZE OF COLLECTION / USG FOR 420 340 250
ASCITES - Additional Hospital Charges
USCDC USG FOR SIZE OF COLLECTION / USG FOR 1050 840 630
ASCITES - Doctor Fee
543 USGOS USG GUIDED SINGLE TIME
ASPIRATION - (Doctor Fee +
Hospital Charges)
UGSHC USG GUIDED SINGLE TIME ASPIRATION - 1260 1010 760
UGSDC USG GUIDED SINGLE TIME ASPIRATION - 3150 2520 1890
Doctor Fee
Interventional Neurology
281
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
594 ABLDSOS Angiography of B/L
Dorsolumbar Spinal Radicular
Arteries
ABLDAF Angiography of B/L Dorsolumbar Spinal 13860 13860 6930 5540 4160
Radicular Arteries - Anasthetist fee
ABLDS Angiography of B/L Dorsolumbar Spinal 69300 69300 34650 27720 20790
Radicular Arteries - Doctor Fee
ABLDSLA Angiography of B/L Dorsolumbar Spinal 33260 33260 16630 13310 9980
Radicular Arteries - Lab charges
595 ATHOS Intracranial stenting for
Atherosclerosis -
INTERVENTION NEUROLOGY
ATHDF Intracranial stenting for Atherosclerosis - 190580 190580 95290 76230 57170
Surgeon Fee
596 AVMOS Complex AVM/AVF
Embolization via trans arterial
and transvenous route -
AVMLC Complex AVM/AVF Embolization via trans 91480 91480 45740 36590 27440
arterial and transvenous route - Intervention
lab charges
AVMDF Complex AVM/AVF Embolization via trans 190580 190580 95290 76230 57170
arterial and transvenous route - Surgeon
Fee
597 BACEDOS Balloon Assisted Coil
Embolization of a
Direct/Indirect Cavernous
Fistula
BACEDAN Balloon Assisted Coil Embolization of a 46200 46200 23100 18480 13860
Direct/Indirect Cavernous Fistula -
Anasthetist fee
BACEDF Balloon Assisted Coil Embolization of a 231000 231000 115500 92400 69300
Direct/Indirect Cavernous Fistula - Doctor
Fee
BACEDLB Balloon Assisted Coil Embolization of a 110880 110880 55440 44350 33260
Direct/Indirect Cavernous Fistula - Lab
charges
598 BASCIOS Balloon Angioplasty & Stenting
in Cervical ICA/Vertebral
BASCAN Balloon Angioplasty & Stenting in Cervical 41580 41580 20790 16630 12470
ICA/Vertebral - Anasthetist Fee
BASCD Balloon Angioplasty & Stenting in Cervical 207900 207900 103950 83160 62370
ICA/Vertebral - Doctor Fee
BASCLC Balloon Angioplasty & Stenting in Cervical 99790 99790 49900 39920 29940
ICA/Vertebral - Lab charges
599 BTOUMO Balloon test occlusion ( Under
S2 Monitoring )
BTOANM2 Balloon test occlusion - anaesthetists 16910 16910 8460 6760 5070
charges for monitoring
BTODF2 Balloon test occlusion - doctor fee 84560 84560 42280 33820 25370
BTOLC2 Balloon test occlusion - intervention lab 40590 40590 20290 16230 12180
charges
600 CASUMOS Carotid angioplasty & stenting
2 ( Under Monitoring )
CASANM2 Carotid angioplasty & stenting - 27060 27060 13530 10820 8120
anaesthetists charges for monitoring
CASDF2 Carotid angioplasty & stenting - doctor fee 135280 135280 67640 54110 40580
CASLC2 Carotid angioplasty & stenting - intervention 64930 64930 32470 25970 19480
lab charges
282
601 CCDSAOS Check cerebral DSA ( Under LA
2 )
CCDSADF2 Check cerebral DSA - doctor fee 30460 30460 15230 12180 9140
CCDSALC2 Check cerebral DSA - intervention lab 14620 14620 7310 5850 4390
charges
602 CCDSAUG Check cerebral DSA ( Under GA
AOS2 )
CCDANGA2 Check cerebral DSA - anaesthetists charges 9140 9140 4570 3650 2740
for GA
charges
603 CCDSAUM Check cerebral DSA ( Under
OS2 Monitoring )
CCDANM2 Check cerebral DSA - anaesthetists charges 6090 6090 3050 2440 1830
for monitoring
charges
604 CCFEUGA CCF embolisation ( Under GA )
OS2
CCFEANGA2 CCF embolisation - anaesthetists charges for 45660 45660 22830 18260 13700
GA
CCFEDF2 CCF embolisation - doctor fee 152200 152200 76100 60880 45660
CCFELC2 CCF embolisation - intervention lab charges 73060 73060 36530 29220 21920
605 CDSAGAO Cerebral DSA ( Under GA )
S
CDANGA2 Cerebral DSA - anaesthetists charges for GA 10150 10150 5070 4060 3050
CDANM2 Cerebral DSA - anaesthetists charges for 6760 6760 3380 2710 2030
monitoring
CDSADF2 Cerebral DSA - doctor fee 33820 33820 16910 13530 10150
LC2 Cerebral DSA - intervention lab charges 16230 16230 8120 6490 4870
606 CDSALAO Cerebral DSA ( Under LA )
S2
CDSADF2 Cerebral DSA - doctor fee 33820 33820 16910 13530 10150
LC2 Cerebral DSA - intervention lab charges 16230 16230 8120 6490 4870
607 CHBOS Intraarterial chemotherapy for
malignant brain tumours -
CHBLC Intraarterial chemotherapy for malignant 97570 97570 48790 39030 29270
brain tumours - Intervention Lab charges
CHBDF Intraarterial chemotherapy for malignant 203280 203280 101640 81310 60980
brain tumours - Surgeon Fee
608 CHHNOS Intra-arterial chemotherapy of
head and neck tumours -
CHHNLC Intra-arterial chemotherapy of head and 91480 91480 45740 36590 27440
neck tumours - Intervention Lab charges
CHHNDF Intra-arterial chemotherapy of head and 190580 190580 95290 76230 57170
neck tumours - Surgeon Fee
609 CIATUGA Cerebral intra-arterial
OS2 thrombolysis ( Under GA )
CIATANGA2 Cerebral intra-arterial thrombolysis - 30440 30440 15220 12170 9130
anaesthetists charges for GA
CIATDF2 Cerebral intra-arterial thrombolysis - doctor 101460 101460 50730 40580 30440
fee
CIATLC2 Cerebral intra-arterial thrombolysis - 48700 48700 24350 19480 14610
intervention lab charges
610 CIATUMO Cerebral intra-arterial
S2 thrombolysis ( Under
Monitoring )
CIATANM2 Cerebral intra-arterial thrombolysis - 20290 20290 10150 8120 6090
283
CIATDF2 Cerebral intra-arterial thrombolysis - doctor 101460 101460 50730 40580 30440
fee
CIATLC2 Cerebral intra-arterial thrombolysis - 48700 48700 24350 19480 14610
611 CVSTUGA Cerebral venous sinus
OS2 thrombolysis ( Under GA )
CVSTANGA2 Cerebral venous sinus thrombolysis - 40580 40580 20290 16230 12170
CVSTDF2 Cerebral venous sinus thrombolysis - doctor 135280 135280 67640 54110 40580
fee
CVSTLC2 Cerebral venous sinus thrombolysis - 64930 64930 32470 25970 19480
612 CVSTUMO Cerebral venous sinus
S2 thrombolysis ( Under
Monitoring )
CVSTANM2 Cerebral venous sinus thrombolysis - 27060 27060 13530 10820 8120
CVSTDF2 Cerebral venous sinus thrombolysis - doctor 135280 135280 67640 54110 40580
fee
CVSTLC2 Cerebral venous sinus thrombolysis - 64930 64930 32470 25970 19480
613 ESPFDOS Embolization of Spinal
Pial/dural Fistula
ESPFDNA Embolization of Spinal Pial/dural Fistula - 46200 46200 23100 18480 13860
Anasthetist fee
ESPFD Embolization of Spinal Pial/dural Fistula - 231000 231000 115500 92400 69300
Doctor Fee
ESPFDLA Embolization of Spinal Pial/dural Fistula - 110880 110880 55440 44350 33260
Lab charges
614 FDPIAOS Flow Divertor Placement for
Intracranial Aneurysm
FDPIANA Flow Divertor Placement for Intracranial 55440 55440 27720 22180 16630
Aneurysm - Anasthetist fee
FDPIA Flow Divertor Placement for Intracranial 277200 277200 138600 110880 83160
Aneurysm - Doctor Fee
FDPIALC Flow Divertor Placement for Intracranial 133060 133060 66530 53220 39920
Aneurysm - Lab charges
615 IACMUGA Intracranial aneurysm coiling (
OS2 multiple / complex ) ( Under
GA )
IACMANGA2 Intracranial aneurysm coiling ( multiple / 60880 60880 30440 24350 18260
complex ) - anaesthetists charges for GA
IACMDF2 Intracranial aneurysm coiling ( multiple / 202940 202940 101470 81180 60880
complex ) - doctor fee
IACMLC2 Intracranial aneurysm coiling ( multiple / 97410 97410 48710 38970 29220
complex ) - intervention lab charges
616 IACSUGA Intracranial aneurysm coiling
OS2 (single) ( Under GA )
IACSANGA2 Intracranial aneurysm coiling (single) - 45660 45660 22830 18260 13700
IACSDF2 Intracranial aneurysm coiling (single) - 152200 152200 76100 60880 45660
doctor fee
IACSLC2 Intracranial aneurysm coiling (single) - 73060 73060 36530 29220 21920
617 IADUGAO Intracranial angioplasty (
S2 Under GA )
IAANGA2 Intracranial angioplasty - anaesthetists 50740 50740 25370 20300 15220
charges for GA
IADF2 Intracranial angioplasty - doctor fee 169120 169120 84560 67650 50740
IALC2 Intracranial angioplasty - intervention lab 81180 81180 40590 32470 24360
charges
618 IAELEOS Intracranial AVM Embolization
using Liquid Embolic material
IAELNA Intracranial AVM Embolization using Liquid 46200 46200 23100 18480 13860
Embolic material - Anasthetist fee
IAELE Intracranial AVM Embolization using Liquid 231000 231000 115500 92400 69300
Embolic material - Doctor Fee
284
IAELLC Intracranial AVM Embolization using Liquid 110880 110880 55440 44350 33260
Embolic material - Lab charges
619 IAVDOS Intracranial Angioplasty for
Vasaspasm
IAVDNA Intracranial Angioplasty for Vasaspasm - 27720 27720 13860 11090 8320
Anasthetist fee
IAVDF Intracranial Angioplasty for Vasaspasm - 138600 138600 69300 55440 41580
Doctor Fee
IAVDLA Intracranial Angioplasty for Vasaspasm - 66530 66530 33260 26610 19960
Lab charges
620 IAVLAOS2 Intra arterial vasodialation
(interventional neurology) (
Under LA )
IAVDF2 Intra arterial vasodialation (interventional 47340 47340 23670 18940 14200
neurology) - doctor fee
IAVLC2 Intra arterial vasodialation (interventional 22720 22720 11360 9090 6820
neurology) - intervention lab charges
621 IAVMEUG Intracranial AVM embolisation
AOS2 ( Under GA )
IAVMEANGA2 Intracranial AVM embolisation - 45660 45660 22830 18260 13700
IAVMEDF2 Intracranial AVM embolisation - doctor fee 152200 152200 76100 60880 45660
IAVMELC2 Intracranial AVM embolisation - 73060 73060 36530 29220 21920
622 IAVUGAO Intra arterial vasodialation
S2 (interventional neurology) (
Under GA )
IAVANGA2 Intra arterial vasodialation (interventional 14200 14200 7100 5680 4260
neurology) - anaesthetists charges for GA
623 IAVUMOS Intra arterial vasodialation
2 (interventional neurology) (
Under Monitoring )
IAVANM2 Intra arterial vasodialation (interventional 9470 9470 4730 3790 2840
neurology) - anaesthetists charges for
monitoring
624 ISRDOS Intracranial Stenting in Stroke
Revascularization
ISRNA Intracranial Stenting in Stroke 46200 46200 23100 18480 13860
Revascularization - Anasthetist fee
ISRDF Intracranial Stenting in Stroke 231000 231000 115500 92400 69300
Revascularization - Doctor Fee
ISRLC Intracranial Stenting in Stroke 110880 110880 55440 44350 33260
Revascularization - Lab charges
625 ISUGAOS2 Intracranial stenting ( Under
GA )
ISANGA2 Intracranial stenting - anaesthetists charges 50740 50740 25370 20300 15220
for GA
ISDF2 Intracranial stenting - doctor fee 169120 169120 84560 67650 50740
ISLC2 Intracranial stenting - intervention lab 81180 81180 40590 32470 24360
charges
626 ITEUGAOS Intracranial tumour
2 embolisation ( Under GA )
ITEANGA2 Intracranial tumour embolisation - 25370 25370 12680 10150 7610
ITEDF22 Intracranial tumour embolisation - doctor 84560 84560 42280 33820 25370
fee
ITELC2 Intracranial tumour embolisation - 40590 40590 20290 16230 12180
285
627 ITEUMOS Intracranial tumour
2 embolisation ( Under
Monitoring )
ITEANM2 Intracranial tumour embolisation - 16910 16910 8460 6760 5070
ITEDF22 Intracranial tumour embolisation - doctor 84560 84560 42280 33820 25370
fee
ITELC2 Intracranial tumour embolisation - 40590 40590 20290 16230 12180
628 IVMECOS Intracranial AVM Embolization
(Complex)
IVMECNA Intracranial AVM Embolization (Complex) - 55440 55440 27720 22180 16630
Anasthetist fee
IVMEC Intracranial AVM Embolization (Complex) - 277200 277200 138600 110880 83160
Doctor Fee
IVMECLC Intracranial AVM Embolization (Complex) - 133060 133060 66530 53220 39920
Lab charges
629 IVSUGAO Intracranial Venous stenting (
S2 Under GA )
IVSANGA2 Intracranial Venous stenting - anaesthetists 40580 40580 20290 16230 12170
charges for GA
IVSDF2 Intracranial Venous stenting - doctor fee 135280 135280 67640 54110 40580
IVSLC2 Intracranial Venous stenting - intervention 64930 64930 32470 25970 19480
lab charges
630 MTASROS Mechanical thrombectomy for
actue stroke using stent
retrievers - INTERVENTION
NEUROLOGY
MRASRLC Mechanical thrombectomy for actue stroke 91480 91480 45740 36590 27440
using stent retrievers - intervention lab
charges
MTASRDF Mechanical thrombectomy for actue stroke 190580 190580 95290 76230 57170
using stent retrievers - Surgeon Fee
631 PSTEUGA Percutaneous Spinal tumour
OS2 embolisation ( Under GA )
PSTEANGA2 Percutaneous Spinal tumour embolisation - 16240 16240 8120 6500 4870
PSTEDF2 Percutaneous Spinal tumour embolisation - 54120 54120 27060 21650 16240
doctor fee
PSTELC2 Percutaneous Spinal tumour embolisation - 25980 25980 12990 10390 7800
632 PSTEUMO Percutaneous Spinal tumour
S2 embolisation ( Under
Monitoring )
PSTEANM2 Percutaneous Spinal tumour embolisation - 10820 10820 5410 4330 3250
PSTEDF2 Percutaneous Spinal tumour embolisation - 54120 54120 27060 21650 16240
doctor fee
PSTELC2 Percutaneous Spinal tumour embolisation - 25980 25980 12990 10390 7800
633 PSUMOS2 Percutaneous Sclerotherapy
Under Monitoring )
PSANM2 Percutaneous Sclerotherapy (interventional 9470 9470 4730 3790 2840
monitoring
PSDF2 Percutaneous Sclerotherapy (interventional 47340 47340 23670 18940 14200
PSLC2 Percutaneous Sclerotherapy (interventional 22720 22720 11360 9090 6820
634 PVUMOS2 Percutaneous Vertebroplasty
Under Monitoring )
PVANM2 Percutaneous Vertebroplasty (interventional 10820 10820 5410 4330 3250
monitoring
286
PVDF2 Percutaneous Vertebroplasty (interventional 54120 54120 27060 21650 16240
PVLC2 Percutaneous Vertebroplasty (interventional 25980 25980 12990 10390 7800
635 SACEIOS Stent Assisted Coil
Embolization of Intracranial
ICA Aneurysm
