SGR Tariff

Sir Ganga Ram Hospital
Schedule of Charges (2019-20)
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: 1. 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 in these areas
2. 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.
1
Other Special Care Charges*
Cat-1C / D
Premium
Cat-1A
All Cat
Cat-1B
Cat-2
Cat-3
Suite
SNo Service Area
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.
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. 6100/-
GENERAL INFORMATION
1. Checking In / Out
i. 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
ii. If patient is discharged within 24 hrs. of admission, room/bed charges are charged only for one day.
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. Hospital charges will be billed @40% for all Gastroentrology / Bronchoscopy procedures and @10%/15% for all bedside
procedures.
iv. 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.
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4. Operation charges
i) In case more than one surgeon of the same speciality 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) In case one surgeon performs a procedure / operation and another procedure / operation of the same type is also required through one access,
the charges of the higher cost surgery will be charged at actual and the lower cost surgery will be charged at 50% rates.
v) For re-exploratory surgery at different sittings, the operation charges will not exceed 50% of that procedure.
vi) Surgeons can charge for visits after the 5th Post Operative day.
vii) The operation/procedure charges/visit fees for patients admitted in Category 1A / B will be double the charges of Category 1C/D.
viii) The charges for Category 2 / 3 will be 80% / 60% of Category 1D charges respectively.
ix) The charges for Operation theatre will be 70% of Surgeons Fee for patients operated under General Anaesthesia and patients operated
under Regional Blocks.
x) The charges for Operation theatre will be 50% of Surgeons Fee for patients operated under Local Anaesthesia.
xi) The charges for Operation theatre will be 42% of Surgeons Fee for patients operated in Minor OT.
xii) The charges for Cath lab will be 48% of Consultants Fee for patients undergoing procedure in Cath lab.
xiii) The Hospital charges for general anaesthesia (consumables) will be 15% of Surgeons Fee.
xiv) The Hospital charges for local anaesthesia (consumables) will be Rs. 350/- per procedure.
xv) Anaesthetist Fee will be 30% of Surgeons Fee for patients operated under General Anaesthesia.
xvi) Anaesthetist Fee will be 25% of Surgeons Fee for patients operated in Minor OT.
xvii) Anaesthetist Fee will be 20% of Surgeons Fee for patients operated under Local Anaesthesia (minor cases) with stand by.
xviii) The Cardiologist’s charges for monitoring (if required / requested) will be 20% of Surgeons Fee.
xix) The Neurologist / Neurosurgeon charges for standby/monitoring (if required / requested) will be 20% of Surgeons Fee.
xx) 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.
xxi) Any related procedure to facilitate an intended surgery will not be charged extra.
xxii) Additional Robotic Surgery charges as per Schedule of charges will be payable for Robotic Surgery.
xxiii) 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
6. Category - 3 5250
7. Day Care 5000
Note :
1. Maternity / Day Care Advance : Non-refundable
2. Room booking advance/cancellation of the booking should be before the date of admission. Advance is non-refundable after the
due date.
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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
4. Category 3 50000
5. Day Care Cases AS PER OPERATION
6. 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) following deposit will be in addition to Advance deposit mentioned
in Point no. (ii).
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 Transplant 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
HBsAg ( Australia antigen ) 820 490
Hepatitis C virus serology antibody test 1090 650
HIV antibody test 820 490
RPR 350 210
3 CROSSMATCH AND ANTIBODY SCREENING OF

BLOOD / RED CELLS [CMBROS]
ABO & Rh D and Antibody screening of patient's 770
blood ( pre-transfusion ) WITH X-MATCH
BLOOD GROUP - 1 FOR BLOOD / PACKED CELL 150
X-MATCH (mention quantity)
BLOOD GROUPING -2 FOR X-MATCH
4
4 CROSSMATCH AND ANTIBODY SCREENING OF
FFP / PLATELETS / CRYOPRECIPITATE /
GRANULOCYTES [XMATCHBLPR]

BLOOD GROUPING-1 FFP / PLATELETS Etc. FOR 150

X-MATCH (Mention quantity)
5 CROSSMATCH AND ANTIBODY SCREENING FOR

ALL BLOOD COMPONENT [XMATCHPAOS]
BLOOD GROUP - 1 FOR PLATELET APHERESE X-MATCH 150
BLOOD GROUP - 1 FOR CRYOPRECIPITATE X-MATCH 150

BLOOD GROUP - 1 FOR FFP X-MATCH 150
BLOOD GROUP - 1 FOR GRANULOCYTES X-MATCH 150
BLOOD GROUP - 1 FOR PLATELETS X-MATCH 150
BLOOD GROUP - 1 FOR BLOOD / PACKED CELL 150
BLOOD GROUP - 1 FOR BLOOD /WASHED PACKED 150
CELL X-MATCH (mention quantity)
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 Platelets concentrate leukocyte

reduced ( NAT tested) Filter [OSPCNAT]
Issue Platelets concentrate leukocyte reduced ( NAT tested) 400
Issue Platelets concentrate leukocyte reduced ( NAT 1500
tested) + Filter
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 Filter For Platelets [PCWFIT] 1500

2 Infectious Marker Charges for 750
Granulocyte Donor [IMCFGD]
3 Infectious marker test ( donor 750
refused for apheresis ) [IMTDR]
4 Issue Cryoprecipitate leucocyte reduced (AHF 830
- factor VIII) per unit [ICRYOLR]
5 Issue Fresh Frozen Plasma (FFP) leukocyte 400
reduced (NAT Tested) [FFPNAT]
6 Issue packed red cells ( Dialysis ) [IPRCCSD] 2400
7 Issue Platelets concentrate leukocyte 400
reduced ( NAT tested) [PCNAT]
8 Issue Red Blood Cells leukocytes depleted 5160
( NAT Tested) excluding X Match [RBCNAT]
9 Issue single donor platelet 11000
concentrate INCLUDING SCREENING
TESTS ( platelet apheresis by cell
separator ) [ISCPLAT]
5
10 Issue single donor platelet concentrate with 9500
prior SCREENING TESTS ( platelet apheresis
by cell) [ISCPLATES]
11 Issue Washed Red Blood Cells 5830
leukocytes depleted ( NAT Tested)
excluding X Match [RBCWNET]
12 Single Donor Platelet apheresis with 15400
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]
2 Cryo preservation of bone marrow without 78830 78830 72770 66700 46080
processing ( Up to one year
in LN2 at -80oC ) [CRPBMWP1]
3 Granulocyte apheresis procedure [GRAPPR] 26560 26560 24250 20330 24250 20330 12700
4 Granulocyte Procedure Chargers 23500 19580
without infectious marker [GPCWIM]
5 Phlebotomy for polycythemia vera [PHEPOLV] 1670 1670 1670 1450 1520 830 830
6 Plasma exchange procedure by cell separator 38100 38100 31760 25400 31760 25400 19000
( Charges of FFP extra ) [PLEXPR]
7 PLASMAPHERESIS WITH ANTIBODY 66000 66000 63000 55000 63000 55000 52000
FILTER [AWANF]
8 Pooling of blood products by sterile 400 400 330 280 330 280 220
connecting device [POPLSTCON]
9 PRP (Platelet Rich Plasma) [PRP] 3630 2780
10 Red Cell Exchange [RCE] 38100 38100 31760 25400 31760 25400 19000
11 Stem cell harvesting and preservation at -80 C 86710 86710 80040 66700 46700
( upto to 1 Year ) [STEMCELLPR]
12 Stem cells harvesting without 38200 38200 35650 28000 35020 28000 15400
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 880 700
3 Anti body identification ABI 4890 4160
4 Antibody Screening ANTIS 660 330
5 Antibody Tier ( IgM & IgG ) (Anti A , Anti B ) ATIGMI 2150 1850
6 BLOOD GROUP - 1 FOR BLOOD / PACKED CELL BG1CM
7 BLOOD GROUP - 1 FOR BLOOD /WASHED PACKED BGWCM
CELL X-MATCH (mention quantity)
8 Blood group - ABO + Rh(D) BGROUP 570 340
9 Compatibility testing with irregular antibody ( One Card ) CTI
10 Compatibility testing with irregular antibody ( Two Card ) CTTWO
11 DAT Titre DATT 2200 1540
12 Direct Antihuman Globulin Test ( DAT ) DCT 1050 820
6
13 Indirect Antihuman Globulin Test ( IAT ) ICT 1400 1080
14 Minor Blood Grouping ( Blood Bank )/Red Cell Extended Phenoype RCEP 5320 4480
15 Monospecific Coombs Test (IgG, IgM, C3d) MCIGMC 1980 1450
16 Red Cell Rh & Kell Phenotype ( patient ) RCRHK 1270 1020
17 Screening of cold antibodies SCAB 720 440
18 Subclasses IgG ( IgG1 , IgG2 & IgG3 ) SUBIG 1210 1030
19 Titre of cold antibodies at room temp and 4 degree C TITCART4 1520 1150
20 Titre of incomplete antibody by ICT ICTRE 1150 980
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
Code Description
PACCHARGES Anaesthetists charges for PAC 3680 1840 1470 1100
Doctor monitoring charges

CSADS Cardiac Surgery Assistance During Chest Surgery 30430 24340 18260
( Minor ) - Doctors monitoring charges
CCCSC Critical care consultant standby charges 3680 1840 1470 1100
Doctor visit charges

DOCVISITCHA RGE1 Doctor visit charges 3680 1840 1470 1100 300
DOCVISITCHA RGE2 Doctor visit charges (category 2 units only) 2920 1460 1170 880
DOCVISTACPU N Doctor visit charges (Acupuncture) 3150 2620 2100
DOCVISITDEVP ED Doctor visit charges (development paediatrics) 1060 530 420 320
FETALIUT DOCTORS VISIT CHARGES FOR IUT 1660
LACSTDF Lactation / Stress consultation ( per visit ) - 2160 1080 860
Neonatology
CLPSCC Clinical psychologist consultation charges 890
NEPHKTCHRG Nephrologists charges for kidney 92400 46200 46200 46200
transplant patient care
PAEDVISITFEE Paediatric / Neonatologists visit charges 3680 1840 1470 1100
for newborns
PLCAERD Palliative Care Services 1840 1470 1100
STOMY STERNOTOMY 192940 96470 77180 57880
STRCOUN Stroke Counselling 1100 660
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.
7
Laboratory and Imaging Charges
CT Scan Charges
SNo Description Code POPD/ CAT GOPD/

1/CAT2 CAT3
1 CD Loading charges CTCDLD 500 500
2 CT 3D surface rendering (plain) CTGBI 2500 2500
3 CT abdomen to ankle joint CTABDANK 26700 26700
4 CT angiography (non-ionic contrast) lower abdomen & pelvis CTANGLO 20270 20270
5 CT angiography (non-ionic contrast) upper abdomen CTAN 20270 20270
6 CT angiography abdomen & chest CTAAC 26000 26000
7 CT angiography brain CTANGIOB 14050 14050
8 CT angiography neck CTANGION 14050 14050
9 CT angiography neck & brain CTANGIONB 18900 18900
10 CT angiography thorax and descending/thoracic aorta CTANGIO 18850 18850
11 CT angiography whole abdomen and abdominal aorta CTANGIOA 20270 20270
12 CT ankle joint (non-ionic contrast) both sides CTANKCTBS 8000 8000
13 CT ankle joint (non-ionic contrast) left side CTANKCTLS 8000 8000
14 CT ankle joint (non-ionic contrast) right side CTANKCTRS 8000 8000
15 CT ankle joint (plain) both sides CTANKPLBS 5780 5780
16 CT ankle joint (plain) left side CTANKPLLS 5780 5780
17 CT ankle joint (plain) right side CTANKPLRS 5780 5780
18 CT bronchoscopy CTBRP 9450 9450
19 CT cardiac calcium scoring CTCCSP 6400 6400
20 CT cisternography CTCIST 9500 9500
21 CT colonoscopy CTCP 9450 9450
22 CT coronary angiograpy CTCTAP 14200 14200
23 CT denta scan ( OPG ) CTDSP 9400 9400
24 CT elbow joint (non-ionic contrast) both sides CTELBCTBS 8000 8000
25 CT elbow joint (non-ionic contrast) left side CTELBCTLS 8000 8000
26 CT elbow joint (non-ionic contrast) right side CTELBCTRS 8000 8000
27 CT elbow joint (plain) both sides CTELBPLBS 5780 5780
28 CT elbow joint (plain) left side CTELBPLLS 5780 5780
29 CT elbow joint (plain) right side CTELBPLRS 5780 5780
30 CT Enterography CTE 12080 12080
31 CT extended study for body scan CTES 1980 1980
32 CT extended study for single scan CTESSS 3950 3950
33 CT face (extended) (non- ionic contrast) CTFACECE 9080 9080
34 CT face / salivary glands (non-ionic contrast) CTFACENI 7150 7150
35 CT face / salivary glands (plain) CTFACEP 4800 4800
36 CT face angiography CTFACEANG 15000 15000
37 CT FNAC procedure (scan done from our hospital) CTFNACIN 7350 7350
38 CT FNAC procedure (scan provided from outside hospital) CTFNACOUT 9450 9450
39 CT foot (non-ionic contrast) both sides CTFTCTBS 8000 8000
40 CT foot (non-ionic contrast) left side CTFTCTLS 8000 8000
41 CT foot (non-ionic contrast) right side CTFTCTRS 8000 8000
42 CT foot (plain) both sides CTFTPLBS 5780 5780
43 CT foot (plain) left side CTFTPLLS 5780 5780
44 CT foot (plain) right side CTFTPLRS 5780 5780
45 CT for TAVI Planning CTTAVI 22000 22000
46 CT full abdomen (non-ionic contrast) CTFANI 10300 10300
47 CT full abdomen (oral contrast only) CTFACT 8540 8540
8
48 CT full abdomen (plain) CTFAP 7750 7750
49 CT full thorax (non-ionic contrast) CTFTNI 9100 9100
50 CT full thorax (plain) CTFTP 6250 6250
51 CT Gated Study for Aortogram CTGAOR 26000 26000
52 CT guided aspiration procedure CTASPIR 7350 7350
53 CT guided aspiration procedure (scan provided from outside hospital) CTGAP 9450 9450
54 CT guided drain placement procedure CTDRAIN 11000 11000
55 CT guided drain placement procedure (scan provided from outside hospital) CTGAPD 11000 11000
56 CT guided pigtail catheter drain placement procedure CTPIG 11000 11000
57 CT hand (non-ionic contrast) both sides CTHACTBS 8000 8000
58 CT hand (non-ionic contrast) left side CTHACTLS 8000 8000
59 CT hand (non-ionic contrast) right side CTHACTRS 8000 8000
60 CT hand (plain) both sides CTHAPLBS 5780 5780
61 CT hand (plain) left side CTHAPLLS 5780 5780
62 CT hand (plain) right side CTHAPLRS 5780 5780
63 CT head (bone window) CTHBW 3200 3200
64 CT head (extended) (non- ionic contrast) CTHEADEXTDN 4800 4800
65 CT head (extended) (plain) CTHEADEXTDP 4260 4260
66 CT head (non-ionic contrast) CTHNI 4250 4250
67 CT head (plain) CTHP 2750 2750
68 CT head (plain) with 3D scan CTHP3D 6400 6400
69 CT high resolution pituitary (non-ionic contrast) CTHRNI 8750 8750
70 CT high resolution pituitary (plain) CTHRPP 4800 4800
71 CT high resolution pns coronal (plain) CTRPNS 3200 3200
72 CT hip joint (non-ionic contrast) both sides CTHIPCTBS 8000 8000
73 CT hip joint (plain) both sides CTHIPPLBS 5780 5780
74 CT knee joint (non-ionic contrast) both sides CTKNCTBS 8000 8000
75 CT knee joint (non-ionic contrast) left side CTKNCTLS 8000 8000
76 CT knee joint (non-ionic contrast) right side CTKNCTRS 8000 8000
77 CT knee joint (plain) both sides CTKNPLBS 5780 5780
78 CT knee joint (plain) left side CTKNPLLS 5780 5780
79 CT knee joint (plain) right side CTKNPLRS 5780 5780
80 CT KUB (non-ionic contrast) CTKUBCT 11250 11250
81 CT KUB (plain) CTKUBPL 7500 7500
82 CT KUB extended (non-ionic contrast) CTKUBECT 12900 12900
83 CT KUB extended (plain) CTKUBEPL 9500 9500
84 CT Liver donor evaluation CTLIVDONEVAL 21950 21950
85 CT Low Dose Screening Chest CTLDC 2560 2560
86 CT lower abdomen (non-ionic contrast) CTLANI 8100 8100
87 CT lower abdomen (oral contrast only) CTLACT 4730 4730
88 CT lower abdomen (plain) CTLAP 4000 4000
89 CT lower thorax (non-ionic contrast) CTLTNI 6400 6400
90 CT lower thorax (plain) CTLTP 3900 3900
91 CT myclo CTMYCLO 11000 11000
92 CT neck (extended) (non- ionic contrast) CTNECKCE 10780 10780
93 CT neck / larynx (non-ionic contrast) CTNECKNI 7250 7250
94 CT neck / larynx (plain) CTNECKP 4830 4830
95 CT orbit (extended) (non- ionic contrast) CTOCE 10780 10780
96 CT orbit (non-ionic contrast) CTONI 7350 7350
97 CT orbit (plain) CTOP 5780 5780
98 CT perfusion studies CTPSP 15000 15000
99 CT peripheral angiography (non-ionic contrast) forearm both sides CTFACTBS 18850 18850
100 CT peripheral angiography (non-ionic contrast) forearm left side CTFACTLS 18850 18850
9
101 CT peripheral angiography (non-ionic contrast) forearm right side CTFACTRS 18850 18850
102 CT peripheral angiography (non-ionic contrast) upper arm both sides CTUACTBS 18850 18850
103 CT peripheral angiography (non-ionic contrast) upper arm left side CTUACTLS 18850 18850
104 CT peripheral angiography (non-ionic contrast) upper arm right side CTUACTRS 18850 18850
105 CT peripheral angiography (non-ionic contrast) whole upper limb both sides CTWULCTBS 18850 18850
106 CT peripheral angiography (non-ionic contrast) whole upper limb left side CTWULCTLS 18850 18850
107 CT peripheral angiography (non-ionic contrast) whole upper limb right side CTWULCTRS 18850 18850
108 CT peripheral angiography hip and thigh both sides CTHATBS 18850 18850
109 CT peripheral angiography hip and thigh left side CTHATLS 18850 18850
110 CT peripheral angiography hip and thigh right side CTHATRS 18850 18850
111 CT peripheral angiography lower leg both sides CTLLBS 18850 18850
112 CT peripheral angiography lower leg left side CTLLLS 18850 18850
113 CT peripheral angiography lower leg right side CTLLRS 18850 18850
114 CT peripheral angiography whole lower limb both sides CTWLLBS 18850 18850
115 CT peripheral angiography whole lower limb left side CTWLLLS 18850 18850
116 CT peripheral angiography whole lower limb right side CTWLLRS 18850 18850
117 CT peripheral venography (non-ionic contrast) forearm both sides CTVFACTBS 18850 18850
118 CT peripheral venography (non-ionic contrast) forearm left side CTVFACTLS 18850 18850
119 CT peripheral venography (non-ionic contrast) forearm right side CTVFACTRS 18850 18850
120 CT peripheral venography (non-ionic contrast) upper arm both sides CTVUACTBS 18850 18850
121 CT peripheral venography (non-ionic contrast) upper arm left side CTVUACTLS 18850 18850
122 CT peripheral venography (non-ionic contrast) upper arm right side CTVUACTRS 18850 18850
123 CT peripheral venography (non-ionic contrast) whole upper limb both sides CTVWULCTBS 18850 18850
124 CT peripheral venography (non-ionic contrast) whole upper limb left side CTVWULCTLS 18850 18850
125 CT peripheral venography (non-ionic contrast) whole upper limb right side CTVWULCTRS 18850 18850
126 CT peripheral venography hip and thigh both sides CTVHATBS 18850 18850
127 CT peripheral venography hip and thigh left side CTVHATLS 18850 18850
128 CT peripheral venography hip and thigh right side CTVHATRS 18850 18850
129 CT peripheral venography lower leg both sides CTVLLBS 18850 18850
130 CT peripheral venography lower leg left side CTVLLLS 18850 18850
131 CT peripheral venography lower leg right side CTVLLRS 18850 18850
132 CT peripheral venography whole lower limb both sides CTVWLLBS 18850 18850
133 CT peripheral venography whole lower limb left side CTVWLLLS 18850 18850
134 CT peripheral venography whole lower limb right side CTVWLLRS 18850 18850
135 CT PNS axial / coronal (non-ionic contrast) CTACNI 7150 7150
136 CT PNS axial / coronal (plain) CTACP 4600 4600
137 CT PNS axial / coronal / sagittal (non-ionic contrast) CTACSNI 8000 8000
138 CT PNS axial / coronal / sagittal (plain) CTACSP 5550 5550
139 CT renal angiography CTRENANG 18800 18800
140 CT review CD charges (without written report) CTRCDC 2000 2000
141 CT review CD with written report charges CTRCWR 3000 3000
142 CT Review film charges CTRFC (without written report) CTRFC 1500 1500
143 CT Review Film with written report charges CTRFW 2650 2650
144 CT sacro iliac joints (non-ionic contrast) CTSIJCT 8000 8000
145 CT sacro iliac joints (plain) CTSIJPL 5780 5780
146 CT scan / MRI images on compact disc CTSMCD 550 550
147 CT scanogram (plain) CTSCP 2100 2100
148 CT sella (plain) CTSELLAP 4850 4850
149 CT shoulder joint (non-ionic contrast) both sides CTSJCTBS 8000 8000
150 CT shoulder joint (non-ionic contrast) left side CTSJCTLS 8000 8000
151 CT shoulder joint (non-ionic contrast) right side CTSJCTRS 8000 8000
152 CT shoulder joint (plain) both sides CTSJPLBS 5780 5780
153 CT shoulder joint (plain) left side CTSJPLLS 5780 5780
154 CT shoulder joint (plain) right side CTSJPLRS 5780 5780
155 CT spine (3 vertebral levels) (non-ionic contrast) CTSNIV 8000 8000
10
156 CT spine (3 vertebral levels) (plain) CTSPV 5780 5780
157 CT spine extended study CTSES 7150 7150
158 CT spine extended study (with contrast) CTSEC 10780 10780
159 CT stereotactic localization (contrast) CTSL 4730 4730
160 CT sterotactic localization CTSLP 3680 3680
161 CT temporal bone ( package ) CTTBPK 4800 4800
162 CT temporal bone (non-ionic contrast) CTTBNI 8950 8950
163 CT temporal bone (plain) high resolution CTTBP 6250 6250
164 CT Trucut biopsy procedure (scan done from our hospital) CTTBIN 8400 8400
165 CT Trucut biopsy procedure (scan provided from outside hospital) CTTBOUT 9450 9450
166 CT upper abdomen & liver volumetery (non-ionic contrast) CTUALVCT 22400 22400
167 CT upper abdomen (dual phase non-ionic contrast) CTUACT 20270 20270
168 CT upper abdomen (non-ionic contrast) CTUANI 7850 7850
169 CT upper abdomen (oral contrast only) CTUAOCT 4730 4730
170 CT upper abdomen (plain) CTUAP 3950 3950
171 CT upper abdomen (triple phase non-ionic contrast) CTUATCT 20270 20270
172 CT upper abdomen (triple phase non-ionic contrast) -FOR DONOR CTUATCTDO 18380 18380
173 CT upper thorax (non-ionic contrast) CTUTNI 6400 6400
174 CT upper thorax (plain) CTUTP 3950 3950
175 CT venography brain CTVBR 15000 15000
176 CT venography neck CTVNE 15000 15000
177 CT venography neck & brain CTVNAB 18900 18900
178 CT venography thorax and descending/thoracic aorta CTVTAD 20270 20270
179 CT venography whole abdomen and abdominal aorta CTVWA 20270 20270
180 CT Visipaque add-on 30 ml CTVISI30 1570 1570
181 CT Visipaque add-on 60 ml CTVISI60 3140 3140
182 CT wrist (non-ionic contrast) both sides CTWRCTBS 8000 8000
183 CT wrist (non-ionic contrast) left side CTWRCTLS 8000 8000
184 CT wrist (non-ionic contrast) right side CTWRCTRS 8000 8000
185 CT wrist (plain) both sides CTWRPLBS 5780 5780
186 CT wrist (plain) left side CTWRPLLS 5780 5780
187 CT wrist (plain) right side CTWRPLRS 5780 5780
CT Scan Dye Charges
SNo Description Code POPD/ GOPD/

CAT 1/CAT2 CAT3
1 Additional CT non-ionic contrast (10 ml) CTADCT10 320 320
6 Additional CT rectal contrast CTADCT 320 320
7 Additional film (CT scan) CTADFILM 550 550
8 CT additional oral contrast CTAOC 320 320
9 Pressure injector usage in CT scan CTPI 430 430
Biochemical Genetics Charges
SNo Description Code POPD/ CAT GOPD/ CAT3

1/CAT2
1 Beta galactosidase enzyme assay ( GMI gang / MPS IVB ) BMP7 4050 3200
2 Biotinidase enzyme assay BIOTINEA 2500 2000
3 1st Trimester biochemical screen ( PAPP , Fr, Beta HCG ) BFTS 2300 1800
4 1st trimester dual markers screening with PLGF risk BFTPE 4000 3200
11
5 2nd Trimester biochemical triple markers screening (AFP, Free-Beta HCG, UE3) BTR2 2800 2200
6 Alkaptonuria ( Qualitative ) BALK 1200 950
7 Alpha feto protein - AFP (Serum / Amniotic fluid ) BAFP 800 650
8 Aminoaciduria (Qualitative)- Urine Metabolic tests + BAAM 2200 1750
Amino acid analysis (Plasma/urine) by TLC
9 Aminoaciduria (Quantitative)- amino acid analysis (UPLC) BUPLC 5500 4400
10 Anti phospholipid IgG antibodies screening for eight antigens BPG 1200 950
11 Anti phospholipid IgM antibodies screening for eight antigens BPM 1200 950
12 Biogenetic Prenatal diagnosis BPND 12500 10000
13 Biogenetic Prenatal diagnosis- Non hydrops (any four enzymes) BPND-NH 16500 13000
14 Ceruloplasmin (Serum) BCPL 1250 1000
15 Enzyme Package - (organomegaly) - Gaucher+NP+GM1 BEPK 11500 9200
16 Fabry disease-alpha-Galactosidase enzyme BFD 4400 3500
17 Fibroblast Growth Factor ( FGF - 21 ) BFGF21 1450 1150
18 Free beta HCG ( Genetics lab ) BFBH 1350 1050
19 Fucosidosis-Fucosidase enzyme assay BFUC 5100 4050
20 G6PD (Quantitative) BG6PD 800 650
21 Galactosemia - Galactitol estimation in urine by GC-MS BGLTT 2000 1600
22 Galactosemia - GALT enzyme (Quantitative) + Urine BGGLT 4500 3600
Galactitol (GC-MS) urine by GC-M5
23 Galactosemia- Epimerase Enzyme assay BGEP 2800 2200
24 Galactosemia- Galctose 1 phosphate uridyl GALT 3000 2400
transferase enzyme (GALT) assay
25 Galactosemia Panel: Galt+ Galactose+ Gal-1-PO4 BGALEM 8000 6400
26 Galactosemia-Galactokinase enzyme assay BGK 3650 2900
27 Galactosemia-Galactose 1 Phosphate in RBCs BGALP 2800 2200
28 Galactosemia-Galactose estimation BGAL1P 3850 3050
29 Gaucher disease-beta glucosidase enzyme assay BGLUC 3800 3000
30 Gaucher disease-Chitotriosidase enzyme BCHT 2600 2050
31 Genetic Medicine: Thyroid stimulating hormone (TSH) and T4 estimation BTT4 660 525
32 Genetic Medicine: Thyroid stimulating hormone estimation ( TSH ) BTSH 450 350
33 Genetic Medicine: Thyroid stimulating hormone BTH6 925 750
estimation ( TSH ) , F T4 and F T3
34 Genzyme (>40) Fabry (?-galactosidase) GENFGAL 2100 2100
35 Genzyme (>40) Gaucher(?-glucosidase) GENGLU 2000 2000
36 Genzyme (>40) Gaucher(chitotiosidase) GENCHITO 1750 1750
37 Genzyme (>40) Hurler (?-iduronidase) GENHIDU 2300 2300
38 Genzyme (>40) Niemann Pick A&B GENNIE 3100 3100
39 Genzyme (>40) Pompe (?-glucosidase) GENPGLU 2300 2300
40 Gliadin IgA antibody BGLA 1700 1350
41 GM1 gangliosidosis-beta galactosidase enzyme assay BGM2 4050 3650
42 Human IL-10 assay BIL10 1000 800
43 Hunter (MPS 2) disease -Iduronate 6 sulphatase enzyme assay IDSUEA 6350 5050
44 Hurler (MPS I) disease- alpha Iduronidase enzyme assay BHUR 5100 4050
45 I-Cell disease- Enzyme assay in plasma (beta-Galactosidase+ alpha- BIC 11500 9200
Fucosidase + alpha-mannosidase)
46 Inhibin A BINH 970 750
47 Interleukin -2 BIL2 970 750
48 Krabbe disease -Galactocerebrosidase enzyme assay BKRB 5100 4050
49 Leptin assay ALABT 1200 950
50 Mannosidosis A & B disease-Mannosidase enzyme assay BMAN 6350 5050
51 Mannosidosis disease (Mannosidase B enzyme) BMANB 3850 3050
52 Mannosidosis disease-Mannosidase A enzyme assay BMANA 3850 3050
53 Maroteaux Lamy (MPS VI) -Aryl sulphatase – B enzyme assay BMP6 5400 4300
54 Metabolic screening tests in urine BAMT 600 450
12
55 Metachromatic leukodystrophy-Aryl sulphatase – A enzyme assay BARA 3800 3000
56 Methyl malonic acid on GC-MS BMGC 2000 1600
57 Methylmalonic acid (Screening test) BMAT 600 500
58 Minor blood group antigens (Fya+Jka+KCcEe) BMINOR 2400 1920
59 Morquio (MPIV) disease panel: Urinary GAGs+ Urine MPS electrophoresis+ BMPIV 12500 10000
Enzyme assays for MPS IVa & MPS IVb
60 Morquio IV A (MPS 4a) disease- Galactose - 6 - Sulphatase enzyme assay G6SF 4500 3600
61 Morquio IVb (MPS 4b) disease-beta Galactosidase enzyme assay BMP4B 4100 3250
62 MPS Electrophoresis for GAGs in urine BUME 4000 3200
63 MPS Quantification - Glycosoaminoglycans (GAGs) estimation BQMPS 2300 1850
64 Mps Quantitative + Electrophoresis + 3 enzymes - MPS 1+2+6 BQEMPS126 22000 17500
65 Mps Quantitative + Electrophoresis + 4 enzymes of MPS III BQEMPSIII 25000 20000
66 MPS screen (spot test) in urine BURN 400 300
67 MPS screening panel (Urine): Spot test+ Urinary GAGs BMPS 5500 4400
(Quantitative)+ Urine electrophoresis
68 Multiple Sulfatase deficiency ( Three enzymes ) BMSD 15000 12000
69 NCL 1 (Infantle- early) disease- Palmitoyl protein thioesterase BNIL1 4100 3250
70 NCL2 (Late Infantile) disease - Tripeptidyl Peptidases BNIL2 4100 3250
71 New born screening ( TSH, G6PD, 17 OHP ) – Genetics lab NBSM 1200 950
72 Niemann Pick (A/B) disease-Sphingomyelinase enzyme assay BNPD 5100 4050
73 Nitro blue tetrazolium dye test - Slide ( NBT ) NBT 850 650
74 Organic acid analysis by Gas Chromatography-Mass Spectrometry (GC-MS) BOA 4500 3600
75 PAPP - A assay BPAP 1450 1150
76 Phospholipid 8 pro IgG to identify which of the eight antigens is positive BG8 1700 1350
77 Phospholipid 8 pro IgM to identify which of the eight antigens is positive BM8 1700 1350
78 Pompe disease- Alpha glucosidase enzyme assay BPOM 5050 4000
79 Porphyria - Chromatography for Coproporphyrin & Uroporphyrin in urine BCU 1500 1200
80 Porphyria - Porphobilinogen in urine ( Qualitative + Quantitative ) BPORQNQL 2500 2000
81 Porphyria biochemical panel: Total porphyrin (Quantitative) + BPOR-PANEL 3500 2800
Chromatography
82 Porphyria- quantitative estimation of Coproporphyrin & Uroporphyrin BPCU 2500 2000
83 Porphyria screening (Blood + Urine) BPORUPL 1800 1450
84 Porphyria screening (Qualitative + Quantitative) in Urine BPORQL 2500 2000
85 Porphyria screening (Qualitative) in blood BPOR BL 1000 800
86 Porphyria screening (Qualitative) in urine BPOR 1200 950
87 Porphyrin total in urine (Quantitative) BPORQ 1500 1200
88 Preeclampsia 1,2,3 (upto 256 days GA) BPE 2100 1650
89 Preeclampsia screening- PAPP A + PLGF BPAPL 3350 2650
90 Preeclampsia-Quadruple test (PAPP-A, Free b-HCG, AFP, PLGF) BQUAD-P 4500 3600
91 Quadruple test (Triple markers + Inhibin A) BQAD 3400 2700
92 Sandoff disease-Hexosaminidase (A+B) enzyme assay BSD 5100 4050
93 Sanfillipo IIIa (MPS 3a) disease- Heparan sulphamidase enzyme assay BMP3A 5700 4550
94 Sanfillipo IIIb (MPS 3b) disease-alpha-hexosaminidase BMP3B 5100 4050
(alpha-N acetyl glucosaminidase) enzyme assay
95 Sanfillipo IIIc (MPS 3c) disease- Acetyl- CoA : a- BMP3C 5100 4050
glucosaminide N-acetyltransferase enzyme assay
96 Sanfillipo IIId (3d) disease-alpha-hexosaminidase BMP3D 5300 4200
(alpha-N acetyl glucosaminide 6 - sulfate) enzyme assay
97 Sanfillippo (3a+3b) BMP3 (A+B) 10000 8000
98 Sanfillippo (3c+3d) BMP3 (C+D) 10000 8000
99 Schindler disease - alpha N – Acetylgalactosaminidase enzyme assay BNAGA 5500 4400
100 Sly syndrome (MPS VII)-Beta glucuronidase enzyme assay BGAC 4050 3200
101 Sugar chromatography in urine BSC 1650 1300
102 Sweat test for cystic fibrosis - lab charges BSWT 1200 950
103 Tandem Mass Screening in newborn - High Risk BTMSH 3000 3000
13
104 Tandem Mass Screening in newborn ( Outsourced ) BTMSN 2000 2000
105 Tandem Mass Screening in newborn ( Outsourced ) +NBS (SGRH) BTMSNBNBSG 3000 2700
106 Tay Sach + Sandoff BTSSD 9200 7350
107 Tay Sach disease- beta Hexosaminidase A enzyme assay BTAYSACH 5100 4050
108 TNF-alpha BTNF 1200 950
109 Transglutaminase (IgA)antibody BTGM 1350 1050
110 Tyrosinemia Panel: Urine screening test+ UPLC (amino BTY 7500 6000
acids)+ AFP (Blood)+ urine Succinyl acetone on GC-MS
111 Tyrosinemia- Succinyl acetone in blood + urine succinyl acetone on GC-MS BSA-GC 7500 6000
112 Tyrosinemia-Succinyl acetone in blood/urine BSA 3500 2800
113 Unconjugated estriol assay ( Serum ) BEST 1100 880
114 Urinary Iodine BUI 1500 1200
115 VLCFA Analysis BVLC 8500 6800
116 Wolman disease - acid lipase/ acid esterase enzyme assay BWM 5100 4050
Cytogenetics Charges

CAT 1/CAT2 CAT3
1 Ataxia Telengiectasia chromosomal analysis (Lieomycin Assay ) CAT 7300 5100
2 Blood chromosome analysis CBLD 3650 2550
3 Fanconi's syndrome chromosomal analysis (Mitomycin Assay ) CFA 7300 5100
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 Culture ) CPOC 7300 5100
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 Culture ) CVS 10900 7650
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
14
37 POC Microarray (60K) + MCC CMPOC(60K)mc 20000 20000
38 Postnatal Microarray CMIC - POST (180K) 25000 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
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
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
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
15
36 HLA tissue cross match serology - Donor HCMD 0 0
37 HLA tissue cross match serology - Patient / Recipient HCM 6000 4500
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 (serology ) - Donor HCRMATD 0 0
43 HLA Typing ( 2 persons ) and Tissue cross match (serology ) - Patient / HCRMAT 25000 20000
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 FGFR3 common mutation study MACH 5000 3500
2 Albinism – (OCA1A) TYR gene 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 – MS MLPA Methylation MANG 8000 6000
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 - Pro250Arg MCNS 5000 3500
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 testing MDD 4200 3000
16 Duchenne muscular dystrophy ( DMD ) prenatal diagnosis MDP 15000 12000
17 Factor V Leiden mutation MFVL 2700 1900
18 Folate polymorphism 3'5 MTHFR - ( 677C>T, 1298A>C ) MFOL 4200 3000
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
16
25 Hypochondroplasia common mutation MHCM 6000 4200
26 Infection - Cytomegalovirus ( CMV ) PCR – Genetic Medicine MCMV 3300 2300
27 Infection - PCR for Rubella Virus ( Genetics ) MR41 4200 3000
28 Maternal cell contamination (MCC) of fetal sample by molecular analysis MMCC 7000 5000
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 Osteogenesis imperfecta, Type IX-PPIB Gene sequencing(NGS) MPPIBF 25000 25000
38 Osteogenesis imperfecta-Type VIII-P3H1 Gene sequencing(NGS) MP3H1F 25000 25000
39 Osteogenesis imperfecta-Type XIV-TMEM38B Gene sequencing(NGS) MTMEM38BF 25000 25000
40 Osteogenesis imperfecta-Type X-SERPINH1 Gene sequencing(NGS) MSERPINH1F 25000 25000
41 Osteogenesis imperfecta-Type XV-WNT1 Gene sequencing(NGS) MWNT1F 25000 25000
42 Parvo virus infection ( PCR ) MPAR 3300 2300
43 Prenatal diagnosis ( Includes test for MCC ) MPND 15000 12000
44 RH typing ( Rh+ or Rh- ) MMRHT 3300 2300
45 Sequencing restrictive dermopathy ( specific mutation ) SRD 5500 4000
46 Spinal muscular atrophy ( SMA ) – molecular diagnosis MSMA 4000 2700
47 Spinal muscular atrophy ( SMA ) - prenatal diagnosis MSMP 15000 12000
48 Sry + Amxy gene study ( Y chromosome ) MSAGS 5000 3000
49 Thalassemia beta prenatal diagnosis ( Repeat test ) MTPR 13000 10000
50 Thanatophoric dwarfism ( common mutation ) MTD 5000 3500
51 Toxoplasmosis infection PCR ( Genetics ) MTOX 3300 2300
52 1p36 MLPA ML1p36 7000 5000
53 22q11.2 deletion syndrome-TBX1 Gene sequencing MTBX1F 25000 22000
54 2-oxoacid dehydrogenase deficiency-DLST Gene sequencing MDLSTF 25000 25000
55 3-hydroxyacyl-CoA dehydrogenase deficiency-HADHA Gene sequencing MHADHAF 25000 25000
56 3-hydroxymethyl-3-methylglutaryl-CoA lyase MHMGCLF 25000 25000
deficiency-HMGCL Gene sequencing
57 3-methylcrotonyl-CoA carboxylase deficiency-MCCC1 Gene sequencing MCCC1F 25000 25000
58 3-methylcrotonyl-CoA carboxylase deficiency-MCCC2 Gene sequencing MCCC2F 25000 25000
59 3-methylglutaconyl-CoA hydratase deficiency-AUH Gene sequencing MAUHF 25000 25000
60 Acetyl-CoA acetyltransferase-2 deficiency-ACAT2 Gene sequencing (NGS) MACAT2F 25000 25000
61 Achondroplasia Gene Sequencing FGFR3 MACS 30000 22500
62 Achondroplasia with Acantharis Nigricans - SADDAN MSAD 5000 3500
mutation Lys 650 Met in FGFR3 gene
63 ACTN3 GENOTYPING MACTP 3300 2300
64 Acute necrotizing encephalopathy ( ANE ) RANBP2 MANE 5500 4400
gene mutation T585M
65 Acute promyelocytic leukemia, Growth hormone insensitivity with MSTAT5BF 25000 25000
immunodeficiency-STAT5B Gene sequencing (NGS)
66 Adenosine deaminase enzyme deficiency-ADA Gene sequencing (NGS) MADAF 25000 25000
67 Adrenoleukodystrophy (X-linked ALD) sequencing of ABCD1 gene MXALD 30000 22500
68 ADSpastic paraplegia 4, (SPG4) - SPAST gene targeted exon 12 MSPASTT 5500 4000
69 Aicardi-Goutieres syndrome 3 (AGS3) - RNASEH2C gene, targeted exon 2 MRNASEH2CT 5500 4000
70 AICARDI-GOUTIERES SYNDROME ex 2+3 MRNASEH2C 10000 7000
71 Alagille syndrome 1 targeted exon 12 MJAG 1 5500 4000
72 Albinism - OCA2 sequencing P gene MOCA2SQ 25000 25000
73 Albinism - OCA3 - TYRP1 gene sequencing MOCA3SQ 15000 12000
74 Albinism - Xlinked -GPR143 gene sequencing MGPR143 22000 17500
17
75 Albinism (TYR, P gene, TYRP1) del dup MOCA2MLPA 7000 5000
76 Albinism-oca1(TYR), OCA2(Pgene),OCA3( TYRP1) sequencing (NGS) MACBNGS 25000 25000
77 Alkaptonuria - HGD- gene sequencing (NGS) MALK1 25000 22000
78 Allgrove Syndrome -AAAS gene sequencing MAAS 26000 22000
79 Alpha 1 anti-trypsin ( Z, X & M mutations ) MAAT 3500 3000
80 Alpha Globin gene deletion analysis by strip assay GENALPHA 8000 7000
81 Alpha Thalassemia - Deletions MATH 6000 4200
82 Alpha Thalassemia Triplication by MLPA MATHMLPA 7000 5000
83 Alpha-ketoglutarate dehydrogenase deficiency-OGDH Gene sequencing MOGDHF 25000 25000
(NGS)
84 Anauxetic dysplasia, cartilage-hair hypoplasia, metaphyseal dysplasia MRMRPF 25000 25000
without hypotrichosis-RMRP Gene sequencing (NGS)
85 Androgen Insensitivity-AR- gene sequencing + deletion/duplications MARSQML 24000 17000
86 Androgen Insentivity- AR MLPA MLARA 7000 5000
87 Androgen receptor gene sequencing MARC 20000 16000
88 Aneuploidy screening (21, 18, 13,X,Y, chm) - Additional to other PND MANU 5000 3500
89 APC gene analysis for Adenomatous Polyposis Syndrome (APC) (By NGS) MAPCNGS 35000 35000
90 Apo E genotyping MAPO 3600 2500
91 Arginosuccinicaciduria -ASL gene sequencing MASL 35000 27000
92 ARKPD ARKPD 35000 35000
93 Atrial Septal Defect + Atrioventricular Block- NKX2 gene sequencing MNKX2 15000 12000
94 Autosomal Dominant Polycystic Kidney Disease - ADPKD (del/dup) MADPKDMLPA 9000 7000
95 Autosomal Dominant Polycystic Kidney Disease - ADPKD 1+2 sequencing- ADPKD 23000 23000
NGS
96 Autosomal recessive hypercholesterolemia-LDLRAP1 Gene sequencing MLDLRAP1F 25000 25000
(NGS)
97 Autosomal recessive hypotrichosis-LPA Gene sequencing (NGS) MLPAF 25000 25000
98 Autosomal recessive polycystic kidney disease-ARKPD-NGS panel MARNG 23000 23000
99 Autosomal-dominant hypercholesterolemia MSTAP1F 25000 25000
(ADH)-STAP1 Gene sequencing (NGS)
100 Barth syndrome (3-methylglutaconic aciduria type II) TAZ gene sequencing MTAZ 22000 17000
101 Barth Syndrome-TAZ Gene sequencing MTAZF 25000 25000
102 Bartter syndrome type 2 - KCNJ1 TARGETED MUTATION MKCNJ1T 5500 4000
103 BASAL CELL NEVUS CARCINOMA, HOLOPROSENCEPHALY (Exon 20) MPTCH1 7000 5000
104 BCR - ABL Qualitative ( Molecular Genetics ) CBA 3600 2500
105 BCR - ABL Quantitative ( Molecular Genetics ) CBAR 7000 5000
106 Beckwith-Weidemann / Silver Russel (Chr11 UPD ?MLPA) MBWS11 8800 6600
107 Beta - Ketothiolase sequencing - ACAT1- Gene Sequencing (NGS) MBKT 25000 25000
108 BILATERAL FRONTOPARIETAL POLYMICROGYRIA ex6 MGPR56 7000 5000
109 Biotinidase Deficiency- BTD gene sequencing MBTD 19000 14500
110 Biotin-responsive basal ganglia disease (BBGD), SLC19A3 gene sequencing MSLC19A3 19800 15000
111 Blepharophimosis ptosis-epicanthus inversion syndrome ( BPES)- FOXL2 MFOXLSQML 26000 22000
gene sequencing and deletion/duplication
112 Blepharophimosis –ptosis-epicanthus inversion MFOXL2 22000 17000
syndrome ( BPES) FOXL2 gene sequencing
113 BPES- FOXL2/TWIST1 MLPA MLFOX 7000 5000
114 BRAF exon 15 gene sequencing MBRAF 6000 4200
115 BRANCHIOOTORENAL (BOR) SYNDROME MEYA1 7000 5000
116 BRCA1 DELETION / DUPLICATION CBRD 7000 5000
117 BRCA2 DELETION / DUPLICATION CBR2D 7000 5000
118 BRCA2 MUTATION ( 27 EXONS BY SEQUENCING ) CBR2 50000 38000
119 Breast cancer- BRCA2/CHEK2 MLPA MLBRCH 7000 5000
120 Bruton type X-linked Agammaglobulinemia (XLA)- BTK gene sequencing MBTK 35000 27000
121 Gastrointestional Stromal Tumors(GIST) C - KITGene Mutations ( 4 Exons ) MCKIT 10000 7200
18
122 Calpainopathy - CAPN3 gene sequencing (NGS) MCAPN 25000 25000
123 Calpainopathy - CAPN3 gene sequencing and deletion/duplication (MLPA) MCAPNSQML 32000 32000
124 Calpainopathy- CAPN3 2 common mutations MCAL 8800 6600
125 Calpainopathy-CAPN3 MLPA MLCAP 7000 5000
126 Camurati-Engelmann disease - TGFB-1 gene sequencing MTGFB1 22000 17000
127 Canavan disease (ASPA- gene sequencing and deletion/duplication (MLPA) MASQML 25000 25000
128 Canavan disease -ASPA, MLPA MLCAN 7000 5000
129 Canavan disease gene sequencing MSCG 20000 16000
130 Cancer : VHL gene deletion/ duplication MLPA MVHLMLPA 7000 5000
131 Cancer : Breast cancer- BRCA 1 and 2 –gene sequencing (BY NGS) MBRANGS 23000 23000
132 Cancer : Breast cancer- BRCA 1 and 2 gene sequencing (BY NGS) + MLPA MBRANGSD 32000 32000
133 Cancer : Breast cancer- BRCA1 -deletion/duplication MCBRD 7000 5000
134 Cancer : Breast cancer- BRCA2 -deletion/duplication MCBR2D 7000 5000
135 Cancer : Chronic Myeloid Leukemia : (BCR-ABL) MCIR 9000 7000
Imatinib Resistance mutation analysis
136 Cancer : Gliomas (IDH1/IDH2 and MGMT- MLPA) MIDH1/IDH2 16000 12000
137 Cancer : Li-Fraumeni syndrome (TP53 deletion/duplication MTP53D 7000 5000
138 Cancer : Li-Fraumeni syndrome (TP53 Gene Sequencing MTP53S 15000 11000
139 Cancer : Multiple endocrine neoplasia- MEN1 – Gene Sequencing MCMEN 22000 17000
140 Cancer : Retinoblastoma (RB gene analysis by NGS) MRBNGS 23000 23000
141 Cancer : Retinoblastoma gene sequencing and deletion/duplication MLPA MRBSQML 32000 32000
142 Cancer : VHL gene sequencing MVHL 12000 8000
143 Cancer :Cowden syndrome : PTEN gene sequencing MPTEN 22000 20000
144 Cancer :VHL gene sequencing and deletion/duplication MLPA MCVHS 15000 11000
145 Cancer Colon :Lynch syndrome - NGS gene panel MLYNCHNGS 23000 23000
146 Cancer: Chronic myeloid leukemia -BCR - ABL- Qualitative ( only after MCBA 3600 2500
confirming from molecular genetics laboratory) )
147 Cancer:Chronic myeloid leukemia BCR - ABL - Quantitative ( only after MCBAR 7000 5000
confirming from molecular genetics laboratory)
148 Cardiomyopathies by NGS MCQTNGS 23000 23000
149 Carpenter syndrome- RAB23 gene sequencing MRAB23 20000 16000
150 Cataract-2 congenital Autosomal recessive (FYCO1 gene) MFYO1 33000 26000
151 Catecholaminergic polymorphic ventricular tachycardia (TRIADIN) (Exon 5) MTRDN 7000 5000
152 Charcot - Marie tooth Disease- EGR2 gene sequencing MEGR2 13000 11000
153 Charcot - Marie tooth Disease- GDAP1 gene sequencing MGDAP1 16500 13200
154 Charcot - Marie tooth Disease- MFN2 – gene sequencing MMFN2 25000 22000
155 Charcot - Marie tooth Disease- MPZ gene sequencing MMPZ 16500 13200
156 Charcot - Marie tooth Disease- NGS panel MCMTNGS 23000 23000
157 Charcot - Marie tooth Disease- PRX - gene sequencing MPRX 22000 20000
158 Charcot - Marie tooth Disease/ HNPP ( PMP 22 gene ) dosage MCMT 7000 5000
159 Charcot Marie Tooth disease X-linked -GJB1 MLPA MLCMX 7000 5000
160 Charcot-Marie-Tooth - X-Linked GJB1 gene sequencing MCMTX 17000 13500
161 Charcot-Marie-Tooth - X-Linked GJB1- gene MCMTSQML 21000 16500
sequencing and deletion /duplication MLPA
162 Charcot-Marie-Tooth disease, type 4J targeted mutations exon 16 and IVS7 MFIG4 11000 7700
163 Chicken Pox Infection- Varicella PCR (AF) MVA 4000 2700
164 Chicken Pox Infection- Varicella PCR (blood) MVB 3000 2100
165 Chimerism analysis (quantitative )per sample MCHIMER 7000 5000
166 Chronic granulomatous disease (CGD) X linked -CYBB gene sequencing MCYBB 22000 20000
167 Chronic granulomatous disease CDG1- Targeted MPMM2 9000 7000
PMM2 gene mutation analysis
168 CHRONIC GRANULOMATOUS DISEASE exon 5 MCYBB1 7000 5000
169 Citrullinemia type 1-ASS1 gene sequencing MASS1 25000 25000
170 Cleidocranial dysplasia - RUNX2- gene sequencing MRUNX2 25000 22000
19
171 COL1A1 Gene sequencing MCOL1A1F 23000 23000
172 COLD-INDUCED SWEATING SYNDROME (exon 2) MCRLF 1 7000 5000
173 Colon Cancer (NRAS/KRAS gene Exon 2,3,4 gene sequencing) MNRAS 13000 10000
174 Combined malonic and methylmalonic aciduria-ACSF3 Gene sequencing MACSF3F 25000 25000
(NGS)
175 COMBINED OXIDATIVE PHOSPHORYLATION DEFICIENCY 10 (COXPD10)ex 7 MMTO1 7000 5000
176 COMBINED OXIDATIVE PHOSPHORYLATION DEFICIENCY 8 (COXPD8), MAARS2T 7000 5000
LEUKOENCEPHALOPATHYWITH OVARIAN FAILURE (LKENP)exon3
177 Combined pituitary hormone deficiency 3 - LHX3 GENE MLHX3 19800 15000
178 Complement component 7 deficiency-C7orf10 Gene sequencing (NGS) MC7ORF10F 25000 25000
179 Complex I, mitochondrial respiratory chain, MNDUFS6 5500 4000
deficiency, NDUFS6 targeted single exon
180 Congenital Adernal Hyperplasia CYP - 21A2 Gene Sequencing MCAS 20000 17000
181 Congenital Adrenal hyperplasia - Deletions by dosage test MCHD 7000 5000
182 Congenital Adrenal hyperplasia -CYP21A2gene MCAHC 22000 20000
sequecing+ deletion/duplication
183 Congenital central hypoventilation syndrome PARM analysis MPARM 8000 6000
184 CONGENITAL GLYCOSYLATION 1Q disorder( KAHRIZI SYNDROME)exon1 MSRD5A3 7000 5000
185 Congenital Insensitivity to Pain with Anhidrosis (CIPA) MCIPA 15000 12000
-( Prenatal Diagnosis by Linkage )TRKA( NTRK1) gene
186 CONGENITAL MYASTHENIC SYNDROME (exon 14) MCOLQ 7000 5000
187 Congenital Myasthenic Syndrome-RAPSN gene Common mutation(p. N88K) RAPSN 7000 5000
188 Conradi Hunermann syndrome- EBP gene sequencing MEBP 16500 13200
189 Corneal Dystrophy-CHST gene sequencing MCHST 20000 16000
190 Cortical dysplasia (KIF5C :Exon 24) MKIF5C 5000 5000
191 Costeff syndrome-OPA3 Gene sequencing (NGS) MOPA3F 25000 25000
192 Crouzon Disease : FGFR 2 gene - 2 common exons MCRZ 9000 7000
193 Cyclical Neutropenia-ELA2 gene sequencing MELA2 20000 16000
194 CYP2C9 ( 1,2,3 ) VKORC1(1639G>A) GENOTYPING MCYY 5500 4000
195 Cystic Fibrosis -CFTR MLPA MLCF 7000 5000
196 Cystic fibrosis panel (29 mutations) MCFP 8800 6600
197 Cystic Fibrosis, Gene sequencing MCFS 30000 25000
198 Cystic fibrosis-CFTR- gene analysis (By NGS) MCFTRNGS 25000 25000
199 Cystic fibrosis-CFTR gene analysis (By NGS) + dosage MCFTRNGSD 32000 32000
200 Cystic Megalencephaly (MLC2) HEPACAM gene sequencing MPEPACAM 22000 17000
201 Cystic Megalencephaly - MLC1 Gene Sequencing MLCS 22000 17000
202 D-2-hydroxyglutaric aciduria-D2HGDH Gene sequencing (NGS) MD2HGDHF 25000 25000
203 Deafness - Connexin 26 - Gene Sequencing MD2S 7000 5500
204 Deafness -(Non syndromic X linked Hearing loss gene MXNSHL 15000 12000
sequencing-POU3F4 gene )
205 Deafness Connexin 30 Gene Deletion MSD 3600 3000
206 Deafness -Connexin 30 gene sequencing MDD30 9000 7000
207 Deafness Connexin 31 Gene Sequencing MD31 7000 5000
208 Deafness Dystonia Optic Neuronopathy Syndrome- Mohr Tranebjaerg MMTS 16500 13200
syndrome. TIMM8A gene sequencing
209 Deafness -Mondini defect-KCNJ10 gene sequencing MMD 15000 12000
210 Deafness- NGS panel MDFNG 23000 23000
211 Deafness -SLC26A4 Gene Sequencing MSLC26A4 35000 35000
212 Deafness-Mondini defect-FOXI1 gene sequencing MFOXI 1 12000 9000
213 Deletion - 22q deletion - ( Conotruncal Heart disease ) MD22D 12000 9000
214 Dengue fever - Molecular diagnosis MDENG 4200 3000
215 DENT DISEASE 2, LOWE SYNDROMEex 22 MOCRL 7000 5000
216 Dentatorubral - Pallidoluysian atrophy ( Triplet repeat) MDRPLA 5000 3500
217 Desbuquois Dysplasia- CANT1 gene sequencing MCANT 16500 13200
20
218 Desbuquois Dysplasia- CHST3 gene sequencing MCHSTT 22000 18000
219 Diabetes Mellitus -Type 1 - SIRTI- gene sequencing MSIRT 22000 20000
220 Diastrophic Dysplasia-SLC26A2 gene sequencing MSLC26A2 20000 16000
221 Dihydrolipoamide dehydrogenase deficiency-DLD Gene sequencing (NGS) MDLDF 25000 25000
222 Dilated cardiomyopathy with ataxia MDNAJC19F 25000 25000
syndrome-DNAJC19 Gene sequencing (NGS)
223 Dilated Cardiomyopathy, Hypertrophic MYBPC3T 5500 4000
cardiomyopathy- MYBPC3 targeted 1 exon
224 DMD - Dosage Studies in Females MDDF 9000 7000
225 DNA - Isolation & storage for POC MDNAPOC 1200 800
226 DNA isolation and storage of fetal sample MDNAFETAL 1200 800
227 Donnai-Barrow syndrome- LRP2 gene targeted mutation exon 23 & 27 MLRP2 11000 7700
228 Duchenne muscular dystrophy ( DMD ) deletion DMDMLPA 9000 7000
analysis by MLPA ( 79 exons )
229 Duchenne muscular dystrophy-DMD - MLPA ( 79 exons ) MDMDMLPA 9000 7000
230 Duchenne muscular dystrophy-DMD -gene Seq (By NGS) MDMDNGS 25000 25000
231 Duchenne muscular dystrophy-DMD -gene Seq (By MDMDSQML 34000 24000
NGS) and deletion/duplication MLPA
232 Dyschromatosis Symmetrica hereditaria 1 (DSH1) hot spot MADAR 11000 7700
233 Dystonia ( DYT5 gene sequencing ) MDYT5 15000 11000
234 Dystonia (DYT1 gene sequencing) MDYT1 15000 11000
235 Dystonia (DYT1,6,12,16) MLPA MLDYT 7000 5000
236 Dystrophic Epidermolysis Bullosa (AD)-COL7A1-EXONS72-75 gene MEBAD 15000 11000
sequencing
237 Ectodermal Dysplasia - hypohidrotic X - linked EDA gene MEDS 20000 16000
238 EGFR Gene Mutations ( 4 Exons ) MEGFR 10000 7200
239 Ehlers-Danlos syndrome, Type II, III, IV osteogenesis MCOL1A2F 25000 25000
imperfecta-COL1A2 Gene sequencing (NGS)
240 Electron transfer flavoprotein dehydrogenase METFDHF 25000 25000
enzyme-ETFDH Gene sequencing
241 Electron transfer flavoprotein enzyme inhibition-ETFA Gene sequencing METFAF 25000 25000
242 Electron transfer flavoprotein enzyme inhibition-ETFB Gene sequencing METFBF 25000 25000
243 Emery Driefuss Muscular Dystrophy -EMD gene sequencing MEMD 15000 11000
244 Emery-Dreifuss muscular dystrophy 2, autosomal MLMNAS 5500 4000
dominant (EDMD2) targeted exon 11
245 Enterovirus PCR (Genetics) MEV 3300 2300
246 Epidermolysis bulllosa simplex - KRT14 (exons1,4 and6) MEBKRT14 15000 11000
247 Epidermolysis bulllosa simplex - KRT5(exons1,4 and6) MEBKRT5 15000 11000
248 Epidermolysis Bullosa - NGS panel MEBPP 23000 23000
249 Epidermolysis bullosa dystrophica, autosomal MCOL7A1 11000 7700
dominant (DDEB) hotspot exons 105, 116
250 Epilepsy - SCN1A - gene sequencing MSCN 23000 23000
251 Establishment and validation of known mutation MEVKM 19000 14500
252 Establishment and validation of known mutation-sgrh only MEVKMSGRH 13000 10000
253 Ethylmalonic encephalopathy - ETHE1- gene seq NGS) METHE-1 25000 25000
254 Fabry disease GLA gene sequensing MGLA 22000 17000
255 Factor XIII deficiency (Exon 10) MF13A1 7000 5000
256 Familial Exudative Vitreoretinopathy - FZD4 exon2 mutation MFZD4 5000 3500
257 Familial HDL deficiency-APOA1 Gene sequencing (NGS) MAPOA1F 25000 25000
258 FAMILIAL HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS PRF1 MPRF1 13000 10000
259 Familial hypercholanemia (FHCA)-BAAT Gene sequencing (NGS) MBAATF 25000 25000
260 Familial Hypercholesteriemia-APOB gene (exon 26 and exon 29) MFHAPOB 9000 7000
261 Familial Hypercholesterolemia 6 Genes ( NGS Panel ) MFHP 25000 25000
( LDLR, ApoB, PCK59, ApoE, LDLRAPI )
21
262 Familial Hypercholesterolemia- LDLR –gene sequencing (NGS) MFHLDLR 25000 25000
263 Familial Hypercholesterolemia- PCSK9- gene sequencing (NGS) MFHPCSK9 25000 25000
264 familial hypobetalipoproteinemia (FHBL), familial defective apolipoprotein MAPOBF 25000 22000
B-100 (FDB)-APOB Gene sequencing (NGS)
265 Familial Juvenile Nephronophthisis- NPHP1 MLPA MLNPH 7000 5000
266 Familial renal glucosuria- SLC5A2- gene sequencing MSLC5A2 22000 20000
267 Family Member of Patient MFMD
268 Farber lipogranulomatosis (Exon 6,12) MASAH1 10000 7000