SACEAN Stent Assisted Coil Embolization of 46200 46200 23100 18480 13860
Intracranial ICA Aneurysm - Anasthetist fee
SACEI Stent Assisted Coil Embolization of 231000 231000 115500 92400 69300
Intracranial ICA Aneurysm - Doctor Fee
SACELC Stent Assisted Coil Embolization of 110880 110880 55440 44350 33260
Intracranial ICA Aneurysm - Lab charges
636 SACEOS Stent assisted coil
embolization of intracranial
aneurysms - INTERVENTION
NEUROLOGY
SADELC Stent assisted coil embolization of 97570 97570 48790 39030 29270
intracranial aneurysms - intervention lab
charges
SACEDF Stent assisted coil embolization of 203280 203280 101640 81310 60980
intracranial aneurysms - Surgeon Fee
637 SAVMEUG Spinal AVM embolisation (
AOS2 Under GA )
SAVMEANGA2 Spinal AVM embolisation - anaesthetists 45660 45660 22830 18260 13700
charges for GA
SAVMEDF2 Spinal AVM embolisation - doctor fee 152200 152200 76100 60880 45660
SAVMELC2 Spinal AVM embolisation - intervention lab 73060 73060 36530 29220 21920
charges
638 SDSAUGA Spinal DSA ( Under GA )
OS2
SDSAANGA2 Spinal DSA - anaesthetists charges for GA 12180 12180 6090 4870 3650
SDSADF2 Spinal DSA - doctor fee 40600 40600 20300 16240 12180
SDSALC2 Spinal DSA - intervention lab charges 19490 19490 9740 7800 5850
639 SVCAOS Six Vessel Cerabral Angiogram
SVCAAC Six Vessel Cerabral Angiogram - Anasthetist 11550 11550 5780 4620 3470
Fee
SVCAD Six Vessel Cerabral Angiogram - Doctor fee 57760 57760 28880 23100 17330
SVCALB Six Vessel Cerabral Angiogram - Lab charges 27720 27720 13860 11090 8320
640 VSSLAOS2 Venous sinus sampling ( Under
LA )
VSSDF2 Venous sinus sampling - doctor fee 84560 84560 42280 33820 25370
VSSLC2 Venous sinus sampling - intervention lab 40590 40590 20290 16230 12180
charges
641 VSSUGAO Venous sinus sampling ( Under
S2 GA )
VSSANGA2 Venous sinus sampling - anaesthetists 25370 25370 12680 10150 7610
charges for GA
charges
642 VSSUMOS Venous sinus sampling ( Under
2 Monitoring )
VSSANM2 Venous sinus sampling - anaesthetists 16910 16910 8460 6760 5070
charges for monitoring
charges
643 YSBAOS Y-Stenting in a Basilar Top
Aneurysm
YSBAN Y-Stenting in a Basilar Top Aneurysm - 55440 55440 27720 22180 16630
Anasthetist fee
YSBAD Y-Stenting in a Basilar Top Aneurysm - 277200 277200 138600 110880 83160
Doctor Fee
287
YSBALC Y-Stenting in a Basilar Top Aneurysm - Lab 133060 133060 66530 53220 39920
charges
Interventional Radiology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
644 BEMBOS Bronchial a embolization
(Intervention Radiology ) -
Doctor Fee + Hospital Charges
BEMBDF Bronchial a embolization (Intervention 92240 92240 46120 36900 27670
Radiology ) - Doctor Fee
BEMBHC Bronchial a embolization (Intervention 44280 44280 22140 17710 13280
Radiology) - Hospital Charges
645 BEXOS Biliary externalization
BEXHC Biliary externalization (Intervention 32470 32470 16230 12990 9740
BEXDF Biliary externalization Intervention 67640 67640 33820 27060 20290
646 BIXOS Biliary internalization
(Intervention Radiology) -
Doctor fee + Hospital Charges
BIXHC Biliary internalization (Intervention 32470 32470 16230 12990 9740
BIXDF Biliary internalization (Intervention 67640 67640 33820 27060 20290
Radiology) - Doctor Fee
647 BPCNOS Bilateral PCN (IR) in Vascular
Cath Lab - Interventional
Radiology - ( Doctor Fee +
Hospital Charges )
BPCNDF Bilateral PCN (IR) in Vascular Cath Lab - 67000 67000 33500 26800 20100
Interventional Radiology - Doctor Fee
BPCNHC Bilateral PCN (IR) in Vascular Cath Lab - 32160 32160 16080 12860 9650
Interventional Radiology - Hospital Charges
648 BRTOIROS Balloon occluded retrograde
transvenous obliteration of
varices (BRTO) IT (Doctor +
Hospital Charges)
BRTOIRDC Balloon occluded retrograde transvenous 206740 206740 103370 82700 62020
obliteration of varices (BRTO) IT - Doctor
Charges
BRTOIRHC Balloon occluded retrograde transvenous 99240 99240 49620 39700 29770
obliteration of varices (BRTO) IT - Hospital
Charges
649 CABIROS Chemical Ablation of Tumour
IR (Doctor+Hospital Charges)
CABIRDC Chemical Ablation of Tumour IR Doctor 70360 70360 35180 28140 21110 35180
Charges
CABIRHC Chemical Ablation of Tumour IR Hospital 33770 33770 16890 13510 10130 16890
Charges
650 CGRFAOS CT Guided RFA of Tumour IR
Cath Lab (Doctor + Hospital
Charges)
CGRFADC CT Guided RFA of Tumour Cath Lab IR - 119280 119280 59640 47710 35780 59640
Doctor Charges
CGRFAHC CT Guided RFA of Tumour Cath Lab IR - 57250 57250 28630 22900 17170 28630
Hospital Charges
288
651 COILEMB Coil embolization (
OLOS Interventional radiology )
(Doctor fee + Hospital service
charges)
COILEMBOLDF Coil embolization ( Interventional radiology ) 74400 74400 37200 29760 22320 37200 22320
- Doctor Fee
COILEMBOLHC Coil embolization ( Interventional radiology ) 35710 35710 17860 14280 10710 17860 10710
- Hospital charges
652 COIVESTC Coiling of vessels + TC 99
99OS infusion (Interventional
Radiology) (Doctor fee +
Hospital charges)
COIVESTC99D Coiling of vessels + TC 99 infusion - 104840 104840 52420 41940 31450 52420 31450
F Interventional radiology (Doctor fee)
COIVESTC99H Coiling of vessels + TC 99 infusion - 50320 50320 25160 20130 15100 25160 15100
C Interventional radiology (Hospital charges)
653 COMBIRO Complex Biliary Externalization
S (Two/Three System ) IR
(Doctor + Hospital Charges)
COMBIRDC Complex Biliary Externalization (Two/Three 151200 151200 75600 60480 45360
System ) IR - Doctor Fee
COMBIRHC Complex Biliary Externalization (Two/Three 72580 72580 36290 29030 21770
System ) IR - Hospital Charges
654 COMINTIR Complex Biliary internalization
OS (Two/Three System ) IR -
(Doctor + Hosptal Charges)
COMINTIRDC Complex Biliary internalization (Two/Three 176400 176400 88200 70560 52920
System ) IR - Doctor Fee
COMINTIRHC Complex Biliary internalization (Two/Three 84670 84670 42340 33870 25400
System ) IR - Hospital Charges
655 CONECTIR Cone Beam CT assisted TACE IR
OS - (Doctor + Hospital Charges)
CONECTIRDC Cone Beam CT assisted TACE IR - Doctor 201600 201600 100800 80640 60480
Charges
CONECTIRHC Cone Beam CT assisted TACE IR - Hospital 96770 96770 48380 38710 29030
Charges
656 CTBIOS CT Guided Biopsy - IR (
Interventional radiology )
(Doctor Fee + Hospital service
charges)
CTBIOD CT Guided Biopsy - IR ( Interventional 22000 22000 11000 8800 6600 11000
radiology ) (Doctor Fees)
CTBIOHC CT Guided Biopsy - IR ( Interventional 2200 2200 1100 880 660 1100
radiology ) (Hospital service charges)
657 CTBONOS CT Guided Bone Biopsy - IR (
charges)
CTBODC CT Guided Bone Biopsy - IR ( Interventional 25000 25000 12500 10000 7500 12500
CTGUHC CT Guided Bone Biopsy - IR ( Interventional 2500 2500 1250 1000 750 1250
658 CTGOS CT guided aspiration / drainage
( Interventional radiology )
Charges)
CTGDC CT guided aspiration / drainage - Doctor Fee 14200 14200 7100 5680 4260
CTGHC CT guided aspiration / drainage - Hospital 1420 1420 710 570 430
Charges
659 CTPMULO CT Guided PCD Multiple (
S Interventional radiology )
charges)
289
PCDMULD CT Guided PCD Multiple ( Interventional 36760 36760 18380 14700 11030 18380
CTPCHOS CT Guided PCD Multiple ( Interventional 3680 3680 1840 1470 1100 1840
660 DIAGPLEO USG Guided Ascitic / Pleural
S Diagnostic Tapping - IR (
charges)
PLEDIAGD USG Guided Ascitic / Pleural Diagnostic 8800 8800 4400 3520 2640 4400
Tapping - IR ( Interventional radiology )
(Doctor Fees)
GUITAPPIRH USG Guided Ascitic / Pleural Diagnostic 880 880 440 360 270 440
(Hospital service charges)
661 DOXOTAC Doxorubicin loaded bead TACE
EIROS IR (Doctor + Hospital Charges)
DOXOTACEIRD Doxorubicin loaded bead TACE IR - Doctor 176400 176400 88200 70560 52920
C Charges
DOXOTACEIRH Doxorubicin loaded bead TACE IR - Hospital 84670 84670 42340 33870 25400
C Charges
662 EMBABDT Embolization of abdominal
UMOS tumours (Interventional
radiology) - (Doctor fee +
Hospital service charges)
EMBABDTUM Embolization of abdominal tumours 74400 74400 37200 29760 22320
DF (Interventional radiology) - Doctor fee
EMBABDTUM Embolization of abdominal tumours 35710 35710 17860 14280 10710
HC (Interventional radiology) - Hospital charges
663 GPCIDOS Guided PCD/ICD done in Cath
Lab IR (Doctor + Hospital
Charges)
GPCIDC Guided PCD/ICD done in Cath Lab IR Doctor 23100 23100 11550 9240 6930 11550
Fee
GPCIHC Guided PCD/ICD done in Cath Lab IR Hospial 11090 11090 5540 4440 3330 5540
Charges
664 GUIDRAN CT Guided Dranage - IR (
OS Interventional radiology )
charges)
GUIDEDD CT Guided Dranage - IR ( Interventional 18800 18800 9400 7520 5640 9400
CTHOSN CT Guided Dranage - IR ( Interventional 1880 1880 940 760 570 940
665 GUIPLEM USG Guided Ascitic / Pleural
OBOS Diagnostic Tapping (Mob) - IR (
charges)
GUIPLE USG Guided Ascitic / Pleural Diagnostic 12800 12800 6400 5120 3840
Tapping (Mob) - IR ( Interventional radiology
) (Doctor Fees)
TAPPHOSIR USG Guided Ascitic / Pleural Diagnostic 1280 1280 640 520 390
) (Hospital service charges)
666 INCYTOS Intraductal Cytology/Biopsy IR
Cath Lab (Doctor + Hospital
Charges)
INCYTOB Intraductal Cytology/Biopsy IR Cath Lab - 31500 31500 15750 12600 9450 15750
Doctor Fee
INCYTOBHC Intraductal Cytology/Biopsy IR Cath Lab - 15120 15120 7560 6050 4540 7560
Hospital Charges
290
667 IRRDCOS Irrigation of Drain / Change of
Dressing - IR ( Interventional
radiology ) (Doctor Fee +
IRR Irrigation of Drain / Change of Dressing - IR ( 5000 5000 2500 2000 1500
Interventional radiology ) (Doctor Fees)
IRRDESHC Irrigation of Drain / Change of Dressing - IR ( 500 500 250 200 150
Interventional radiology ) (Hospital service
charges)
668 IRRDERM Irrigation of Drain / Change of
OBOS Dressing (Mob) - IR (
(Doctor Fee Hospital service
charges)
IRRCHADC Irrigation of Drain / Change of Dressing 7000 7000 3500 2800 2100
(Mob) - IR ( Interventional radiology )
(Doctor Fees)
IRRCHAHC Irrigation of Drain / Change of Dressing 700 700 350 280 210
(Mob) - IR ( Interventional radiology )
669 LYMDEOS Lymphatic Duct embolization (
Interventional Radiology ) - (
Doctor Fee + Hospital Chares )
LYMDEDF Lymphatic Duct embolization (IR) - Doctor 144000 144000 72000 57600 43200
Fee
LYMDEHC Lymphatic Duct embolization (IR) - Hospital 69120 69120 34560 27650 20740
Charges
670 LYMIROS Lymphangiography (
LYMIRDF Lymphangiography (IR) - Doctor Fee 42000 42000 21000 16800 12600
LYMIRHC Lymphangiography (IR) - Hospital Charges 20160 20160 10080 8060 6050
671 PAIROS PAIR Interventinal Radiology IR
- (Doctor + Hospital Charges)
PAIRDC PAIR Interventinal Radiology IR - Doctor 70360 70360 35180 28140 21110
Charges
PAIRHC PAIR Interventinal Radiology IR - Hospital 33770 33770 16890 13510 10130 16890
Charges
672 PBEMOS Percutaenous Biopsy with tract
embolization ath Lab IR
PBEMCF Percutaenous Biopsy with tract embolization 12600 12600 6300 5040 3780 5380
- Cath Lab Charges
PBEMB Percutaenous Biopsy with tract embolization 26260 26260 13130 10500 7880 12500
- Doctor Charges
673 PCDCHCO Percutaneous Cholecystotomy
S - Doctor Fee + Hospital Charges
PCDF Percutaneous Cholecystotomy - Doctor Fee 25420 25420 12710 10170 7630
PCHC Percutaneous Cholecystotomy - Hospital 12200 12200 6100 4880 3660
Charges
674 PCDCTOS CT Guided PCD - IR (
charges)
PCDDOCC CT Guided PCD - IR ( Interventional radiology 26260 26260 13130 10500 7880
) (Doctor Fees)
PCDHOSPI CT Guided PCD - IR ( Interventional radiology 2630 2630 1310 1050 790 1310
675 PCDMOB USG Guided PCD (Mob) - IR (
charges)
291
PCDDOC USG Guided PCD (Mob) - IR ( Interventional 26000 26000 13000 10400 7800
PCSDHC USG Guided PCD (Mob) - IR ( Interventional 2600 2600 1300 1040 780
676 PDEBOS Precision TACE by drug eluting
beads (Intervention Radiology
) - Doctor Fee + Hospital
Charges
PDEBDF Precision TACE by drug eluting beads 110700 110700 55350 44280 33210
(Intervention Radiology ) - Doctor Fee
PDEBHC Precision TACE by drug eluting beads 53140 53140 26570 21250 15940
(Intervention Radiology) - Hospital Charges
677 PDSPOS Partial devascularization of
spleen ( for hypersplenism)
PDSPDF Partial devascularization of spleen ( for 92240 92240 46120 36900 27670
hypersplenism) (Intervention Radiology ) -
Doctor Fee
PDSPHC Partial devascularization of spleen (for 44280 44280 22140 17710 13280
hypersplenism) (Intervention Radiology) -
Hospital Charges
678 PEADSNE Percutaenous Esophagostomy/
WOS Gastrostomy/ Jejunostomy/
Caecostomy - IR (
charges)
PEGJDOC Percutaenous Esophagostomy/ 89040 89040 44520 35620 26710
Gastrostomy/ Jejunostomy/ Caecostomy - IR
( Interventional radiology ) (Doctor Fee)
IPFGPJHC Percutaenous Esophagostomy/ 42740 42740 21370 17100 12820
Gastrostomy/ Jejunostomy/ Caecostomy - IR
( Interventional radiology ) (Hospital service
charges)
679 PERANGIR Percutaenous Endovascular
OS Angioplasty IR (Doctor +
Hospital Charges)
PERANGIRDC Percutaenous Endovascular Angioplasty IR - 206860 206860 103430 82740 62060
Doctor Charges
PERANGIRHC Percutaenous Endovascular Angioplasty IR - 99290 99290 49650 39720 29790
Hospital Charges
680 PROSIROS Prostatic Artery Embolization
IR (Doctor + Hospital Charges)
PROSIRDH Prostatic Artery Embolization IR - Doctor 130200 130200 65100 52080 39060
Charges
PROSIRHC Prostatic Artery Embolization IR - Hospital 62500 62500 31250 25000 18750
Charges
681 PVFDOS Portal vein flow diversion
PVFDDF Portal vein flow diversion (Intervention 110700 110700 55350 44280 33210