269 FGFR1 +FGFR2+FGFR3 gene analysis (By NGS) MFGFRNGS 23000 23000
270 FGFR2 probemix MLPA MLFGR2 9000 7000
271 FGFR2 sequencing ( Crouzon, Jackson Weiss, Pfeiffer, AD craniosynostosis) MFGFR2S 25000 25000
272 FGFR3 Gene Sequencing ( Achondroplasia , MFGS 25000 25000
Hypochondroplasia Thonotrophic Dwarfism )
273 Fibrodysplasia ossificans progressiva (FOP- ACVR1 common mutation) MACVR 5000 3500
274 Fibrodysplasia ossificans progressiva (FOP- ACVR1-gene sequencing MACVR1SQ 22000 17000
275 Fibrodysplasia ossificans progressiva (FOP), ACVR1 gene sequencing MACVR1 22000 17000
276 FLT3 mutations(AML) MFLT3 4000 2700
277 Fragile X in Females MSXF 8800 6600
278 Friedreich ataxia (FXTN gene sequencing) MFXTN 15000 11000
279 Frontotemporal lobar dimentia ( MAPT ) exons 9-13 ) sequencing MMAPT 15000 11000
280 Fructose intolerance Aldolase B deficiency – ALDOB gene sequencing MALDOB 19800 15000
281 Fructose-1-6 Bisphosphatase Deficiency - FBP Gene Sequencing (7 Exons ) MFBP 18000 15000
282 Fuchs Endothelial Corneal Dystrophy (FECD) MOLFECD 8000 6000
283 Fukutin related protein-Fukuyama congenital MFKRP 19000 14500
muscular dystrophy- FKRP gene sequencing
284 Fukuyama congenital muscular dustrophy-FKTN -gene sequencing MFKTN 25000 22000
285 Fumarase deficiency, hereditary leiomyomatosis and renal cell cancer MFHF 25000 22000
(HLRCC), primary macronodular adrenal hyperplasia-FH Gene sequencing
286 G-6- PD ONE MUTATION MGP1 3300 2300
287 G-6-PD ( Mediterranean & Orissa types ) - G6PD MG6PD 6000 4200
288 Galactokinase deficiency - GALKI gene Sequencing MGALKI 18000 15000
289 Galactosemia- GALT-Gene sequencing MGALTSEQ 22000 17000
290 Galactosemia Gene sequencing ( GALT ) GALTSEQ 22000 17000
291 Gaucher disease - GBA gene sequencing MGDSG 25000 25000
292 Gene panel for Organic aciduria - SGRH MNGSOA 25000 25000
293 Gene panel for Osteogenesis Imperfecta - SGRH MNGSOI 25000 25000
294 Gene panel for Primary Immunodeficiencies- B cell +ve/-ve - SGRH MNGSPID 25000 25000
295 Gene panel for Urea cycle disorders - SGRH MNGSUREA 25000 25000
296 Gilbert's Disease Sequencing - UGT1A1 Gene MGDS 22000 18000
297 GLUTARIC ACIDEMIA TYPE II, exon6 METFB 7000 5000
298 Glutaric acidemia type II-ETFB gene, targeted exon 6 METFBT 5500 4000
299 Glutaric Aciduria-GCDH gene sequencing MGCDH 20000 16000
300 Glycogen Storage 1A Gene Sequencing MGSDS 15000 11000
301 Glycogen Storage disease III- known targeted mutation AGL gene MGSD3 7000 5000
302 GM1 Gangliosidosis-GLB1- gene sequencing MGLB1 25000 22000
303 Goldberg-Sphrintzen syndrome-KIAA1279 –gene sequencing MKIAA1279 25000 22000
304 Grebe syndrome- GDF5 gene sequencing MGDF5 16500 13200
305 Gyrate Atrophy of Choroid and Retina- OAT- gene sequencing MOAT 25000 22000
306 HADDAD syndrome- PHOX2B gene sequencing MHADDAD 15000 11000
307 Haemochromatosis ( 2 mutations ) MHACM 5000 3500
308 Haemophilia A (F8) - Gene sequencing MHAS 25000 25000
309 Haemophilia A (F8) - Inversions 1/22 and deletion MHASQML 32000 32000
duplication and Gene sequencing
310 Haemophilia B (F9) - Gene sequencing and deletion duplication MLPA MHBSQML 26000 22000
22
311 Hallermann Strieff Syndrome-GJA1 gene sequencing MHSS 8800 6600
312 Hallervorden Spatz - PANK2 Common mutation MHSC 6600 4500
313 Hallervorden-Spatz Syndrome - PANK2- deletion duplication MLPA MHSMLPA 7000 5000
314 Hallervorden-Spatz Syndrome - PANK2- gene sequencing MHSDSEQ 25000 22000
315 Hallervorden-Spatz Syndrome - PANK2- gene MHSQML 32000 22500
sequencing and deletion duplication MLPA
316 Hb D Iran MHBD 3300 2300
317 Hb D Punjab MHBP 3300 2300
318 Hb E MHBE 3300 2300
319 Hb Q India MHBQI 3300 2300
320 Hb Sickle MHBSI 3300 2300
321 Heme oxygenase 1 deficiency HO 1 gene targeted mutation MHO 1 5500 4000
322 Hemolytic uremic syndrome atypical 1 (AHUS1) – CFH gene, targeted exon 21 MCFHT 5500 4000
323 Hemophilia A Inversions 1/22 MHAI 6000 4200
324 Hemophilia B - Gene sequencing MHBS 22000 17000
325 Hemophilia B- MLPA MLF9 7000 5000
326 HEPATOCEREBRAL MITOCHONDRIAL DNA DEPLETION SYNDROMEex5+6 MMPV17 10000 7000
327 HFI - ALDOB - Agarwal mutaion MHFIA 5500 4000
328 HLA-B 1502 GENOTYPING, CARBAMAZEPINE, PHENYTOIN HB1502 3600 2500
329 HLA-B 5701, GENOTYPING, ABACAVIR HB5701 1800 1200
330 HNPCC - MLH1 / MSH2 DELETION / DUPLIATIONS MID 7000 5000
331 HNPCC - MLH1 Gene Sequencing MMLH1 35000 27000
332 HNPCC - MLH1/ MSH2 MICRO SATELLLTE INSTABILITY ( MSI ) MIT 8000 5600
333 HNPCC - MSH2 Gene Sequencing MMSH2 26000 22000
334 HNPCC - MSH6 Gene Sequencing MMSH6 19000 14500
335 Holocarboxylase deficiency -HLCS -gene sequnecing MHLCS 25000 25000
336 HOMOCYSTINURIA- CBS -gene Sequencing MCBS 25000 22000
337 HSD10 disease-HSD17B10 Gene sequencing MHSD17B10F 25000 25000
338 Human Telomere-7 (dosage ch9p,10p,11p and 12p)MLPA MLTEL7 7000 5000
339 Hunter syndrome (MPS II) - IDS- Gene Sequencing MMPSII 25000 25000
340 Hunter syndrome (MPS II) IDS gene sequencing and deletion duplication MLPA MMPSSQML 32000 32000
341 Hyperoxaluria AGXT gene sequencing MHO 22000 17000
342 Hyperoxaluria-AGXT MLPA MLAGX 7000 5000
343 Hyperoxaluria-AGXT sequencing and deletion duplication MLPA MLAGXSQML 26000 22000
344 Hypomyelination with Congenital Cataract- FAM126A gene sequencing MHCF 26000 22000
345 Ichthyosis, congenital, autosomal recessive: TGM1 GENE SEQ MIGMS 25000 22000
346 IDH1(R132) IDH2 (R172) Mutations in Gliomas MIDH 10000 7000
347 IDH1/IDH2 and MGMTMLPA IDH1/IDH2 16000 12000
348 IDUA Full gene (Hurler Syndrome) all 14 exons MIDUA 25000 25000
349 Iminitib Resistance mutation analysis CIR 9000 7000
350 Immunodeficiency 18-CD3E Gene sequencing (NGS) MCD3EF 25000 25000
351 Immunodeficiency 19-CD3D Gene sequencing (NGS) MCD3DF 25000 25000
352 Immunodeficiency due to defect in cd3-zeta-CD247Gene sequencing (NGS) MCD247F 25000 25000
353 INCONTINENTIA PIGMENTI NEMO GENE COMMON DELETION MNEMO 5000 3500
354 Infantile neuroaxonal dystrophy ( INAD )- PLA2G6-gene sequencing MPLA2G6 22000 20000
355 Infantile neuroaxonal dystrophy ( INAD )- PLA2G6 MPLASQML 29000 20000
-gene sequencing and deletion/ duplication MLPA
356 Infantile systemic hyalinosis (ANTXR2 TARGETTED gene sequencing-2 MANXSQ 8000 6000
exons)
357 IPEX syndrome (immunodysregulation polyendocrinopathy enteropathy X- MFOXP3 6600 4400
linked syndrome) Targeted mutation FOXP3 gene
358 Isobutyryl-CoA dehydrogenase (IBD) MACAD8F 25000 25000
deficiency-ACAD8 Gene sequencing (NGS)
359 Isovaleric acidemia-ACAD2 Gene sequencing (NGS) MACAD2F 25000 25000
23
360 Isovaleryl-CoA dehydrogenase deficiency - IVD- gene sequencing MIVD 25000 25000
361 JAK-2 mutation ( Molecular Genetics ) MJACK2 3300 2300
362 JAK3-deficient severe combined immunodeficiency MJAK3F 25000 25000
(SCID)-JAK3 Gene sequencing
363 Jarcho levin syndrome - MESP2 gene sequencing MMESP2 20000 16000
364 Joubert Syndrome -21 (exon 19 and 23) MCSPP1 10000 7000
365 JUNCTIONAL EPIDERMOLYSIS BULLOSA, LARYNGO-ONYCHO-CUTANEOUS MLAMA3 7000 5000
SYNDROME, (exon55)
366 Kallman syndrome gene -FGFR1- gene sequencing MKAL 25000 22000
367 KHDC3L gene sequencing MKHDSQ 8000 6000
368 Klippel - Feil syndrome 2 - MEOX1 gene MEOX1 16500 13200
369 Known Mutation ( By Sequencing ) MSQ 5000 3500
370 Krabbe Disease - GALC- Gene Sequencing MGALC 25000 22000
371 Krabbe Disease - GALC Deletion/ Duplication MGALCMLPA 7000 5000
372 Krabbe Disease - GALC- Gene Sequencing And Deletion/ Duplication MLPA MGALCSQML 32000 27000
373 KRABBE S DISEASE GALC COMMON DELETION MKD 5000 3500
374 KUFS DISEASE, LATE-INFANTILE NEURONAL CEROID LIPOFUSCINOSIS, exon3 MCLN6T1 7000 5000
375 Kuskokwim syndrome, Type XI osteogenesis MFKBP10F 25000 25000
imperfecta-FKBP10 Gene sequencing (NGS)
376 L-2-hydroxyglutaric aciduria-L2HGDH Gene sequencing (NGS) ML2HGDHF 25000 25000
377 Lafora Disease-EPM2A gene sequencing MLD1 20000 16000
378 Lafora Disease-NHLRC1 gene sequencing NHLRC1 20000 16000
379 LBSL - DARS 2 gene sequencing MDARS2 33000 26000
380 Leb Hered Optic atrophy - (LHON) 3 mutations MLHO 6000 4200
381 LEBER CONGENITAL AMAUROSIS, CONE-ROD DYSTROPHYex 11 MGUCY2D 7000 5000
382 LEIGH SYNDROME (LS), MITOCHONDRIAL COMPLEX I MNDUFV1 10000 7000
DEFICIENCY (MT-C1D)ex8+9
383 Leigh syndrome with cytochrome c oxidase (COX) MLSCOX 20000 16000
deficiency-SURF1gene sequencing
384 Leigh syndrome, Beta-hydroxyisobutyryl-CoA MHIBCHF 25000 25000
deacylase deficiency-HIBCH Gene sequencing (NGS)
385 LEPRE1-Related Osteogenesis Imperfecta ( targeted mutations exons 13 / 14) MLEPRE 11000 7700
386 Leri-Weill dyschondrosteosis and Langer mesomelic MSHOX 19800 15000
dysplasia SHOX gene sequencing
387 Lesch Nyhan syndrome HPRT1 gene sequencing MLN 25000 25000
388 LEUKOCYTE ADHESION DEFICIENCY TYPE 1 MITGB2 7000 5000
389 Leukocyte adhesion deficiency type I (LAD1) - ITGB2 gene, targeted exon 6 MITGB2T 5500 4000
390 Linkage analysis MLA 12000 9000
391 Lissencephaly (Exon 35) MDYNC1H1 7000 5000
392 Lissencephaly- DCX -gene sequencing MDCX 22000 20000
393 Long QT - NGS panel (KCNQ1, KCNH2, SCN5A) MLQT 23000 23000
394 Long QT2- KCNH2 gene sequencing MKCNH2 44000 32000
395 Long QT3- SCN5A gene sequencing MSCN5A 65000 45000
396 LOWE SYNDROME LINKAGE STUDIES – FAMILY MEMBER MLSLF 0 0
397 Lymphedema (Congenital)-FLT4 gene sequencing MCL 20000 16000
398 Machado - Joseph disease - Spino cerebellar ataxia (SCA3 ) MJD 5000 3500
399 Malonyl-CoA decarboxylase deficiency-MLYCD Gene sequencing (NGS) MLYCDF 25000 25000
400 Mandibuloacral dysplasia- LMNA (Lamin A/C) gene targeted mutation MLMNA 6600 4400
401 Maple Syrup Urine Disease- BCKDHA- gene sequencing MMSUDA 25000 25000
402 Maple Syrup Urine Disease- BCKDHB –gene sequencing MMSUDB 25000 25000
403 Maple Syrup Urine Disease- DBT- gene sequencing MMSUDDBT 25000 25000
404 Marfan syndrome- FBN1 MLPA MLMAR 9000 7000
405 Marfan syndrome- FBN1-gene sequencing MFBNSQ 23000 23000
406 Marfan Syndrome, Loeys-Deitz Aortic Aneurysm Syndrome (Exon8) MTGFBR2 7000 5000
24
407 Maroteaux-Lamy syndrome- MPS VI- ASRB –gene sequencing MASRB 22000 20000
408 MCAD mutation ( Medium chain Acyl-coA dehydrogenase ) MCAD 3300 2300
409 McArdle disease gene sequencing -PYGM gene MPYGM 35000 27000
410 Meckel Gruber- TMEM67 gene targeted analysis MTMEM67 11000 7700
411 Medium chain Acyl-coA dehydrogenase (MCAD)- ACADM gene sequencing MACADM 22000 20000
412 MEGDEL syndrome-SERAC1 Gene sequencing (NGS) MSERAC1F 25000 25000
413 MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS TYPE II exon 21 MCFHT1 7000 5000
414 MEN1 GENE MUTATION ( 7 EXONS BY SEQUENCING ) CMEN 22000 17000
415 Menke’s Disease - ATP7A gene targeted mutations MATP7A 8800 6600
416 MENKES, exon 4+5 MATP7AT 10000 7000
417 Mental Retardation - X Linked – Panel Deletions/Duplications MRX 7000 5000
418 Mental Retardation Panel1 – Multiple Deletions/Duplications MR1 7000 5000
419 Mental Retardation Panel2 – Multiple Deletions/Duplications MR2 7000 5000
420 Merosin-deficient congenital muscular dystrophy 1A MLAMA2S 11000 7700
(MDC1A) targeted exons 27 & 56
421 Metachromatic Leukodystrophy gene sequencing MMLD 22000 17000
422 Metaphyseal Dysplasia - COL 10A1 Gene Sequencing MC10S 22000 17000
423 Methyl Malonic Aciduria- MMAA gene sequencing MMMAA 17000 13500
424 Methyl Malonic Aciduria- MMAB gene sequencing MMMMA 17000 13500
425 Methylmalonate semialdehyde dehydrogenase MALDH6A1F 25000 25000
deficiency-ALDH6A1 Gene sequencing (NGS)
426 Methylmalonic acedimia- MUT -gene sequencing(NGS) MMUT 25000 25000
427 Methylmalonic acidemia with homocystinuria-ABCD4 Gene sequencing (NGS) MABCD4F 25000 25000
428 Methylmalonic acidemia with homocystinuria-LMBRD1 Gene sequencing (NGS) MLMBRD1F 25000 22000
429 Methylmalonic acidemia-MCEE Gene sequencing(NGS) MCEEF 25000 22000
430 Methylmalonic aciduria and homocystinuria type cbIC full gene MMACHC 22000 17000
431 Mevalonate kinase deficiency-MVK Gene sequencing (NGS) MVKF 25000 22000
432 MGMT Methylation MMGMT 15000 13000
433 MGMT methylation by MLPA MGMT 9000 7000
434 Microcephalic Osteodysplastic Primordial Dwarfism type 1 (MOPD) MRNU4ATAC 5500 4000
435 Microcephaly -ASPM gene sequencing MASPM 35000 35000
436 Microcephaly -PQBP1 gene sequencing MPQBP1 17000 13500
437 Microdeletion panel MLPA any 1 MMICRO 7000 5000
438 Microdeletion panel MLPA any -2 MMICRO2 11000 8000
439 Microdeletion-1 MLPA (Probe-P245) MLDL1 7000 5000
440 Microdeletion-6 MLPA(Confirmation P245) MLDL6 7000 5000
443 Micropthalmia/ Anopthalmia- FOXE3 gene sequencing MFOXE3 9000 7000
444 Mitochindrial DNA Genome sequencing MMITOSQ 23000 23000
445 Mitochindrial DNA Genome sequencing and deletion/duplication MLPA MMITSQML 30000 30000
446 Mitochondrial 3-hydroxy-3-methylglutaryl-CoA MHMGCS2F 25000 25000
synthase deficiency-HMGCS2 Gene sequencing (NGS)
447 Mitochondrial 3-hydroxyisobutyrate dehydrogenase MHIBADHF 25000 25000
enzyme deficiency-HIBADH Gene sequencing (NGS)
448 Mitochondrial complex V deficiency-TMEM70 Gene sequencing (NGS) MTMEM70F 25000 25000
449 Mitochondrial Deafness-2 mutations(A1555G, 7445G) MMDEAF 5500 4000
450 Mitochondrial DNA depletion syndrome 6 (MDDS6) - MMDDS6T 11000 7700
MPV17 gene, targeted exons 5 & 6
451 Mitochondrial Genome - Deletion/Duplication MGDD 7000 5000
452 Mitochondrial trifunctional protein deficiency-HADHB Gene sequencing (NGS) MHADHBF 25000 25000
453 MLPA general code MMLPA 7000 5000
454 Mowat Wison syndrome (MWS)-ZEB2 –gene sequencing MMWS 25000 22000
455 Mowat Wison syndrome /deletion duplication MMWSDD 9000 7000
25
456 MPS II Hunter syndrome ( IDS gene deletions ) MHUNTD 7000 5000
457 MPS IIIB gene sequencing ( NAGLU gene ) MMPS3B 22000 17000
458 Mucolipidosis II alpha/beta.- GNPTAB- gene sequencing MGNPTAB 40000 25000
459 Mucopolysaccharidosis IVA (Morquio A) - GALNS full gene MGALNSF 35000 27000
460 Multiple endocrine neoplasia- MEN1 MLPA MLMEN 7000 5000
461 Multiple epiphyseal dysplasia targeted exon 17 MCOL9A2 5500 4000
462 Multiple epiphyseal dysplasia type 3 targeted exon 5 MCOL9A3 5500 4000
463 Multiple myeloma; Omenn syndrome; Lig4 MLIG4F 25000 25000
syndrome-LIG4 Gene sequencing (NGS)
464 Multiple sclerosis, Omenn syndrome,severe combined immunodeficiency MIL7RF 25000 25000
(SCID)-IL7R Gene sequencing
465 Multiple Sulphatases- SUMF1 gene sequencing MMS 20000 16000
466 Mutation analysis ( single ) MMAS 5000 3000
467 Myoadenylate Deaminase Deficiency-AMPD1 exon 2 &3 gene sequencing MAMPD1 7000 5000
468 Myopathy, centronuclear , X-linked targeted mutation MMTM1 5500 4000
469 Nail Patella syndrome -ex4+5 MLMX1B 10000 7000
470 NBIA Neurodegeneration with brain iron accumulation-PLA2G gene MNBIA 25000 20000
targeted mutations by sequencing
471 NBIA- PANK2/PLA2G6 MLPA MLPANK 7000 5000
472 NCL - Infantile ( 2 Mutaiton Assay ) ( We advice MNCLH 3300 2300
enzyme assay before this test )
473 NCL - Juvenile ( 1 Mutation - common deletion ) MNCLJ 4000 3000
474 NCL - Late infantile ( 2 Mutations ) MNCLL 4000 3000
475 Neonatal Diabetes Mellitus ABCC8 gene targeted mutation MABCC8 8800 6600
476 Nephropathic Cystinosis CTNS gene (one mutation) / (exon 10) MCTNST 5500 4000
477 Nephrotic syndrome (NPHS1 and NPHS2 gene sequcencing) MNPHS 40000 40000
478 Neurofibromatosis (Exon 16) MNF1 7000 5000
479 Neurofibromatosis -NF1 deletion/duplication(MLPA) MNFMLPA 7000 5000
480 Neurofibromatosis type 2 NF2 22q12 MLPA MLNF2 7000 5000
481 Neuronal ceriod lipo fucinosis ( NCL ) or Batten disease MNCLF 9000 7000
482 Neuronal Ceroid Lipofuscinosis(NCL) CLN8 (one mutation exon 2) MCLN8T 5500 4000
483 Neuronal ceroid-lipofuscinoses 6-CLN 6 gene, targeted exon3 MCLN6T 5000 4000
484 Neuronal Ceroid-Lipofuscinosis 2 (CLN2).- TPP1 gene sequencing MTPP1 22000 20000
485 Neutrophil immunodeficiency syndrome (NEUID)-RAC2 Gene sequencing MRAC2F 25000 25000
486 NGS-General code-SGRH MNGSSGRH 25000 25000
487 Niemann Pick disease gene sequencing MNP 30000 22500
488 Niemann-Pick type C disease- NPC MLPA MLNPC 7000 5000
489 Non-ketotic hyperglycinemia (NKH) MGLDC 7000 5000
490 Norrie disease - NDP -gene sequencing MNDP 12000 13200
491 NOTCH3 gene sequencing ( cadASIL ) 5 exons MNOT 15000 11000
492 NPM1 gene Mutations(AML) MNPM1 3000 2000
493 Obesity due to leptin deficiency Leptin gene sequencing MLEPTIN 13000 11000
494 Omenn syndrome-RAG1 Gene sequencing (NGS) MRAG1F 25000 22000
495 Omenn syndrome-RAG2 Gene sequencing (NGS) MRAG2F 25000 22000
496 Ornithine transcarbamylase deficiency - OTC –gene sequencing and MLPA MOTCSQML 34000 24000
497 OSTEOGENESIS IMPERFECTA ex13,14,18 MLEPRE1OI 13000 10000
498 Osteogenesis imperfecta type VIII - targeted exon 14 MLEPRE1T 5500 4000
499 Osteogenesis imperfecta-Type V -IFITM5 Gene sequencing(NGS) MIFITM5F 25000 25000
500 Osteogenesis imperfecta-Type VI -SERPINF1 Gene sequencing(NGS) MSERPINF1F 25000 25000
501 Osteogenesis imperfecta-Type VII -CRTAP Gene sequencing(NGS) MCRTAPF 25000 25000
502 Osteogenesis imperfecta-Type XII -SP7 Gene sequencing(NGS) MSP7F 25000 25000
503 Osteogenesis imperfecta-Type XIII -BMP1 Gene sequencing(NGS) MBMP1F 25000 25000
504 Osteogenesis imperfecta-Type XVII -SPARC Gene sequencing (NGS) MSPARCF 25000 25000
505 Osteopetrosis TCIRG gene common mutations ( exon 13 & 18) MTCIRG 8800 6600
26
506 OSTEOPETROSIS,common +14-15 MTCIRG1 10000 7000
507 OTC deficiency- MLPA MLOTC 7000 5000
508 OTC gene sequencing MOTC 25000 25000
509 Otopalato digital syndrome FLNA gene (3 exons) MFLNA 11000 7700
510 Pancreatitis- PRSS1 gene sequencing MPRSS 17000 13500
511 Pancreatitis- SPINK1 gene sequencing MSPINK 17000 13500
512 Paramyotonia common mutations Arg 1448 His Thr 1313 Met MPM 7000 5000
513 Parkinson targeted single mutation MSGLY19 5500 4000
514 Pelizaeus Merzbacher Deletion/Duplication MPZD 7000 5000
515 Pelizaeus-Merzbacher disease (PMD)-PLP1- gene sequencing and MLPA MPZDSQML 24000 17000
516 Pelizaeus-Merzbacher disease-PLP1 gene sequencing MPMD 20000 16000
517 Permanent neonatal diabetes mellitus - INS gene targeted mutation MINS 8800 6600
518 PEROXISOME BIOGENESIS DISORDER 5A/5B exon3 MPEX2 7000 5000
519 PFIC1-Progressive familial intrahepatic cholestasis MATP8B1 35000 35000
type 1 - ATP8B1 gene sequencing
520 PFIC1-Progressive familial intrahepatic cholestasis type 1 +2+3 MATB123 40000 40000
521 PFIC2-Progressive familial intrahepatic cholestasis MABCB11 35000 35000
type 2 -ABCB11 gene Sequencing
522 PFIC3-Progressive familial intrahepatic cholestasis MABCB4 35000 35000
type 3 - ABCB4 gene Sequencin
523 Phenylketonuria - phenylalanine hydroxylase (PAH) gene MPKU 22000 17000
524 PML-RARA (APML) MPMLRARA 3600 2500
525 POLYCYSTIC KIDNEY AND HEPATIC DISEASE 1 (AUTOSOMAL MPKDH1 10000 7000
RECESSIVE)ex4+61
526 Polycystic kidney disease, autosomal recessive MPKHD-1 11000 7700
(ARPKD) targeted exon 11 & 19
527 Pompe disease - GAA gene sequencing MGAA 25000 25000
528 Pompe disease - GAA gene sequencing and MLPA MGAASQML 34000 24000
529 Pompe MLPA MLPOM 7000 5000
530 Pontocerebellar hypoplasia-TSEN54 gene sequencing MTSEN54 25000 25000
531 Porphyria (HMBS Gene ) Sequencing and MLPA MPSQML 26000 22000
532 PORPHYRIA SEQUENCING MPSQ 22000 17000
533 Prader willi syndrome molecular test MPWS 8000 6000
534 Praderwilli/ Angelman - MLPA MLPWAS 7000 5000
535 preconception screening by NGS- six hotspot agarwal mutations M1AGG 22000 18000
536 Preconception screening by NGS-common genes- MAGG+ HBB, DMD ,CF, MPRNG 30000 22000
Gauher,Criggler najjar, GALT,Deaf,OCA, Wilson disease
537 preconception screening by NGS-common genes- MAGG+ HBB, DMD M2PRESCREEN 30000 22000
,CF,Gauhcer,CJ, GALT,Deaf,OCA, wilson
538 preconception screening cmpehensive MPRESCREEN M3SCREEND 44000 38000
by NGS-+Fx, DOSAGE SMA,DMD,
539 Preconception screening comprehensive Prescreen MSCREN 44000 38000
by NGS-+Fx, Dosage SMA, DMD
540 Prenatal diagnosis by gene sequencing MPNDSEQ 20000 16500
541 Primary Congenital Glaucoma/ Buphthalmos- CYP1B1 gene sequencing MCYP1B1 15000 11000
542 Progressive pseudorheumatoid dysplasia (PPRD) :WISP3 gene sequencing MWISPSQ 15000 12000
543 Progressive Pseudorheumatoid Dysplasia (PPRD) Ex MWISP3 5000 5000
2-WISP3-Common mutation
544 Propionic academia- PCCA MLPA MLPCC 7000 5000
545 Propionic aciduria- PCCA gene sequencing MPCCA 25000 25000
546 Propionic aciduria- PCCA gene sequencing- A+B NGS MPCCAB 25000 25000
547 Propionic aciduria- PCCA gene sequencing and MLPA MPCASQML 32000 32000
548 Propionic aciduria- PCCB gene sequencing MPCCB 25000 25000
549 Prothrombin gene polymorphism ( G20210A ) MPRO 3300 2300
550 Pseudoachondroplasia - COMP gene sequencing of exons 10-14, 16 MCOMP 17000 13500
27
551 Purine nucleoside phosphorylase deficiency-PNP Gene sequencing MPNPF 25000 25000
552 Pyknodysostosis-CTSK sequencing MCTSK 22000 20000
553 Pyruvate Carboxylase deficiency - gene sequencing MPCD 35000 27000
554 Pyruvate Dehydrogenase Deficiency (PDH)X-linked -PDHA1 gene sequencing MPDH 25000 22000
555 RAG1 deficiency MRAG1 21000 16500
556 Rapid-onset dystonia parkinsonism (RDP) (also MATP1A3 33000 26000
known as DYT12)- ATP1A3 gene sequencing
557 Recessive forms of osteogenesis imperfecta (Intron 2) MPPIB 7000 5000
558 Recurrent Hydatidiform mole :NLRP7 gene sequencing MNLRSQ 20000 16500
559 Renpenning Syndrome-PQBP1 gene sequencing MRSPQBP1 21000 16500
560 Respiratory distress syndrome (RDS) due to Surfactant Deficiency( three MRDS 11000 7700
common mutations - SFTPB, SP-C and ABCA3 gene mutations
561 Restrictive dermopathy ( specific mutation ) MSRD 5500 4000
562 RET Gene Mutations ( 6 Exons ) MRET 15000 11000
563 Reticular dysgenesis-AK2 Gene sequencing (NGS) MAK2F 25000 25000
564 Retinitis Pigmentosa : RPE65 Gene Sequencing MRPE65 25000 22000
565 Retinoblastoma - Deletion/Duplication MRBDD 7000 5000
566 RETINOBLASTOMA GENE SEQUENCING MRBS 35000 35000
567 Rett syndrome ( MECP2 sequencing and Deletion / duplication ) MRS 30000 22500
568 Rett syndrome atypical -CDKL5 MLPA MLCDK 7000 5000
569 RETT Syndrome MECP2 Deletion/Duplication MRTSQ 7000 5000
570 Rett syndrome MECP2 Sequencing MRSS 20000 16500
571 RH genotyping - Both alleles ( +/+ or -/- ) MRH 6000 4200
572 Rh Typing On Fetal DNA in Maternal Blood MRHMB 5000 3500
573 Rheumatoid arthritis, Severe combined immunodeficiency, autosomal MPTPRCF 25000 25000
recessive, T cell-negative, B cell-positive, NK cell-positive-PTPRC
Gene sequencing
574 RRM2B - related mitochondrial disease - RRMB2 GENE Sequencing (9 Exons ) MRRMB 20000 18000
575 Russel Silver - Methylatio H - 19 MRSS19 8800 6600
576 Russel Silver - Methylation H - 19 and UPD7 (MSMLPA) MRSS2 15000 12000
577 Russel Silver ? UPD chr7 MRSS7 8800 6600
578 Saethre- Chotzen syndrome - TWIST gene Dosage +sequencing MTWISTSD 18000 14000
579 Saethre- Chotzen syndrome - TWIST gene sequencing MTWISTS 13000 11000
580 Sandhoff disease- HEXB gene sequencing MHEXB 22000 20000
581 Sanfillipo Disease (MPS IIIA) -SGSH -gene sequencing MMPS3A 25000 22000
582 Sanjad Sakati syndrome/common mutation – TBCE gene MTBCE 7000 5000
583 SCID Radiosensitive - DCLRE1C MLPA MLDCLR 7000 5000
584 SCOT deficiency-OXCT1 Gene sequencing (NGS) MOXCT1F 25000 25000
585 Sengers Syndrome (Mitochondrial ) exon 13,14 MAGK 10000 7000
586 Sequencing Parkinson ( Gly19 ser mutation ) SGLY19 5500 4000
587 Severe Combined Immunodeficiency (Exon 1) MRFXAP 7000 5000
588 Severe combined immunodeficiency Athabaskan type (SCIDA); Omenn MDCLRE1CF 25000 25000
syndrome; Histiocytic medullary reticulosis-DCLRE1C Gene sequencing
589 Severe combined Immunodeficiency syndrome MADA 25000 25000
(SCID)-Adenosine Deaminase (ADA) gene sequencing
590 Severe combined immunodeficiency with microcephaly, growth MNHEJ1F 25000 25000
retardation, and sensitivity to ionizing radiation-NHEJ1 Gene sequencing
591 short rib-polydactyly syndrome type 5 MWDR35 7000 5000
592 Short/branched chain acyl-CoA dehydrogenase MACADSBF 25000 25000
(SBCAD) deficiency-ACADSB Gene sequencing
593 Sialidosis (Exon 4) MNEU1 7000 5000
594 Simpson-Golabi-Behmel syndrome 1 targeted mutation MGPC3 5500 4000
595 Sjogren-Larsson syndrome - ALDH3A2 gene sequencing MALDH3A2 20000 16500
596 SJORGEN- LARSSON SYNDROME LINKAGE-ALDH3A2 MSLS 12000 9000
28
597 SMA carrier screening by MLPA SMAMLPA 7000 5000
598 SPASTIC PARAPLEGIA TYPE 4, exon 12 MSPAST 7000 5000
599 SPG 11 - Q906fs Agrawal mutaion MSPG11A 5500 4000
600 SPINAL BULBAR MUSCULAR ATROPHY CAG REPEATS MSBM 5000 3500
601 Spinal cerebellar ataxia ( SCA ) - one gene MSCA 5000 3500
602 Spinal cerebellar ataxia ( SCA ) - two gene MSCATG 7000 5000
603 Spinal cerebellar ataxia package ( 1, 2, 3, 12 ) MSCA4 12000 9000
604 Spinal cerebellar ataxia package ( 1, 2, 3, 6, 7, 12, 17 ) MSC4 21000 16500
605 Spinal Muscular Atrophy - SMN 1 Gene Sequencing MSMNS 22000 22000
606 Spinal muscular atrophy (SMA carrier screening by MLPA MSMAMLPA 7000 5000
607 Spinal muscular atrophy (SMA with respiratory MSMARD 25000 22000
distress1- SMARD1 gene sequencing
608 Spinal muscular atrophy -SMN2 copy number analysis MSMC 7000 5000
609 Spinocerebellar ataxia with peripheral neuropathy-autosomal recessive- MSCAN 7000 5000
SCAN1 targeted mutation analysis
610 Spinocerebellar ataxia with peripheral neuropathy-autosomal recessive- MTDP1 25000 22000
TDP1 gene sequenicng
611 Spondyloepimetaphaseal dysplaisa - KIF22 exon 4 MKIF22 6600 4400
612 Spondyloepiphyseal Dysplasia X-Linked gene Sequencing MSEDS 17000 13500
613 SSjogren-Larsson syndrome( Prenatal Diagnosis by Linkage ) MSJOL 15000 12000
614 Stormorken syndrome, tubular aggregate myopathy, MSTIM1F 25000 25000
primary immunodeficiency 10-STIM1 (NGS)
615 Subtelomeric Deletions / Duplications – All Autosomes MTELD 7000 5000
616 Succinate-CoA ligase deficiency-SUCLA2 Gene sequencing (NGS) MSUCLA2F 25000 25000
617 Surfactant B deficiency gene (SFTPB gene sequencing) MSURFB 25000 22000
618 Surfactant C gene sequencing MSURFC 22000 17000
619 Tay-Sachs disease (TSD) /GM2 gangliosidosis variant B- HEXA gene sequencing MHEXA 25000 22000
620 T-cell immunodeficiency, congenital alopecia and nail MFOXN1F 25000 25000
dystrophy-FOXN1 Gene sequencing (NGS)
621 Thalassemia - XMN, Bcl1 and HBSIL- MYB polymorphism MXM3 8800 6600
622 Thalassemia ALPHA globin gene sequencing MALPHAGS 8500 6000
623 Thalassemia Beta globin gene large deletions (HPFH) MBGLD 8500 6000
624 Thalassemia BETA globin gene sequencing MBETAGS 8500 6000
625 Thalassemia beta mutation study - couple MTHC1 8500 6000
626 Thalassemia beta mutation study -child MTHPRO 5000 3500
627 Thalassemia beta mutation study -child and parents MTHCP 8500 6000
628 Thalassemia Intermedia - Bcl1 and HBSIL- MYB polymorphism MXM2 6600 4400
629 Thalassemia prenatal diagnosis MTHP 15000 12000
630 Thalassemia prenatal diagnosis ( Thalassemia society patient ) MTHPTS 12500 10000
631 THROMBOPHILIA DUE TO PROTEIN C DEFICIENCY (Exon 7,9) MPROC 10000 7000
632 Thrombophilia profile ( DNA ) - 3 polymorphisms MTHR 7000 5000
633 THROSENEMIA - FAH GENE SEQUENCING MTYS 21000 16500
634 Torsion dystonia 1 ( DYT 1 ) deletion analysis MDYT 3600 2500
635 TP53 DELETION/ DUPLICATION C53D 7000 5000
636 TP53 SEQUENCING CP53 15000 11000
637 TPMT ( 1,2,3A,3B,3C ) GENOTYPING, AZA, 6MP,6-THIOGUANINE MTP5 5500 4000
638 TPMT ( 1,2,3C ) GENOTYPING, AZA,6MP,6-THIOGUANINE MTP3 3300 2300
639 Tricho hepatoenteric syndrome- TTC37 exon 28 common mutation MTTC 5000 3500
640 Tuberculosis mycobacterium infection ( PCR )- qualitative MTBINF 4200 3000
641 Tuberous sclerosis ( TSC1 ) deletion / duplication MDTS1 7000 5000
642 Tuberous sclerosis ( TSC1+2)- NGS TUBES 35000 25000
643 Tuberous sclerosis ( TSC2 ) deletion / duplication MDTS2 7000 5000
644 Tuberous Sclerosis : TSC1 and TSC2 gene analysis( ByNGS)+ dosage MTCSNGSD 32000 32000
29
645 Tubular aggregate myopathy, Immune dysfunction with T-cell inactivation MORAI1F 25000 25000
due to calcium entry defect 1-ORAI1 Gene sequencing(NGS)
646 UGT1A1 28 GENOTYPING IRINOTECAN MUGG 3300 2300
647 Unverricht–Lundborg disease MEPM1 8800 6600
648 Usher syndrome and nonsyndromic AR deafness (Exon 58) MCDH23 7000 5000
649 Usher syndrome type IIa and retinitis pigmentosa targeted exons 38 & 53 MUSH2A 11000 7700
650 validation of NGS mutation- SGRH only MVALSGRH 7000 5000
651 Very Long Chain Fatty Acid Dehydrogenase Deficiency-ACADVL gene MACADVL 25000 22000
652 VGT1A1 28 ( (TA) ) GENOTYPING, IRINOTECAN MUGT 2500 1750
653 VHL GENE DELETION/ DUPLICATION CVHL 7000 5000
654 VHL GENE MUTATION ( 3 EXONS BY SEQUENCING, MLPA ) CVHS 15000 11000
655 Vitamin B12 Polymorphism : Single mutation in TCN2 gene MTCN 4000 2500
656 Waardenburg Syndrome - PA X 3 Gene Sequencing MWSS 22000 17000
657 Waardenburg Syndrome - PA X 3 Gene Sequencing and MLPA MWSQML 26000 22000
658 Waardenburg Syndrome - PA X 3 MLPA MWSMLPA 7000 5000
659 Waardenburg syndrome type 2 (Hirschsprung ) EDN3 gene sequencing MEDN3 19800 15000
660 WILMS TUMOR 1, ex 9+7 MWT 1 10000 7000
661 Wilson Disease - ATP7B Gene MLPA MWDMLPA 7000 5000
662 Wilson Disease - ATP7B Gene Sequencing MWDS 25000 25000
663 Wilson Disease - ATP7B Gene Sequencing and MLPA MWDSQML 32000 32000
664 Winchester Syndrome - MMP2 gene targeted mutations MMMP2 6600 4400
665 Wiskott Aldrich gene sequencing- WAS gene MWAS 25000 22000
666 Wolfram syndrome WFS1 gene sequencing MWFS1 18000 15000
667 X - L Chondrodysplasia punctata Arse gene MXLCDP 22000 17000
668 X - linked ichthyosis ( deletion in Steroid sulfatase gene ) MXIC 5000 3500
669 X - linked ichthyosis -carrier screening by dosage analysis of STS gene MXICD 7000 5000
670 X - linked ichthyosis -extent of deletion MXICEXT 7000 5000
671 X- severe combined immunodeficiency (X-SCID)-IL2RG gene sequencing MXSCID 25000 25000
672 Xeroderma pigmentosum - XPC gene sequencing MXPC 35000 27000
673 XERODERMA PIGMENTOSUM,exon3 MXPA 7000 5000
674 X-linked congenital adrenal hypoplasia- DAX gene sequencing MDAX 17000 13500
675 X-linked dyserythropoietic anemia and MGATA-F 15000 12000
thrombocytopenia GATA 1 gene sequencing
676 X-linked dyserythropoietic anemia and MGATA-1 15000 12000
thrombocytopenia GATA 1 hotspot
677 X-Linked Hydrocephalus - L1CAM gene sequencing ML1CAM 35000 35000
678 X-LINKED MYOTUBULAR MYOPATHY3,12,13 MMTMX 13000 10000
679 XMN polymorphism Gr gene ( thalassemia child ) MXM1 4000 2700
680 Y - chromosome deletions ( DNA ) - 10 MYDL 7000 5000
681 ZAP70-related severe combined immunodeficiency MZAP70F 25000 25000
(SCID)-ZAP70 Gene sequencing
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
30
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 menses ) SOBDM 700 420
13 Serum Progesterone PROGEST 700 420
14 Serum Prolactin SPROLAC 700 420
IVF Procedure Charges

CAT 1/CAT2 CAT3
1 Embryo Biopsy (1-2 Embryos) - Hospital Charges EMBRHC 7600 7600
2 Embryo Biopsy (3-4 Embryos) - Hospital Charges EMBRYO 15300 15000
3 Embryo Biopsy (5-8 Embryos) - Hospital Charges EMBRYOHC 23000 23000
4 Oocyte cryopreservation (upto 6 eggs ) OOCYTE 31000 31000
5 Re-Vitrification - Hospital Charges REVITEHC 7875 7875
IVF Investigations

CAT 1/CAT2 CAT3
1 IVF PGS Testing for 1st Embryo IVFPGOS
IVF PGS Testing for 1st Embryo - Clinician Charges IVFPGCC
6000 6000
IVF PGS Testing for 1st Embryo - Embryologists Fee IVFPGEF 4000 4000
IVF PGS Testing for 1st Embryo - Genetics Charges IVFPGGC 5000 5000
IVF PGS Testing for 1st Embryo - Hospital Charges IVFPGHC
27000 27000
2 IVF PGS Testing for Every Subsequent Embryo IVFPGSOS
IVF PGS Testing for Every Subsequent Embryo - Embryologists Fee IVFPGSBCC 4000 4000
IVF PGS Testing for Every Subsequent Embryo - Hospital Charges IVFPGSBHC 23000 23000
IVF Procedures

CAT 1/CAT2 CAT3
1 Aspiration of ovarian cyst under ultrasound guidance - (Doctor Fee + AOVUGOS
Hospital Charges )
Aspiration of ovarian cyst under ultrasound guidance - Anaesthetist Fee AOVUGAF 1710 1710
Aspiration of ovarian cyst under ultrasound guidance - Doctor Fee AOVUGDF 5710 5710
Aspiration of ovarian cyst under ultrasound guidance - Hospital Charges AOVUGHC 2850 2850
2 CULTURE AND EMBRYO TRANSFER CHARGES ( AFTER CETCPDCHOS
RYOPRESERVATION ) (EMBRYOLOGIST FEE + HOSPITAL CHARGES)
Culture and embryo transfer charges ( after cryopreservation ) – Clinical doctor fees CETCDFCL 11760 10780
Culture and embryo transfer charges ( after cryopreservation ) -Embryologist fee CETCDFEMBR 3960 3630
Culture and embryo transfer charges ( after cryopreservation ) – hospital service charges CETCDFAHC 20400 18700
3 DIAGNOSTIC SPERM EXTRACTION ( TESA / PESA ) (PACKAGE CHARGES + DSEPCADCHOS
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
4 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
5 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
31
6 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
7 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
8 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
9 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
10 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
11 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
12 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
13 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
14 Egg Freezing (Non Fertility Preservation :upto 9 oocytes) IVFEN
Egg Freezing (Non Fertility Preservation :upto 9 oocytes) – Embryologists Charges EFDCN 6400 6400
Egg Freezing (Non Fertility Preservation :upto 9 oocytes) – Hospital Charges EFHCN 19000 19000
15 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
32
16 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
17 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
18 Oocyte aspiration (no oocytes retrieved and further IVF suspended) OOCYTEASPOS
(Package charges + all doctor fees + Hospital charges)
IVF CYCLE IVFCY
Oocyte aspiration (no oocytes retrieved and further IVF suspended) -Anaesthetist fee OAAF 3700 3000
Oocyte aspiration (no oocytes retrieved and further IVF suspended) Clinical Doctor fee OACF 10500 8700
Oocyte aspiration (no oocytes retrieved and further IVF suspended) -Hospital amount OAHA 8500 8000
Oocyte aspiration (no oocytes retrieved and further IVF suspended) -Ultrasound charges OAUC 2200 1750
19 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
20 Renewal charges for embryo cryopreservation (for every RENCRYOOS
six months) - (Embryologist fee + Hospital charges)
Renewal charges for embryo cryopreservation (for every six months) -embryologists fee RCSCRYOEMBR 1250 1250
Renewal charges for embryo cryopreservation (for every six months) -hospital charges RCSCRYO 3700 3700
21 Re-Vitrification (Embryologists fee + Hospital charges) REVITEOS
Re-Vitrification - Embryologist fee REVITEMB 2900 2900
Re-Vitrification - Hospital Charges REVITEHC 7875 7875
22 Embryo cryopreservation for 1-3 bactes (Embryologist fee + hospital SPERMCRYO
charges)
Embryo cryopreservation ( freezing ) charges (Embryologists fee) SCRYCEMB 6480 5940
Embryo cryopreservation ( freezing ) charges (Hospital amount) SCRYC 19200 17600
23 Embryo cryopreservation for 4-6 bactes (Embryologist fee SPERMCRYO46
+ hospital charges)
24 Embryo cryopreservation for 7-9 bactes (Embryologist fee SPERMCRYO79
+ hospital charges)
25 REPEAT DIAGNOSTIC SPERM EXTRACTION ( TESA / PESA ) (PACKAGE TESADHCHCOS
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
IVF PACKAGE
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
SNo Code Description

26 FETALRED OS Fetal reduction in IVF lab (All charges)
FETALREDAC Fetal reduction in IVF lab - Anaesthetist fee 3100 2840
FETALREDDF Fetal reduction in IVF lab - Surgeon fee 11090 10160
FETALREDUL Fetal reduction in IVF lab – Ultrasound charges 4520 4150
33
27 IVFR2OS IVF procedure ( Registration 2)
- (Valid for 5 Months)
IVFREG2 IVF procedure ( Registration 2) – Clinician Charges 2620 2400
IVFEMB2 IVF procedure ( Registration 2) -Embryologists Fee 860 790
IVFREGHC2 IVF procedure ( Registration 2) – Hospital Charges 17400 15950
IVFR2PC IVF procedure ( Registration 2) – Packages Charges 24000 22000
IVFREGUC2 IVF procedure ( Registration 2) – Ultasound Charges 3120 2860
IVF package charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
28 IVF1SPROC IVF procedure ( 1ST OCR - DUO STIM ) - 97200 78000
Package Charges
Biochemistry Laboratory Charges

CAT 1/CAT2 CAT3
1 Fluid Amylase FLUAMY 480 330
2 Fluid Bilirubin ( Total & Direct ) FLUBIL 330 200
3 Fluid Bilirubin ( Total & Direct ) - for Kidney Transplant KT-FLUBIL 180 180
4 Fluid Bilirubin ( Total & Direct ) - for Liver Transplant LT-FLUBIL 180 180
5 Fluid Bun FLUMIS 180 110
6 Fluid Calcium FLUCAL 230 140
7 Fluid Chloride FLUCHL 190 120
8 Fluid Cholesterol FLUCHOL 220 140
9 Fluid Creatinine FLUCREAT 180 110
10 Fluid Glucose FLUGLU 120 80
11 Fluid LDH PFLDH 330 200
12 Fluid Lipase FLULIP 480 290
13 Fluid Osmolality FLUOSM 750 600
14 Fluid Potassium FLUPOT 190 120
15 Fluid Protein & albumin PFPROT 350 200
16 Fluid Sodium FLUIDSOD 190 120
17 Fluid Triglycerides FLUTRIG 320 200
18 Fluid Uric Acid FLUUA 260 160
19 24 Hours Urine ( Calcium, Phosphorus ) 24CPU 430 260
20 24 Hours Urine Calcium 24C 230 140
21 24 Hours Urine Chloride 24CHLO 210 130
22 24 Hours Urine Creatinine 24UCR 200 120
23 24 Hours Urine Micro Albumin 24URINALB 420 260
24 24 Hours Urine Phosphorous 24P 230 140
25 24 Hours Urine Potassium 24UP 210 130
26 24 Hours Urine Protein (Excludes Albumin) 24URINPROT 320 200
27 24 Hours Urine Protein (Excludes Albumin) - ( Kidney Transplant ) KT-24URINPROT 190 120
28 24 Hours Urine Protein (Excludes Albumin) - ( Liver Transplant ) LT-24URINPROT 190 120
29 24 Hours Urine Sodium 24US 210 130
30 24 Hours Urine Uric Acid 24U 260 160
31 Active B12 ACTIVEB12 1300 1100
32 Acute Cardiac Profile CPA 4000 2400
33 Adenosine Deaminase ( ADA ) - CSF ADAC 620 380
34 Adenosine Deaminase ( ADA ) - Fluid ( Enter Specimen in Processing Notes ) ADA 620 380
35 Adenosine Deaminase ( ADA ) - Serum ADAS 620 380
34
36 Alkaline Phosphatase ( ALP ) ALKP 220 140
37 Alphafetoprotein (AFP) AFP 1000 850
38 ALT / SGPT SGPT 220 140
39 ALT / SGPT ( Kidney Transplant ) KT-SGPT 130 130
40 ALT / SGPT ( Liver Transplant ) LT-SGPT 130 130
41 Amikacin levels AMICA 2000 1200
42 Ammonia SEA 1100 660
43 Amylase AMYL 480 330
44 Anaemia Profile ( Biochemical ) ENP 4200 2520
45 Angiotensin Converting Enzyme ( ACE ) ACE 1100 850
46 Animal Allergen Mix - Blood ANIM 1100 700
47 Anti Mullerian Hormone BAMH 2350 2100
48 Apolipoprotein A1 APA1 1200 720
49 Apolipoprotein B APAB 1200 720
50 AST / SGOT SGOT 220 140
51 AST / SGOT ( Kidney Transplant ) KT-SGOT 130 130
52 AST / SGOT ( Liver Transplant ) LT-SGOT 130 130
53 Bence Jones Proteins ( Urine ) BJP 400 240
54 Beta 2 Microglobulin (Serum) B2MICROS 1650 990
55 Bicarbonate BCAR 300 180
56 Bilirubin ( Total & Direct ) BILL 330 200
57 Bilirubin ( Total & Direct ) - ( Kidney Transplant ) KT-BILL 180 180
58 Bilirubin ( Total & Direct ) - ( Liver Transplant ) LT-BILL 180 180
59 Blood Glucose 1 Hour After 50gm Glucose ( Glucose Spot Test ) BLGL1 120 80
60 Blood Lead Test BLT 850 750
61 Blood Lead test - PHFI BLTPHFI 700 700
62 BUN BUN 180 110
63 BUN ( Dialysis ) D-BUN 90 90
64 BUN ( Kidney Transplant ) KT-BUN 90 90
65 BUN ( Liver Transplant ) LT-BUN 90 90
66 CA 125 CA125 1400 840
67 CA 15-3 CA153 1400 840
68 CA 19-9 CA199 1400 840
69 Calcium CALC 230 140
70 Calcium ( Dialysis) D-CALC 130 130
71 CAPD Fluids ( 24 Hrs Protein ) C-UPRO 300 180
72 Carbamazepine ( CPZ ) / Tegretol Assay CPZA 1250 900
73 Cardiac Checkup Extended Profile CCUE 7000 4200
74 Cardiac Profile CPC 2450 1470
75 CCR - Creatinine Clearance CCR 550 330
76 CCR - Creatinine Clearance ( Liver Transplant ) LT-CCR 380 230
77 CEA ( Carcino-Embryonic Antigen ) CEA 900 540
78 Chloride CHLO 190 120
79 CK ( CPK ) CPK 480 290
80 CKMB ( Activity ) CKMB ( ACTIVITY ) 500 300
81 CKMB ( MASS ) CKMBM 550 330
82 Comprehensive Allergy Panel Mixes ( CAPMIX ) -Blood ALLERGYP 12500 7600
83 Comprehensive Individual Allergy Panel ( COMPALL ) -Blood EXTENSIVE 32000 19300
84 Creatinine Clearance including serum creatinine, KT-CCR 380 230
proteins & CCR ( Kidney Transplant )
85 CRP ( HS ) High Sensitivity C-Reactive Protein HS 650 400
86 CSF ( Glucose/Protein/Chloride ) BCSF 550 330
87 CSF Albumin CSFALB 400 240
88 CSF Chloride CSFC 190 120
89 CSF Glucose CSFS 120 80
35
90 CSF IgA ( Immunoglobulin ) CSFIGA 750 450
91 CSF LDH CSFLDF 330 200
92 CSF Methotrexate Level METHOCSF 1800 1100
93 CSF Protein CSFP 370 230
94 Dehydroepiandrosterone Sulfate ( DHEA-S ) DHEAS 1100 900
95 Diabetes Monitoring Profile (Glu F,PP Insulin F,PP HbA1c) DIAMP 1800 1100
96 Diabetes Screening Profile (Glu F,PP Insulin F,PP) DIASP 900 540
97 Diabetic Profile DP 900 540
98 Digoxin Level (SGRH Bioch.) DIGO 900 600
99 Drug Panel - Blood DRUGP 4600 2800
100 D-Xylose Excretion Test - 25 grams (5 hours sample) DXYL25 850 510
101 D-Xylose Excretion Test - 5 grams (5 hours sample) DXYL 800 480
102 Eczema Mini Panel - Blood ECZEMAM 6600 4000
103 Eczema Panel Extensive ( EXZEMA EX ) - Blood ECZEMA 15000 9000
104 Everolimus EVEROL 4400 3400
105 Extended Lipid Profile ELIPP 4000 2400
106 Extended Metabolic Profile (Diabetic Profile, Insulin F+PP, C Peptide EMETP 6500 6500
F+PP, Renal Function, Liver Function, Lipid Profile, Homocystine,
Magnesium, hsCRP, Bile Acids, Anemia Profile, Vitamin D, TSH, fT3, fT4)
107 Ferritin FERI 1000 600
108 Fluid Alkaline Phosphatase ( ALP ) ALKPF 220 140
109 Fluid Lipid Profile FLIPP 1200 720
110 Folic Acid FACID 1000 600
111 Food Allergen Mix - Blood FOOD 1100 700
112 Food Intolerance Test FIT 5500 5500
113 Food Panel Extensive ( FPEX ) - Blood ASTHMA 10300 6200
114 Free/Total PSA Ratio FTPA 1250 950
115 FRUCTOSAMINE FRUCT 900 750
116 Gamma GT GAMMA GT 320 200
117 Gentamicin Level ( Gentamycin ) GENTA 950 570
118 Glucose F GLUF 120 80
119 Glucose F ( Dialysis ) D-GLUF 80 80
120 Glucose F ( Kidney Transplant ) KT-GLUF 80 80
121 Glucose F ( Liver Transplant ) LT-GLUF 80 80
122 Glucose F + Glucose PP ( 75 g Glucose ) GTT6 250 150
123 Glucose PP GLUP 120 80
124 Glucose PP ( Dialysis ) D-GLUP 80 80
125 Glucose PP ( Kidney Transplant ) KT-GLUP 80 80
126 Glucose PP ( Liver Transplant ) LT-GLUP 80 80
127 Glucose Random GLUR 120 80
128 Glucose Random ( Dialysis ) D-GLUR 80 80
129 Glucose Random ( Kidney Transplant ) KT-GLUR 80 80
130 Glucose Random ( Liver Transplant ) LT-GLUR 80 80
131 Glucose Tolerance Test ( 100 g ) - ½ hrly x 3 hrs GTT8 750 450
132 Glucose Tolerance Test ( 100 g ) - 1 hrly x 3 hrs GTT3 450 280
133 Glucose Tolerance Test ( 75 g ) - ½ hrly x 2½ hrs GTT4 700 420
134 Glucose Tolerance Test ( 75 g ) - ½ hrly x 3 hrs GTT5 750 450
137 Glucose Tolerance Test ( Standard GTT ) ( 75 g ) - ½ hrly x 2 hrs GTT1 650 390
138 Glycosylated Haemoglobin ( HbA1c ) GLYCOHA 830 500
139 Grass Allergen Mix - Blooc GRASS 1100 700
140 HDL Cholesterol HDL 320 200
141 HE - 4 HE4 3500 3500
142 HE - 4 And CA 125 HE4CA 4000 4000
36
143 Homocysteine HMYT 1250 900
144 hS Troponin I TROP 1100 660
145 i Valproie Acid IVA 800 650
146 Immunoglobulin A ( IgA ) IGA 750 450
147 Immunoglobulin E ( IgE ) IGE 750 450
148 Immunoglobulin G ( IgG ) IGG 750 450
149 Immunoglobulin M ( IgM ) IGM 750 450
150 Immunological profile ( IgA, IgG, IgM ) IMMPROF 1950 1200
151 Immunological profile ( IgA, IgG, IgM, IgE ) IMMPROF-I 2400 1440
152 Individual Allergen - Blood INDIVIDUALA 1100 700
153 Interleukin 6 ( IL6 ) INTER 1400 900
154 Lactate SLACTALI 450 270
155 LACTATE (FLUID) LACFLU 450 270
156 LDH LDH 330 200
157 LDL Cholesterol LDL 450 280
158 Legume Allergen Mix LEGUM 1100 700
159 LFT - Liver Function Test ( Hepatic Profile ) HEPA 1500 900
160 LFT - Liver Function Test ( Hepatic Profile ) - ( Liver Transplant ) LT-HEPA 600 600
161 Lipase SLIPASE 480 290
162 Lipid Profile LIPP 1200 720
163 Lipoprotein ( a ) LP 1100 660
164 Magnesium SMAG 330 200
165 Metabolic Profile (Ca,Phos, ALP, Lipid Profile, Vitamin METAPRO 4200 2700
B12, Glu F,PP, HbA1C, TSH, Uric Acid, Insulin F)
166 Mold Allergen Mix - Blood MOLD 1100 700
167 NAGL ( Urine ) - Thesis Paed NAGLPRO 1900 1300
168 NGAL (Plasma) NGALP 1900 1300
169 NGAL (Urine) NGALU 1900 1300
170 NGAL (URINE) - Free for Post Angioplasty patients (Project) NGALANGIO
171 NT- proBNP ( Biochemistry Lab ) NTPRO 2000 1600

172 Ostase (Bone Alkaline Phosphatase) OSTASE 1800 1800
173 Phadiatop Atopic Screening Test - Blood ATOPIC 1100 700
174 Phenytoin / Dilantin Assay PHEN 1200 900
175 Phosphorus PHOS 230 140
176 Phosphorus ( Dialysis ) D-PHOS 110 110
177 Potassium POTA 190 120
178 Potassium ( Dialysis ) D-POTA 100 100
179 Potassium ( Kidney Transplant ) KT-POTA 100 100
180 Potassium ( Liver Transplant ) LT-POTA 100 100
181 Prostatic Specific Antigen ( PSA ) PROST 850 500
182 Renal Anaemia Profile ( Biochemical )(Fe,TIBC,Transferrin,Ferretin) ARENP 1500 900
183 Renal Biochemical Profile – Basic (BUN,Creat,Ca,PO4,Na,K,Bicarbonate,Cl) RENPI 1450 870
184 Renal Biochemical Profile – Complete (BUN,Creat,Ca,PO4,Na, K, RENPP 2000 1200
RBS,Uric,Prot,Alk PO4,Cholest,Bicarbonate,Cl)
185 Respiratory Panel Extensive ( RESPEX ) - Blood WHEEZE 14000 8500
186 Respiratory Panel-Mini (RESPMINI) - Blood WHEEZERM 8000 5000
187 RFT with eGFR RFTEGFR 1600 960
188 Serum Cortisol SRC 600 450
189 Serum Creatinine CREA 180 110
190 Serum Creatinine ( Dialysis ) D-CREA 100 100
191 Serum Creatinine ( Kidney Transplant ) KT-CREA 100 100
192 Serum Creatinine ( Liver Transplant ) LT-CREA 100 100
193 Serum Iron IRON 400 240
194 Serum Iron Binding Capacity ( TIBC ) TIBC 500 300
195 Serum Methotrexate Level METHO 1800 1100
37
196 Serum Osmolality SEROSM 750 600
197 Serum Pre - albumin level SPAL 1300 950
198 Serum procalcitonin SPROC 2250 1850
199 Serum total bile acids STBA 1200 720
200 Sodium SODI 190 120
201 Sodium ( Dialysis ) D-SODI 100 100
202 Sodium ( Kidney Transplant ) KT-SODI 100 100
203 Sodium ( Liver Transplant ) LT-SODI 100 100
204 Sodium + Potassium + Chlorides + Bicarbonate SPC 750 450
205 Soluble Transferrin Receptor STRAREC 2500 2500
206 ST2 ST2 3000 3000
207 Stone Qualitative Analysis STON 900 800
208 Tacrolimus test TACRO 1900 1900
209 Theophylline THEO 1650 1100
210 Thesis_Ferritin FERITHESIS 0 0
211 Total Beta- hCG ( Biochemistry ) BHC 750 450
212 Total Cholesterol CHOL 220 140
213 Total Proteins TPRO 350 200
214 Total Proteins ( Dialysis ) D-TPRO 200 200
215 Transferrin TF 700 420
216 Tree Allergen Mix - Juniperus - Blood TREEJ 1100 700
217 Tree Allergen Mix - Pines - Blood TREEP 1100 700
218 Triglycerides TRIG 320 200
219 Tumor Necrosis Factor Alpha ( TNF Alpha ) TUFA 1200 1000
220 Uric Acid URIA 260 160
221 Urinary ( Urine ) VMA (24 hours) UVMA 2000 1200
222 Urinary Albumin creatinine ratio UACR 350 210
223 Urine Osmolality OSMLU 750 600
224 Urine Spot Calcium : Creatinine Ratio SPOTCC 360 220
225 Urine Spot Test for Calcium USCA 230 140
226 URINE SPOT TEST FOR CHLORIDE CHLOSP 190 120
227 Urine Spot Test for Creatinine USCREAT 180 110
228 Urine Spot Test for Microalbumin ( Biochemistry ) MA 380 230
229 Urine Spot Test for Phosphorus USPOTPH 200 120
230 Urine Spot Test for Potassium UK 190 120
231 Urine Spot Test for Protein & Creatinine ( PC Ratio ) USPRCR 380 230
232 Urine Spot Test for Protein ( Excludes Albumin ) USPROT 320 200
233 Urine Spot Test for Sodium UNA 190 120
234 Urine Spot Test for Uric Acid USUR 260 160
235 Vancomycin Level VANCO 1200 1000
236 Veg. Food Panel ( VEGFP ) - Blood ASTHMAR 8000 5000
237 Vegetable Allergen Mix - Blood VEGE 1100 700
238 Vitamin B 12 ( B12 ) VB12 950 570
239 VLDL Cholesterol VLDL 960 570
240 Weed Allergen Mix - Blood WEED 1100 700
241 Zinc Serum ZINCZN 800 500
242 Zinc Urine ZINCU 800 500
243 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
38
Cardiac Laboratory Charges
CAT 1/CAT2 CAT3
1 Diagnosis of Acute Myocardial Infarcation ( AMI ) Cardiac Dept CARAMI 1430 1150
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 1770 1770
Clinical Pathology Charges

CAT 1/CAT2 CAT3
1 Urine examination ( Routine / Microscopy ) URINERE 320 190
2 Urine for Acetone UROK 240 145
3 Urine for albumin / protein UROP 240 145
4 Urine for Bile pigment / salt BPIG 320 190
5 Urine for chyle URC 320 190
6 Urine for Dysmorphic RBCs UDYRBC 330 200
7 Urine for haemoglobin URHEM 350 220
8 Urine for myoglobin URMYO 350 220
9 Urine for porphobilinogen URP 400 250
10 Urine for sugar / reducing substance UROG 320 190
11 Urine for urobilinogen UROB 400 250
12 Urine pH URINEPH 195 130
13 Urine specific gravity URINESPGR 195 130
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 tartrate CYTOAP 2000 1200
2 Cell count CELLC 770 450
3 Immunophenotyping ( flow cytometry ) - Acute leukemia panel ACLP 17500 14400
(cMPO, cCD79a, c3, CD45, 19, 10, 5, 7, 3, 14, 13, 34, 33)
4 Immunophenotyping ( flow cytometry ) - Chronic lymphocytic CLLPANEL 17500 14400
leukemia panel ( CLL ) - k,l,CD45,19,5,10,FMC7,23,103,11c,38,56
5 Immunophenotyping ( flow cytometry ) - Lymphoma LYMPHPANEL 17500 14400
panel (CD45, 19, 10, 5, 7, 3, 4, 8, k, l)
6 Leukocyte alkaline phosphatase ( LAP ) score CYTOLAP 1850 1150
7 Microfilaria ( Peripheral smear ) MF 530 320
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
39
12 (Factor Xa Heparin for Enoxaparin ) (Anti xa levels) PROJECT ANTIXAP 0 0
13 Absolute eosinophil count ( AEC ) AEC 330 200
14 Absolute Lymphocyte Count ( ALC ) ALC 330 200
15 Absolute neutrophil count ( ANC ) ANC 330 200
16 ANA Profile 3 ANA 3200 1900
17 Antibodies to ds - DNA ( Enzyme Immuno Assay ) DNA 1500 900
18 Anti-c ANCA ( anti - PR3 ) AANCA-AP 2100 1260
19 Anticardiolipin antibodies ( ACA ) - IgM ACLM 1500 900
20 Anticardiolipin antibodies ( ACA ) - IgG ACLG 1500 900
21 Anti-p ANCA ( anti - MPO ) AANCA-AM 2100 1260
22 Antithrombin functional assay (Haematology) ANTITHROH 4000 2400
23 APT test APTS 350 220
24 APTT ( Activated partial thromboplastin time ) APTT 750 450
25 APTT based inhibitor screen APPTIN 1500 900
26 APTT mixing experiment APTTMIX 1500 900
27 Ascitic fluid cell counts ASF 770 450
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 2900 1700
32 Bone marrow slides for issue to patient ( 1 slide ) BMSFITP1S 350 220
33 CAPD fluid cell counts CAPD 770 450
34 CBC - Complete blood count CBC 470 300
35 CBC , DLC with Peripheral smear CBCDLCPBF 780 470
36 CD 19 / CD 20 / CD45 by flowcytometry CD1945 3400 2000
37 Cerebrospinal fluid ( CSF ) cell count CSF 770 450
38 Clot retraction test CRT 380 230
39 Clot solubility test ( Factor-XIII ) CST 680 400
40 Coagulation factor IX assay COAGF9 2800 1640
41 Coagulation factor VIII assay COAGF8 2800 1640
42 Coagulation profile screening (PT / APTT/ TT / CBC /PS ) CPST 3800 2250
43 Complete blood count ( CBC ) - ( Dialysis ) DCBC 380 280
44 Complete blood count ( CBC ) - ( Kidney Transplant ) KT-CBC 380 280
45 Complete blood count ( CBC ) - ( Liver Transplant ) LT-CBC 380 280
46 Complete blood count ( CBC ) with Differential leukocyte count (DLC ) CBCDLC 660 400
47 Complete blood count ( CBC ) with Differential DCBCDLC 480 360
leukocyte count ( DLC ) - ( Dialysis )
48 Complete blood count ( CBC ) with Differential KT-CBCDLC 480 360
leukocyte count ( DLC ) - ( Kidney Transplant )
49 Complete blood count ( CBC ) with Differential LT-CBCDLC 480 360
leukocyte count ( DLC ) - ( Liver Transplant )
50 D-dimer D-DIMER 1800 1100
51 Differential leukocyte count ( DLC ) DLC 450 270
52 Dihydrorhodamine Assay by Flow Cytometry DAFC 2800 1680
53 dRVVT screen dRVVT confirm LACC 2700 1600
54 EMA dye binding test EMADB 1600 1000
63 Erythrocyte sedimentation rate ( ESR ) ESR 400 250
64 Factor II assay FACTOR2 3800 2650
65 Factor V assay FACTOR5 3400 2200
66 Factor V Leiden ( APC-R) FVLEDN 4300 2600
67 Factor VII assay FACTOR7 3800 2650
68 Factor X assay FACTOR10 3300 2150
69 Factor Xa Heparin for Enoxaparin FXAENO 4400 2600
70 Factor XI assay FACTOR11 3900 2700
71 Factor XII assay FACTOR12 3900 2700
40
72 Factor XIII assay FACTOR13 10000 8000
73 Fibrinogen (Quantitative) FIBEST 1400 840
74 FLOW CYTOMETRIC FOR ANY SINGLE PANEL OF LEUKEMIA / LYMPHOMA FCSLL 3700 2400
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 3500 2350
79 FLOWCYTOMETRIC HLA - CROSS MATCH FCXM 12000 7200
80 Flowcytometric MDS Panel FMYMDS 8500 6150
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 280 160
85 Haemoglobin ( Hb ) - Dialysis DHB 190 140
86 Haemoglobin ( Hb ) - Transplant KT-HB 190 140
87 Haemoglobin ( Hb ) FOR THALASSEMIC PATIENTS ONLY HBTH 0 0
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 800 550
92 HB / PCV HBPCV 390 250
93 HbH Inclusion HBHI 500 300
94 Heinz bodies HZB 500 300
95 Hemosiderin in urine HSU 530 330
96 Heparin induced thrombocytopenia (gel card) HITA 2400 1750
97 IgG and IgM antibodies to Leishmania (Rapid test) IGGIGM 1100 650
98 Immature Platelet Fraction IPF 750 450
99 Immunodeficiency / HIV panel ( CD3 / CD4 / CD8 counts ) HIVIMM 3400 2000
100 Immunodeficiency / Non HIV panel BTCELL 3500 2100
101 Immunofixation electrophoresis - 24 hrs urine IMMUNOU 10000 6000
102 Immunofixation electrophoresis - serum IMMUNOS 9000 5400
103 Immunophenotyping ( flow cytometry ) - NK / Obstetric Panel NKCELL 5200 3100
104 Immunophenotyping ( flow cytometry ) - PNH panel PNHPAN 7900 4700
105 Incubation osmotic fragility ( CBC / PS / Retic) IOFT 1800 1100
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 2100
110 Osmotic fragility test ( CBC / PS / Retic) OST 1800 1100
111 Pericardial fluid cell count PESF 770 450
112 Peripheral smear for malaria ( MP ) MP 890 530
113 Plasma Hemoglobin PHB 540 320
114 Platelet aggregation test for HIT (confirmatory functional Assay) PAT 1350 1100
115 Platelet count PLT 250 150
116 Platelet Count for Dengue Patients DENGUEPLT 50 50
117 Platelet function test for bleeding disorders PFTFBD 8700 6400
118 Platelet function test for drug monitoring PFTFDM 6400 4000
119 Platelet function test for von Willebrand disease PFTFVWD 8800 6300
120 Pleural fluid cell count PLSF 770 450
121 Protein C functional assay PROTEINC 4200 2500
122 Protein S functional assay PROTEINS 4200 2500
123 Prothrombin time ( PT ) Haematology Lab PT 450 270
124 PT mixing experiment PTMIX 900 540
125 Renal/BMT Reticulocyte Count RBRC 640 380
41
126 Reticulocyte count RTIC 640 380
127 Review of stained bone biopsy section received from HBBS 1500 900
outside ( Hematology )
128 Screening for beta thalassemia / haemoglobinopathies ( CBC / HbF / HbA2 ) BTHAL 1750 1100
129 Serum Freelight Chain Assay SFLCA 5000 3000
130 Serum protein electrophoresis ( SPE ) PROELECT 2000 1200
131 Sickling test SLT 440 280
132 STEM CELL ENUMERATION ( CD34 + CELL COUNT ) SCEN34 7700 4800
133 Synovial fluid cell count SYSF 770 450
134 Synovial fluid for crystals by Polarizer SYFLD 620 380
135 T-B-NK with CD4 & CD8 counts TBNK 6600 4100
136 Test for HbH Inclusion HBH 570 340
137 Thrombin time ( TT ) TT 800 480
138 Total leukocyte count ( TLC ) TC 270 170
139 Total leukocyte count ( TLC ) - Transplant KT-TLC 200 160
140 Urine For Eosinophils UFE 460 270
141 Urine protein electrophoresis URIELECTRO 3300 1950
142 Von Willebrand factor VONWILL 6600 3900
143 Von Willebrand Ristocetin Cofactor activity VWRCA 8400 6700
144 Comprehensive Myeloma Panel - Haematology HCOMP 10200 8800
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 Thrombophilia Panel ( Molecular + Coagulant assays ) ( Mutations of THROMMH 20000 18000
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 Cofactor activity VONWOS 13000 9000
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
4 1 pathology slide for issue to patient - NO Barcode FPSR 290 290
5 1 pathology slide for issue to patient (2nd time) – NO Barcode PSIP21 440 440
6 2 pathology slides for issue to patient - NO Barcode FPSR2 440 440
7 2 pathology slides for issue to patient (2nd time) – NO Barcode PSIP22 710 710
42
8 3 pathology slides for issue to patient - NO Barcode PSIP3 610 610
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 ) -WITH Barcode ALKMA 1560 940
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 Barcode ASMA 1340 800
29 Anti thyroid antibodies ( ATA )- WITH Barcode (Histopathology) ATA 1340 800
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 barcodes BIOIMM7 6680 4010
34 Biopsy Medium with Immuno fluroscent study – WITH Barcode BIOIMM 5570 3340
35 Block For Patient BFP 980 980
36 Bronchial washing/BAL/ET secretions for malignant cells - Cytology MCBRO 1240 780
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 Barcode FNACN 1120 670
40 DSDNA - WITH Barcode DSDNA 1120 670
41 Enzyme Histochemistry - Each additional enzyme stain - Histopathology ENZHISE 1400 840
42 Enzyme Histochemistry - One enzyme stain -Histopathology ENZHIS 2480 1490
43 FNAC Cytology of aspirate (DONE IN PATHOLOGY LAB) WITH Barcode ASFNAC 1980 1190
44 FNAC for Endoscopic ultrasound specimen ( EUSFNAC) - Cytology MCEUS 3390 2030
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 HPV-DNA for Anal Smears (HPVDNAAS) HPVDNAAS 3250 1980
51 IHC 10 markers and above / ADD ON without barcode IHS10H 15590 9350
52 IHC 10 markers and above with barcode IHS10 15590 9350
53 IHC 7 markers / ADD ON without barcode IHS7H 11800 7080
54 IHC 7 markers with barcode IHS7 11800 7080
55 IHC 8 Markers - With Barcode IHC8 11570 6950
43
56 IHC 8 markers - Without Barcode IHC8H 11570 6950
57 IHC 9 markers / ADD ON without barcode IHS9H 13140 7880
58 IHC 9 markers with barcode IHS9 13140 7880
59 Immuno fluroscent staining ( 1 stain ) - WITH Barcode IFS1 1110 660
60 Immuno fluroscent staining ( 2 stains ) – WITH Barcode IFS2 1890 1510
64 Immuno histochemistry ADD ON staining (Cytopathology ) - 1 stain IHISTCHEM1C 1710 1030
NO Barcode
65 Immuno histochemistry ADD ON staining (Cytopathology ) - 2 stains IHISTCHEM2C 3420 2050
NO Barcode
66 Immuno histochemistry ADD ON staining (Cytopathology ) - 3 stains IHISTCHEM3C 4970 2980
NO Barcode
67 Immuno histochemistry ADD ON staining (Cytopathology ) - 4 stains IHS4C 6200 3720
NO Barcode
68 Immuno histochemistry ADD ON staining (Histopathology ) - 1 stain IHISTCHEM1H 2120 1260
- NO Barcode
69 Immuno histochemistry ADD ON staining (Histopathology ) - 2 IHISTCHEM2H 4230 2540
stains - NO Barcode
70 Immuno histochemistry ADD ON staining (Histopathology ) - 3 IHISTCHEM3H 5920 3550
stains - NO Barcode
71 Immuno histochemistry ADD ON staining (Histopathology ) - 4 IHS4H 6520 3910
stains - NO Barcode
72 Immuno histochemistry staining ( 1 stain ) WITH barcode IHISTCHEM 2010 1200
73 Immuno histochemistry staining ( 2 stain ) – WITH Barcode IHISTCHEM2 4010 2400
74 Immuno histochemistry staining ( 3 stain ) – WITH Barcode IHISTCHEM3 5670 3410
75 Immuno histochemistry staining ( 4 stains ) WITH barcode IHS4 6460 3880
76 Immuno histochemistry staining ( 5 stain ) WITHOUT barcode IHS5H 7790 4670
77 Immuno histochemistry staining ( 5 stain ) WITH barcode IHS5 9130 5480
78 Liquid Base Cytology for Anal Smears (LBCAS) LBCAS 1260 770
79 Microwave processing for rapid diagnosis (small biopsies) MPRD 4460 2670
80 Neurogen Antigen Profile 2 NAP2 4000 3500
81 One to two stained histopathology slide(s) from FPS1 840 840
outside for opinion - WITH Barcode
82 PAP smear / Hormonal smear / Vault smear / Cervical PAPS 600 360
smear WITH Barcode
83 Paraffin Blocks / Unstained slides received from PBUSM3 2120 1260
outside (more than 3) - WITH Barcode
84 Paraffin Blocks / Unstained slides received from PBUS 1670 1000
outside (up to 3) - WITH Barcode
85 PLA2R ELISA PLA2RE 4000 4000
86 Pleural / Ascitic / Pericardial / Peritoneal wash /any MCPLE 990 600
other fluid for malignant cells - Cytology
87 Remaining of frozen tissue ( Extra Large ) – NO Barcode REMXLARGE 4230 2540
88 Remaining of frozen tissue ( Large ) - NO Barcode REMLARGE 2780 2010
89 Remaining of frozen tissue ( Medium ) - NO Barcode REMMEDIUM 2120 1260
90 Remaining of frozen tissue ( Small ) - NO Barcode REMSMALL 1400 840
91 Six and more stained histopathology slide(s) from FPS6 1670 1670
92 Sputum for malignant cells - Cytology MCSPU 820 490
93 Stained pathology slide (s) from outside for opinion STPHCY3 850 850
(Cytopathology) - More than 2 WITH Barcode
44
94 Stained pathology slide (s) from outside for opinion STPHCY2 500 500
(Cytopathology) - Up to 2 WITH Barcode
95 Three to five stained histopathology slide(s) from FPS3-5 1110 1110
96 Trans bronchial needle aspiration ( TBNA ) Reporting MCTBNA 1240 780
for malignant cells - Cytology
97 Ultrasound/CT guided FNAC Reporting for malignant cells - MCFNAC 1690 1020
Cytology
98 Urine for malignant cells ( 1 sample ) - Cytology MCURI 820 490
99 Urine for malignant cells ( 3 samples ) - Cytology MCURI3 2240 1360
100 Vaginal / cervical cytology by liquid base cytology ( LBC ) LBC 1260 770
Microbiology Laboratory Charges

CAT 1/CAT2 CAT3
1 (OPD case only) AFB culture and sensitivity – LJ Method ( Aspirate ) AFBCULTASP 2070 1240
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 )
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 Method ( CSF ) AFBCULTCSF 2070 1240
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 Method ( Pus ) AFBCULTPUS 2070 1240
18 (OPD case only) AFB culture and sensitivity - LJ AFBCULTRVF 2070 1240
Method ( Romovac fluid )
19 (OPD case only) AFB culture and sensitivity – LJ Method ( Sputum ) AFBCULTSPM 2070 1240
20 (OPD case only) AFB culture and sensitivity – LJ Method ( Stool ) AFPCULTSTL 2070 1240
21 (OPD case only) AFB culture and sensitivity - LJ AFBCULTSYF 2070 1240
Method ( Synovial fluid )
22 (OPD case only) AFB culture and sensitivity – LJ Method ( Tissue ) AFBCULTTIS 2070 1240
23 (OPD case only) AFB culture and sensitivity – LJ Method ( Urine ) AFBCULTURI 2070 1240
45
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 SWAB) AVQTHS 6970 4500
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
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 ( Bone Marrow ) AERBTA+B-BM 2310 1400
71 BacT/Alert aerobic culture ( CSF ) AERBTACSF 2310 1400
72 BacT/Alert aerobic culture ( Dialysis catheter/ Trylase sample) AERBTA+B-BRO 2310 1400
73 BacT/Alert aerobic culture ( Pericardial fluid ) AERBTA+B-PEC 2310 1400
74 BacT/Alert aerobic culture ( Peritoneal fluid ) AERBTA+B-PET 2310 1400
75 BacT/Alert aerobic culture ( Pleural fluid ) AERBTA+B-PLE 2310 1400
76 BacT/Alert aerobic culture ( Pus ) AERBTA+B-PUS 2310 1400
77 BacT/Alert aerobic culture ( Synovial fluid ) AERBTA+B-SYN 2310 1400
78 BacT/Alert anaerobic culture ( Aspirate ) ANABTA+BASP 2310 1400
46
79 BacT/Alert anaerobic culture ( Aspiration fluid ) ANABTA+BASF 2310 1400
80 BacT/Alert anaerobic culture ( Blood ) ANABTA+BBLD 2310 1400
81 BacT/Alert anaerobic culture ( Bone Marrow) ANABTA+BBON 2310 1400
82 BacT/Alert anaerobic culture ( CSF ) ANABTA+BCSF 2310 1400
83 BacT/Alert anaerobic culture ( P. D. fluid ) ANABTA+BPDF 2310 1400
84 BacT/Alert anaerobic culture ( Pericardial fluid ) ANABTA+BPER 2310 1400
85 BacT/Alert anaerobic culture ( Peritoneal fluid ) ANABTA+BPEF 2310 1400
86 BacT/Alert anaerobic culture ( Pleural fluid ) ANABTA+BPLE 2310 1400
87 BacT/Alert anaerobic culture ( Pus ) ANABTA+BPUS 2310 1400
88 BK Polyomavirus Quantitative real time PCR (BLOOD) BKPQBLD 7320 4390
89 BK Polyomavirus Quantitative real time PCR (CSF) BKPQCSF 7320 4390
90 BK Polyomavirus Quantitative real time PCR (MISC) BKPQMIS 7320 4390
91 BK Polyomavirus Quantitative real time PCR (URINE) BKPQURI 7320 4390
92 Brucella antibody assay BAS 700 420
93 C - Reactive protein ( CRP ) CRP 930 570
94 CAPD Fluid Microscopy ( Cell count + Gram Stain + KOH ) CAPDFCUL 650 390
95 Charges for screening tests for blood donor BLOODDS 4790(Cat 1D)/3830 (2) /2880 (3)
96 Chikungunya & Dengue Real Time Qualitative PCR CDRTPCQ 3370 3370
97 Chikungunya Real Time Qualitative PCR CRTQPCR 1580 1580
98 Clostridium Difficile toxin A & B CDTAB 2110 1270
99 CMV antibody IgG CMVAG 820 490
100 CMV antibody IgM CMVAM 770 460
101 CMV avidity IgG CMVAVIGG 1000 600
102 CMV Quantitative Real Time PCR - Microbiology CMVQRTP 6000 4500
103 Cryptococcus antigen test ( Cryptola ) - Blood CDT 2320 1400
104 Cryptococcus antigen test ( Cryptola ) - CSF CDTCSF 2320 1400
105 CSF bacterial antigen test for meningitis causing organsims CSFBATM 3050 1830
106 CSF VDRL VDRLCSF 350 210
107 Cysticercosis antibody test ( ELISA ) CYSTICER 1600 1000
108 Dengue antibody serology (IgM) DENGU 670 670
109 Dengue Duo spot plus test ( IgG / IgM / NS - 1 ) DDSTPLIGGIGM 2500 1500
110 Dengue Duo spot test ( IgG / IgM ) DDSTIGGIGM 2200 1320
111 Dengue NS 1 Antigen Assay DENGUNS1 630 630
112 Dengue Real Time PCR DENREATPC 1690 1690
113 Direct Fluorescent staining for AFB ( Aspirate ) FLUOREAFBASP 1000 600
114 Direct Fluorescent staining for AFB ( Aspirate ) Northern Railway FLUOREAFBASPN 630 630
115 Direct Fluorescent staining for AFB ( Aspiration fluid ) FLUOREAFBASPF 1000 600
116 Direct Fluorescent staining for AFB ( Aspiration smears ) FLUOREAFBASPS 1000 600
117 Direct Fluorescent staining for AFB ( Bone marrow ) FLUOREAFBBOM 1000 600
118 Direct Fluorescent staining for AFB ( Bronchial washing ) FLUOREAFBBRW 1000 600
119 Direct Fluorescent staining for AFB ( Bronchoalveolar lavage ) FLUOREAFBBRL 1000 600
120 Direct Fluorescent staining for AFB ( Chest irrigatin fluid ) FLUOREAFBCIF 1000 600
121 Direct Fluorescent staining for AFB ( CSF ) FLUOREAFBCSF 1000 600
122 Direct Fluorescent staining for AFB ( Drainage fluid ) FLUOREAFBDRF 1000 600
123 Direct Fluorescent staining for AFB ( E. T. secretion ) FLUOREAFBETS 1000 600
124 Direct Fluorescent Staining for AFB ( Gastrtric aspirate ) FLUOREAFBGAS 1000 600
125 Direct Fluorescent staining for AFB ( Miscellaneous ) FLUOREAFB 1000 600
126 Direct Fluorescent staining for AFB ( P. D. fluid ) FLUOREAFBPDF 1000 600
127 Direct Fluorescent staining for AFB ( Pericardial fluid ) FLUOREAFBPEF 1000 600
128 Direct Fluorescent staining for AFB ( Peritoneal fluid ) FLUOREAFBPRF 1000 600
129 Direct Fluorescent staining for AFB ( Pleural fluid ) FLUOREAFBPLF 1000 600
130 Direct Fluorescent staining for AFB ( PUS ) FLUOREAFBPUS 1000 600
131 Direct Fluorescent staining for AFB ( Sputum ) FLUOREAFBSPU 1000 600
132 Direct Fluorescent staining for AFB ( Stool ) FLUOREAFBSTO 1000 600
133 Direct Fluorescent staining for AFB ( Synovial fluid ) FLUOREAFBSYF 1000 600
47
134 Direct Fluorescent staining for AFB ( Tissue ) FLUOREAFBTIS 1000 600
135 Direct Fluorescent staining for AFB ( Urine ) FLUOREAFBURN 1000 600
136 E histolytica antibody test (IgG) - Amoebic serology IGGEHIST 1480 890
137 EBV Quantitative Real Time PCR EBQRTP 7320 5240
138 Echinococcus antibody test ( ELISA ) – Hydatid serology ECHINOIGG 1330 800
139 ELISA for Chikungunya IgM EFCI 630 630
140 Enterovirus real time PCR (Microbiology) ERTN 7820 5000
141 Fungal culture ( Aspiration fluid ) FUNGCULTAPF 1190 710
142 Fungal culture ( Blister fluid ) FUNGCULTBTF 1190 710
143 Fungal culture ( Bronchial washing ) FUNGCULTBRW 1190 710
144 Fungal culture ( Bronchoalveolar lavage ) FUNGCULTBRL 1190 710
145 Fungal culture ( CSF ) FUNGCULTCSF 1190 710
146 Fungal culture ( Drainage fluid ) FUNGCULTDRF 1190 710
147 Fungal culture ( E. T. secretion ) FUNGCULTETS 1190 710
148 Fungal culture ( Faecal fluid ) FUNGCULTFLF 1190 710
149 Fungal culture ( Hair ) FUNGCULTHAIR 1190 710
150 Fungal culture ( Miscellaneous ) FUNGCULT 1190 710
151 Fungal culture ( Nail ) FUNGCULTNAIL 1190 710
152 Fungal culture ( P. D. fluid ) FUNGCULTPDF 1190 710
153 Fungal culture ( Percardial fluid ) FUNGCULTPCF 1190 710
154 Fungal culture ( Peritoneal fluid ) FUNGCULTPTF 1190 710
155 Fungal culture ( Pleural fluid ) FUNGCULTPLF 1190 710
156 Fungal culture ( PUS ) FUNGCULTPUS 1190 710
157 Fungal culture ( Skin scrapings ) FUNGCULTSKIN 1190 710
158 Fungal culture ( Sputum ) FUNGCULTSPU 1190 710
159 Fungal culture ( Stool ) FUNGCULTSTL 1190 710
160 Fungal culture ( Synovial fluid ) FUNGCULTSYF 1190 710
161 Fungal culture ( Tissue ) FUNGCULTTIS 1190 710
162 Fungal culture ( Urine ) FUNGCULTURN 1190 710
163 Fungal culture by Bact Alert ( Blood ) FUNGCULBLD 2310 1400
164 Fungal culture by Bact Alert ( Bone Marrow ) FUNGCULBONE 2310 1400
165 Fungal smear - India ink preparation for cryptococcus INDINK 320 190
166 Fungal smear - KOH preparation ( Ascitic fluid ) KOHMEFATF 280 170
167 Fungal smear - KOH preparation for fungus ( Aspirate) KOHMEFASP 280 170
168 Fungal smear - KOH preparation for fungus (Aspiration fluid ) KOHMEFAPS 280 170
169 Fungal smear - KOH preparation for fungus ( Blister fluid ) KOHMEFBLF 280 170
170 Fungal smear - KOH preparation for fungus ( Bone marrow ) KOHMEFBMW 280 170
171 Fungal smear - KOH preparation for fungus (Bronchial washing ) KOHMEFBRW 280 170
172 Fungal smear - KOH preparation for fungus (Bronchoalveolar lavage ) KOHMEFBRL 280 170
173 Fungal smear - KOH preparation for fungus ( Chest irrigation fluid ) KOHMEFCIF 280 170
174 Fungal smear - KOH preparation for fungus ( Chest wound swab ) KOHMEFCWS 280 170
175 Fungal smear - KOH preparation for fungus ( Drainage fluid ) KOHMEFDRF 280 170
176 Fungal smear - KOH preparation for fungus ( E.T. secretion ) KOHMEFETS 280 170
177 Fungal smear - KOH preparation for fungus ( Ear swab) KOHMEFERS 280 170
178 Fungal smear - KOH preparation for fungus ( Eye swab ) KOHMEFEYS 280 170
179 Fungal smear - KOH preparation for fungus ( Gastric aspirate ) KOHMEFGTS 280 170
180 Fungal smear - KOH preparation for fungus ( Hair ) KOHMEFHAIR 280 170
181 Fungal smear - KOH preparation for fungus (Laryngeal swab ) KOHMEFLYS 280 170
182 Fungal smear - KOH preparation for fungus (Miscellaneous ) KOHMEF 280 170
183 Fungal smear - KOH preparation for fungus ( Nail ) KOHMEFNAIL 280 170
184 Fungal smear - KOH preparation for fungus ( P.D. fluid) KOHMEFPDF 280 170
185 Fungal smear - KOH preparation for fungus (Pericardial fluid ) KOHMEFPCF 280 170
186 Fungal smear - KOH preparation for fungus (Peritoneal fluid ) KOHMEFPTF 280 170
187 Fungal smear - KOH preparation for fungus ( Pleural fluid ) KOHMEFPLF 280 170
188 Fungal smear - KOH preparation for fungus ( Pus ) KOHMEFPUS 280 170
48
189 Fungal smear - KOH preparation for fungus (Romovac fluid ) KOHMEFRVF 280 170
190 Fungal smear - KOH preparation for fungus ( Skin scrapings ) KOHMEFSKIN 280 170
191 Fungal smear - KOH preparation for fungus ( Sputum ) KOHMEFSPU 280 170
192 Fungal smear - KOH preparation for fungus ( Stool ) KOHMEFSTOOL 280 170
193 Fungal smear - KOH preparation for fungus ( Synovial fluid ) KOHMEFSYF 280 170
194 Fungal smear - KOH preparation for fungus ( Tissue ) KOHMEFTIS 280 170
195 Fungal smear - KOH preparation for fungus ( Urine ) KOHMEFURN 280 170
196 Fungal smear - KOH preparation for fungus ( Vaginal swab ) KOHMEFVGS 280 170
197 Galactomannam test for aspergillus PAG 2180 1300
198 Giemsa stain ( Aspiration smears ) - Inclusion bodies in CMV or herpes GIEMSAASP 320 190
199 Giemsa stain ( Blister fluid ) - Inclusion bodies in CMV or herpes GIEMSABLF 320 190
200 Giemsa stain ( Bronchial washing ) - PCP / Inclusion GIEMSABRW 320 190
bodies in CMV or herpes
201 Giemsa stain ( E.T. secretion ) - PCP GIEMSAETS 320 190
202 Giemsa stain ( Miscellaneous ) - Inclusion bodies in CMV or herpes GIEMSA 320 190
203 Giemsa stain ( Sputum ) - PCP GIEMSASPU 320 190
204 Giemsa stain ( Tissue ) - Inclusion bodies in CMV orherpes GIEMSATIS 320 190
205 Gram stain ( Aortic valve ) GRMSTAINAOV 330 200
206 Gram stain ( Ascitic fluid) GRMSTAINASC 330 200
207 Gram stain ( Aspirate) GRMSTAINASE 330 200
208 Gram stain ( Aspiration fluid ) GRMSTAINASF 330 200
209 Gram stain ( Aspiration smears) GRMSTAINASP 330 200
210 Gram stain ( Blister fluid ) GRMSTAINBLF 330 200
211 Gram stain ( Bronchial washing ) GRMSTAINBRW 330 200
212 Gram stain ( Bronchoalveolar lavage ) GRMSTAINBVL 330 200
213 Gram stain ( Chest irrigation fluid ) GRMSTAINCIF 330 200
214 Gram stain ( CSF ) GRMSTAINCSF 330 200
215 Gram stain ( CT guided aspirate ) GRMSTAINCTGA 330 200
216 Gram stain ( Drainage fluid ) GRMSTAINDRF 330 200
217 Gram stain ( E.T. secretion ) RCULTUREETS 330 200
218 Gram stain ( Laryngeal swab ) GRMSTAINLAS 330 200
219 Gram stain ( Miscellaneous ) GRMSTAIN 330 200
220 Gram stain ( P.D. fluid ) GRMSTAINPDF 330 200
221 Gram stain ( Pericardial fluid ) GRMSTAINPEF 330 200
222 Gram stain ( Peritoneal fluid ) GRMSTAINPER 330 200
223 Gram stain ( Pleural fluid ) GRMSTAINPLF 330 200
224 Gram stain ( Pus ) GRMSTAINPUS 330 200
225 Gram stain ( Romovac fluid ) GRMSTAINROF 330 200
226 Gram stain ( Semen ) GRMSTAINSEM 330 200
227 Gram stain ( Sputum ) GRMSTAINSPU 330 200
228 Gram stain ( Stool ) GRMSTAINSTO 330 200
229 Gram stain ( Throat swab ) GRMSTAINTHS 330 200
230 Gram stain ( Tissue ) GRMSTAINTIS 330 200
231 Gram stain ( Urine ) GRMSTAINURN 330 200
232 Gram stain ( Vaginal swab / High vaginal swab ) GRMSTAINVAS 330 200
233 Gram stain ( Venticular fluid ) GRMSTAINVEF 330 200
234 Gram stain ( Wound swab ) GRMSTAINWOS 330 200
235 Group B Streptococci Screening GBSS 1110 660
236 H1N1 / 09 SWINE FLU Qualitative Real Time PCR H1N1 4730 3920
237 Hanging Drop examination ( Stool ) HDROP 270 170
238 HBeAg for hepatitis B HBE 1950 1170
239 HBsAg ( Australia antigen ) HBSAG 820 490
240 HBsAg ( Australia antigen ) ( Dialysis ) DHBSAG 410 410
241 HBsAG SPOT HBSAGSPOT 1410 840
242 HBV Monitor ( Quantitative ) HBVM 9000 6000
49
243 HBV Qualitative HBVQ 6000 4000
244 HCV Monitor ( Quantitative ) HCVM 10000 6500
245 HCV Qualitative HCVQ 6000 4000
246 HCV Spot test HCVSPOT 1630 980
247 Hepatitis B core specific antibody ( total ) HEPBCSAT 1410 840
248 Hepatitis C virus serology antibody test HCV 1090 650
249 Hepatitis C virus serology antibody test ( Dialysis ) DHCV 540 540
250 Hepatitis E Virus Quantitative Real Time PCR HENRNA 7000 6000
251 Herpes antibody ( IgG ) - Blood HERPAN 1000 620
252 Herpes antibody ( IgG ) - CSF HERPANCSF 1000 620
253 Herpes antibody ( IgM ) - Blood HERPA 1000 620
254 Herpes antibody ( IgM ) - CSF HERPACSF 1000 620
255 HIC Screen Endotracheal secretion culture HICESC 1300 790
256 HIC Screen Stool Culture HICST 1300 790
257 HIC Screen Urine Culture HICUC 1190 710
258 HIV - 1 QUANTITATIVE TEST HIV1Q 8200 5490
259 HIV antibody test HIV 820 490
260 HIV antibody test ( Dialysis ) DHIV 410 410
261 HIV Spot test HIVSPOT 1080 650
262 HSV 1 & 2 and VZV real time PCR (CSF) HSVCSF 9470 5680
263 HSV 1 & 2 real time PCR (BLOOD) HSVBLD 8500 5000
264 HSV 1 & 2 real time PCR (MIS) HSVMIS 8500 5000
265 IgG4 Serum Levels IGG4 3370 2250
266 JC Polyomavirus Qualitative real time PCR (BLOOD) JCVQBLD 7000 6000
267 JC Polyomavirus Qualitative real time PCR (CSF) JCVQCSF 7000 6000
268 JC Polyomavirus Qualitative real time PCR (MIS) JCVQMIS 7000 6000
269 JC Polyomavirus Qualitative real time PCR (URINE) JCVQURI 7000 6000
270 Kinyoun Stain ( Nocardia / Cryptospordium ) -Bronchial washing KINYOUNBRW 450 270
271 Kinyoun Stain ( Nocardia / Cryptospordium ) -Bronchoalvcolar lavage KINYOUNBRO 450 270
272 Kinyoun Stain ( Nocardia / Cryptospordium ) - E.T. Secretion KINYOUNETS 450 270
273 Kinyoun Stain ( Nocardia / Cryptospordium ) - Other KINYOUN 450 270
fluids (NOT FOR CSF)
274 Kinyoun Stain ( Nocardia / Cryptospordium ) – Pleural fluid KINYOUNPLF 450 270
275 Kinyoun Stain ( Nocardia / Cryptospordium ) - Pus KINYOUNPUS 450 270
276 Kinyoun Stain ( Nocardia / Cryptospordium ) - Sputum KINYOUNSPU 450 270
277 Kinyoun Stain ( Nocardia / Cryptospordium ) - Stool KINYOUNSTO 450 270
278 Legionella urinary antigen test LUAT 1500 900
279 Leptospira IgM LEPTOIGM 1100 700
280 Mantoux test MONTOUX 210 130
281 Modified ZN stain ( M. leprae ) - Slit smears nasal septum ZNMLEPNASAL 440 260
282 Modified ZN stain ( M. leprae ) - Slit smears skin ZNMLEPSKIN 440 260
283 Monospot test MSPOT 690 420
284 Pneumocystis carinii Immunoflourescent PCI 2320 1400
285 Quantiferon Gold QUQNGOLD 5000 4000
286 Rapid AFB culture - (BacT/ALERT 3D) + Accuprobe identification and AFB4DRUGBLD 8330 5830
sensitivity 4 drugs BLOOD - Streptomycin, Isoniazid, Rifampicin and
Ethambutol (SIRE)
287 Rapid AFB culture ( BacT/Alert 3D ) with accuprobe RAPIDWITHOUTSEN 2110 1480
identification without sensitivity
288 Rapid AFB culture ( BacT/Alert 3D ) with accuprobe RAPIDWITHOUTSEN
identification without sensitivity Northern Railway

289 Rapid AFB culture (BacT/ALERT 3D) + Accuprobe identification and AFB10DRUGBLD 15000 10000
sensitivity 10 drugs BLOOD - SIRE , Ofloxacin, Amikacin, kanamycin,
Capreomycin, PAS and D- Cycloserine
50
290 Rapid anti mycobacteria sensitivity 2nd line , Single MTBSINGLE 3560 3160
drug sensitivity ( MTB )
291 Rapid anti mycobacterial sensitivity 2nd line, 6 drugs - Ofloxacin, RAP6DRUG 7410 5570
Amikacin, kanamycin, Capreomycin, PAS and D- Cycloserine
292 Rapid antimycobacterial sensitivity to 4 drugs (SIRE) RAS4D 5930 4950
293 Rapid Biofire Gastrointestinal Panel RBGP 15000 13000
294 Rapid Biofire Meningitis / Encephalitis Panel RBFM 15000 13000
295 Rapid Biofire Positive Blood Culture Panel RBFP 13940 11760
296 Rapid Biofire Respiratory Panel RBFR 15000 13000
297 Rapid Gene Xpert Influenza A/H1N1/B PCR RGXI 7380 4430
298 Respiratory - panel (Real Time Qualitative PCR) RESPIRATORY 22 13130 10500
299 Rheumatoid factor - RF ( blood ) RF 820 490
300 Rheumatoid factor - RF ( Synovial fluid ) RFSF 820 490
301 Rota Virus Antigen Test RVAT 1350 820
302 Routine culture and sensitivity ( Ascitic fluid ) RCULTUREASF 1000 600
303 Routine culture and sensitivity ( Aspiration fluid ) RCULTUREASP 1000 600
304 Routine culture and sensitivity ( Bile ) RCULTUREBILE 1000 600
305 Routine culture and sensitivity ( Blister fluid ) RCULTUREBLF 1000 600
306 Routine culture and sensitivity ( Bone marrow ) RCULTUREBOM 1000 600
307 Routine culture and sensitivity ( Bronchial washing ) RCULTUREBRW 1000 600
308 Routine culture and sensitivity ( Bronchoalveolar lavage ) RCULTUREBRL 1000 600
309 Routine culture and sensitivity ( Chest irrigation fluid) RCULTURECIF 1000 600
310 Routine culture and sensitivity ( CSF ) RCULTURECSF 1000 600
311 Routine culture and sensitivity ( CT guided aspirate ) RCULTURECTG 1000 600
312 Routine culture and sensitivity ( Drain tip ) RCULTUREDRT 1000 600
313 Routine culture and sensitivity ( Drainage fluid ) RCULTUREDRF 1400 840
314 Routine culture and sensitivity ( Ear swab ) RCULTUREESW 1000 600
315 Routine Culture and Sensitivity ( Endotracheal Secretion ) RCULTUREES 1400 840
316 Routine culture and sensitivity ( Eye swab ) RCULTUREEYS 1000 600
317 Routine culture and sensitivity ( Faecal fluid ) RCULTUREFAF 1000 600
318 Routine culture and sensitivity ( Line tip ) RCULTURELIT 1000 600
319 Routine culture and sensitivity ( Miscellaneous ) RCULTURE 1000 600
320 Routine culture and sensitivity ( Nail ) RCULTURENAIL 1000 600
321 Routine culture and sensitivity ( P.D. fluid ) RCULTUREPDF 1000 600
322 Routine culture and sensitivity ( Pericardial fluid ) RCULTUREPEF 1000 600
323 Routine culture and sensitivity ( Peritoneal fluid ) RCULTUREPER 1000 600
324 Routine culture and sensitivity ( Pleural fluid ) RCULTUREPLF 1000 600
325 Routine culture and sensitivity ( Pus ) RCULTUREPUS 1000 600
326 Routine culture and sensitivity ( Pus Swab ) RCULTUREPUSSW 1000 600
327 Routine culture and sensitivity ( Romovac fluid ) RCULTUREROF 1000 600
328 Routine culture and sensitivity ( Semen ) RCULTURESEM 1000 600
329 Routine culture and sensitivity ( Skin scraping swab ) RCULTURESKS 1000 600
330 Routine culture and sensitivity ( Sputum ) RCULTURESPU 1000 600
331 Routine culture and sensitivity ( Stool ) RCULTURESTO 1000 600
332 Routine culture and sensitivity ( Throat swab ) RCULTURETHS 1000 600
333 Routine culture and sensitivity ( Tissue ) RCULTURETIS 1000 600
334 Routine culture and sensitivity ( Uretheral Swab ) RCULTUREURSW 1000 600
335 Routine culture and sensitivity ( Vaginal swab ) RCULTUREVAS 1000 600
336 Routine culture and sensitivity ( Venticular fluid ) RCULTUREVEF 1000 600
337 Routine culture and sensitivity ( Wound swab ) RCULTUREWOS 1400 840
338 RPR VDRL 350 210
339 Rubella antibody serology ( IgG ) - Blood RUBVAG 1240 740
340 Rubella antibody serology ( IgG ) - CSF RUBVAGCSF 1240 740
341 Rubella antibody serology ( IgM ) - Blood RUBVAM 1240 740
342 Rubella antibody serology ( IgM ) - CSF RUBVAMCSF 1240 740
343 Rubella IgG Avidity Test RUBEAV 1500 900
51
344 Scrub Typhus IgM Elisa STIGM 2750 1650
345 Serum complement C-3 (Nephelometric method) C3 1110 660
346 Serum complement C-4 (Nephelometric method) C4 1110 660
347 Stool examination ( Routine / Microscopy ) STOOLRE 150 110
348 Stool Examination for Parasites ( Conc. Method ) SEFP 250 150
349 Stool fat globules STOOLFG 150 110
350 Stool Occult blood STOB 210 130
351 Stool pH STPH 140 90
352 Stool reducing substance STRED 150 110
353 SUPPLEMENTARY Direct Fluorescent staining for AFB FLUREAF 0 0
( Bronchoalveolar lavage )
354 TB - Xpert MTB / Rif TBXPERT 4070 3400
355 TB-HAINS Genotypic test MTB/INH,Rif TBHAINS 3400 2720
356 TORCH complex IgG serology ( Blood ) TORCHPROG 2320 1400
357 TORCH complex IgG serology ( CSF ) TORCHPROGCSF 2320 1400
358 TORCH complex IgM serology ( Blood ) TORCHPROM 2320 1400
359 TORCH complex IgM serology ( CSF ) TORCHPROMCSF 2320 1400
360 Toxoplasma antibody serology ( IgG ) TOXOPLAG 1300 790
361 Toxoplasma antibody serology ( IgM ) TOXOPLAM 1300 790
362 Toxoplasma avidity ( IgG ) TOXOAVIGG 1000 600
363 Treponema pallidum haemagglutination test ( TPHA )- Blood TPHA 690 420
364 Treponema pallidum haemagglutination test ( TPHA )- CSF TPHACSF 690 420
365 Typhi Dot Assay ( IgG ) TDAIGG 680 420
366 Typhi Dot Assay ( IgM ) TDAIGM 680 420
367 Urine culture URNCULT 1000 600
368 Urine culture ( Kidney Transplant ) KT-URNCULT 630 630
369 Urine culture ( Liver Transplant ) LT-URNCU 630 630
370 Urine Pregnancy test ( Beta HCG ) - Microbiology PREG.TST 500 300
371 VZV IgG VZVIGG 1600 1130
372 VZV Real time PCR VZV 8500 5000
373 Weil - felix Test WFELIX 860 510
374 Wet mount examination ( Ameobic liver abcess ) WETMEALA 290 180
375 Wet mount examination ( Aspirate for scolicls /hooklets ) WETMEASH 290 180
376 Wet mount examination ( Miscellaneous ) WETMEMIS 290 180
377 Wet mount examination ( Stool / faecal fluid ) WETME 290 180
378 Widal test for Typhoid WIDAL 500 300
379 ZN staining for A.F.B. ( Aortic Valve ) AFBSNAVE 440 260
380 ZN staining for A.F.B. ( Aspirate ) AFBSNASP 440 260
381 ZN staining for A.F.B. ( Aspiration Fluid ) AFBSNASF 440 260
382 ZN staining for A.F.B. ( Body Fluid ) AFBSNBFD 440 260
383 ZN staining for A.F.B. ( Bronchial Washing ) AFBSNBRW 440 260
384 ZN staining for A.F.B. ( Bronchoalveolar Lavage ) AFBSNBRO 440 260
385 ZN staining for A.F.B. ( CAPD Fluid ) AFBSNCAP 440 260
386 ZN staining for A.F.B. ( Chest Irrigation Fluid ) AFBSNCHE 440 260
387 ZN staining for A.F.B. ( CSF ) AFBSNCSF 440 260
388 ZN staining for A.F.B. ( Drainage Fluid ) AFBSNDRA 440 260
389 ZN staining for A.F.B. ( E.T. Secretion ) AFBSNETS 440 260
390 ZN staining for A.F.B. ( Gastric Aspirate ) AFBSNGAS 440 260
391 ZN staining for A.F.B. ( Miscellaneous ) AFBSN 440 260
392 ZN staining for A.F.B. ( Mitral Valve ) AFBSNMIT 440 260
393 ZN staining for A.F.B. ( P.D. Fluid ) AFBSNPDF 440 260
394 ZN staining for A.F.B. ( Pericardial Fluid ) AFBSNPER 440 260
395 ZN staining for A.F.B. ( Peritoneal Fluid ) AFBSNPEF 440 260
396 ZN staining for A.F.B. ( Pleural Fluid ) AFBSNPLE 440 260
397 ZN staining for A.F.B. ( Pus ) AFBSNPUS 440 260
52
398 ZN staining for A.F.B. ( Sputum ) AFBSNSPU 440 260
399 ZN staining for A.F.B. ( Synovial Fluid ) AFBSNSYN 440 260
400 ZN staining for A.F.B. ( Tissue ) AFBSNTIS 440 260
401 ZN staining for A.F.B. ( Urine ) AFBSNURI 440 260
402 Rapid AFB culture ( BacT/ALERT 3D) + Accuprobe identification and AFB10DRUGOS 18740 14570
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
403 Rapid AFB culture ( BacT/ALERT 3D) + Accuprobe identification and AFB4DRUG 8330 5830
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 sensitivity 4 drugs - AFB4DRUG
Streptomycin, Isoniazid, Rifampicin and Ethambutol (SIRE)
404 BacT/Alert aerobic culture ( Blood ) - 2 Bottles BACTALERT2OS 3500 2200

BacT/Alert aerobic culture ( Blood ) - L BALERTA
BacT/Alert aerobic culture ( Blood ) - R BALERTB
405 BacT/Alert aerobic culture ( Blood ) - 3 Bottles BACTALERT3OS 5000 4000

BacT/Alert aerobic culture ( Blood ) - L BALERTA
BacT/Alert aerobic culture ( Blood ) - R BALERTB
BacT/Alert aerobic culture ( Blood ) - C BALERTC
406 CAPD Fluid Package ( Cell count + Gram Stain + KOH + Culture Senstivity ) CAPDFCUL 4190 2520
CAPD fluid culture/ABST RCULTURECAPD
CAPD Fluid Microscopy ( Cell count + Gram Stain + KOH ) CAPDFCUL
407 CMV antibody IgG & IgM CMVAGAM 2750 1650

CMV antibody IgG CMVAG
CMV antibody IgM CMVAM
408 Enterically transmitted hepatitis profile ( IgM HAV, IgM HEV ) ENTHEP 3160 1900
Anti HAV - IgM ( hepatitis A virus serology ) HAVT
Anti HEV - IgM ( hepatitis E virus serology ) HEVT
409 Herpes antibody ( IgG & IgM ) - Blood HERPANGM 2750 1650
Herpes antibody ( IgG ) - Blood HERPAN
Herpes antibody ( IgM ) - Blood HERPA
410 Herpes antibody ( IgG & IgM ) - CSF HERPANGMCSF 2750 1650
Herpes antibody ( IgG ) - CSF HERPANCSF
Herpes antibody ( IgM ) - CSF HERPACSF
411 Rubella antibody serology ( IgG & IgM) - Blood RUBVAGM 2750 1650
Rubella antibody serology ( IgG ) - Blood RUBVAG
Rubella antibody serology ( IgM ) - Blood RUBVAM
412 Rubella antibody serology ( IgG & IgM) - CSF RUBVAGMCSF 2750 1650
Rubella antibody serology ( IgG ) - CSF RUBVAGCSF
Rubella antibody serology ( IgM ) - CSF RUBVAMCSF
413 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
414 TORCH complex IgG & IgM serology ( CSF ) TORCHPRCSF

TORCH complex IgG serology ( CSF ) TORCHPROGCSF
2320 1400
TORCH complex IgM serology ( CSF ) TORCHPROMCSF
2320 1400
415 TORCH complex IgG & IgM serology ( Blood ) TORCHPROGM 6260 3750
TORCH complex IgG serology ( Blood ) TORCHPROG
TORCH complex IgM serology ( Blood ) TORCHPROM
416 Toxoplasma antibody serology ( IgG & IgM ) TOXOPLAGM 2110 1270
Toxoplasma antibody serology ( IgG ) TOXOPLAG
Toxoplasma antibody serology ( IgM ) TOXOPLAM
53
417 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
418 VIRAL MARKER (CHRONIC HEPATITIS SCREEN PANEL) VIRCHGAS 1440 860
Hepatitis C virus serology antibody test HCV
419 VIRAL MARKER (DIALYSIS) VIRDIA 1350 1350

HBsAg ( Australia antigen ) ( Dialysis ) DHBSAG
Hepatitis C virus serology antibody test ( Dialysis ) DHCV
HIV antibody test ( Dialysis ) DHIV
420 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
421 VIRAL MARKER(NON PREGNANT / GASTRO) VIRNONP 2050 1230

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

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

424 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 7250 6090
2 AML PCR Panel (Any 4) AMLMH 9200 7900
3 AML1 - ETO Translocation ( Molecular Haematogy ) AML1 7000 4500
4 BCR - ABL Qualitative ( Molecular Haematology ) MMBCRABL 6800 4200
5 BCR - ABL Quantitative ( Molecular Haematology ) BCRABL 8850 7700
6 CALR Mutation (Type 1 and Type2) CALRMH 6500 4900
7 c-KIT Mutation Analysis CKMA 11000 11000
8 Composite Thrombophilia Mutation Panel CTMPMH 8100 6100
9 Extended MPN reflex panel EMPN 14200 12700
10 Factor V ( Leiden ) Gene mutations – Molecular Haematology FVLGMMH 5300 3500
11 FIP1L1-PDGFRA Rearrangement FIP1L1 5300 5300
12 FLT3 Mutation ( D835 & IDT ) ( Molecular Haemtology ) FLTMH 6300 4200
13 FV-PTH-MTHFR Assay FVPTH 8000 6800
14 Inversion 16 translocation ( Molecular Haemtology ) INVERSIONMH 7000 4500
15 JAK-2 (V617F) reflex to JAK-2 exon-12 JRTJE 10200 9000
16 JAK-2 Exon-12 Mutation JAKEM 7200 7200
54
17 JAK-2 mutation ( Molecular Haematology ) MMPCR 6800 4750
18 MLL-AF4 Translocation MLLAF4 6200 5250
19 MPL mutation MPLMMH 4400 3350
20 MPN Reflex Panel MPNMH 9000 7900
21 MTHFR ( C677T ) Gene Polymorphism – Molecular Haematology MTHFRGMMH 4000 3000
22 NPM-1 Mutation NPM1 4750 4200
23 PML-RARA Quantitative PMLRARA 7500 6800
24 Prothrombin ( G20210A ) Gene Mutation – Molecular Haematology PGMMH 4000 3000
25 Qualitative Reverse Transcriptase PCR (RT-PCR) for MMPMLRARA 6800 4200
PML-RARA ( Molecular Haematology Laboratory )
26 Qualitative Reverse Transcriptase PCR (RT-PCR) for MMTELAML1 6800 4200
TEL-AML1 ( Molecular Haematology Laboratory )
27 TPMT Genotyping ( Molecular Hematology ) TGMH 6200 4600
Research Lab Charges

SNo Description Code POPD/ CAT1/CAT2 GOPD/CAT3
1 Soluble interleukin-2 receptor (SIL2R) SIL2R 4820 3530
MRI Charges
SNo Description Code POPD/ CAT1/CAT2 GOPD/ CAT3
1 Ankylosing Spondylosis Screening Package - for 2 parts ASSP2 7350 7350
2 Ankylosing Spondylosis Screening Package - for 3 parts ASSP3 10300 10300
3 Breast MRI - MRI Dept.Charges BRMRI 12800 12800
4 Comprehensive Left breast imaging package bilateral(2D + 3D Left MM2D3DRM 12000 12000
Mammogram + Breast MRI) - MRI Department Charges
5 Contrast enhanced MRI brain MRICEMRIB 14600 14600
6 MR Venography Neck ( Plain ) MRIMRVNP 9450 9450
7 MR Venography Neck with contrast ( double dose ) MRIMRVNCDD 21000 21000
8 MR Venography Neck with contrast ( single dose ) MRIMRVNCSD 15350 15350
9 MRI 3D ( Extra ) MRI3D 10300 10300
10 MRI add on anaesthesia MRIADDANAES 4700 4700
11 MRI add on charges for CD MRICD 700 700
12 MRI add on double dose contrast MRISODDC 11900 11900
13 MRI add on extended study MRIAOES 5800 5800
14 MRI add on extra film charges MRIEXTFILM 500 500
15 MRI add on scout both ankles MRIAOSBA 9450 9450
16 MRI add on scout both arms MRIAOSBF 9450 9450
17 MRI add on scout both feet MRIAOSFO 9450 9450
18 MRI add on scout both knee joints MRIAOSBKJ 9450 9450
19 MRI add on scout both lower legs MRIAOSLLB 9450 9450
20 MRI add on scout both shoulders MRIAOSSBS 9450 9450
21 MRI add on scout both thighs MRIAOSTB 9450 9450
22 MRI add on scout brain MRIAOSB 5000 5000
23 MRI add on scout cervical spine MRIAOSCS 5250 5250
24 MRI add on scout dorsal/thoracic spine MRIAOSDTS 5250 5250
25 MRI add on scout hip joints MRIAOSHJ 5250 5250
26 MRI add on scout left ankle MRIAOSLA 5250 5250
27 MRI add on scout left arm MRIAOSRUA 5250 5250
28 MRI add on scout left feet MRIAOSF 5250 5250
29 MRI add on scout left knee joint MRIAOSLKJ 5250 5250
30 MRI add on scout left lower leg MRIAOSLL 5250 5250
31 MRI add on scout left shoulder MRIAOSLS 5250 5250
32 MRI add on scout left thigh MRIAOST 5250 5250
55
33 MRI add on scout lumbo-sacral spine MRIAOSLSS 5250 5250
34 MRI add on scout of neck MRISNK 5250 5250
35 MRI add on scout of wrist MRISWR 5250 5250
36 MRI add on scout orbit MRIAOSO 5250 5250
37 MRI add on scout right ankle MRIAOSRA 5250 5250
38 MRI add on scout right arm MRIAOSRF 5250 5250
39 MRI add on scout right feet MRIAOSFR 5250 5250
40 MRI add on scout right knee joint MRIAOSRKJ 5250 5250
41 MRI add on scout right lower leg MRIAOSLLR 5250 5250
42 MRI add on scout right shoulder MRIAOSRS 5250 5250
43 MRI add on scout right thigh MRIAOSTR 5250 5250
44 MRI add on scout sacro-iliac joints MRIAOSSIJ 5250 5250
45 MRI add on single dose contrast MRIAOSDC 5900 5900
46 MRI angiography both forearms MRASFB 20500 20500
47 MRI angiography both forearms (double dose contrast) MRASFDDCB 33600 33600
48 MRI angiography both lower legs MRABLL 16800 16800
49 MRI angiography both lower legs (double dose contrast) MRABLLDDC 33600 33600
50 MRI angiography both thighs MRABT 16800 16800
51 MRI angiography both thighs (double dose contrast) MRABTDDC 33600 33600
52 MRI angiography both upper arms MRASUAB 16800 16800
53 MRI angiography both upper arms (double dose contrast) MRASUADDCB 33600 33600
54 MRI angiography left forearm MRASFL 10300 10300
55 MRI angiography left forearm (double dose contrast) MRASFDDCL 16800 16800
56 MRI angiography left upper arm MRASUA 10300 10300
57 MRI angiography left upper arm (double dose contrast) MRASUADDC 16800 16800
58 MRI angiography lower abdomen / pelvis MRALAP 10300 10300
59 MRI angiography lower abdomen / pelvis (double dose contrast) MRALAPDDC 16800 16800
60 MRI angiography lower thorax MRALT 10300 10300
61 MRI angiography lower thorax (double dose contrast) MRALTDDC 16800 16800
62 MRI Angiography Peripheral With Contrast ( Single Part ) MRIANGIO 16800 16800
63 MRI angiography right forearm MRASFR 10300 10300
64 MRI angiography right forearm (double dose contrast) MRASFDDCR 16800 16800
65 MRI angiography right upper arm MRASUAR 10300 10300
66 MRI angiography right upper arm (double dose contrast) MRASUADDCR 16800 16800
67 MRI angiography upper abdomen MRAUA 10300 10300
68 MRI angiography upper abdomen (double dose contrast) MRAUADDC 16800 16800
69 MRI angiography upper thorax MRAUT 10300 10300
70 MRI angiography upper thorax (double dose contrast) MRAUTDDC 16800 16800
71 MRI Arthography one Shoulder MRIATRHO 20500 20500
72 MRI Arthography one Wrist MRIARW 20500 20500
73 MRI Arthrography MRIARTH 20500 20500
74 MRI both ankles MRIA 20500 20500
75 MRI both ankles (contrast) MRBAC 27000 27000
76 MRI both elbows MRIESB 20500 20500
77 MRI both elbows (contrast) MRSECB 27000 27000
78 MRI both forearm (contrast) MRSCFCB 27000 27000
79 MRI both forearms MRFB 20500 20500
80 MRI both hand MRSHB 20500 20500
81 MRI both hand (contrast) MRSHCB 27000 27000
82 MRI both knee joints MRBNJ 20500 20500
83 MRI both knee joints (contrast) MRBNJC 27000 27000
84 MRI both shoulders MRISBS 20500 20500
85 MRI both shoulders (contrast) MRSSCB 27000 27000
86 MRI both wrist MRIWB 20500 20500
56
87 MRI both wrist (contrast) MRIWBC 27000 27000
88 MRI brachial plexus MRBP 10300 10300
89 MRI brachial plexus (contrast) MRBPC 16800 16800
90 MRI Brachial Plexus + Cervical Spine MRIBRCER 16800 16800
91 MRI brain MRIBRAIN 9000 9000
92 MRI brain (angiography) MRIBANGIO 9000 9000
93 MRI brain (venography) MRIBVEN 9000 9000
94 MRI Brain + Diffusion MRIBRDIF 13700 13700
95 MRI Brain + Diffusion + Perfusion + Contrast MRIBRDIPECON 28300 28300
96 MRI Brain + Dynamic CSF Flow Studies MRIBRDY 13000 13000
97 MRI Brain + Functional MRIBRFUN 14500 14500
98 MRI Brain + Orbits MRIBRORB 13700 13700
99 MRI Brain + Perfusion + Contrast MRIBRPERCON 19500 19500
100 MRI Brain + Sella MRIBRSELLA 13700 13700
101 MRI Brain + Spectroscopy MRIBRSP 13700 13700
102 MRI Brain Cisternography MRIBRCIS 13700 13700
103 MRI brain epilepsy protocol MRIBEP 11500 11500
104 MRI Brain Stroke Protocol SWI + DWI + T2W + ASL + MRA MRISWIDWI 15000 15000
105 MRI Cardiac Package Plain MRICARPKPL 16800 16800
106 MRI cervical spine MRICS 9450 9450
107 MRI cervical spine (contrast) MRCSC 16800 16800
108 MRI Contrast For Cardiac MRICONCAR 9450 9450
109 MRI Diffusion Weighted MRIDFW 5000 5000
110 MRI dorsal / thoracic spine MRIDS 9450 9450
111 MRI dorsal / thoracic spine (contrast) MRDTSC 16800 16800
112 MRI Dynamic CSF study MRIDCSF 9450 9450
113 MRI ear MRIEAR 10300 10300
114 MRI Ear with contrast MRIEWC 16800 16800
115 MRI face MRIFACE 10300 10300
116 MRI Face with contrast MRIFWC 16800 16800
117 MRI feet MRBF 20500 20500
118 MRI feet (contrast) MRBFC 27000 27000
119 MRI Foetus MRIFOETUS 10300 10300
120 MRI foot MRF 10300 10300
121 MRI foot (contrast) MRFC 16800 16800
122 MRI hip joints MRIHJ 10300 10300
123 MRI hip joints (contrast) MRHJC 16800 16800
124 MRI KUB MRIKUB 16800 16800
125 MRI left ankle MRSAL 10300 10300
126 MRI left ankle (contrast) MRSACL 16800 16800
127 MRI left elbow MRIESL 10300 10300
128 MRI left elbow (contrast) MRSECL 16800 16800
129 MRI left forearm MRFL 10300 10300
130 MRI left forearm (contrast) MRSCFCL 16800 16800
131 MRI left hand MRSHL 10300 10300
132 MRI left hand (contrast) MRSHCL 16800 16800
133 MRI left knee joint MRIKJSL 10300 10300
134 MRI left knee joint (contrast) MRSKJCL 16800 16800
135 MRI left shoulder MRISL 10300 10300
136 MRI left shoulder (contrast) MRSSCL 16800 16800
137 MRI left upper arm MRSUAL 10300 10300
138 MRI left upper arm (contrast) MRSUACL 16800 16800
139 MRI left wrist MRIWL 10300 10300
140 MRI left wrist (contrast) MRSWCL 16800 16800
141 MRI Liver Transplant Package MRILIVPK 25200 25200
57
142 MRI lower abdomen / pelvis MRLAP 10300 10300
143 MRI lower abdomen / pelvis (contrast) MRLAPC 16800 16800
144 MRI lower legs MRLL 10300 10300
145 MRI lower legs (contrast) MRLLC 16800 16800
146 MRI lumbar plexus MRLP 10300 10300
147 MRI lumbar plexus (contrast) MRLPC 16800 16800
148 MRI lumbo-sacral spine MRILSS 9450 9450
149 MRI lumbo-sacral spine (contrast) MRLSSC 16800 16800
150 MRI mammogram both breasts MRMBB 14500 14500
151 MRI mammogram both breasts (contrast) MRMBBC 15750 15750
152 MRI MRCP MRIMRCP 10300 10300
153 MRI neck MRINECK 10300 10300
154 MRI neck carotid angiography MRIENCKANGIO 9450 9450
155 MRI neck carotid angiography (double dose contrast) MRINADD 15300 15300
156 MRI neck with contrast MRINECKC 16800 16800
157 MRI Oncology Package MRIONCOPK 36750 36750
158 MRI orbit MRIORBIT 10300 10300
159 MRI orbit with (contrast) MRIORBITWC 16800 16800
160 MRI para nasal sinuses ( PNS ) MRPNS 10300 10300
161 MRI para nasal sinuses ( PNS with contrast) MRPNSWC 16800 16800
162 MRI Parametric Map MRIPARA 3500 3500
163 MRI pelvis MRIP 10300 10300
164 MRI pelvis with contrast MRIPWC 16800 16800
165 MRI perineum MRP 10300 10300
166 MRI perineum (contrast) MRPC 16800 16800
167 MRI pituitary fossa/sella MRIPFS 9450 9450
168 MRI pituitary fossa/sella contrast MRIPFSC 16800 16800
169 MRI Prostate Package ( Contrast ) MRIPROSPK 36300 36300
170 MRI Pyelography MRIPYE 4700 4700
171 MRI renal angiography MRIRA(CE-S) 10300 10300
172 MRI renal angiography (double dose contrast) MRIRA(CE-D) 16800 16800
173 MRI right ankle MRSAR 10300 10300
174 MRI right ankle (contrast) MRSACR 16800 16800
175 MRI right elbow MRIESR 10300 10300
176 MRI right elbow (contrast) MRSECR 16800 16800
177 MRI right forearm MRFR 10300 10300
178 MRI right forearm (contrast) MRSCFCR 16800 16800
179 MRI right hand MRSHR 10300 10300
180 MRI right hand (contrast) MRSHCR 16800 16800
181 MRI right knee joint MRIKJSR 10300 10300
182 MRI right knee joint (contrast) MRSKJCR 16800 16800
183 MRI right shoulder MRISR 10300 10300
184 MRI right shoulder (contrast) MRSSCR 16800 16800
185 MRI right upper arm MRSUAR 10300 10300
186 MRI right upper arm (contrast) MRSUACR 16800 16800
187 MRI right wrist MRIWR 10300 10300
188 MRI right wrist (contrast) MRSWCRL 16800 16800
189 MRI sacro-iliac joints MRISIJ 10300 10300
190 MRI sacro-iliac joints (contrast) MRSIJC 16800 16800
191 MRI screening of brain & MRA MRISB 12700 12700
192 MRI Screening of Lower abdomen MRISLAB 5250 5250
193 MRI Screening of upper abdomen MRISUAB 5250 5250
194 MRI screening with contrast MRISC 10300 10300
195 MRI screening without contrast MRISWC 4700 4700
196 MRI Spectroscopy MRISPE 10300 10300
58
197 MRI Spine screening MRISPSC 4700 4700
198 MRI Stroke DWI + SWI MRIDWSW 7000 7000
199 MRI Thalassemia Package MRITHALPK 0 0
200 MRI Thalassemia Protocol MRITHALPR 5900 5900
201 MRI thigh MRT 10300 10300
202 MRI thigh (contrast) MRTC 16800 16800
203 MRI thorax MRITHORAX 10300 10300
204 MRI thorax (contrast) MRTHOC 16800 16800
205 MRI TM joint/temporo-mandibular joint MRITMJTMJ 10300 10300
206 MRI TM joint/temporo-mandibular joint contrast MRITMJTMJC 16800 16800
207 MRI Tractography MRITRAC 3800 3800
208 MRI Triple Phase Upper Abdomen with Contrast MRITPUAWC 16800 16800
209 MRI upper abdomen MRIUA 10300 10300
210 MRI upper abdomen (contrast) MRUAC 16800 16800
211 MRI upper abdomen with MRCP MRUAMRCP 16800 16800
212 MRI Urography MRIUROY 16800 16800
213 MRI venography both forearm MRVSFB 20500 20500
214 MRI venography both forearm (double dose contrast) MRVSFDDCB 33600 33600
215 MRI venography both lower legs MRVBLL 10300 10300
216 MRI venography both lower legs (double dose contrast) MRVBLLDDC 16800 16800
217 MRI venography both thighs MRVBT 10300 10300
218 MRI venography both thighs (double dose contrast) MRVBTDDC 16800 16800
219 MRI venography both upper arm MRVSUAB 20500 20500
220 MRI venography both upper arm (double dose contrast) MRVSUADDCB 33600 33600
221 MRI venography left forearm MRVSFL 10300 10300
222 MRI venography left forearm (double dose contrast) MRVSFDDCL 16800 16800
223 MRI venography left upper arm MRVSUAL 10300 10300
224 MRI venography left upper arm (double dose contrast) MRVSUADDCL 16800 16800
225 MRI venography lower abdomen / pelvis MRVLAP 10300 10300
226 MRI venography lower abdomen / pelvis (double dose contrast) MRVLAPDDC 16800 16800
227 MRI venography lower thorax MRVLT 10300 10300
228 MRI venography lower thorax (double dose contrast) MRVLTDDC 16800 16800
229 MRI venography right forearm MRVSFR 10300 10300
230 MRI venography right forearm (double dose contrast) MRVSFDDCR 16800 16800
231 MRI venography right upper arm MRVSUAR 10300 10300
232 MRI venography right upper arm (double dose contrast) MRVSUADDCR 16800 16800
233 MRI venography upper abdomen MRVUA 10300 10300
234 MRI venography upper abdomen (double dose contrast) MRVUADDC 16800 16800
235 MRI venography upper thorax MRVUTHO 10300 10300
236 MRI venography upper thorax (double dose contrast) MRVUTHODDC 16800 16800
237 MRI whole abdomen MRIWHAB 20500 20500
238 MRI whole abdomen with contrast MRIWAWC 27000 27000
239 MRI Whole Body MRIWHBD 28000 28000
240 MRI Whole Body Angio ( Plain ) MRIWHBDANGIO 28000 28000
241 MRI Whole Body Diffusion MRIWHBDIF 14200 14200
242 MRI review CD/Film charges without written report MEICDFILM 2000 2000
243 MRI review CD/Film charges with written report MRICDREPPORT 3000 3000
MRI Charges
CAT 1/CAT2 CAT3
1 MRI DEFECOGRAPHY MRIDEF 16100 16100
2 MRI ENTEROGRAPHY MRIENTER 16100 16100
3 MRI BRAIN + MRA BRAIN MRIMRA 10890 10890
MRI brain MRIBRAIN
59
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
2800 2800
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
Nephrology 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
AVADDH ACUTE VASCULAR ACCESS FOR
OS DIALYSIS (DOCTOR FEE + HOSPITAL
CHARGES)
ACADAHC Acute vascular access for dialysis - 2040 2040 1020 820 610
Additional hospital charges
AVADDF Acute vascular access for dialysis – Doctor fees 20380 20380 10190 8150 6110
BCMCOS BCMC (Body Composition
Monitoring Charge ) - (Doctor
Fee + Hospital Charges)
BCMCDF BCMC (Body Composition Monitoring 210
Charge ) - Doctor Fee
BCMCHC BCMC (Body Composition Monitoring 320
Charge ) - Hospital Charges
CADKIDD Cadaveric Kidney Donation
OS (Bench Surgery) - Doctor fee +
Hospital charges
CADKDHC Cadaveric kidney donation (Bench Surgery) - 2940
CADKDF Cadaveric kidney donation (Bench Surgery) -Doctor fee 29400
CAPD1WD CAPD 1 week daycase training
COS (Doctor fee + Hospital charges)
CAPD1WDCDF CAPD 1 week daycase training - doctor fee 18220
CAPD1WDCHC CAPD 1 week daycase training – hospital charges 1830
60
CAPDTDH CAPD training (doctor charges
COS + hospital service charges)
CAPDAHC CAPD training - Additional hospital charges 4180 4180 2090 1670 1250
CAPDDF CAPD training - Doctor fees 41680 41680 20840 16670 12500
CRRTPPD CRRT - PLANNING AND MONITORING

CHOS (DOCTOR FEE + HOSPITAL CHARGES)
CRRTPMDF CRRT - planning and monitoring - Doctor fee 16800 16800 8400 6720 5040
CRRTPMAHC CRRT - planning and monitoring – hospital charges 1680 1680 840 670 500
HAEM48S Haemodialysis charges for Daycare

OS patients (Doctor + Hospital + Kit
charges) 4008S
HEMODIALDO Haemodialysis - amount given to doctor 810
CCH
HEMODIALKIT CH Haemodialysis - kit charges 320
HAEPC48S Haemodialysis package charges 4008S 2700
HAEHOS4SN Haemodialysis procedure (4008S) – Hospital charges 1890
HAEMDH Haemodialysis charges for INPATIENTS

OS 4008S ( Doctor + Hospital )
CCH
HAEHOS4SN Haemodialysis procedure (4008S) – Hospital charges 1890
HAEMIPD Haemodialysis charges for INPATIENTS
HOS 5008S ( Doctor + Hospital )
CCH
HAEHC8S Haemodialysis procedure (5008S) – hospital charges 2450
HAEMPAC Haemodialysis charges for
8SOS Daycare patients (Doctor +
Hospital + Kit charges) 5008S
BLBINAV $$BLOODLINE AV SET (TUBING) 5008S 250
DIAFLSL $$DIALYSER FX60 HIGH FLUX SINGLE USE 490
HEMODIALDO CCH Haemodialysis - amount given to doctor 810
HAEOCHS Haemodialysis package charges 5008S 3260
HAEHC8S Haemodialysis procedure (5008S) – hospital charges 2450
HEMODIA Haemodialysis ( emergency ) charges

LEORDSET for daycare patient (all charges)
HEMODIALEP C Haemodialysis (emergency) package charges 4970
HEMOEDF Haemodialysis Emergency - amount given to doctor 1440 1440
HEEHC Haemodialysis procedure emergency -hospital charges 3530 3530
IJCSBOS Internal jugular ( IJ ) catheter /
subclavion catheter insertion in Dialysis
Room (Doctor fee + Hospital Charges)
IJCATHC Internal jugular ( IJ ) catheter / subclavion 1680 1680 840 670 500
catheter insertion in Dialysis Room -
Hospital Charges
IJCSCATDF Internal jugular ( IJ ) catheter / subclavion catheter 16800 16800 8400 6720 5040
insertion in Dialysis Room ( Doctor Fee )
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 - 280
Vancomycin, Solumedrol, Endoxan ) in
Dialysis Room - Hospital Charges
INJDF Charges for giving injection (I/V infusion - 590
Vancomycin, Solumedrol, Endoxan ) in
Dialysis Room ( Doctor Fee )
IPDDHCH PERITONEAL DIALYSIS - NTERMITTENT
OS (DOCTOR FEE + HOSPITAL CHARGES)
61
IPDAHC Intermittent peritoneal dialysis - Additional 1700 1700 850 680 510
hospital charges
IPDDF Intermittent peritoneal dialysis - Doctor fees 16900 16900 8450 6760 5070
KTPSOS KTP Surcharge ( Surgeon +

Hospital + Anastheist )
KTPSA KTP Surcharge - Anasthesist fee 2920
KTPSH KTP Surcharge - Hospital charges 5830
KTPSS KTP Surcharge - Surgeon Fee 5830
NEPHROB Ambulatory B.P. Monitoring
POS for 24 Hrs. - (Nephrology)
NEPHROBPHS Ambulatory B.P. Monitoring for 24 Hrs. - 2400 2400 2400 2520
(Nephrology) - Hospital Charges
NEPHROBP Ambulatory B.P. Monitoring for 24 Hrs. - 1200 1200 1200 1260
(Nephrology) -Doctor Fee
ONHOS Online Haemodialysis (Doctor fee +
Hospital Charges + kit charges)
AVSET $$ AV SET ONLINE 560
BIBAG $$ Bibag 960 gm 230
HEDFON Online Haemodialysis - amount given to doctor 710
HHCON Online Haemodialysis - Hospital Charges 1890
HEPPCON Online Haemodialysis package charges 2600
PHLEDFOS Phlebotomy (Nephrology)

PHLEHC Phlebotomy (Nephrology) - Hospital Charges 780 780 390 310 230
PHLEDF Phlebotomy (Nephrology)-Doctor Fee 7840 7840 3920 3140 2350
PLPEROS Pleural / Peritoneal tapping in Dialysis
Room ( Doctor Fee + Hospital charges)
PLEPERHC Pleural / Peritoneal tapping in Dialysis Room 590
- Hospital Charges
PTAPPERDF Pleural / Peritoneal tapping in Dialysis Room 2760 2760 2760 2900
( Doctor Fee )
SLEEDDHC SLEDD - PLANNING AND MONITORING
HOS CHARGES (DOCTOR FEE + HOSPITAL
CHARGES)
SLEDDAHC SLEDD - Planning and monitoring charges by 1680 1680 840 670 500
nephrologist - Additional hospital charges
SLEDDNDF SLEDD - Planning and monitoring charges 16800 16800 8400 6720 5040
for Nephrologist - Doctor fee
UGIVMOS Ultrasound guided intrajugular

vein mapping for A.V Fistula
creation (Nephrology)
UGIVM Ultrasound guided intrajugular vein 630
mapping for A.V Fistula creation
(Nephrology)-Doctor Fee
UGIVMHC Ultrasound guided intrajugular vein 630
mapping for A.V Fistula creation
(Nephrology)-Hospital Charges
UGKBOSO Ultrasound guided kidney

S biopsy (Nephrology)
UGKBOS Ultrasound guided kidney biopsy 3780 3780 1890 1510 1130 1890
(Nephrology)- Doctor Fee
UGKBHC Ultrasound guided kidney biopsy 3780 3780 1890 1510 1130 1890 1890
(Nephrology)- Hospital Charges
KBSET Kidney biopsy set usage charges 410
KBDHCHO KIDNEY BIOPSY (DOCTOR FEE +

S HOSPITAL CHARGES)
KBHC Kidney biopsy - Additional hospital charges 1760 1760 880 710 530
KBDF Kidney biopsy - Doctor fees 17640 17640 8820 7060 5290
62
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 22000
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) 6370

2 SLEDDMPD SLEDD - Use of machine (per day) 6370
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 ) 22400 11200 8960 6720
3 OP3397 Basilic vein transposition in OT 67220 33610 26890 20170
4 OP0240 Brachio - basilic loop AV graft for haemodialysis 44800 22400 17920 13440
5 OP0242 Brachio - basilic straight ( above elbow ) AV graft for haemodialysis 44800 22400 17920 13440
6 OP0239 Brachio - cephalic loop AV graft for haemodialysis 44800 22400 17920 13440
7 OP0241 Brachio - cephalic straight ( above elbow ) AV graft for haemodialysis 44800 22400 17920 13440
8 OP0245 Brachio AV fistula at elbow for haemodialysis 32240 16120 12900 9670
9 OP0443 CAPD placement ( laparosopic ) 27200 13600 10880 8160
10 OP1080 CAPD placement ( open ) 27200 13600 10880 8160
11 OP0448 CAPD removal & placement ( laparosopic ) 35660 17830 14260 10700
12 OP0445 CAPD removal & placement ( open ) 35660 17830 14260 10700
13 OP0447 CAPD removal ( laparosopic ) 17060 8530 6820 5120
14 OP0444 CAPD removal ( open ) 17060 8530 6820 5120
15 OP0446 CAPD revision ( laparosopic ) 13600 6800 5440 4080
16 OP0449 CAPD revision ( open ) 13600 6800 5440 4080
17 OP0437 Conversion of arteriovenous ( AV ) shunt to arteriovenous ( AV ) fistula 32240 16120 12900 9670
18 OP0440 Creation of arteriovenous ( AV ) fistula at axillary artery 40740 20370 16300 12220
19 OP0433 Creation of arteriovenous ( AV ) fistula at elbow (brachial artery ) 40740 20370 16300 12220
20 OP1077 Creation of arteriovenous ( AV ) fistula at wrist ( radial artery ) 40740 20370 16300 12220
21 OP4205 GSV translocation for AV access 67220 33610 26890 20170
22 OP0320 Ligation of ruptured AV fistula 17060 8530 6820 5120
23 OP0319 Ligation of ruptured AV graft 22400 11200 8960 6720
24 OP0436 Placement of arteriovenous ( AV ) shunt at ankle (posterior tibial 22400 11200 8960 6720
artery )
63
25 OP1078 Placement of arteriovenous ( AV ) shunt at wrist (radial artery ) 22400 11200 8960 6720
26 OP0243 Radio - basilic straight ( below elbow ) AV graft for haemodialysis 44800 22400 17920 13440
27 OP0244 Radio - cephalic straight ( below elbow ) AV graft for haemodialysis 44800 22400 17920 13440
28 OP4204 Repair of A.V.Fistula aneurysm 45840 22920 18340 13750
29 OP0441 Revision of arteriovenous ( AV ) fistula at axillary artery 17060 8530 6820 5120
30 OP0435 Revision of arteriovenous ( AV ) fistula at elbow (brachial artery ) 17060 8530 6820 5120
31 OP0434 Revision of arteriovenous ( AV ) fistula at wrist ( radial artery ) 17060 8530 6820 5120
32 OP0439 Revision of arteriovenous( AV ) shunt at ankle (posterior tibial artery) 11200 5600 4480 3360
33 OP0438 Revision of arteriovenous ( AV ) shunt at wrist ( radial artery ) 11200 5600 4480 3360
34 OP1083 Vascular prosthetic graft in forearm 50940 25470 20380 15280
35 OP0526 Vascular prosthetic graft in thigh 50940 25470 20380 15280
36 OP0525 Vascular prosthetic graft in upper arm 50940 25470 20380 15280
ECG Charges

CAT 1/CAT2 CAT3
1 Electrocardiogram ( ECG ) ECG 440 330
Echo Lab Charges

CAT 1/CAT2 CAT3
1 Ambulatory B.P. Monitoring for 24 Hrs. ( Echo ) AMBPMONIT 4000 3000
2 Carotid (Portable) Doppler CPDOPP 5000 3900
3 Carotid doppler (ECHO ROOM) CARODOP 3800 2900
4 Dobutamine stress echo (Echo Department) DECHO 6500 5000
5 Echocardiogram with Doppler ( Echo ) ECHODOP 3800 2900
6 Echocardiography with Bubble / Saline contrast ECBSC 4800 3900
7 Fetal cardiac assessment ( Echo ) FECHO 4030 2420
8 Holter test (cardiac lab) ( Echo ) HOLTER 4000 3000
9 Portable Echo Additional Charges ECHO_BS 1200 700
10 Stress Echo (Echo Deparment) SECHOOS 6000 4500
11 Tilt table test ( Cardiology ) ( Echo ) TILT 6000 4500
12 Transoeophageal - Echocardiography / Multiplane TEE ( Echo ) TEE 6500 4500
13 Treadmill test ( TMT) TMT 3740 2850
14 V-Scan Screening Echo SCRECHO 850 850
15 Dobutamine Stress Echo with Contrast DOBUSECHOWD
Contrast for Echocardiography COFOEC 3000 3000
Dobutamine stress echo (Echo Department) DECHO
6500 5000
16 Echocardiogram with Doppler ( with Contrast ) ECHODOPWD
Contrast for Echocardiography COFOEC
3000 3000
Echocardiogram with Doppler ( Contrast charged extra) ECHODOPWD
3800 2900
17 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
64
EEG/EMG lab charges