PVFDHC Portal vein flow diversion (Intervention 53140 53140 26570 21250 15940
682 RABTUOS Radiofrequency ablation of
Tumour Interventional
Radiology IR Cath Lab (Doctor
+ Hospital Charges)
RABTUDC Radiofrequency ablation of Tumour 119280 119280 59640 47710 35780 56800
Interventional Radiology IR Cath Lab -
Doctor Charges
RABTUHC Radiofrequency ablation of Tumour 57250 57250 28630 22900 17170 24420
Interventional Radiology IR Cath Lab -
Hospital Charges
292
683 RFAIROS RFA of Osteiod Osteoma IR -
RFAIRDC RFA of Osteiod Osteoma IR - Doctor Charges 89040 89040 44520 35620 26710 44520
RFAIRHC RFA of Osteiod Osteoma IR - Hospital 42740 42740 21370 17100 12820 21370
Charges
684 STHROIRO Selective Thrombolysis IR
S (Hospital + Doctor Charges)
STHROIRDC Selective Thrombolysis IR - Doctor Charges 130200 130200 65100 52080 39060
STHROIRHC Selective Thrombolysis IR - Hospital Charges 62500 62500 31250 25000 18750
685 TACEOS TACE (Trans arterial chemo
embolization) (Intervention
Radiology) - Doctor Fee +
Hospital Charges
TACEDF TACE (Trans arterial chemo embolization) 92240 92240 46120 36900 27670
(Intervention Radiology ) Doctor Fee
TACEHC TACE (Trans arterial chemo embolization) 44280 44280 22140 17710 13280
(Intervention Radiology) - Hospital Charges
686 TAPPASO USG Guided Ascitic / Pleural
S Therapeutic Tapping - IR (
charges)
THEPLED USG Guided Ascitic / Pleural Therapeutic 11200 11200 5600 4480 3360 5600
(Doctor Fees)
THEPLERAHC USG Guided Ascitic / Pleural Therapeutic 1120 1120 560 450 340 560
687 TBIOPOS Transjugular Trucut Biopsy in
Cath Lab IR (Doctor + Hospital
Charges )
TBIOPDC Transjugular Trucut Biopsy in Cath Lab IR - 44100 44100 22050 17640 13230
Doctor Charge
TBIOPHC Transjugular Trucut Biopsy in Cath Lab IR - 21170 21170 10580 6350
Hospital Charge
688 THABOS Thermal Ablation of Liver
Tumours ( Interventional
Radiology ) - ( Doctor Fee +
Hospital Charges )
THABDF Thermal Ablation of Liver Tumours (IR) - 144000 144000 72000 57600 43200
Doctor Fee
THABHC Thermal Ablation of Liver Tumours (IR) - 69120 69120 34560 27650 20740
Hospital Charges
689 THTPOS Thermal Ablation of
Thyroid/Parathyroid Nodule (
THTPDC Thermal Ablation of Thyroid/Parathyroid 144000 144000 72000 57600 43200
Nodule (IR) - Doctor Fee
THTPHC Thermal Ablation of Thyroid/Parathyroid 69120 69120 34560 27650 20740
Nodule (IR) - Hospital Charges
690 TIPPSOS TIPSS (Doctor fee + Hospital
charges)
TIPSARWP TIPSS - Interventional radiology - amount 219840 219840 109920 87940 65950
given to doctor
TIPSPC TIPSS - Interventional radiology - hospital 105520 105520 52760 42210 31660
charges
691 TIPSSROS TIPSS Revision (Intervention
Radiology ) - Doctor Fee +
Hospital Charges
TIPPSRDF TIPSS Revision (Intervention Radiology ) - 67640 67640 33820 27060 20290
Doctor Fee
293
TIPPSRHC TIPSS Revision (Intervention Radiology) - 32470 32470 16230 12990 9740
Hospital Charges
692 TRUSGUO TRUS Guided Prostate Biopsy -
S IR ( Interventional radiology )
charges)
TRUSDOC TRUS Guided Prostate Biopsy - IR ( 22000 22000 11000 8800 6600 11000
TRUSNHC TRUS Guided Prostate Biopsy - IR ( 2200 2200 1100 880 660 1100
charges)
693 TRUSTVS TRUS/TVS Guided Drainage - IR
OS ( Interventional radiology )
charges)
TVSUSGD TRUS/TVS Guided Drainage - IR ( 21600 21600 10800 8640 6480 10800
USDETVSH TRUS/TVS Guided Drainage - IR ( 2160 2160 1080 870 650 1080
charges)
694 TUBEUPO Tube Change / Tube Upsizing /
S Tube Repositioning - IR (
charges)
TUBERESD Tube Change / Tube Upsizing / Tube 12800 12800 6400 5120 3840 6400
Repositioning - IR ( Interventional radiology )
(Doctor Fees)
TUPERESHC Tube Change / Tube Upsizing / Tube 1280 1280 640 520 390 640
Repositioning - IR ( Interventional radiology )
695 TVSTRUS TVS or TRUS Guidedsampling -
OS IR ( Interventional radiology )
charges)
TVSTQSD TVS or TRUS Guidedsampling - IR ( 18800 18800 9400 7520 5640 9400
TVSUSHC TVS or TRUS Guidedsampling - IR ( 1880 1880 940 870 570 940
charges)
696 USGASIPL USG Guided Ascitic / Pleural
TAOS Therapeutic Tapping (Mob) - IR
charges)
USGMOBDC USG Guided Ascitic / Pleural Therapeutic 15200 15200 7600 6080 4560
) (Doctor Fees)
USGMOBHCC USG Guided Ascitic / Pleural Therapeutic 1520 1520 760 610 460
697 USGASPRI USG Guided Aspiration /
OS Drainage - IR ( Interventional
radiology ) (Doctor Fee +
USGASPID USG Guided Aspiration / Drainage - IR ( 10200 10200 5100 4080 3060 5100
USGPIDRAH USG Guided Aspiration / Drainage - IR ( 1020 1020 510 410 310 510
charges)
698 USGBION USG Guided Biopsy Multiple -
OS IR ( Interventional radiology )
charges)
294
USGBIOD USG Guided Biopsy Multiple - IR ( 30460 30460 15230 12180 9140 15230
USGBIOHC USG Guided Biopsy Multiple - IR ( 3050 3050 1520 1220 910 1520
charges)
699 USGBIOS USG Guided Biopsy - IR (
charges)
USGBID USG Guided Biopsy - IR ( Interventional 21600 21600 10800 8604 6480 10800
USGBHC USG Guided Biopsy - IR ( Interventional 2160 2160 1080 870 650 1080
700 USGDEPO USG Making in dept - (IR) (
charges)
USGDEPDOC USG Making in dept - (IR) ( Interventional 7200 7200 3600 2880 2160
USGDEPHC USG Making in dept - (IR) ( Interventional 720 720 360 290 220
701 USGFLUD USG and Fluoroscopic Guided
OOS PCD done in Cath Lab - IR (
charges)
USGPCIRD USG and Fluoroscopic Guided PCD done in 32000 32000 16000 12800 9600 16000
Cath Lab - IR ( Interventional radiology )
(Doctor Fees)
USGDAHC USG and Fluoroscopic Guided PCD done in 15360 15360 7680 6140 4610 7680
Cath Lab - IR ( Interventional radiology )
702 USGFNA USG Guided FNAC Multiple- IR
MOS ( Interventional radiology )
charges)
USGFNADOC USG Guided FNAC Multiple- IR ( 9000 9000 4500 3600 2700 4500
USGFNAHC USG Guided FNAC Multiple- IR ( 900 900 450 360 270 450
charges)
703 USGGUIO USG Guided FNAC - IR (
(Doctor fee + Hospital service
charges)
USGDOC USG Guided FNAC - IR ( Interventional 6100 6100 3050 2440 1830 3050
radiology ) (Doctor Fee )
USGHOSPI USG Guided FNAC - IR ( Interventional 610 610 310 250 190 310
radiology ) Hospital service charges)
704 USGGUM USG Guided Biopsy (Mob) - IR (
(Doctor Fee Hospital service
charges)
USGMOD USG Guided Biopsy (Mob) - IR ( 25600 25600 12800 10240 7680
MOBNEWHC USG Guided Biopsy (Mob) - IR ( 2560 2560 1280 1030 770
charges)
705 USGICDOS USG Guided ICD - IR (
charges)
USGICDD USG Guided ICD - IR ( Interventional 22000 22000 11000 8800 6600 11000
295
USGICDHC USG Guided ICD - IR ( Interventional 2200 2200 1100 880 660 1160
706 USGMOB USG Guided Aspiration /
1OS Drainage (Mob) - IR (
charges)
MOBUSGIRD USG Guided Aspiration / Drainage (Mob) - IR 14200 14200 7100 5680 4260
( Interventional radiology ) (Doctor Fees)
MOBDOSHC USG Guided Aspiration / Drainage (Mob) - IR 1420 1420 710 570 430
( Interventional radiology ) (Hospital service
charges)
707 USGMOB USG Guided FNAC (Mob) - IR (
charges)
SGGDOCC USG Guided FNAC (Mob) - IR ( Interventional 10100 10100 5050 4040 3030
USGMH USG Guided FNAC (Mob) - IR ( Interventional 1010 1010 510 410 310
708 USGMUL USG Guided PCD Multiple - IR (
charges)
USGMULD USG Guided PCD Multiple - IR ( 29000 29000 14500 11600 8700 14500
USGHOSM USG Guided PCD Multiple - IR ( 2900 2900 1450 1160 870 1450
charges)
709 USGMULT USG Guided ICD Multiple - IR (
IOS Interventional radiology )
charges)
USGMOLTID USG Guided ICD Multiple - IR ( Interventional 29000 29000 14500 11600 8700 14500
USGDOCN USG Guided ICD Multiple - IR ( Interventional 2900 2900 1450 1160 870 1450
710 USGOTOS USG Making in Ward / OT - (IR)
charges)
USGOTDOC USG Making in Ward / OT - (IR) ( 11200 11200 5600 4480 3360
USGOTHC USG Making in Ward / OT - (IR) ( 1120 1120 560 450 340
charges)
711 USGPCDO USG Guided PCD - IR (
charges)
USGPCDH USG Guided PCD - IR ( Interventional 2200 2200 1100 880 660 1100
USGPCD USG Guided PCD - IR( Interventional 22000 22000 11000 8800 6600 11000
712 USGPLBO Usg Guided Paediatric Liver
S Biopsy (IR) - (Doctor Fee +
Hospital Charges)
UGPLBDC Usg Guided Paediatric Liver Biopsy (IR) - 14200 14200 7100 5680 4260
Doctor Fee
UGPLBHC Usg Guided Paediatric Liver Biopsy (IR) - 1420 1420 710 570 430
Hospital Charges
296
713 USSGBOM USG Guided ICD (Mob) - IR (
DOS Interventional radiology )
charges)
USGMOBHC USG Guided ICD (Mob) - IR ( Interventional 2600 2600 1300 1040 780
USGMOBD USG Guided ICD (Mob) - IR ( Interventional 26000 26000 13000 10400 7800
714 XAOBIOP Abdominal Organ Biopsy -
OS Interventional Radiology
Charges)
XAOBIOPDF Abdominal Organ Biopsy - Interventional 13980 13980 6990 5590 4190
Radiology (Doctor Fee)
XAOBIOPHC Abdominal organ biopsy - Interventional 6710 6710 3360 2680 2010
Radiology (Hospital charges)
715 XBAAOS Bronchial Artery Angiography -
Interventional Radiology
Charges)
XBAADF Bronchial Artery Angiography - 27960 27960 13980 11180 8390
Interventional Radiology (Doctor Fee)
XBAAHC Bronchial Artery Angiography - 13420 13420 6710 5370 4030
Interventional Radiology (Hospital charges)
716 XBDJSVCL Bilateral DJ Stenting (IR) in
OS Vascular Cath Lab -
Charges)
XBDJSVCLDF Bilateral DJ Stenting (IR) in Vascular Cath 83860 83860 41930 33540 25160
Lab - Interventional Radiology (Doctor Fee)
XBDJSVCLHC Bilateral DJ stenting (IR) in Vascular Cath 40250 40250 20130 16100 12080
Lab - Interventional Radiology (Hospital
charges)
717 XCBAEOS Complex Bronchial Artery
Embolization - Interventional
Radiology (Doctor Fee +
Hospital Charges)
XCBAEDF Complex Bronchial Artery Embolization - 139760 139760 69880 55900 41930
XCBAEHC Complex Bronchial Artery Embolization - 67080 67080 33540 26830 20130
718 XCBEOS Complex Biliary Externalization
- Interventional Radiology
Charges)
XCBEDF Complex Biliary Externalization - 111800 111800 55900 44720 33540
XCBEHC Complex Biliary Externalization - 53660 53660 26830 21470 16100
719 XCBIOS Complex Biliary Internalization
- Interventional Radiology
Charges)
XCBIDF Complex Biliary Internalization - 111800 111800 55900 44720 33540
XCBIHC Complex Biliary Internalization - 53660 53660 26830 21470 16100
720 XEVOS Embolization for varicocele -
Charges)
297
XEVDF Embolization for Varicocele - Interventional 111800 111800 55900 44720 33540
XEVHC Embolization for Varicocele - Interventional 53660 53660 26830 21470 16100
721 XMACDOS Multiple Abscess / Collection
drainage - Interventional
Hospital Charges)
XMACDDF Multiple Abscess / Collection Drainage - 27960 27960 13980 11180 8390
XMACDHC Multiple Abscess / Collection Drainage - 13420 13420 6710 5370 4030
722 XMBIOPO Miscellaneous biopsy -
S Interventional Radiology
Charges)
XMBIOPDF Miscellaneous Biopsy - Interventional 13980 13980 6990 5590 4190
XMBIOPHC Miscellaneous Biopsy - Interventional 6710 6710 3360 2680 2010
723 XMCTACE Multiple / Complex TACE -
Charges)
XMCTACEDF Multiple / Complex TACE - Interventional 167700 167700 83850 67080 50310
XMCTACEHC Multiple / Complex TACE - Interventional 80500 80500 40250 32200 24150
724 XPCNVCL PCN (IR) in Vascular Cath Lab -
Charges)
XPCNVCLDF PCN (IR) in Vascular Cath Lab - 55900 55900 27950 22360 16770
XPCNVCLHC PCN (IR) in Vascular Cath Lab - 26830 26830 13420 10730 8050
725 XPPVEOS Presurgical portal vein
embolization - Interventional
Hospital Charges)
XPPVEDF Presurgical Portal Vein Embolization - 139760 139760 69880 55900 41930
XPPVEHC Presurgical Portal Vein Embolization - 67080 67080 33540 26830 20130
726 XRYANGA ANGIOPLASTY OF ABDOMINAL
BVSOS VESSELS (Doctor fee + hospital
service charges)
XRAYANGPLA Angioplasty of abdominal vessels - 74400 74400 37200 29760 22320 37200 22320
BDVSL Interventional radiology (done in X-ray dept)
- doctor fee
XRAYANGPLST Angioplasty of abdominal vessels - 35710 35710 17860 14280 10710 17860 10710
ABVSHSP Interventional radiology (done in X-ray dept)
- hospital service charges
727 XRYSELAB Selective Abdominal
DANGOS Angiography (Doctor fee +
hospital service charges)
XRYSELABDAN Selective Abdominal Angiography - 22000 22000 11000 8800 6600 11000 6600
GDF Interventional radiology - doctor fee
XRYSELABDAN Selective Abdominal Angiography - 10560 10560 5280 4220 3170 5280 3170
GHC Interventional radiology - hospital service
charges
298
728 XSIRTLTII Selective Internal Radiation
OS Therapy for Liver Tumors Part
II (SIRT) - Interventional
Hospital Charges)
XSIRTLTIIDF Selective Internal Radiation Therapy for 83860 83860 41930 33540 25160
Liver Tumors Part II (SIRT) - Interventional
XSIRTLTIIHC Selective Internal Radiation Therapy for 40250 40250 20130 16100 12080
Liver Tumors Part II (SIRT) - Interventional
729 XSIRTLTIO Selective Internal Radiation
S Therapy for Liver Tumors Part I
(SIRT) - Interventional
Hospital Charges)
XSIRTLTIDF Selective Internal Radiation Therapy for 212440 212440 106220 84980 63730
Liver Tumors Part I (SIRT) - Interventional
XSIRTLTIHC Selective Internal Radiation Therapy for 101970 101970 50990 40790 30590
Liver Tumors Part I (SIRT) - Interventional
Radiology (Hospital Charges)
730 XUDJSVCL Unilateral DJ Stenting (IR) in
OS Vascular Cath Lab -
Charges)
XUDJSVCLDF Unilateral DJ Stenting (IR) in Vascular Cath 67080 67080 33540 26830 20120
Lab - Interventional Radiology (Doctor Fee)
XUDJSVCLHC Unilateral DJ stenting (IR) in Vascular Cath 32200 32200 16100 12880 9660
Lab - Interventional Radiology (Hospital
charges)
LITHOTRIPSY PACKAGE
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

734 LITHOFSPC Lithotripsy follow-up session 0
package charges
735 LITPDHCH LITHOTRIPSY PROCEDURE
OS1 (STONE < 1 CM) (PACKAGE
LITHO1PC Lithotripsy procedure (stone < 1 cm) 26000
package charges
OS12 (STONE 1.6 - 2.5 CM)
FEE)
LITHO12PC Lithotripsy procedure (stone 1.6 - 2.0 cm) 40000
package charges
OS15 (STONE 1 - 1.5 CM) (PACKAGE
LITHO15PC Lithotripsy procedure (stone 1 - 1.5 cm) 32000
package charges
299
OS21 (STONE 2.1 - 2.5 CM)
FEE)
package charges
OS23 (STONE 2.6 - 3.0 CM)
FEE)
package charges
Minor OT Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
827 ABJMOTO Maxillofacial-Alveolectomy
S (Both jaws) For Minor OT
ABJMOTAC Alveolectomy (Both jaws) For Minor OT ( 2310
ABJMOTHC Alveolectomy (Both jaws) For Minor OT ( 3850
Hospital Charges )
ABJMOTSC Alveolectomy (Both jaws) For Minor OT ( 9240
Surgeon Charges )
828 AFDFOS Maxillofacial -Archbar fixation
dentoalveolar fracture
segment For Minor OT
AFDFAC Archbar fixation dentoalveolar fracture 1390
segment For Minor OT ( Anaesthetists
Charges )
AFDFHC Archbar fixation dentoalveolar fracture 2310
segment For Minor OT ( Hospital Charges )
AFDFSF Archbar fixation dentoalveolar fracture 5530
segment For Minor OT ( Surgeon Charges )
829 ALPMOTO Maxillofacial-Alveoloplasty For
S Minor OT
ALPMOTAC Alveoloplasty For Minor OT ( Anaesthetists 1290
Charges )
ALPMOTHC Alveoloplasty For Minor OT ( Hospital 2160
Charges )
ALPMOTSF Alveoloplasty For Minor OT ( Surgeon 5170
Charges )
830 ANDLOS Anal Dilatation For Minor OT
ANDLANA Anal Dilatation For Minor OT ( Anaesthetists 870
Charges )
ANDLHC Anal Dilatation For Minor OT ( Hospital 1460
Charges )
ANDL Anal Dilatation For Minor OT ( Surgeon 3480
Charges )
831 ASJNOS Maxillofacial-Alveolectomy
(one jaws) For Minor OT
ASJNMOTAC Alveolectomy (one jaws) For Minor OT ( 1300
ASJNMOTHC Alveolectomy (one jaws) For Minor OT ( 2170
Hospital Charges )
ASJNOTAC Alveolectomy (one jaws) For Minor OT ( 5220
Surgeon Charges )
832 ATEBJOS Maxillofacial-All teeth
extractions (both jaws) For
Minor OT
300
ATEBJMOTAC All teeth extractions (both jaws) For Minor 3700
ATEBJMOTHC All teeth extractions (both jaws) For Minor 6150
OT ( Hospital Charges )
ATEBJMOTDC All teeth extractions (both jaws) For Minor 14760
OT ( Surgeon Charges )
833 AULAOS Maxillofacial-Apicectomy
(Under LA) For Minor OT
AULAC Apicectomy (Under LA) For Minor OT ( 1850
AULAHC Apicectomy (Under LA) For Minor OT ( 3080
Hospital Charges )
AULASC Apicectomy (Under LA) For Minor OT ( 7370
Surgeon Charges )
834 BAVOS Brachio AV fistula at elbow for
hemodialysis
BAVAC Brachio AV fistula at elbow for hemodialysis 2420
- Anaesthetists Charges
BAVHC Brachio AV fistula at elbow for hemodialysis 4060
- Hospital Charges
BAVDF Brachio AV fistula at elbow for hemodialysis 9670
- Surgeon Charges
835 CARAVFO Conversion of arteriovenous
S (AV) shunt to arteriovenous
(AV) fistula
CARAVFAC Conversion of arteriovenous (AV) shunt to 2420
arteriovenous (AV) fistula - Anaesthetists
Charges
CARAVFHC Conversion of arteriovenous (AV) shunt to 4060
arteriovenous (AV) fistula - Hospital Charges
CARAVFDC Conversion of arteriovenous (AV) shunt to 9670
arteriovenous (AV) fistula - Surgeon Charges
836 CAREVFB Creation of arteriovenous (AV)
OS Fistula at elbow ( Brachial
artery )
CAREVFBHC Creation of arteriovenous (AV) Fistula at 5130
elbow ( Brachial artery ) - Hospital Charges
CAREVFBDC Creation of arteriovenous (AV) Fistula at 12220
elbow ( Brachial artery ) - Surgeon Charges
CAREVFBAC Creation of arteriovenous (AV) Fistula at 3060
elbow ( Brachial artery ) - Anaesthetists
Charges
837 CAREVFB Creation of arteriovenous (AV)
WOS Fistula at wrist ( Radial Artery
)
CAREVFWBAC Creation of arteriovenous (AV) Fistula at 3060
wrist ( Radial Artery ) - Anaesthetists
Charges
CAREVFBWHC Creation of arteriovenous (AV) Fistula at 5130
wrist ( Radial Artery ) - Hospital Charges
CAREVFBWDC Creation of arteriovenous (AV) Fistula at 12220
wrist ( Radial Artery ) - Surgeon Charges
838 CAREVFO Creation of arteriovenous (AV)
S Fistula at axillary artery
CAREVFHC Creation of arteriovenous (AV) Fistula at 5130
axillary artery - Hospital Charges
CAREVFDC Creation of arteriovenous (AV) Fistula at 12220
axillary artery - Surgeon Charges
CAREVFAC Creation of arteriovenous (AV) Fistula at 3060
axillary artery - Anaesthetists Charges
839 CCMINPL CARPAL TUNNEL RELEASE
ASDBOS (PLASTIC SURGERY) For Minor
OT
CCMINPLASBK CARPAL TUNNEL RELEASE (PLASTIC 4500
N SURGERY) For Minor OT ( Anaesthetists
Charges )
CCMINPLASBK CARPAL TUNNEL RELEASE (PLASTIC 7500
H SURGERY) For Minor OT ( Hospital Charges )
301
CCMINPLASBD CARPAL TUNNEL RELEASE (PLASTIC 18000
SURGERY) For Minor OT ( Surgeon Charges )
840 CCMOS Circumcision For Minor OT
CCMANA Circumcision For Minor OT ( Anaesthetists 1560
Charges )
CCMHC Circumcision For Minor OT ( Hospital 2630
Charges )
CCM Circumcision For Minor OT ( Surgeon 6250
Charges )
841 CDMINPL MEDIUM DRESSING (PLASTIC
ASDBOS SURGERY) For Minor OT
CDMINPLASBK MEDIUM DRESSING (PLASTIC SURGERY) For 750
N Minor OT ( Anaesthetists Charges )
CDMINPLASBK MEDIUM DRESSING (PLASTIC SURGERY) For 1250
H Minor OT ( Hospital Charges )
CDMINPLASB MEDIUM DRESSING (PLASTIC SURGERY) For 3000
D Minor OT ( Surgeon Charges )
842 CIMCPLA CIRCUMCISION +
OS PHRENULOPLASTY ( Doctor
Charges + Hospital Charges)
CIRLASTYA Circumcision + Phrenuloplasty For Minor OT 4140
( Anaesthetists Charges )
PLALASTY Circumcision + Phrenuloplasty For Minor OT 16540
( Doctor Charges )
CIRPHEH Circumcision + Phrenuloplasty For Minor OT 6950
( Hospital Charges )
843 COEOSKG Scar Revision Complex (
RAOS Doctor Charges + Hospital
Charges )
COATKGRAA Scar Revision Complex For Minor OT ( 5790
COATKGRAD Scar Revision Complex For Minor OT ( 23150
Doctor Charges )
COATKGRAH Scar Revision Complex For Minor OT ( 9720
Hospital Charges )
844 CROSKGR Crossfinger Flap ( Doctor
AOS Charges + Hospital Charges )
CROATKGRAA Crossfinger Flap For Minor OT ( 4140
CROATKGRAH Crossfinger Flap For Minor OT ( Hospital 6950
Charges )
CROATKGRAD Crossfinger Flap For Minor OT ( Doctor 16540
Charges )
845 CTZOS Catheterization For Minor OT
CTZANA Catheterization For Minor OT ( 520
CTZHC Catheterization For Minor OT ( Hospital 870
Charges )
CTZ Catheterization For Minor OT ( Surgeon 2080
Charges )
846 DBFMOS Diagnostic Bronchoscopy For
Minor OT
DBFMNA Diagnostic Bronchoscopy For Minor OT ( 1930
DBFMHC Diagnostic Bronchoscopy For Minor OT ( 3240
Hospital Charges )
DBFM Diagnostic Bronchoscopy For Minor OT ( 7720
Surgeon Charges )
847 DBWBOS Diagnostic Bronchoscopy with
Biopsy For Minor OT
DBWBNA Diagnostic Bronchoscopy with Biopsy ( 2810
DBWBHC Diagnostic Bronchoscopy with Biopsy ( 3750
Hospital Charges )
DBWB Diagnostic Bronchoscopy with Biopsy ( 9380
Surgeon Charges )
848 DCDROS Dressing change/drain removal
For Minor OT
302
DCDRA Dressing change/drain removal For Minor 440
OT (Anaesthetists Charges)
DCDRH Dressing change/drain removal For Minor 730
OT (Hospital Charges)
DCDR Dressing change/drain removal For Minor 1740
OT (Surgeon Charges)
849 DENIMPO Maxillofacial- Implant (first
S stage) For Minor OT
DENIMPAC Dental Implant (first stage) For Minor OT ( 9220
DENIMHC Dental Implant (first stage) For Minor OT ( 15370
Hospital Charges )
DENIMSC Dental Implant (first stage) For Minor OT ( 36900
Surgeon Charges )
850 DISTMJOS Maxillofacial-Dislocation of
TMJ For Minor OT
DISTMJAC Dislocation of TMJ For Minor OT ( 1160
DISTMJHC Dislocation of TMJ For Minor OT ( Hospital 1920
Charges )
DISTMJSC Dislocation of TMJ For Minor OT ( Surgeon 4610
Charges )
851 DOSOS Dorsal Slit For Minor OT
DOSANA Dorsal Slit For Minor OT ( Anaesthetists 1220
Charges )
DOSHC Dorsal Slit For Minor OT ( Hospital Charges ) 2040
DOS Dorsal Slit For Minor OT ( Surgeon Charges ) 4860
852 DREMOS Dressing (minor) For Minor OT
DREMA Dressing (minor) For Minor OT ( 520
DREMH Dressing (minor) For Minor OT ( Hospital 870
Charges )
DREM Dressing (minor) For Minor OT ( Surgeon 2080
Charges )
853 ELRBOS Ear lobe repair BL For Minor
OT
ELRBA Ear lobe repair BL For Minor OT ( 1040
ELRBH Ear lobe repair BL For Minor OT ( Hospital 1750
Charges )
ELRB Ear lobe repair BL For Minor OT ( Surgeon 4170
Charges )
854 ELRUOS Ear lobe repair UL For Minor
OT
ELRUA Ear lobe repair UL For Minor OT ( 700
ELRUH Ear lobe repair UL For Minor OT ( Hospital 1170
Charges )
ELRU Ear lobe repair UL For Minor OT ( Surgeon 2780
Charges )
855 EXBIMOS Maxillofacial-Excisional biospy
For Minor OT
EXBIMAC Excisional biospy For Minor OT ( 1390
EXBIMHC Excisional biospy For Minor OT ( Hospital 2310
Charges )
EXBIMOT Excisional biospy For Minor OT ( Surgeon 5530
Charges )
856 EXPFOS Maxillofacial-Excision of
pericoronal flap For Minor OT
EXPFAC Excision of pericoronal flap For Minor OT ( 910
EXPFHC Excision of pericoronal flap For Minor OT ( 1520
Hospital Charges )
EXPFSC Excision of pericoronal flap For Minor OT ( 3640
Surgeon Charges )
857 FATKGRA Fat Grafting Major ( Doctor
OS Charges + Hospital Charges )
303
FATKGRAA Fat Grafting Major For Minor OT ( 4960
FATKGRAD Fat Grafting Major For Minor OT ( Doctor 19850
Charges )
FATKGRAH Fat Grafting Major For Minor OT ( Hospital 8340
Charges )
858 FLAMOTO Maxillofacial-Fracture
S mandible open reduction
under LA (Cost of plates &
screws etc.) For Minor OT
FLAMOTAC Fracture mandible open reduction under LA 6920
(Cost of plates & screws etc.) For Minor OT
FLAMOTHC Fracture mandible open reduction under LA 11540
(Cost of plates & screws etc.) For Minor OT (
Hospital Charges )
FLAMOTSC Fracture mandible open reduction under LA 27680
(Cost of plates & screws etc.) For Minor OT (
Surgeon Charges )
859 FLDIMTOS Flap Division and Inset For
Minot OT
FLDIMTAC Flap Division and Inset For Minor OT ( 2980
Anaesthetists Charges)
FLDIMTHC Flap Division and Inset For Minor OT ( 5000
Hospital Charges)
FLDIMTSC Flap Division and Inset For Minor OT ( 11910
Surgeon Charges)
860 FLMTOS Flap Large For Minor OT
FLMTAC Flap Large For Minor OT ( Anaesthetists 4960
Charges )
FLMTHC Flap Large For Minor OT ( Hospital Charges ) 8340
FLMTSC Flap Large For Minor OT ( Surgeon Charges ) 19850
861 FNPOS Frenuloplasty For Minor OT
FNPANA Frenuloplasty For Minor OT ( Anaesthetists 780
Charges )
FNPHC Frenuloplasty For Minor OT ( Hospital 1310
Charges )
FNP Frenuloplasty For Minor OT ( Surgeon 3130
Charges )
862 FOASOS Foam Sclerotherapy For Minor
OT
FOASA Foam Sclerotherapy For Minor OT ( 3470
FOASH Foam Sclerotherapy For Minor OT ( Hospital 5830
Charges )
FOAS Foam Sclerotherapy For Minor OT ( Surgeon 13890
Charges )
863 FRMOTOS Maxillofacial -Frenectomy For
Minor OT
FRMOTAC Frenectomy For Minor OT ( Anaesthetists 990
Charges )
FRMOTHC Frenectomy For Minor OT ( Hospital Charges 1660
)
FRMOTSC Frenectomy For Minor OT ( Surgeon Charges 3970
)
864 FSBQOS Maxillofacial-Flap surgery with
bone graft (per quadrant) For
Minor OT
FSBQAC Flap surgery with bone graft (per quadrant) 1850
FSBQHC Flap surgery with bone graft (per quadrant) 3080
For Minor OT ( Hospital Charges )
FSBQSC Flap surgery with bone graft (per quadrant) 7370
For Minor OT ( Surgeon Charges )
865 FSMTOS Flap Small For Minor OT
FSMTAC Flap Small For Minor OT ( Anaesthetists 4140
Charge)
FSMTHC Flap Small For Minor OT ( Hospital Charges ) 6950
304
FSMTSC Flap Small For Minor OT ( Surgeon Charges ) 16540
866 GINPMOT Maxillofacial-Gingivoplasty For
OS Minor OT
GINPMOTSC Gingivoplasty For Minor OT ( Surgeon 5530
Charges )
GINPMOTAC Gingivoplasty For Minor OT ( Anaesthetists 1390
Charges )
GINPMOTHC Gingivoplasty For Minor OT ( Hospital 2310
Charges )
867 IBSMOTO Maxillofacial-Impaction
S (Bony/soft tissue) For Minor
OT
IBSMOTAC Impaction (Bony/soft tissue) For Minor OT ( 2610
IBSMOTHC Impaction (Bony/soft tissue) For Minor OT ( 4350
Hospital Charges )
IBSMOTSC Impaction (Bony/soft tissue) For Minor OT ( 10440
Surgeon Charges )
868 ICCPLOS ICD insertion for complex
effusion/pneumothorax For
Minor OT
ICCPLNA ICD insertion for complex 1930
effusion/pneumothorax For Minor OT (
ICCPLHC ICD insertion for complex 3240
Hospital Charges )
ICCPL ICD insertion for complex 7720
Surgeon Charges )
869 ICDSMOS ICD insertion for simple
effusion/pneumothorax For
Minor OT
ICDSMNA ICD insertion for simple 830
ICDSMHC ICD insertion for simple 1390
Hospital Charges )
ICDSMOT ICD insertion for simple 3310
Surgeon Charges )
870 IDLAOS Incision and Drainage of
Multiple/ Large Superficial
Abscess For Minor OT
IDLANA Incision and Drainage of Multiple/ Large 1390
Superficial Abscess For Minor OT (
IDLAHC Incision and Drainage of Multiple/ Large 2330
Superficial Abscess For Minor OT ( Hospital
charges )
IDLA Incision and Drainage of Multiple/ Large 5550
Superficial Abscess For Minor OT ( Surgeon
charges )
871 IDSAOS Incision And Drainage of
Small/Superficial Abscess For
Minor OT
IDSANA Incision And Drainage of Small/Superficial 700
Abscess For Minor OT ( Anaesthetists
Charges )
IDSAHC Incision And Drainage of Small/Superficial 1170
Abscess For Minor OT ( Hospital Charges )
IDSA Incision And Drainage of Small/Superficial 2780
Abscess For Minor OT ( Surgeon Charges )
872 IMFMOTO Maxillofacial-Inter - Maxillary
S fixation with archbar For Minor
OT
305
IMFMOTHC Inter - Maxillary fixation with archbar For 5390
Minor OT ( Hospital Charges )
IMFMOTDC Inter - Maxillary fixation with archbar For 12920
Minor OT ( Surgeon Charges )
IMFMOTAC Inter - Maxillary fixation with archbar For 3230
Minor OT( Anaesthetists Charges )
873 INADMOS Incision and drainage (major)
For Minor OT
INADMA Incision and drainage (major) For Minor OT ( 1390
INADMH Incision and drainage (major) For Minor OT ( 2330
Hospital Charges )
INADM Incision and drainage (major) For Minor OT ( 5550
Surgeon Charges )
874 INADOS Incision and drainage For