CAT 1/CAT2 CAT3
1 Bedside EEG (less than 1 hr) EEG_BS 4050 2430
2 Bedside EMG EMG_BS 5870 3520
3 Bedside EMG & NCV EMGNCV_BS 9470 5680
4 Bedside Evoked Potential - Auditory ( AEP / BAER / BERA ) AUDIT_BS 4520 2710
5 Bedside Evoked Potential - Somatosensory ( SSEP ) EVOPOTSSEP_BS 4520 2710
6 Bedside Evoked Potential - Visual ( VEP / VER ) VISUAL_BS 4520 2710
7 Bedside NCV / NCS ( Nerve conduction velocity / study ) NCV_BS 4950 2970
8 Bedside Repetitive nerve stimulation / Decremental response (RNST ) REPNERSTI_BS 4520 2710
9 Botox injection under EMG control BIEMGC 1160 700
10 EEG EEG 2700 1620
11 Electroretinography ERG 3390 2030
12 EMG EMG 4050 2430
13 EMG / NCV EMGNCV 7650 4590
14 Evoked Potential - Auditory ( AEP / BAER / BERA ) AUDIT 3380 2030
15 Evoked potential - P300 EVOPOTP300 3080 1850
16 Evoked Potential - Somatosensory EVOPOTSSEP 3620 2170
17 Evoked Potential - Visual ( VEP / VER ) VISUAL 3380 2030
18 Long term bedside EEG ( 6 - 24 hrs ) LTEEG24H 9310 5590
19 Long term video EEG (6 to 24 hrs) - charges for video recording LTVEEG 11170 6700
20 NCV / NCS ( Nerve conduction velocity / study ) NCV 3840 2300
21 Overnight Video EEG for 12 hour - Lab Charges ONVEEG12LAB 10160 6100
22 Repetitive nerve stimulation / Decremental response ( RNST ) REPNERSTI 3380 2030
23 Short term bedside EEG ( 1 - 6 hrs ) STEEG6H 5580 3350
24 Short term video EEG monitoring (less than 6 hrs) VMT 5580 3350
25 Sleep deprivation EEG SDEEG 3620 2170
26 DIAGNOSTIC SLEEP STUDIES WITH OVERNIGHT VIDEO DSSWONVEEGOS
EEG(LABORATRY CHARGES + DOCTOR CHARGES)
Diagnostic sleep studies with overnight video EEG - Doctor fee DSSWONVEEGDF 12130 7280
Diagnostic sleep studies with overnight video EEG - Test charges DSSWONVEEG 9790 5870
27 Electrocorticography ECOGOS
Electrocorticography - charges for procedure ECOGPC 18600 11160
Electrocorticography - Doctor Fee ECOGDF 9310 5590
28 Intraoperative Neurophysiology monitoring INOPMONOS
Intraoperative Neurophysiology monitoring - Charges for procedure INOPMONPC 18600 11160
Intraoperative Neurophysiology monitoring - Doctor Fee INOPMONDF
9310 5590
29 Overnight Video EEG for 12 hours -(LABORATORY ONVEEG12OS
CHARGES + DOCTOR CHARGES)
Overnight Video EEG for 12 hour - Lab Charges ONVEEG12LAB 10160 6100
Overnight Video EEG for 12 hours - Doctor Fee ONVEEG12D 2540 1520
30 Diagnostic Sleep Studies (Laboratory charges + Professional charges) DSSPCHDHCOS
Diagnostic sleep studies - Doctor fee DSSDF 9320 5590
Diagnostic sleep studies test charges DSSTC 7640 4580
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 Cardiac Sciences ) AMBPMONITPS 2640 1840
2 Echocardiogram with Doppler ( Paedtriatric Cardiac Sciences ) ECHODOPPS 2660 1670
3 Electrocardiogram ECG ( Paedtriatric Cardiac Sciences ) ECGPS 310 190
4 Fetal Cardiac Assessment ( Paedtriatric Cardiac Sciences ) FECHOPS 3660 2420
5 Holter Test ( Paedtriatric Cardiac Sciences ) HOLTERPS 2640 1840
65
6 Review Echo for LV Function RELVF 1000 600
7 Review Follow up Fetal Echo RFEH 2000 1200
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 5000 5000
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 ( DRCG ) GS6 6250 6250
14 DMSA renal scan GS5 6250 6250
15 DTPA Scan GS1 6250 6250
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
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 5000 5000
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 charges B2 7500 7500
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
44 Resting MUGA CVS5 5000 5000
45 Scintimammography SMGPY 6000 6000
66
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 ) - 2 Samples 17OHP2 1510 1510
2 25-OH VIT D Level (Nuclear RIA) 25OHVIT 1710 1710
3 Anti - TG ( Thyroid Antibody ) - Nuclear Medicine TG 580 580
4 Anti - TPO ( Thyroid Antibody ) - Nuclear Medicine TPO 640 640
5 C - Peptide Test PEPTIDE 640 640
6 Cyclosporin Level ( C0 and C2 ) CYCLOSPORINC 1920 1920
7 Cyclosporin Level ( C2 ) CYCLOSPC2 1200 1200
8 Cyclosporin Level ( CO ) CYCLOSPCO 1200 1200
9 Free T3 T3 430 430
10 Free T3 / Free T4 T3T4 880 880
11 Free T4 T4 440 440
12 Free T4 / TSH T4TSH 880 880
13 Growth Hormone (HGH) ( Nuclear RIA ) GHORMONE 760 760
14 Growth Hormone Stimulation Test ( Clonidine ) (Nuclear RIA ) GHORMONES 3140 3140
15 IGF 1 (Nuclear Medicine) IGF1 2750 2750
16 IGF BP3 (Nuclear Medicine) IGFBP3 2750 2750
17 Insulin Estimation (5 Samples) INSULINC 1800 1800
18 Insulin Level - Fasting INSULINLF 390 390
19 Insulin Level - PP INSULIPP 410 410
20 Insulin Level - Random INSULINLR 410 410
21 Insulin Level ( Fasting + PP ) INSULINFPP 800 800
22 Insulin Level ( Fasting, 1 hourly and 2 hourly ) INSULINF12 1320 1320
23 Neuron Specific Enolase (NSE) NMNSE 1500 1500
24 PTH Level PTH 1270 1270
25 Renin Levels RENIN 4200 4200
26 Testesterone (Free) TESTF 1760 1760
27 Testesterone (Total) TESTT 690 690
28 Thyroglobulin assay THGLOA 3990 3990
29 Thyroid Antibodies - Nuclear Medicine TANTIBODIES 1240 1240
30 Thyroid Profile ( T3, T4, TSH ) T3T4TSH 1240 1240
31 TSH (Nuclear) TSH 410 410
32 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
67
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 COMPANY PCTAWBCOS
PATIENTS )
FDG PET CT Angiography Whole Body with Contrast (FDG isotope charges extra) PCTAWBC 18500 18500
3 FDG PET CT Brain plain PCTBPos
FDG PET CT Brain plain (FDG isotope charges extra) PCTBP 3500 3500
4 FDG PET CT Brain plain with Contrast PCTBWCOS
FDG PET CT Brain plain with Contrast (FDG isotope charges extra) PCTBWC 5500 5500
5 Whole body PET CT scan with TRODAT brain (With Contrast) PCTTROBROS
FDG isotope charges F18FDGISO
10500 10500
Whole body PET CT Scan with TRODAT brain (With Contrast) PCTTROBR 28500 28500
6 Whole body PET CT Scan with TRODAT brain (Plain) PCTTROBRPOS
10500 10500
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
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 isotope charges extra) PCTABWC 8998 8998
9 FDG PET CT Angiography Whole Body with Contrast PCTAWBC 18500 18500
(FDG isotope charges extra)
10 FDG PET CT Brain plain (FDG isotope charges extra) PCTBP 3500 3500
68
11 FDG PET CT Brain plain with Contrast (FDG isotope charges extra) PCTBWC 5500 5500
12 FDG PET CT Cardiac plain (FDG isotope charges extra) CPCTP 6500 6500
13 FDG PET CT Myocardial Viability and Perfusion study CPCTMVPSP 10120 10120
plain (FDG isotope charges extra)
14 FDG PET CT Myocardial viability and Perfusion with CT Coronary PCTMVPAWC 16874 16874
Angiography with Contrast (FDG isotope charges extra)
15 FDG PET CT Whole Body Plain (FDG isotope charges extra) PCTWBP 10500 10500
16 FDG PET CT Whole Body with Contrast (FDG isotope charges extra) PCTWBC 13500 13500
17 Gallium Whole body PET scan GWBPET 30000 30000
18 Human Serum Albumin (HSA) HSA 11000 11000
19 MIBG isotope charges MIBGC 22000 22000
20 MIBG isotope charges ( Routine ) MIBGPET 10450 10450
21 PET CT - Regional somatostatin ( DOTANOC ) receptor imaging ( regional) DOTANOC 8180 8180
22 PET CT - Whole body somatostatin receptor imaging (DOTONOC PCTSRI 15340 15340
isotope charges extra)
23 PET CT BRAIN AND DAT SCAN PTBDS 25000 25000
24 PET CT guided procedure PETBIOPSY 9200 9200
25 Pet CT Scan whole body (Sarcoidosis) PCWB 28000 28000
26 PET Whole Body Sweep PWBS 3070 3070
27 PSMA PET CT Whole Body Plain PSMAPET 22000 22000
28 PSMA PET CT Whole Body with Contrast PSMPETC 25560 25560
29 Urgent PET CT Brain scan with TRODAT Brain PCTBWT 38000 38000
30 Visipaque contrast charges for PET CT PETVC 1050 1050
31 Whole body PET CT Scan with TRODAT brain (With Contrast) PCTTROBR 28500 28500
Allergy Tests
SNo Description Code POPD/ CAT1/CAT2 GOPD/ 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 Prick AERESCPOS
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
5 Impulse Oscillometry Test (Doctor Charges + Hospital Charges) PAEDIMPOS
Impulse Oscillometry Test - Doctor Fee PAEDIMPDF
2200 1300
Impulse Oscillometry Test - Hospital Charges PAEDIMPHC
300 200
Ioc Filter
100 100
Fetal Medicine Charges

CAT 1/CAT2 CAT3
1 AMNIO DRAINAGE AMNIODR 5000 3000
2 CERVICAL LENGTH WITH UTERINE ARTERY DOPPLER UCLAD 2000 1200
3 FETAL REDUCTION QUADRUPLETS FETALRED 26500 15800
4 Portable ultrasound hospital service charges ( Fetal Medicine ) FETAL_BS 1000 600
5 TWIN OBSTETRICS BIOPHYSICAL PROFILE WITH DOPPLER TOBPD 2000 1200
6 Ultrasound 3 D Reconstruction of face 3DRF 5780 3470
7 Ultrasound Amino infusion AMINOINF 5000 3300
69
8 Ultrasound AVI & Doppler only UAVID 1900 1250
9 Ultrasound bio-physical scoring BPSC 1100 650
10 Ultrasound BPS with doppler + AVI BPSDOP 2000 1250
11 Ultrasound colour doppler Fetal echo with 4 D UFED4 4040 2430
12 Ultrasound colour doppler Fetal echo with doppler UFED 3470 2080
13 Ultrasound colour doppler Twins UTDS 4000 2800
14 Ultrasound colour doppler Twins with growth scan UCDTGS 5500 3500
15 Ultrasound CVS chorionic villus sampling UCVS 11000 8500
16 Ultrasound CVS chorionic villus sampling (Thalassemia society UCVSTS 6500 4850
patient )
17 Ultrasound Evaluation of AVI / Scar thickness / UEAVI 870 550
presentation / placental localisation
18 Ultrasound fetal blood sampling UFBS 15000 8750
19 Ultrasound fetal For cardiac activity UFCA 900 600
20 Ultrasound fetal Portable charges for fetal medicine UFPCH 1100 650
21 Ultrasound fetal reduction in Fetal Medicine Dept FRED 17550 10500
22 Ultrasound fetal skin sampling (Fetal medicine charges) FETALSKIN 4520 2730
23 Ultrasound fetal Triplet BPS UFTRBPS 1650 1000
24 Ultrasound fetal Triplet BPS - colour Doppler UFTRBPSCD 4980 3050
25 Ultrasound fetal Triplet Growth scan UFTRGS 4000 2500
26 Ultrasound fetal Triplet Growth scan Doppler flows UFTRGSDF 6090 4000
27 Ultrasound fetal Triplet Level II - Doppler flows UFTRLII 7000 4000
28 Ultrasound fetal Triplet MCA / UA / Umblical / uterine artery UFTRMCA 2100 1360
29 Ultrasound fetal Twin anamoly scan - doppler flows UFTACDF 5800 3800
30 Ultrasound fetal Twin biophysical score UFTBPS 1600 1100
31 Ultrasound fetal Twin Genetic sonogram UFTGS 4500 2650
32 Ultrasound fetal Twin MCA/UA/Umblical/uterine artery-Doppler UFTMCA 1600 1000
33 Ultrasound fetal urine sampling FETALURI 6500 4000
34 Ultrasound for Genetic Sonogram (16-18 weeks) UANEU 3000 2000
35 Ultrasound guided Aminocentesis (Twins) FETAMINOTWIN 9500 6500
36 Ultrasound guided amniocentesis UGAMINO 6800 4500
37 Ultrasound guided Amniocentesis and Amnioinfusiuon UGAAF 8500 5200
38 Ultrasound guided CVS (Twins) FETCVSTWIN 12600 9000
39 Ultrasound Intrauterine transfusion INTRATRA 19950 12600
40 Ultrasound obstetric growth scan + colour doppler flow study + AVI OBSTDOP 4500 2800
41 Ultrasound Obstetric Intervention OBSINTER 7500 4500
42 Ultrasound obstetrics - MCA / UA / Umblical / Uterine artery - FETOBSMCAUA 1650 1000
Doppler
43 Ultrasound obstetrics - Mid trimester anomaly scan FETMTAS 4500 2600
(MTAS / Level II / TIFFA) with Doppler
44 Ultrasound obstetrics - Miscellaneous FETOBSMIS 1500 850
45 ULTRASOUND OBSTETRICS - NUCHAL SCAN WITH UONSUAD 3500 1950
UTERINE ARTERY DOPPLER
46 Ultrasound obstetrics - viability / dating scan ( upto 10 weeks ) UO10 1650 1000
47 ULTRASOUND OBSTETRICS WITH DETAILED STUDY OF FETAL KUB UODFKS 4500 2600
(KIDNEYS-SIZES, PELVICALYCED DILATATION, CORTICAL THICKNESS,
URETERS AND URINARY BLADDER) SINGLETON
48 ULTRASOUND OBSTETRICS WITH MATERNAL KIDNEYS UOWMK 2200 1300
49 Ultrasound obstetrics ( Twins ) ( After 18 weeks without Level II ) UOT 3500 2100
50 Ultrasound obstetrics (Triplets) - Level II / MTAS /TIFFA FETOBSTRI 5500 3500
51 Ultrasound obstetrics Dating + cervical length UTDCL 1300 800
52 Ultrasound obstetrics growth scan ( 26 weeks till term ) UOGS26 2500 1500
53 Ultrasound obstetrics Quadruplets NT Scan UTQTMT 5000 3000
54 Ultrasound obstetrics Triplet Dating cardiac activity UTTRIDCA 2250 1400
70
55 Ultrasound obstetrics Triplet extended screening UTTRIEX 4500 2850
56 Ultrasound obstetrics Twins AVI Doppler UTTWAVID 2250 1400
57 Ultrasound obstetrics Twins Dating cardiac activity UTTWDCA 2000 1100
58 Ultrasound obstetrics Twins extended screening UTTWEX 4000 2500
59 ULTRASOUND OBSTETRICS WITH DETAILED NEUROSONOGRAPHY ULFNEUR 4000 2400
60 Ultrasound placental biopsy ULPLABIO 11000 8000
Ultrasound Charges

CAT 1/CAT2 CAT3
1 Breasr FNAC under ultrasound guidance - Ultrasound UFNACULC 1650 990
Department Charges
2 Duplex Transcranial Doppler in combo with Neck vessels UDTDCNV 4500 2700
3 Intussusception Reduction ULINR 3500 2100
4 LIVER TRANSPLANT PACKAGE - Ultrasound charges LTRULT
5 Portable ultrasound hospital service charges (Ultrasound Dept) ULTRA_BS 1100 670
6 Ultrasound 3D / 4D upper abdomen lower abdomen U3DUA 4200 2520
7 Ultrasound Transplant kidney with scrotum (with colour doppler) ULKWISCR 3100 1840
8 Ultrasound Transplant kidney with scrotum (without colour doppler) ULKWSCR 2100 1250
9 Ultrasound whole abdomen with scrotum ULWBWSCR 3600 2160
10 Ultrasound & colour doppler of transplanted kidney KT 1850 1090
11 Ultrasound breast SPB 2200 1320
12 Ultrasound carotid doppler UCARODOP 3000 1500
13 Ultrasound colour doppler eye UEYE 1680 1010
14 Ultrasound colour doppler follicle monitoring (single day) CDS 650 390
15 Ultrasound colour doppler orthosonography UOSONO 2090 1250
16 Ultrasound colour doppler renal artery RENAL 3500 2100
17 Ultrasound colour doppler thyroid THYROID 1960 1180
18 Ultrasound colour doppler vessel / vein mapping / marking VLM 1000 500
19 Ultrasound Elastography - Breast ULELASB 2000 1220
20 Ultrasound Elastography - Liver ULELASLIV 2000 1670
21 Ultrasound Elastography - Prostate ULELASPRRO 2000 1220
22 Ultrasound Elastography - Scrotum ULELASSCR 2000 1220
23 Ultrasound Elastography - Thyroid ULELASTTHY 2000 1220
24 Ultrasound Extra Film Charges ULTEF 500 500
25 Ultrasound follicle monitoring ( single day ) UFMSD 500 300
26 Ultrasound follicle study full FSF 2300 1380
27 Ultrasound for detection of ascitis UFDA 600 360
28 Ultrasound for detection of pleural effusion ULDPE 600 360
29 Ultrasound for residual urine RU 450 270
30 Ultrasound for undescended testis UUT 1890 1130
31 Ultrasound for Uterine Fibroid Mapping ULUFM 1700 1020
32 Ultrasound guidance charges for Ascites / Effusion UASCUINT 1300 780
tapping ( interventional)
33 Ultrasound guidance charges for FNAC / Biopsy (interventional) UFNACINT 1300 780
34 Ultrasound gynae with colour doppler UGCD 2100 1250
35 Ultrasound joints UJTS 2500 1500
36 Ultrasound KUB KUB 1600 960
37 Ultrasound KUB + doppler scrotum ( without TRS ) UKUBDS 2800 1670
38 Ultrasound KUB + pelvis ( Female ) UKUBPF 2100 1260
39 Ultrasound KUB + prostate ( TRUS ) KUBP 2100 1260
40 Ultrasound KUB + prostate + scrotum (without doppler) KUBPROSC 2600 1560
41 Ultrasound KUB + prostate + TRS + doppler scrotum UKUBPTRS 3500 2100
42 Ultrasound KUB + residual urine KUBRU 1600 960
71
43 Ultrasound lower abdomen / pelvis LA 1500 880
44 Ultrasound monitoring ( PICU / ICU / OT ) UMBOT 380 380
45 Ultrasound Monitoring charges ( GE - Anaesthesia ) UMANGE 650 650
46 Ultrasound Monitoring charges ( M Turbo -Anaesthesia ) UMANMT 450 450
47 Ultrasound musculoskeletal system UMUSCU 2600 1560
48 Ultrasound Neck UNECK 1700 1020
49 Ultrasound neurosonography ( cranial ultrasound in babies ) SPN 1350 800
50 Ultrasound of a focal swelling FOCALSW 840 510
51 Ultrasound pelvis with colour doppler GCD 2250 1340
52 Ultrasound penile colour doppler PLD 3100 1840
53 Ultrasound peripheral arterial colour doppler both arms PBLU 5500 2750
54 Ultrasound peripheral arterial colour doppler both legs PBLL 5500 2750
55 Ultrasound peripheral arterial colour doppler left arm PLA 3000 1500
56 Ultrasound peripheral arterial colour doppler left leg PLL 3000 1500
57 Ultrasound peripheral arterial colour doppler right arm PRA 3000 1500
58 Ultrasound peripheral arterial colour doppler right leg PRL 3000 1500
59 Ultrasound scrotum ULTRASCROT 1550 920
60 Ultrasound scrotum with colour doppler OSONO 2400 1430
61 Ultrasound small parts ULSMP 1500 900
62 Ultrasound thorax SPCH 1110 670
63 Ultrasound thyroid SPT 1500 900
64 Ultrasound transplant ( graft ) kidney (without doppler) TK 700 420
65 Ultrasound transrectal + pelvis ultrasound (Male) TRUS 1500 880
66 Ultrasound upper abdomen UA 1600 960
67 Ultrasound upper abdomen & doppler study ABDO 3800 2280
68 Ultrasound venous colour doppler both arms PBLUV 5500 2750
69 Ultrasound venous colour doppler both legs PBLLV 5500 2750
70 Ultrasound venous colour doppler left arm PLAV 3000 1500
71 Ultrasound venous colour doppler left leg PLLV 3000 1500
72 Ultrasound venous colour doppler neck PNV 2450 1470
73 Ultrasound venous colour doppler right arm PRAV 3000 1500
74 Ultrasound venous colour doppler right leg PRLV 3000 1500
75 Ultrasound whole abdomen & pelvis ( Adult ) WA 2600 1560
76 Ultrasound whole abdomen & pelvis (age less than 12 years) WA12 1800 1080
77 Ultrasound whole abdomen with TRUS UWAWTRUS 2900 1740
Ultrasound Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1 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 )
2 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 )
3 AFNACOD Ultrasound guided FNAC
OS outside the department
AFNACODDF Ultrasound guided FNAC outside the 2090 2090 1060 2090
department - ultrasonologist fee
72
AFNACOD Ultrasound guided FNAC outside the 2090 2090 1060 2090 2090
4 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
(Ultrasound dept charges )
5 BIOCTMRI Biopsy under guidance of
OS ultrasound / CT / MRI fusion
UBUGCTMRID Biopsy under guidance of ultrasound / CT / 2090 2090 1250 2090
F MRI fusion - Ultrasonologist fee
UBUGCTMRID Biopsy under guidance of ultrasound / CT / 2090 2090 1250 2090 2090
C MRI fusion - Ultrasound dept. charges
6 BRMRIOS Breast MRI + Tomosynthesis
Charges
BRMRI Breast MRI - MRI Dept.Charges 12800 12800 12800 12800 12800 12800 12800
TOMOMAM Tomosynthesis Charges - Mammography 6500 6500 6500 6500 6500 6500 3900
Dept.Charges
7 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
8 ENDOBRO ENDOBRONCHIAL ULTRASOUND -
ULOS (DOCTOR FEE + HOSPITAL CHARGES +
DISPOSABLES CHARGES +
CYTOLOGY CHARGES)
ENDOBROULH C Endobronchial Ultrasound – Hospital charges 8840 8840 4420 3540 2650 4420 2650
ENDOBROULD F Endobronchial Ultrasound - Doctor Fee 22140 22140 11070 8860 6640 11070 6640
ENDOBROPAC Endobronchial Ultrasound - For PACS - NOT
S FOR BILLING PURPOSE
ENDOBRONUL Endobronchial Ultrasound - Package 46840 46840 23420 18740 14050 23420 14050
TAPC charges
9 FRUOS Fetal Reduction by Ultrasound Dept
FRUDF Fetal Reduction by Ultrasound Dept – Doctor Fee 8800 8800 4750
FRUUD Fetal Reduction by Ultrasound Dept - 8800 8800 4750
Ultrasound Deptt. Charges
10 SALSONO OS Salpingo sonography
USALSODF Salpingo sonography - Ultrasonologist fee 1400 1400 840 1400
USALSODC Salpingo sonography - Ultrasound dept. charges 1400 1400 840 1400 1400
11 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 (Ultrasound dept 1100 1100 660 1100 660
charges )
12 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 )
13 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
14 UAODOS Ultrasound guided aspiration
outside the U/S department
UAODDF Ultrasound guided aspiration outside the 2100 2100 1260 2100
U/S department - ultrasonologist fee
73
UAOD Ultrasound guided aspiration outside the 2100 2100 1260 2100 2100
U/S department ( Ultrasound dept charges )
15 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
16 UGLAAOD Ultrasound guided liver abscess
OS 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
17 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
18 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
19 UGLBOS Ultrasound guided liver biopsy
UGLBDC Ultrasound guided liver biopsy - Dept. charges 1820 1820 1210 1820 1820
UGLBDF Ultrasound guided liver biopsy - Doctor fee 1820 1820 1210 1820
20 UGMTPOS Ultrasound guided MTP
UGMTPDF Ultrasound guided MTP - ultrasonologist fee 2200 2200 1320 2200
UGMTP Ultrasound guided MTP ( Ultrasound dept charges ) 2200 2200 1320 2200 2200
21 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
22 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
23 UGPAOS Ultrasound guided perigraft aspiration
UGPADC Ultrasound guided perigraft aspiration -Dept. charges 1100 1100 660 1100 1100 1100
UGPADF Ultrasound guided perigraft aspiration -Doctor fee 1100 1100 660 1100
24 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 aspiration / 2420 2420 1210 2420 2420
biopsy ( Ultrasound dept charges )
25 UGRBOD OS Ultrasound guided renal biopsy

UGRBDC Ultrasound guided renal biopsy - Dept. charges 1800 1440 1080 1800 1800
UGRBDF Ultrasound guided renal biopsy - Doctor fee 1800 1440 1080 1800
26 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
27 UGTAFAO Ultrasound guided therapeutic
S aspiration for ascitis
74
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
28 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
29 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
31 ULCON Contrast ultrasound

CULTRA Contrast Ultrasound - Ultrasonologist fee 1500 1500 900 1500
CONULHC Contrast ultrasound - Ultrasound dept. charges 7500 7500 4500 7500 4500
32 ULGYNOS Contrast ultrasound Gynae

ULGYNDF Contrast Ultrasound Gynae – Ultrasonologist fee 1500 1500 900 1500
ULGYNDC Contrast Ultrasound Gynae – Ultrasound dept. charges 7500 7500 4500 7500 4500
ULHEPLTO Contrast Ultrasound Hepatic

33 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
34 ULKIDOS Contrast ultrasound Kidney

ULKIDDF Contrast ultrasound Kidney – Ultrasonologist fee 1500 1500 900 1500
ULKIDDC Contrast ultrasound Kidney – Ultrasound dept. charges 7500 7500 4500 7500 4500
35 ULLIVOS Contrast ultrasound Liver

ULLIVDF Contrast Ultrasound Liver – Ultrasonologist fee 1500 1500 900 1500
ULLIVDC Contrast ultrasound Liver - Ultrasound dept. charges 7500 7500 4500 7500 4500
36 ULOESOS Contrast ultrasound Oesophagus

ULOESDF Contrast Ultrasound Oesophagus -Ultrasonologist fee 1500 1500 900 1500
ULOESDC Contrast ultrasound Oesophagus -Ultrasound dept. 3500 3500 2100 3500 2100
charges
37 ULPROOS Contrast ultrasound Prostate

ULPRODF Contrast Ultrasound Prostate -Ultrasonologist fee 1500 1500 900 1500
ULPRODC Contrast ultrasound Prostate - Ultrasound 7500 7500 4500 7500 4500
dept. charges
ULRFAOS Contrast ultrasound charges
38 for Radio frequency ablation
ULRFADF Contrast ultrasound charges for Radio 3500 3500 2100 3500
frequency ablation - Ultrasonologist fee
ULRFADC Contrast ultrasound charges for Radio frequency 13980 13980 8390 13980 8390
ablation - Ultrasound dept. charges
39 ULSPLOS Contrast ultrasound Spleen

ULSPLDF Contrast Ultrasound Spleen – Ultrasonologist fee 1500 1500 900 1500
ULSPLDC Contrast Ultrasound Spleen – Ultrasound dept. charges 7500 7500 4500 7500 4500
40 ULTHYOS Contrast ultrasound Thyoid

ULTHYDF Contrast Ultrasound Thyroid -Ultrasonologist fee 1500 1500 900 1500 850
ULTHYDC Contrast ultrasound Thyroid – Ultrasounddept. charges 7500 7500 4500 7500 4500
41 ULUVROS Contrast Ultrasound for U V Reflux
ULUVRDF Contrast Ultrasound for UV reflux -Ultrasonologist fee 1500 1500 900 1500
ULUVRDC Contrast Ultrasound for UV reflux - 3500 3500 2100 3500 2100
Ultrasound dept. charges
42 USAVFC Ultrasound guided venous mapping for
I/J catheter insertion and A.V Fistula
creation
USAVFDF Ultrasound guided venous mapping for I/J catheter 630
insertion and A.V Fistula creation - Doctor Fee
75
USAVFHS Ultrasound guided venous mapping for I/J catheter 600
insertion and A.V Fistula creation - Machine Charges
43 USBRSTBP Ultrasound guided breast
SYOS biopsy
USBRSTBPSYD F Ultrasound guided breast biopsy -ultrasonologist fee 1680 1680 840 1680
USBRSTBPSY Ultrasound guided breast biopsy (Ultrasound dept 1680 1680 840 1680 1680
charges )
44 USSKBRO T Ultrasound skin marking for 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 WARD/Recovery XRAY_BS 580 350
2 Additional Xray Contrast AXCONTRAST 150 150
3 Additional Xray film charges for vascular / neuro lab XFCVAS 400(Cat 1)/ 310 (Cat 2)/210 (Cat 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 charges ) BDG 3910 3910
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 done in OT BOTPX 2500 1500
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
40 Lt. Humerus Oblique view - Xray XRAYLTHOV 520 310
76
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 position LUMSLD 520 310
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
93 Xray ankle oblique (bilateral) ANKOBB 520 310
94 Xray ankle oblique (L) ANKOBL 520 310
95 Xray ankle oblique (R) ANKOBR 520 310
77
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 (bilateral) ARAPLEB 2000 1200
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 (bilateral) ARAPLSB 2000 1200
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
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
78
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 junction CSPLCV 520 310
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
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
79
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 ionic contrast) ERCPWPT 4620 2770
211 Xray ERCP with papilotomy & dormia basketing of stone ERCPPDB 4620 2770
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 (bilateral) FRKJAPLTB 2000 1200
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
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
80
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
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
81
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 dislocation) - bilateral HIPITHB 1010 610
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
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
82
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
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
83
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 & extension LLSLTEFE 1010 610
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
463 Xray oesophageal dilatation under fluoroscopy ODUTVC 3540 2120
464 Xray oesophageal dilatation under fluoroscopy + endo prosthesis insertion ODUTVEI 3540 2120
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
84
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
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
85
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 view SKUBAS 520 310
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
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
86
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) (bilateral) TMJCMB 1010 610
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 mouth) (bilateral) TMJOCMB 2000 1200
602 Xray temporo mandibular joints (open & closed mouth) (L) TMJOCML 1010 610
603 Xray temporo mandibular joints (open & closed mouth) (R) TMJOCMR 1010 610
604 Xray temporo mandibular joints (open mouth) (bilateral) TMJOMB 1010 610
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
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 Bending) XWSDFAPLLB 1770 1770
632 Xray Whole spine digital film AP & Lateral (Right Bending) XWSDFAPLRB 1770 1770
633 Xray Whole spine digital film AP ( Right & Left Bending ) XWSDFAPLRLB 2660 2660
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
87
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
662 Xray barium meal upper GI BMUGIT
Xray barium dye Charges BHFTDYE
150 150
Xray barium meal upper GI BMUGIT
3110 1870
663 Xray barium swallow for foreign body localisation BSFBL
Xray barium swallow for foreign body localisation BSFBL
2150 1290
664 Xray barium swallow (for heart) with fluoroscopy BSHFLS
150 150
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
150 150
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
250 250
88
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
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
250 250
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
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
Xray Loopogram with Barium LOOPOGRAM
2220 1330
689 Xray Loopogram with gastrografin LOOPOGASOS
500 500
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
89
500 500
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
150 150
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
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
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
250 250
Xray RGU RGU
3740 2240
701 Xray small bowel barium enema ( enteroclysis ) SBBEMA
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
250 250
Xray parotid sialogram (bilateral) SIALBS
3100 1860
704 Xray parotid sialogram (R) SIALOR
250 250
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
250 250
Xray submandibular sialogram (L) SMABSL
1770 1070
709 Xray submandibular sialogram (R) SMABSR
90
Xray submandibular sialogram (R) SMABSR
1770 1070
710 Xray T - tube cholangiogram TTCG
Xray T - tube cholangiogram TTCG
2940 1760
711 Ultrasound guided trucut biopsy breast multiple lesions UGBIOMULTIOS
upto three (Gun procured from pharmacy / outside)
Ultrasound guided trucut biopsy breast multiple lesions upto three (Gun UGBIOMULTICC
500 500
procured from pharmacy / outside)- Consumable charges
Ultrasound guided trucut biopsy breast multiple lesions upto three (Gun UGBIOMULTIHC 4500 4500
procured from pharmacy / outside)- Hospital Charges
Ultrasound guided trucut biopsy breast multiple lesions upto three (Gun UGBIOMULTIPF
4500 4500
procured from pharmacy / outside)- Professional fee
712 Ultrasound guided trucut biopsy -(Gun procured from UGBIOS

pharmacy / outside)
Ultrasound guided trucut biopsy -(Gun procured from pharmacy / outside) UGBIOCC
500 500
- Consumable charges
Ultrasound guided trucut biopsy -(Gun procured from pharmacy / outside) UGBIOHC
3000 3000
- Hospital Charges
Ultrasound guided trucut biopsy -(Gun procured from pharmacy / outside) UGBIOPF
3000 3000
- Professional fee
713 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
714 Ultrasound guided FNAC breast ( Department of Radiology) UGFNACOS
Ultrasound guided FNAC breast ( Department of Radiology) – Consumable charges UGFNACCON
1500 1500
Ultrasound guided FNAC breast ( Department of Radiology) – Hospital Charges UGFNACHC
2500 2500
Ultrasound guided FNAC breast ( Department of Radiology) – Professional Fee UGFNACPF
2500 2500
715 Ultrasound guided trucut biopsy breast Multiple lesions UGMLES3OS
upto three ( Department of Radiology)
Ultrasound guided trucut biopsy breast Multiple lesions upto three (Department of Radiology) UGMLES3CON
4000 4000
- Basic Consumable charges
Ultrasound guided trucut biopsy breast Multiple lesions upto three (Department of Radiology) UGMLES3HS 4500 4500
- Hospital Charges
Ultrasound guided trucut biopsy breast Multiple lesions upto three (Department of Radiology) UGMLES3PF
4500 4500
- Professional Fee
716 Ultrasound guided trucut biopsy breast( Department of Radiology) UGTOS

Ultrasound guided trucut biopsy breast( Department of Radiology)-Consumable Charges UGTCONC
4000 4000
Ultrasound guided trucut biopsy breast( Department of Radiology)-Hospital Charges UGTHC
3000 3000
Ultrasound guided trucut biopsy breast( Department of Radiology)-Professional Fee UGTDF
3000 3000
717 Ultrasound guided therapeutic Vacuum Assisted Breast UGTVOS
Biopsy ( Department of Radiology)
Ultrasound guided therapeutic Vacuum Assisted Breast Biopsy (Department of Radiology) - UGTVCON
18000 18000
Consumable charges
Ultrasound guided therapeutic Vacuum Assisted Breast Biopsy (Department of Radiology) - UGTVHC 13500 13500
Hospital Charges
Ultrasound guided therapeutic Vacuum Assisted Breast Biopsy (Department of Radiology) - UGTVPF
13500 13500
Professional Fee
718 Ultrasound guided FNAC ( Department of Radiology) ULTRAGFNACOS

Ultrasound guided FNAC ( Department of Radiology) – Consumable charges ULTRAGFNACCON 1500 1500
Ultrasound guided FNAC ( Department of Radiology) - Hospital Charges ULTRAGFNACHC
2500 2500
Ultrasound guided FNAC ( Department of Radiology) - Professional Fee ULTRAGFNACPF
2500 2500
719 Ultrasound guided trucut biopsy ( Department of Radiology) ULTRATOS
Ultrasound guided trucut biopsy ( Department of Radiology) – Consumable Charges ULTRAGTCONC
4000 4000
Ultrasound guided trucut biopsy ( Department of Radiology) – Hospital Charges ULTRAGTHC
3000 3000
Ultrasound guided trucut biopsy ( Department of Radiology) – Professional Fee ULTRAGDF
3000 3000
720 Ultrasound guided Vacuum Assisted Breast Biopsy( UVBOS
Diagnositic Department Radiology)
Ultrasound guided Vacuum Assisted Breast Biopsy( Diagnositic UVBCONC
18000 18000
Department Radiology)- Consumable Charges
Ultrasound guided Vacuum Assisted Breast Biopsy( Diagnositic UVBSHC
8500 8500
Department Radiology)- Hospital Charges
Ultrasound guided Vacuum Assisted Breast Biopsy( Diagnositic UVBDF
8500 8500
Department Radiology)- Professional Fee
721 Vacuum Assisted Breast Biopsy under Mammographic Guidance VABBMGOS
91
Vacuum Assisted Breast Biopsy under Mammographic Guidance – Doctor Fee VABBMG
5000 5000
Vacuum Assisted Breast Biopsy under Mammographic Guidance – Hospital Charges VABBMGHC
35000 35000
722 Vacuum Assisted Breast Biopsy under Ultrasound Guidance VABBUGOS
Vacuum Assisted Breast Biopsy under Ultrasound Guidance - Doctor Fee VABBUG
5000 5000
Vacuum Assisted Breast Biopsy under Ultrasound Guidance – Hospital Charges VABBUGHC
30000 30000
723 Xray VP shuntogram VENOVPS
250 250
Xray VP shuntogram VENOVPS
3300 1980
724 Xray Distal Cologram ( Barium + Gastrografin ) XDCBGOS
150 150
Xray Distal Cologram ( Barium + Gastrografin ) XDCBG
3540 2120
250 250
725 Xray gastrografin swallow (Adult) XGSAOS
Xray Gastrografin (Adult) dye charges XGSADC
500 500
Xray gastrografin swallow (Adult) XGSA 1960 1170
726 Xray Gastrografin Swallow (Child - < 12 Years) XGSCOS
250 250
Xray Gastrografin Swallow (Child - < 12 Years) XGSC
1960 1170
727 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
728 Pericatheteric RGU( including dye charges ) - XRAY XRAYRGOS
Pericatheteric RGU - Dye charges XRAYRGUDY
250 250
Pericatheteric RGU - Xray XRAYRGU
3740 2240
729 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 biopsy marker BBMAR 6300 6300
3 Breast FNAC under Radiological guidance -consumable charges BFNAC 1500 1500
4 Breast FNAC under Radiological guidance – Radiology Dept. Charges BFNACDF 2500 2500
5 Breast Ultrasound ( Radiology ) BRERAD 2400 1450
6 Comprehensive Left breast imaging package bilateral (2D + 3D Left MM2D3DLM 3000 1800
Mammogram + Breast MRI) - X-Ray Department Charges
7 Extra DVD / CD + films upto 5 in number + Duplicate report EXTRAMEMO 1500 1500
8 Extra Film beyond 5 films (for duplicate report only) EXTFILMB 150 150
9 Mammographic hook wire localisation HWLOCAL 10000 6000
10 Mammographic hook wire localizatio ( Hook wire and film charges only) MAHWL 2000 2000
11 Mammography Guided (Stereotactic) trucut breast biospy breast MAMMAC 3500 3500
Multiple lesions (Upto two) –Additional Consumable charges
12 Radiological evaluation of collection REVACOL 510 510
13 Radiological evaluation of stent patency REVASTPT 510 510
14 Radiological guidance charges for FNAC / Biopsy (interventional) - RDFNACINT 600 600
Dept Charges
15 Sectioning of pathology specimen under mammography MAMMPATH 1000 1000
16 Specimen Mammography MAMMSM 1500 900
17 Tomosynthesis Charges – Mammography Dept.Charges TOMOMAM 6500 3900
18 Ultrasound guided trucut biopsy breast Multiple ULTRACON 3500 3500
lesions upto three - Additional consumable charges
19 Breast FNAC under Radiological guidance BFNACOS
92
Breast FNAC under Radiological guidance - Radiologist fee BFNACRF
2500 2500
Breast FNAC under Radiological guidance - Radiology Dept. Charges BFNACDF
2500 2500
20 Breast core biopsy under radiological guidance BRBIOS
Breast core biopsy under radiological guidance - Radiologist fee BRBIORF
3000 1800
Breast core biopsy under radiological guidance - Radiology Dept. Charges BRBIOHC 5000 3000
21 Hook wire localisation under radiological guidance HKWLOS
Hook wire localisation under radiological guidance - Radiologist fee HKWLRF 4000 2400
Hook wire localisation under radiological guidance - Radiology Dept. fee HKWLHC
6000 3600
22 Mammography Guided (Stereotactic) trucut breast biospy MAM2BOS
breast Multiple lesions (Upto two)
Mammography Guided (Stereotactic) trucut breast biopsy breast Multiple MAM2BCON
4000 4000
lesions (Upto two) - Basic Consumable charges
Mammography Guided (Stereotactic) trucut breast biospy breast Multiple MAM2BHC 6000 6000
lesions (Upto two) - Hospital Charges
Mammography Guided (Stereotactic) trucut breast biospy breast Multiple MAM2BDF
6000 6000
lesions (Upto two) - Professional Fee
23 Mammography Guided (Stereotactic) trucut breast biospy MAMGBBOS

( Department of Radiology)
Mammography Guided (Stereotactic) trucut breast biospy ( Department of MAMGBBCON
4000 4000
Radiology) - Consumable charges
Mammography Guided (Stereotactic) trucut breast biospy ( Department of MAMGBBHC
4500 4500
Radiology) - Hospital Charges
Mammography Guided (Stereotactic) trucut breast biospy ( Department of MAMGBBPF 4500 4500
Radiology) - Professional Fee
24 Mammography Guided (Stereotactic) Vacuum Assisted MAMMBCOS

Breast Biopsy Diagnostic ( Department of Radiology)
Mammography Guided (Stereotactic) Vacuum Assisted Breast Biopsy MAMMBCON 18000 18000
Diagnostic ( Department of Radiology) - Consumable charges
Mammography Guided (Stereotactic) Vacuum Assisted Breast Biopsy MAMMBBHC
6000 6000
Diagnostic ( Department of Radiology) - Hospital Charges
Mammography Guided (Stereotactic) Vacuum Assisted Breast Biopsy MAMMBBDF
6000 6000
Diagnostic ( Department of Radiology) - Professional Fee
25 Breast Tomosynthesis (3D Mammography) - Left Breast only MAMMBT3DLOS

Breast Tomosynthesis (3D Mammography) - Left Breast only MAMMBT3DL 3250 1950
Breast Ultrasound ( Mammography ) BRULTMAM
26 Breast Tomosynthesis ( 3D Mammography ) - Bilateral MAMMBT3DOS

Breast Tomosynthesis (3D Mammography) MAMMBT3D
6500 3900
27 Breast Tomosynthesis (3D Mammography) - Right Breast only MAMMBT3DROS

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

Mammography (bilateral) ( Xray dept charges ) MAMMOP 3750 2250
29 Mammography guided (Stereotactic) trucut breast biopsy MAMMOBOPOS
(Gun procured from pharmacy / outside)
Mammography guided (Stereotactic) trucut breast biopsy (Gun procured MAMMOBOCC
500 500
from pharmacy / outside) - Consumable charges
Mammography guided (Stereotactic) trucut breast biopsy (Gun procured MAMMOBOHC
4500 4500
from pharmacy / outside) - Hospital Charges
Mammography guided (Stereotactic) trucut breast biopsy (Gun procured MAMMOBOPF
4500 4500
from pharmacy / outside) - Professional Fee
30 Mammography ( Left ) MAMMOLTOS

Mammography ( Left ) ( Xray dept charges ) MAMMOPL
1850 1100
31 Mammography guided (Stereotactic) trucut biopsy breast MAMMOMULOS
Multiple lesions (Upto two)- (Gun procured from pharmacy / outside)
Mammography guided (Stereotactic) trucut biopsy breast Multiple lesions MAMMOMULCC
500 500
(Upto two)- (Gun procured from pharmacy / outside) - Consumable charges
Mammography guided (Stereotactic) trucut biopsy breast Multiple lesions MAMMOMULHC
6000 6000
(Upto two)- (Gun procured from pharmacy / outside) - Hospital Charges
Mammography guided (Stereotactic) trucut biopsy breast Multiple lesions MAMMOMULPF
6000 6000
(Upto two)- (Gun procured from pharmacy / outside) - Professional Fee
93
32 Mammography ( Right ) MAMMORTOS
Mammography (R) ( Xray dept charges ) MAMMOPR 1850 1100
33 Mammography Guided (Stereotactic) FNAC breast (Department of MAMOFNACOS
Radiology)
Mammography Guided (Stereotactic) FNAC breast (Department of MAMOFNACCON
1500 1500
Radiology) - Consumable charges
Mammography Guided (Stereotactic) FNAC breast (Department of MAMOFNACHC 4000 4000
Mammography Guided (Stereotactic) FNAC breast (Department of MAMOFNACDF
4000 4000
Radiology) - Professional Fee
34 Radiological skin marking for lesion RAFSMAROS

Radiological skin marking for lesion - Radiologist fee RAFSMARDF
2000 1200
Radiological skin marking for lesion - Radiology Dept. Charges RAFSMARHC 2000 1200
35 Radiological skin marking for lesion in OT RAFSMOTOS
Radiological skin marking for lesion in OT - Radiologist fee RAFSMOTDF
4000 2400
Radiological skin marking for lesion in OT - Radiology Dept. Charges RAFSMOTHC 4000 2400
36 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
530 530
interventional) - Radiologist fee
37 Radiological guidance charges for FNAC / Biopsy (interventional) RDFNACINTOS

Radiological guidance charges for FNAC / Biopsy ( interventional) – Dept Charges RDFNACINT
600 600
Radiological guidance charges for FNAC / Biopsy ( interventional) - Radiologist Fee RDFNACINTRF
530 530
Respiratory & Chest Medicine Lab Charges

CAT 1/CAT2 CAT3
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 test charges

CAT 1/CAT2 CAT3
1 Complete Urodynamic Study ( Uroflowmetery , UROCOMPLETE 4500 2700
Cystometrography and EMG )
2 Dorsal Slit URODOSL 6000 3600
3 Electromyography ( EMG ) urinary sphincter EMGU 1000 600
4 FNAC of Testis/Epididymis/any solid mass UROFNAMA 3000 1800
5 Paraphimosis reduction Procedure UROPRP 3000 1800
6 Urethral profile pressure ( UPP ) UPP 2000 1200
7 Uroflowmetery ( UFM ) UFM 1000 600
9 Water cystometrography ( CMG ) CMG 2500 1500
10 Water cystometrography ( CMG ) with Electrmyography ( EMG ) WATCYST 3500 2100
94
URODYNAMICS PROCEDURES
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1 CATHMOS Catheterization with instillation of any
medicine -Urodynamics
CATHMHC Catheterization with instillation of any 700 700 350 280 210 350 2270
medicine - Hospital Charges
CATHMDF Catheterization with instillation of any 6860 6860 3430 2740 2060 3430
medicine - Procedure Charges
2 CATHOS Catheterization - Urodynamics
CATHHC Catheterization - Hospital Charges 500 500 250 200 150 250 1640
CATHDF Catheterization - Procedure Charges 4960 4960 2480 1980 1490 2480
3 CESOS Cyst Excision - Urodynamics
CESHC Cyst Excision - Hospital Charges 960 960 480 380 290 480 3150
CESDF Cyst Excision - Procedure Charges 9540 9540 4770 3820 2860 4770
4 DMAJOS Dressing Major – Urodynamics
DMAJHC Dressing Major - Hospital Charges 380 380 190 150 110 190 1260
DMAJDF Dressing Major - Procedure Charges 3820 3820 1910 1530 1150 1910
5 DMOS Dressing Minor – Urodynamics
DMINHC Dressing Minor - Hospital Charges 180 180 90 70 50 90 630
DMDF Dressing Minor - Procedure Charges 1920 1920 960 770 580 960
6 FREOS Frenuloplasty - Urodynamics
FREHC Frenuloplasty - Hospital Charges 760 760 380 300 230 380 2520
FREDF Frenuloplasty - Procedure Charges 7640 7640 3820 3060 2290 3820
7 NSBWOS Bladder wash with catheter
removal - Urodynamics
BWHC Bladder wash with catheter removal -Hospital Charges 380 380 190 150 110 190 1260
NSBWDF Bladder wash with catheter removal - 3820 3820 1910 1530 1150 1910
Procedure Charges
8 PBIOOS Prostate Biopsy - Urodynamics
PBIOHC Prostate Biopsy - Hospital Charges 960 960 480 380 290 480 3150
PBIODF Prostate Biopsy - Procedure Charges 9540 9540 4770 3820 2860 4770
9 SUPBIOOS Superficial Biopsy - Urodynamics
SUPBIOHC Superficial Biopsy - Hospital Charges 700 700 350 280 210 350 2270
SUPBIODF Superficial Biopsy - Procedure Charges 6860 6860 3430 2740 2060 3430
10 TBIOOS Testicular Biopsy -Urodynamics
TBIOHC Testicular Biopsy - Hospital Charges 1160 1160 580 460 350 580 3780
TBIODF Testicular Biopsy - Procedure Charges 11440 11440 5720 4580 3430 5720
11 UDILOS Urethral Dilatation -Urodynamics
UDILHC Urethral Dilatation - Hospital Charges 960 960 480 380 290 490 3280
UDILDF Urethral Dilatation - Procedure Charges 9540 9540 4770 3820 2860 4970
12 UROSPCO S SPC - Urodynamics
UROSPCHC SPC - Hospital Charges 2000 2000 1000 800 600 1000 6550
UROSPHC SPC - Procedure Charges 19840 19840 9920 7940 5950 9920
13 UROTESA OS Tesa - Urodynamics
UROTESA Tesa - Hospital Charges 980 980 490 390 290 490 3280
UROTESADF Tesa - Procedure Charges 9940 9940 4970 3980 2980 4970
95
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 (Anaesthetists 3890
Charges )
2 ABJMOTAC Alveolectomy(Both jaws) For Minor OT (Anaesthetists Charges) 2430
3 ASJNMOTAC Alveolectomy (one jaws) For Minor OT (Anaesthetists Charges ) 1370
4 ALPMOTAC Alveoloplasty For Minor OT ( Anaesthetists Charges) 1350
5 ALPDMANCH Anaesthetists charges for Argon laser photocoagulation (single 690
sitting ) for diabetic maculopathy - Doctor fees
6 CRDFICGANCH Anaesthetists charges for Combined retinal digital fluorescein & 670
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 photocoagulation - Doctor fees 700
11 ANDLANA Anal Dilatation For Minor OT ( Anaesthetists Charges ) 910
12 ABLDAF Angiography of B/L Dorsolumbar Spinal Radicular 14560 7280 5820 4370
Arteries - Anasthetist fee
13 AULAC Apicectomy (Under LA) For Minor OT (Anaesthetists Charges ) 1940
14 AFDFAC Archbar fixation dentoalveolar fracture segment 1460
For Minor OT ( Anaesthetists Charges )
15 BASCAN Balloon Angioplasty & Stenting in Cervical 43660 21830 17460 13100
ICA/Vertebral - Anasthetist Fee
16 BACEDAN Balloon Assisted Coil Embolization of a 48520 24260 19410 14560
Direct/Indirect Cavernous Fistula - Anasthetist fee
17 BAVAC Brachio AV fistula at elbow for hemodialysis - 2540
Anaesthetists Charges
18 CSTLACSMF Cataract Surgery MULTIFOCAL TORIC LENS - 3170
Anaesthetist Charges
19 CSTLACSY Cataract Surgery SYMFONY LENS – Anaesthetist Charges 3970
20 CSTLACSYT Cataract Surgery SYMFONY TORIC LENS -Anaesthetist Charges 4370
21 CTZANA Catheterization For Minor OT ( Anaesthetists Charges ) 550
22 CIRETDAC Caval Interruption using retrievable device - Doctor 15960 7980 6380 3990
Anaesthesia Charges
23 CMRMOTSF Chemoport Removal For Minor OT – Anaesthetists charges 2210
24 CCMANA Circumcision For Minor OT ( Anaesthetists Charges) 1640
25 COMREAF Complex Fistula Closure For Minor OT -Anaesthetists charges 3060
26 CARAVFAC Conversion of arteriovenous (AV) shunt to 2540
arteriovenous (AV) fistula - Anaesthetists Charges
27 CAREVFBAC Creation of arteriovenous (AV) Fistula at elbow(Brachial artery) 3210
- Anaesthetists Charges
28 CAREVFWBAC Creation of arteriovenous (AV) Fistula at wrist (Radial Artery ) - 3210
Anaesthetists Charges
29 CAREVFAC Creation of arteriovenous (AV) Fistula at axillary 3210
artery - Anaesthetists Charges
30 CMPANGA CT/MRI/PET ( Anaesthesia Charges ) - GA 5000
31 CMPANGANE W CT/MRI/PET ( Anaesthesia Charges ) - High risk patient 7500
32 CMPANSB CT/MRI/PET ( Anaesthesia Charges ) - Standby 2500
33 DENIMPAC Dental Implant (first stage) For Minor OT (Anaesthetists Charges ) 9680
34 DNTANSB Dental OPD ( Anaesthesia Charges ) - GA 5000
35 DOPDANSB Dental OPD ( Anaesthesia Charges ) - Standby 2500
36 DBFMNA Diagnostic Bronchoscopy For Minor OT (Anaesthetists Charges ) 2030
37 DBWBNA Diagnostic Bronchoscopy with Biopsy (Anaesthetists Charges ) 2950
38 DISTMJAC Dislocation of TMJ For Minor OT ( Anaesthetists Charges ) 1220
39 DOSANA Dorsal Slit For Minor OT ( Anaesthetists Charges ) 1280
40 DREMA Dressing (minor) For Minor OT ( Anaesthetists Charges ) 550
96
41 DCDRA Dressing change/drain removal For Minor OT(Anaesthetists 460
Charges)
42 ELRBA Ear lobe repair BL For Minor OT ( Anaesthetists Charges ) 1090
43 ELRUA Ear lobe repair UL For Minor OT ( Anaesthetists Charges ) 740
44 ESPFDNA Embolization of Spinal Pial/dural Fistula -Anasthetist fee 48520 24260 19410 14560
45 IVFERABIOAC Embryo transfer under anesthesia/ERA/Endometrial Biopsy 1500
under anesthesia (PVT.OPD & Gen OPD) – Anesthesia Charges
46 ENDOBYAC Endoluminal bypass - Doctor Anaesthesia Charges 15960 7980 6380 3990
47 ANAANAF Endoscopy submucosal dissection – Anaesthetists Fee 56230 28110 22490 16870
48 EXPFAC Excision of pericoronal flap For Minor OT (Anaesthetists Charges ) 960
49 EXBIMAC Excisional biospy For Minor OT ( Anaesthetists Charges ) 1460
50 EYENANSB Eye / ENT OPD ( Anaesthesia Charges ) - Standby 2500
51 FLDIMTAC Flap Division and Inset For Minor OT ( Anaesthetists Charges) 3130
52 FLMTAC Flap Large For Minor OT ( Anaesthetists Charges ) 5210
53 FSMTAC Flap Small For Minor OT ( Anaesthetists Charge) 4350
54 FSBQAC Flap surgery with bone graft (per quadrant) For 1940
Minor OT ( Anaesthetists Charges )
55 FDPIANA Flow Divertor Placement for Intracranial Aneurysm 58220 29110 23290 17470
- Anasthetist fee
56 FOASA Foam Sclerotherapy For Minor OT ( Anaesthetists Charges ) 3640
57 FLAMOTAC Fracture mandible open reduction under LA (Cost of plates & 7270
screws etc.) For Minor OT (Anaesthetists Charges )
58 FRMOTAC Frenectomy For Minor OT ( Anaesthetists Charges ) 1040
59 FNPANA Frenuloplasty For Minor OT ( Anaesthetists Charges) 820
60 GASPROPOEM Gastroenterology Procedures Poem – Anasthetist Fee 59040 29520 23620 17710
61 GINPMOTAC Gingivoplasty For Minor OT ( Anaesthetists Charges ) 1460
62 HYBAC Hybrid Procedure- Anaesthetist Charge 24650 23870 19950 16030
63 ICCPLNA ICD insertion for complex effusion/pneumothorax 2030
64 ICDSMNA ICD insertion for simple effusion/pneumothorax 870
65 IBSMOTAC Impaction (Bony/soft tissue) For Minor OT (Anaesthetists 2740
Charges )
66 ICVADPAC Implantable Central Venous Access Device 5000 2500 2010 1250
Placement - Doctor Anaesthesia Charges
67 INDMOTAC Incision and drainage For Minor OT( Anaesthetists Charges ) 970
68 IDLANA Incision and Drainage of Multiple/ Large Superficial 1460
Abscess For Minor OT ( Anaesthetists Charges )
69 IDSANA Incision And Drainage of Small/Superficial Abscess 740
70 IMFMOTAC Inter - Maxillary fixation with archbar For Minor 3390
OT( Anaesthetists Charges )
71 IAVDNA Intracranial Angioplasty for Vasaspasm -Anasthetist fee 29100 14550 11640 8730
72 IVMECNA Intracranial AVM Embolization (Complex) -Anasthetist fee 58220 29110 23290 17470
73 IAELNA Intracranial AVM Embolization using Liquid Embolic 48520 24260 19410 14560
material - Anasthetist fee
74 ISRNA Intracranial Stenting in Stroke Revascularization -Anasthetist fee 48520 24260 19410 14560
75 JFMOTAC Jaw fracture closed reduction For Minor OT(Anaesthetists Charges ) 3890
76 KTPSA KTP Surcharge - Anasthesist fee 2920
77 LIVHIAF Liver Transplant High - Anaesthetist Charges 105000
78 LIVTANF Liver Transplant Low - Anaesthetist Charges 75000
79 LINNRAF Liver Transplant Normal Risk - Anaesthetist Charges 90000
80 MTANA Meatotomy For Minor OT ( Anaesthetists Charges ) 770
81 MINIMPAC Mini implant for anchorage (per implant) For Minor 2910
OT ( Anaesthetists Charges )
82 MINDA Minor debridement For Minor OT ( Anaesthetists Charges ) 910
83 NEDLAA Needle aspiration For Minor OT (Anaesthetists Charges ) 460
84 NERBLAC Nerve block in Neuralgias For Minor OT(Anaesthetists Charges ) 1460
85 ORANCAC Oro antral communication closure For Minor OT (Anaesthetists Charges) 6780
86 PTBANA Prostatic Trucut Biopsy For Minor OT (Anaesthetists Charges ) 740
97
87 RFCHTVOAC Recanalization for Chronic Total Vascular Occlusion 13970 6990 5590 3500
- Doctor Anaesthesia Charges
88 RIOHAN Reduction of Irreducible Obstructed Hernia For 4560
89 RSPANA Reduction of Stomal Prolapsed For Minor OT (Anaesthetists Charges ) 2740
90 RATMOTAC Reimplantation of avulsed tooth For Minor OT(Anaesthetists Charges ) 1280
91 RCIDAC Removal of Caval Interruption Device – Doctor Anaesthesia Charges 5990 3000 2400 1500
92 RPMLAAC Removal of plates of mandible and maxilla (Under 3890
LA) For Minor OT( Anaesthetists Charges )
93 SCMOTAC Scaling full mouth For Minor OT ( Anaesthetists Charges ) 1040
94 SSFTNA Secondary Suturing For Minor OT ( Anaesthetists Charges ) 1160
95 SVCAAC Six Vessel Cerabral Angiogram - Anasthetist Fee 12140 6070 4860 3640
96 SKGMTAC Skin Grafting For Minor OT ( Anaesthetists Charges) 3480
97 SMSKGRAA Small Skin Grafting For Minor OT ( Anaesthetists Charges ) 3480
98 STSEA Soft tissue swelling excision for Minor OT (Anaesthetists Charges ) 2550
99 SPTCANA SPC (Suprapubic Trocar Cystostomy) For Minor OT 2090
(Anaesthetists Charges )
100 SPREMOTAC Splint Removal For Minor OT ( Anaesthetists Charges ) 640
101 SACEAN Stent Assisted Coil Embolization of Intracranial ICA 48520 24260 19410 14560
Aneurysm - Anasthetist fee
102 SUBCURAC Subgingival scaling & curretage full mouth For 1460
Minor OT (Anaesthetists Charges)
103 SUEXTAC Surgical extraction of tooth For Minor OT (Anaesthetists Charges) 1450
104 SUTREA Suture removal For Minor OT (Anaesthetists Charges) 460
105 SMLANA Suturing of Medium Lacerations (Large) For Minor 2550
106 SSLANA Suturing of Small Lacerations For Minor OT (Anaesthetists Charges ) 1460
107 TCBANA Teslicular Biopsy For Minor OT ( Anaesthetists Charges ) 1090
108 THHYD Therapeutic Hypothermia for 24-48 hrs – Doctor Fee 20000 10000 8000 6000
109 TUEXAC Tumour Excision For Minor OT (Anaesthetists Charges) 4840
110 URCANA Uretheral Catheterization For Minor OT (Anaesthetists Charges) 550
111 URDLA Urethral dilatation For Minor OT (Anaesthetists Charges) 910
112 VAMSNA VAC Application For Minor OT ( Anaesthetists Charges ) 580
113 VENSAPBAC Venography guided laser assisted saphenous vein 17460 8740 6990 4370
closure (B/L) - Doctor Anaesthesia Charges
114 VENSAPAC Venography guided laser assisted saphenous vein 13970 6990 5590 3500
closure (U/L) - Doctor Anaesthesia Charges
115 YSBAN Y-Stenting in a Basilar Top Aneurysm – Anasthetist fee 58220 29110 23290 17470
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
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
98
19 DGRAFTL Cat- 1 - Autograft Large 48000 48000
20 DGRAFTM Cat- 1 - Autograft Medium 36000 36000
21 DGRAFTS Cat- 1 - Autograft Small 24000 24000
22 DBP-1 Cat- 1 - Bite plate 4400 2940
23 DBT-1 Cat- 1 - Bleaching of teeth 7330 7330
24 DCPD-1 Cat- 1 - Cast partial dentures (metal casting) 8790 6600
25 CSPT-1 Cat- 1 - Cavity sealant (per tooth) 940 940
26 DCFMC-1 Cat- 1 - Ceramic Fused to Metal Crown 15000 15000
27 CCPV-1 Cat- 1 - Chemical cauterisation (per visit) 750 590
28 DCULAR-1 Cat- 1 - Closure of upper & lower anterior spaces + retainers 27820 17580
29 DENCDUL-1 Cat- 1 - Complete denture upper and lower (both) 17580 13180
30 DENCDUOL-1 Cat- 1 - Complete denture upper or lower (either one) 8790 7330
31 DSFMOUL Cat- 1 - Complete Scaling Lower Arch 2200
32 DSFMOUU Cat- 1 - Complete Scaling Upper Arch 2200
33 DCFILL-1 Cat- 1 - Composite filling 2200 2000
34 DCOSFILL-1 Cat- 1 - Cosmetic Filling 3000 3000
35 DCBC-1 Cat- 1 - Crown / Bridge per unit (ceramic) 6600 5140
36 DCBM-1 Cat- 1 - Crown / Bridge per unit (metal) 4400 2940
37 DCBP-1 Cat- 1 - Crown / Bridge per unit (Procera) 19970
38 DCURRE-1 Cat- 1 - Curettage (per quadrant) 3660 1330
39 DCYSTMAR-1 Cat- 1 - Cyst Enucleation / Marsupialisation 11720 5850
40 DDIFS-1-C Cat- 1 - Dental implant ( complete ) 66550 48400
41 DDIFS-1 Cat- 1 - Dental implant (first stage) 29280 11720
42 DDIMP2-1 Cat- 1 - Dental implant (second stage) 14640 10250
43 DIWC Cat- 1 - Dental Implant with Crown 66550
44 DDTMJ-1 Cat- 1 - Dislocation of TMJ 3660 3030
45 DENEMAX1 Cat- 1 - E-Max Crown 15000 10000
46 DENMELPLASTY Cat- 1 - Enameloplasty 1500 1000
47 DEPF-1 Cat- 1 - Excision of pericoronal flap 1460 1460
48 DEB-1 Cat- 1 - Excisional biopsy 4390 2340
49 DRPTO-1 Cat- 1 - Extraction (per tooth) 740 590
50 DEFDTO-1 Cat- 1 - Extraction of fractured / decayed tooth 1460 880
51 DFCS-1 Cat- 1 - Fabrication of Circummandibular splint 5860 4840
52 DFMASK-1 Cat- 1 - Face mask 10250 9530
53 DFAGI-1 Cat- 1 - Filling amalgam / Glass ionomer 2240 1600
54 DFFOCJ-1 Cat- 1 - Fixed Functional Appliance for Orthopedic correction of JAW 43920
55 DFOCERN-1 Cat- 1 - Fixed Orthodontics ( Ceramic Braces ) – First installment 21970 14640
56 DFOCERS-1 Cat- 1 - Fixed Orthodontics ( Ceramic Braces ) - Subsequent installment 2940 2570
57 DFOCER-1 Cat- 1 - Fixed orthodontics (ceramic braces) - Full amount 51250 49670
58 DFOSSN-1 Cat- 1 - Fixed orthodontics (steel braces) - First installment 14640 14640
59 DFOSS-1 Cat- 1 - Fixed orthodontics (steel braces) - Full amount 39930 36610
60 DFOSSS-1 Cat- 1 - Fixed orthodontics (steel braces) – Subsequent installment 2570 2210
61 DFRLB-1 Cat- 1 - Fixed Retainers ( Lingual Bonded ) 7330
62 DFOPFM-1 Cat- 1 - Flap operation (full mouth) 14640 13180
63 DFOPQ-1 Cat- 1 - Flap operation (per quadrant) 4390 3660
64 DFSBG-1 Cat- 1 - Flap surgery with bone graft (per quadrant) 5850 5850
65 DFAPP-1 Cat- 1 - Fluoride application 1180 1180
66 DFMORLA-1 Cat- 1 - Fracture mandible open reduction under LA ( Cost 21970 18150
of Plates & screws etc. )
67 DFRENE-1 Cat- 1 - Frenectomy 2200 1180
68 DGTOMY-1 Cat- 1 - Gingivectomy (per quadrant) 3660 2930
69 DGPLASTY-1 Cat- 1 - Gingivoplasty (per quadrant) 4390 3660
70 DHBA-1 Cat- 1 - Habit Breaking appliance 8790
71 DIMPACT-1 Cat- 1 - Impaction (Bony / soft tissue) 7330 6660
99
72 DIPW-1 Cat- 1 - Implant Prosthetic work up Stage 2 and Stage 3 35000 25000
73 DIDRAIN-1 Cat- 1 - Incision and drainage 2930 2340
74 DIBIOP-1 Cat- 1 - Incisional biopsy 2200 1180
75 DIMFA-1 Cat- 1 - Inter - maxillary fixation with archbar 10250 8790
76 DIWSPIL-1 Cat- 1 - Interdental wiring + splinting (per quadrant) 4390 4390
77 DIAINJ-1 Cat- 1 - Intra articular injection 1180 1180
78 DIFF-1 Cat- 1 - Iodoform Dressing for CYST 590 530
79 DJFCR-1 Cat- 1 - Jaw fracture closed reduction 11720 10990
80 DLFREN-1 Cat- 1 - Lingual frenectomy 2200 1770
81 DENCDULL-1 Cat- 1 - Lucitone Denture 24630 24630
82 DMJOD Cat- 1 - Major Oral Dressing 6000 6000
83 DENMCR-1 Cat- 1 - Metal Ceramic Crown 10000
84 DMFCC-1 Cat- 1 - Metal free ceramic crown 10250 8790
85 DMIA-1 Cat- 1 - Mini - implant for anchorage (per implant) 8790 7330
86 DMNOD Cat- 1 - Minor Oral Dressing 3200 3200
87 DENMONO-1 Cat- 1 - Monolith Crown 25000
88 DMFA-1 Cat- 1 - Myfunctional Appliance - Twin Block 9080 7260
89 DNBN-1 Cat- 1 - Nerve block in Neuralgias 4390 3630
90 DOBTU-1 Cat- 1 - Obturators 11720 10990
91 DOPER-1 Cat- 1 - Operculectomy 1460 1460
92 DOACC-1 Cat- 1 - Oro antral communication closure 20490
93 DPDAC-1 Cat- 1 - Partial dentures (acrylic) 2940 2660
94 DATD-1 Cat- 1 - per additional tooth in denture 750 590
95 DPIOSMF-1 Cat- 1 - Placentrax Inj for OSMF 1180
96 DPOS-1 Cat- 1 - Planning Orthognathic Surgery 7870 7260
97 DPLCENE-1 Cat- 1 - Porcelain laminate veneers 5860 5140
98 DPPSOCPN-1 Cat- 1 - Pre & post surgical orthodontics for cleft palate -First installment 17580 14640
99 DPPSOCP-1 Cat- 1 - Pre & post surgical orthodontics for cleft palate -Full amount 32220 29280
100 DPPSOCPS-1 Cat- 1 - Pre & post surgical orthodontics for cleft palate -Subsequent installment 1470 3670
101 DPSOSN-1 Cat- 1 - Pre & post surgical orthodontics for orthognathic 23430 20500
surgery - First installment
102 DPSOS-1 Cat- 1 - Pre & post surgical orthodontics for orthognathic 36610 41000
surgery - Full amount
103 DPSOSS-1 Cat- 1 - Pre & post surgical orthodontics for orthognathic 2210 2570
surgery - Subsequent installment
104 DPUCAP-1 Cat- 1 - Pulp capping 2240 1330
105 DPULPO-1 Cat- 1 - Pulpotomy 1460 1460
106 DRME-1 Cat- 1 - Rapid maxillary expansion ( RME ) 10250 9530
107 DRCB-1 Cat- 1 - Recementation of crown / bridge 890 590
108 DRAT-1 Cat- 1 - Reimplantation of avulsed tooth 2930 2930
109 DREDENT-1 Cat- 1 - Relining of denture 890 890
110 DRORTHON-1 Cat- 1 - Removable orthodontics - First installment 14640 14640
111 DRORTHO-1 Cat- 1 - Removable orthodontics - Full amount 23430 23430
112 DRORTHOS-1 Cat- 1 - Removable orthodontics - Subsequent installment 1470 1470
113 DRFW-1 Cat- 1 - Removal of Frontosuspension wiring 5850
114 DROCBU-1 Cat- 1 - Removal of old crown/bridge/unit 740
115 DRPMMLA-1 Cat- 1 - Removal of plates of mandible and maxilla ( Under LA ) 11720
116 DRDENT-1 Cat- 1 - Repair of dentures 890 530
117 DRRBA-1 Cat- 1 - Retainers replacement (both arches) 2940 2210
118 DRRPA-1 Cat- 1 - Retainers replacement (per arch) 1470 1110
119 DRCTANT-1 Cat- 1 - Root canal treatment ( RCT ) - anterior 3660 2930
120 DRCTPOS-1 Cat- 1 - Root canal treatment ( RCT ) - posterior 5850 3990
121 DRCAPIC-1 Cat- 1 - Root canal with Apicectomy 7330 5850
122 DSFMOU-1 Cat- 1 - Scaling full mouth 2200 2000
123 DSMEA-1 Cat- 1 - Slow Maxillary Expansion Appliance 7330
100
124 DSMAINT-1 Cat- 1 - Space maintainers 3670 3670
125 DSMODEL-1 Cat- 1 - Study model 450 390
126 DSSCFM-1 Cat- 1 - Subgingival scaling & curretage full mouth 4390 3660
127 DSETO-1 Cat- 1 - Surgical extraction of tooth 2930 2930
128 DSREMO-1 Cat- 1 - Suture removal 1460 1030
129 DENTEMP-1 Cat- 1 - Temporarization Placement of Permanent Crown 1500 1000
130 DTMJP-1 Cat- 1 - TMJ Physiotherapy 750
131 DTINLY-1 Cat- 1 - Tooth inlay 2210 2210
132 DTEXCI-1 Cat- 1 - Tumour excision 14640 8790
133 DVOSPL-1 Cat- 1 - Vacuum formed occlusal splint 4400 3670
134 FPD3 Cat- 1 - Velaplast (Flexible Partial Dentures)- Upto 3 10000 7000
missing teeth to be replaced
135 FPD6 Cat- 1 - Velaplast (Flexible Partial Dentures) - Upto 6 15000 12000
136 FPD9 Cat- 1 - Velaplast (Flexible Partial Dentures) - Upto or 18000 15000
more than 9 missing teeth to be replaced
137 DZCFULA-1 Cat- 1 - Zygonatic Complex Fracture under LA 14640
138 DACR-1 Cat- 1-Acrylic Crown 5000 3000
139 DAGFTPU-1 Cat- 1-Allograft Per Unit 15000
140 DAPISURS-1 Cat- 1-Apical Surgery for tooth preservation subsequent tooth 3000 1500
141 DBPEX-1 Cat- 1-Bone Preserving Dental Extraction 5000 3000