Minor OT
INADA Incision and drainage (Minor) For Minor OT 700
INADH Incision and drainage (Minor) For Minor OT 1170
( Hospital Charges )
INAD Incision and drainage (Minor) For Minor OT 2780
(Surgeon Charges)
875 INDMOTO Maxillofacial - Incision and
S drainage For Minor OT
INDMOTHC Incision and drainage For Minor OT ( 1540
Hospital Charges )
INDMOTSC Incision and drainage For Minor OT ( 3700
Surgeon Charges )
INDMOTAC Incision and drainage For Minor OT( 920
876 IOTNOS Ingrowing toe nail For Minor
OT
IOTNANA Ingrowing toe nail For Minor OT ( 2430
IOTNHC Ingrowing toe nail For Minor OT ( Hospital 4080
Charges )
IOTN Ingrowing toe nail For Minor OT ( Surgeon 9720
Charges )
877 JFMOTOS Maxillofacial-Jaw fracture
closed reduction For Minor OT
JFMOTSC Jaw fracture closed reduction For Minor OT ( 14760
Surgeon Charges )
JFMOTAC Jaw fracture closed reduction For Minor OT( 3700
JFMOTHC Jaw fracture closed reduction For Minor OT( 6150
Hospital Charges )
878 LAMINPL SKIN & SOFT TISSUE BIOPSY-
ASDBOS LARGE (PLASTIC SURGERY) For
Minor OT
LAMINPLASBK SKIN & SOFT TISSUE BIOPSY- LARGE 1500
N (PLASTIC SURGERY) For Minor OT (
LAMINPLASBK SKIN & SOFT TISSUE BIOPSY- LARGE 2500
H (PLASTIC SURGERY) For Minor OT ( Hospital
Charges )
LAMINPLASBD SKIN & SOFT TISSUE BIOPSY- LARGE 6000
(PLASTIC SURGERY) For Minor OT ( Surgeon
Charges )
879 LATKGRA Skin Lesion Large ( Doctor
LATKGRAA Skin Lesion Large For Minor OT ( 5290
LATKGRAH Skin Lesion Large For Minor OT ( Hospital 8890
Charges )
LATKGRAD Skin Lesion Large For Minor OT ( Doctor 21170
Charges )
306
880 LLMINPLA BURN DRESSING - LARGE
SDBOS (PLASTIC SURGERY) For Minor
OT
LLMINPLASBK BURN DRESSING - LARGE (PLASTIC 1200
Charges )
LLMINPLASBK BURN DRESSING - LARGE (PLASTIC 2000
LLMINPLASBD BURN DRESSING - LARGE (PLASTIC 4800
881 LNBMOS Lymph Node Biopsy For Minor
OT
LNBMN Lymph Node Biopsy For Minor OT ( 830
LNBMHC Lymph Node Biopsy For Minor OT ( Hospital 1390
Charges )
LNBM Lymph Node Biopsy For Minor OT ( Surgeon 3310
Charges )
882 MADMOS Major Debridement For Minor
OT
MADMANA Major Debridement For Minor OT ( 1740
MADMHC Major Debridement For Minor OT ( Hospital 2920
Charges )
MADM Major Debridement For Minor OT ( Surgeon 6950
Charges )
883 MATKGRA Fat Grafting Minor ( Doctor
MATKGRAD Fat Grafting Minor For Minor OT ( Doctor 13230
Charges )
MATKGRAA Fat Grafting Minor For Minor OT ( 3310
MATKGRAH Fat Grafting Minor For Minor OT ( Hospital 5560
Charges )
884 MINDOS Minor debridement For Minor
OT
MINDA Minor debridement For Minor OT ( 870
MINDH Minor debridement For Minor OT ( Hospital 1460
Charges )
MIND Minor debridement For Minor OT ( Surgeon 3480
Charges )
885 MINIMPO Maxillofacial-Mini implant for
S anchorage (per implant) For
Minor OT
MINIMPHC Mini implant for anchorage (per implant) 4620
MINIMPAC Mini implant for anchorage (per implant) 2770
For Minor OT( Anaesthetists Charges )
886 MMMINP BURN DRESSING - MEDIUM
LASDBOS (PLASTIC SURGERY) For Minor
OT
MMMINPLASB BURN DRESSING - MEDIUM (PLASTIC 900
KN SURGERY) For Minor OT ( Anaesthetists
Charges )
KH SURGERY) For Minor OT ( Hospital Charges )
D SURGERY) For Minor OT ( Surgeon Charges )
887 MMOTH Hymenoplasty for Minor OT
MOS (Doctors charges+ Hospital
Charges)
MHOOT Hymenoplasty for Minor OT (Anasthetist 5250
charges)
MMOTDOC Hymenoplasty for Minor OT (Doctors 21000
charges)
307
MHOTM Hymenoplasty for Minor OT (Hospital 8750
charges)
888 MTOS Meatotomy For Minor OT
MTANA Meatotomy For Minor OT ( Anaesthetists 730
Charges )
MTHC Meatotomy For Minor OT ( Hospital Charges 1230
)
MT Meatotomy For Minor OT ( Surgeon Charges 2920
)
889 NEDLAOS Needle aspiration For Minor
OT
NEDLAA Needle aspiration For Minor OT 440
NEDLAH Needle aspiration For Minor OT (Hospital 730
Charges )
NEDLA Needle aspiration For Minor OT (Surgeon 1740
charges)
890 NERBLOS Maxillofacial-Nerve block in
Neuralgias For Minor OT
NERBLAC Nerve block in Neuralgias For Minor OT ( 1390
NERBLSC Nerve block in Neuralgias For Minor OT( 2310
Hospital Charges )
NERBLDC Nerve block in Neuralgias For Minor OT( 5530
Surgeon Charges )
891 ORANCOS Maxillofacial-Oro antral
communication closure For
Minor OT
ORANCAC Oro antral communication closure For Minor 6460
ORANCDC Oro antral communication closure For Minor 25820
ORANCHC Oro antral communication closure For Minor 10760
OT (Hospital Charges )
892 PTBOS Prostatic Trucut Biopsy For
Minor OT
PTBANA Prostatic Trucut Biopsy For Minor OT ( 700
PTBHC Prostatic Trucut Biopsy For Minor OT ( 1170
Hosiptal Charges )
PTB Prostatic Trucut Biopsy For Minor OT ( 2780
Surgeon Charges )
893 RATMOT Maxillofacial-Reimplantation
OS of avulsed tooth For Minor OT
RATMOTDC Reimplantation of avulsed tooth For Minor 4900
RATMOTAC Reimplantation of avulsed tooth For Minor 1220
RATMOTHC Reimplantation of avulsed tooth For Minor 2040
OT( Hospital Charges )
894 REOSKGR Scar Revision Simple ( Doctor
REATKGRAA Scar Revision Simple For Minor OT ( 3310
REATKGRAH Scar Revision Simple For Minor OT ( 5560
Hospital Charges )
REATKGRAD Scar Revision Simple For Minor OT ( Doctor 13230
Charges )
895 RIOHOS Reduction of Irreducible
Obstructed Hernia For Minor
OT
RIOHAN Reduction of Irreducible Obstructed Hernia 4340
RIOHC Reduction of Irreducible Obstructed Hernia 7300
For Minor OT ( Hospital charges )
RIOH Reduction of Irreducible Obstructed Hernia 17370
For Minor OT ( Surgeon charges )
308
896 RPMLAOS Maxillofacial-Removal of
plates of mandible and maxilla
(Under LA) For Minor OT
RPMLAAC Removal of plates of mandible and maxilla 3700
(Under LA) For Minor OT( Anaesthetists
Charges )
RPMLAHC Removal of plates of mandible and maxilla 1540
(Under LA) For Minor OT( Hospital Charges
)
RPMLADC Removal of plates of mandible and maxilla 14760
(Under LA) For Minor OT( Surgeon Charges )
897 RSPOS Reduction of Stomal Prolapsed
For Minor OT
RSPANA Reduction of Stomal Prolapsed For Minor OT 2610
RSPHC Reduction of Stomal Prolapsed For Minor OT 4380
( Hospital charges )
RSP Reduction of Stomal Prolapsed For Minor OT 10420
( Surgeon charges )
898 SATKGRA Skin Lesion Small ( Doctor
SATKGRAA Skin Lesion Small For Minor OT ( 2980
SATKGRAH Skin Lesion Small For Minor OT ( Hospital 5000
Charges )
SATKGRAD Skin Lesion Small For Minor OT ( Doctor 11910
Charges )
899 SCMOTOS Maxillofacial-Scaling full
mouth For Minor OT
SCMOTAC Scaling full mouth For Minor OT ( 990
SCMOTDC Scaling full mouth For Minor OT ( Surgeon 3970
Charges )
SCMOTHC Scaling full mouth For Minor OT( Hospital 1660
Charges )
900 SCUBCUR Maxillofacial-Subgingival
OS scaling & curretage full mouth
For Minor OT
SUBCURDC Subgingival scaling & curretage full mouth 5530
SUBCURAC Subgingival scaling & curretage full mouth 1390
For Minor OT (Anaesthetists Charges)
SUBCURHC Subgingival scaling & curretage full mouth 2310
For Minor OT (Hospital Charges)
901 SKGMTOS Skin Grafting For Minor OT
SKGMTAC Skin Grafting For Minor OT ( Anaesthetists 3310
Charges )
SKGMTHC Skin Grafting For Minor OT ( Hospital 5560
Charges )
SKGMTSC Skin Grafting For Minor OT ( Surgeon 13230
Charges )
902 SMALLSK Small skin graft for Minot OT
OS
SMSKGRAA Small Skin Grafting For Minor OT ( 3310
SMSKGRAD Small Skin Grafting For Minor OT ( Doctor 13230
Charges )
SMSKGRAH Small Skin Grafting For Minor OT ( Hospital 5560
Charges )
903 SMLOS Suturing of Medium
Lacerations (Large) For Minor
OT
SMLANA Suturing of Medium Lacerations (Large) For 2430
SMLHC Suturing of Medium Lacerations (Large) For 4080
Minor OT ( Hospital charges )
SML Suturing of Medium Lacerations (Large) For 9720
Minor OT ( Surgeon charges )
309
904 SOFTSWE Soft Tissue Swelling Large (
NOS Doctor Charges + Hospital
Charges )
SOFTTSFD Soft Tissue Swelling Large For Minor OT ( 19850
Doctor Charges )
SOFTTSACC Soft Tissue Swelling Large For Minor OT ( 4960
SOFTTSHH Soft Tissue Swelling Large For Minor OT ( 8340
Hospital Charges )
905 SOFTSWE Soft Tissue Swelling Small (
OS Doctor Charges + Hospital
Charges )
SOFTTSD Soft Tissue Swelling Small For Minor OT ( 13230
Doctor Charges )
SOFTTSAC Soft Tissue Swelling Small For Minor OT ( 3310
SOFTTSH Soft Tissue Swelling Small For Minor OT ( 5560
Hospital Charges )
906 SPMINPL SKIN & SOFT TISSUE BIOPSY-
ASDBOS MEDIUM (PLASTIC SURGERY)
For Minor OT
SPMINPLASBK SKIN & SOFT TISSUE BIOPSY- MEDIUM 1200
SPMINPLASBK SKIN & SOFT TISSUE BIOPSY- MEDIUM 2000
Charges )
SPMINPLASBD SKIN & SOFT TISSUE BIOPSY- MEDIUM 4800
Charges )
907 SPREMOS Maxillofacial-Splint Removal
For Minor OT
SPREMOTAC Splint Removal For Minor OT ( Anaesthetists 610
Charges )
SPREMOTHC Splint Removal For Minor OT ( Hospital 1020
Charges )
SPREMOTSC Splint Removal For Minor OT ( Surgeon 2440
Charges )
908 SPTCOS SPC (Suprapubic Trocar
Cystostomy) For Minor OT
SPTCANA SPC (Suprapubic Trocar Cystostomy) For 2090
SPTCHC SPC (Suprapubic Trocar Cystostomy) For 3500
SPTC SPC (Suprapubic Trocar Cystostomy) For 8340
909 SSFTOS Secondary Suturing For Minor
OT
SSFTNA Secondary Suturing For Minor OT ( 1100
SSFTHC Secondary Suturing For Minor OT ( Hospital 1850
Charges )
SSFT Secondary Suturing For Minor OT ( Surgeon 4410
Charges )
910 SSLOS Suturing of Small Lacerations
For Minor OT
SSLANA Suturing of Small Lacerations For Minor OT ( 1390
SSLHC Suturing of Small Lacerations For Minor OT ( 2330
Hospital Charges )
SSL Suturing of Small Lacerations For Minor OT ( 5550
Surgeon Charges )
911 SSMINPLA BURN DRESSING - SMALL
SDBOS (PLASTIC SURGERY) For Minor
OT
310
SSMINPLASBK BURN DRESSING - SMALL (PLASTIC 530
Charges )
SSMINPLASBK BURN DRESSING - SMALL (PLASTIC 870
SSMINPLASBD BURN DRESSING - SMALL (PLASTIC 2100
912 SSMINPLA SKIN TAG REMOVAL (PLASTIC
SDKOS SURGERY) For Minor OT
SSMINPLASDK SKIN TAG REMOVAL (PLASTIC SURGERY) For 1130
N Minor OT ( Anaesthetists Charges )
SSMINPLASDK SKIN TAG REMOVAL (PLASTIC SURGERY) For 1870
H Minor OT ( Hospital Charges )
SSMINPLASKD SKIN TAG REMOVAL (PLASTIC SURGERY) For 4500
913 SSMINPLA SECONDARY SUTURING
SDOS (PLASTIC SURGERY) For Minor
OT
SSMINPLASDN SECONDARY SUTURING (PLASTIC SURGERY) 2250
SSMINPLASDH SECONDARY SUTURING (PLASTIC SURGERY) 3750
SSMINPLASD SECONDARY SUTURING (PLASTIC SURGERY) 9000
914 STMINPLA SKIN & SOFT TISSUE BIOPSY-
SDBOS SMALL (PLASTIC SURGERY) For
Minor OT
STMINPLASBK SKIN & SOFT TISSUE BIOPSY- SMALL 900
STMINPLASBK SKIN & SOFT TISSUE BIOPSY- SMALL 1500
Charges )
STMINPLASBD SKIN & SOFT TISSUE BIOPSY- SMALL 3600
Charges )
915 STSEOS Soft tissue swelling excision
For Minor OT
STSEA Soft tissue swelling excision for Minor OT 2430
STSEH Soft tissue swelling excision for Minor OT 4080
(Hospital Charges )
STSE Soft tissue swelling excision for Minor OT 9720
(Surgeon Charges )
916 STUMINI Stump Closure Major ( Doctor
OS Charges + Hospital Charges)
STUAINAC Stump Closure Major For Minor OT ( 4960
STUMINIO Stump Closure Major For Minor OT ( Doctor 19850
Charges )
STUCLOMIN Stump Closure Major For Minor OT ( 8340
Hospital Charges )
917 STUMINO Stump Closure Minor ( Doctor
S Charges + Hospital Charges)
STUANAC Stump Closure Minor For Minor OT ( 3310
STUMINO Stump Closure Minor For Minor OT ( Doctor 13230
Charges )
STUCLMIN Stump Closure Minor For Minor OT ( 5560
Hospital Charges )
918 SUEXTOS Maxillofacial-Surgical
extraction of tooth For Minor
OT
SUEXTDC Surgical extraction of tooth For Minor OT ( 5510
Surgeon Charges )
SUEXTAC Surgical extraction of tooth For Minor OT 1380
SUEXTHC Surgical extraction of tooth For Minor OT 2300
(Hospital Charges)
311
919 SUTREOS Suture removal For Minor OT
SUTREA Suture removal For Minor OT (Anaesthetists 440
Charges)
SUTREH Suture removal For Minor OT (Hospital 730
Charges)
SUTRE Suture removal For Minor OT (Surgeon 1740
Charges)
920 TCBOS Teslicular Biopsy For Minor OT
TCBANA Teslicular Biopsy For Minor OT ( 1040
TCBHC Teslicular Biopsy For Minor OT ( Hospital 1750
Charges )
TCB Teslicular Biopsy For Minor OT ( Surgeon 4170
Charges )
921 TPATKGR Finger Tip Injury ( Doctor
URLATKGRAA Finger Tip Injury For Minor OT ( 3310
URLATKGRAH Finger Tip Injury For Minor OT ( Hospital 5560
Charges )
URLATKGRAD Finger Tip Injury For Minor OT ( Doctor 13230
Charges )
922 TUEXOS Maxillofacial-Tumour Excision
For Minor OT
TUEXDC Tumour excision For Minor OT ( Surgeon 18450
Charges )
TUEXAC Tumour Excision For Minor OT 4610
TUEXHC Tumour excision For Minor OT (Hospital 7690
Charges)
923 UCADOS Urethral Calibration and
Dilatation For Minor OT
UCADANA Urethral Calibration and Dilatation For 700
UCADHC Urethral Calibration and Dilatation For 1170
UCAD Urethral Calibration and Dilatation For 2780
924 URCAOS Uretheral Catheterization For
Minor OT
URCANA Uretheral Catheterization For Minor OT ( 520
URCAHC Uretheral Catheterization For Minor OT ( 870
Hospital charges )
URCA Uretheral Catheterization For Minor OT ( 2080
Surgeon charges )
925 URDLOS Urethral dilatation For Minor
OT
URDLA Urethral dilatation For Minor OT 870
URDLH Urethral dilatation For Minor OT (Hospital 1460
Charges)
URDL Urethral dilatation For Minor OT (Surgeon 3480
Charges)
926 VAMSOS VAC Application For Minor OT
VAMHC VAC Application For Minor OT ( Hospital 930
Charges )
VAMSNA VAC Application For Minor OT ( 550
VAMS VAC Application For Minor OT ( Surgeon 2210
Charges )
927 WDMTOS Wound Debridement For
Minor OT
WDMTN Wound Debridement For Minor OT ( 550
WDMTHC Wound Debridement For Minor OT ( 930
Hospital Charges )
WDMT Wound Debridement For Minor OT ( 2210
Surgeon Charges )
312
Oncology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
973 CPSDHCO CHEMOTHERAPY PLANNING /
S SUPERVISION (DOCTOR FEE +
HOSPITAL CHARGES)
CPSAHC Chemotherapy planning / supervision - 350 350 180 140 110
CPSDF Chemotherapy planning / supervision - 3500 3500 1750 1400 1050
Doctor fee
974 EDCF Early detection of cancer ( 1470
Package of women )
MAMMOP Mammography (bilateral) ( Xray dept