142 DCAEX-1 Cat- 1-Canine Exposure 12500 10000
143 DCERON-1 Cat- 1-Ceramic Onlay 20000 15000
144 COSINVISCB-1 Cat- 1-Clear Aligners Complicated Both 350000
145 COSINVISCS-1 Cat- 1-Clear Aligners Complicated Single 200000
146 COSINVISSB-1 Cat- 1-Clear Aligners Simple Both 175000
147 COSINVISSS-1 Cat- 1-Clear Aligners Simple Single 150000
148 DREBOND-1 Cat- 1-Crown Rebonding 3000 2750
149 DRECEM-1 Cat- 1-Crown Recementation 1500 750
150 CUTOCR-1 Cat- 1-Cutting Out Old Crown 2500 1750
151 DISTASG-1 Cat- 1-Deep Impaction 15000 10000
152 DEMAXV-1 Cat- 1-E Max Veneer/ Crown 25000 20000
153 DFLAP-1 Cat- 1-Flap Surgery per Segment 5000 3500
154 DLASE-1 Cat- 1-Laser Surgery 12500
155 DMEMBL-1 Cat- 1-Membrane Large 20000
156 DMEMBM-1 Cat- 1-Membrane Medium 15000
157 DMEMBS-1 Cat- 1-Membrane Small 10000
158 DLPDEN3-1 Cat- 1-Partial Denture Lucitone upto 3 Teeth 8500 6500
161 DPIEZ-1 Cat- 1-Piezo Surgery 12500
162 DPOST-1 Cat- 1-Post and Core 3000 2000
163 DRISATS-1 Cat- 1-Reimplantation and Cosmetic splinting of Avulsed Subsequent Tooth 5500 2500
164 DRISAT-1 Cat- 1-Reimplantation and Cosmetic splinting of Avulsed Tooth 15000 12500
165 SIRCT-1 Cat- 1-Single Sitting RCT 10000

166 DTAC-1 Cat- 1-Tacs 1500
167 DITEX4F-1 Cat- 1-Teeth Express on 4 Implants First Stage Per Arch 150000 130000
168 DITEX4S-1 Cat- 1-Teeth Express on 4 Implants Second Stage Per Arch 150000 130000
169 DITEX6F-1 Cat- 1-Teeth Express on 6 Implants First Stage Per Arch 200000 175000
170 DITEX6S-1 Cat- 1-Teeth Express on 6 Implants Second Stage Per Arch 250000 225000
101
171 DIMPLL-II Cat- 2 - Implant Laser Lok 46550
172 DORTHTR-1 Cat-1-Orthodontic Trainer 12000 10000
173 PITFISRE-1 Cat-1-Pit and Fissure Sealant 1800 1500
174 CLEGNESD Clear Aligners Double 150000
175 CLEGNES Clear Aligners Single 120000
176 CULHIDR Complete ( U / L ) Hybrid Implant Dentures 75000 75000
177 CDWPLA Complete Denture With Implant Location 225000 225000
178 DLOSJA Denture with Implant Locators / Single Jaw 130000 130000
179 DSLLPA Direct Sinus Lift For Implant Placement 250000 250000
180 DRVGRAD DRVG - Dental Radiovision Graphy 250 150
181 GRAPC Graft ( Per CC ) 7000 7000
182 HYIDRS Hybrid Implant Dentures / Single Jaw 375000 375000
183 IMCTDISG Impaction ( Distoangular ) 10000 10000
184 ISLFTP Indirect Sinus Lift For Implant Placement 10000 10000
185 LACLASRE LANAP (Laser Assisted New Attachment Procedure) – per quadrant 7500 4500
186 LACAEX Laser Canine Exposure 5000 3500
187 LACROQUA Laser Crown Lengthening (per Quadrant) 7500 5000
188 LACROLE Laser Crown Lengthening (per Tooth) 2000 2000
189 LASDISMO Laser Disinfection ( Full Mouth ) 10000 7500
190 LAFRETO Laser Frenectomy 7500 5000
191 LAGITOMX Laser Gingivectomy (per Quadrant) 7500 5000
192 LAGINTH Laser Gingivectomy (per Tooth) 2000 1500
193 LAGUMBLE Laser Gum Bleaching (per Quadrant) 10000 6000
194 LAPHRA Laser Physiotherapy 6 Sittings 5000 3000
195 LASERMAJ Laser Surgery Major 10000 7500
196 LASESUR Laser Surgery Minor 5000 3500
197 LASEFULL Laser Whitening ( Full Mouth ) 20000 15000
198 LASEWHI Laser Whitening (per Tooth) 2000 2000
199 LADC1 Local Anaesthesia Category 1 - Dental 200 150
200 MEFOT Metal Free ONLAY / Tooth 15000 15000
201 PITFISRE Pit and Fissure Sealants (per Tooth) 1800 1500
202 RETNTCT Retreatment RCT 8000 8000
203 SEALICEBA Self Ligating Ceramic Braces 80000 70000
204 SELIBRAS Self Ligating Metal Braces 65000 55000
205 SIRCT Single Sitting RCT 10000 10000
206 SUTREMO Suture Removal For Dental 1000 1000
207 VSTDESJ Valplast Denture / Single Jaw 18000 18000
208 NGA Night Guard Appliance ( Dental )
NGA Cat- 1 - Dental Night Guard Appliance 3670
DENLAB150 Dental Lab Charges Rs - 210 210 210
209 DCERLAM2 Cat- 2 - Ceramic laminate 3600
210 DCOMPVEN2 Cat- 2 - Composite veneers 1550
211 DCOVUCST2 Cat- 2 - Core build up ( casting ) 1550
212 DCOVUPREF2 Cat- 2 - Core build up ( prefab ) 530
213 DSPREMO2 Cat- 2 - Splint Removal 1030
214 DATEXT-2 Cat- 2 - All teeth extractions (both jaws) 6160
215 DABJAW-2 Cat- 2 - Alveolectomy (both jaws) 4100
216 DAOJAW-2 Cat- 2 - Alveolectomy (one jaws) 2060
217 DALVPLS2 Cat- 2- Alveoloplasty 1030
218 DARCT-2 Cat- 2 - Apexification + Root canal treatment ( RCT ) 2060
219 DAPISUR-2 Cat- 2 - Apical Surgery for tooth preservation 11500
220 DAULA-2 Cat- 2 - Apicectomy ( Under LA ) 3090
221 DAPICE-2 Cat- 2 - Apicectomy (Endodontics) 2570
222 DAPAT-2 Cat- 2 - Apicectomy per additional tooth 1030
223 DAFDDS-2 Cat- 2 - Archbar fixation dentoalveolar fracture segment 2060
102
224 DBP-2 Cat- 2 - Bite plate 2060
225 DBT-2 Cat- 2 - Bleaching of teeth 5140
226 DCPD-2 Cat- 2 - Cast partial dentures (metal casting) 4630
227 CSPT-2 Cat- 2 - Cavity sealant (per tooth) 530
228 CCPV-2 Cat- 2 - Chemical cauterisation (per visit) 430
229 DCULAR-2 Cat- 2 - Closure of upper & lower anterior spaces + retainers 12310
230 DENCDUL-2 Cat- 2 - Complete denture upper and lower (both) 9240
231 DENCDUOL-2 Cat- 2 - Complete denture upper or lower (either one) 5140
232 DCFILL-2 Cat- 2 - Composite filling 1030
233 DCBC-2 Cat- 2 - Crown / Bridge per unit (ceramic) 3600
234 DCBM-2 Cat- 2 - Crown / Bridge per unit (metal) 2060
235 DCURRE-2 Cat- 2 - Curettage (per quadrant) 530
236 DCYSTMAR-2 Cat- 2 - Cyst Enucleation / Marsupialisation 4100
237 DDIFS-2-C Cat- 2 - Dental implant ( complete ) 24200
238 DDIFS-2 Cat- 2 - Dental implant (first stage) 8210
239 DDIMP3-2 Cat- 2 - Dental implant (second stage) 7190
240 NGA-2 Cat- 2 - Dental Night Guard Appliance 2570
241 DENMELPLASTY Cat- 2 - Enameloplasty 1500 750
242 DEPF-2 Cat- 2 - Excision of pericoronal flap 1030
243 DEB-2 Cat- 2 - Excisional biopsy 1650
244 DRPTO-2 Cat- 2 - Extraction (per tooth) 430
245 DEFDTO-2 Cat- 2 - Extraction of fractured / decayed tooth 630
246 DFMASK-2 Cat- 2 - Face mask 6680
247 DFAGI-2 Cat- 2 - Filling amalgam / Glass ionomer 530
248 DFOCERN-2 Cat- 2 - Fixed Orthodontics ( Ceramic Braces ) – First installment 11430
249 DFOCERS-2 Cat- 2 - Fixed Orthodontics ( Ceramic Braces ) -Subsequent installment 590
250 DFOCER-2 Cat- 2 - Fixed orthodontics (ceramic braces) - Full amount 35820
251 DFOSSN-2 Cat- 2 - Fixed orthodontics (steel braces) - First installment 11430
252 DFOSS-2 Cat- 2 - Fixed orthodontics (steel braces) - Full amount 24610
253 DFOSSS-2 Cat- 2 - Fixed orthodontics (steel braces) – Subsequent installment 1660
254 DFOPFM-2 Cat- 2 - Flap operation (full mouth) 9240
255 DFOPQ-2 Cat- 2 - Flap operation (per quadrant) 2570
256 DFSBG-2 Cat- 2 - Flap surgery with bone graft (per quadrant) 4100
257 DFAPP-2 Cat- 2 - Fluoride application 830
258 DFRENE-2 Cat- 2 - Frenectomy 830
259 DGTOMY-2 Cat- 2 - Gingivectomy (per quadrant) 2060
260 DGPLASTY-2 Cat- 2 - Gingivoplasty (per quadrant) 2570
261 DIMPACT-2 Cat- 2 - Impaction (Bony / soft tissue) 3090
262 DIMPCR-II Cat- 2 - Implant Screw Retained Crown 20000
263 DIDRAIN-2 Cat- 2 - Incision and drainage 1650
264 DIBIOP-2 Cat- 2 - Incisional biopsy 830
265 DIMFA-2 Cat- 2 - Inter - maxillary fixation with archbar 6160
266 DIWSPIL-2 Cat- 2 - Interdental wiring + splinting (per quadrant) 3090
267 DIAINJ-2 Cat- 2 - Intra articular injection 830
268 DJFCR-2 Cat- 2 - Jaw fracture closed reduction 7700
269 DLFREN-2 Cat- 2 - Lingual frenectomy 1240
270 DMFCC-2 Cat- 2 - Metal free ceramic crown 6160
271 DMIA-2 Cat- 2 - Mini - implant for anchorage (per implant) 5140
272 DMFA-2 Cat- 2 - Myfunctional Appliance - Twin Block 5450
273 DOBTU-2 Cat- 2 - Obturators 7700
274 DOPER-2 Cat- 2 - Operculectomy 1030
275 DPDAC-2 Cat- 2 - Partial dentures (acrylic) 1550
276 DATD-2 Cat- 2 - per additional tooth in denture 430
277 DPOS-2 Cat- 2 - Planning Orthognathic Surgery 4840
278 DPLCENE-2 Cat- 2 - Porcelain laminate veneers 3600
103
279 DPPSOCPN-2 Cat- 2 - Pre & post surgical orthodontics for cleft palate -First installment 10250
280 DPPSOCP-2 Cat- 2 - Pre & post surgical orthodontics for cleft palate -Full amount 20500
281 DPPSOCPS-2 Cat- 2 - Pre & post surgical orthodontics for cleft palate -Subsequent installment 2570
282 DPSOSN-2 Cat- 2 - Pre & post surgical orthodontics for orthognathic 15530
283 DPSOS-2 Cat- 2 - Pre & post surgical orthodontics for orthognathic 28710
284 DPSOSS-2 Cat- 2 - Pre & post surgical orthodontics for orthognathic 1660
285 DPUCAP-2 Cat- 2 - Pulp capping 530
286 DPULPO-2 Cat- 2 - Pulpotomy 1030
287 DRME-2 Cat- 2 - Rapid maxillary expansion ( RME ) 6680
288 DRCB-2 Cat- 2 - Recementation of crown / bridge 430
289 DRAT-2 Cat- 2 - Reimplantation of avulsed tooth 2060
290 DREDENT-2 Cat- 2 - Relining of denture 630
291 DRORTHON-2 Cat- 2 - Removable orthodontics - First installment 9820
292 DRORTHO-2 Cat- 2 - Removable orthodontics - Full amount 16410
293 DRORTHOS-2 Cat- 2 - Removable orthodontics - Subsequent installment 1110
294 DRDENT-2 Cat- 2 - Repair of dentures 360
295 DRRBA-2 Cat- 2 - Retainers replacement (both arches) 1550
296 DRRPA-2 Cat- 2 - Retainers replacement (per arch) 780
297 DRCTANT-2 Cat- 2 - Root canal treatment ( RCT ) - anterior 1860
298 DRCTPOS-2 Cat- 2 - Root canal treatment ( RCT ) - posterior 2570
299 DRCAPIC-2 Cat- 2 - Root canal with Apicectomy 4100
300 DSFMOU-2 Cat- 2 - Scaling full mouth 530
302 DSMAINT-2 Cat- 2 - Space maintainers 2570
303 DSMODEL-2 Cat- 2 - Study model 280
304 DSSCFM-2 Cat- 2 - Subgingival scaling & curretage full mouth 2570
305 DSETO-2 Cat- 2 - Surgical extraction of tooth 2060
306 DSREMO-2 Cat- 2 - Suture removal 750
307 DENTEMP-2 Cat- 2 - Temporarization Placement of Permanent Crown 750
308 DTINLY-2 Cat- 2 - Tooth inlay 1550
309 DTEXCI-2 Cat- 2 - Tumour excision 6160
310 DVOSPL-2 Cat- 2 - Vacuum formed occlusal splint 2570
311 FPD3-2 Cat- 2 - Velaplast (Flexible Partial Dentures)- Upto 3 4900
312 FPD6-2 Cat- 2 - Velaplast (Flexible Partial Dentures) - Upto 6 8400
313 FPD9-2 Cat- 2 - Velaplast (Flexible Partial Dentures) - Upto or 10500
314 DACR-2 Cat- 2-Acrylic Crown 1650
315 DAPISURS-2 Cat- 2-Apical Surgery for tooth preservation subsequent tooth 750
316 DBPEX-2 Cat- 2-Bone Preserving Dental Extraction 1650
317 DCAEX-2 Cat- 2-Canine Exposure 7500
318 DCERON-2 Cat- 2-Ceramic Onlay 12500
319 DCOSFILL-2 Cat- 2-Cosmetic Filling 2000
320 DREBOND-2 Cat- 2-Crown Rebonding 2500
321 DRECEM-2 Cat- 2-Crown Recementation 550
322 CUTOCR-2 Cat- 2-Cutting Out Old Crown 1550
323 DISTASG-2 Cat- 2-Deep Impaction 7500
324 DEMAXV-2 Cat- 2-E Max Veneer/ Crown 15000
325 DFLAP-2 Cat- 2-Flap Surgery per Segment 2550
326 DORTHTR-2 Cat- 2-Orthodontic Trainer 7500
327 DLPDEN3-2 Cat- 2-Partial Denture Lucitone upto 3 Teeth 5500
104
330 PITFISRE-2 Cat- 2-Pit and Fissure Sealant 1000
331 DPOST-2 Cat- 2-Post and Core 1500
332 DRISATS-2 Cat- 2-Reimplantation and Cosmetic splinting of Avulsed Subsequent Tooth 1550
333 DRISAT-2 Cat- 2-Reimplantation and Cosmetic splinting of Avulsed Tooth 11500
334 DITEX4F-2 Cat- 2-Teeth Express on 4 Implants First Stage Per Arch 125000
335 DITEX4S-2 Cat- 2-Teeth Express on 4 Implants Second Stage Per Arch 125000
336 DITEX6F-2 Cat- 2-Teeth Express on 6 Implants First Stage Per Arch 150000
337 DITEX6S-2 Cat- 2-Teeth Express on 6 Implants Second Stage Per Arch 220000
338 LADC2 Local Anaesthesia Category 2 - Dental 100
339 DCERLAM3 Cat- 3 - Ceramic laminate 1550
340 DCOMPVEN3 Cat- 3 - Composite veneers 670
341 DAPISUR-3 Cat- 3 - Apical Surgery for tooth preservation 900
342 DBP-3 Cat- 3 - Bite plate 890
343 DBT-3 Cat- 3 - Bleaching of teeth 2210
344 DCPD-3 Cat- 3 - Cast partial dentures (metal casting) 1990
345 DCULAR-3 Cat- 3 - Closure of upper & lower anterior spaces + retainers 5280
346 DENCDUL-3 Cat- 3 - Complete denture upper and lower (both) 3960
347 DENCDUOL-3 Cat- 3 - Complete denture upper or lower (either one) 2210
348 DENCOSCL-3 Cat- 3 - Cosmetic Cleaning & Polishing 500
349 DCOSFILL-3 Cat- 3 - Cosmetic Filling 700
350 DCOSPRES-3 Cat- 3 - Cosmetic Preservation of Tooth 900
351 DCBC-3 Cat- 3 - Crown / Bridge per unit (ceramic) 1550
352 DCBM-3 Cat- 3 - Crown / Bridge per unit (metal) 890
353 DDIFS-3 Cat- 3 - Dental implant (first stage) 3510
354 DDIMP4-3 Cat- 3 - Dental implant (second stage) 3090
355 NGA-3 Cat- 3 - Dental Night Guard Appliance 1110
356 DFMASK-3 Cat- 3 - Face mask 2860
357 DFOCERN-3 Cat- 3 - Fixed Orthodontics ( Ceramic Braces ) – First installment 5860
358 DFOCER-3 Cat- 3 - Fixed orthodontics (ceramic braces) - Full amount 15370
359 DFOSSN-3 Cat- 3 - Fixed orthodontics (steel braces) - First installment 5860
360 DFOSS-3 Cat- 3 - Fixed orthodontics (steel braces) - Full amount 10560
361 DFOSSS-3 Cat- 3 - Fixed orthodontics (steel braces) – Subsequent installment 590
362 DMFCC-3 Cat- 3 - Metal free ceramic crown 2640
363 DMIA-3 Cat- 3 - Mini - implant for anchorage (per implant) 2210
364 DMFA-3 Cat- 3 - Myfunctional Appliance - Twin Block 3030
365 DOBTU-3 Cat- 3 - Obturators 3310
366 DPDAC-3 Cat- 3 - Partial dentures (acrylic) 670
367 DATD-3 Cat- 3 - per additional tooth in denture 190
368 DPLCENE-3 Cat- 3 - Porcelain laminate veneers 1550
369 DPPSOCPN-3 Cat- 3 - Pre & post surgical orthodontics for cleft palate -First installment 5860
370 DPPSOCP-3 Cat- 3 - Pre & post surgical orthodontics for cleft palate -Full amount 8790
371 DPPSOCPS-3 Cat- 3 - Pre & post surgical orthodontics for cleft palate - 750
Subsequent installment
372 DPSOSN-3 Cat- 3 - Pre & post surgical orthodontics for orthognathic 7620
373 DPSOS-3 Cat- 3 - Pre & post surgical orthodontics for orthognathic 12310
374 DPSOSS-3 Cat- 3 - Pre & post surgical orthodontics for orthognathic 590
375 DRME-3 Cat- 3 - Rapid maxillary expansion ( RME ) 2860
376 DRCB-3 Cat- 3 - Recementation of crown / bridge 190
377 DREDENT-3 Cat- 3 - Relining of denture 280
378 DRORTHON-3 Cat- 3 - Removable orthodontics - First installment 4400
105
379 DRORTHO-3 Cat- 3 - Removable orthodontics - Full amount 7040
380 DRORTHOS-3 Cat- 3 - Removable orthodontics - Subsequent installment 450
381 DRDENT-3 Cat- 3 - Repair of dentures 170
382 DRRBA-3 Cat- 3 - Retainers replacement (both arches) 670
383 DRRPA-3 Cat- 3 - Retainers replacement (per arch) 340
385 DSMAINT-3 Cat- 3 - Space maintainers 1110
386 DSMODEL-3 Cat- 3 - Study model 120
387 DENTEMP-3 Cat- 3 - Temporarization Placement of Permanent Crown 530
388 DVOSPL-3 Cat- 3 - Vacuum formed occlusal splint 1110
389 FPD3-3 Cat- 3 - Velaplast (Flexible Partial Dentures)- Upto 3 2100
390 FPD6-3 Cat- 3 - Velaplast (Flexible Partial Dentures) - Upto 6 3600
391 FPD9-3 Cat- 3 - Velaplast (Flexible Partial Dentures) - Upto or 4500
392 DACR-3 Cat- 3-Acrylic Crown 1250
393 DAPISURS-3 Cat- 3-Apical Surgery for tooth preservation subsequent tooth 250
394 DBPEX-3 Cat- 3-Bone Preserving Dental Extraction 0
395 DCAEX-3 Cat- 3-Canine Exposure 0
396 DRECEM-3 Cat- 3-Crown Recementation 190
397 CUTOCR-3 Cat- 3-Cutting Out Old Crown 300
398 DEMAXV-3 Cat- 3-E Max Veneer/ Crown 0
399 DEMPLSTY-3 Cat- 3-Enameloplasty 200
403 PITFISRE-3 Cat- 3-Pit and Fissure Sealant 300
404 DPOST-3 Cat- 3-Post and Core 250
405 DRISATS-3 Cat- 3-Reimplantation and Cosmetic splinting of Avulsed Subsequent Tooth 300
406 DRISAT-3 Cat- 3-Reimplantation and Cosmetic splinting of Avulsed Tooth 750
407 LADC3 Local Anaesthesia Category 3 - Dental 70
408 CERBR7000 Ceramic Braces Rs - 10250 10250
409 DENLAB1000 Dental Lab Charges Rs - 1330 1330 1330
415 DENLAB2000 Dental Lab Charges Velaplast Rs - 2300 2300 2300
416 DPROSTH1000 Dental Prosthetics - 1000 1000 1000
106
Dental Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1 BMSDHC BILIARY MICROLITH STUDY (DOCTOR
OS FEE + HOSPITAL CHARGES)
BMSHC Biliary microlith study - Additional hospital charges 6200 6200 3100 2490 1860
BMSDF Biliary microlith study - Doctor fee 17730 17730 8870 7100 5320
BMSHCPACS Biliary microlith study - For PACS - NOT FOR
BILLING PURPOSE
2 CSPTOS Dental - Cavity sealant (per tooth)-
INPATIENT Doctor & Hospital charges
CSPTHC Dental - Cavity sealant (per tooth) – Hospital Charges 180 180 90 70 50
CSPT-1 Dental Category 1 - Cavity sealant (per tooth) 940 940
3 DABJOS Dental - Alveolectomy (both jaws)-
DABJHC Dental - Alveolectomy (both jaws) – Hospital Charges 1470 1470 740 590 440
DABJAW-1 Dental Category 1 - Alveolectomy (both jaws) 7330 5850
4 DAFDOS Dental - Archbar fixation entoalveolar
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
5 DALVOS Dental - Alveoloplasty- INPATIENT
Doctor & Hospital charges
DALVHC Dental - Alveoloplasty - Hospital Charges 460 460 230 190 140
DALVPLS1 Dental Category 1 - Alveoloplasty 2200 1460
6 DAOJOS Dental - Alveolectomy (one jaws)-
DAOJHC Dental - Alveolectomy (one jaws) – Hospital Charges 750 750 370 300 220
DAOJAW-1 Dental Category 1 - Alveolectomy (one jaws) 3660 2930
7 DAPAOS Dental - Apicectomy per
additional tooth- INPATIENT
DAPAHC Dental - Apicectomy per additional tooth - 460 460 230 190 140
Hospital Charges
DAPAT-1 Dental Category 1 - Apicectomy per 2200
additional tooth
8 DAPIOS Dental - Apicectomy
(Endodontics)- INPATIENT
DAPIHC Dental - Apicectomy (Endodontics) – Hospital Charges 1190 1190 590 470 350
DAPICE-1 Dental Category 1 – Apicectomy (Endodontics) 5850 3990
9 DARCOS Dental - Apexification + Root canal
treatment ( RCT )- INPATIENT Doctor &
Hospital 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 )
10 DARTOS Dental - Arthocentesis of TMJ-
DARTHC Dental - Arthocentesis of TMJ – Hospital Charges 1470 1470 740 590 440
DARTMJ-1 Dental Category 1 - Arthocentesis of TMJ 7330 5450
107
11 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)
12 DAULOS Dental - Apicectomy ( Under LA )-
DAULHC Dental - Apicectomy ( Under LA ) – Hospital Charges 1190 1190 590 470 350
DAULA-1 Dental Category 1 - Apicectomy ( Under LA ) 5850 4390
13 DCFIOS Dental - Composite filling- INPATIENT
DCFIHC Dental - Composite filling - Hospital Charges 460 460 230 190 140
DCFILL-1 Dental Category 1 - Composite filling 2200 2000
14 DCUROS Dental - Curettage (per quadrant)-
DCURHC Dental - Curettage (per quadrant) – Hospital Charges 750 750 370 300 220
DCURRE-1 Dental Category 1 - Curettage (per quadrant) 3660 1330
15 DCYSOS Dental - Cyst Enucleation /
Marsupialisation- INPATIENT
DCYSTMAR-1 Dental OPD Category 1 - Cyst Enucleation / 11720 5850
Marsupialisation
16 DDIFCOS Dental - Dental implant (
complete )- INPATIENT Doctor
& Hospital charges
DDIFCHC Dental - Dental implant ( complete ) -Hospital Charges 8780 8780 4390 3510 2630
DDIFS-1-C Dental OPD Category 1 - Dental implant (complete ) 66550 48400
17 DDIFOS Dental - Dental implant (first stage)-
DDIFHC Dental - Dental implant (first stage) -Hospital Charges 5850 5850 2930 2340 1760
DDIFS-1 Dental OPD Category 1 - Dental implant (first stage) 29280 11720
18 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)
19 DDTMOS Dental - Dislocation of TMJ- NPATIENT
DDTMHC Dental - Dislocation of TMJ – Hospital Charges 750 750 370 300 220
DDTMJ-1 Dental Category 1 - Dislocation of TMJ 3660 3030
20 DEB-OS Dental - Excisional biopsy- INPATIENT
DEB-HC Dental - Excisional biopsy - Hospital Charges 900 900 450 360 270
DEB-1 Dental OPD Category 1 - Excisional biopsy 4390 2340
21 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
22 DEIPDHC DENTAL EXTRACTION ( INPATIENT )
DEAHC Dental extraction ( inpatient ) - Additional 130 130 70 60 40
hospital charges
DEDF Dental extraction ( inpatient ) - Doctor fee 1190 1190 590 470 350
108
23 DEPFOS Dental - Excision of pericoronal flap-
DEPFHC Dental - Excision of pericoronal flap -Hospital Charges 310 310 150 120 90
DEPF-1 Dental OPD Category 1 - Excision of pericoronal flap 1460 1460
24 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 ionomer 2240 1600
25 DFAPOS Dental - Fluoride application-
DFAPHC Dental - Fluoride application – Hospital Charges 240 240 120 100 70
DFAPP-1 Dental Category 1 - Fluoride application 1180 1180
26 DFMOOS Dental - Fracture mandible open
reduction under LA- INPATIENT Doctor
& Hospital charges
DFMOHC Dental - Fracture mandible open reduction 4400 4400 2200 1760 1320
under LA - Hospital Charges
DFMORLA-1 Dental Category 1 - Fracture mandible open reduction 21970 18150
under LA ( Cost of Plates & screws etc. )
27 DFOPFOS Dental - Flap operation (full mouth)-
DFOPFHC Dental - Flap operation (full mouth) -Hospital Charges 2930 2930 1460 1170 880
DFOPFM-1 Dental OPD Category 1 - Flap operation (full mouth) 14640 13180
28 DFOPOS Dental - Flap operation (per quadrant)-
DFOPHC Dental - Flap operation (per quadrant) - 900 900 450 360 270
Hospital Charges
DFOPQ-1 Dental OPD Category 1 - Flap operation (per quadrant) 4390 3660
29 DFREOS Dental - Frenectomy- INPATIENT
DFREHC Dental - Frenectomy - Hospital Charges 460 460 230 190 140
DFRENE-1 Dental OPD Category 1 - Frenectomy 2200 1180
30 DFSBOS Dental - Flap surgery with bone graft
(per quadrant)- INPATIENT Doctor &
Hospital 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)
31 DGPLOS Dental - Gingivoplasty (per quadrant)-
DGPLHC Dental - Gingivoplasty (per quadrant) - 900 900 450 360 270
Hospital Charges
DGPLASTY-1 Dental OPD Category 1 - Gingivoplasty (per quadrant) 4390 3660
32 DGTOOS Dental - Gingivectomy (per quadrant)-
DGTOHC Dental - Gingivectomy (per quadrant) - 750 750 370 300 220
Hospital Charges
DGTOMY-1 Dental OPD Category 1 - Gingivectomy (per quadrant) 3660 2930
33 DIAIOS Dental - Intra articular injection-
DIAIHC Dental - Intra articular injection – Hospital Charges 240 240 120 100 70
DIAINJ-1 Dental OPD Category 1 - Intra articular injection 1180 1180
34 DIBIOS Dental - Incisional biopsy- INPATIENT
DIBIHC Dental - Incisional biopsy - Hospital Charges 460 460 230 190 140
DIBIOP-1 Dental OPD Category 1 - Incisional biopsy 2200 1180
109
35 DIDROS Dental - Incision and drainage-
DIDRHC Dental - Incision and drainage – Hospital Charges 620 620 310 240 190
DIDRAIN-1 Dental OPD Category 1 - Incision and drainage 2930 2340
36 DIFFOS Dental - Iodoform Dressing for CYST-
DIFFHC Dental - Iodoform Dressing for CYST - 130 130 70 60 40
Hospital Charges
DIFF-1 Dental Category 1 - Iodoform Dressing for CYST 590 530
37 DIMFOS Dental - Inter - maxillary fixation with
archbar- INPATIENT Doctor & Hospital
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
38 DIMPOS Dental - Impaction (Bony / soft tissue)-
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)
39 DIWSOS Dental - Interdental wiring + splinting
(per quadrant)- INPATIENT Doctor &
Hospital 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)
40 DJFCOS Dental - Jaw fracture closed reduction-
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
41 DLFROS Dental - Lingual frenectomy-
DLFRHC Dental - Lingual frenectomy – Hospital Charges 460 460 230 190 140
DLFREN-1 Dental OPD Category 1 - Lingual frenectomy 2200 1770
42 DMIAOS Dental - Mini - implant for anchorage
(per implant)- INPATIENT Doctor &
Hospital 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)
43 DNBNOS Dental - Nerve block in Neuralgias-
DNBNHC Dental - Nerve block in Neuralgias – Hospital Charges 900 900 450 360 270
DNBN-1 Dental Category 1 - Nerve block in Neuralgias 4390 3630
44 DOACOS Dental - Oro antral communication
closure - INPATIENT Doctor & Hospital
charges
DOACHC Dental - Oro antral communication closure - 4110 4110 2060 1650 1240
Hospital Charges
DOACC-1 Dental Category 1 - Oro antral 20490
communication closure
45 DOBTOS Dental - Obturators- INPATIENT Doctor
& Hospital charges
DOBTHC Dental - Obturators - Hospital Charges 2350 2350 1180 950 710
DOBTU-1 Dental Category 1 - Obturators 11720 10990
110
46 DOPEOS Dental - Operculectomy- INPATIENT
DOPEHC Dental - Operculectomy - Hospital Charges 310 310 150 120 90
DOPER-1 Dental Category 1 - Operculectomy 1460 1460
47 DPIOOS Dental - Placentrax Inj for OSMF-
DPIOHC Dental - Placentrax Inj for OSMF – Hospital Charges 240 240 120 100 70
DPIOSMF-1 Dental Category 1 - Placentrax Inj for OSMF 1180
48 DPUCOS Dental - Pulp capping- INPATIENT
DPUCHC Dental - Pulp capping - Hospital Charges 220 220 110 90 70
DPUCAP-1 Dental Category 1 - Pulp capping 2240 1330
49 DPULOS Dental - Pulpotomy- INPATIENT Doctor
& Hospital charges
DPULHC Dental - Pulpotomy - Hospital Charges 310 310 150 120 90
DPULPO-1 Dental Category 1 - Pulpotomy 1460 1460
50 DRATOS Dental - Reimplantation of avulsed
tooth- INPATIENT Doctor & Hospital
charges
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
51 DRCAOS Dental - Root canal with Apicectomy-
DRCAHC Dental - Root canal with Apicectomy - 1470 1470 740 590 440
Hospital Charges
DRCAPIC-1 Dental Category 1 - Root canal with 7330 5850
Apicectomy
52 DRCTFOS Dental - Root canal treatment ( RCT ) -
anterior- INPATIENT Doctor & Hospital
charges
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
53 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
54 DRFWOS Dental - Removal of Frontosuspension
wiring- INPATIENT Doctor & Hospital
charges
DRFWHC Dental - Removal of Frontosuspension 1190 1190 590 470 350
wiring - Hospital Charges
DRFW-1 Dental Category 1 - Removal of 5850
Frontosuspension wiring
55 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
56 DRPMOS Dental - Removal of plates of
mandible and maxilla ( Under LA )-
DRPMHC Dental - Removal of plates of mandible and 2350 2350 1180 950 590
maxilla ( Under LA ) - Hospital Charges
111
DRPMMLA-1 Dental Category 1 - Removal of plates of 11720
mandible and maxilla ( Under LA )
57 DRPTOS Dental - Extraction (per tooth)-
DRPTHC Dental - Extraction (per tooth) – Hospital Charges 180 180 90 70 50
DRPTO-1 Dental OPD Category 1 - Extraction (per tooth) 740 590
58 DSETOS Dental - Surgical extraction of tooth-
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
59 DSFMOS Dental - Scaling full mouth- INPATIENT
DSFMHC Dental - Scaling full mouth – Hospital Charges 460 460 230 190 140
DSFMOU-1 Dental Category 1 - Scaling full mouth 2200 2000
60 DSPROS Dental - Splint Removal- INPATIENT
DSPRHC Dental - Splint Removal - Hospital Charges 310 310 150 120 90
DSPREMO1 Dental Category 1 - Splint Removal 1460 1460
61 DSREOS Dental - Suture removal- INPATIENT
DSREHC Dental - Suture removal - Hospital Charges 180 180 90 70 50
DSREMO-1 Dental OPD Category 1 - Suture removal 1460 1030
62 DSSCOS Dental - Subgingival scaling &
curretage full mouth- INPATIENT
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
63 DTEXOS Dental - Tumour excision- INPATIENT
DTEXHC Dental - Tumour excision - Hospital Charges 2930 2930 1460 1170 880
DTEXCI-1 Dental OPD Category 1 - Tumour excision 14640 8790
64 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

1 SKINDERMAR Dermaroller for face 5000
2 SKINDMAR Dermaroller for stretch marks 8000
3 SKINEXCIC Excision of cyst 6500
4 SKINWARTS Intralesional immunotherapy for warts 1500 900
5 SKINCP Pairing-single lesion 800 480
6 SKINPAL Palmer/Planter wart cauterization and excision – single lesion 3000 1800
7 SKINPAL23 Palmer/Planter wart cauterization and excision – Three lesion 7900 4740
8 SKINPAL2 Palmer/Planter wart cauterization and excision – Two lesion 5300 3180
9 SKINPUNCH2 Punch grafting for vitiligo 2-3 patch 14000
10 SKINPUNCH3 Punch grafting for vitiligo 4-5 patch 20000
11 SKINPUNCH Punch grafting for vitiligo single patch 8000
12 SKINBIOPL Skin biopsy of lesion 0.5 cm to 1 cm 3700 2220
13 SKINCTLOPD Skin Cauterisation - 3 to 4 Lesion 3500
14 SKINCTLOPD1 Skin Cauterisation - 5 to 6 Lesion 4500
112
17 SKINCML Skin Cauterisation - Multiple lesions 3500 2100
18 SKINCSL Skin Cauterisation - Single lesion 1470 880
19 SKINCTL Skin Cauterisation - Two lesions 2420 1450
20 SKINCAULES11 Skin cauterization 11-15 Lesion 8800 5280
21 SKINCAULES Skin cauterization 1-5 Lesion 3200 1920
22 SKINCAULES6 Skin cauterization 6-10 Lesion 6000 3600
23 SKINCRML Skin Cryosurgery - Multiple Lesions 4000 2400
24 SKINCRSL Skin Cryosurgery - Single Lesion 1600 960
25 SKINCRTL Skin Cryosurgery - Two Lesions 2500 1500
26 SKINNEEDLE11 Skin needling 11-15 lesion 5000 3000
27 SKINNEEDLE Skin needling 1-5 lesion 2000 1200
28 SKINNEEDLE6 Skin needling 6-10 lesion 3700 2220
29 SKINSLESION Skin OPD - Cauterization and excision - Single Lesion 2500
30 SKINSLESION3 Skin OPD - Cauterization and excision - Three Lesion 6200
31 SKINSLESION2 Skin OPD - Cauterization and excision - Two Lesion 4500
32 SKINCH Skin OPD - Chemical Peeling - Arms 3500
33 SKINCHBACK Skin OPD - Chemical Peeling - Back 3500
34 SKINFACE Skin OPD - Chemical Peeling - Face 2000
35 SKINFACENECK Skin OPD - Chemical Peeling - Face & Neck 2800
36 SKINPEEL Skin OPD - Chemical Peeling -2 Peels on Face 3500
37 SKINCOMEDO3 Skin OPD - Comedo Extration 11-15 Lesion 3700 2220
40 SKINDERMAPLA T Skin OPD - Dermaroller and platelet rich plasma therapy for face 6000
41 SKINHLOSS Skin OPD - Dermaroller and platelet rich plasma therapy for hair loss 6500
42 SKINDER Skin OPD - Dermaroller for facial marks 4000
43 SKINDERMA Skin OPD - Dermaroller for stretch marks 5500
44 SKININTRAINJ Skin OPD - few intralesion injection 2500 1500
45 SKINOPD Skin OPD - Few Intralesional Injection 2500
46 SKINGSP Skin OPD - Gram Stain procedure 420 240
47 SKINKPP Skin OPD - KOH preparation procedure 500 300
48 SKINMESOFACE Skin OPD - Mesotherapy for face 2000
49 SKINMESO Skin OPD - Mesotherapy for hair loss 1500
50 SKINMULINJ Skin OPD - multiple intralesion injection 4000 2400
51 SKINMULTIOPD SKIN OPD - Multiple Intralesional Injection 4000
52 SKINSFOPD Skin OPD - Nail Clipping for Onychomycosis 400
53 SKINCOMEDOF EW Skin OPD - Needle/Comedo Extration - Few Lesion 1500
54 SKINCOMEDO Skin OPD - Needle/comedo Extration - Single Lesion 800
55 SKINFLES Skin OPD - Pairing Few Lesion 1500
56 SKINMLESION Skin OPD - Pairing Multiple Lesion 2800
57 SKINPLASMA Skin OPD - Platelet rich plasma therapy for face 4500
58 SKINHAIR Skin OPD - Platelet rich plasma therapy for hair loss 5700
59 SKINPLASMAR Skin Opd - Platelet rich plasma therapy for strecth marks 8000
60 SKINPODOMUL TI Skin OPD - Podophyllin application - Multiple Lesion 3000
61 SKINPODO Skin OPD - Podophyllin application - Single Lesion 700
62 SKINPODO2 Skin OPD - Podophyllin application - Two Lesion 1400
63 SKINPUVA Skin OPD - PUVA Therapy 420 250
64 SKINSPTP Skin OPD - Skin patch testing procedure 4000 2400
65 SKINSPTPAC Skin OPD - Skin patch testing procedure - charges for additional antigen 200 120
66 SKINCAT1 SKIN OPD - Skin Procedure Category 1 1500
67 SKINCAT2 SKIN OPD - Skin Procedure Category 2 3000
68 SKINSCARS Skin OPD - Subcision for Scars 3700
69 SKINTACML Skin OPD - Trichloacetia acid cauterisation – Multiple lesions 3000 1800
113
70 SKINTACTL Skin OPD - Trichloacetia acid cauterisation - Two lesions 1400 840
71 SKINSMEAR Skin OPD - Tzanck Smear Procedure 500
72 SKINSFP Skin OPD- KOH examination under microscope for fungus 300 180
73 SKINIIP Skin OPD- Single intralesional injection 800 480
74 SKINSMAFB Skin OPD- Slit skin smear for AFB procedure 800 480
75 SKINTACSL Skin OPD- Trichloroacetic acid application-single lesion 700 420
76 SKINBP Skin OPD-Skin Biopsy procedure of lesion <0.5 cm 3000 1800
77 SKINSUCSIN2 Suction blister grafting for vitiligo (2-3 patch) 14000
78 SKINSUCSIN3 Suction blister grafting for vitiligo (4-5) 20000
79 SKINSUCSIN Suction blister grafting for vitiligo (single patch) 8000
ENT Procedure Charges

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

6 ENGDF Videonystagmography (VNG) (Doctor Fee) 3480 0
ENT Therapy Charges
Cat-1D Single/
Cat-2 Beded
Premium/
4 Bedded
GOPD
POPD
Cat-3
Suite
1 STHER Speech Therapy (per sitting) 580 560 340 560 340
2 SPEECHC Speech Therapy per 10 Session – Hospital Charges 4970 2980 4970 2980
3 SPSINHC Speech Therapy specialised for singers - Hospital Charges 1660 1000 1660 1000
4 ENTINHC Tinnitus retraining therapy - Hospital Charges 560 340 560 340
ENT charges
SNo Code Description POPD GOPD ALL CAT

1 DCHFENT Dressing charges for ENT 270
2 EUMCH Examination under microscope charges 290
3 TTCCH Tracheostomy tube change charges 710
4 ENGHC Videonystagmography (VNG)(Hospital Fee) 3480 3480
ENT Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1 ASEHOS Speech Assessment ( Endoscopic
Laryngology & Stroboscopy ) - ( Doctor
fee + Hospital Share )
ASEDF Speech Assessment ( Endoscopic 3480
Laryngology & Stroboscopy ) - Doctor fee
ASEHC Speech Assessment ( Endoscopic 2310 3470
Laryngology & Stroboscopy ) - Hospital
Share
114
2 ASSRDH Auditory Steady State
Response( ASSR )(DOCTOR FEE
+ HOSPITAL CHARGES)
ASSR Auditory Steady State Response ( ASSR ) - 4550 2730
Doctor fee
ASSRHA Auditory Steady State Response ( ASSR ) - 910 550
hospital amount
3 DBHLDH Detailed BERA for hearing loss
(DOCTOR FEE + HOSPITAL CHARGES)
DBHL Detailed BERA for hearing loss - Doctor fee 2920 1750
DBHLHA Detailed BERA for hearing loss- hospital amount 590 350
4 DPOAEDH Distortion Product Otoacoustic
Emisssion( DPOAE )(DOCTOR
FEE + HOSPITAL CHARGES)
DPOAE Distortion Product Otoacoustic Emisssion (DPOAE ) - 1300 780
Doctor fee
DPOAEHA Distortion Product Otoacoustic Emisssion (DPOAE ) - 260 160
hospital amount
5 ELDHOS Endoscopic Laryngology
(Doctor fee + Hospital Share)
ELDF Endoscopic Laryngology - Doctor fee 2320
SAELSH Endoscopic Laryngology - Hospital Share 1170 2090
6 ENGOS Videonystagmography (VNG)
(Doctor fee + Hospital fee)
ENGDF Videonystagmography (VNG) (Doctor Fee) 5220 5220 4350 3480 2600 3480
ENGHC Videonystagmography (VNG)(Hospital Fee) 5220 5220 4350 3480 2600 3480 3480
7 ENTBIOP ENT Biopsy (Doctor fee +
OS Hospital Charges)
ENTBIOPDF ENT Biopsy - Doctor fee 5250
ENTBIOPHC ENT Biopsy - Hospital Charges 2630 4730
8 ENTINJPO ENT Injection Botox / Steroid
S (Doctor fee + Hospital Charges)
ENTINJPDF ENT Injection Botox / Steroid - Doctor fee 4200
ENTINJPHC ENT Injection Botox / Steroid - Hospital fee 2100 3780
9 ENTOPDA ENT Augmentation Laryngoplasty
UGOS (Doctor fee + Hospital Charges)
ENTOPDAUGD F ENT Augmentation Laryngoplasty – Doctor fee 6300
ENTOPDAUGH C ENT Augmentation Laryngoplasty – Hospital Charges 3150 5670
10 ENTOPDBI ENT OPD - Nasal Endoscopy and
OS bipolar cautery for epistaxis (Doctor
ENTOPDBIDF ENT OPD - Nasal Endoscopy and bipolar 9090
cautery for epistaxis - Doctor Fee
ENTOPDBIHC ENT OPD - Nasal Endoscopy and bipolar 910
cautery for epistaxis - Hospital Charges
11 ENTOPDC ENT OPD - Post - operative Nasal
LOS Endoscopy and cleaning (Doctor Fee +
Hospital Charges)
ENTOPDCLDF ENT OPD - Post - operative Nasal Endoscpy 4090
and cleaning - Doctor Fee
ENTOPDCLHC ENT OPD - Post - operative Nasal Endoscpy 410
and cleaning - Hospital Charges
12 ENTOPDE ENT OPD - Examination under
MOS Microscope (Doctor Fee +
Hospital Charges)
ENTOPDEMDF ENT OPD - Examination under Microscope - 1360
Doctor Fee
ENTOPDEMHC ENT OPD - Examination under Microscope - 140
Hospital Charges
115
13 ENTOPDF ENT OPD - Examination under
ROS Microscope with foreign body removal
(Doctor fee + Hospital charges)
ENTOPDFRDF ENT OPD - Examination under Microscope 3180
with foreign body removal - Doctor fee
ENTOPDFRHC ENT OPD - Examination under Microscope with foreign 320
body removal – Hospital Charges
14 ENTOPDN ENT OPD - Anterior Nasal Packing
POS (Doctor Fee + Hospital Charges)
ENTOPDNPDF ENT OPD - Anterior Nasal Packing – Doctor Fee 2730
ENTOPDNPHC ENT OPD - Anterior Nasal Packing – Hospital Charges 270
15 ENTOPDO ENT OPD - Examination under
MOS miroscope with video -Otoendoscopy/
Minor procedure (Doctor Fee +
Hospital Charges)
ENTOPDOMD ENT OPD - Examination under miroscope 3180
F with video - otoendoscopy/Minor procedure
- Doctor Fee
ENTOPDOMH ENT OPD - Examination under miroscope 320
C with video - otoendoscopy/Minor procedure
- Hospital Charges
16 ENTOPDO ENT OPD Diagnostic Nasal Endoscopy
S (Doctor Fee+Hospital Charges)
ENTOPDNASD F ENT OPD - Diagnostic Nasal Endoscopy -Doctor Fee 3180
ENTOPDNASH C ENT OPD - Diagnostic Nasal Endoscopy -Hospital 320
Charges
17 ENTOPDS ENT Stricture Dilatation
TRICOS (Doctor fee + Hospital Charges)
ENTOPDSTRIC ENT Stricture Dilatation - Doctor fee 8400
DF
ENTOPDSTRIC ENT Stricture Dilatation - Hosital Charges 4200 7560
HC
18 ENTOPDT ENT - Diagnostic TNE (Doctor
NEOS fee + Hospital Charges)
ENTOPDTNED F ENT - Diagnostic TNE - Doctor fee 3150
ENTOPDTNEH C ENT - Diagnostic TNE - Hospital Charges 1580 2840
19 ENTOPPN ENT OPD - Posterior Nasal Packing
OS (Doctor fee + Hospital charges)
ENTOPPNDF ENT OPD - Posterior Nasal Packing – Doctor fee 5450
ENTOPPNHC ENT OPD - Posterior Nasal Packing -Hospital Charges 550
20 OTOESDH OTO-ACOUSTIC EMISSION TEST FOR
CHOS NEWBORN BABIES (DOCTOR FEE +
HOSPITAL CHARGES)
OETNBDF OTO-acoustic emission test for newborn 980 980 490 390 290
babies - Doctor fee
OETNBHC OTO-acoustic emission test for newborn 520 520 260 210 160
babies - Hospital charges
21 VAOS VOICE ANALYSIS
VACDC Voice analysis - Clinical doctor charges 3050 1510
VAHC Voice analysis - Hospital Charges 6070 3050
VASPC Voice analysis - Speech pathologists charges 3050 1510
Hospital 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
116
4 DRESSCAS Dressing in casualty 240 220
5 HIDORFEOS HIGH DOSE CHEMOTHERAPY AND RESCUE - Ho 23490 11750 9400 7050
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
13 VACBA Vaccum assisted would closure (VAC) applicat 2840 1420 1130 850
KTP Charges
14 KTPCHA KTP Service Charges 10680 5340 4010 2680 4850
Resuscitation charges
15 NEWBRNRESCES Resuscitation charges of newborn baby following 5070 2540 1910 1280
HOS caeserian section
16 NEWBRNRESCH Resuscitation charges of newborn baby followind normal 4010 2020 1520 1010
RHOS delivery
Bedside procedure charges (Glucometry)
Code Description POPD GOPD ALL CAT

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
CAPDONEB AG CAPD - Exchange procerdure (One Bag) 200
CAPDEXIT CAPD - Exit Site Dressing 200
CAPDINFLU SH CAPD - Initial Flushing 500
CAPDINTRA FLUSH CAPD - Intraperitoneal Antibiotics and Flushing 500
CAPDPET CAPD - Peritoneal Equilibration Test (PET TEST) 1000
CAPDSUTU RE CAPD - Suture Removal 1000
CAPDDAILY CAPD - Training on Daily Basis 1000
CAPDTRAN SET CAPD - Transfr Set Change 500
DRESSPLAS Dressing in Plastic Surgery 240
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
117
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
GRIPMER FUND
GRIFUN Book ( GRIPMER ) 200
Hospital charges
ALPTRDL ALPHA TRACELL DELUX CHARGES 450
ALPTRA ALPHA TRACELL CHARGES 250
ALPXC ALPHA XCELL CHARGES 450
APAC Angiography Pool Account 2000
ACAC Angioplasty combo a/c 3000
AULG AUTOLOGIC CHARGES 510
DIETASA Diet as advised 0
DCPICCL Dressing charges for PICC line 200 200
ECMOHC ECMO - Maintenance Charges Per Day (Cardiac surgery) 11580
INTERCH Interpreter charges 1390
KTPSH KTP Surcharge - Hospital charges 5830
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 1000 6550
SPICCL Statlock for PICC line 200 200
SUPAR SUPAR TEST CHARGES 640
LAVDMC Temporary LVAD - Maintenance Charges Per Day 11580
UROTESA Tesa - Hospital Charges 490 3280
USAVFHS Ultrasound guided venous mapping for I/J catheter insertion and 600
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 RHC Diabetic foot - minor outpatient procedure (hospital charges) 1370 1370 1370
TOEBRAIND Toe Brachial Index 250 250
Hospital charges for haemodialysis

HDFHC Online Hemodiafiltration (HDF) (5008S) - Hospital Charges 3860 3860
PLEXHD Plasma exchange procedure by cell separator (Dialysis) 22000 22000
118
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

SNo Code Description POPD GOPD ALL CAT
1 STOMCARE Stoma care charge 220
CHRG
2 STOMAC3 Stoma care charges ( Complex ) 410
3 STOMAC1 Stoma care charges ( Easy ) 180
4 STOMAC4 Stoma care charges ( Extra Complex ) 590
5 STOMAC2 Stoma care charges ( Normal ) 340
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 ) 22400 11200 8960 6720
3 OP3397 Basilic vein transposition in OT 67220 33610 26890 20170
4 OP0240 Brachio - basilic loop AV graft for haemodialysis 44800 22400 17920 13440
5 OP0242 Brachio - basilic straight ( above elbow ) AV graft for haemodialysis 44800 22400 17920 13440
6 OP0239 Brachio - cephalic loop AV graft for haemodialysis 44800 22400 17920 13440
7 OP0241 Brachio - cephalic straight ( above elbow ) AV graft for haemodialysis 44800 22400 17920 13440
8 OP0245 Brachio AV fistula at elbow for haemodialysis 32240 16120 12900 9670
9 OP0443 CAPD placement ( laparosopic ) 27200 13600 10880 8160
10 OP1080 CAPD placement ( open ) 27200 13600 10880 8160
11 OP0448 CAPD removal & placement ( laparosopic ) 35660 17830 14260 10700
12 OP0445 CAPD removal & placement ( open ) 35660 17830 14260 10700
13 OP0447 CAPD removal ( laparosopic ) 17060 8530 6820 5120
14 OP0444 CAPD removal ( open ) 17060 8530 6820 5120
15 OP0446 CAPD revision ( laparosopic ) 13600 6800 5440 4080
16 OP0449 CAPD revision ( open ) 13600 6800 5440 4080
17 OP0437 Conversion of arteriovenous ( AV ) shunt to 32240 16120 12900 9670
arteriovenous ( AV ) fistula
18 OP0440 Creation of arteriovenous ( AV ) fistula at axillary artery 40740 20370 16300 12220
19 OP0433 Creation of arteriovenous ( AV ) fistula at elbow (brachial artery ) 40740 20370 16300 12220
20 OP1077 Creation of arteriovenous ( AV ) fistula at wrist ( radial artery ) 40740 20370 16300 12220
21 OP4205 GSV translocation for AV access 67220 33610 26890 20170
22 OP0320 Ligation of ruptured AV fistula 17060 8530 6820 5120
23 OP0319 Ligation of ruptured AV graft 22400 11200 8960 6720
24 OP0436 Placement of arteriovenous ( AV ) shunt at ankle (posterior tibial 22400 11200 8960 6720
artery )
25 OP1078 Placement of arteriovenous ( AV ) shunt at wrist (radial artery ) 22400 11200 8960 6720
26 OP0243 Radio - basilic straight ( below elbow ) AV graft for haemodialysis 44800 22400 17920 13440
27 OP0244 Radio - cephalic straight ( below elbow ) AV graft for haemodialysis 44800 22400 17920 13440
28 OP4204 Repair of A.V.Fistula aneurysm 45840 22920 18340 13750
119
29 OP0441 Revision of arteriovenous ( AV ) fistula at axillary artery 17060 8530 6820 5120
30 OP0435 Revision of arteriovenous ( AV ) fistula at elbow (brachial artery ) 17060 8530 6820 5120
31 OP0434 Revision of arteriovenous ( AV ) fistula at wrist ( radial artery ) 17060 8530 6820 5120
32 OP0439 Revision of arteriovenous ( AV ) shunt at ankle (posterior tibial artery ) 11200 5600 4480 3360
33 OP0438 Revision of arteriovenous ( AV ) shunt at wrist ( radial artery ) 11200 5600 4480 3360
34 OP1083 Vascular prosthetic graft in forearm 50940 25470 20380 15280
35 OP0526 Vascular prosthetic graft in thigh 50940 25470 20380 15280
36 OP0525 Vascular prosthetic graft in upper arm 50940 25470 20380 15280
Aesthetic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
37 OP1305 Abdominoplasty 127340 63670 50940 38200
38 OP1303 Abdominoplasty with limited incision 101880 50940 40750 30560
39 OP1304 Abdominoplasty with liposuction 152820 76410 61130 45850
40 OP2996 Belt Lipectomy 193100 96550 77240 57930
41 OP3082 Bilateral face dimple construction ( dimploplasty ) 89140 44570 35660 26740
42 OP3007 Botox / Fillers 35440 17720 14180 10630
43 OP1803 Brachioplasty / arm lift 118100 59050 47240 35430
44 OP0842 Brow / forehead lift 155780 77890 62310 46730
45 OP1804 Buttock implant 122740 61370 49100 36820
46 OP4383 Buttock Lift 140100 70050 56040 42030
47 OP1802 Calf implant 113280 56640 45310 33980
48 OP0840 Centralisation of chin 103820 51910 41530 31150
49 OP0083 Chemical peel of face 88600 44300 35440 26580
50 OP0060 Chin augmentation - multiple sliding osteotomies (Genioplasty ) 107620 53810 43050 32290
51 OP0061 Chin augmentation - osteotomy with bone graft (Genioplasty ) 122740 61370 49100 36820
52 OP1320 Chin augmentation - prosthetic / allograft (Genioplasty ) 103820 51910 41530 31150
53 OP0059 Chin augmentation - single sliding osteotomy (Genioplasty ) 84900 42450 33960 25470
54 OP0826 Chin reduction 118100 59050 47240 35430
55 OP4382 Circumferential Body Lift 210100 105050 84040 63030
56 OP3423 Contouring of bones of the face - multiple Bones 101880 50940 40750 30560
57 OP3422 Contouring of bones of the face - single Bone 63680 31840 25470 19100
58 OP1364 Correction / revision of face scars - single 51000 25500 20400 15300
59 OP3060 Correction / revision of two face scars 68720 34360 27490 20620
60 OP3431 Correction of complex scar - large 106320 53160 42530 31900
61 OP3430 Correction of complex scar - medium 70880 35440 28350 21260
62 OP3429 Correction of complex scar - small 53180 26590 21270 15950
63 OP1798 Correction of congenital ear lobule deformity 70880 35440 28350 21260
64 OP4368 Correction of Contour Deformity Face (Fat, Implant, Flap) - Minor 67220 33610 26890 20170
65 OP4369 Correction of Contour Deformity Face (Fat, Implant, Flap)-Majorlip 112060 56030 44820 33620
66 OP3005 Correction of multiple facial scars 85920 42960 34370 25780
67 OP1588 Corrective rhinoplasty - augmentation with bone graft 106320 53160 42530 31900
68 OP1587 Corrective rhinoplasty - augmentation with cartilage 106320 53160 42530 31900
69 OP1586 Corrective rhinoplasty - augmentation with implant 81520 40760 32610 24460
70 OP3310 Corrective rhinoplasty - complete 167120 83560 66850 50140
71 OP1584 Corrective rhinoplasty - nasal tip 70880 35440 28350 21260
72 OP1593 Corrective rhinoplasty - reduction 110940 55470 44380 33280
73 OP1580 Corrective rhinoplasty - with septoplasty 124060 62030 49620 37220
74 OP1594 Corrective rhinoplasty for crooked / deviated nose 141720 70860 56690 42520
75 OP1315 Cosmetic blepharoplasty ( four lids ) 106320 53160 42530 31900
76 OP0135 Cosmetic blepharoplasty ( one lid ) 47320 23660 18930 14200
77 OP0136 Cosmetic blepharoplasty ( three lids ) 67500 33750 27000 20250
78 OP0058 Cosmetic blepharoplasty ( two lids ) 65440 32720 26180 19630
79 OP1095 Dermabrasion 94440 47220 37780 28330
80 OP1336 Dermabrasion full face 94440 47220 37780 28330
120
81 OP1337 Dermabrasion partial face 66120 33060 26450 19840
82 OP1345 Ear lobule repair - bilateral 19120 9560 7650 5740
83 OP1344 Ear lobule repair - unilateral 12740 6370 5100 3820
84 OP3077 Ear lobule repair with cartilage graft 77320 38660 30930 23200
85 OP1350 Endoscopic brow / forehead lift 155780 77890 62310 46730
86 OP1349 Endoscopic face lift 212420 106210 84970 63730
87 OP1363 Eyebrow graft 77960 38980 31180 23390
88 OP0138 Eyelash graft 77960 38980 31180 23390
89 OP0841 Face lift - classic operations 141720 70860 56690 42520
90 OP1767 Face lift - facial suspension 94440 47220 37780 28330
91 OP1789 Face lift - mid face 106320 53160 42530 31900
92 OP1766 Face lift - minimum scar 124060 62030 49620 37220
93 OP1790 Face lift - with SMAS 159500 79750 63800 47850
94 OP4459 Fat grafting ( Non cosmetic ) 63680 31840 25470 19100
95 OP3326 Genital labioplasty 83660 41830 33460 25100
96 OP4226 Hair transplant other then scalp (Large) 184880 92440 73950 55460
97 OP4227 Hair transplant other then scalp (Medium) 138660 69330 55460 41600
98 OP4228 Hair transplant other then scalp (Small) 61640 30820 24660 18490
99 OP0814 Hair transplantation - major 311860 155930 124740 93560
100 OP0813 Hair transplantation - medium 233880 116940 93550 70160
101 OP0812 Hair transplantation - minor 155940 77970 62380 46780
102 OP3329 Hymenoplasty 83660 41830 33460 25100
103 OP4821 Implant Removal Face 52500 26250 21000 15750
104 OP1769 Intralesional injection (in OT) 12620 6310 5050 3790
105 OP4495 Laser Resurfacing - Large 101880 50940 40750 30560
106 OP4496 Laser Resurfacing - Medium 76400 38200 30560 22920
107 OP4497 Laser Resurfacing - Small 50940 25470 20380 15280
108 OP2969 Lateral canthoplasty 35440 17720 14180 10630
109 OP3078 Lip reconstruction with multiple flaps 128780 64390 51510 38630
110 OP3079 Lip reconstruction with single flap 120200 60100 48080 36060
111 OP1770 Lip reduction 51980 25990 20790 15590
112 OP1768 Lipo-injection - major 106320 53160 42530 31900
113 OP3081 Lipoinjection - medium 88600 44300 35440 26580
114 OP1771 Lipo-injection - minor 70880 35440 28350 21260
115 OP1774 Liposuction - large 103820 51910 41530 31150
116 OP3080 Liposuction - medium 73020 36510 29210 21910
117 OP1776 Liposuction - small 51980 25990 20790 15590
118 OP4817 Liposuction ( Non-Cosmetic ) 65620 32810 26250 19690
119 OP4491 Liposuction (Multiple Areas) 152820 76410 61130 45850
120 OP1805 Malar / cheek implant 103820 51910 41530 31150
121 OP3084 Malar reduction 111640 55820 44660 33490
122 OP4215 Medial Canthoplasty 61640 30820 24660 18490
123 OP3062 Midline etching 63800 31900 25520 19140
124 OP3037 Neo - umbiloplasty 94440 47220 37780 28330
125 OP0084 Otoplasty for bat ears ( bilateral ) 106320 53160 42530 31900
126 OP1343 Otoplasty for bat ears ( unilateral ) 70880 35440 28350 21260
127 OP3341 Penile augumentation 139200 69600 55680 41760
128 OP3000 Penile lengthening procedure 128780 64390 51510 38630
129 OP4454 PRP injection Full face 25480 12740 10190 7640
130 OP4457 PRP injection hair or scar removal 12740 6370 5100 3820
131 OP4455 PRP Medium 12740 6370 5100 3820
132 OP4456 PRP Small 7640 3820 3060 2290
133 OP3036 Radiofrequency excision of moles - multiple 63800 31900 25520 19140
134 OP3038 Radiofrequency excision of moles - single 43000 21500 17200 12900
135 OP1801 Reverse abdominoplasty / torsoplasty 141640 70820 56660 42490
136 OP1800 Reverse thigh lift 141640 70820 56660 42490
137 OP3350 Scar revision of trunk of extremity ( large ) 76400 38200 30560 22920
138 OP3351 Scar revision of trunk of extremity ( medium ) 63680 31840 25470 19100
139 OP3352 Scar revision of trunk of extremity ( small ) 50940 25470 20380 15280
121
140 OP3075 Thighplasty 137340 68670 54940 41200
141 OP1797 Thread lift 103820 51910 41530 31150
142 OP3063 Transverse etching ( abdominal ) 85920 42960 34370 25780
143 OP3353 Umbilical reconstruction 83660 41830 33460 25100
144 OP1796 Umblicoplasty 70880 35440 28350 21260
145 OP3083 Unilateral face dimple construction ( dimploplasty ) 53180 26590 21270 15950
146 OP3066 Upper body lift 171660 85830 68660 51500
147 OP4472 Vaginal Rejuvenation (Laser) 50940 25470 20380 15280
148 OP4473 Vaginal Rejuvenation (Surgical) 76400 38200 30560 22920
149 OP4465 Xanthelasma Bilateral / Both Eyelid 47260 23630 18900 14180
150 OP4464 Xanthelasma Single 36760 18380 14700 11030
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) 29780 14890 11910 8930
152 OP0250 Amputation / disarticulation of toe(s) 29780 14890 11910 8930
153 OP0467 Amputation of hand ( carpal level ) 64520 32260 25810 19360
154 OP0256 Amputation of hand ( metacarpal level ) 64520 32260 25810 19360
155 OP0253 Amputation of lower limb - above knee 89340 44670 35740 26800
156 OP0252 Amputation of lower limb - below knee 89340 44670 35740 26800
157 OP0258 Amputation of upper limb ( above elbow ) 89340 44670 35740 26800
158 OP0257 Amputation of upper limb ( below elbow ) 89340 44670 35740 26800
159 OP1808 Chopart's amputation ( mid - tarsal ) 54080 27040 21630 16220
160 OP1811 Disarticulation at the level of ankle 63880 31940 25550 19160
161 OP1810 Disarticulation at the level of knee 63880 31940 25550 19160
162 OP1817 Disarticulation of elbow joint 63880 31940 25550 19160
163 OP1812 Disarticulation of hip joint 104200 52100 41680 31260
164 OP1818 Disarticulation of shoulder joint 104200 52100 41680 31260
165 OP1815 Disarticulation of wrist joint 58620 29310 23450 17590
166 OP4154 Forefoot excisional arthroplasty (Multiple) 101440 50720 40580 30430
167 OP4153 Forefoot excisional arthroplasty (Single) 67620 33810 27050 20290
168 OP2994 Forequarter amputation 119080 59540 47630 35720
169 OP1813 Hind Quarter disarticulation 119080 59540 47630 35720
170 OP1809 Lisfranc ampuation ( tarso - metatarsal ) 72940 36470 29180 21880
171 OP3033 Ray excision of digit 48620 24310 19450 14590
172 OP0254 Revision of amputation stump 67020 33510 26810 20110
173 OP0469 Syme's amputation 63880 31940 25550 19160
Ano-rectal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