charges )
PAPS PAP smear / Hormonal smear / Vault smear
/ Cervical smear WITH Barcode
WA Ultrasound whole abdomen & pelvis ( Adult

)
975 EDCM Early detection of cancer ( 1470
Package of men )
WA Ultrasound whole abdomen & pelvis ( Adult

)
Ophthalmology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

976 ACFOS AC Formation - (Doctor
ACFAC AC Formation - Anasthesia Consumables 320
ACFCO AC Formation - Consumables Charges 600
ACFDF AC Formation - Doctor Fee 1320
ACFTC AC Formation - Theatre Charges 660
ANPACCHSY Anaesthetist PAC charges for Daycare 610
Packages (Rs. 610)
MRDCHG MRD Charges 500 500 500 500 500
977 ALPDHCO RETINAL LASER
SDM PHOTOCOAGULATION - SINGLE
SITTING (DOCTOR FEE +
HOSPITAL CHARGES)
ALPDMHC Argon laser photocoagulation ( single sitting 1780 1780
) for diabetic maculopathy - Additional
hospital charges
ALPDMDF Argon laser photocoagulation ( single sitting 3060 3060
) for diabetic maculopathy - Doctor fees
978 BIBLBIOS Botox Injection - Bilateral
BIBLBI Botox Injection Blepharospasam - Bilateral 16500 16500 8250 6600 4950
313
BOIEBI Botox Injection Epiphora - Bilateral 8260 8260 4130 3300 2480
BISTPBI Botox Injection Squint/Lid retraction/ Four 8260 8260 4130 3300 2480
inducing temporary Ptosis - Bilateral
979 BIBUNIOS Botox Injection - Unilateral
BIBLUNI Botox Injection Blepharospasam - Unilateral 11000 11000 5500 4400 3300
BOIEUNI Botox Injection Epiphora - Unilateral 5500 5500 2750 2200 1650
BISTPUNI Botox Injection Squint/Lid retraction/ Four 5500 5500 2750 2200 1650
inducing temporary Ptosis - Unilateral
980 C3ROS C3R (laser room) - (Doctor
Fee+Hospital Charges )
C3RHC C3R (laser room) - Additional Hospital 8800
Charges
C3RCC C3R (laser room) - Consumables Charges 5000
C3RDF C3R (laser room) - Doctor Fee 13200
C3REC C3R (laser room) - Equipment Charges 3300
981 CAGAOS Cyno Acrylate Glue Application
( Surgeon Fee + Hospital
Charges )
CAGAHC Cyno Acrylate Glue Application ( Hospital 580 350
Charges )
CAGASC Cyno Acrylate Glue Application ( Surgeon 870 520
Charges )
982 CFBOS Corneal Foreign Body Removal
( Surgeon Fee + Hospital
Charges )
CFBHC Corneal Foreign Body Removal ( Hospital 580 350
Charges )
CFBR Corneal Foreign Body Removal ( Surgen 870 520
Charges )
983 CFPSOS Colour Fundus Photography (
Surgen Fee + Hospital Charges )
CFPHC Colour Fundus Photography ( Hospital 550 330
Charges )
CFPSF Colour Fundus Photography ( Surgeon Fee ) 940 560
984 CLIOLOS Glued IOL - (Doctor
Packages (Rs. 610)
GLIOLCA Glued IOL - Anasthesia Consumables 320
GLIOLAC Glued IOL - Anasthetist Charges 3960
GLIOLCO Glued IOL - Consumables Charges 5000
GLIOLDF Glued IOL - Doctor Fee 19800
GLIOLTC Glued IOL - Theatre Charges 9900
985 CORSOS Corneal Scrapping - (Doctor
CORSDF Corneal Scrapping - Doctor Fee 660
CORSHC Corneal Scrapping - Hospital Charges 440
986 CRDFICGP COMBINED RETINAL DIGITAL
DCOS FLUORESCEIN & INDOCYANINE
GREEN ( ICG ) IMAGING
CHARGES)
CRDFICGHC Combined retinal digital fluorescein & 6200 3720
indocyanine green ( ICG ) imaging
angiography - Additional hospital charges
CRDFICGDF Combined retinal digital fluorescein & 2660 1600
indocyanine green ( ICG ) imaging
angiography - Doctor fees
987 DALKOS DALK - (Doctor Fee+Hospital
Charges)
314
Packages (Rs. 610)
DALKCA DALK - Anasthesia Consumables 320
DALKAC DALK - Anasthetist Charges 8360
DALKCO DALK - Consumables Charges 7000
DALKDF DALK - Doctor Fee 41800
DALKTC DALK - Theatre Charges 20900
988 DECSDHC DIABETIC EYE CARE SERVICE
CHARGES)
DECHC Diabetic eye care service - Additional 670 400
hospital charges
DECDF Diabetic eye care service - Doctor fee 400 240
989 DSEKOS Descemets's stripping
Endothelial Keraoplasty -
Packages (Rs. 610)
DSEKCA Descemets's stripping Endothelial 320
Keraoplasty - Anasthesia Consumables
DSEKAC Descemets's stripping Endothelial 7920
Keraoplasty - Anasthetist charges
DSEKCO Descemets's stripping Endothelial 7000
Keraoplasty - Consumables Charges
DSEKDF Descemets's stripping Endothelial 39600
Keraoplasty - Doctor Fee
DSEKTC Descemets's stripping Endothelial 19800
Keraoplasty - Theatre charges
990 EDBCLOS Epithelial Debridetment with
BCL - (Doctor Fee+Hospital
Charges)
Packages (Rs. 610)
EDBCLCA Epithelial Debridetment with + BCL - 320
Anasthesia Consumables
EDBCLAC Epithelial Debridetment with + BCL - 2200
Anasthetist Charges
EDBCLCO Epithelial Debridetment with + BCL - 7000
Consumables Charges
EDBCLDF Epithelial Debridetment with + BCL - Doctor 11000
Fee
EDBCLTC Epithelial Debridetment with + BCL - Theatre 5500
Charges
991 ELTLOS Electrolysis - (Doctor
ELTLDF Electrolysis - Doctor Fee 3300
ELTLHC Electrolysis - Hospital Charges 2200
992 HALOS Chalazion ( Surgen Fee +
Hospital Charges )
CHALA Chalazion ( Surgen Charges ) 3630 2180
CHALHC Chalazion Hospital Charges 2420 1450
993 IITAOS Intravitreal Injection TA (OT) -
Packages (Rs. 610)
IITACO Intravitreal Injection TA (OT) - Anasthesia 320
consumables
IITAAC Intravitreal Injection TA (OT) - Anasthetist 880
charges
IITAOC Intravitreal Injection TA (OT) - Consumable 900
charges
315
IITADF Intravitreal Injection TA (OT) - Doctor Fee 4400
IITATC Intravitreal Injection TA (OT) - Theatre 2200
usage charges
994 KRTPOS Keratoprosthesis - (Doctor
Packages (Rs. 610)
KRTPCA Keratoprosthesis - Anasthesia Consumables 320
KRTPAC Keratoprosthesis - Anasthetist Charges 8800
KRTPCO Keratoprosthesis - Consumables Charges 14000
KRTPDF Keratoprosthesis - Doctor Fee 44000
KRTPTC Keratoprosthesis - Theatre Charges 22000
995 LBDOS Lid Abscess Drainage ( Surgeon
LBDHC Lid Abscess Drainage ( Hospital Charges ) 2900 1740
LBDSC Lid Abscess Drainage ( Surgeon Charges ) 4360 2620
996 LBOOS Lid Biopsy (OT) - (Doctor
Packages (Rs. 610)
LBOCA Lid Biopsy (OT) - Anasthesia consumables 320
LBOAC Lid Biopsy (OT) - Anasthetist charges 1100
LBOCO Lid Biopsy (OT) - Consumables Charges 4000
LBODF Lid Biopsy (OT) - Doctor Fee 5500
LBOTC Lid Biopsy (OT) - Theatre charges 2750
997 LMMMOS Lid Margin Mucous Membrane
Graft Fibrin Glue - (Doctor
Packages (Rs. 610)
LMMMCA Lid Margin Mucous Membrane Graft + 320
Fibrin Glue - Anasthesia Consumables
LMMMAC Lid Margin Mucous Membrane Graft + 6600
Fibrin Glue - Anasthetist charges
LMMMCO Lid Margin Mucous Membrane Graft + 7000
Fibrin Glue - Consumables Charges
LMMMDF Lid Margin Mucous Membrane Graft + 33000
Fibrin Glue - Doctor Fee
LMMMTC Lid Margin Mucous Membrane Graft + 16500
Fibrin Glue - Theatre charges
998 LPARMDD Laser photocoagulation for
FHC ARMD - (Doctor fee+Hospital
Charges)
LPARMDDF Laser photocoagulation for ARMD - doctor 5840 5840
fee
LPARMDHC Laser photocoagulation for ARMD - hospital 3560 3560
charges
999 LPLAT2DF Laser photocoagulation for
HC LATTICE ( 2 quadrants ) -
LPLAT2DF Laser photocoagulation for LATTICE ( 2 3060 3060
quadrants ) - doctor fee
LPLAT2HC Laser photocoagulation for LATTICE ( 2 1780 1780
quadrants ) - hospital charges
316
1000 LPLAT3DF Laser photocoagulation for
HC LATTICE ( 3 quadrants ) -
Charges)
LPLAT3DF Laser photocoagulation for LATTICE ( 3 5840 5840
quadrants ) - doctor fee
LPLAT3HC Laser photocoagulation for LATTICE ( 3 3540 3540
quadrants ) - hospital charges
1001 LPLATM3 Laser photocoagulation for
DFHC LATTICE ( more than 3
quadrants ) - (Doctor Fee +
Hospital Charges)
LPLATM3DF Laser photocoagulation for LATTICE ( more 8870 8870
than 3 quadrants ) - doctor fee
LPLATM3HC Laser photocoagulation for LATTICE ( more 5320 5320
than 3 quadrants ) - hospital charges
1002 LPPRPDFH Laser photocoagulation PRP
C Package ( Doctor Fee +
Hospital Charges)
LPPRPDF Laser photocoagulation ( PRP package ) - 8870 8870
doctor fee
LPPRPHC Laser photocoagulation ( PRP package ) - 5320 5320
hospital charges
1003 LPRBDFHC Laser photocoagulation for
retinal break - (Doctor Fee +
Hospital Charges)
LPRBDF Laser photocoagulation for retinal break - 5840 5840
doctor fee
LPRBHC Laser photocoagulation for retinal break - 3540 3540
hospital charges
1004 LPROPDF Laser photocoagulation for
HC retinopathy of prematurity (
ROP ) - (Ddoctor Fee + Hospital
Charges)
LPROPDF Laser photocoagulation for retinopathy of 8870 8870
prematurity ( ROP ) - doctor fee
LPROPHC Laser photocoagulation for retinopathy of 5320 5320
prematurity ( ROP ) - hospital charges
1005 LPVMQDF Laser photocoagulation for
HC vasculitis ( more than one
quadrant ) - (Doctor Fee +
Hospital Charges)
LPVMQDF Laser photocoagulation for vasculitis ( more 5840 5840
than one quadrant ) - doctor fee
LPVMQHC Laser photocoagulation for vasculitis ( more 3540 3540
than one quadrant ) - hospital charges
1006 LPVOMQ Laser photocoagulation for
DFHC vascular occlusions ( more than
one quadrant ) - (Doctor Fee +
Hospital Charges)
LPVOMQDF Laser photocoagulation for vascular 5840 5840
occlusions ( more than one quadrant ) -
doctor fee
LPVOMQHC Laser photocoagulation for vascular 3540 3540
occlusions ( more than one quadrant ) -
hospital charges
1007 LPVOOQD Laser photocoagulation for
FHC vascular occlusions ( one
quadrant ) - (Doctor Fee +
Hospital Charges)
LPVOOQDF Laser photocoagulation for vascular 3060 3060
occlusions ( one quadrant ) - doctor fee
317
LPVOOQHC Laser photocoagulation for vascular 1780 1780
occlusions ( one quadrant ) - hospital
charges
1008 LPVOQDF Laser photocoagulation for
HC vasculitis ( one quadrant ) -
Charges)
LPVOQDF Laser photocoagulation for vasculitis ( one 3060 3060
quadrant ) - doctor fee
LPVOQHC Laser photocoagulation for vasculitis ( one 1780 1780
quadrant ) - hospital charges
1009 MLLOS Minor Lid Laceration ( Surgeon
MLLHC Minor Lid Laceration ( Hospital Charges ) 2900 1740
MLLSC Minor Lid Laceration ( Surgeon Charges ) 4360 2620
1010 OBOS Orbital Biopsy (OT) - (Doctor
Packages (Rs. 610)
OBCA Orbital Biopsy (OT) - Anasthesia 320
consumables
OBAC Orbital Biopsy (OT) - Anasthetist charges 1760
OBCO Orbital Biopsy (OT) - Consumables Charges 900
OBDF Orbital Biopsy (OT) - Doctor Fee 8800
OBTC Orbital Biopsy (OT) - Theatre charges 4400
1011 OPTMAC OPTICAL COHERENCE
ULADFHC TOMOGRAPHY (MACULA)
OCTMACULAD Optical coherence tomography ( OCT ) 1240 1240
OC (MACULA) - doctor charges
OCTMACULAH Optical coherence tomography ( OCT ) 2660 2660
OS (MACULA) - hospital service charge
1012 OPTRNFL OPTICAL COHERENCE
DFHC TOMOGRAPHY (RNFL)
OCTRNFLDOC Optical coherence tomography ( OCT ) 1240 1240
(RNFL) - doctor charges
OCTRNFLHOS Optical coherence tomography ( OCT ) 2660 2660
(RNFL) - hospital service charge
1013 PHOTAC Photodynamic therapy - All
Charges
PHOTDC Photodynamic therapy - doctor fee 17710 17710
PHOTTDYE Photodynamic therapy - dye charges 70000 70000
PHOTHC Photodynamic therapy - hospital charges 7080 7080
PHOTLRC Photodynamic therapy - laser rental charges 17710 17710
1014 PSIOOS Punctal Snip with Intubation
(OT) - (Doctor Fee+Hospital
Charges)
Packages (Rs. 610)
PSICA Punctal Snip with Intubation (OT) - 320
Anasthesia consumables
PSIAC Punctal Snip with Intubation (OT) - 1540
Anasthetist charges
PSICO Punctal Snip with Intubation (OT) - 4000
Consumables Charges
PSIDF Punctal Snip with Intubation (OT) - Doctor 7700
Fee
PSITC Punctal Snip with Intubation (OT) - Theatre 3850
charges
1015 PSIOS Posterior Subtenon Injection (
Surgeon Fee + Hospital Charges
)
318
PSIHC Posterior Subtenon Injection ( Hospital 1100
Charges )
PSISC Posterior Subtenon Injection ( Surgeon 1650
Charges )
1016 RDFIDCHC RETINAL DIGITAL
HOS FLURORESCEIN IMAGING
RDFIHC Retinal digital flurorescein imaging 1950 1950
angiography - Additional hospital charges
RDFIDF Retinal digital flurorescein imaging 1240 1240
angiography - Doctor fees
1017 RDICGDH RETINAL DIGITAL
CHOS INDOCYANINE GREEN ( ICG )
IMAGING (DOCTOR FEE +
HOSPITAL CHARGES)
RDICGHC Retinal digital indocyanine green ( ICG ) 6200 6200
imaging angiography - Additional hospital
charges
RDICGDF Retinal digital indocyanine green ( ICG ) 1770 1770
imaging angiography - Doctor fees
1018 SFIOLOS SF - IOL Scleral Fixated -
Packages (Rs. 610)
SFIOLCA SF - IOL Scleral Fixated - Anasthesia 320
Consumables
SFIOLAC SF - IOL Scleral Fixated - Anasthetist Charges 3960
SFIOLCO SF - IOL Scleral Fixated - Consumables 5000
Charges
SFIOLDF SF - IOL Scleral Fixated - Doctor Fee 19800
SFIOLTC SF - IOL Scleral Fixated - Theatre Charges 9900
1019 SPECMICR Specular Microscope - (Doctor
OOS Fee+Hospital Charges)
SPECMICRODF Specular Microscope - Doctor Fee 320
SPECMICROHC Specular Microscope - Hospital Charges 480
1020 SYPOS Syringing & Probing - (Doctor
SYPDF Syringing & Probing - Doctor Fee 660
SYPHC Syringing & Probing - Hospital Charges 440
1021 TOS Trasorrhaphy ( Surgeon Fee +
Hospital Charges )
THC Trasorrhaphy ( Hospital Charges ) 2900 1740
TSC Trasorrhaphy ( Surgeon Charges ) 4360 2620
1022 TROS Trasorrhaphy Release (
Surgeon Fee + Hospital Charges
)
TRHC Trasorrhaphy Release ( Hospital Charges ) 1450 870
TRSC Trasorrhaphy Release ( Surgeon Charges ) 2180 1310
1023 TRSPOS Tarasoraphy - (Doctor
TRSPDF Tarasoraphy - Doctor Fee 5280
TRSPHC Tarasoraphy - Hospital Charges 3520
1024 VITENDOL Vitrectomy (Endolaser) -
AOS Doctor fee + Hospital Charges
VITENDOLA Vitrectomy (Endolaser) - Doctor Fee 3660
VITENDOLAHC Vitrectomy (Endolaser) - Hospital Charges 3660
1025 YAGLPDH YAG LASER