174 OP1025 Anal sphincter repair after injury 94900 47450 37960 28470
175 OP1242 Anal transposition 71140 35570 28460 21340
176 OP1243 Anoplasty 62580 31290 25030 18770
177 OP1033 Anoplasty for imperforate anus with low opening 62580 31290 25030 18770
178 OP3360 Band ligation of haemorrhoids ( in OT ) 16040 8020 6420 4810
179 OP4862 COMPLEX FISTULA CLOSURE 40740 20370 16300 12220
180 OP1029 Excision / laying open of fistula in ano ( high level ) 71140 35570 28460 21340
with or without seton
181 OP1030 Excision / laying open of fistula in ano ( low level ) 56920 28460 22770 17080
182 OP1031 Haemorrhoidectomy 56920 28460 22770 17080
122
183 OP3359 Injection sclerotherapy of haemorrhoids / piles ( in OT) 16040 8020 6420 4810
184 OP1037 Lateral sphincterotomy or fissurectomy 52200 26100 20880 15660
185 OP1276 PSARP - complete 97760 48880 39100 29330
186 OP1277 PSARP - limited 69560 34780 27820 20870
187 OP1281 Rectal myomectomy 38020 19010 15210 11410
188 OP1282 Rectal polyp excision 17360 8680 6940 5210
189 OP0029 Rectal prolapse repair - Delormes rectopexy 109100 54550 43640 32730
190 OP0030 Rectal prolapse repair abdominal ( open technique ) 109100 54550 43640 32730
191 OP1076 Seton removal / laying open of residual fistula-in-ano 33200 16600 13280 9960
192 OP0689 Stapled haemorrhoidectomy 56920 28460 22770 17080
193 OP1038 Thiersch’s wiring 33200 16600 13280 9960
194 OP1280 Trans-anal rectal biopsy 23800 11900 9520 7140
Aortic Aneurysm Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
195 OP4209 Aortic Aneurysm fenestrated stent grafting 823640 411820 329460 247090
196 OP4825 Application and Monitoring of Digital Chest Suction Machine 16400 8200 6560 4920
197 OP4832 Carinal tumour resection and anastomosis 295320 147660 118130 88600
198 OP3367 Chest wall repair in OT 194120 97060 77650 58240
199 OP4208 Complex endovascular repair of aortic aneurysm 588320 294160 235330 176500
200 OP0091 Elective infra renal abdominal aortic aneurysm repair - 241200 120600 96480 72360
aorto bifemoral bypass graft
aorto bi-iliac bypass graft
aorto uni-iliac uni-femoral bypass graft
tube graft
204 OP0088 Elective supra renal abdominal aortic aneurysm repair 241200 120600 96480 72360
- aorto bifemoral bypass graft
205 OP0089 Elective supra renal abdominal aortic aneurysm repair 241200 120600 96480 72360
- aorto bi-iliac bypass graft
206 OP1503 Elective supra renal abdominal aortic aneurysm repair- tube graft 241200 120600 96480 72360
207 OP0315 Elective thoracic aortic aneurysm repair 241200 120600 96480 72360
208 OP4824 Empyema decortication with rib resection 196880 98440 78750 59060
209 OP4822 Empyema Grade I 131260 65630 52500 39380
210 OP4823 Empyema II 164080 82040 65630 49220
211 OP4207 Endovascular repair of aortic aneurysm 411820 205910 164730 123550
212 OP4850 Hemithorax Mass (Complex) 295320 147660 118130 88600
213 OP4826 ICD Removal 16400 8200 6560 4920
214 OP4851 Intraoperative repair of diapragm 82020 41010 32810 24610
215 OP4833 lobectomy 131260 65630 52500 39380
216 OP4835 Open Adhesiolysis 53820 26910 21530 16150
217 OP4839 Open Bilobectomy 273280 136640 109310 81980
218 OP4852 Open Bullectomy 196400 98200 78560 58920
219 OP4828 Open Cyst Excision 98440 49220 39380 29530
220 OP4843 Open drainage of mediastinal collection 65620 32810 26250 19690
221 OP4841 Open Excision of complex mediastinal mass 295320 147660 118130 88600
222 OP4837 Open Hematoma Evacuation 98440 49220 39380 29530
223 OP4845 Open metastasectomy 98440 49220 39380 29530
224 OP4846 Open Pleurectomy 82020 41010 32810 24610
225 OP4849 Open repair of pericardial defect 49220 24610 19690 14770
226 OP4829 Robotic Excision of bronchogenic cyst 164080 82040 65630 49220
227 OP4830 Robotic excision of complex intra-thoracic cyst 321580 160790 128630 96470
228 OP4831 Robotic Thymectomy for small thymoma/MG 190320 95160 76130 57100
123
229 OP0086 Ruptured infra renal abdominal aortic aneurysm 294140 147070 117660 88240
repair - aorto bifemoral bypass graft
repair - aorto bi-iliac bypass graft
repair - aorto uni-iliac uni-femoral bypass graft
repair - tube graft
233 OP0105 Ruptured supra renal abdominal aortic aneurysm 294140 147070 117660 88240
repair - aorto bi-iliac bypass graft
234 OP0104 Ruptured supra renal abdominal aortic aneurysm 294140 147070 117660 88240
repair - aorto-bifemoral bypass graft
235 OP0103 Ruptured supra renal abdominal aortic aneurysm repair - tube graft 294140 147070 117660 88240
236 OP4834 Thoracoscopic Adhesiolysis 82020 41010 32810 24610
237 OP4836 Thoracoscopic Hematoma Evacuation 131260 65630 52500 39380
238 OP4844 Thoracoscopic metastasectomy 124700 62350 49880 37410
239 OP4840 Tracheal Resection & Reconstruction (complex) 262500 131250 105000 78750
240 OP4838 VATS Bilobectomy 328120 164060 131250 98440
241 OP4827 VATS Cyst Excision 131260 65630 52500 39380
242 OP4842 VATS drainage of mediastinal collection 82020 41010 32810 24610
243 OP4847 VATS Pleurectomy 114840 57420 45940 34450
244 OP4848 VATS repair of pericardial defect 65620 32810 26250 19690
Appendicular Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
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245 OP1013 Appendicectomy 62580 31290 25030 18770
246 OP1014 Appendicular abscess drainage 71140 35570 28460 21340
247 OP1268 Laparoscopic appendicectomy 62580 31290 25030 18770
Arthrodesis
OT Day Care
Single Bed
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2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

248 OP3253 Arthrodesis ( hip ) 81780 40890 32710 24530
249 OP3254 Arthrodesis ( SI Joints ) 81780 40890 32710 24530
250 OP1980 Arthrodesis ankle 81780 40890 32710 24530
251 OP1981 Arthrodesis foot - Bachelor's / Green Grice 62080 31040 24830 18620
252 OP1983 Arthrodesis knee joint 81780 40890 32710 24530
253 OP1984 Arthrodesis of elbow joint 81780 40890 32710 24530
254 OP1989 Arthrodesis of hand & foot bone(s) 66420 33210 26570 19930
255 OP1982 Arthrodesis of shoulder joint 81780 40890 32710 24530
256 OP1985 Arthrodesis of wrist joint 81780 40890 32710 24530
257 OP4142 Calcaneo-cuboid arthrodesis 85840 42920 34340 25750
258 OP4338 Joint Arthrogram 53480 26740 21390 16040
259 OP4339 Joint Arthrotomy with debridement 106980 53490 42790 32090
260 OP1979 Lambrinudi / Triple Arthrodesis of ankle 81780 40890 32710 24530
261 OP4349 Large Joint Arthrodesis 112320 56160 44930 33700
262 OP4144 MTP Joint fusion 60380 30190 24150 18110
263 OP4140 Subtalar fusion / arthrodesis 74360 37180 29740 22310
264 OP4141 Talonavicular arthrodesis 85840 42920 34340 25750
265 OP4337 Triple Arthrodesis (Adult) 112320 56160 44930 33700
124
Arthroscopic Surgery
OT Day Care
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4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
266 OP4247 Arthoroscopic biceps tenodesis 70740 35370 28300 21220
267 OP4243 Arthoroscopic PASTA repair 69460 34730 27780 20840
268 OP4244 Arthoroscopic subscapularis repair 61540 30770 24620 18460
269 OP2150 Arthroscopic ACL and PCL reconstruction of knee 155560 77780 62220 46670
270 OP4578 Arthroscopic ACL and PCL Reconstruction single stage ( Two site graft ) 213000 106500 85200 63900
271 OP4253 Arthroscopic ACL avulsion fracture fixation 104560 52280 41820 31370
272 OP4576 Arthroscopic ACL Ganglion cyst Decompression 92620 46310 37050 27790
273 OP2151 Arthroscopic ACL reconstruction of knee ( arthroscopy 116000 58000 46400 34800
with single site tendon graft )
274 OP2152 Arthroscopic arthrodesis of ankle 81780 40890 32710 24530
275 OP2153 Arthroscopic arthrofibrolysis of elbow 81780 40890 32710 24530
276 OP2154 Arthroscopic arthrofibrolysis of hip 81780 40890 32710 24530
277 OP2155 Arthroscopic arthrofibrolysis of knee 81780 40890 32710 24530
278 OP2156 Arthroscopic arthrofibrolysis of shoulder 81780 40890 32710 24530
279 OP2157 Arthroscopic arthrofibrolysis of wrist 81780 40890 32710 24530
280 OP4254 Arthroscopic Bankart's Repair (Soft Tissue) 108500 54250 43400 32550
281 OP4560 Arthroscopic Biceps Tenodesis 138920 69460 55570 41680
282 OP4258 Arthroscopic Bony Bankart's Repair 113800 56900 45520 34140
283 OP4246 Arthroscopic capsulorrhaphy 70740 35370 28300 21220
284 OP2158 Arthroscopic carpal repair of wrist 76400 38200 30560 22920
285 OP2159 Arthroscopic debridement of ankle 76400 38200 30560 22920
286 OP2160 Arthroscopic debridement of elbow 76400 38200 30560 22920
287 OP2161 Arthroscopic debridement of hip 76400 38200 30560 22920
288 OP2162 Arthroscopic debridement of knee 76400 38200 30560 22920
289 OP2163 Arthroscopic debridement of shoulder 76400 38200 30560 22920
290 OP2164 Arthroscopic debridement of wrist 76400 38200 30560 22920
291 OP2165 Arthroscopic diagnostic arthroscopy of ankle 35760 17880 14300 10730
292 OP4245 Arthroscopic global labrum repair (A-P) - Anterior - Posterior 101500 50750 40600 30450
293 OP2166 Arthroscopic impingement release of ankle 76400 38200 30560 22920
294 OP4572 Arthroscopic labral cyst decompression 104180 52090 41670 31250
295 OP2167 Arthroscopic lateral collateral ligament reconstruction of knee 76400 38200 30560 22920
296 OP2168 Arthroscopic lateral release of knee 76400 38200 30560 22920
297 OP2169 Arthroscopic lavage of ankle 35760 17880 14300 10730
298 OP2170 Arthroscopic lavage of knee 35760 17880 14300 10730
299 OP2171 Arthroscopic loose body removal from ankle 76400 38200 30560 22920
300 OP2172 Arthroscopic loose body removal from elbow 76400 38200 30560 22920
301 OP2173 Arthroscopic loose body removal from hip 76400 38200 30560 22920
302 OP2174 Arthroscopic loose body removal from knee 76400 38200 30560 22920
303 OP2175 Arthroscopic loose body removal from shoulder 76400 38200 30560 22920
304 OP2176 Arthroscopic loose body removal from wrist 76400 38200 30560 22920
305 OP2177 Arthroscopic medial collateral ligament reconstruction of knee 76400 38200 30560 22920
306 OP2179 Arthroscopic meniscal repair of knee 76400 38200 30560 22920
307 OP4575 Arthroscopic Meniscus repair with implant 104180 52090 41670 31250
308 OP4251 Arthroscopic microfracture of OCD 69460 34730 27780 20840
309 OP2180 Arthroscopic osteoarticular transport / mosaic plasty of knee 76400 38200 30560 22920
310 OP4571 Arthroscopic Partial Meniscectomy - Discoid Meniscus 127340 63670 50940 38200
311 OP2181 Arthroscopic partial meniscectomy of knee 76400 38200 30560 22920
312 OP2182 Arthroscopic patellar stabilisation 76400 38200 30560 22920
313 OP2183 Arthroscopic PCL avulsion fixation of knee 84240 42120 33700 25270
314 OP2184 Arthroscopic PCL reconstruction of knee ( arthroscopy 155560 77780 62220 46670
with two site tendon graft )
315 OP4577 Arthroscopic PCL Reconstruction with implants 156280 78140 62510 46880
125
316 OP2185 Arthroscopic posterolateral corner repair of knee 76400 38200 30560 22920
317 OP2186 Arthroscopic release of frozen shoulder 76400 38200 30560 22920
318 OP4570 Arthroscopic release of impingment of ankle 127340 63670 50940 38200
319 OP4569 Arthroscopic release of tennis elbow 115780 57890 46310 34730
320 OP4579 Arthroscopic Remplissage Shoulder 104180 52090 41670 31250
321 OP4563 Arthroscopic repair of posterior labrum 127340 63670 50940 38200
322 OP4574 Arthroscopic Revision - ACL Reconstruction 150480 75240 60190 45140
323 OP2187 Arthroscopic rotator cuff repair of shoulder 76400 38200 30560 22920
324 OP4256 Arthroscopic Rotator Cuff Repair with Anchors (Double Row) 113800 56900 45520 34140
325 OP4255 Arthroscopic Rotator Cuff Repair with Anchors (Single Row) 108500 54250 43400 32550
326 OP4257 Arthroscopic Rotator Cuff Repair with Biceps Tenotomy 113800 56900 45520 34140
327 OP2188 Arthroscopic SLAP lesion repair of shoulder 76400 38200 30560 22920
328 OP2189 Arthroscopic stabilisation of shoulder for Recurrent dislocation 99200 49600 39680 29760
329 OP2190 Arthroscopic subacromial decompression /acromioplasty of shoulder 76400 38200 30560 22920
330 OP4259 Arthroscopic Superior Labrum Repair 108500 54250 43400 32550
331 OP2191 Arthroscopic synovectomy of ankle 76400 38200 30560 22920
332 OP2192 Arthroscopic synovectomy of elbow 76400 38200 30560 22920
333 OP2193 Arthroscopic synovectomy of hip 76400 38200 30560 22920
334 OP2194 Arthroscopic synovectomy of knee 76400 38200 30560 22920
335 OP2195 Arthroscopic synovectomy of shoulder 76400 38200 30560 22920
336 OP2196 Arthroscopic synovectomy of wrist 76400 38200 30560 22920
337 OP2198 Arthroscopic tibial plateau reconstruction of knee 76400 38200 30560 22920
338 OP2199 Arthroscopic tibial spine fixation of knee 76400 38200 30560 22920
339 OP2197 Arthroscopic triangular fibro-cartilage ( TFC ) repair of wrist 76400 38200 30560 22920
340 OP4573 Arthroscpic Para Meniscal Cyst Decompression 127340 63670 50940 38200
341 OP4557 Arthrscopic both Meniscus Partial Meniscectomy 127340 63670 50940 38200
342 OP4567 Comlex Ligament Reconstruction - Single 150480 75240 60190 45140
343 OP4568 Complex Ligamant Reconstrcuction - Multiple 196800 98400 78720 59040
344 OP2200 Diagnostic arthroscopy of elbow 35760 17880 14300 10730
345 OP2201 Diagnostic arthroscopy of hip 35760 17880 14300 10730
346 OP2202 Diagnostic arthroscopy of knee 35760 17880 14300 10730
347 OP2203 Diagnostic arthroscopy of shoulder 35760 17880 14300 10730
348 OP2204 Diagnostic arthroscopy of wrist 35760 17880 14300 10730
349 OP4301 MPFL Reconstruction for Recurrent Dislocation Patella 108500 54250 43400 32550
350 OP4562 Open Biceps Tenodesis 115780 57890 46310 34730
351 OP4302 Open Fixation of Intra - Articular Osteochondral Fragment 108500 54250 43400 32550
352 OP4565 Open LCL Reconstruction 150480 75240 60190 45140
353 OP4561 Open LCL Repair 127340 63670 50940 38200
354 OP4559 Open MCL Reconstrction 127340 63670 50940 38200
355 OP4558 Open MCL repair 104180 52090 41670 31250
356 OP4300 Open PCL Avulsion + Fixation 115000 57500 46000 34500
357 OP4564 Open release of tennis elbow 11580 5790 4630 3470
358 OP4566 Open release of tennis elbow with fixation 150480 75240 60190 45140
Bedsore Operations
OT Day Care
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4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

359 OP0042 Coccygeal bedsore excision with flap closure 117180 58590 46870 35150
360 OP1310 Coccygeal bedsore excision with primary closure 99120 49560 39650 29740
361 OP3424 Debridement of bedsore 36480 18240 14590 10940
362 OP0049 Ischial bedsore excision with myocutaneous / muscle 105000 52500 42000 31500
flap closure ( unilateral )
363 OP0047 Ischial bedsore excision with primary closure (unilateral ) 78760 39380 31500 23630
364 OP0048 Ischial bedsore excision with skin grafting ( unilateral ) 91880 45940 36750 27560
365 OP0037 Other bedsore excision with myocutaneous flap closure 105000 52500 42000 31500
366 OP0033 Other bedsore excision with primary closure 78760 39380 31500 23630
126
367 OP0036 Other bedsore excision with skin flap closure 91880 45940 36750 27560
368 OP0034 Other bedsore excision with skin grafting 91880 45940 36750 27560
369 OP0045 Sacral bedsore excision with myocutaneous flap closure 105000 52500 42000 31500
370 OP0043 Sacral bedsore excision with primary closure 78760 39380 31500 23630
371 OP0044 Sacral bedsore excision with skin flap closure 91880 45940 36750 27560
372 OP0046 Sacral bedsore excision with skin grafting 91880 45940 36750 27560
373 OP0035 Trochanteric bedsore excision with myocutaneous flap closure ( unilateral) 105000 52500 42000 31500
374 OP0050 Trochanteric bedsore excision with primary closure (unilateral ) 78760 39380 31500 23630
375 OP0020 Trochanteric bedsore excision with skin flap closure (unilateral ) 91880 45940 36750 27560
376 OP0032 Trochanteric bedsore excision with skin grafting (unilateral ) 91880 45940 36750 27560
Bone Tumour Operations
OT Day Care
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2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
377 OP2007 Curettage and bone grafting - long bones 78220 39110 31290 23470
378 OP2006 Curettage and bone grafting - small bones 51880 25940 20750 15560
379 OP2001 Excision of large exostosis 51880 25940 20750 15560
380 OP2003 Excision of large tumours ( without bone grafting ) -long bones 78220 39110 31290 23470
381 OP2005 Excision of large tumours + reconstruction with custom prosthesis 182460 91230 72980 54740
382 OP2002 Excision of large tumours with bone grafting – long bones 85360 42680 34140 25610
383 OP2004 Excision of large tumours with bone grafting with fixation for long bones 101700 50850 40680 30510
384 OP2000 Excision of small exostosis 26120 13060 10450 7840
Breast Operations
OT Day Care
Single Bed
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2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

385 OP3308 Augmentation mammoplasty by fat grafting 177980 88990 71190 53390
386 OP1772 Augmentation mammoplasty by implant 113800 56900 45520 34140
387 OP4476 Bilateral Mastectomy with free nipple graft 121560 60780 48620 36470
388 OP2821 Breast abscess drainage 21360 10680 8540 6410
389 OP4718 Breast Conservation Surgery with SLNB 95560 47780 38220 28670
390 OP4719 Breast Conservation Surgery with SLNB with axillary clearance 102900 51450 41160 30870
391 OP1777 Breast lift / mastopexy 123280 61640 49310 36980
392 OP2873 Breast lumpectomy - large 45080 22540 18030 13520
393 OP1023 Breast lumpectomy - small 33200 16600 13280 9960
394 OP0602 Breast lumpectomy with axillary clearance ( BCS ) 94900 47450 37960 28470
395 OP2868 Breast lumpectomy with axillary sampling 71140 35570 28460 21340
396 OP2869 Breast lumpectomy with sentinal lymph node biopsy 71140 35570 28460 21340
397 OP2833 Breast reconstruction using free flap 236980 118490 94790 71090
398 OP2832 Breast reconstruction using implant 142280 71140 56910 42680
399 OP2829 Breast reconstruction using latisimus dorsi muscle 170660 85330 68260 51200
400 OP2830 Breast reconstruction using rectus abdominis muscle 189640 94820 75860 56890
401 OP3085 Breast reconstruction with DIEP flap 215480 107740 86190 64640
402 OP1806 Correction of inverted nipple - unilateral 113800 56900 45520 34140
403 OP1807 Correction of inverted nipples - bilateral 142280 71140 56910 42680
404 OP2971 Endoscopic breast lump excision 38940 19470 15580 11680
405 OP1781 Endoscopic gynaecomastia excision - bilateral 113800 56900 45520 34140
406 OP1788 Endoscopic gynaecomastia excision - unilateral 75900 37950 30360 22770
407 OP1018 Excision of breast lump under ultrasound guidance 45080 22540 18030 13520
408 OP1787 Excision of supernumerary / accessory breast -bilateral 113800 56900 45520 34140
409 OP1775 Excision of supernumerary / accessory breast -unilateral 75900 37950 30360 22770
410 OP0599 Gynaecomastia excision - unilateral 84000 42000 33600 25200
127
411 OP4715 Gynaecomastia - Large 110260 55130 44100 33080
412 OP4714 Gynaecomastia - Medium 88200 44100 35280 26460
413 OP4713 Gynaecomastia - Small 66160 33080 26460 19850
414 OP4381 Mastectomy For Gender Identify Disorder 93600 46800 37440 28080
415 OP1024 Micodochotomy & removal of papilloma in breast duct 47540 23770 19020 14260
416 OP0603 Needle localisation biopsy of breast mass / lump 56920 28460 22770 17080
417 OP1792 Nipple reconstruction - bilateral 105280 52640 42110 31580
418 OP1791 Nipple reconstruction - unilateral 70220 35110 28090 21070
419 OP1778 Peri-areolar breast lift / mastopexy 104300 52150 41720 31290
420 OP1022 Radical / modified radical mastectomy 94900 47450 37960 28470
421 OP4720 Radical / Modified Radical Mastectomy with SLNB 95560 47780 38220 28670
422 OP4721 Radical / Modified Radical Mastectomy with SLNB 102900 51450 41160 30870
with axillary clearance
423 OP2828 Radical / modified radical mastectomy with 94900 47450 37960 28470
supraclavicular lymph node clearance
424 OP1773 Reduction mammoplasty - bilateral 156480 78240 62590 46940
425 OP1786 Reduction mammoplasty - unilateral 104300 52150 41720 31290
426 OP2831 Removal of breast implant 94900 47450 37960 28470
427 OP1021 Simple mastectomy 59360 29680 23740 17810
428 OP2871 Simple mastectomy with axillary sampling 71140 35570 28460 21340
429 OP2870 Simple mastectomy with sentinal lymph node biopsy 71140 35570 28460 21340
Cardiac Surgery
OT Day Care
Single Bed
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2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
430 OP4581 Complex CABG 91880 45940 36750 27560
431 OP4505 ECMO Initiation Charges - Cardiac Surgery 204200 102100 81680 61260
432 OP3365 Epicardial pacemaker Explantation in OT 88260 44130 35300 26480
433 OP3364 Epicardial pacemaker Implantation in OT 84060 42030 33620 25220
434 OP4504 Permanent LVAD - Cardiac Surgery 1458620 729310 583450 437590
435 OP3366 Premie PDA clipping in OT 176480 88240 70590 52940
436 OP4503 Temporary LVAD Initiation Charge - Cardiac Surgery 486220 243110 194490 145870
Cleft Lip And Palate Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

437 OP1585 Cleft lip nose rhinoplasty - complete 101500 50750 40600 30450
438 OP1583 Cleft lip nose rhinoplasty - nasal tip 84580 42290 33830 25370
439 OP1323 Cleft lip repair - bilateral complete 102980 51490 41190 30890
440 OP1576 Cleft lip repair - bilateral incomplete 92620 46310 37050 27790
441 OP0062 Cleft lip repair - unilateral complete 99120 49560 39650 29740
442 OP1577 Cleft lip repair - unilateral incomplete 81120 40560 32450 24340
443 OP1247 Cleft palate repair - complete 121560 60780 48620 36470
444 OP1248 Cleft palate repair - posterior 97260 48630 38900 29180
445 OP4305 PALATAL IMPLANT (SET OF 3) 44120 22060 17650 13240
446 OP4306 PALATAL IMPLANT (SET OF 5) 58820 29410 23530 17650
447 OP0041 Palatal re-repair / lengthening 97260 48630 38900 29180
448 OP1307 Repair of palatal fistula with alveolar bone grafting 144100 72050 57640 43230
449 OP0038 Repair of palatal fistula with buccal flap 117180 58590 46870 35150
450 OP1578 Repair of palatal fistula with free flap 207220 103610 82890 62170
451 OP0040 Repair of palatal fistula with local flap 135220 67610 54090 40570
128
452 OP0039 Repair of palatal fistula with tongue flap - first stage 108120 54060 43250 32440
453 OP1579 Repair of palatal fistula with tongue flap – second stage 81120 40560 32450 24340
454 OP1581 Revision of lip repair 99120 49560 39650 29740
455 OP1582 Revision of lip repair and Alveolar bone grafting 135220 67610 54090 40570
Closed Reduction And Internal Fixation
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
456 OP1890 Closed Ender's nailing for fracture shaft femur 103220 51610 41290 30970
457 OP1888 Closed Ender's nailing for fracture tibia 103220 51610 41290 30970
458 OP1887 Closed interlock nailing for fracture tibia 103220 51610 41290 30970
459 OP1889 Closed interlocking nailing for fracture shaft femur 103220 51610 41290 30970
460 OP3260 Closed nailing humerus 92760 46380 37100 27830
461 OP2993 Closed percutaneous screw fixation for neck of humerus 60440 30220 24180 18130
462 OP1886 Closed percutaneous screw fixation for tibial plateau fracture 54840 27420 21940 16450
463 OP1893 Closed reduction fracture distal radius with K-wire fixation 29700 14850 11880 8910
464 OP1896 Closed reduction fracture neck humerus with K-wire fixation 58340 29170 23340 17500
465 OP1895 Closed reduction fracture supracondylar humerus with K-wire fixation 58340 29170 23340 17500
466 OP3065 Closed reduction of ankle 23060 11530 9220 6920
467 OP3045 Closed reduction of elbow 23060 11530 9220 6920
468 OP4131 Closed reduction of femur 20960 10480 8380 6290
469 OP4128 Closed reduction of forearm bones 20960 10480 8380 6290
470 OP3447 Closed reduction of fracture of metacarpal / phalynx 32360 16180 12940 9710
471 OP3057 Closed reduction of hip 23060 11530 9220 6920
472 OP4130 Closed reduction of humerus 20960 10480 8380 6290
473 OP4133 Closed reduction of IP / MP Joints 20960 10480 8380 6290
474 OP4129 Closed reduction of leg bones 20960 10480 8380 6290
475 OP3058 Closed reduction of shoulder 23060 11530 9220 6920
476 OP3055 Closed reduction of wrist 23060 11530 9220 6920
477 OP1894 K-wire fixation for fracture radial styloid 29700 14850 11880 8910
478 OP3263 Nailing of radius and ulna 92760 46380 37100 27830
Dental
OT Day Care
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Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

479 OP4780 Dental-Deep Impaction 15750
480 OP3094 Alveolectomy ( both jaws ) in OT 16980 8490 6790 5090 8490
481 OP3095 Alveolectomy ( one jaws ) in OT 8480 4240 3390 2540 4240
482 OP3096 Alveoloplasty in OT 5120 2560 2050 1540 2560
483 OP3099 Apicectomy ( per tooth ) in OT 13560 6780 5420 4070 6780
484 OP4086 Archbar fixation dentoalveolar fracture per segement- Dental 10180 5090 4070 3050 5090
485 OP3102 Arthocentesis of TMJ in OT 16980 8490 6790 5090 8490
486 OP3103 Cavity sealant ( per tooth ) in OT 2180 1090 870 650 1090
487 OP4114 Ceramic laminate - Dental 13560 6780 5420 4070 6780
488 OP3105 Chemical cauterisation in OT 1740 870 700 520 870
489 OP3130 Circum-mandibular splint removal in OT 3400 1700 1360 1020 1700
490 OP3104 Composite filling in OT 5120 2560 2050 1540 2560
491 OP4110 Composite veneers - Dental 5120 2560 2050 1540 2560
492 OP4109 Core build up (prefab) - Dental 3400 1700 1360 1020 1700
493 OP4108 Core buildup (casting) - Dental 5120 2560 2050 1540 2560
494 OP4117 Crown / Bridge per unit (procera) - Dental 46240 23120 18500 13870 23120
495 OP4116 Crown/Bridge per unit (metal) - Dental 10180 5090 4070 3050 5090
496 OP4115 Crown/Bridge per unit (PFM) - Dental 15280 7640 6110 4580 7640
129
497 OP4124 Curettage (Per quadrant) - Dental 8480 4240 3390 2540 4240
498 OP3136 Dental Implant in OT 154080 77040 61630 46220 77040
499 OP4787 Dental-Acrylic Crown 5250
500 OP4793 Dental-Allograft Per Unit 15750
501 OP4765 Dental-Apical Surgery for tooth preservation 15750
502 OP4766 Dental-Apical Surgery for tooth preservation subsequent tooth 3150
503 OP4774 Dental-Bone Preserving Dental Extraction 5250
504 OP4768 Dental-Canine Exposure 13130
505 OP4791 Dental-Ceramic Onlay 21000
506 OP4804 Dental-Clear Aligners Complicated Both 367500
507 OP4803 Dental-Clear Aligners Complicated Single 210000
508 OP4802 Dental-Clear Aligners Simple Both 183750
509 OP4801 Dental-Clear Aligners Simple Single 157500
510 OP4786 Dental-Cosmetic Filling 3150
511 OP4789 Dental-Crown Rebonding 3150
512 OP4788 Dental-Crown Recementation 1580
513 OP4792 Dental-Cutting Out Old Crown 2630
514 OP4782 Dental-Cyst Enucleation/Marsupialisation 13130
515 OP4767 Dental-E Max Veneer/ Crown 26250
516 OP4779 Dental-Enameloplasty 1580
517 OP4784 Dental-Flap Surgery per Segment 5250
518 OP4800 Dental-Laser Surgery 13130
519 OP4796 Dental-Membrane Large 21000
520 OP4795 Dental-Membrane Medium 15750
521 OP4794 Dental-Membrane Small 10500
522 OP4781 Dental-Orthodontic Trainer 12600
523 OP4771 Dental-Partial Denture Lucitone upto 3 Teeth 8930
526 OP4799 Dental-Piezo Surgery 13130
527 OP4785 Dental-Pit and Fissure Sealant 1890
528 OP4783 Dental-Post and Core 3150
529 OP4770 Dental-Reimplantation and Cosmetic splinting of 5780
Avulsed Subsequent Tooth
530 OP4769 Dental-Reimplantation and Cosmetic splinting of Avulsed Tooth 15750
531 OP4790 Dental-Single Sitting RCT 10500
532 OP4797 Dental-Tacs 1580
533 OP4777 Dental-Teeth Express on 4 Implants First Stage Per Arch 157500
534 OP4778 Dental-Teeth Express on 4 Implants Second Stage Per Arch 157500
535 OP4775 Dental-Teeth Express on 6 Implants First Stage Per Arch 210000
536 OP4776 Dental-Teeth Express on 6 Implants Second Stage Per Arch 262500
537 OP4798 Dental-Temporary Crown 1050
538 OP4087 Dislocation of TMJ - Dental 8480 4240 3390 2540 4240
539 OP3132 Elevation of zygomatic complex fracture in OT 33900 16950 13560 10170 16950
540 OP4098 Excisional biopsy - Dental 10180 5090 4070 3050 5090
541 OP4097 Extraction- All Teeth- Both Jaws - Dental 27160 13580 10860 8150 13580
542 OP4099 Extraction of fractured/decayed tooth - Dental 3400 1700 1360 1020 1700
543 OP3147 Extraction of impacted tooth in OT 16980 8490 6790 5090 8490
544 OP4088 Fabrication of Circummandibular splint - Dental 13560 6780 5420 4070 6780
545 OP3110 Filling amalgam / Glass ionomer in OT 5180 2590 2070 1550 2590
546 OP3142 Flap operation ( per quadrant ) in OT 10180 5090 4070 3050 5090
547 OP4125 Flap operation (full arch) - Dental 33900 16950 13560 10170 16950
548 OP3143 Flap surgery with bone graft ( per quadrant ) in OT 13560 6780 5420 4070 6780
549 OP4112 Fluoride application per arch - Dental 2740 1370 1100 820 1370
550 OP4089 Fracture mandible open reduction (cost of plates & screws extra ) - 50860 25430 20340 15260 25430
Dental
551 OP4100 Frenectomy - Dental 5120 2560 2050 1540 2560
552 OP3145 Gingivectomy ( per quadrant ) in OT 8480 4240 3390 2540 4240
553 OP3146 Gingivoplasty ( per quadrant ) in OT 10180 5090 4070 3050 5090
130
554 OP4126 Implant Surgery First Stage) - Dental 67780 33890 27110 20330 33890
555 OP4127 Implant Surgery Second Stage - Dental 33900 16950 13560 10170 16950
556 OP4102 Incision & drainage - Dental 6800 3400 2720 2040 3400
557 OP4101 Incisional biopsy - Dental 5120 2560 2050 1540 2560
558 OP4103 Inta articular injection - Dental 2740 1370 1100 820 1370
559 OP3150 Interdental wiring + splinting ( per quadrant ) in OT 10180 5090 4070 3050 5090
560 OP4090 Inter-maxillary fixation with archbar - Dental 23740 11870 9500 7120 11870
561 OP4091 Iodoform Dressing - Dental 1360 680 540 410 680
562 OP4104 Jaw fracture closed reduction - Dental 27160 13580 10860 8150 13580
563 OP4118 Metal Free ceramic crown - Dental 23740 11870 9500 7120 11870
564 OP3154 Mini implant for anchorage ( per implant ) in OT 20340 10170 8140 6100 10170
565 OP4092 Nerve block in Neuralgias - Dental 10180 5090 4070 3050 5090
566 OP3116 Obturator for cleft palate in OT 27160 13580 10860 8150 13580
567 OP4093 Operculectomy - Dental 3400 1700 1360 1020 1700
568 OP4094 Oro antral communication closure - Dental 47480 23740 18990 14240 23740
569 OP3119 Placentrax injection for OSMF in OT 2740 1370 1100 820 1370
570 OP3121 Pulp capping in OT 5180 2590 2070 1550 2590
571 OP3122 Pulpotomy in OT 3400 1700 1360 1020 1700
572 OP4122 Rapid maxillary expansion (RME) - Dental 23740 11870 9500 7120 11870
573 OP4119 Recementation of crown /bridge per unit - Dental 2060 1030 820 620 1030
574 OP3155 Reimplantation of avulsed tooth in OT 6800 3400 2720 2040 3400
575 OP4120 Relining of Denture - Dental 2060 1030 820 620 1030
576 OP3123 Removal of Fronto-suspension wiring in OT 13560 6780 5420 4070 6780
577 OP4121 Removal of old crown/ bridge per unit - Dental 1740 870 700 520 870
578 OP4095 Removal of plates of mandible and maxilla - Dental 27160 13580 10860 8150 13580
579 OP3125 Removal of plates of mandible and maxilla in OT 27160 13580 10860 8150 13580
580 OP3126 Root canal treatment ( RCT ) - anterior in OT 8480 4240 3390 2540 4240
581 OP3127 Root canal treatment ( RCT ) - posterior in OT 13560 6780 5420 4070 6780
582 OP3129 Scaling full mouth in OT 5120 2560 2050 1540 2560
583 OP3140 Simple extraction of tooth in OT 1740 870 700 520 870
584 OP4123 Space maintainers - Dental 8480 4240 3390 2540 4240
585 OP4107 Splint removal - Dental 3400 1700 1360 1020 1700
586 OP3131 Subgingival scaling & curretage full mouth in OT 10180 5090 4070 3050 5090
587 OP3156 Surgical extraction of tooth in OT 6800 3400 2720 2040 3400
588 OP4105 Suture removal - Dental 3400 1700 1360 1020 1700
589 OP4096 TMJ Physiotherapy - Dental 1740 870 700 520 870
590 OP4111 Tooth inlay - Dental 5120 2560 2050 1540 2560
591 OP4106 Tumour excision - Dental 33900 16950 13560 10170 16950
Endocrine Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