CHOS PHOTOCOAGULATION
CHARGES)
319
YAGHC YAG laser photocoagulation - Additional 1790 1790
hospital charges
YAGDF YAG laser photocoagulation - Doctor fees 2830 2830
Other Procedure
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1054 AATDHCO ANTIGEN ALLERGY PRICK
S TESTING (DOCTOR FEE +
HOSPITAL CHARGES)
AATPTHC Antigen allergy testing ( prick testing ) - 1800 1800 2000
AATPTDF Antigen allergy testing ( prick testing ) - 3550 3550 3900
Doctor fees
1055 AATDHOS ANTIGEN ALLERGY
INTRADERMAL TESTING
CHARGES)
AATITHC Antigen allergy testing ( intradermal testing 1340 1340 1410
AATITDF Antigen allergy testing ( intradermal testing 2680 2680 2940
) - Doctor fees
1056 CPAPDHC CPAP TITRATION
OS (LABORATORY CHARGES +
PROFESSIONAL CHARGES)
CPAPDF CPAP titration - Doctor fee 11760 11760 5880 4700 3530 5880 3530
CPAPTC CPAP titration test charges 8820 8820 4410 3530 2650 4410 2650
1057 ECOS ELECTIVE CARDIOVERSION
FEE)
ECPC ELECTIVE CARDIOVERSION PACKAGE 13740 12740 12220 10700 7330
CHARGES
1058 EPCATOS Epidural Catheter Insertion
Charges
EPCATHC Epidural Catheter Insertion - Hospital 864 864 432 346 259
Charges
EPCATIC Epidural Catheter Insertion Charges 8640 8640 4320 3460 2590
1059 EPCTOS EUPHORBIA PROSTRATA
CLINICAL TRIAL
APTT APTT ( Activated partial thromboplastin 700 420
time )
CRT Clot retraction test 350 210
CBCDLC Complete blood count ( CBC ) with 600 360
Differential leukocyte count ( DLC )
GLUR Glucose Random 120 80
HEPA LFT - Liver Function Test ( Hepatic Profile ) 1350 800
PT Prothrombin time ( PT ) Haematology Lab 420 250
RENPI Renal Biochemical Profile - Basic 1280 770
(BUN,Creat,Ca,PO,4,Na,K,Bicarbonate)
1060 GRAOS Granulocyte transfusion ( GCSF
mobilized, third party) -Doctor
fee + Hospital vharges
GRADF Granulocyte transfusion ( GCSF mobilized, 46300 46300 23150 18520 13890
third party) - Doctor fee
GRAHC Granulocyte transfusion ( GCSF mobilized, 4630 4630 2320 1850 1390
third party) - Hospital Charges
320
1061 HAPOS Haploidentical allogenic
stem/bone marrow
transplantation - Doctor fee +
Hospital Charges
HAPDF Haploidentical allogenic stem/bone marrow 347300 347300 173650 138920 104190
transplantation - Doctor fee
HAPHC Haploidentical allogenic stem/bone marrow 34730 34730 17370 13890 10420
transplantation - Hospital Charges
1062 HLITOS LIT therapy ( Doctor fee + lab
charges)
HLITDF LIT therapy - Doctor fee 3690 3690 3690 3510 2760
HLIT LIT therapy - Lab charges 3690 3690 3690 3510 2460
1063 MLSTDHC MULTIPLE SLEEP LATENCY TEST
OS ( MLST ) PACKAGE CHARGES
Professional Charges +
HOSPITAL CHARGES)
MLSTDF Multiple sleep latency test ( MLST ) - Doctor 11760 11760 5880 4700 3530
fee
MLSTTC Multiple sleep latency test ( MLST ) test 8820 8820 4410 3530 2650
charges
1064 PACSGDC PULMONARY ARTERY
HCHOS CATHETERISATION (
SWAN-GANZ ) (DOCTOR FEE +
HOSPITAL CHARGES)
PACAHC Pulmonary artery catheterisation ( Swan 1940 1940 970 780 580
Ganz ) - Additional hospital charges
Ganz ) - Doctor fee
1065 PULFNAC Guided FNAC/Needle Biopsy -
OS PULMONOLOGY
PULFNACDF Guided FNAC/Needle Biopsy - Pulmonology 5520 5520 2760 2210 1660
Doctor Fee
PULFNACHC Guided FNAC/Needle Biopsy - Pulmonology 550 550 280 220 170
Hospital Charges
1066 PULGAOS Guided Abscess drainage -
PULMONOLOGY
PULGAHC Guided Abscess drainage - Hospital Charges 660 660 330 270 200
PULGADF Guided Abscess drainage - Pulmonology 6620 6620 3310 2650 1990
Doctor Fee
1067 PULGPAO Guided pleural aspiration
S (Diagnostic ) - PULMONOLOGY
PULGPA Guided pleural aspiration (Diagnostic) 6620 6620 3310 2650 1990
PULGPAHC Guided pleural aspiration (Diagnostic) 660 660 330 270 200
1068 PULGPOS Guided pleural aspiration
(Therapeutic ) -
PULMONOLOGY
PULGTDF Guided pleural aspiration (Therapeutic) 9940 9940 4970 3980 2980
PULGTHC Guided pleural aspiration (Therapeutic) 990 990 500 400 300
1069 PULGTBO Guided trucut biopsy (Small) -
S PULMONOLOGY
PULGTBDF Guided trucut biopsy (Small) - Pulmonology 9940 9940 4970 3980 2980
Doctor Fee
PULGTBHC Guided trucut biopsy (Small) - Pulmonology 990 990 500 400 300
Hospital Charges
1070 RHSA Rheumatology Scan - RHS ( 1 -
2 areas)
RHSADC Rheumatology Scan - RHS - ( 1-2 areas ) - ( 950 950 950 950 950 750
Doctors Charges )
RHSAHC Rheumatology Scan - RHS - ( 1-2 areas ) - ( 750 750 750 750 750 750 500
Hospital Charges )
321
1071 RHSB Rheumatology Scan - RHS ( 3 or
more areas )
RHSBHC Rheumatology Scan - RHS - ( 3 or more 1000 1000 1000 1000 1000 1000 500
areas ) ( Hospital Charges )
RHSBDC Rheumatology Scan - RHS - ( 3 or more 1250 1250 1250 1250 1250 1000
areas ) ( Doctors Charges )
1072 RHSC Joint injection with US
guidance - RHS - first joint
RHSCDC Joint injection with US guidance - RHS - first 2500 2500 2500 2500 2500 2000
joint ( Doctors Charges )
RHSCHC Joint injection with US guidance - RHS - first 1000 1000 1000 1000 1000 1000 500
joint ( Hospital Charges )
Paediatric Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1073 ALBOS Aspiration of liver abscess -
(Docor Fee + Hospital Charges)
ALADF Aspiration of liver abscess - Docor Fee 10680 10680 5340 4270 3200
ALAHC Aspiration of liver abscess - Hospital 1620 1620 810 650 490
Charges
1074 ANOS Anal dilatation - (Docor Fee +
Hospital Charges)
ANDF Anal dilatation - Docor Fee 17380 17380 8690 6950 5210
ANHC Anal dilatation - Hospital Charges 2610 2610 1300 1040 780
1075 BPVCDOS Bedside paediatric vascular cut
down under GA ( venesection )
BPVCDAF Bedside paediatric vascular cut down under 7640 7640 3820 3060 2290
GA ( venesection ) - Anaesthetists charges
BPVCDHF Bedside paediatric vascular cut down under 3820 3820 1910 1530 1150
GA ( venesection ) - Hospital service charges
BPVCDSF Bedside paediatric vascular cut down under 25480 25480 12740 10190 7640
GA ( venesection ) - Surgeon fee
1076 ETDFHCH EXCHANGE TRANSFUSION
CHARGES)
ETHC Exchange transfusion - Additional hospital 2120 2120 1060 850 640
charges
ETDF Exchange transfusion - Doctor fees 14100 14100 7050 5640 4230
1077 PBMADC PAEDIATRIC BONE MARROW
HOS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
PBMAAD Paediatric bone marrow aspiration - Doctor 2100 2560
fee
PBMAAHC Paediatric bone marrow aspiration - 390
hospital service charge
1078 PBMBAD PAEDIATRIC BONE MARROW
HCHOS BIOPSY + ASPIRATION
CHARGES)
PBMBAD Paediatric bone marrow biopsy + aspiration 4560
- Doctor fee
PBMBAAHC Paediatric bone marrow biopsy + aspiration 680
- hospital service charge
1079 PBMBDHC PAEDIATRIC BONE MARROW
HOS BIOPSY (DOCTOR FEE +
HOSPITAL CHARGES)
PBMBADP Paediatric bone marrow biopsy - Doctor fee 3340
322
PBMBAHC Paediatric bone marrow biopsy - hospital 490
service charge
1080 PBRPDHC PAEDIATRIC BRONCHOSCOPY
CHARGES)
PBADWP Paediatric bronchoscopy - Doctor fee 5810
PBAHC Paediatric bronchoscopy - hospital service 870
charge
1081 PKBDCHC PAEDIATRIC KIDNEY BIOPSY
CHARGES)
PKBADWP Paediatric kidney biopsy - Doctor fee 4670
PKBAHC Paediatric kidney biopsy - hospital service 640 700
charge
1082 PLBDCHC PAEDIATRIC LIVER BIOPSY
CHARGES)
PLBADWP Paediatric liver biopsy - Doctor fee 4670
PLBAHC Paediatric liver biopsy - hospital service 640 700
charge
1083 PLPDHCH PAEDIATRIC LUMBAR
OS PUNCTURE (DOCTOR FEE +
HOSPITAL CHARGES)
PLPADWP Paediatric lumbar puncture - Doctor fee 3210
PLPAHC Paediatric lumbar puncture - hospital 430 480
service charge
1084 PPTDCHC PAEDIATRIC PLEURAL TAP
CHARGES)
PPTADWP Paediatric pleural tap - Doctor fee 3080
PPTAHC Paediatric pleural tap - hospital service 460
charge
1085 PVCDOS Paediatric vascular cut down (
venesection ) under GA in Cath
Lab
PVCDAF Paediatric vascular cut down ( venesection ) 9100 9100 4550 3640 2730
under GA in Cath Lab - Anaesthetists
charges
PVCDCF Paediatric vascular cut down ( venesection ) 14560 14560 7280 5830 4370
under GA in Cath Lab - Cath lab Charges
PVCDSF Paediatric vascular cut down ( venesection ) 30340 30340 15170 12140 9100
under GA in Cath Lab - Surgeon fee
1086 RPOS Reduction of paraphimosis -
(Docor Fee + Hospital Charges)
RPDF Reduction of paraphimosis - Docor Fee 13380 13380 6690 5350 4010
RPHC Reduction of paraphimosis - Hospital 2000 2000 1000 800 600
Charges
1087 SDPDHCH SURFACTANT DELIVERY
COS PROCEDURE (DOCTOR FEE +
HOSPITAL CHARGES)
SDPAHC Surfactant delivery procedure - Additional 1740 1740 870 700 520
hospital charges
SDPDF Surfactant delivery procedure - Doctor fee 11640 11640 5820 4660 3490
1088 SPOS Separation of prepucial/ labial
adhesion - (Docor Fee +
Hospital Charges)
SPLADF Separation of prepucial/ labial adhesion - 13380 13380 6690 5350 4010
Docor Fee
SPLHC Separation of prepucial/ labial adhesion - 2020 2020 1010 810 610
Hospital Charges
1089 SWTECFO Sweat test (Doctor fee + lab
S charges)
323
BSWTBSP Sweat test for cystic fibrosis - Additional 380 230
hospital charges
BSWTDC Sweat test fot cystic fibrosis - doctor fee 2540 2030 1520 2540 1520
Pain Control Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1090 EPCADHC ELECTRONIC PCA PUMP
HOS INSTALLATION (DOCTOR FEE +
HOSPITAL CHARGES)
EPCAPI Electronic PCA pump installation - Doctor 11200 11200 5600 4480 3360
fees
ELPCAINSTBSP Electronic PCA pump installation - hospital 1120 1120 560 450 340
service charges
1091 MIBPINSD MECHANICAL INFUSOR (
HCOS BAXTER ) PUMP INSTALLATION
CHARGES)
MIBAXPIHC Mechanical infusor ( Baxter ) pump 680 680 340 270 200
installation - Additional hospital charges
MIBAXPI Mechanical infusor ( Baxter ) pump 6780 6780 3390 2710 2030
installation - Doctor fees
Psychiatry Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1113 ARTPAOS ARTERIAL PRESSURE ANALYSIS
CHARGES)
ARTPNDF Arterial pressure analysis - Doctor fee 80 80
ARTPAHC Arterial pressure analysis - Hospital Charges 160 160 160 160 90 160 160
1114 ATDHCOS AVERSION THERAPY (DOCTOR
AVTDF Aversion therapy - Doctor Fee 1520 1520 760 610 460 760 460
AVTPSC Aversion therapy - hospital charges 320 320 160 130 100 160 100
1115 BTDHCOS BIOFEEDBACK THERAPY
CHARGES)
BIT Biofeedback therapy - Doctor Fee 1520 1520 760 610 460 760 460
BITPSC Biofeedback therapy - hospital charges 320 320 160 130 100 160 100
1116 GT1DHCH GROUP THERAPY ( 1 HOUR )
CHARGES)
GT Group therapy ( 1 hour ) - Doctor Fee 3700 3700 1850 1480 1110 1850 1110
GTPSC Group therapy ( 1 hour ) - hospital charges 740 740 370 300 220 370 220
1117 PSYDCHC PSYCHOTHERAPY ( 50 MINUTE
HOS SESSION ) (DOCTOR FEE +
HOSPITAL CHARGES)
PSHO Psychotherapy ( 50 minute session ) - Doctor 1840 1840 920 740 550 920 550
Fee
324
PSHPSC Psychotherapy ( 50 minute session ) - 370 370 180 150 110 180 110
hospital charges
1118 RTDHCHC RELAXATION THERAPY ( 30-40
OS MINUTE SESSION ) (DOCTOR
RET Relaxation therapy ( 30-40 minute session ) 1840 1840 920 740 550 920 550
- Doctor Fee
RETPSC Relaxation therapy ( 30-40 minute session ) 370 370 180 150 110 180 110
- hospital charges
1119 VENRAOS VENOUS REFLUX ANALYSIS
CHARGES)
VENRADF Venous reflux analysis - Doctor fee 90 90
VENRAHC Venous reflux analysis - Hospital Charges 150 150 150
Respiratory medicine package charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1120 ENDOBRON Endobronchial Ultrasound - 46840 46840 23420 18740 14050 23420 14050
ULTAPC Package charges
Robotic Surgery Package
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1121 ROBSURG Robotic Surgery
ROBBG30 $$ Bowel Grasper, 30mm Jaw 18100
ROBCF $$ Cadiere Forceps 15800
ROBCS $$ Curved Scissors (NOT hot shears) 15800
ROBDFG $$ Double Fenestrated Grasper 15800
ROBDK3 $$ Drape Kit, 3 Arm 3200
ROBDK4 $$ Drape Kit, 4 Arm 4200
ROBFBF $$ Fenestrated Bipolar Forceps 21500
ROBHACE $$ Harmonic ACE (requires Harmonic ACE 4400
Insert)
ROBHACEI $$ Harmonic ACE Insert 34100
ROBHS $$ Hot Shears (Monopolar Curved Scissors - 25200
requires tip cover 400180)
ROBLCA $$ Large Clip Applier (used with Weck P/N 1100
544240)
ROBLND $$ Large Needle Driver 17300
ROBMBF $$ Maryland Bipolar Forceps 21500
ROBMD $$ Maryland Dissector 18100
ROBMND $$ Mega Needle Driver 17300
ROBND $$ Needle driver 18100
ROBPCH $$ Permanent Cautery Hook 15800
ROBPF $$ ProGrasp Forceps 17300
ROBSG $$ Small Graptor (Grasping Retractor) 18900
ROBSI $$ Suction/ Irrigator 17300
ROBTF $$ Tenaculum Forceps 17300
ROBSURCH Robot Usage - Hospital charges 48000
Small bowel transplant package charges
325
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1122 SBTSDPC Small bowel transplant surgery - 0
donor package charges
Vascular Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1188 ABITMOS Ankle - brachial index ( ABI )
tonometry
ABITM Ankle - brachial index ( ABI ) tonometry 500
Doctor fee
ABITMHC Outpatient ankle - brachial index ( ABI ) 500 500
tonometry - Lab Charges
1189 ACSFDHC ARTERIAL LINE
OS CATHETERISATION (
SUBCLAVIAN / FEMORAL / ANY
OTHER ) (DOCTOR FEE +
HOSPITAL CHARGES)
BACHC Arterial catheterisation ( subclavian / 1120 1120 560 450 340
femoral / any other ) - Additional hospital
charges
BACDF Arterial catheterisation ( subclavian / 11200 11200 5600 4480 3360
femoral / any other ) - Doctor fees
1190 AVAOS AV Access in cath lab
AVCLC AV Access in cath lab - Cath Lab Charges 21520 21520 10760 8610 6460
AVAC AV Access in cath lab - Doctor Fee 44840 44840 22420 17940 13450
1191 BVTOS Basilic vein transposition in