592 OP0540 Endoscopic hemi-thyroidectomy / lobectomy 64720 32360 25890 19420
593 OP0542 Endoscopic parathyroidectomy 104300 52150 41720 31290
594 OP0541 Endoscopic subtotal thyroidectomy 104300 52150 41720 31290
595 OP1043 Excision of lingual thyroid 47540 23770 19020 14260
596 OP1044 Excision of thyroglossal cyst 47540 23770 19020 14260
597 OP1272 Excision of thyroglossal fistula / sinus 47540 23770 19020 14260
598 OP4722 Hemithyroidectomy (size <5 cms) 67760 33880 27100 20330
599 OP4724 Hemithyroidectomy (size >10 cms) 88200 44100 35280 26460
600 OP4723 Hemithyroidectomy (size 5 - 10 cms) 77180 38590 30870 23150
601 OP1051 Hemi-thyroidectomy / lobectomy 71140 35570 28460 21340
602 OP4388 Laparoscopic Adrenalectomy 147100 73550 58840 44130
603 OP0567 Laparoscopic adrenalectomy ( transabdominal ) 113800 56900 45520 34140
604 OP4389 Open Adrenalectomy 133700 66850 53480 40110
605 OP0627 Parathyroidectomy - multiple glands 94900 47450 37960 28470
131
606 OP0626 Parathyroidectomy - multiple glands & reimplantation in muscle 94900 47450 37960 28470
607 OP1045 Parathyroidectomy - single gland 94900 47450 37960 28470
608 OP0568 Retroperitoneoscopic adrenalectomy 104300 52150 41720 31290
609 OP4537 Robotic Adrenalectomy 175100 87550 70040 52530
610 OP1011 Subtotal adrenalectomy 125600 62800 50240 37680
611 OP0806 Subtotal thyroidectomy 71140 35570 28460 21340
612 OP0628 Thyroid isthmectomy 71140 35570 28460 21340
613 OP1012 Total adrenalectomy 142280 71140 56910 42680
614 OP1050 Total thyroidectomy 94900 47450 37960 28470
615 OP4727 Total Thyroidectomy - Large (>10 cms) 117600 58800 47040 35280
616 OP4726 Total Thyroidectomy - Medium (5-10 cms) 102900 51450 41160 30870
617 OP4725 Total Thyroidectomy - Small (<5 cms) 90360 45180 36140 27110
618 OP2874 Total thyroidectomy with sternotomy for retrosternal goiter 142280 71140 56910 42680
Ent
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
619 OP0988 Adenoidectomy 23940 11970 9580 7180
620 OP0960 Adeno-tonsillectomy 45700 22850 18280 13710
621 OP4588 Advanced Schwannomas and Hemangiomas of the Facial Nerve 165380 82690 66150 49610
622 OP0996 Antral puncture & wash - bilateral 17300 8650 6920 5190
623 OP0405 Antral puncture & wash - unilateral 10480 5240 4190 3140
624 OP4585 Arytenoidectomy 60640 30320 24260 18190
625 OP3470 Augmentation laryngeal surgery 56080 28040 22430 16820
626 OP4587 Aural Atresia Recanalization 90960 45480 36380 27290
627 OP3466 Aural Meatoplasty 38040 19020 15220 11410
628 OP4580 BAHA 82700 41350 33080 24810
629 OP4860 Balloon Sinuplasty (Frontal + Sphenoid) 42000 21000 16800 12600
630 OP4855 Balloon Sinuplasty (Frontal ostium) 37800 18900 15120 11340
631 OP4858 Balloon Sinuplasty (Maxillary + Frontal + Sphenoid) 52500 26250 21000 15750
632 OP4857 Balloon Sinuplasty (Maxillary + Frontal) 42000 21000 16800 12600
633 OP4859 Balloon Sinuplasty (Maxillary + Sphenoid) 42000 21000 16800 12600
634 OP4854 Balloon Sinuplasty (Maxillary ostium) 31500 15750 12600 9450
635 OP4856 Balloon Sinuplasty (Sphenoid ostium) 31500 15750 12600 9450
636 OP4596 Bleeding Polypus Septum Removal 19300 9650 7720 5790
637 OP0962 Caldwel Luc's operation - bilateral 41880 20940 16750 12560
638 OP0978 Caldwel Luc's operation - unilateral 27640 13820 11060 8290
639 OP0922 Choanal atresia repair 118540 59270 47420 35560
640 OP3496 Coblation / radiofrequency channeling anterior and 38040 19020 15220 11410
posterior tonsillar pillar
641 OP3497 Coblation / radiofrequency channeling base of tongue 38040 19020 15220 11410
642 OP3495 Coblation / radiofrequency channeling of soft palate 38040 19020 15220 11410
643 OP4603 Coblation Assisted Inferior Turbinate Reduction 27580 13790 11030 8270
644 OP4325 COBLATION ENDOSCOPIC ADENOIDECTOMY 53480 26740 21390 16040
645 OP4703 Coblation Lingual Tonsillectomy 41340 20670 16540 12400
646 OP3492 Coblation tonsillectomy 41800 20900 16720 12540
647 OP4706 Collaural Fistula 55120 27560 22050 16540
648 OP0938 Cortical mastoidectomy 64500 32250 25800 19350
649 OP4607 Crico Thyroid Approximation 41340 20670 16540 12400
650 OP4589 Debridement for Malignant Otitis Externa 88200 44100 35280 26460
651 OP0914 Decompression of endolymphatic sac 107780 53890 43110 32330
652 OP0999 Diagnostic nasal endoscopy 7780 3890 3110 2330
653 OP0756 Dilatation of hypopharynx 23940 11970 9580 7180
654 OP0990 Direct laryngoscopy 23940 11970 9580 7180
655 OP3472 DRAF I - bilateral 55820 27910 22330 16750
656 OP3471 DRAF I - unilateral 38040 19020 15220 11410
132
657 OP3474 DRAF II - bilateral 75260 37630 30100 22580
658 OP3473 DRAF II - unilateral 55820 27910 22330 16750
659 OP3475 DRAF III 107780 53890 43110 32330
660 OP4085 Emergency foreign body removal by rigid 84140 42070 33660 25240
bronchoscope with optical forceps
661 OP0975 Endoscopic adenoidectomy 34740 17370 13900 10420
662 OP0966 Endoscopic antrostomy - bilateral 25960 12980 10380 7790
663 OP0402 Endoscopic antrostomy - unilateral 17300 8650 6920 5190
664 OP3476 Endoscopic clivus resection of lesion / approach 112640 56320 45060 33790
665 OP0959 Endoscopic DCR 43780 21890 17510 13130
666 OP0972 Endoscopic frontal recess clearance of disease -bilateral 33200 16600 13280 9960
667 OP0982 Endoscopic frontal recess clearance of disease -unilateral 27640 13820 11060 8290
668 OP0971 Endoscopic maxillary clearance of disease - bilateral 33200 16600 13280 9960
669 OP0981 Endoscopic maxillary clearance of disease - unilateral 27640 13820 11060 8290
670 OP0989 Endoscopic maxillary clearance of disease ( canine 33200 16600 13280 9960
fossa approach ) - bilateral
671 OP0404 Endoscopic maxillary clearance of disease ( canine 22000 11000 8800 6600
fossa approach ) - unilateral
672 OP3485 Endoscopic nasal + sinus Debridment for invasive 80900 40450 32360 24270
fungal sinusitis - bilateral
673 OP3484 Endoscopic nasal + sinus Debridment for invasive 64720 32360 25890 19420
fungal sinusitis - unilateral
674 OP0994 Endoscopic nasal biopsy 18100 9050 7240 5430
675 OP0920 Endoscopic orbital decompression 118540 59270 47420 35560
676 OP0919 Endoscopic pan sinus surgery - bilateral 118540 59270 47420 35560
677 OP0398 Endoscopic pan sinus surgery - unilateral 82800 41400 33120 24840
678 OP3488 Endoscopic Septoplasty 39780 19890 15910 11930
679 OP3398 Endoscopic transnasal medial maxillectomy 198160 99080 79260 59450
680 OP0954 Endoscopy and surgical decannulation of tracheostomy 23940 11970 9580 7180
681 OP0985 Endoscopy, decannulation & strapping of tracheostomy 23940 11970 9580 7180
682 OP0998 Examination under microscopy (ENT) 7780 3890 3110 2330
683 OP0908 Excision of acoustic neuroma – translabrynthine approach 155140 77570 62060 46540
684 OP0909 Excision of glomus jugulare tumour 155140 77570 62060 46540
685 OP0947 Excision of laryngeal papilloma 61700 30850 24680 18510
686 OP0951 Excision of palatal mass 61700 30850 24680 18510
687 OP1401 Excision of pharyngeal diverticulum 82800 41400 33120 24840
688 OP1358 Excision of pharyngeal pouch and cricopharyngeal myotomy 82800 41400 33120 24840
689 OP0965 Excision of tumour of external auditory canal 34740 17370 13900 10420
690 OP4420 Exploratory Tympanotomy 33860 16930 13540 10160
691 OP0934 External ethmoidectomy - bilateral 82800 41400 33120 24840
692 OP0943 External ethmoidectomy - unilateral 61700 30850 24680 18510
693 OP0918 External osteoplastic frontal sinus surgery 118540 59270 47420 35560
694 OP4701 Feminizing Thyroplasty 96480 48240 38590 28940
695 OP0941 FESS - bilateral 64500 32250 25800 19350
696 OP0955 FESS - unilateral 43780 21890 17510 13130
697 OP0928 FESS ( extended ) - bilateral 86560 43280 34620 25970
698 OP0940 FESS ( extended ) - unilateral 64500 32250 25800 19350
699 OP0969 FESS ( minimal ) - bilateral 43780 21890 17510 13130
700 OP0957 FESS ( minimal ) - unilateral 34740 17370 13900 10420
701 OP2958 FESS revision surgery - bilateral 47760 23880 19100 14330
702 OP2960 FESS revision surgery - unilateral 37900 18950 15160 11370
703 OP1000 Fibreoptic laryngoscopy 8120 4060 3250 2440
704 OP0898 Foreign body ear removal 10960 5480 4380 3290
705 OP0899 Foreign body nose removal 10960 5480 4380 3290
706 OP3478 Frontal ostium balloon sinuplasty-bilateral 55820 27910 22330 16750
707 OP3477 Frontal ostium bBalloon sinuplasty-unilateral 38040 19020 15220 11410
708 OP3498 Hyoid bone suspension 75260 37630 30100 22580
709 OP0991 Hypopharyngoscopy 23940 11970 9580 7180
710 OP0902 Incision and drainage of Ludwigs angina 54080 27040 21630 16220
133
711 OP4605 Injection Laryngoplasty - Fat 33080 16540 13230 9920
712 OP4705 Intratympanic Injection 11020 5510 4410 3310
713 OP4608 Laryngeal Drop 27580 13790 11030 8270
714 OP4702 Laryngeal T-tube Placement 55120 27560 22050 16540
715 OP0948 Laryngeal web excision 56080 28040 22430 16820
716 OP0945 Laryngofissure & repair 64500 32250 25800 19350
717 OP3494 Laser / coblation / radiofrequency assisted uvulopalatoplasty 75260 37630 30100 22580
718 OP3468 Laser / coblation excision of laryngeal papilloma 75260 37630 30100 22580
719 OP3469 Laser / coblation MLS decortication 75260 37630 30100 22580
720 OP3493 Laser / coblation resection of midline base of tongue 50760 25380 20300 15230
721 OP4591 Laser Assisted Resurfacing of Buccal Mucosa 27580 13790 11030 8270
722 OP3467 Laser MLS 56080 28040 22430 16820
723 OP4609 Laser Stapedotomy 86620 43310 34650 25990
724 OP3183 Laser Tonsillectomy 53400 26700 21360 16020
725 OP0897 Major vessel ligation for epistaxis 64720 32360 25890 19420
726 OP0927 Mastoidectomy with cavity obliteration 82800 41400 33120 24840
727 OP3480 Maxillary ostium balloon sinuplasty-bilateral 55820 27910 22330 16750
728 OP3479 Maxillary ostium balloon sinuplasty-unilateral 38040 19020 15220 11410
729 OP0949 Microlaryngoscopic ( MLS ) decortication 61700 30850 24680 18510
730 OP0968 Microlaryngoscopic ( MLS ) excision of nodule / polyp 34740 17370 13900 10420
731 OP0980 Microlaryngoscopy ( MLS ) & biopsy 28860 14430 11540 8660
732 OP0964 MLS radiofrequency biopsy of mass (ENT) 34740 17370 13900 10420
733 OP0953 MLS radiofrequency excision of mass / nodule / polyp (ENT) 43780 21890 17510 13130
734 OP0925 Modified radical mastoidectomy 86560 43280 34620 25970
735 OP0937 Myringoplasty 61700 30850 24680 18510
736 OP3462 Myringotomy - bilateral 21760 10880 8700 6530
737 OP3463 Myringotomy - unilateral 16460 8230 6580 4940
738 OP0986 Myringotomy with grommet - bilateral 33860 16930 13540 10160
739 OP0997 Myringotomy with grommet - unilateral 16920 8460 6770 5080
740 OP3465 Myringotomy with T-Tube insertion - unilateral 39780 19890 15910 11930
741 OP3464 Myringotomy with T-Tube insertion- bilateral 41720 20860 16690 12520
742 OP0894 Nasal anterior & posterior (both) packing 21900 10950 8760 6570
743 OP0896 Nasal anterior packing 9100 4550 3640 2730
744 OP0893 Nasal endoscopic cautery 27300 13650 10920 8190
745 OP0895 Nasal posterior packing 16500 8250 6600 4950
746 OP0903 Nasal septal abscess drainage 10960 5480 4380 3290
747 OP0976 Nasal septoplasty 28860 14430 11540 8660
748 OP0958 Nasal septoplasty + submucosal diathermy 43780 21890 17510 13130
749 OP3487 Nasal septoplasty-Complex 39780 19890 15910 11930
750 OP4599 Nasal Septum Perforation Closure (Local Flap) 41340 20670 16540 12400
751 OP3483 Nasal spacer plate placement 21160 10580 8460 6350
752 OP3491 Nasal valve correction - bilateral 38040 19020 15220 11410
753 OP3490 Nasal valve correction - unilateral 25120 12560 10050 7540
754 OP4700 Nasolabilal Cyst Excision 49620 24810 19850 14890
755 OP0702 Oral excisional biopsy 20800 10400 8320 6240
756 OP1001 Oral incisional biopsy 10500 5250 4200 3150
757 OP0932 Ossiculoplasty 82800 41400 33120 24840
758 OP0973 Pan-endoscopy (ENT) 34740 17370 13900 10420
759 OP0900 Parapharyngeal abscess drainage 28860 14430 11540 8660
760 OP4582 Parapharyngeal Tumour Excision 68900 34450 27560 20670
761 OP4763 Parotid Gland Combined Approach 65620 32810 26250 19690
762 OP3486 Partial septectomy 38040 19020 15220 11410
763 OP4084 Pediatric Tracheotomy with superior tracheal flap 64720 32360 25890 19420
764 OP0935 Pharyngeal diverticulum excision 82800 41400 33120 24840
765 OP4704 Pinna Seroma Drainage 27580 13790 11030 8270
766 OP4594 Plunging Ranula Excision 49620 24810 19850 14890
767 OP4592 Posterior Cordectomy and Arytenoidectomy 68900 34450 27560 20670
768 OP0961 Pre-auricular sinus excision - bilateral 43780 21890 17510 13130
769 OP0979 Pre-auricular sinus excision - unilateral 28860 14430 11540 8660
134
770 OP4583 Quincy Incision and Drainage 22060 11030 8820 6620
771 OP0926 Radical mastoidectomy 86560 43280 34620 25970
772 OP0963 Radiofrequency excision of mass in nose 41880 20940 16750 12560
773 OP0974 Radiofrequency nose submucosal diathermy 33200 16600 13280 9960
774 OP0984 Radiofrequency turbinate reduction 27640 13820 11060 8290
775 OP4584 Ranula Marsupialisation 33080 16540 13230 9920
776 OP1285 Release of tongue tie / frenuloplasty 14460 7230 5780 4340
777 OP4490 Release of Tongue Tie with Z plasty 48620 24310 19450 14590
778 OP2962 Repair of CSF otorrhea 107840 53920 43140 32350
779 OP0950 Repair of oro-antral fistula with flap 61700 30850 24680 18510
780 OP0983 Retropharyngeal abscess drainage 28860 14430 11540 8660
781 OP2968 Revision mastoidectomy 90160 45080 36060 27050
782 OP2961 Revision tympanoplasty 86260 43130 34500 25880
783 OP4597 Rhinolith Removal 13780 6890 5510 4130
784 OP4598 Rhinosporidiosis Excision 68900 34450 27560 20670
785 OP4000 SEPTAL FRAMEWORK SURGERY 97080 48540 38830 29120
786 OP3482 Sphenoid ostium balloon sinuplasty-bilateral 55820 27910 22330 16750
787 OP3481 Sphenoid ostium balloon sinuplasty-unilateral 38040 19020 15220 11410
788 OP0942 Sphenoidotomy - bilateral 61700 30850 24680 18510
789 OP0956 Sphenoidotomy - unilateral 41880 20940 16750 12560
790 OP3489 Spurectomy 25120 12560 10050 7540
791 OP0931 Stapedectomy 86560 43280 34620 25970
792 OP0802 Stomaplasty ( tracheal ) 25960 12980 10380 7790
793 OP0944 Styloidectomy - bilateral 61700 30850 24680 18510
794 OP0967 Styloidectomy - unilateral 33200 16600 13280 9960
795 OP4762 Submandibular Gland Combined approach 52500 26250 21000 15750
796 OP0952 Submucosal uvulo-palato-pharyngo-plasty by radiofrequency ( UPPP ) 41880 20940 16750 12560
797 OP0987 Surgical turbinate reduction - bilateral 22900 11450 9160 6870
798 OP0403 Surgical turbinate reduction - unilateral 17300 8650 6920 5190
799 OP0946 Thyroplasty - type 1 61700 30850 24680 18510
803 OP0977 Tonsillectomy 33860 16930 13540 10160
804 OP4604 Tonsillotomy 27580 13790 11030 8270
805 OP0917 Tracheal reconstruction 118540 59270 47420 35560
806 OP4593 Tracheal Stoma Closure (Tracheo cutaneous fistula closure) 33080 16540 13230 9920
807 OP0799 Tracheo-oesophageal puncture 18100 9050 7240 5430
808 OP0798 Tracheo-oesophageal valve insertion 22660 11330 9060 6800
809 OP0889 Tracheostomy ( open ) - elective 32980 16490 13190 9890
810 OP0890 Tracheostomy ( open ) - emergency 38380 19190 15350 11510
811 OP0394 Tracheostomy ( percutaneous ) - elective 31560 15780 12620 9470
812 OP0395 Tracheostomy ( percutaneous ) - emergency 36660 18330 14660 11000
813 OP4707 Tracheostomy Site Bleeding re-exploration 41340 20670 16540 12400
814 OP4601 Trans Tymapanic BERA - Bilateral 24800 12400 9920 7440
815 OP4600 Trans Tymapanic BERA - Unilateral 13780 6890 5510 4130
816 OP0929 Trans-nasal vidian neurectomy - bilateral 92680 46340 37070 27800
817 OP0939 Trans-nasal vidian neurectomy - unilateral 61700 30850 24680 18510
818 OP0734 Triple endoscopy ( laryngoscopy, tracheoscopy & oesophagoscopy ) 43200 21600 17280 12960
819 OP0933 Tympanoplasty 82800 41400 33120 24840
820 OP0936 Uvulo-palato-pharyngo-plasty ( UPPP ) 34740 17370 13900 10420
821 OP4595 Vallecular Cyst Excision 41340 20670 16540 12400
822 OP4606 Vocal Fold Injection - Fillers/Steroid 22060 11030 8820 6620
823 OP4326 Z-PLATAPLASTY 85580 42790 34230 25670
824 OP4423 Position Testing ( Dix - Hallpike / Head - Shaking ) 5100 2550 2040 1530
825 OP4424 Re-Position ( Epley's ) Manouvere 10180 5090 4070 3050
135
External Fixators
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
826 OP1957 Ankle / foot deformity correction using JESS fixator 148720 74360 59490 44620
827 OP1909 Ankle arthrodesis using Ilizarov fixator 85520 42760 34210 25660
828 OP3456 Application of Ilizarov & Hexapod/Ortho-SUV frame 135300 67650 54120 40590
829 OP4448 ATFL/CFL ankle reconstruction 116700 58350 46680 35010
830 OP1917 Bone transport femur using Ilizarov fixator 85520 42760 34210 25660
831 OP1933 Bone transport femur using Orthofix fixator 85520 42760 34210 25660
832 OP1918 Bone transport tibia using Ilizarov fixator 85520 42760 34210 25660
833 OP1938 Bone transport tibia using Orthofix fixator 85520 42760 34210 25660
834 OP4451 Capitullum or coronoid fracture fixation / excision 58340 29170 23340 17500
835 OP4444 Change of wires / screws 20420 10210 8170 6130
836 OP2845 Closed ankle / foot fracture fixation using JESS fixator 85520 42760 34210 25660
837 OP1921 Closed elbow fracture fixation using Ilizarov fixator 85520 42760 34210 25660
838 OP1902 Closed femoral condyle fracture using Ilizarov fixator 85520 42760 34210 25660
839 OP2837 Closed femoral shaft fracture fixation using Ilizarov fixator 85520 42760 34210 25660
840 OP1922 Closed forearm fracture fixation using Ilizarov fixator 85520 42760 34210 25660
841 OP2847 Closed forearm fracture fixation using JESS fixator 85520 42760 34210 25660
842 OP1919 Closed fracture dislocation shoulder fixation using Ilizarov fixator 85520 42760 34210 25660
843 OP1930 Closed fracture femur fixation using Orthofix fixator 85520 42760 34210 25660
844 OP1944 Closed fracture forearm fixation using Orthofix fixator 85520 42760 34210 25660
845 OP2851 Closed fracture humerus fixation using Orthofix fixator 85520 42760 34210 25660
846 OP2848 Closed fracture metacarpal and phalanges fixation using JESS fixator 94180 47090 37670 28250
847 OP1934 Closed fracture tibia fixation using Orthofix fixator 85520 42760 34210 25660
848 OP1950 Closed fracture wrist joint fixation using Orthofix fixator 85520 42760 34210 25660
849 OP1920 Closed humerus fracture fixation using Ilizarov fixator 85520 42760 34210 25660
850 OP4450 Closed reduction of fractur with percutaneous fixation with screw / wire 58340 29170 23340 17500
851 OP1905 Closed tibial plafond and ankle fracture fixation using Ilizarov fixator 85520 42760 34210 25660
852 OP1903 Closed tibial plateau fracture fixation using Ilizarov fixator 85520 42760 34210 25660
853 OP1904 Closed tibial shaft fracture fixation using Ilizarov fixator 85520 42760 34210 25660
854 OP1923 Closed wrist fracture fixation using Ilizarov fixator 85520 42760 34210 25660
855 OP2849 Closed wrist fracture fixation using JESS fixator 35760 17880 14300 10730
856 OP4453 Complex joint reconstruction using external fixator 126420 63210 50570 37930
857 OP4443 Complex trauma fixation using external fixator / K-wire 85100 42550 34040 25530
858 OP1955 Contractures fingers release using JESS fixator 163560 81780 65420 49070
859 OP3262 Corticotomy - long bones 81780 40890 32710 24530
860 OP1899 Cross leg fixaton in flap surgery using Universal External Fixator 79340 39670 31740 23800
861 OP1910 Deformity correction femur using Ilizarov fixator 85520 42760 34210 25660
862 OP1932 Deformity correction femur using Orthofix fixator 85520 42760 34210 25660
863 OP1912 Deformity correction foot and ankle using Ilizarov fixator 85520 42760 34210 25660
864 OP1942 Deformity correction foot using Orthofix fixator 85520 42760 34210 25660
865 OP1949 Deformity correction forearm bones using Orthofix fixator 85520 42760 34210 25660
866 OP1925 Deformity correction forearm using Ilizarov fixator 85520 42760 34210 25660
867 OP1924 Deformity correction humerus using Ilizarov fixator 85520 42760 34210 25660
868 OP1948 Deformity correction humerus using Orthofix fixator 85520 42760 34210 25660
869 OP1954 Deformity correction of wrist using JESS fixator 94180 47090 37670 28250
870 OP1911 Deformity correction tibia using Ilizarov fixator 85520 42760 34210 25660
871 OP1937 Deformity correction tibia using Orthofix fixator 85520 42760 34210 25660
872 OP1926 Deformity correction wrist using Ilizarov fixator 85520 42760 34210 25660
873 OP2865 External fixation for closed fracture femur using 59580 29790 23830 17870
Universal External Fixator
874 OP2867 External fixation for closed fracture forearm using 59580 29790 23830 17870
875 OP2866 External fixation for closed fracture humerus using 59580 29790 23830 17870
136
876 OP2864 External fixation for closed fracture tibia using 59580 29790 23830 17870
877 OP1897 External fixation for open fracture femur using 59580 29790 23830 17870
878 OP2859 External fixation for open fracture forearm using 59580 29790 23830 17870
879 OP2860 External fixation for open fracture humerus using 59580 29790 23830 17870
880 OP2861 External fixation for open fracture tibia using 59580 29790 23830 17870
881 OP1900 External fixator application for fracture pelvis using 59580 29790 23830 17870
882 OP1913 Femoral lengthening using Ilizarov fixator 85520 42760 34210 25660
883 OP1940 High tibial osteotomy ( HTO ) of tibia with Orthofix 85520 42760 34210 25660
884 OP1931 Infected non-union femur fixation using Orthofix fixator 85520 42760 34210 25660
885 OP2855 Infected non-union tibia fixation using Orthofix fixator 85520 42760 34210 25660
886 OP1908 Knee arthrodesis using Ilizarov fixator 85520 42760 34210 25660
887 OP1915 Knee contracture release using Ilizarov fixator 85520 42760 34210 25660
888 OP1935 Lenghtening femur using Orthofix fixator 85520 42760 34210 25660
889 OP1939 Lenghtening tibia using Orthofix fixator 85520 42760 34210 25660
890 OP1945 Lengthening humerus using Orthofix fixator 85520 42760 34210 25660
891 OP1947 Lengthening metacarpals / phalanges hand using Orthofix fixator 85520 42760 34210 25660
892 OP1941 Lengthening metatarsals and foot bones using Orthofix fixator 85520 42760 34210 25660
893 OP1956 Lengthening of metacarpals & phalanges using JESS fixator 94180 47090 37670 28250
894 OP1958 Lengthening of metatarsal using JESS fixator 39000 19500 15600 11700
895 OP1946 Lenthening forearm ( radius or ulna ) using Orthofix fixator 85520 42760 34210 25660
896 OP4446 Lower limb tendon tenodesis 116700 58350 46680 35010
897 OP2854 Non-infected non-union femur fixation using Orthofix fixator 85520 42760 34210 25660
898 OP1936 Non-infected non-union tibia fixation using Orthofix fixator 85520 42760 34210 25660
899 OP2834 Non-union femur fixation using Ilizarov fixator (Infected ) 85520 42760 34210 25660
900 OP1927 Non-union femur fixation using Ilizarov fixator (Non-infected ) 85520 42760 34210 25660
901 OP3457 Only application of Hexapod/Ortho-SUV frame on 37220 18610 14890 11170
already applied Ilizarov fixator
902 OP2846 Open ankle / foot fracture fixation using JESS fixator 85520 42760 34210 25660
903 OP2835 Open elbow fracture fixation using Ilizarov fixator 85520 42760 34210 25660
904 OP2836 Open femoral condyle fracture using Ilizarov fixator 85520 42760 34210 25660
905 OP1901 Open femoral shaft fracture fixation using Ilizarov fixator 85520 42760 34210 25660
906 OP2838 Open forearm fracture fixation using Ilizarov fixator 85520 42760 34210 25660
907 OP1951 Open forearm fracture fixation using JESS fixator 85520 42760 34210 25660
908 OP2839 Open fracture dislocation shoulder fixation using Ilizarov fixator 85520 42760 34210 25660
909 OP2850 Open fracture femur fixation using Orthofix fixator 85520 42760 34210 25660
910 OP2856 Open fracture forearm fixation using Orthofix fixator 85520 42760 34210 25660
911 OP1943 Open fracture humerus fixation using Orthofix fixator 85520 42760 34210 25660
912 OP1953 Open fracture metacarpal and phalanges fixation using JESS fixator 35760 17880 14300 10730
913 OP2852 Open fracture tibia fixation using Orthofix fixator 85520 42760 34210 25660
914 OP2853 Open fracture wrist joint fixation using Orthofix fixator 85520 42760 34210 25660
915 OP2840 Open humerus fracture fixation using Ilizarov fixator 85520 42760 34210 25660
916 OP4449 Open reduction of fracture with screw / K-wire fixation 72940 36470 29180 21880
917 OP2841 Open tibial plafond and ankle fracture fixation using Ilizarov fixator 85520 42760 34210 25660
918 OP2842 Open tibial plateau fracture fixation using Ilizarov fixator 97260 48630 38900 29180
919 OP2843 Open tibial shaft fracture fixation using Ilizarov fixator 85520 42760 34210 25660
920 OP2844 Open wrist fracture fixation using Ilizarov fixator 85520 42760 34210 25660
921 OP1952 Open wrist fracture fixation using JESS fixator 40620 20310 16250 12190
922 OP1929 Osteotomy hip using Orthofix fixator 85520 42760 34210 25660
923 OP4447 Patellar tendon reconstruction/repair 116700 58350 46680 35010
924 OP4452 Pelvic repositioning osteotomy 126420 63210 50570 37930
925 OP1914 Tibial lengthening using Ilizarov fixator 85520 42760 34210 25660
926 OP1898 Transarticular external fixation of ankle using Universal External Fixator 59580 29790 23830 17870
927 OP2863 Transarticular external fixation of knee using Universal External Fixator 59580 29790 23830 17870
137
928 OP2862 Transarticular external fixation of wrist using Universal External Fixator 59580 29790 23830 17870
929 OP4445 Upper limb tendon tenodesis 116700 58350 46680 35010
930 OP3550 Cosmetic lengthening bilateral tibia and fibula with TSF/SUV 439220 219610 175690 131770
931 OP3551 Lengthening unilateral tibia and fibula with TSF/SUV 219620 109810 87850 65890
932 OP3552 Cosmetic lengthening bilateral femur with TSF/SUV 352380 176190 140950 105710
933 OP3553 Lengthening unilateral femur with TSF/SUV 176200 88100 70480 52860
934 OP3554 Cosmetic lengthening bilateral tibia with lengthening over nail (LON) 405740 202870 162300 121720
935 OP3555 Lengthening unilateral tibia with lengthening over nail (LON) 202880 101440 81150 60860
936 OP3556 Cosmetic lengthening bilateral femur with lengthening over nail (LON) 373740 186870 149500 112120
937 OP3557 Lengthening unilateral femur with lengthening over nail (LON) 186880 93440 74750 56060
938 OP3558 Cosmetic lengthening bilateral tibia and fibula using ilizarov / LRS 339660 169830 135860 101900
939 OP3559 Lengthening unilateral tibia and fibula using ilizarov / LRS 169840 84920 67940 50950
940 OP3560 Cosmetic lengthening bilateral femur using ilizarov / LRS 252820 126410 101130 75850
941 OP3561 Lengthening unilateral femur using ilizarov / LRS 126420 63210 50570 37930
942 OP3562 Fibulectomy 64000 32000 25600 19200
Eye And Eyelid Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
943 OP4498 AC Formation 4780 2390 1910 1430
944 OP0414 Aminotic membrane transplant of cornea 65520 32760 26210 19660
945 OP1235 Antenor chamber paracentesis 3660 1830 1460 1100
946 OP4500 Biopsy ( Conjunctival / Eyelid / Ocular Surface ) 15920 7960 6370 4780
947 OP2898 Blepharoplasty lower lid for ectropion ( both eyes ) 72300 36150 28920 21690
948 OP2897 Blepharoplasty lower lid for ectropion ( single eye ) 45280 22640 18110 13580
949 OP0134 Blepharoplasty lower lid for entropion ( both eyes ) 72300 36150 28920 21690
950 OP0133 Blepharoplasty lower lid for entropion ( single eye ) 45280 22640 18110 13580
951 OP2896 Blepharoplasty upper lid for ectropion ( both eyes ) 72300 36150 28920 21690
952 OP2895 Blepharoplasty upper lid for ectropion ( single eye ) 45280 22640 18110 13580
953 OP0132 Blepharoplasty upper lid for entropion ( both eyes ) 72300 36150 28920 21690
954 OP0131 Blepharoplasty upper lid for entropion ( single eye ) 45280 22640 18110 13580
955 OP0130 Blepharoplasty, with grafting, lower lid for ectropion (both eyes ) 90380 45190 36150 27110
956 OP0129 Blepharoplasty, with grafting, lower lid for ectropion (single eye ) 61000 30500 24400 18300
957 OP0128 Blepharoplasty, with grafting, upper lid for ectropion (both eyes ) 90380 45190 36150 27110
958 OP0127 Blepharoplasty, with grafting, upper lid for ectropion (single eye ) 61000 30500 24400 18300
959 OP1238 Buckle removal 6260 3130 2500 1880
960 OP1189 Conjunctival flap creation 17040 8520 6820 5110
961 OP0904 Corneal foreign body removal - deep 22720 11360 9090 6820
962 OP1190 Corneal foreign body removal - superficial 8240 4120 3300 2470
963 OP1191 Corneal grafting 84540 42270 33820 25360
964 OP1192 Cyclocryopexy 10380 5190 4150 3110
965 OP1193 Dacryocystorhinostomy / cystectomy 48340 24170 19340 14500
966 OP1200 Enucleation of eye ( with implant) 54160 27080 21660 16250
967 OP1199 Enucleation of eye ( without implant ) 29420 14710 11770 8830
968 OP0430 Epicanthus & telecanthus correction 76800 38400 30720 23040
969 OP1201 Epicanthus correction 38400 19200 15360 11520
970 OP0021 Evisceration of eye ( with implant ) 54160 27080 21660 16250
971 OP1202 Evisceration of eye ( without implant ) 29420 14710 11770 8830
972 OP1204 Exenteration of orbit 76800 38400 30720 23040
973 OP1203 Eye examination under GA 5080 2540 2030 1520
974 OP0137 Eye lid reconstruction ( multiple lids ) 97080 48540 38830 29120
975 OP1362 Eye lid reconstruction ( one lid ) 42120 21060 16850 12640
976 OP0416 Fascia lata sling surgery (Eye) 85780 42890 34310 25730
977 OP1188 Incision and drainage of chalazion 5080 2540 2030 1520
978 OP1205 Intraocular foreign body removal 70500 35250 28200 21150
138
979 OP1206 Intraocular lens implant (THIS IS NOT A CATARACT OPERATION) 63260 31630 25300 18980
980 OP1207 Intraocular surgery of anterior segment for glaucoma 56540 28270 22620 16960
981 OP0022 Intraocular surgery of anterior segment for secondary IOL 56540 28270 22620 16960
982 OP1234 Intravitreal injection 5040 2520 2020 1510
983 OP1194 Lacrimal abscess drainage 7500 3750 3000 2250
984 OP1208 Lensectomy 70500 35250 28200 21150
985 OP1195 Lid abscess drainage 7500 3750 3000 2250
986 OP4499 Lid Cyst / Benign Mass Excision 19120 9560 7650 5740
987 OP1197 Lid entropion correction - both eyes 52200 26100 20880 15660
988 OP2899 Lid entropion correction - single eye 34780 17390 13910 10430
989 OP1209 Lid tumour excision & repair ( WITHOUT grafting or flaps ) 42120 21060 16850 12640
990 OP1210 Lid tumour excision & repair with skin / mucosal 65520 32760 26210 19660
grafting or flap construction
991 OP0415 Limbal stem cell transplant (eye) 65520 32760 26210 19660
992 OP1223 Orbital abscess drainage 27200 13600 10880 8160
993 OP1211 Orbitotomy 84540 42270 33820 25360
994 OP3023 Phaco-emulsification cataract operation (without IOL) 57500 28750 23000 17250
- NOT FOR DAYCARE
995 OP1233 Pneumatic retinopexy 32900 16450 13160 9870
996 OP1213 Probing and syringing of naso-lacrimal duct 8240 4120 3300 2470
997 OP1214 Probing and syringing of naso-lacrimal duct with 27200 13600 10880 8160
inferior turbinate infracture
998 OP1232 Prophylactic retinal detachment surgery ( buckling procedure ) 24720 12360 9890 7420
999 OP1216 Pterygium surgery ( with grafting ) 35740 17870 14300 10720
1000 OP1215 Pterygium surgery ( without grafting ) 12880 6440 5150 3860
1001 OP1217 Ptosis surgery 51980 25990 20790 15590
1002 OP1237 Reinjection of silicone oil 20640 10320 8260 6190
1003 OP1218 Repair of lacrimal canaliculi 56540 28270 22620 16960
1004 OP1220 Repair of lid coloboma 42120 21060 16850 12640
1005 OP1219 Repair of lid coloboma with skin / mucosal grafting or flap construction 65520 32760 26210 19660
1006 OP1221 Repair of lid injuries 43900 21950 17560 13170
1007 OP1222 Repair of lid injuries with flaps or grafts 65520 32760 26210 19660
1008 OP1212 Repair of perforating injury of eyeball 56540 28270 22620 16960
1009 OP1224 Retinal detachment surgery 64080 32040 25630 19220
1010 OP1225 Retinocryopexy 24720 12360 9890 7420
1011 OP1236 Silicone oil removal 16480 8240 6590 4940
1012 OP1226 Squint horizontal muscle surgery 54160 27080 21660 16250
1013 OP1227 Squint vertical muscle surgery 70500 35250 28200 21150
1014 OP1228 Symblephron release ( WITHOUT grafting ) 27200 13600 10880 8160
1015 OP1229 Symblephron release with grafting 52900 26450 21160 15870
1016 OP1230 Tarsorrhaphy 14500 7250 5800 4350
1017 OP1799 Tarsorrhaphy release 5080 2540 2030 1520
1018 OP1231 Vitrectomy 64080 32040 25630 19220
Foot Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1019 OP4151 Ankle ligament reconstruction 105440 52720 42180 31630
1020 OP4150 Ankle ligament repair 69460 34730 27780 20840
1021 OP4331 Extensive CTEV Release 101600 50800 40640 30480
1022 OP4332 Medial CTEV Release 72220 36110 28890 21670
1023 OP4333 Posterior CTEV Release 72220 36110 28890 21670
1024 OP4149 Tarsal tunnel release 54080 27040 21630 16220
1025 OP4148 Tibialis post tendon release 54080 27040 21630 16220
139
Gastro-duodenal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1026 OP4540 Bariatric Surgery Super Obese ( BMI > 50 ) 233200 116600 93280 69960
1027 OP1009 Closure of perforated duodenal ulcer 94180 47090 37670 28250
1028 OP0027 Closure of perforated gastric ulcer 94180 47090 37670 28250
1029 OP3392 Delayed gastric pull-up 142360 71180 56940 42710
1030 OP1003 Gastro-jejunostomy (without vagotomy) 104300 52150 41720 31290
1031 OP1004 Gastrostomy 66420 33210 26570 19930
1032 OP1005 Highly selective vagotomy 74400 37200 29760 22320
1033 OP3391 Laparoscopic distal gastrectomy with Bilroth 1 reconstruction 249140 124570 99660 74740
1034 OP3368 Laparoscopic distal gastrectomy with Roux-en-Y gastrojejunostomy 199320 99660 79730 59800
1035 OP0564 Laparoscopic duodenal perforation closure 104300 52150 41720 31290
1036 OP3027 Laparoscopic gastrectomy 112880 56440 45150 33860
1037 OP0688 Laparoscopic gastric perforation closure 104300 52150 41720 31290
1038 OP0560 Laparoscopic gastro - jejunostomy ( GJ ) 109000 54500 43600 32700
1039 OP0634 Laparoscopic gastrostomy 66420 33210 26570 19930
1040 OP3369 Laparoscopic pyloromyotomy 85480 42740 34190 25640
1041 OP3370 Laparoscopic pyloroplasty 85480 42740 34190 25640
1042 OP3375 Laparoscopic total gastrectomy with with roux-en-Y 284760 142380 113900 85430
oesophagojejunostomy
1043 OP0636 Laparoscopic truncal vagotomy & gastro - jejunostomy 123960 61980 49580 37190
1044 OP3377 Laparoscopic truncal vagotomy and pyloroplasty 142360 71180 56940 42710
1045 OP1402 Partial / subtotal gastrectomy 93140 46570 37260 27940
1046 OP1279 Pyloromotomy for pyloric stenosis 62940 31470 25180 18880
1047 OP1404 Radical gastrectomy 117620 58810 47050 35290
1048 OP4538 Revisional Bariatric Surgery 233200 116600 93280 69960
1049 OP4534 Robotic Sleeve Gastrectomy 233200 116600 93280 69960
1050 OP4529 Single Incision Sleeve Gastrectomy 233200 116600 93280 69960
1051 OP1403 Total gastrectomy 145640 72820 58260 43690
1052 OP1010 Truncal vagotomy & gastro - jejunostomy 109000 54500 43600 32700
1053 OP0635 Truncal vagotomy & pyloroplasty 118540 59270 47420 35560
General Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1054 OP2016 Aspiration of ganglion with local / steroid injection 6840 3420 2740 2050
1055 OP2317 Aspiration of hematoma 6840 3420 2740 2050
1056 OP1299 Central venous access in neonate 34660 17330 13860 10400
1057 OP3024 Central venous line insertion in OT 10880 5440 4350 3260
1058 OP1328 Debridement ( large ) in OT 32020 16010 12810 9610
1059 OP1329 Debridement ( medium ) in OT 21340 10670 8540 6400
1060 OP1330 Debridement ( small ) in OT 16000 8000 6400 4800
1061 OP3311 Debridement of crush avulsion injury of extremity 67020 33510 26810 20110
1062 OP4812 Debridement of Diabetc Foot - Major 39380 19690 15750 11810
1063 OP0318 Debridement of foot - forefoot / heel 55720 27860 22290 16720
1064 OP0317 Debridement of foot - toes 31240 15620 12500 9370
1065 OP0544 Diagnostic laparoscopy ( with or without biopsy ) 37940 18970 15180 11380
1066 OP3164 Drainage of abdominal wall haematoma 46920 23460 18770 14080
1067 OP2046 Drainage of paravertebral abscess 37540 18770 15020 11260
1068 OP2047 Drainage of psoas abscess 37540 18770 15020 11260
1069 OP0140 Excision of Bartholin's cyst 26120 13060 10450 7840
140
1070 OP4327 Excision of Bony Tumour with Reconstruction & Fixation 181960 90980 72780 54590
1071 OP1072 Excision of carbuncle 78100 39050 31240 23430
1072 OP2020 Excision of ganglion 40020 20010 16010 12010
1073 OP0248 Excision of haemangioma - extremities / trunk (5 – 10 cm) 80060 40030 32020 24020
1074 OP0355 Excision of haemangioma - extremities / trunk (less than 5 cm) 70300 35150 28120 21090
1075 OP0249 Excision of haemangioma - extremities / trunk (more than 10 cm) 114480 57240 45790 34340
1076 OP0354 Excision of haemangioma - face (less than 2 cm) 70300 35150 28120 21090
1077 OP0247 Excision of haemangioma - face (more than 2 cm) 114480 57240 45790 34340
1078 OP1073 Excision of large superficial soft tissue mass / tumour - 66720 33360 26690 20020
Excluding neuroma or ganglion
1079 OP2318 Excision of medium size superficial soft tissue mass / 53360 26680 21340 16010
tumour - Excluding neuroma or ganglion
1080 OP2970 Excision of multiple cysts 53360 26680 21340 16010
1081 OP3073 Excision of pilonidal sinus with flap cover 118340 59170 47340 35500
1082 OP1027 Excision of pilonidal sinus with primary closure 66720 33360 26690 20020
1083 OP1028 Excision of pilonidal sinus without primary closure 53360 26680 21340 16010
1084 OP1275 Excision of preauricular tags 26700 13350 10680 8010
1085 OP3035 Excision of sinus ( soft tissue ) 28540 14270 11420 8560
1086 OP1075 Excision of small superficial soft tissue mass / tumour - 40020 20010 16010 12010
Excluding neuroma or ganglion
1087 OP1256 Exomphalos ( omphalocele ) repair 132260 66130 52900 39680
1088 OP1002 Exploratory laparotomy ( including small biopsy ) 54500 27250 21800 16350
1089 OP0111 Gastroschisis repair 132260 66130 52900 39680
1090 OP1736 Glomus tumour excision 48440 24220 19380 14530
1091 OP3361 Incision & drainage of MULTIPLE deep abscesses 39060 19530 15620 11720
1092 OP0601 Incision and drainage of large / deep abscess 23460 11730 9380 7040
1093 OP0901 Incision and drainage of small / superficial abscess 11520 5760 4610 3460
1094 OP1034 Ischorectal abscess drainage 65140 32570 26060 19540
1095 OP1267 Laparoscopic division of intra-abdominal adhesions / bands (adhesiolysis) 85860 42930 34340 25760
1096 OP0546 Laparoscopic drainage of intra-abdominal collection 85860 42930 34340 25760
1097 OP4861 Laparoscopic Placement of VP Shunt 62640 31320 25060 18790
1098 OP3054 Laparoscopic removal of infected mesh (following hernia repair) 85220 42610 34090 25570
1099 OP0562 Laparoscopic splenectomy 119640 59820 47860 35890
1100 OP2901 Laparotomy and division of intra-abdominal adhesions / bands 88420 44210 35370 26530
1101 OP1139 Marsupialization of Bartholin's cyst 19020 9510 7610 5710
1102 OP1006 Mesenteric cyst excision 78100 39050 31240 23430
1103 OP4143 MTP Joint debridement 56760 28380 22700 17030
1104 OP0518 Muscle biopsy 18840 9420 7540 5650
1105 OP0117 Neuroblastoma excision 133480 66740 53390 40040
1106 OP1007 Omentectomy 78100 39050 31240 23430
1107 OP3363 Paediatric vascular cut down ( venesection ) in OT 39060 19530 15620 11720
1108 OP1035 Perianal abscess drainage 52180 26090 20870 15650
1109 OP3450 Preauricular tag excision - complex 53300 26650 21320 15990
1110 OP3449 Preauricular tag excision - simple 35520 17760 14210 10660
1111 OP4816 Removal of Soft Tissue / Lipoma - Multiple 91880 45940 36750 27560
1112 OP4815 Removal of Soft Tissue / Lipoma - Single 39380 19690 15750 11810
1113 OP3348 Repair of complex lacerated wound 53360 26680 21340 16010
1114 OP1144 Resuturing of abdomen 77100 38550 30840 23130
1115 OP1394 Retroperitoneal drainage of abscess 75220 37610 30090 22570
1116 OP1008 Retroperitoneal tumour excision 114260 57130 45700 34280
1117 OP2010 Secondary wound closure ( suturing ) 77100 38550 30840 23130
1118 OP4805 Secondary wound closure (Small Wound) 31500 15750 12600 9450
1119 OP0593 Splenectomy ( open ) 125180 62590 50070 37550
1120 OP0905 Suturing of large lacerated wound 40020 20010 16010 12010
1121 OP4458 Suturing of Multiple lacerated wound 60780 30390 24310 18230
1122 OP0906 Suturing of small lacerated wound 26700 13350 10680 8010
1123 OP4146 Tendoachilles debridement 89060 44530 35620 26720
1124 OP4145 Tendoachilles decompression 59320 29660 23730 17800
141
1125 OP4312 Umbilectomy with/ without entering peritoneal cavity 79240 39620 31700 23770
(umbilical exploration / PVID)
1126 OP1298 Venesection 27900 13950 11160 8370
1127 OP2319 Wide excision of superficial tumour ( trunk / limbs ) 78100 39050 31240 23430
1128 OP1294 Wilms’ tumour excision 133480 66740 53390 40040
Hand Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1129 OP4385 Anastomosis by Vein Graft in Reimplantation (Multiple ) 133700 66850 53480 40110
1130 OP4384 Anastomosis by Vein Graft in Reimplantation ( Single ) 80220 40110 32090 24070
1131 OP1612 AO plating for fracture distal phalynx 72160 36080 28860 21650
1132 OP1613 AO plating for fracture middle phalynx 72160 36080 28860 21650
1133 OP1614 AO plating for fracture proximal phalynx 72160 36080 28860 21650
1134 OP1615 AO plating for metacarpal fracture 72160 36080 28860 21650
1135 OP1325 Burns contracture release - multiple fingers /extensive 135220 67610 54090 40570
1136 OP1326 Burns contracture release - one finger / toe / minor 90160 45080 36060 27050
1137 OP2304 Burns contracture release - two fingers / toes /medium 108120 54060 43250 32440
1138 OP1763 Button hole deformity correction - multiple fingers 135220 67610 54090 40570
1139 OP1764 Button hole deformity correction - single finger 90160 45080 36060 27050
1140 OP1765 Button hole deformity correction - two fingers 112720 56360 45090 33820
1141 OP1663 Closed reduction of fracture scaphoid 63100 31550 25240 18930
1142 OP4336 Complex Foot Reconstruction / Hand 120360 60180 48140 36110
1143 OP1605 Composite grafting for finger tip injuries 67640 33820 27060 20290
1144 OP4467 Contracture Hand - Moderate 97260 48630 38900 29180
1145 OP4468 Contracture Hand - Severe 133700 66850 53480 40110
1146 OP4466 Contracture Hand - Simple 60780 30390 24310 18230
1147 OP2307 Contracture release for camptodactyly – multiple fingers 103680 51840 41470 31100
1148 OP2305 Contracture release for camptodactyly - single finger 45180 22590 18070 13550
1149 OP2306 Contracture release for camptodactyly - two fingers 67640 33820 27060 20290
1150 OP2310 Contracture release with tendon transfer for 144100 72050 57640 43230
camptodactyly - multiple fingers
camptodactyly - single finger
camptodactyly - two fingers
1153 OP0420 Correction of complex bifid thumb ( Wassal type 1 ) 67640 33820 27060 20290
1159 OP1654 Correction of Mallet finger 63100 31550 25240 18930
1160 OP1655 Correction of Mallet finger - extensor tendon repair 108120 54060 43250 32440
1161 OP1656 Correction of Mallet finger - tendon repair with K-wiring 112720 56360 45090 33820
1162 OP0844 Correction of simple bifid thumb / finger 49620 24810 19850 14890
1163 OP1311 Correction of simple bifid toe 49620 24810 19850 14890
1164 OP1600 Cross finger flap for finger tip injuries 90160 45080 36060 27050
1165 OP1670 Debridement for hand injuries 45180 22590 18070 13550
1166 OP1702 Debulking for macrodactyly 65620 32810 26250 19690
1167 OP1616 Distractor / JESS application for fracture distal phalynx 47260 23630 18900 14180
1168 OP1617 Distractor / JESS application for fracture middle phalynx 47260 23630 18900 14180
1169 OP1618 Distractor / JESS application for fracture proximal phalynx 47260 23630 18900 14180
1170 OP1619 Distractor / JESS application for metacarpal fracture 47260 23630 18900 14180
1171 OP1602 Dorsal dermodesis for nail bed injuries 72160 36080 28860 21650
142
1172 OP1596 Drainage of subungual haematoma 27180 13590 10870 8150
1173 OP4469 Dupuytren's Contracture - Mild 48620 24310 19450 14590
1174 OP4470 Dupuytren's Contracture - Moderate 72940 36470 29180 21880
1175 OP4471 Dupuytren's Contracture - Severe 97260 48630 38900 29180
1176 OP1683 Excision of extra digit (excluding thumb) 31500 15750 12600 9450
1177 OP4807 Excision of extra digit (Excluding thumb) Complex 63000 31500 25200 18900
1178 OP4806 Excision of extra digit (Excluding thumb) Simple 47260 23630 18900 14180
1179 OP0419 Excision of extra digit with ligament reconstruction(excluding thumb) 90160 45080 36060 27050
1180 OP4372 Excision of glomus tumor finger 80220 40110 32090 24070
1181 OP1635 Extensor tendon repair ( Zone 1) 52500 26250 21000 15750
1182 OP1636 Extensor tendon repair ( Zone 2) - single tendon 52500 26250 21000 15750
1183 OP1640 Extensor tendon repair ( Zone 2) - two tendons 73500 36750 29400 22050
1184 OP1639 Extensor tendon repair ( Zone 3) - multiple tendons 112720 56360 45090 33820
1196 OP1699 First web release for cleft hand 90160 45080 36060 27050
1197 OP1620 Flexor tendon repair ( Zone 1) 72160 36080 28860 21650
1198 OP1621 Flexor tendon repair ( Zone 2) - single tendon 52500 26250 21000 15750
1199 OP1625 Flexor tendon repair ( Zone 2) - two tendons 73500 36750 29400 22050
1200 OP1624 Flexor tendon repair ( Zone 3) - multiple tendons 112720 56360 45090 33820
1212 OP1734 Free microvascular joint transfer 198180 99090 79270 59450
1213 OP1706 Free phalangeal / bone transfer for brachydactyly 90160 45080 36060 27050
1214 OP1604 Full thickness skin grafting for finger tip injuries 52500 26250 21000 15750
1215 OP1679 Groin / abdominal flap cover for hand injuries - large (multiple flaps ) 108120 54060 43250 32440
1216 OP1673 Groin / abdominal flap cover for hand injuries - large (single flap ) 90160 45080 36060 27050
1217 OP1676 Groin / abdominal flap cover for hand injuries - large (two flaps ) 99120 49560 39650 29740
1218 OP1678 Groin / abdominal flap cover for hand injuries -medium ( multiple flaps ) 90160 45080 36060 27050
1219 OP1672 Groin / abdominal flap cover for hand injuries -medium ( single flap ) 72160 36080 28860 21650
1220 OP1675 Groin / abdominal flap cover for hand injuries -medium ( two flaps ) 81120 40560 32450 24340
1221 OP1677 Groin / abdominal flap cover for hand injuries - small (multiple flaps ) 72160 36080 28860 21650
1222 OP1671 Groin / abdominal flap cover for hand injuries - small (single flap ) 54080 27040 21630 16220
1223 OP1674 Groin / abdominal flap cover for hand injuries - small (two flaps ) 63100 31550 25240 18930
1224 OP1760 Hand abscess drainage 31500 15750 12600 9450
1225 OP1606 Homodigital flap for finger tip injuries 90160 45080 36060 27050
1226 OP1750 Incision and drainage for flexor tenosynovitis 45180 22590 18070 13550
1227 OP1608 K - wire fixation for fracture distal phalynx 54080 27040 21630 16220
1228 OP1609 K - wire fixation for fracture middle phalynx 54080 27040 21630 16220
1229 OP1610 K - wire fixation for fracture proximal phalynx 54080 27040 21630 16220
143
1230 OP1611 K - wire fixation for metacarpal fracture 67640 33820 27060 20290
1231 OP0470 Krukenberg's operation 90160 45080 36060 27050
1232 OP1664 K-wire fixation of fracture scaphoid 67640 33820 27060 20290
1233 OP1697 Ligament reconstruction for hypoplastic thumb 90160 45080 36060 27050
1234 OP4235 Mini Plate for fracture phalanx 61540 30770 24620 18460
1235 OP3071 Nail bed reconstruction - multiple fingers 131100 65550 52440 39330
1236 OP3008 Nail bed reconstruction - single finger 73800 36900 29520 22140
1237 OP3072 Nail bed reconstruction - two fingers 102440 51220 40980 30730
1238 OP2302 Nail bed repair - multiple 60780 30390 24310 18230
1239 OP1595 Nail bed repair - single 36480 18240 14590 10940
1240 OP2303 Nail bed repair - two nail beds 48620 24310 19450 14590
1241 OP1599 Oblique triangular flap for finger tip injuries 90160 45080 36060 27050
1242 OP1680 On-top plasty / pollicization 144100 72050 57640 43230
1243 OP1669 Open reduction and ligament repair of wrist 90160 45080 36060 27050
1244 OP1666 ORIF and bone grafting for non-union of scaphoid 90160 45080 36060 27050
1245 OP1667 ORIF and vascularised bone grafting for non-union of scaphoid 180220 90110 72090 54070
1246 OP4487 Orthoplastic Reconstruction Thumb/Finger 121560 60780 48620 36470
1247 OP1747 Osteotomy for metacarpal malunion 90160 45080 36060 27050
1248 OP1748 Osteotomy for phalangeal malunion 90160 45080 36060 27050
1249 OP1698 Pollicization for hypoplastic thumb 171180 85590 68470 51350
1250 OP3438 Primary tendon repair by tendon graft 84580 42290 33830 25370
1251 OP1668 Proximal row carpectomy 90160 45080 36060 27050
1252 OP1684 Radial club hand - centralisation / radialisation 85600 42800 34240 25680
1253 OP1686 Radial club hand - distractor / external fixator application 63100 31550 25240 18930
1254 OP1685 Radial club hand - free epiphysis / fibula transfer 207220 103610 82890 62170
1255 OP1682 Radial club hand - osteotomy of ulna 135220 67610 54090 40570
1256 OP1742 Radial collateral ligament reconstruction of thumb 90160 45080 36060 27050
1257 OP1744 Radial collateral ligament repair of thumb 72160 36080 28860 21650
1258 OP1703 Ray resection for macrodactyly 108120 54060 43250 32440
1259 OP1759 Release of first extensor compartment 45180 22590 18070 13550
1260 OP1607 Reverse dermal cross finger flap for finger tip injuries 90160 45080 36060 27050
1261 OP1665 Screw fixation of fracture scaphoid 63100 31550 25240 18930
1262 OP1597 Shortening and closure of finger stump 39380 19690 15750 11810
1263 OP1700 Snow - Littler's procedure for cleft hand 135220 67610 54090 40570
1264 OP1603 Split skin grafting for finger tip injuries 47260 23630 18900 14180
1265 OP1756 Swan neck deformity correction - multiple fingers 112720 56360 45090 33820
1266 OP1754 Swan neck deformity correction - single finger 90160 45080 36060 27050
1267 OP1755 Swan neck deformity correction - two fingers 99120 49560 39650 29740
1268 OP1708 Syndactyly release - complex 135220 67610 54090 40570
1269 OP1288 Syndactyly release - simple 90160 45080 36060 27050
1270 OP1652 Tendon grafting - stage 1 85600 42800 34240 25680
1271 OP1653 Tendon grafting - stage 2 108120 54060 43250 32440
1272 OP1650 Tenolysis of flexor / extensor tendons - single 54080 27040 21630 16220
1273 OP1601 Thenar flap for finger tip injuries 65620 32810 26250 19690
1274 OP1701 Toe transfer - great toe 207220 103610 82890 62170
1275 OP1740 Toe transfer - second toe 207220 103610 82890 62170
1276 OP1749 Trigger finger release 36480 18240 14590 10940
1277 OP1741 Ulnar collateral ligament reconstruction of thumb 90160 45080 36060 27050
1278 OP1743 Ulnar collateral ligament repair of thumb 72160 36080 28860 21650
1279 OP1598 V - Y advancement flap for finger tip injuries 90160 45080 36060 27050
1280 OP1752 Wrist synovectomy 69460 34730 27780 20840
1281 OP1746 Zimmer splint application for multiple fingers 67640 33820 27060 20290
1282 OP1745 Zimmer splint application for one finger 67640 33820 27060 20290
144
Head And Neck Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1283 OP0733 Buccal mucosal radical excision 69020 34510 27610 20710
1284 OP0911 Commando operation 155140 77570 62060 46540
1285 OP0736 Composite oral resection - large 137880 68940 55150 41360
1286 OP0735 Composite oral resection - small 103440 51720 41380 31030
1287 OP0766 Cordectomy - larynx 86260 43130 34500 25880
1288 OP4313 Cystic hygroma (major) 73540 36770 29420 22060
1289 OP4314 Cystic hygroma (minor) 58820 29410 23530 17650
1290 OP2957 Endoscopic nasal mass excision 98020 49010 39210 29410
1291 OP0115 Excision of branchial cyst / fistula ( bilateral ) 64720 32360 25890 19420
1292 OP0114 Excision of branchial cyst / fistula ( unilateral ) 43200 21600 17280 12960
1293 OP1319 Excision of carcinoma cheek 109000 54500 43600 32700
1294 OP2963 Excision of nasopharyngeal angiofibroma - big 137160 68580 54860 41150
1295 OP2964 Excision of nasopharyngeal angiofibroma - small 98020 49010 39210 29410
1296 OP2966 Excision of nasopharyngeal angiofibroma with intracranial extension 176320 88160 70530 52900
1297 OP4590 Excision of Sinus in neck 41340 20670 16540 12400
1298 OP0763 Extended laryngo-pharyngectomy 172380 86190 68950 51710
1299 OP0780 Extended maxillectomy 146480 73240 58590 43940
1300 OP0785 Extended neck dissection 146480 73240 58590 43940
1301 OP0803 Extra-cranial skull base resection 189560 94780 75820 56870
1302 OP1046 Glossectomy - partial 69020 34510 27610 20710
1303 OP0737 Glossectomy - subtotal 86260 43130 34500 25880
1304 OP0738 Glossectomy - total 103440 51720 41380 31030
1305 OP0797 Head and neck repair - complex 69020 34510 27610 20710
1306 OP0796 Head and neck repair - simple 34540 17270 13820 10360
1307 OP0776 Hypopharyngeal laser resection - large 94820 47410 37930 28450
1308 OP0775 Hypopharyngeal laser resection - medium 69020 34510 27610 20710
1309 OP0774 Hypopharyngeal laser resection - small 43200 21600 17280 12960
1310 OP0753 Infra - temporal fossa resection 155140 77570 62060 46540
1311 OP4221 Inter Maxillary Fixation 29440 14720 11780 8830
1312 OP0773 Laryngeal laser resection - large 86260 43130 34500 25880
1313 OP0772 Laryngeal laser resection - medium 60380 30190 24150 18110
1314 OP0771 Laryngeal laser resection - small 43200 21600 17280 12960
1315 OP0762 Laryngectomy with partial pharyngectomy 137880 68940 55150 41360
1316 OP0912 Laryngo-pharyngectomy 155140 77570 62060 46540
1317 OP0782 Laryngoscopic excision of tumours - large 69020 34510 27610 20710
1318 OP0781 Laryngoscopic excision of tumours - small 34540 17270 13820 10360
1319 OP0758 Local head and neck flap - large 86260 43130 34500 25880
1320 OP3070 Local head and neck flap - medium 70580 35290 28230 21170
1321 OP0757 Local head and neck flap - small 60380 30190 24150 18110
1322 OP4217 Mandibular Distraction Stage-I 73540 36770 29420 22060
1323 OP4218 mandibular Distraction Stage-II 29440 14720 11780 8830
1324 OP0777 Mandibulectomy - marginal 60380 30190 24150 18110
1325 OP0778 Mandibulectomy - segmental 86260 43130 34500 25880
1326 OP0779 Mandibulotomy 69020 34510 27610 20710
1327 OP4219 Maxillary Distractor Stage - I 73540 36770 29420 22060
1328 OP4220 Maxillary Distractor Stage - II 29440 14720 11780 8830
1329 OP0784 Modified neck dissection 129320 64660 51730 38800
1330 OP0761 Near total laryngectomy 129320 64660 51730 38800
1331 OP0787 Neck mass excision - complex 51700 25850 20680 15510
1332 OP0786 Neck mass excision - simple 25960 12980 10380 7790
1333 OP0755 Oral laser resection - large 129320 64660 51730 38800
1334 OP0759 Oral laser resection - medium 103440 51720 41380 31030
1335 OP0754 Oral laser resection - small 69020 34510 27610 20710
145
1336 OP0789 Oral lesion excision - complex 69020 34510 27610 20710
1337 OP0788 Oral lesion excision - simple 34540 17270 13820 10360
1338 OP0770 Oropharyngeal laser resection - large 146480 73240 58590 43940
1339 OP0769 Oropharyngeal laser resection - medium 120680 60340 48270 36200
1340 OP0768 Oropharyngeal laser resection - small 86260 43130 34500 25880
1341 OP0760 Other partial laryngectomy 86260 43130 34500 25880
1342 OP0795 Parapharyngeal space excision 120680 60340 48270 36200
1343 OP0910 Partial maxillectomy 86260 43130 34500 25880
1344 OP0794 Pedicled flap for head and neck - major 103440 51720 41380 31030
1345 OP0764 Pedicled flap for head and neck - medium 77620 38810 31050 23290
1346 OP0792 Pedicled flap for head and neck - minor 51700 25850 20680 15510
1347 OP0993 Pharyngeal fistula repair - simple without flap 51700 25850 20680 15510
1348 OP2959 Pharyngeal fistula repair with flap 94080 47040 37630 28220
1349 OP2967 Pharyngeal flap 94080 47040 37630 28220
1350 OP0767 Pharyngeal repair 77620 38810 31050 23290
1351 OP2965 Pharyngoplasty 94080 47040 37630 28220
1352 OP0793 Pharyngotomy 86260 43130 34500 25880
1353 OP0791 Photo-dynamic therapy ( PDT ) for head and neck -complex 129320 64660 51730 38800
1354 OP0790 Photo-dynamic therapy ( PDT ) for head and neck -simple 86260 43130 34500 25880
1355 OP1047 Radical neck dissection 112080 56040 44830 33620
1356 OP0783 Selective neck dissection 94820 47410 37930 28450
1357 OP0800 Skin graft for head and neck - large 73300 36650 29320 21990
1358 OP0801 Skin graft for head and neck - small 43200 21600 17280 12960
1359 OP0913 Supra-cricoid partial laryngectomy 129320 64660 51730 38800
1360 OP0924 Total laryngectomy 120680 60340 48270 36200
1361 OP0923 Total maxillectomy 120680 60340 48270 36200
1362 OP0807 Trans-cervical base of tongue resection 103440 51720 41380 31030
1363 OP0396 Vertical partial laryngectomy 103440 51720 41380 31030
1364 OP0809 Wide excision of lesion in head and neck - major 112080 56040 44830 33620
1365 OP0808 Wide excision of lesion in head and neck - minor 68980 34490 27590 20690
Hepato-bilio-pancreatic Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1366 OP1368 Cholecystectomy 99580 49790 39830 29870
1367 OP1015 Cholecystectomy and choledocholithotomy ( open ) 114080 57040 45630 34220
1368 OP1386 Distal pancreatectomy & pancreatico-jejunostomy 125160 62580 50060 37550
1369 OP1371 Excision of cholangiocarcinoma 130860 65430 52340 39260
1370 OP1370 Excision of choledochal cyst and hepatico-jejunostomy 130860 65430 52340 39260
1371 OP1389 Frey's procedure 163540 81770 65420 49060
1372 OP1016 Hepatico - jejunostomy ( open ) 125400 62700 50160 37620
1373 OP1274 Hepatico porto-enterostomy ( Kasai's operation ) 159560 79780 63820 47870
1374 OP1387 Insulinoma excision 125160 62580 50060 37550
1375 OP4413 Laparoscopic Assisted Distal pancreatectomy 291200 145600 116480 87360
1376 OP4414 Laparoscopic Assisted Hepatico Jejunostomy 258840 129420 103540 77650
1377 OP4415 Laparoscopic Assisted Lateral Pancreatico-Jejunostomy 300460 150230 120180 90140
1378 OP0554 Laparoscopic cholecystectomy 104300 52150 41720 31290
1379 OP0549 Laparoscopic cholecystectomy and choledocholithotomy ( CBD exploration ) 119960 59980 47980 35990
1380 OP0555 Laparoscopic cholecystectomy with choledochoduodenostomy 119960 59980 47980 35990
1381 OP3393 Laparoscopic cholecystectomy with intra-operative cholangiogram 121020 60510 48410 36310
1382 OP0565 Laparoscopic cysto - gastrostomy 109000 54500 43600 32700
1383 OP0566 Laparoscopic cysto - jejunostomy 109000 54500 43600 32700
1384 OP0563 Laparoscopic deroofing of non-hydatid liver cyst 109000 54500 43600 32700
1385 OP3031 Laparoscopic distal pancreatectomy 136400 68200 54560 40920
1386 OP0588 Laparoscopic drainage of liver abscess drainage 109000 54500 43600 32700
1387 OP1391 Laparoscopic drainage of pseudopancreatic cyst 104300 52150 41720 31290
146
1388 OP0591 Laparoscopic excision of choledochal cyst and hepatico-jejunostomy 136320 68160 54530 40900
1389 OP0550 Laparoscopic hepatico - jejunostomy 136320 68160 54530 40900
1390 OP3032 Laparoscopic Peustow's operation 112720 56360 45090 33820
1391 OP3371 Laparoscopic repair of CBD injury 106780 53390 42710 32030
1392 OP3030 Laparoscopic Whipple's operation 188100 94050 75240 56430
1393 OP4412 Laparoscopic Whipples procedure 323580 161790 129430 97070
1394 OP1390 Laparotomy and drainage of pseudopancreatic cyst 76580 38290 30630 22970
1395 OP1388 Lateral pancreatico-jejunostomy 119960 59980 47980 35990
1396 OP1375 Left hepatectomy 142280 71140 56910 42680
1397 OP1067 Left liver lobectomy 153600 76800 61440 46080
1398 OP1377 Liver abscess drainage (open) 81500 40750 32600 24450
1399 OP1372 Liver resection with excision of CBD 204700 102350 81880 61410
1400 OP1393 Necrosectomy and drainage of pancreatic abscess 109000 54500 43600 32700
1401 OP0732 Open deroofing / excision of non-hydatid liver cyst 81500 40750 32600 24450
1402 OP1376 Partial liver resection ( lateral segmentectomy ) 92060 46030 36820 27620
1403 OP1017 Primary repair of common hepatic or bile duct ( CBD ) 69420 34710 27770 20830
1404 OP4311 Pseudo pancreatic cyst - cystogastrostomy 80220 40110 32090 24070
1405 OP1369 Radical cholecystectomy ( liver bed excision with bile 129320 64660 51730 38800
duct excision + lymph nodal dissection )
1406 OP0119 Radical cholecystectomy ( lymph nodal dissection + 129320 64660 51730 38800
liver bed excision WITHOUT bile duct excision )
resection of segment 4B & 5 with bile duct excision )
right tri-segmentectomy with bile duct excision )
1409 OP4539 Revisional Cholecystectomy Surgery 124180 62090 49670 37250
1410 OP1374 Right hepatectomy 170680 85340 68270 51200
1411 OP1373 Right hepatic trisegmentectomy 210340 105170 84140 63100
1412 OP4417 Robotic Assisted Distal pancreatectomy 349460 174730 139780 104840
1413 OP4419 Robotic Assisted Hepatico-Jejunostomy 271780 135890 108710 81530
1414 OP4418 Robotic Assisted Lateral Pancreatico- Jejunostomy 360600 180300 144240 108180
1415 OP4416 Robotic Assisted Whipples procedure 388320 194160 155330 116500
1416 OP1392 Roux-en-Y cystojejunostomy ( open ) 107060 53530 42820 32120
1417 OP4528 Single Incision Laparoscopic Cholecystectomy 124180 62090 49670 37250
1418 OP1385 Whipple's procedure 194120 97060 77650 58240
Hernia Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1419 OP0681 Bassini repair of inguinal hernia with mesh ( bilateral ) 90100 45050 36040 27030
1420 OP0682 Bassini repair of inguinal hernia with mesh ( unilateral) 80580 40290 32230 24170
1421 OP0600 Incisional hernia repair with abdominoplasty 155160 77580 62060 46550
1422 OP4492 Incisional Hernia Repair with Component Separation 170180 85090 68070 51050
1423 OP1057 Inguinal herniotomy ( bilateral ) 64060 32030 25620 19220
1424 OP1058 Inguinal herniotomy ( unilateral ) 56920 28460 22770 17080
1425 OP2941 Inguinal herniotomy in Neonates ( bilateral ) 70420 35210 28170 21130
1426 OP2940 Inguinal herniotomy in Neonates ( unilateral ) 47540 23770 19020 14260
1427 OP1097 Laparoscopic epigastric hernia repair - transabdominal 75900 37950 30360 22770
intra-peritoneal onlay mesh
1428 OP0426 Laparoscopic epigastric hernia repair - transabdominal 75900 37950 30360 22770
pre-peritoneal inlay mesh
1429 OP1101 Laparoscopic incisional hernia repair - transabdominal 119000 59500 47600 35700
intraperitoneal onlay mesh
1430 OP0535 Laparoscopic inguinal herniotomy - bilateral 60240 30120 24100 18070
1431 OP0534 Laparoscopic inguinal herniotomy - unilateral 52200 26100 20880 15660
1432 OP0598 Laparoscopic lumbar hernia repair 109100 54550 43640 32730
147
1433 OP1103 Laparoscopic repair of diaphragmatic hernia 276480 138240 110590 82940
1434 OP1102 Laparoscopic spigelian hernia repair - transabdominal 109100 54550 43640 32730
1435 OP0531 Laparoscopic total extra-peritoneal mesh repair of 109100 54550 43640 32730
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
1443 OP1098 Laparoscopic umbilical hernia repair - transabdominal 86320 43160 34530 25900
1444 OP0427 Laparoscopic umbilical hernia repair - transabdominal 86320 43160 34530 25900
pre-peritoneal inlay mesh
1445 OP1099 Laparoscopic ventral hernia ( others ) 94100 47050 37640 28230
1446 OP4001 Laproscopic Diaphragmatic rupture repair 276480 138240 110590 82940
1447 OP1059 Mesh repair of inguinal hernia ( bilateral ) 99580 49790 39830 29870
1448 OP1060 Mesh repair of inguinal hernia ( unilateral ) 83060 41530 33220 24920
1449 OP1283 Mesh repair of Recurrent inguinal hernia ( bilateral ) 104300 52150 41720 31290
1450 OP1284 Mesh repair of Recurrent inguinal hernia ( unilateral ) 90100 45050 36040 27030
1451 OP3380 Open incisional hernia repair with component separation with flap 249140 124570 99660 74740
advancement and mesh placement
1452 OP3026 Open removal of infected mesh (following hernia repair) 64720 32360 25890 19420
1453 OP1053 Open repair of epigastric hernia with mesh 68780 34390 27510 20630
1454 OP0684 Open repair of epigastric hernia without mesh 68780 34390 27510 20630
1455 OP1054 Open repair of femoral hernia 75900 37950 30360 22770
1456 OP1055 Open repair of incisional hernia ( first repair ) with mesh 104100 52050 41640 31230
1457 OP1056 Open repair of incisional hernia ( first repair ) without mesh 94180 47090 37670 28250
1458 OP0025 Open repair of lumbar hernia 109100 54550 43640 32730
1459 OP0024 Open repair of obturator hernia 109100 54550 43640 32730
1460 OP1062 Open repair of Recurrent incisional hernia with mesh 119000 59500 47600 35700
1461 OP1287 Repair of congenital diaphragmatic hernia 140700 70350 56280 42210
1462 OP2942 Repair of Recurrent inguinal hernia without mesh (bilateral ) 104300 52150 41720 31290
1463 OP2943 Repair of Recurrent inguinal hernia without mesh (unilateral ) 90100 45050 36040 27030
1464 OP1425 Repair of traumatic diaphragmatic hernia ( open ) 230440 115220 92180 69130
1465 OP1291 Repair of umbilical hernia with mesh ( open ) 104300 52150 41720 31290
1466 OP0683 Repair of umbilical hernia without mesh ( open ) 78220 39110 31290 23470
1467 OP1065 Repair of ventral hernia (not umbilical or epigastric) with mesh 104300 52150 41720 31290
1468 OP1064 Repair of ventral hernia (not umbilical or epigastric) without mesh 78220 39110 31290 23470
1469 OP4536 Robotic Hiatus Hernia Repair 124180 62090 49670 37250
1470 OP4535 Robotic RYGB 233200 116600 93280 69960
1471 OP4533 Single Incision IPOM 102740 51370 41100 30820
1472 OP4532 Single Incision TEP ( Bilateral ) 129900 64950 51960 38970
1473 OP4531 Single Incision TEP ( Unilateral ) 109000 54500 43600 32700
1474 OP1061 Spigelian hernia repair 109100 54550 43640 32730
1475 OP0431 Strangulated incisional hernia repair ( open technique) 114080 57040 45630 34220
1476 OP1063 Strangulated non-incisional ventral hernia repair (open technique) 109100 54550 43640 32730
1477 OP1306 Ventral hernia repair with abdominoplasty 142280 71140 56910 42680
148
Hydatid Cyst Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1478 OP1378 Excision or drainage of hydatid cyst of liver (open) 119960 59980 47980 35990
1479 OP0589 Excision or drainage of intraperitoneal hydatid cyst 119960 59980 47980 35990
1480 OP1379 Laparoscopic excision or drainage of hydatid cyst of liver 104300 52150 41720 31290
1481 OP1066 Laparoscopic excision or drainage of intraperitoneal hydatid cyst 104300 52150 41720 31290
Intestinal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1482 OP1406 Abdominoperineal resection ( APR ) - open 129440 64720 51780 38830
1483 OP1026 Anterior resection of rectum ( open ) 129440 64720 51780 38830
1484 OP1405 Anterior resection with total mesorectal excision (TME ) - open 117620 58810 47050 35290
1485 OP2947 Bishop Koop ileostomy in Neonates 75900 37950 30360 22770
1486 OP1296 Closure of colostomy 56920 28460 22770 17080
1487 OP0118 Closure of ileostomy 56920 28460 22770 17080
1488 OP1398 Colonic interposition 109000 54500 43600 32700
1489 OP1250 Colostomy and colonic biopsy 75900 37950 30360 22770
1490 OP3394 Delayed colon interpostion 177980 88990 71190 53390
1491 OP1507 Duhamel's abdomino-perineal pull through resection 104300 52150 41720 31290
with colo-anal anastomosis for Hirschprung's disease
1492 OP4308 Duodenal atresia/annular pancreas 85580 42790 34230 25670
(dudenodudenostomy/dudenojejunostomy)
1493 OP2950 End colostomy in Neonates 75900 37950 30360 22770
1494 OP0101 End ileostomy 59360 29680 23740 17810
1495 OP2949 End ileostomy in Neonates 75900 37950 30360 22770
1496 OP4307 Gastro-jejunostomy and pyloroplasty 77580 38790 31030 23270
1497 OP1266 Imaging guided hydrostatic reduction of intussusception 47540 23770 19020 14260
1498 OP0026 Jejunostomy / feeding jejunostomy 66420 33210 26570 19930
1499 OP4395 Laparoscoic Sigmoid colectomy with colo-colic anastmosis 226500 113250 90600 67950
1500 OP4397 Laparoscopic Abdomino-perineal resection with permanent Colostomy 291200 145600 116480 87360
1501 OP4396 Laparoscopic Anterior Resection with TME with 258840 129420 103540 77650
Colorectal anastmosis with/without diverting stoma
1502 OP0552 Laparoscopic anterior resection with total mesorectal excision (TME) 131880 65940 52750 39560
1503 OP0553 Laparoscopic assisted abdominoperineal resection (APR ) 131880 65940 52750 39560
1504 OP0551 Laparoscopic assisted left hemicolectomy 109000 54500 43600 32700
1505 OP0592 Laparoscopic assisted right hemicolectomy 109000 54500 43600 32700
1506 OP2903 Laparoscopic closure of intestinal perforation 104300 52150 41720 31290
1507 OP4391 Laparoscopic Left hemicolectomy with Colo-Colic 226500 113250 90600 67950
Anastmosis with/without Diverting Stoma
1508 OP3093 Laparoscopic Meckel's diverticulectomy 67700 33850 27080 20310
1509 OP3028 Laparoscopic proctocolectomy 141100 70550 56440 42330
1510 OP4393 Laparoscopic Procto-colectomy with diverting Ileostomy 258840 129420 103540 77650
1511 OP1505 Laparoscopic pull through for Hirschprung's disease 109100 54550 43640 32730
1512 OP0561 Laparoscopic rectopexy 125400 62700 50160 37620
1513 OP4394 Laparoscopic Restorative Procto-colectomy with/ without diverting Ileostomy 323580 161790 129430 97070
1514 OP4390 Laparoscopic Right hemicolectomy with Ileo-Transverse Anastmosis 226500 113250 90600 67950
with/without Diverting Stoma
1515 OP4399 Laparoscopic Sigmoid Colectomy with Colo-Rectal 258840 129420 103540 77650
Anastmosis with diverting loop ileostomy
1516 OP4398 Laparoscopic Sigmoid Colectomy with Hartman's Procedure 226500 113250 90600 67950
1517 OP0545 Laparoscopic small bowel resection 109000 54500 43600 32700
149
1518 OP3029 Laparoscopic total colectomy 141100 70550 56440 42330
1519 OP4400 Laparoscopic Total Colectomy For IBD/Cancer 258840 129420 103540 77650
1520 OP4392 Laparoscopic Total Colectomy with Ileo- Rectal anastmosis 258840 129420 103540 77650
1521 OP1070 Laparotomy & bowel resection for intussusception 82780 41390 33110 24830
1522 OP2902 Laparotomy & closure of intestinal perforation 75900 37950 30360 22770
1523 OP1265 Laparotomy & reduction of intussusception 75900 37950 30360 22770
1524 OP1297 Laparotomy for correction of intestinal malrotation 66420 33210 26570 19930
1525 OP0432 Left hemicolectomy ( open ) 109000 54500 43600 32700
1526 OP2952 Loop colostomy in Neonates 75900 37950 30360 22770
1527 OP0001 Loop ileostomy 59360 29680 23740 17810
1528 OP2951 Loop ileostomy in Neonates 75900 37950 30360 22770
1529 OP4310 Meckel's diverticulum (open) 58820 29410 23530 17650
1530 OP4309 Mesentric cyst excision 56160 28080 22460 16850
1531 OP2948 Miculicz operation in Neonates 75900 37950 30360 22770
1532 OP1508 Modified Soave's abdomino-perineal pull through resection with 109100 54550 43640 32730
colo-anal anastomosis for total colonic Hirschprung's disease
1533 OP1271 Multiple intestinal resection and anastomosis 123960 61980 49580 37190
1534 OP2946 Multiple intestinal resection and anastomosis in Neonates 125400 62700 50160 37620
1535 OP1409 Proctocolectomy ( open ) 119000 59500 47600 35700
1536 OP4324 PSARP + laparotomy for anorectal malformation 106980 53490 42790 32090
1537 OP1412 Rectal prolapse repair with mesh ( laproscopic ) 106020 53010 42410 31810
1538 OP1411 Rectal prolapse repair with mesh ( open ) 70420 35210 28170 21130
1539 OP2953 Resection of band of Ladd 85820 42910 34330 25750
1540 OP1410 Restorative proctocolectomy 163540 81770 65420 49060
1541 OP1407 Right hemicolectomy ( open ) 114080 57040 45630 34220
1542 OP4409 Robotic Assisted Total Colectomy For IBD/Cancer 310640 155320 124260 93190
1543 OP4408 Robotic Assisted Abdomino-perineal resection with permanent Colostomy 349460 174730 139780 104840
1544 OP4407 Robotic Assisted Anterior Resection with TME with 310640 155320 124260 93190
Colorectal anastmosis with/without diverting stoma
1545 OP4402 Robotic Assisted Left hemicolectomy with Colo-colic 271780 135890 108710 81530
1546 OP4404 Robotic Assisted Procto-colectomy with diverting Ileostomy 310640 155320 124260 93190
1547 OP4405 Robotic Assisted Restorative Procto-colectomy with/ 388320 194160 155330 116500
without diverting Ileostomy
1548 OP4401 Robotic Assisted Right hemicolectomy with Ileo-Transverse 271780 135890 108710 81530
1549 OP4406 Robotic Assisted Sigmoid colectomy with Colo-Colic anastmosis 271780 135890 108710 81530
1550 OP4411 Robotic Assisted Sigmoid Colectomy with Colo-Rectal 310640 155320 124260 93190
Anastmosis with diverting loop ileostomy
1551 OP4410 Robotic Assisted Sigmoid Colectomy with Hartman's Procedure 271780 135890 108710 81530
1552 OP4403 Robotic Assisted Total Colectomy with Ileo- Rectal anastmosis 310640 155320 124260 93190
1553 OP1036 Sigmoid / descending colectomy ( open ) 119000 59500 47600 35700
1554 OP0100 Sigmoid end colostomy 59360 29680 23740 17810
1555 OP1249 Sigmoid loop colostomy 59360 29680 23740 17810
1556 OP1041 Sigmoid resection for volvulus of colon 114080 57040 45630 34220
1557 OP1042 Simple untwisting for volvulus of colon 74400 37200 29760 22320
1558 OP1071 Single intestinal resection and anastomosis 64720 32360 25890 19420
1559 OP2945 Single intestinal resection and anastomosis in Neonates 85820 42910 34330 25750
1560 OP3010 Small bowel transplant recipient operation(Normal /Early) 135920 67960 54370 40780
1561 OP1278 Soave's abdomino-perineal pull through resection 109100 54550 43640 32730
1562 OP1408 Subtotal colectomy ( open ) 119000 59500 47600 35700
1563 OP1506 Swenson's abdomino-perineal pull through resection 109100 54550 43640 32730
1564 OP0587 Transabdominal rectopexy ( open ) 114080 57040 45630 34220
1565 OP1032 Trans-anal pull through for Hirschprung's disease 109100 54550 43640 32730
1566 OP1039 Transverse colectomy ( open ) 114080 57040 45630 34220
1567 OP0099 Transverse colostomy 109100 54550 43640 32730
1568 OP1040 Tube caecostomy 47540 23770 19020 14260
150
Kidney Transplantation
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1569 OP1081 Donor nephrectomy ( open ) 82300 41150 32920 24690
1570 OP0450 Laparoscopic donor nephrectomy 105780 52890 42310 31730
1571 OP0528 Laparoscopic internal drainage of post renal 58820 29410 23530 17650
transplant lymphocele
1572 OP0442 Native nephro-ureterectomy of prospective / 98020 49010 39210 29410
operated renal transplant patient - bilateral
1573 OP1079 Native nephro-ureterectomy of prospective / 66620 33310 26650 19990
operated renal transplant patient - unilateral
1574 OP0524 Nephrectomy of transplanted kidney 86140 43070 34460 25840
1575 OP1084 Post renal transplant lymphocele aspiration / drain insertion in OT 58820 29410 23530 17650
1576 OP0527 Post renal transplant lymphocele internal drainage (open procedure) 58820 29410 23530 17650
1577 OP1082 Renal transplant recipient surgery 145640 72820 58260 43690
1578 OP0523 Rexploration & drainage of collection following renal 58820 29410 23530 17650
transplant recipient surgery
1579 OP0456 Rexploration following renal transplant recipient 58820 29410 23530 17650
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
Lymphadenectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1586 OP2822 Axillary clearance for breast carcinoma 94900 47450 37960 28470
1587 OP2823 Axillary sampling for breast disease 94900 47450 37960 28470
1588 OP2824 Axillary sentinal lymph node biopsy 38020 19010 15210 11410
1589 OP0543 Endoscopic axillary lymph node sampling 38020 19010 15210 11410
1590 OP0687 Ilio-inguinal lymph nodal block dissection - bilateral 106740 53370 42700 32020
1591 OP0686 Ilio-inguinal lymph nodal block dissection - unilateral 71140 35570 28460 21340
1592 OP4166 Ilioinguinal lymphadenectomy ( Bilateral ) 176480 88240 70590 52940
1593 OP4165 Ilioinguinal lymphadenectomy ( Unilateral ) 117660 58830 47060 35300
1594 OP2875 Inguinal lymph nodal block dissection - bilateral 106740 53370 42700 32020
1595 OP2876 Inguinal lymph nodal block dissection - unilateral 71140 35570 28460 21340
1596 OP3395 Laparoscopic abdominal lymphadenectomy 121020 60510 48410 36310
1597 OP1074 Lymph node biopsy 23800 11900 9520 7140
1598 OP0765 Paratracheal lymph nodal dissection 91100 45550 36440 27330
1599 OP2878 Pelvic lymph nodal block dissection 94900 47450 37960 28470
1600 OP0017 Retroperitoneal lymphadenectomy for malignancy (RPLND ) 118540 59270 47420 35560
1601 OP4386 RPLND Bilateral 160460 80230 64180 48140
1602 OP4387 RPLND Unilateral 106980 53490 42790 32090
151
1603 OP4729 Superficial Inguinal Lymph Nodal Dissection - Bilateral 88200 44100 35280 26460
1604 OP4728 Superficial Inguinal Lymph Nodal Dissection -Unilateral 55120 27560 22050 16540
1605 OP3383 Thoracic lymphadenectomy (open) 106780 53390 42710 32030
1606 OP3386 Thoracoscopic lymphadenectomy 106780 53390 42710 32030
Miscellaneous Orthopaedics Procedures
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1607 OP2011 Above-knee / Above-elbow plaster cast application 12000 6000 4800 3600
1608 OP2982 Application of skeletal traction 11780 5890 4710 3530
1609 OP3255 Arthrotomy for septic arthritis 54220 27110 21690 16270
1610 OP2015 Aspiration of hemarthrosis 6480 3240 2590 1940
1611 OP2012 Below-knee / Below-elbow plaster cast application 8940 4470 3580 2680
1612 OP2991 Bone grafting / Allograft / Bone subsitute - Long bone 56840 28420 22740 17050
1613 OP2992 Bone grafting / Allograft / Bone subsitute - Short bone 37000 18500 14800 11100
1614 OP3061 Capsulotomy of elbow 68940 34470 27580 20680
1615 OP3053 Capsulotomy of metatarsophalyngeal ( MP ) joints 63160 31580 25260 18950
1616 OP3052 Capsulotomy of metatarsophalyngeal +interphalyngeal ( MP & IP ) joints 68940 34470 27580 20680
1617 OP3261 Closed tendo-achilles tenotomy 25700 12850 10280 7710
1618 OP2987 Core decompression hip 63160 31580 25260 18950
1619 OP2985 Core decompression hip + bone grafting 81180 40590 32470 24350
1620 OP1973 Curettage, drainage & debridement for osteomyelitis 38240 19120 15300 11470
1621 OP1976 DeQuervein's release 27200 13600 10880 8160
1622 OP2984 Egger's Operation 63160 31580 25260 18950
1623 OP2983 Epiphyseal Drilling 54220 27110 21690 16270
1624 OP2974 Epiphysiodesis 63160 31580 25260 18950
1625 OP4318 Examination under general anaesthesia 13380 6690 5350 4010
1626 OP2027 Fasciotomy - Upper / Lower limb 43640 21820 17460 13090
1627 OP3042 Halo pelvis application 45220 22610 18090 13570
1628 OP2986 Halo vest application 27200 13600 10880 8160
1629 OP2022 Ingrowing toe nail excision 36480 18240 14590 10940
1630 OP2014 Intra-articular injections 6480 3240 2590 1940
1631 OP4317 Large procedure (Misc) - Paed 44120 22060 17650 13240
1632 OP2017 Local hydrocortisone infiltration 6480 3240 2590 1940
1633 OP2990 Manipulation of club foot 11780 5890 4710 3530
1634 OP2029 Manipulation of frozen shoulder joint under GA 20900 10450 8360 6270
1635 OP2018 Manipulation of joints with hydrocortisone infiltration 11480 5740 4590 3440
1636 OP2030 Manipulation of stiff knee under GA 20900 10450 8360 6270
1637 OP4316 Medium procedure (Misc) - Paed 29440 14720 11780 8830
1638 OP2981 Needle biopsy of bone / soft tissue, in OT 22660 11330 9060 6800
1639 OP2975 Open adductor tenotomy 45220 22610 18090 13570
1640 OP2976 Open adductor tenotomy with obturator neurectomy 63160 31580 25260 18950
1641 OP2989 Open Bone Biopsy 16260 8130 6500 4880
1642 OP3265 Open synovectomy ( ankle ) 76400 38200 30560 22920
1643 OP3266 Open synovectomy ( elbow ) 76400 38200 30560 22920
1644 OP3267 Open synovectomy ( Hip ) 76400 38200 30560 22920
1645 OP3268 Open synovectomy ( knee ) 76400 38200 30560 22920
1646 OP3269 Open synovectomy ( small joints of foot ) 76400 38200 30560 22920
1647 OP3270 Open synovectomy ( small joints of hand ) 76400 38200 30560 22920
1648 OP3381 Partial claviculectomy 59580 29790 23830 17870
1649 OP3382 Partial manubriectomy 59580 29790 23830 17870
1650 OP1840 Partial patellectomy 62200 31100 24880 18660
1651 OP4350 Periarticular Soft Tissue Reconstruction 80220 40110 32090 24070
1652 OP1974 Posteromedial release for CTEV 64920 32460 25970 19480
1653 OP2900 Removal of deep foreign body - limbs or trunk 43640 21820 17460 13090
1654 OP2025 Removal of superficial foreign body - limbs or trunk 24880 12440 9950 7460
152
1655 OP1972 Sequestrectomy + saurcerisation (major) for osteomyelitis 59520 29760 23810 17860
1656 OP1971 Sequestrectomy + saurcerisation (minor) for osteomyelitis 27200 13600 10880 8160
1657 OP4315 Small procedure (Misc) -Paed 14700 7350 5880 4410
1658 OP1978 Souter's / Yount's contracture release for polio 54600 27300 21840 16380
1659 OP2013 Spica plaster cast application in OT 20040 10020 8020 6010
1660 OP2977 Subcutaneous Adductor Tenotomy 25700 12850 10280 7710
1661 OP2028 Synovial biopsy 16260 8130 6500 4880
1662 OP1841 Total patellectomy 62200 31100 24880 18660
1663 OP1977 Trigger thumb / finger release 36480 18240 14590 10940
Miscellaneous Vascular Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1664 OP0417 Carotid body tumour excision 123280 61640 49310 36980
1665 OP0418 Internal iliac artery ligation 37940 18970 15180 11380
1666 OP2918 Pseudoaneurysm repair 75860 37930 30340 22760
1667 OP3022 Stem cell therapy for limb ischaemia 86260 43130 34500 25880
1668 OP0316 Temporal artery biopsy 25900 12950 10360 7770
Morbid Obesity Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1669 OP0536 Laparoscopic adjustable gastric banding 118540 59270 47420 35560
1670 OP0539 Laparoscopic bilio-pancreatic diversion 215460 107730 86180 64640
1671 OP0547 Laparoscopic gastric band removal 43200 21600 17280 12960
1672 OP0537 Laparoscopic Roux-en-Y gastric bypass 195880 97940 78350 58760
1673 OP0538 Laparoscopic sleeve gastrectomy 195880 97940 78350 58760
1674 OP4530 Single Incision RYGB 233200 116600 93280 69960
Nerve Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1675 OP1710 Anterior transposition of ulnar nerve 83440 41720 33380 25030
1676 OP2178 Arthroscopic median nerve decompression 56920 28460 22770 17080
1677 OP1312 Brachial plexus exploration & nerve repair 145860 72930 58340 43760
1678 OP1313 Brachial plexus exploration & nerve transfer /neurotization 170180 85090 68070 51050
1679 OP1314 Brachial plexus exploration with nerve grafting 189640 94820 75860 56890
1680 OP1112 Brachial plexus repair - neurolysis 145860 72930 58340 43760
1681 OP3257 Carpal tunnel release (open) without synovectomy 56920 28460 22770 17080
1682 OP1705 Carpal tunnel release operation with Guyon's canal release 56920 28460 22770 17080
1683 OP1704 Carpal tunnel release operation with opponensplasty 142280 71140 56910 42680
1684 OP1712 Carpal tunnel release operation with synovectomy 78760 39380 31500 23630
1685 OP1707 Cubital tunnel release 56920 28460 22770 17080
1686 OP1716 Digital nerve grafting 72940 36470 29180 21880
1687 OP1713 Digital nerve repair 52500 26250 21000 15750
1688 OP0921 Endoscopic optic nerve decompression 130440 65220 52180 39130
1689 OP1722 Excision of neuroma - major nerve 123280 61640 49310 36980
1690 OP1721 Excision of neuroma - minor nerve 85380 42690 34150 25610
153
1691 OP3433 Exploration (alone) for brachial plexus injury 72940 36470 29180 21880
1692 OP0930 Facial nerve decompression - vertical / tympanic segment 170660 85330 68260 51200
1693 OP0915 Facial nerve decompression complete ( vertical +horizontal segment) 170660 85330 68260 51200
1694 OP1176 Laparoscopic presacral neurectomy 94900 47450 37960 28470
1695 OP1720 Median nerve grafting 151660 75830 60660 45500
1696 OP1715 Median nerve repair 104300 52150 41720 31290
1697 OP1107 Micro-surgical decompression of 5th cranial nerve (trigeminal ) 170660 85330 68260 51200
1698 OP0479 Micro-surgical decompression of 7th cranial nerve (facial ) 170660 85330 68260 51200
1699 OP3335 Miscellaneous nerve grafting ( complex ) 127060 63530 50820 38120
1700 OP3336 Miscellaneous nerve grafting ( simple ) 76380 38190 30550 22910
1701 OP1123 Nerve biopsy 17160 8580 6860 5150
1702 OP2300 Nerve exploration + neurolysis for median nerve 83440 41720 33380 25030
1703 OP2301 Nerve exploration + neurolysis for radial nerve 83440 41720 33380 25030
1704 OP1968 Nerve exploration + neurolysis for ulnar nerve 83440 41720 33380 25030
1705 OP4225 Neurolysis for major nerve 88260 44130 35300 26480
1706 OP1966 Neurolysis of lateral popliteal nerve 105000 52500 42000 31500
1707 OP1969 Other nerve repair 94900 47450 37960 28470
1708 OP1090 Peripheral neurectomy ( maxilla / mandible ) 46100 23050 18440 13830
1709 OP4708 Peroneal Nerve Repair ( Direct ) 99220 49610 39690 29770
1710 OP4709 Peroneal Nerve Repair ( with nerve graft ) 132300 66150 52920 39690
1711 OP1719 Radial nerve grafting 142280 71140 56910 42680
1712 OP1717 Radial nerve repair 113800 56900 45520 34140
1713 OP3271 Sciatic nerve exploration 83440 41720 33380 25030
1714 OP3448 Sciatic nerve exploration and repair 117660 58830 47060 35300
1715 OP4240 Sciatic Nerve repair (with nerve graft) 147100 73550 58840 44130
1716 OP0907 Total facial nerve decompression upto geniculate ganglion 170660 85330 68260 51200
1717 OP0397 Total facial nerve repair 170660 85330 68260 51200
1718 OP1718 Ulnar nerve grafting 142280 71140 56910 42680
1719 OP1714 Ulnar nerve repair 113800 56900 45520 34140
Neurosurgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1720 OP1124 Application of skull traction 17140 8570 6860 5140
1721 OP1126 Brain abscess tapping 109100 54550 43640 32730
1722 OP1120 Chronic subdural haematoma tapping 151660 75830 60660 45500
1723 OP1122 Cisternal puncture 16680 8340 6670 5000
1724 OP1104 Clipping of aneurysm of anterior communicating artery of brain 221340 110670 88540 66400
1725 OP0198 Clipping of aneurysm of anterior inferior cerebellar artery 221340 110670 88540 66400
1726 OP0005 Clipping of aneurysm of basilar artery of brain 221340 110670 88540 66400
1727 OP0192 Clipping of aneurysm of carotid bifurcation 221340 110670 88540 66400
1728 OP0191 Clipping of aneurysm of distal anterior cerebral artery 221340 110670 88540 66400
1729 OP0195 Clipping of aneurysm of distal extracranial internal carotid artery 221340 110670 88540 66400
1730 OP0004 Clipping of aneurysm of internal carotid artery 221340 110670 88540 66400
1731 OP0008 Clipping of aneurysm of middle cerebral artery bifurcation 221340 110670 88540 66400
1732 OP0200 Clipping of aneurysm of middle cerebral artery cortical branches 221340 110670 88540 66400
1733 OP0199 Clipping of aneurysm of middle cerebral artery trifurcation 221340 110670 88540 66400
1734 OP0197 Clipping of aneurysm of posterior cerebral artery 221340 110670 88540 66400
1735 OP0003 Clipping of aneurysm of posterior communicating artery of brain 221340 110670 88540 66400
1736 OP0196 Clipping of aneurysm of superior cerebellar artery 221340 110670 88540 66400
1737 OP0006 Clipping of aneurysm of vertebral artery 221340 110670 88540 66400
1738 OP0007 Clipping of aneurysm of vertebro basilar artery 221340 110670 88540 66400
1739 OP0193 Clipping of clinoidal / para-clinoidal region aneurysm 221340 110670 88540 66400
1740 OP3216 Clipping of complex aneurysm of anterior communicating artery of brain 274100 137050 109640 82230
1741 OP3213 Clipping of complex aneurysm of anterior inferior cerebellar artery 274100 137050 109640 82230
1742 OP3204 Clipping of complex aneurysm of basilar artery of brain 274100 137050 109640 82230
154
1743 OP3209 Clipping of complex aneurysm of carotid bifurcation 274100 137050 109640 82230
1744 OP3208 Clipping of complex aneurysm of distal anterior cerebral artery 274100 137050 109640 82230
1745 OP3210 Clipping of complex aneurysm of distal extracranial internal carotid artery 274100 137050 109640 82230
1746 OP3203 Clipping of complex aneurysm of internal carotid artery 274100 137050 109640 82230
1747 OP3207 Clipping of complex aneurysm of middle cerebral artery bifurcation 274100 137050 109640 82230
1748 OP3215 Clipping of complex aneurysm of middle cerebral artery cortical branches 274100 137050 109640 82230
1749 OP3214 Clipping of complex aneurysm of middle cerebral artery trifurcation 274100 137050 109640 82230
1750 OP3212 Clipping of complex aneurysm of posterior cerebral artery 274100 137050 109640 82230
1751 OP3202 Clipping of complex aneurysm of posterior 274100 137050 109640 82230
communicating artery of brain
1752 OP3211 Clipping of complex aneurysm of superior cerebellar artery 274100 137050 109640 82230
1753 OP3205 Clipping of complex aneurysm of vertebral artery 274100 137050 109640 82230
1754 OP3206 Clipping of complex aneurysm of vertebro basilar artery 274100 137050 109640 82230
1755 OP0194 Clipping of ophthalmic artery aneurysm 221340 110670 88540 66400
1756 OP0496 Cranioplasty with artificial bone cement / prosthetic implant 213740 106870 85500 64120
1757 OP0495 Cranioplasty with reposition of bone flap 213740 106870 85500 64120
1758 OP1105 Craniotomy for acute / subacute subdural haematomas 172000 86000 68800 51600
1759 OP3410 Craniotomy for bleed in anterior cranial fossa ( ACF ) 274100 137050 109640 82230
1760 OP1128 Craniotomy for brain abscess excision 187680 93840 75070 56300
1761 OP0482 Craniotomy for brain stem tumours 213740 106870 85500 64120
1762 OP0483 Craniotomy for cerebellar brain tumours 213740 106870 85500 64120
1763 OP0488 Craniotomy for cerebello-pontine angle tumours 221340 110670 88540 66400
1764 OP0471 Craniotomy for chronic subdural haematomas 151660 75830 60660 45500
1765 OP0484 Craniotomy for clival / petrous region tumours 221340 110670 88540 66400
1766 OP3413 Craniotomy for complex intra ventricular tumor 274100 137050 109640 82230
1767 OP3404 Craniotomy for complex Parenchyma Brain tumors 274100 137050 109640 82230
1768 OP0487 Craniotomy for convexity meningiomas of brain 187680 93840 75070 56300
1769 OP1111 Craniotomy for CSF rhinorrhoea repair 198160 99080 79260 59450
1770 OP0475 Craniotomy for decompression of malignant infarcts (supra-tentorial) 187680 93840 75070 56300
1771 OP0473 Craniotomy for depressed fracture of skull 172000 86000 68800 51600
1772 OP0474 Craniotomy for extradural haematomas 172000 86000 68800 51600
1773 OP3405 Craniotomy for intra cerebral bleed 187680 93840 75070 56300
1774 OP0480 Craniotomy for intraventricular brain tumours 187680 93840 75070 56300
1775 OP3221 Craniotomy for large cerebello-pontine angle tumours 274100 137050 109640 82230
1776 OP3218 Craniotomy for large clival / petrous region tumours 274100 137050 109640 82230
1777 OP3402 Craniotomy for large Convexity Meningioma of brain 274100 137050 109640 82230
1778 OP3406 Craniotomy for large intra cerebral bleed 274100 137050 109640 82230
1779 OP3217 Craniotomy for large pineal region tumours 274100 137050 109640 82230
1780 OP3400 Craniotomy for Large posterior fossa tumor 274100 137050 109640 82230
1781 OP3220 Craniotomy for large sellar / parasellar tumours 274100 137050 109640 82230
1782 OP3219 Craniotomy for large skull base tumours 274100 137050 109640 82230
1783 OP3403 Craniotomy for Parasaggital Meningioma of brain 274100 137050 109640 82230
1784 OP1109 Craniotomy for parenchymal brain tumours 187680 93840 75070 56300
1785 OP0472 Craniotomy for parenchymal contusions of brain 172040 86020 68820 51610
1786 OP0481 Craniotomy for pineal region tumours 221340 110670 88540 66400
1787 OP0491 Craniotomy for posterior fossa ( infra-tentorial ) infarcts 213740 106870 85500 64120
1788 OP0490 Craniotomy for posterior fossa haematomas 213740 106870 85500 64120
1789 OP0489 Craniotomy for posterior fossa tumours 213740 106870 85500 64120
1790 OP0486 Craniotomy for sellar / parasellar tumours 221340 110670 88540 66400
1791 OP3399 Craniotomy for Severe Brain injury 274100 137050 109640 82230
1792 OP0485 Craniotomy for skull base tumours 221340 110670 88540 66400
1793 OP0716 Craniotomy for subtemporal decompression of infective disorders 187680 93840 75070 56300
1794 OP4501 Deep Brain Stimulation (DBS) 364660 182330 145860 109400
1795 OP0493 Endoscopic CSF rhinorrhoea repair 198160 99080 79260 59450
1796 OP3396 Endoscopic Skull Base Tumor Surgery 221340 110670 88540 66400
1797 OP1129 Endoscopic third ventriculostomy ( ETV ) 166820 83410 66730 50050
1798 OP3408 Endoscopic VP shunt 151660 75830 60660 45500
1799 OP0009 Excision of AVM of anterior mesial temporal region of brain 221340 110670 88540 66400
1800 OP0206 Excision of AVM of basal ganglion of brain 221340 110670 88540 66400
155
1801 OP0203 Excision of AVM of medial frontal region of brain 221340 110670 88540 66400
1802 OP0201 Excision of AVM of medial occipital region of brain 221340 110670 88540 66400
1803 OP0202 Excision of AVM of medial parietal region of brain 221340 110670 88540 66400
1804 OP0011 Excision of AVM of medial trigonal region of brain 221340 110670 88540 66400
1805 OP0207 Excision of AVM of posterior fossa of brain ( cerebellar) 221340 110670 88540 66400
1806 OP0211 Excision of AVM of posterior fossa of brain ( CPA ) 221340 110670 88540 66400
1807 OP0210 Excision of AVM of posterior fossa of brain (flocculo-nodular ) 221340 110670 88540 66400
1808 OP0209 Excision of AVM of posterior fossa of brain (para-median ) 221340 110670 88540 66400
1809 OP0208 Excision of AVM of posterior fossa of brain ( vermian ) 221340 110670 88540 66400
1810 OP0010 Excision of AVM of posterior mesial temporal region of brain 221340 110670 88540 66400
1811 OP0204 Excision of AVM of thalamo-caudate region of brain 221340 110670 88540 66400
1812 OP0205 Excision of AVM of third ventricular region of brain 221340 110670 88540 66400
1813 OP0213 Excision of brain stem AVM ( mid-brain ) 221340 110670 88540 66400
1814 OP0212 Excision of brain stem AVM ( pontine ) 221340 110670 88540 66400
1815 OP3201 Excision of complex AVM of brain 274100 137050 109640 82230
1816 OP3196 External lumbar drain 47040 23520 18820 14110
1817 OP3222 External ventricular drainage 62640 31320 25060 18790
1818 OP4764 ICP Monitoring Placement 35000 17500 14000 10500
1819 OP1121 Lumbar puncture in OT 11580 5790 4630 3470
1820 OP3411 Microscopic 3rd ventriculostomy 166140 83070 66460 49840
1821 OP3401 Mini craniotomy for Subdural Hematoma 187680 93840 75070 56300
1822 OP0514 Revision of ventriculoperitoneal ( VP ) shunt 91260 45630 36500 27380
1823 OP0519 Stereotactic aspiration of intracerebral abscess 151660 75830 60660 45500
1824 OP0520 Stereotactic biopsy of brain tumours / lesions 187680 93840 75070 56300
1825 OP1127 Stereotactic evacuation of intracerebral haematoma 177800 88900 71120 53340
1826 OP0521 Stereotactic surgery for movement disorders 221340 110670 88540 66400
1827 OP1116 Syringomyelia shunt surgery 151660 75830 60660 45500
1828 OP0515 Thecoperitoneal ( TP ) shunt 91260 45630 36500 27380
1829 OP1110 Trans-sphenoidal pituitary decompression surgery (endoscopic ) 206440 103220 82580 61930
1830 OP0492 Trans-sphenoidal pituitary decompression surgery (microscopic ) 187680 93840 75070 56300
1831 OP1125 Ventricular puncture ( brain ) 20880 10440 8350 6260
1832 OP3195 Ventricular reservoir placement 62640 31320 25060 18790
1833 OP3159 Ventricular Tapping - done in OT 18980 9490 7590 5690
1834 OP0516 Ventriculoatrial ( VA ) shunt 91260 45630 36500 27380
1835 OP1118 Ventriculoperitoneal ( VP ) shunt 91260 45630 36500 27380
1836 OP0513 Ventriculoperitoneal ( VP ) shunt with external ventricular drainage 91260 45630 36500 27380
1837 OP4911 Craniotomy for Bilateral acute / subacute subdural haematomas 344000 172000 137600 103200
1838 OP4912 Craniotomy for Bilateral chronic subdural haematomas 303320 151660 121320 91000
1839 OP4913 Mini craniotomy for Bilateral Subdural Hematoma - Bilateral 375360 187680 150140 112600
1840 OP4914 Trans-sphenoidal large pituitary decompression surgery ( endoscopic ) 274100 137050 109640 82230
1841 OP4915 Complex Spinal Dysraphism 254540 127270 101820 76360
Obstetrics & Gynaecology