Cath lab
BVTDPCL Basilic vein transposition - Cath lab charges 35500 35500 17750 14200 10650
BVTDP Basilic Vein Transposition in Cath Lab - 73960 73960 36980 29580 22190
Doctor fee
1192 CEBOS Complex endoluminal bypass
CEBCLC Complex endoluminal bypass - Cath Lab 107580 107580 53790 43030 32280
Charges
CEBDF Complex endoluminal bypass - Doctor Fee 224120 224120 112060 89650 67240
1193 CFANGPO Complex Fistula Angioplasty
S (Doctor fee + Cath Lab charges)
CFANGCLC Complex Fistula Angioplasty - Cath Lab 35280 35280 17640 14110 10580
charges
CFANGDF Complex Fistula Angioplasty - Doctor fee 73500 73500 36750 29400 22050
1194 CHRPOS Chemoport removal (Doctor
fee + Cath Lab charges)
CHRCLC Chemoport removal - Cath Lab charges 13240 13240 6620 5290 3970
CHRDF Chemoport removal - Doctor fee 27580 27580 13790 11030 8270
1195 CIRETOS Caval Interruption using
retrievable device (Doctor Fee
+ Hospital charges)
CIRETDF Caval Interruption using retrievable device - 98620 98620 49310 39450 29590
Doctor Fee
CIRETDBSP Caval Interruption using retrievable device - 47340 47340 23670 18940 14200
Hospital Charges
326
1196 CLIPOS Chemoport/Permacath/Centra
l Line Insertion (Doctor fee +
Cath Lab charges)
CLICLC Chemoport/Permacath/Central Line 19400 19400 9700 7760 5820
Insertion - Cath Lab charges
CLIDC Chemoport/Permacath/Central Line 40420 40420 20210 16170 12130
Insertion - Doctor fee
1197 CPEBOS Complex peripheral
embolisation for bleeding
CPECLC Complex peripheral embolisation for 67250 67250 33620 26900 20170
bleeding - Cath Lab Charges
CPEB Complex peripheral embolisation for 140100 140100 70050 56040 42030
bleeding - Doctor Fee
1198 CPTEOS Complex peripheral tumor
embolisation
CPTECLC Complex peripheral tumor embolisation - 67250 67250 33620 26900 20170
Cath Lab Charges
CPTMDF Complex peripheral tumor embolisation - 140100 140100 70050 56040 42030
Doctor Fee
1199 CRCOS Complex recanalisation for
chronic total vascular occlusion
CRCTVCLC Complex recanalisation for chronic total 107580 107580 53790 43030 32280
vascular occlusion - Cath Lab Charges
CRCTVDF Complex recanalisation for chronic total 224120 224120 112060 89650 67240
vascular occlusion - doctor fee
1200 EMMALO Embolisation of vascular
S malformation in cath lab
EVMCLC Embolisation of vascular malformation in 40350 40350 20170 16140 12110
cath lab - cath lab charges
EVMCL Embolisation of vascular malformation in 84060 84060 42030 33620 25220
cath lab - doctor fee
1201 ENDOBYO Endoluminal bypass (Doctor
S Fee + Hospital charges)
ENDOBYDF Endoluminal bypass - Doctor Fee 98620 98620 49310 39450 29590
ENDOBYBSP Endoluminal bypass - Hospital Charges 47340 47340 23670 18940 14200
1202 ENRPSEOS Endovascular Repair of
Pseudoaneurysm
327
ERPCLC Endovascular repair of pseudoaneurysm in 43030 43030 21510 17210 12910
ERPCL Endovascular repair of pseudoaneurysm in 89640 89640 44820 35860 26890
1203 FANGPOS Fistula Angioplasty (Doctor fee
+ Cath Lab charges)
FANGCLC Fistula Angioplasty - Cath Lab charges 17640 17640 8820 7060 5290
FANGDF Fistula Angioplasty - Doctor fee 36760 36760 18380 14700 11030
1204 FGPOS Fluoroscopic guided
percutanous tumor
embolisation
FGPCLC Fluoroscopic guided percutanous tumor 40350 40350 20170 16140 12110
embolisation - Cath Lab Charges
FGPTEDF Fluoroscopic guided percutanous tumor 84060 84060 42030 33620 25220
embolisation - Doctor Fee
1205 FLVSCOS Fluroscopy guided vascular
sclerotherapy in cath lab
FLVSCLC Fluroscopy guided vascular sclerotherapy in 26890 26890 13440 10760 8070
FLVSCL Fluroscopy guided vascular sclerotherapy in 56020 56020 28010 22410 16810
1206 IABIOS Inpatient Ankle brachial index (
ABI ) tonometry
IABIDF Inpatient Ankle brachial index ( ABI ) 500
tonometry - Doctor fee
IABIHC Inpatient Ankle brachial index ( ABI ) 500 500
tonometry - Lab Charges
1207 ICVADPOS Implantable Central Venous
Access Device Placement
Charges)
ICVADPDF Implantable Central Venous Access Device 30820 30820 15410 12330 9250
Placement - Doctor Fee
ICVENADPBSP Implantable Central Venous Access Device 14790 14790 7400 5920 4440
Placement - Hospital Charges
1208 ICVAOS Implantable central venous
access device removal
ICVACLC Implantable central venous access device 13460 13460 6730 5390 4040
removal - Cath Lab Charges
ICVARDF Implantable central venous access device 28040 28040 14020 11220 8410
removal - Doctor Fee
1209 IPASVLPD INPATIENT ARTERIAL FLOW
HCOS STUDIES IN VASCULAR LAB
CHARGES)
IAFSVLAHC Inpatient Arterial flow studies in vascular lab 500 500
IAFSVLDF Inpatient Arterial flow studies in vascular lab 500
- Doctor fee
1210 IVFSVLDH INPATIENT VENOUS FLOW
COS STUDIES IN VASCULAR LAB
CHARGES)
IVFSVLAHC Inpatient venous flow studies in vascular lab 500 500
IVFSVLDF Inpatient venous flow studies in vascular lab 500
- Doctor fee
1211 OVFSVLOS Outpatient venous flow studies
in vascular lab
OVFSVLDF Outpatient venous flow studies in vascular 890
lab - Doctor fee
OVFSVLHC Outpatient venous flow studies in vascular 890 890
lab - Lab Charges
328
1212 PCGTCOS Peripheral catheter guided
thrombolysis in cath lab
PCGTCLC Peripheral catheter guided thrombolysis in 38430 38430 19210 15370 11530
PCGTCL Peripheral catheter guided thrombolysis in 80060 80060 40030 32020 24020
1213 PEBOS Peripheral embolisation for
bleeding
PEBCLC Peripheral embolisation for bleeding - Cath 40350 40350 20170 16140 12110
Lab Charges
PEFB Peripheral embolisation for bleeding - 84060 84060 42030 33620 25220
Doctor Fee
1214 PTEOS Peripheral tumor embolisation
PTECLC Peripheral tumor embolisation - Cath Lab 40350 40350 20170 16140 12110
Charges
PTEDF Peripheral tumor embolisation - Doctor Fee 84060 84060 42030 33620 25220
1215 RCIDOS Removal of Caval Interruption
Device (Doctor Fee + Hospital
charges)
RCINDBSP Removal of Caval Interruption Device - 16140 16140 8070 6460 4840
Bedside Procedure Charges
RCIDDF Removal of Caval Interruption Device - 33620 33620 16810 13450 10090
Doctor Fee
1216 RFCHTVO Recanalization for Chronic
OS Total Vascular Occlusion
(Doctor Fee + Hospital charges)
RFCHTVODF Recanalization for Chronic Total Vascular 86280 86280 43140 34510 25880
Occlusion - Doctor Fee
RCHTVOBSP Recanalization for Chronic Total Vascular 41410 41410 20710 16560 12420
Occlusion - Hospital Charges
1217 SKINOXY Tissue ischaemia monitoring
CHARGES)
OTISISCMOND Tissue ischaemia monitoring - Doctor fee 160 160
F
SKINOXYHC Tissue ischaemia monitoring - Hospital 390 390
Charges
1218 UAECOS Uterine artery embolisation in
cath lab
UAECLC Uterine artery embolisation in cath lab - 40350 40350 20170 16140 12110
cath lab charges
UAECL Uterine artery embolisation in cath lab - 84060 84060 42030 33620 25220
doctor fee
1219 USGDHOS Ultrasound Guided Procedure
in Cath Lab - ( Doctor Fee +
Hospital Charges )
USGD Ultrasound Guided Procedure in Cath Lab - 560
Doctor Fee
USGH Ultrasound Guided Procedure in Cath Lab - 560
Hospital Charges
1220 VASTPOS Vascular Cath Lab - Tumescent
Pump (Doctor Fee + Hospital
Charges)
VASTPDF Vascular Cath Lab - Tumescent Pump - 500 500
Doctor Fee
VASTPHC Vascular Cath Lab - Tumescent Pump - 500 500
Hospital charges
1221 VENGSVC Venography guide laser assited
BOS saphenous vein closure (B\L)
VENGSVCBBSP Venography guided laser assisted 51780 51780 25890 20710 15530
saphenous vein closure (B/L) - Hospital
Charges
329
VENGSVCBDF Venography guided laser assisted 107880 107880 53940 43150 32360
saphenous vein closure (bilateral)- Doctor
Fee
1222 VENGSVC Venography guide laser assited
OS saphenous vein closure (U\L)
VENGSVCBSP Venography guided laser assisted 41410 41410 20710 16560 12420
saphenous vein closure (U/L)- Hospital
Charges
VENGSVCDF Venography guided laser assisted 86280 86280 43140 34510 25880
saphenous vein closure (unilateral)- Doctor
Fee
330

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Sir Ganga Ram Hospital

Schedule of Charges (2018-19)

1 Birthing Suite (LR) 12600

Intensive care charges

SNo Service Area Code Cat-1D Cat-2 Cat-3

1 CCU / IMCU monitoring charges INTMONCHCCU 13900 11600 9300

2 NNU charges - level 1 2000

3 NNU charges - level 2 3050

4 NNU charges - level 3 4800 4800 4800 4600 4300

5 Observation nursery charges 750

INTENSIVE CARE AREAS

2. Procedure/ Investigation Charges

3. General Ward (Free ward).

5. ADVANCE BOOKING CHARGES & ADVANCES AT THE TIME OF ADMISSION

i) Room booking / maternity booking

S.NO. Type of accommodation Amount (Rs.)

S.NO. Type of accommodation Amount (Rs.)

1. Categroy 1A/ 1B 100000

iii) In surgical cases (confirmed booking)

S.NO. Department Category 1 Category 2 Category 3

1. GI Surgery 120000 100000 70000

2. General Surgery 50000 40000 30000

3. Neuro Surgery 120000 100000 70000

4. Ortho-Surgery 70000 60000 50000

5. Kidney Transplantation 750000

6. Cardiac Package 100% 100% 100%

7. Liver Transplant (adult) 100% (as per package)

Blood Transfusion Services

Blood bank crossmatch charges

SNo Description [Code]

1 X-match brought from outside 150

BLOOD GROUPING-1 FFP / PLATELETS Etc. FOR 150

BLOOD BANK ISSUE Cat-1B Suite

SNo Description [Code]

1 Issue Fresh Frozen Plasma (FFP)

2 Issue Cryoprecipitate leucocyte reduced

3 Issue packed red cells (Only for Cardiac

4 Issue Red Blood Cells leukocytes

5 Issue red cells (Paed Cardiac Surgery +

7 Issue Platelets concentrate leukocyte

Blood bank issue charges

1 Infectious marker test ( donor 750

Blood bank procedure charges

SNo Description [Code]

1 Aphaeresis Collection & Storage 71500 71500 66000 55000 38500

Blood Bank Test Charges

PIP scan charges

SNo Code Description

Doctor monitoring charges

Doctor visit charges

Laboratory and Imaging Charges

SNo Description Code POPD/ GOPD/

CT Scan Dye Charges

Biochemical Genetics Charges

SNo Description Code POPD/ GOPD/

SNo Description Code POPD/ GOPD/

Amniotic fluid chromosomal analysis ( Cell Culture ) CAF

Amniotic fluid chromosomal analysis + Fish 5 probe (LABEL ONLY) CAF5POS

SNo Description Code POPD/ GOPD/

HLA - Serological & Molecular

SNo Description Code POPD/ GOPD/

Luminex Single Antigen HLA - Class I HLSA I