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

1842 OP1130 Abdominal hysterectomy ( TAH ) ( level 1 ) 100140 50070 40060 30040
1843 OP0096 Abdominal hysterectomy ( TAH ) in patient with 121340 60670 48540 36400
previous pelvic surgery ( level 2 )
1844 OP0095 Abdominal hysterectomy ( TAH ) with pelvic floor repair ( level 2 ) 121340 60670 48540 36400
1845 OP1131 Abdominal sterilisation / Post partum ligation / tubectomy 14380 7190 5750 4310
1846 OP0013 Anterior & posterior colporraphy (AP repair) 52840 26420 21140 15850
1847 OP3161 Anterior Colporraphy 42780 21390 17110 12830
1848 OP1132 Aspiration of ovarian cyst under ultrasound guidance (in OT) 12000 6000 4800 3600
1849 OP0012 Aspiration of peritoneal collection under ultrasound guidance 12000 6000 4800 3600
1850 OP3162 Caesarean hysterectomy 115520 57760 46210 34660
156
1851 OP1133 Caesarean section ( LSCS ) 62520 31260 25010 18760
1852 OP3173 Cautery of vaginal vault granuloma 4540 2270 1820 1360
1853 OP3160 Cervical encirclage 38540 19270 15420 11560
1854 OP3251 Cervical polypectomy 8100 4050 3240 2430
1855 OP3163 Cold knife cone biopsy of cervix 29960 14980 11980 8990
1856 OP1183 Colposcopy 4540 2270 1820 1360
1857 OP1185 Colposcopy with cervical biopsy ( LEEP ) & cauterisation 12160 6080 4860 3650
1858 OP0144 Diagnostic hysteroscopy 20060 10030 8020 6020
1859 OP1167 Diagnostic laparoscopy & hysteroscopy 40460 20230 16180 12140
1860 OP3174 Dialation & curettage of uterus ( D&C ) 14380 7190 5750 4310
1861 OP1154 Drainage of vulval haematoma following delivery 43620 21810 17450 13090
1862 OP1135 End to end fallopian tubal recanalisation /anastomosis - bilateral 89680 44840 35870 26900
1863 OP0023 End to end fallopian tubal recanalisation /anastomosis - unilateral 77780 38890 31110 23330
1864 OP0015 Episiotomy repair - secondary suturing in OT 21420 10710 8570 6430
1865 OP0014 Episiotomy repair in OT - primary repair 21420 10710 8570 6430
1866 OP3168 Excision of endometrial scar 42780 21390 17110 12830
1867 OP3169 Excision of vaginal wall cyst 42780 21390 17110 12830
1868 OP3182 Fetal reduction (in OT)
1869 OP3165 Foreign body removal from vagina 25680 12840 10270 7700
1870 OP1134 Forthergill / Manchester repair of uterine prolapse 58120 29060 23250 17440
1871 OP0139 Forthergill / Manchester repair of uterine prolapse WITH tubal ligation 72600 36300 29040 21780
1872 OP1137 Hematocolpos drainage / colpotomy 42780 21390 17110 12830
1873 OP1161 Hysteroscopic division of thick synechiae 57080 28540 22830 17120
1874 OP1157 Hysteroscopic division of thin synechiae 24960 12480 9980 7490
1875 OP1163 Hysteroscopic metroplasty 57080 28540 22830 17120
1876 OP1162 Hysteroscopic myomectomy ( less than 3 cm) 42880 21440 17150 12860
1877 OP1166 Hysteroscopic myomectomy ( more than 3 cm ) 69620 34810 27850 20890
1878 OP1158 Hysteroscopic polypectomy 25440 12720 10180 7630
1879 OP1159 Hysteroscopic removal of IUCD 24960 12480 9980 7490
1880 OP1160 Hysteroscopic removal of retained products of conception 42080 21040 16830 12620
1881 OP1164 Hysteroscopic resection of uterine septum 57080 28540 22830 17120
1882 OP1165 Hysteroscopic trans-cervical resection of 68400 34200 27360 20520
endometrium ( TCRE )
1883 OP1138 Hysterotomy 70080 35040 28030 21020
1884 OP1172 Laparoscopic adhesiolysis & hysteroscopy 89400 44700 35760 26820
1885 OP3166 Laparoscopic assisted vaginal hysterectomy ( LAVH ) (Uterus < 14 week) 108280 54140 43310 32480
1886 OP3167 Laparoscopic assisted vaginal hysterectomy (LAVH ) ( 129740 64870 51900 38920
Uterus < 14 week ) or with previous pelvic surgery
1887 OP3178 Laparoscopic colposacropexy 95860 47930 38340 28760
1888 OP3176 Laparoscopic excision of board ligament leaves 77700 38850 31080 23310
1889 OP3250 Laparoscopic excision of broad ligament leaves 85520 42760 34210 25660
1890 OP1179 Laparoscopic fallopian tubal recanalisation 99700 49850 39880 29910
1891 OP0110 Laparoscopic milking for ectopic pregnancy 85520 42760 34210 25660
1892 OP1177 Laparoscopic myomectomy ( for fibroid less than 3 cm) 104220 52110 41690 31270
1893 OP0094 Laparoscopic myomectomy ( for fibroid more than 3cm ) 119160 59580 47660 35750
1894 OP1180 Laparoscopic neo-vagina creation 99700 49850 39880 29910
1895 OP0108 Laparoscopic ovarian cystectomy 85520 42760 34210 25660
1896 OP2904 Laparoscopic repair of rectovaginal fistula ( RVF ) 58120 29060 23250 17440
1897 OP1143 Laparoscopic repair of Recurrent rectovaginal fistula (RVF ) 79220 39610 31690 23770
1898 OP1175 Laparoscopic salpingectomy 87080 43540 34830 26120
1899 OP3177 Laparoscopic salpingo-oopherectomy 77700 38850 31080 23310
1900 OP0109 Laparoscopic salpingostomy 87080 43540 34830 26120
1901 OP3175 Laparoscopic surgery for tubo - ovarian torsion 77700 38850 31080 23310
1902 OP1178 Laparoscopic uterine cornual excision 99700 49850 39880 29910
1903 OP3417 Laparoscopic uterine suspension 105660 52830 42260 31700
1904 OP3179 Laparoscopic vesico-vaginal ( VVF ) repair 99820 49910 39930 29950
1905 OP3181 Laparoscopic Wertheims ( radical ) hysterectomy 174240 87120 69700 52270
1906 OP1173 Laparoscopy & hysteroscopy with fimbrioplasty /neosalpingostomy 85520 42760 34210 25660
1907 OP1171 Laparoscopy & hysteroscopy with LUNA 68400 34200 27360 20520
157
1908 OP1169 Laparoscopy & hysteroscopy with ovarian biopsy 51360 25680 20540 15410
1909 OP1168 Laparoscopy & hysteroscopy with ovarian drilling 51360 25680 20540 15410
1910 OP1170 Laparoscopy & hysteroscopy with tubal canulation 68400 34200 27360 20520
1911 OP0092 Laparoscopy with hysteroscopic cornual catheterisation 68400 34200 27360 20520
1912 OP0018 Laparoscopy with ovarian biopsy 51360 25680 20540 15410
1913 OP3170 LeFort operation for uterine prolapse 51360 25680 20540 15410
1914 OP3171 Manual removal of placenta 21420 10710 8570 6430
1915 OP1140 Mid trimester abortion 40440 20220 16180 12130
1916 OP1184 MTP - Medical termination of pregnancy 14380 7190 5750 4310
1917 OP1141 MTP with laparoscopic sterilisation 21340 10670 8540 6400
1918 OP1142 MTP with minilap sterilisation 21340 10670 8540 6400
1919 OP3252 Non descent vaginal hysterectomy ( NDVH ) 100140 50070 40060 30040
1920 OP3416 Non descent vaginal hysterectomy ( NDVH ) for uterus > 12 weeks 110460 55230 44180 33140
1921 OP3415 Non descent vaginal hysterectomy ( NDVH ) + bilateral 110460 55230 44180 33140
salphingo oopherectomy ( BSO )
1922 OP1186 Normal delivery in OT 62520 31260 25010 18760
1923 OP0142 Ovarian cystectomy / oopherectomy ( open technique) 57080 28540 22830 17120
1924 OP1136 Pelvic examination under anaesthesia and aspiration (EUA ) 14380 7190 5750 4310
1925 OP1146 Perineal tear repair ( CPT repair ) 65340 32670 26140 19600
1926 OP3247 Perineorraphy 14680 7340 5870 4400
1927 OP1151 Radical hysterectomy for malignancy / Wertheim’s hysterectomy 173340 86670 69340 52000
1928 OP2877 Radical hysterectomy for malignancy / Wertheim’s hysterectomy + 173460 86730 69380 52040
Cyto-reductive surgery for ovarian cancer
1929 OP2906 Repair of rectovaginal fistula ( RVF ) 50720 25360 20290 15220
1930 OP2905 Repair of Recurrent rectovaginal fistula ( RVF ) 63300 31650 25320 18990
1931 OP2907 Repair of Recurrent vesico-vaginal fistula – abdominal approach 79220 39610 31690 23770
1932 OP2908 Repair of Recurrent vesico-vaginal fistula – vaginal approach 79220 39610 31690 23770
1933 OP1482 Repair of vesico-vaginal fistula - abdominal approach 99680 49840 39870 29900
1934 OP1483 Repair of vesico-vaginal fistula - vaginal approach 99680 49840 39870 29900
1935 OP3068 Repair of vesico-vaginal fistula ( VVF ) with flap cover 143900 71950 57560 43170
1936 OP3172 Repositioning on inverted uterus ( uterine inversion ) 21420 10710 8570 6430
1937 OP0141 Salpingectomy ( open technique ) 57080 28540 22830 17120
1938 OP1145 Salpingo-oophrectomy ( open technique ) 57080 28540 22830 17120
1939 OP1153 Simple vulvectomy 87120 43560 34850 26140
1940 OP1155 Suturing of vaginal / vulval tears 14680 7340 5870 4400
1941 OP1147 Total ( radical ) vulvectomy with dissection of nodes 130700 65350 52280 39210
1942 OP1182 Total laparoscopic hysterectomy ( TLH ) in case of previous pelvic surgery 142960 71480 57180 42890
or intraabdominal adhesions (excluding-tubal-ligation-surgery)
1943 OP0093 Total laparoscopic hysterectomy of uterus less than 14 weeks ( TLH ) 119160 59580 47660 35750
1944 OP1181 Total laparoscopic hysterectomy of uterus more than 14 weeks ( TLH) 142960 71480 57180 42890
1945 OP3249 Trachelectomy ( uterine cervix excision ) 162860 81430 65140 48860
1946 OP3248 Trachelorrhaphy ( uterine cervix repair ) 64220 32110 25690 19270
1947 OP1156 Uterine myomectomy 95800 47900 38320 28740
1948 OP0016 Vaginal hysterectomy & repair 95800 47900 38320 28740
1949 OP0143 Vaginal vault prolapse repair / vault suspension (abdominal approach) 94060 47030 37620 28220
1950 OP1149 Vaginal vault prolapse repair / vault suspension (vaginal approach) 94060 47030 37620 28220
1951 OP1292 Vaginoplasty 130540 65270 52220 39160
1952 OP1148 Vaginoplasty for vaginal agenesis 130540 65270 52220 39160
1953 OP1150 Ventrisuspension of the uterus ( open technique ) 57080 28540 22830 17120
1954 OP1152 Vulval biopsy 12320 6160 4930 3700
Oesophageal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1955 OP1251 Complete correction of oesophageal atresia and TEF 152620 76310 61050 45790
1956 OP0970 Dilatation of oesophageal - first stage 23800 11900 9520 7140
158
1957 OP0992 Dilatation of oesophageal - subsequent stage 16680 8340 6670 5000
1958 OP1399 Enucleation of leiomyoma of oesophagus (transthoracic ) 275480 137740 110190 82640
1959 OP1396 Ivor Lewis oesophagectomy 161780 80890 64710 48530
1960 OP0558 Laparoscopic fundoplication ( Dor's ) & hiatus hernia repair 104300 52150 41720 31290
1961 OP0556 Laparoscopic fundoplication ( Nissen ) & hiatus hernia repair 104300 52150 41720 31290
1962 OP0557 Laparoscopic fundoplication ( Toupet's ) & hiatus hernia repair 104300 52150 41720 31290
1963 OP4080 Laparoscopic fundoplication for GERD 177980 88990 71190 53390
1964 OP0630 Laparoscopic oesophageal cardiomyotomy 165280 82640 66110 49580
1965 OP0559 Laparoscopic placement of magnetic oesophageal sphincter 47540 23770 19020 14260
1966 OP3372 Laparoscopic repair of giant paraesophageal hiatus hernia with fundoplication 177980 88990 71190 53390
1967 OP3373 Laparoscopic repair of giant paraesophageal hiatus 142360 71180 56940 42710
hernia without fundoplication
1968 OP3374 Laparoscopic repair of recurrent hiatus hernia / redo fundoplication 270500 135250 108200 81150
1969 OP3376 Laparoscopic transhiatal oesophagectomy with gastric pull-up 284760 142380 113900 85430
1970 OP1424 Ligation of oesophagus 93420 46710 37370 28030
1971 OP1397 Mc-Keown oesophagectomy 177980 88990 71190 53390
1972 OP2944 Nissen fundoplication & hiatus hernia repair 109000 54500 43600 32700
1973 OP1400 Oesophageal cardiomyotomy 137720 68860 55090 41320
1974 OP4083 Oesophageal Perforation repair 137720 68860 55090 41320
1975 OP0028 Oesophageal stricturoplasty 93420 46710 37370 28030
1976 OP3378 Oesophagectomy with colon interpostion (abdomen 284760 142380 113900 85430
and chest incision for oesophagectomy)
1977 OP3379 Oesophagectomy with colonic interpostion (abdomen, 355920 177960 142370 106780
chest and neck oesophagectomy)
1978 OP1255 Oesophagostomy 69560 34780 27820 20870
1979 OP1413 Removal of foreign body oesophagus by flexible oesophagoscope 34720 17360 13890 10420
1980 OP0892 Removal of foreign body oesophagus by rigid oesophagoscope 23800 11900 9520 7140
1981 OP3384 Thoracoscopic and laparoscopic oesophagectomy with 320340 160170 128140 96100
gastric pull-up (chest anastomosis)
1982 OP3385 Thoracoscopic and laparoscopic oesophagectomy with 355920 177960 142370 106780
gastric pull-up (neck anastomosis)
1983 OP3387 Trans hiatal oesophagectomy with colonic interpostion 249140 124570 99660 74740
1984 OP3388 Trans thoracic fundoplication 156620 78310 62650 46990
1985 OP3389 Trans thoracic redo fundoplicaton 249140 124570 99660 74740
1986 OP1381 Transaction of oesophagus and EEA stapling 93420 46710 37370 28030
1987 OP1395 Transhiatal oesophagectomy 113280 56640 45310 33980
1988 OP3390 VATS enuceation of oesophageal tumors 142360 71180 56940 42710
1989 OP4055 VATS Enucleation of leiomyoma of esophagus 330540 165270 132220 99160
Onco Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1990 OP4322 Saccrococcygel teratoma - External 74880 37440 29950 22460
1991 OP4323 Saccrococcygel teratoma - with intra- pelvic extension 93600 46800 37440 28080
Oncology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

1992 OP2910 Bone marrow / stem cell transplantation (if done in OT) 215460 107730 86180 64640
1993 OP3025 Bone marrow harvesting procedure (if done in OT) 47500 23750 19000 14250
159
Open Reduction And Internal Fixation
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
1994 OP4334 Ankle Bimalleolar Fixation with Syndesmosis screw 128360 64180 51340 38510
1995 OP1824 Calcaneal pin insertion 12980 6490 5190 3890
1996 OP4345 Complex Fracture Fixation with Ilizarov 128360 64180 51340 38510
1997 OP4344 Complex Fracture Fixation with Nailing 128360 64180 51340 38510
1998 OP4343 Complex Fracture Fixation with Plating 128360 64180 51340 38510
1999 OP4348 Complex Joint Reconstruction with Ilizarov 139040 69520 55620 41710
2000 OP4347 Complex Joint Reconstruction with Nailing 139040 69520 55620 41710
2001 OP4346 Complex Joint Reconstruction with Plating 139040 69520 55620 41710
2002 OP1845 Condylar plate fixation for supracondylar fracture femur 99140 49570 39660 29740
2003 OP1848 DCS fixation for subtrochanteric fracture femur 99140 49570 39660 29740
2004 OP1844 DCS fixation for supracondylar fracture femur 99140 49570 39660 29740
2005 OP1846 DHS fixation for intertrochanteric fracture femur 99140 49570 39660 29740
2006 OP4134 Fixation of radial head 77740 38870 31100 23320
2007 OP4136 Fixation of tibial tuberosity 61420 30710 24570 18430
2008 OP1860 K-wire fixation for fracture metacarpal / phalanx 31060 15530 12420 9320
2009 OP1819 K-wire fixation for fracture metatarsal / phalanx 28620 14310 11450 8590
2010 OP1876 Lateral condyle fixation for fracture humerus 62200 31100 24880 18660
2011 OP1875 Medial condyle fixation for fracture humerus 62200 31100 24880 18660
2012 OP4138 Mid tarsal joint plate fixation 90120 45060 36050 27040
2013 OP1859 Mini plate fixation for fracture metacarpals 43400 21700 17360 13020
2014 OP1822 Mini plate fixation for fracture metatarsals 41720 20860 16690 12520
2015 OP1861 Multiple K-wire fixation for fracture metacarpals /phalanges 46560 23280 18620 13970
2016 OP1820 Multiple K-wire fixation for fracture metatarsals /phalanges 37880 18940 15150 11360
2017 OP1847 Multiple screw fixation for fracture neck of femur 99140 49570 39660 29740
2018 OP4328 Non-Union of Long Bones - ORIF with Bone Grafting 128360 64180 51340 38510
2019 OP4250 Open ACI tansplant (Autologous Chondrocyte Implant) 105440 52720 42180 31630
2020 OP1863 Open reduction + K-wire fixation for carpal dislocation 43400 21700 17360 13020
2021 OP1879 Open reduction fracture medial epicondyle + K-wire fixation / screw 59520 29760 23810 17860
2022 OP1883 Open reduction fracture neck humerus + fibular grafting 113940 56970 45580 34180
2023 OP1882 Open reduction fracture neck humerus + plate fixation 85520 42760 34210 25660
2024 OP4329 Open Reduction of Dislocated Large Joint 101600 50800 40640 30480
2025 OP3264 Open Reduction of dislocated MP Joint of thumb /finger 81780 40890 32710 24530
2026 OP1877 Open reduction supracondylar fracture humerus with K-wire fixation 62200 31100 24880 18660
2027 OP4341 ORIF Metacarpal / Metatarsal 112320 56160 44930 33700
2028 OP4330 Osteochondral Fracture Fixation 128360 64180 51340 38510
2029 OP1855 Osteosynthesis anterior pillar / wall of acetabulum (Screw / Plate) 174940 87470 69980 52480
2030 OP1854 Osteosynthesis posterior pillar / wall of acetabulum (screw / Plate) 174940 87470 69980 52480
2031 OP1849 PFN for subtrochanteric fracture femur 96960 48480 38780 29090
2032 OP1829 Plating / nail fixation for fracture lateral malleolus 67580 33790 27030 20270
2033 OP1885 Plating for fracture clavicle 62200 31100 24880 18660
2034 OP1842 Plating for fracture femur 99140 49570 39660 29740
2035 OP1851 Plating for fracture femur with bone grafting 113940 56970 45580 34180
2036 OP1835 Plating for fracture fibula 62200 31100 24880 18660
2037 OP1880 Plating for fracture humerus 99140 49570 39660 29740
2038 OP1881 Plating for fracture humerus + bone grafting 113940 56970 45580 34180
2039 OP1832 Plating for fracture lateral tibial condyle 85520 42760 34210 25660
2040 OP1830 Plating for fracture medial & lateral tibial condyles 85520 42760 34210 25660
2041 OP1831 Plating for fracture medial tibial condyle 85520 42760 34210 25660
2042 OP1836 Plating for fracture shaft of tibia 99140 49570 39660 29740
2043 OP1837 Plating for fracture shaft tibia + bone grafting 113940 56970 45580 34180
2044 OP1834 Plating for fracture tibial plafond 85520 42760 34210 25660
2045 OP1856 Plating for pubic symphysis fracture 174940 87470 69980 52480
2046 OP1867 Plating for radius & ulna fracture 85520 42760 34210 25660
160
2047 OP1865 Plating for radius fracture 62200 31100 24880 18660
2048 OP1858 Plating for SI joint disruption - bilateral 141240 70620 56500 42370
2049 OP1857 Plating for SI joint disruption - unilateral 141240 70620 56500 42370
2050 OP1866 Plating for ulna fracture 62200 31100 24880 18660
2051 OP1871 Plating of fracture radius & ulna + bone grafting 109020 54510 43610 32710
2052 OP1870 Plating of fracture radius + bone grafting 86860 43430 34740 26060
2053 OP2892 Plating of fracture ulna + bone grafting 86860 43430 34740 26060
2054 OP4137 Plating of ilium 90120 45060 36050 27040
2055 OP1823 Reconstruction plate fixation for fracture calcaneum 99140 49570 39660 29740
2056 OP3190 Sacral fracture - open reduction and fixation ( ORIF ) 122780 61390 49110 36830
2057 OP3191 Sacral fracture - percutaneous fixation 122780 61390 49110 36830
2058 OP1821 Screw fixation for fracture 5th metatarsal base 38240 19120 15300 11470
2059 OP1853 Screw fixation for fracture head femur 99140 49570 39660 29740
2060 OP1862 Screw fixation for fracture scaphoid 64920 32460 25970 19480
2061 OP1838 Screw fixation for fracture tibial spine 85520 42760 34210 25660
2062 OP4147 Screw fixation navicular / calcaneum 58980 29490 23590 17690
2063 OP4135 Screw fixation patella 56520 28260 22610 16960
2064 OP4252 Stem cell transplant in knee/shoulder/hip 67640 33820 27060 20290
2065 OP1850 Supracondylar nail for supracondylar fracture femur 96960 48480 38780 29090
2066 OP4340 Surgery for Recurrent Shoulder Dislocation 112320 56160 44930 33700
2067 OP1864 T-buttress plate fixation for fracture distal radius 64920 32460 25970 19480
2068 OP1839 Tension band wiring / encirclage wiring for fracture patella 62200 31100 24880 18660
2069 OP1828 Tension band wiring / malleolar screw for fracture medial malleolus 67580 33790 27030 20270
2070 OP2894 Tension band wiring / malleolar screw for fracture 103660 51830 41460 31100
medial malleolus & plating lateral malleolus
2071 OP1827 Tension band wiring / malleolar screw for fracture medial malleolus 103660 51830 41460 31100
& plating lateral malleolus with screw fixation distal tibia
2072 OP1843 Tension band wiring for fracture greater trochanter 62200 31100 24880 18660
2073 OP1884 Tension band wiring for fracture lateral end clavicle 62200 31100 24880 18660
2074 OP1872 Tension band wiring proximal ulna / screw fixation for fracture ulna 64920 32460 25970 19480
2075 OP4335 Tillaux Fracture ORIF 112320 56160 44930 33700
2076 OP1874 Ulnar osteotomy + coronoid fixation 62200 31100 24880 18660
2077 OP1873 Ulnar osteotomy + fixation of intercondylar femur 107940 53970 43180 32380
humerus - both pillars
Operations For Dislocations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2078 OP1990 Close reduction acromio-clavicular joint with K-wire fixation 28220 14110 11290 8470
2079 OP1891 Closed reduction fracture or dislocation carpal / wrist with K-wire fixation 27340 13670 10940 8200
2080 OP3459 Dislocation Foot - Closed reduction 24860 12430 9940 7460
2081 OP4248 Open latarjet with coracoid 105440 52720 42180 31630
2082 OP4249 Open latarjet with iliac crest 113800 56900 45520 34140
2083 OP1991 Open reduction acromio-clavicular joint with tension band wiring 62200 31100 24880 18660
2084 OP1995 Open reduction for dislocation of carpal / wrist joint 58980 29490 23590 17690
2085 OP3460 Open reduction for dislocation of tarsal bones 54080 27040 21630 16220
2086 OP1996 Open reduction for dislocation shoulder 83340 41670 33340 25000
2087 OP1994 Open reduction for elbow joint dislocation 79840 39920 31940 23950
2088 OP1992 Open reduction for hip joint dislocation 83340 41670 33340 25000
2089 OP1993 Open reduction for knee joint dislocation 83340 41670 33340 25000
2090 OP3458 Open reduction of ankle joint 90120 45060 36050 27040
2091 OP1998 Open repair for Recurrent dislocation of elbow joint 109020 54510 43610 32710
2092 OP1999 Open repair for Recurrent dislocation of patella 109020 54510 43610 32710
2093 OP1997 Open repair for Recurrent dislocation of shoulder 109020 54510 43610 32710
161
Operations For Portal Hypertension
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2094 OP1384 Distal splenorenal shunt ( Warren shunt ) 103680 51840 41470 31100
2095 OP1382 Interposition mesocaval shunt - synthetic graft 180220 90110 72090 54070
2096 OP0828 Interposition mesocaval shunt - vein graft 180220 90110 72090 54070
2097 OP0827 Portacaval shunt 103680 51840 41470 31100
2098 OP1383 Proximal lienorenal shunt 103680 51840 41470 31100
2099 OP1380 Sub-cardiac porta-azygos disconnection & devascularization 98020 49010 39210 29410
Orthognathic Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2100 OP0019 Alveolar bone grafting 90160 45080 36060 27050
2101 OP0171 Alveolar fracture - closed reduction 36120 18060 14450 10840
2102 OP0172 Alveolar fracture - open reduction 54080 27040 21630 16220
2103 OP1309 Arch bar application 45180 22590 18070 13550
2104 OP1308 Arch bar removal 18220 9110 7290 5470
2105 OP0706 Bilateral sagittal split osteotomy - advancement 180220 90110 72090 54070
2106 OP0705 Bilateral sagittal split osteotomy - setback 180220 90110 72090 54070
2107 OP4321 Clitorovaginoplasty for CAH 101600 50800 40640 30480
2108 OP1096 Dental Category 1 - All teeth extraction (single jaw) in OT 16780 8390 6710 5030
2109 OP0709 Dental OPD category 2 - All teeth extraction (single jaw) 11760 5880 4700 3530
2110 OP0152 Frontal sinus fracture ( complicated ) - open reduction ( ORIF ) 90160 45080 36060 27050
2111 OP0151 Frontal sinus fracture ( simple ) - open reduction 76580 38290 30630 22970
2112 OP0829 Full mouth periodontal flap surgery 40580 20290 16230 12170
2113 OP0080 Jaw cyst excision - simple / unilocular 36120 18060 14450 10840
2114 OP0081 Jaw cyst or tumour - radical resection 72160 36080 28860 21650
2115 OP1335 Jaw cyst or tumour excision and bone grafting 90160 45080 36060 27050
2116 OP0082 Jaw cyst or tumour resection and reconstruction of jaw with free fibula flap 198180 99090 79270 59450
2117 OP0707 LeFort I osteotomy with advancement 180220 90110 72090 54070
2118 OP0079 LeFort I osteotomy with application of distractor 180220 90110 72090 54070
2119 OP1093 LeFort I osteotomy with impaction / intrusion 180220 90110 72090 54070
2120 OP0069 LeFort III ( extracranial ) advancement 225220 112610 90090 67570
2121 OP0070 LeFort III ( intracranial ) advancement - monobloc 225220 112610 90090 67570
2122 OP0169 LeFort III complicated fracture - open reduction ( ORIF) 144100 72050 57640 43230
2123 OP0168 LeFort III fracture - open reduction ( ORIF ) 123960 61980 49580 37190
2124 OP0170 LeFort III fracture ( complicated ) - open reduction +bone graft ( ORIF) 162220 81110 64890 48670
2125 OP0078 LeFort III osteotomy with application of distractor 225220 112610 90090 67570
2126 OP0071 LeFort III with Lefort I advancement 270300 135150 108120 81090
2127 OP4380 Malar palate removal Multiple 106980 53490 42790 32090
2128 OP4379 Malar palate removal Single 80220 40110 32090 24070
2129 OP0177 Mandible condylar fracture - open reduction 90160 45080 36060 27050
2130 OP4374 Mandible Distraction 133700 66850 53480 40110
2131 OP0176 Mandible fracture ( complicated ) - open reduction (ORIF ) 90160 45080 36060 27050
2132 OP0173 Mandible fracture - closed reduction 48680 24340 19470 14600
2133 OP0175 Mandible fracture - open reduction ( ORIF ) 76660 38330 30660 23000
2134 OP0174 Mandible fracture - percutaneous reduction / external fixation 76660 38330 30660 23000
2135 OP4376 Mandible palate removal Multiple 106980 53490 42790 32090
2136 OP4375 Mandible palate removal Single 80220 40110 32090 24070
2137 OP0187 Mandible reconstruction with bone graft 76660 38330 30660 23000
2138 OP0185 Mandible reconstruction with bone plate 76660 38330 30660 23000
162
2139 OP0188 Mandible reconstruction with free fibular flap 198180 99090 79270 59450
2140 OP0186 Mandible reconstruction with implant 90160 45080 36060 27050
2141 OP3332 Manual reduction of temporomandibular ( TM ) joint 31880 15940 12750 9560
dislocation under GA
2142 OP0164 Maxillary LeFort I fracture - closed reduction 48680 24340 19470 14600
2143 OP0165 Maxillary LeFort I fracture - open reduction ( ORIF ) 76580 38290 30630 22970
2144 OP0166 Maxillary LeFort I fracture ( complicated ) – open reduction ( ORIF ) 90160 45080 36060 27050
2145 OP0167 Maxillary LeFort I fracture ( complicated ) - open 108120 54060 43250 32440
reduction + bone graft ( ORIF )
2146 OP4378 Maxillary palate removal Multiple 106980 53490 42790 32090
2147 OP4377 Maxillary palate removal Single 80220 40110 32090 24070
2148 OP0190 Maxillary reconstruction ( complicated ) with bone graft 90160 45080 36060 27050
2149 OP0189 Maxillary reconstruction without bone graft 72160 36080 28860 21650
2150 OP1085 Maxillo - mandibular cyst enucleation /marsupialisation 63100 31550 25240 18930
2151 OP0146 Nasal bone fracture - closed reduction with manipulation/ stabilisation 50760 25380 20300 15230
2152 OP0145 Nasal bone fracture - closed reduction without manipulation 47340 23670 18940 14200
2153 OP0147 Nasal bone fracture ( complicated ) - open reduction (ORIF ) 90160 45080 36060 27050
2154 OP0148 Nasal bone fracture ( simple ) - open reduction 76660 38330 30660 23000
2155 OP0150 Naso-ethmoid fracture - open reduction with fixation (ORIF ) 90160 45080 36060 27050
2156 OP0149 Naso-ethmoid fracture - open reduction without fixation 76660 38330 30660 23000
2157 OP0155 Naso-maxillary complicated fracture ( LeFort II ) – open reduction ( ORIF) 144100 72050 57640 43230
2158 OP0156 Naso-maxillary complicated fracture ( LeFort II ) - open 162220 81110 64890 48670
reduction ( ORIF ) + bone graft
2159 OP0153 Naso-maxillary fracture ( LeFort II ) - closed reduction 54080 27040 21630 16220
2160 OP0154 Naso-maxillary fracture ( LeFort II ) - open reduction (ORIF ) 123960 61980 49580 37190
2161 OP0159 Open reduction and internal fixation ( ORIF ) of malar fracture 76660 38330 30660 23000
2162 OP3338 Open reduction and internal fixation of tripod fracture of zygoma 106320 53160 42530 31900
2163 OP1094 Oral submucous cyst excision 36120 18060 14450 10840
2164 OP0708 Oral submucous cyst marsupialisation 31600 15800 12640 9480
2165 OP0160 Orbital blow out fracture - open reduction + alloplastic implant 76660 38330 30660 23000
2166 OP0161 Orbital blow out fracture - open reduction + bone graft 90160 45080 36060 27050
2167 OP0163 Orbital complicated fracture - open reduction 90160 45080 36060 27050
2168 OP0162 Orbital simple fracture - open reduction 76660 38330 30660 23000
2169 OP0157 Percutaneous reduction of malar fracture 54080 27040 21630 16220
2170 OP1091 Repair of oro-antral fistula 78900 39450 31560 23670
2171 OP0548 Root canal filling + apicoectomy 18100 9050 7240 5430
2172 OP1089 Segmental mandibular osteotomy ( multiple ) 135220 67610 54090 40570
2173 OP2909 Segmental mandibular osteotomy ( single ) 108120 54060 43250 32440
2174 OP1092 Segmental maxillary osteotomy ( multiple ) 135220 67610 54090 40570
2175 OP0704 Segmental maxillary osteotomy ( single ) 108120 54060 43250 32440
2176 OP1087 Surgical disimpaction for impacted canine /supernumerary tooth 38380 19190 15350 11510
2177 OP0703 Surgical disimpaction of all four impacted molars 63100 31550 25240 18930
2178 OP1088 Surgical disimpaction of two impacted molars 31600 15800 12640 9480
2179 OP0178 TM joint dislocation - closed reduction 47340 23670 18940 14200
2180 OP0180 TM joint dislocation - open reduction 76660 38330 30660 23000
2181 OP0179 TM joint dislocation ( complicated ) - closed reduction 90160 45080 36060 27050
/ IMF ( arch bars )
2182 OP0158 Zygomatic arch fracture - open reduction 76660 38330 30660 23000
Orthopaedic Implant Removal

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

2183 OP3256 Broken nail removal from long bones 54080 27040 21630 16220
2184 OP3258 Cemented implant removal ( hip ) 54080 27040 21630 16220
2185 OP3259 Cemented implant removal ( knee ) 54080 27040 21630 16220
2186 OP2040 External fixator removal from long bones 18400 9200 7360 5520
163
2187 OP2038 Implant removal from ankle 37360 18680 14940 11210
2188 OP2979 Implant removal from large joint ( Hip, Knee, Shoudler) 42840 21420 17140 12850
2189 OP3040 Implant removal from spine 39300 19650 15720 11790
2190 OP2034 Multiple K-wire removal 21660 10830 8660 6500
2191 OP2031 Nail removal from long bones 24600 12300 9840 7380
2192 OP2037 Plate removal both bones forearm - radius and ulna 37360 18680 14940 11210
2193 OP2036 Plate removal forearm bones - Radius / Ulna 34340 17170 13740 10300
2194 OP2035 Plate removal from long bones 38960 19480 15580 11690
2195 OP2042 Removal of cross leg external fixator 18400 9200 7360 5520
2196 OP2043 Removal of pelvis external fixator 18400 9200 7360 5520
2197 OP2032 Screw removal for dynamisation 22640 11320 9060 6790
2198 OP2033 Single K-wire removal 9140 4570 3660 2740
2199 OP3274 Tension band wire removal from medial / lateral malleolus 18400 9200 7360 5520
2200 OP2039 Tension band wiring removal from patella / olecranon 18400 9200 7360 5520
2201 OP2041 Transarticular external fixator removal 22640 11320 9060 6790
Osteotomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2202 OP2883 Abduction ( valgus ) osteotomy of hip 104300 52150 41720 31290
2203 OP2081 Cervical substraction osteotomy 135580 67790 54230 40670
2204 OP2082 Cervical substraction osteotomy + anterior procedure 135580 67790 54230 40670
2205 OP2881 Chiari osteotomy of hip 104300 52150 41720 31290
2206 OP1724 Derotation osteotomy for humerus 81780 40890 32710 24530
2207 OP2887 Distal radial osteotomy for malunited Colles' fracture 71100 35550 28440 21330
2208 OP2083 Dorsal substraction osteotomy 135580 67790 54230 40670
2209 OP2084 Dorsal substraction osteotomy + anterior procedure 135580 67790 54230 40670
2210 OP2889 Drawyer's calcaneal osteotomy 62080 31040 24830 18620
2211 OP2879 Emslie Trillat advancement of patellar tendon 78220 39110 31290 23470
2212 OP1868 Excision of head of radius 59520 29760 23810 17860
2213 OP2888 Excision of lower end of ulna ( Darrach's procedure ) 56920 28460 22770 17080
2214 OP4152 Hallux valgus correction / osteotomy 60380 30190 24150 18110
2215 OP1987 High tibial osteotomy ( HTO ) of tibia - Coventry 81780 40890 32710 24530
2216 OP1986 Innominate osteotomy of hip 104300 52150 41720 31290
2217 OP2890 Keller's procedure for hallux valgus 39880 19940 15950 11960
2218 OP2884 Lateral closed wedge osteotomy for cubitus varus of elbow 69420 34710 27770 20830
2219 OP2886 Lateral closed wedge osteotomy for genu valgum 81780 40890 32710 24530
2220 OP2085 Lumbar substraction osteotomy 135580 67790 54230 40670
2221 OP2086 Lumbar substraction osteotomy + anterior procedure 135580 67790 54230 40670
2222 OP1711 Medial epicondylectomy 66420 33210 26570 19930
2223 OP2885 Medial open wedge osteotomy for genu valgum 81780 40890 32710 24530
2224 OP1988 Osteotomy of hand / foot + K-wire fixation 39880 19940 15950 11960
2225 OP4342 Osteotomy of Long Bone with Fixation 139040 69520 55620 41710
2226 OP2880 Salter innominate osteotomy 126420 63210 50570 37930
2227 OP2891 Supramalleolar osteotomy of lower end of tibia / fibula 81780 40890 32710 24530
2228 OP2882 Varus derotation osteotomy of hip 104300 52150 41720 31290
Pain Control Procedures

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

2229 OP2935 Celiac plexus local anaesthetic block 16540 8270 6620 4960
2230 OP0845 Celiac plexus neurolytic/USG block 20660 10330 8260 6200
164
2231 OP0888 Combined spinal and epidural block 11840 5920 4740 3550
2232 OP0846 Continuous plexus block 12420 6210 4970 3730
2233 OP2925 Continuous stellate ganglion local anaesthetic block 13780 6890 5510 4130
2234 OP4759 Disc fix 55120 27560 22050 16540
2235 OP0847 Electronic PCA pump installation in OT 10480 5240 4190 3140
2236 OP4554 Endoscopic Dissectomy 27780 13890 11110 8330
2237 OP2937 Epidural adhesioniolysis 16540 8270 6620 4960
2238 OP0849 Epidural block ( Caudal ) 11020 5510 4410 3310
2239 OP0850 Epidural block ( Cervical ) 13780 6890 5510 4130
2240 OP0848 Epidural block ( Lumbar ) 7860 3930 3140 2360
2241 OP0851 Epidural block ( Thoracic ) 9540 4770 3820 2860
2242 OP2938 Epidurography 11700 5850 4680 3510
2243 OP2939 Epiduroscopy ( with epidurography ) 19720 9860 7890 5920
2244 OP2063 Facet joint block 11020 5510 4410 3310
2245 OP4735 Facet joint block - Bilateral 13780 6890 5510 4130
2246 OP0852 Facet joint block by radiofrequency ablation 12420 6210 4970 3730
2247 OP4736 Facet joint block by RFA - Bilateral 13780 6890 5510 4130
2248 OP2926 Ganglion impar local anaesthetic block 16540 8270 6620 4960
2249 OP0853 Ganglion impar neurolytic/USGG block 20660 10330 8260 6200
2250 OP0854 Gasserian gangalion neurolytic/ Radiofrequency anlation block 11840 5920 4740 3550
2251 OP0856 Gasserian ganglion radiofrequency ablation 20660 10330 8260 6200
2252 OP0855 Gasserian ganglion/ local anaesthetic infiltration block 7860 3930 3140 2360
2253 OP4552 Genicular Nerve R.F. 17920 8960 7170 5380
2254 OP4748 Genicular Nerve R.F. - B/L 20660 10330 8260 6200
2255 OP0857 Glossopharyngeal nerve local anaesthetic infiltration block 16540 8270 6620 4960
2256 OP2929 Glossopharyngeal nerve neurolytic block 9880 4940 3950 2960
2257 OP2930 Glossopharyngeal nerve radio-frequency block 19300 9650 7720 5790
2258 OP2936 Hypogastric plexus local anaesthetic block 16540 8270 6620 4960
2259 OP0858 Hypogastric plexus neurolytic/USG block 20660 10330 8260 6200
2260 OP0859 Infra-orbital nerve local anaesthetic infiltration block 11020 5510 4410 3310
2261 OP0860 Infra-orbital nerve neurolytic block 7860 3930 3140 2360
2262 OP2934 Infra-orbital nerve radio-frequency block 13780 6890 5510 4130
2263 OP0861 Intercostal nerve local anaesthetic block 16540 8270 6620 4960
2264 OP2927 Intercostal nerve neurolytic block 7860 3930 3140 2360
2265 OP2928 Intercostal nerve radio-frequency block 20660 10330 8260 6200
2266 OP0862 Intrathecal / epidural neurolysis 11840 5920 4740 3550
2267 OP4747 Knee injection - B/L 15160 7580 6060 4550
2268 OP4746 Knee injection - U/L 13780 6890 5510 4130
2269 OP0863 Local anaesthetic infiltration into scar / trigger point for pain relief 11020 5510 4410 3310
2270 OP4761 Lumbar Drain placement in OT 9640 4820 3860 2890
2271 OP0887 Lumbar puncture Drain for CSF 7860 3930 3140 2360
2272 OP0864 Lumbar sympathetic block 16540 8270 6620 4960
2273 OP0865 Lumbar sympathetic radiofrequency ablation 20660 10330 8260 6200
2274 OP0866 Mandibular nerve local anaesthetic infiltration block 11020 5510 4410 3310
2275 OP0867 Mandibular nerve neurolytic block 7860 3930 3140 2360
2276 OP2931 Mandibular nerve radio-frequency block 13780 6890 5510 4130
2277 OP0868 Maxillary nerve local anaesthetic infiltration block 7860 3930 3140 2360
2278 OP0869 Maxillary nerve neurolytic block 7860 3930 3140 2360
2279 OP2932 Maxillary nerve radio-frequency block 11840 5920 4740 3550
2280 OP0870 Mechanical infusor ( Baxter ) pump installation in OT 6460 3230 2580 1940
2281 OP0871 Mechanical intrathecal pump installation in OT 19720 9860 7890 5920
2282 OP0872 Mental nerve local anaesthetic infiltration block 11020 5510 4410 3310
2283 OP0873 Mental nerve neurolytic block 7860 3930 3140 2360
2284 OP2064 Nerve block 7860 3930 3140 2360
2285 OP2065 Nerve root block 9880 4940 3950 2960
2286 OP4749 Occipital Nerve - Local Infiltration 11020 5510 4410 3310
2287 OP4750 Occipital Nerve - Radiofrequency/USG Ablation 13780 6890 5510 4130
2288 OP4556 Ozone Therapy 9400 4700 3760 2820
2289 OP4758 Paravertebral - Bilateral 19300 9650 7720 5790
165
2290 OP0875 Para-vertebral local anaesthetic infiltration block 16540 8270 6620 4960
2291 OP4752 Penile Nerve / Lateral Cutaneous / Genital Femora 13780 6890 5510 4130
Radiofrequency / USG Ablation
2292 OP4751 Penile Nerve / Lateral Cutaneous / Genital Femoral -Local Infiltration 11020 5510 4410 3310
2293 OP4502 Percutaneous Discectomy 82700 41350 33080 24810
2294 OP0876 Programmable intrathecal pump installation in OT 27580 13790 11030 8270
2295 OP4760 Programmable intrathecal pump installation in OT -Permanent 55120 27560 22050 16540
2296 OP4553 PRP Therapy 20660 10330 8260 6200
2297 OP0877 Psoas compartment local anaesthetic infiltration block 5920 2960 2370 1780
2298 OP4555 Rami Communicans Radiofrequency 13780 6890 5510 4130
2299 OP4743 Rami Communicans Radiofrequency - U/L, B/L 16540 8270 6620 4960
2300 OP4742 Ramus Communicans local infiltration - B/L 12420 6210 4970 3730
2301 OP4741 Ramus Communicans local infiltration - U/L, B/L 11020 5510 4410 3310
2302 OP4740 S. I. Joint R. F. - B/L 16540 8270 6620 4960
2303 OP4739 S. I. Joint R. F. / USG 13780 6890 5510 4130
2304 OP0878 Sacroiliac joint injection block 11020 5510 4410 3310
2305 OP4738 Sacroiliac joint injection block - Bilateral 12420 6210 4970 3730
2306 OP4745 Shoulder injection - B/L 12420 6210 4970 3730
2307 OP4744 Shoulder injection - U/L 11020 5510 4410 3310
2308 OP2922 Spheno-palatine ganglion local anaesthetic block 13780 6890 5510 4130
2309 OP2923 Spheno-palatine ganglion radiofrequency block 16540 8270 6620 4960
2310 OP0880 Spinal cord stimulation implant ( permanent ) 55120 27560 22050 16540
2311 OP0881 Spinal cord stimulation implant ( temporary ) 27580 13790 11030 8270
2312 OP2924 Stellate ganglion local anaesthetic block 16540 8270 6620 4960
2313 OP0882 Stellate ganglion neurolytic block 11840 5920 4740 3550
2314 OP0883 Stellate ganglion radiofrequency/USG ablation 20660 10330 8260 6200
2315 OP0884 Supra-orbital nerve local anaesthetic infiltration block 11020 5510 4410 3310
2316 OP0885 Supra-orbital nerve neurolytic block 13780 6890 5510 4130
2317 OP2933 Supra-orbital nerve radio-frequency block 13780 6890 5510 4130
2318 OP4756 Supra-scapular - Local Infiltration 11020 5510 4410 3310
2319 OP4757 Supra-scapular - Radiofrequency Ablation 13780 6890 5510 4130
2320 OP0886 Trans-foraminal block 11020 5510 4410 3310
2321 OP4737 Trans-foraminal block - Bilateral 13780 6890 5510 4130
2322 OP4755 Trigger point - Radiofrequency Ablation 13780 6890 5510 4130
2323 OP4754 Trochlear Nerve - Local Infiltration 11020 5510 4410 3310
2324 OP4753 Trochlear Nerve - Radiofrequency Ablation 13780 6890 5510 4130
2325 OP4549 Ultrasound Guided Block For Postop Pain Relief 7000 3500 2800 2100
2326 OP4551 Ultrasound Guided Block For Postop Pain Relief 5800 2900 2320 1740
Intracostal & Paravertebral
2327 OP4550 Ultrasound Guided Block For Postop Pain Relief Sciatico Femoral 5800 2900 2320 1740
2328 OP4548 Ultrasound Guided Block For Postop Pain Relief TAP Block 6880 3440 2750 2060
Peripheral Aneurysm Operations

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

2329 OP0303 Brachial aneurysm repair using reversed vein graft 182380 91190 72950 54710
2330 OP0302 Brachial aneurysm repair using synthetic graft 182380 91190 72950 54710
2331 OP0304 Brachial pseudo - aneurysm repair using reversed vein graft 182380 91190 72950 54710
2332 OP4206 Complex peripheral aneurysm repair 241200 120600 96480 72360
2333 OP0294 Femoral aneurysm repair using reversed vein graft 182380 91190 72950 54710
2334 OP0293 Femoral aneurysm repair using synthetic graft 182380 91190 72950 54710
2335 OP0295 Femoral pseudo - aneurysm repair using reversed vein graft 182380 91190 72950 54710
2336 OP0300 Iliac aneurysm repair using reversed vein graft 182380 91190 72950 54710
2337 OP0299 Iliac aneurysm repair using synthetic graft 182380 91190 72950 54710
2338 OP0301 Iliac pseudo - aneurysm repair using reversed vein graft 182380 91190 72950 54710
2339 OP0297 Popliteal aneurysm repair using reversed vein graft 182380 91190 72950 54710
166
2340 OP0296 Popliteal aneurysm repair using synthetic graft 182380 91190 72950 54710
2341 OP0298 Popliteal pseudo - aneurysm repair using reversed vein graft 182380 91190 72950 54710
2342 OP0306 Subclavian aneurysm repair using reversed vein graft 182380 91190 72950 54710
2343 OP0305 Subclavian aneurysm repair using synthetic graft 182380 91190 72950 54710
2344 OP0307 Subclavian pseudo - aneurysm repair using reversed vein graft 151660 75830 60660 45500
2345 OP3020 Ultrasound guided thrombin injection for aneurysm repair 182380 91190 72950 54710
Peripheral Angioplasty
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2346 OP0720 Femoral angioplasty in OT - brachial route 21660 10830 8660 6500
2347 OP0696 Femoral angioplasty in OT - femoral route 21660 10830 8660 6500
2348 OP0731 Femoral subintimal angioplasty in OT ( antegrade ) -femoral route 21660 10830 8660 6500
2349 OP0726 Femoral subintimal angioplasty in OT ( retrograde ) -femoral route 21660 10830 8660 6500
2350 OP0701 Iliac angioplasty in OT - brachial route 21660 10830 8660 6500
2351 OP0695 Iliac angioplasty in OT - femoral route 21660 10830 8660 6500
Plastic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2352 OP4545 Abdomen Wall Reconstruction 106140 53070 42460 31840
2353 OP3087 ALT perforator free flap 214560 107280 85820 64370
2354 OP4524 Apronectomy 151600 75800 60640 45480
2355 OP4239 Bi-paddle PMC 123280 61640 49310 36980
2356 OP4214 Bi-Pedicle flap 46240 23120 18500 13870
2357 OP4362 Botox Injection in Brachial Plexus 42020 21010 16810 12610
2358 OP4359 Burn Contracture Release of Axilla 112060 56030 44820 33620
2359 OP4358 Burn Contracture Release of Elbow 112060 56030 44820 33620
2360 OP4361 Burn Contracture Release of Groin 112060 56030 44820 33620
2361 OP4360 Burn Contracture Release of Knee 112060 56030 44820 33620
2362 OP1318 Burn wound dressing ( large ) 47320 23660 18930 14200
2363 OP1317 Burn wound dressing ( medium ) 28400 14200 11360 8520
2364 OP1316 Burn wound dressing ( minor ) 18960 9480 7580 5690
2365 OP3357 Collagen dressing in OT ( large ) 55740 27870 22300 16720
2366 OP3356 Collagen dressing in OT ( medium ) 41740 20870 16700 12520
2367 OP3309 Collagen dressing in OT ( small ) 27940 13970 11180 8380
2368 OP0065 Composite graft ( large ) - plastic surgery 88600 44300 35440 26580
2369 OP0064 Composite graft ( medium ) - plastic surgery 70880 35440 28350 21260
2370 OP1324 Composite graft ( small ) - plastic surgery 53180 26590 21270 15950
2371 OP4521 Contouring of Mandible Angle 106140 53070 42460 31840
2372 OP1795 Contracture release of lips 94440 47220 37780 28330
2373 OP1794 Contracture release of neck 132200 66100 52880 39660
2374 OP3425 Correction of Binder's Syndrome 106320 53160 42530 31900
2375 OP0810 Correction of macrostomia 42480 21240 16990 12740
2376 OP0811 Correction of microstomia 75580 37790 30230 22670
2377 OP0072 Cranioplasty with bone graft 141640 70820 56660 42490
2378 OP0066 Craniostenosis ( multiple cranial sutures ) - 197740 98870 79100 59320
reconstruction of cranial vault
2379 OP0067 Craniostenosis ( multiple cranial sutures ) - 251680 125840 100670 75500
reconstruction of cranial vault & bone grafting
2380 OP1327 Craniostenosis ( single cranial suture ) – reconstruction of cranial vault 169960 84980 67980 50990
2381 OP0068 Craniostenosis ( single cranial suture ) - reconstruction 188840 94420 75540 56650
of cranial vault & bone grafting
167
2382 OP3437 Cross leg flap 88600 44300 35440 26580
2383 OP0063 Cross lip pedicle flap ( Abbe Estlander ) 94440 47220 37780 28330
2384 OP3312 Debulking of large flap 44640 22320 17860 13390
2385 OP3313 Debulking of small flap 27940 13970 11180 8380
2386 OP4353 Deep – (Biopsy) 56020 28010 22410 16810
2387 OP1331 Delay of flap 26080 13040 10430 7820
2388 OP3314 Deltopectoral flap 111380 55690 44550 33410
2389 OP1338 Dermofat graft – large 63780 31890 25510 19130
2390 OP1339 Dermofat graft – small 37840 18920 15140 11350
2391 OP4482 Digital Vessel Repair 76400 38200 30560 22920
2392 OP3315 Distally based fasciocutaneous flap 89140 44570 35660 26740
2393 OP3316 Division and insetting of flap - single stage ( large ) 66920 33460 26770 20080
2394 OP3317 Division and insetting of flap - single stage ( medium ) 47260 23630 18900 14180
2395 OP3318 Division and insetting of flap - single stage ( small ) 34120 17060 13650 10240
2396 OP3432 Division of flap 26600 13300 10640 7980
2397 OP4489 Dressing (Extra Large) 25480 12740 10190 7640
2398 OP1340 Dressing in OT major 19120 9560 7650 5740
2399 OP1341 Dressing in OT medium 15280 7640 6110 4580
2400 OP1342 Dressing in OT minor / suture removal 10180 5090 4070 3050
2401 OP0823 Ear lobule reconstruction - bilateral 17780 8890 7110 5330
2402 OP0824 Ear lobule reconstruction - unilateral 11920 5960 4770 3580
2403 OP4494 Ear Lobule Repair with Contilage Graft 38220 19110 15290 11470
2404 OP1346 Ear reconstruction 1st stage – cartilage implantation 141640 70820 56660 42490
2405 OP1347 Ear reconstruction 2nd stage – release and graft 77920 38960 31170 23380
2406 OP1348 Ear reconstruction 3rd stage / touching and revisions 63780 31890 25510 19130
2407 OP0822 Ear reconstruction using tissue expander ( bilateral ) 212420 106210 84970 63730
2408 OP0821 Ear reconstruction using tissue expander ( unilateral ) 141640 70820 56660 42490
2409 OP3319 Excision and repair of hidradenitus suppurativa 83660 41830 33460 25100
2410 OP3320 Excision and skin grafting of hidradenitus suppurativa 139200 69600 55680 41760
2411 OP0123 Excision of extremity lesion with Z-plasty or other 63780 31890 25510 19130
adjacent tissue transfer
2412 OP0125 Excision of hand or foot lesion with Z-plasty or other 63780 31890 25510 19130
2413 OP1357 Excision of head and neck lesion with Z-plasty or other 63780 31890 25510 19130
2414 OP0825 Excision of keloid ear lobule 75580 37790 30230 22670
2415 OP4732 Excision of Large Size Pelvic Soft Tissue Tumor (>10cms) 102900 51450 41160 30870
2416 OP4731 Excision of Medium Size Pelvic Soft Tissue Tumor (5 -10 cms) 80860 40430 32340 24260
2417 OP0124 Excision of scalp lesion with Z-plasty or other adjacent tissue transfer 63780 31890 25510 19130
2418 OP1351 Excision of scar / lesion / wound and skin grafting -major 118100 59050 47240 35430
2419 OP1352 Excision of scar / lesion / wound and skin grafting -medium 84980 42490 33990 25490
2420 OP1353 Excision of scar / lesion / wound and skin grafting -minor 56640 28320 22660 16990
2421 OP1785 Excision of skin lesion - extremities / trunk (5 - 10 cm) 94440 47220 37780 28330
2422 OP1784 Excision of skin lesion - extremities / trunk (less than 5cm) 70880 35440 28350 21260
2423 OP1779 Excision of skin lesion - extremities / trunk (more than 10 cm) 118100 59050 47240 35430
2424 OP1780 Excision of skin lesion - face (less than 2 cm) 56640 28320 22660 16990
2425 OP1793 Excision of skin lesion - face (more than 2 cm) 84980 42490 33990 25490
2426 OP4730 Excision of Small Size Pelvic Soft Tissue Tumor (<5 cms) 58800 29400 23520 17640
2427 OP0122 Excision of trunk lesion with Z-plasty or other adjacent tissue transfer 63780 31890 25510 19130
2428 OP0126 Expander insertion - multiple 84000 42000 33600 25200
2429 OP1359 Expander insertion - single 63680 31840 25470 19100
2430 OP3006 Expander insertion ( more than 2 ) 141720 70860 56690 42520
2431 OP1360 Expander removal & contouring - multiple 159500 79750 63800 47850
2432 OP1361 Expander removal & contouring - single 124060 62030 49620 37220
2433 OP3321 Eyebrow reconstruction with flap 83660 41830 33460 25100
2434 OP4484 Face Reanimation FFMT 191020 95510 76410 57310
2435 OP4485 Face Reanimation Muscle Flap 127340 63670 50940 38200
2436 OP4222 Face Swelling (Large) 77040 38520 30820 23110
2437 OP4223 Face Swelling (Medium) 61640 30820 24660 18490
2438 OP4224 Face Swelling (Small) 46240 23120 18500 13870
2439 OP0077 Facial bi-partition for hyperteleorism 283140 141570 113260 84940
2440 OP4483 Facial Nerve Cross Nerve Graft 127340 63670 50940 38200
2441 OP4367 Facial Reanimation (Baby Sitting Procedure) 140100 70050 56040 42030
168
2442 OP4366 Facial Reanimation by cross face nerve graft 140100 70050 56040 42030
2443 OP4363 Facial Reanimation by local muscle transfer – 1 Muscle 84060 42030 33620 25220
2444 OP4364 Facial Reanimation by local muscle transfer – 2 Muscle 112060 56030 44820 33620
2445 OP3067 Fibular osteocutaneous free flap for long bones 214560 107280 85820 64370
2446 OP1332 Flap insetting ( large ) 56640 28320 22660 16990
2447 OP1333 Flap insetting ( small ) 37840 18920 15140 11350
2448 OP4811 Flap insetting (Medim) 39380 19690 15750 11810
2449 OP3322 Foucher flap 100240 50120 40100 30070
2450 OP4486 Free Functional Muscle Transfer 178260 89130 71300 53480
2451 OP3003 Free Perforator flap transfer 214560 107280 85820 64370
2452 OP3323 Full thickness skin graft ( large ) 111380 55690 44550 33410
2453 OP3324 Full thickness skin graft ( medium ) 83660 41830 33460 25100
2454 OP3325 Full thickness skin graft ( small ) 55740 27870 22300 16720
2455 OP3436 Gastrocnemius / Soleus muscle flap 88600 44300 35440 26580
2456 OP4474 Gender Reassignment Surgery Female to Male 178260 89130 71300 53480
2457 OP4475 Gender Reassignment Surgery Male to Female 152820 76410 61130 45850
2458 OP3327 Gracilis flap ( free ) 222880 111440 89150 66860
2459 OP3328 Gracilis flap ( pedicled ) 111380 55690 44550 33410
2460 OP3076 Groin perforator free flap 214560 107280 85820 64370
2461 OP4238 Head & neck reconstruction (Complex) 107880 53940 43150 32360
2462 OP4237 Head & neck reconstruction (Simple) 61640 30820 24660 18490
2463 OP4236 Hepatic artery anastomosis 76400 38200 30560 22920
2464 OP4544 Hernia Repair with Abdominal Wall Reconstruction 181920 90960 72770 54580
2465 OP3074 Iliac crest osteocutaneous free flap 214560 107280 85820 64370
2466 OP3330 Latissimus dorsi ( LD ) free flap 204340 102170 81740 61300
2467 OP4370 LD Pedicle Flap 112060 56030 44820 33620
2468 OP4371 LD Pedicle flap with implant for breast reconsrtruction 140100 70050 56040 42030
2469 OP3331 Littler flap 105000 52500 42000 31500
2470 OP3428 Local Advancement flap - large 106320 53160 42530 31900
2471 OP3427 Local Advancement flap - medium 70880 35440 28350 21260
2472 OP3426 Local Advancement flap - small 53180 26590 21270 15950
2473 OP1737 Local transposition flap - large 82660 41330 33060 24800
2474 OP1739 Local transposition flap - medium 77920 38960 31170 23380
2475 OP1709 Local transposition flap - small 56640 28320 22660 16990
2476 OP3009 Lymphaticovenous shunt 128780 64390 51510 38630
2477 OP3333 Medial plantar artery flap ( neurovascular free flap ) 278540 139270 111420 83560
2478 OP3334 Medial plantar artery flap ( pedicled ) 111380 55690 44550 33410
2479 OP0820 Medpore ear reconstruction ( bilateral ) 283140 141570 113260 84940
2480 OP0815 Medpore ear reconstruction ( unilateral ) 188840 94420 75540 56650
2481 OP4546 Nasal Framework Correction 106140 53070 42460 31840
2482 OP3337 Nasolabial flap 66920 33460 26770 20080
2483 OP3001 Neurovascular island Flap - Free 214560 107280 85820 64370
2484 OP3002 Neurovascular island Flap - Pedicle 128780 64390 51510 38630
2485 OP4354 Oberlin Nerve Transfer 140100 70050 56040 42030
2486 OP0074 Orbital repositioning for hyperteleorism - extracranial 283140 141570 113260 84940
& intracranial approach
& intracranial approach with bone graft
2488 OP0073 Orbital repositioning for hyperteleorism – extracranial approach 259600 129800 103840 77880
approach with bone graft
2490 OP0819 Otoplasty for acquired ear deformity ( bilateral ) 76400 38200 30560 22920
2491 OP0818 Otoplasty for acquired ear deformity ( unilateral ) 50940 25470 20380 15280
2492 OP0817 Otoplasty for lop ears ( bilateral ) 89140 44570 35660 26740
2493 OP0816 Otoplasty for lop ears ( unilateral ) 76400 38200 30560 22920
2494 OP4541 Panniculectomy 60640 30320 24260 18190
2495 OP4231 Partial Ear Reconstruction 77040 38520 30820 23110
2496 OP3339 Pectoralis major myocutaneous flap 111380 55690 44550 33410
2497 OP4373 Pedicle ALT flap 140100 70050 56040 42030
169
2498 OP0466 Pedicle flap cover of amputation stump 94440 47220 37780 28330
2499 OP4216 Pedicle LD for breast 92460 46230 36980 27740
2500 OP4814 Pedicled ALT Flap 131260 65630 52500 39380
2501 OP4213 Pedicled Gastronimius Flap 77040 38520 30820 23110
2502 OP3358 Pedicled perforator flap ( large ) 100240 50120 40100 30070
2503 OP3340 Pedicled perforator flap ( small ) 66920 33460 26770 20080
2504 OP4230 Penile reconstruction (Free flap) 215720 107860 86290 64720
2505 OP4229 Penile reconstruction (Pedicle flap) 154080 77040 61630 46220
2506 OP4522 Post Traumatic Ear Reconstruction Simple 60640 30320 24260 18190
2507 OP4523 Post Traumatic Ear Reconstruction Complex 121280 60640 48510 36380
2508 OP3342 Posterior interosseus artery flap 89140 44570 35660 26740
2509 OP1735 Radial artery forearm free flap 136880 68440 54750 41060
2510 OP3343 Radial artery forearm pedicled flap 100240 50120 40100 30070
2511 OP4478 Radial/Ulnar Artery Repair 76400 38200 30560 22920
2512 OP3344 Reconstruction by Limberg flap ( large ) 83660 41830 33460 25100
2513 OP3345 Reconstruction by Limberg flap ( small ) 55740 27870 22300 16720
2514 OP1592 Reconstructive rhinoplasty - forehead flap ( single stage ) 106320 53160 42530 31900
2515 OP1590 Reconstructive rhinoplasty - forehead flap ( stage One of two stages) 88600 44300 35440 26580
2516 OP1591 Reconstructive rhinoplasty - forehead flap ( stage Two of two stages) 53180 26590 21270 15950
2517 OP3346 Rectus abdominis flap ( free ) 222880 111440 89150 66860
2518 OP3347 Rectus abdominis flap ( pedicled ) 111380 55690 44550 33410
2519 OP3349 Reverse sural artery flap 100240 50120 40100 30070
2520 OP4820 Skin and Soft Tissue Biopsy - Large 26260 13130 10500 7880
2521 OP4819 Skin and Soft Tissue Biopsy - Medium 21000 10500 8400 6300
2522 OP4818 Skin and Soft Tissue Biopsy - Small 15760 7880 6300 4730
2523 OP4547 Skin biopsy 15160 7580 6060 4550
2524 OP2009 Skin grafting - major 80280 40140 32110 24080
2525 OP2008 Skin grafting - minor 42480 21240 16990 12740
2526 OP4355 Somsak Nerve Transfer 140100 70050 56040 42030
2527 OP2999 Split skin grafting - medium 64480 32240 25790 19340
2528 OP1964 Sternomastoid release - unipolar 41540 20770 16620 12460
2529 OP3014 Sternomastoid release Bipolar 85920 42960 34370 25780
2530 OP4813 Supercharging of tissue/flapintestine 118120 59060 47250 35440
2531 OP4352 Superficial – (Biopsy) 33620 16810 13450 10090
2532 OP4477 Sural Nerve graft 63680 31840 25470 19100
2533 OP4543 Surgical Wound Closure - Complex ( By Plastic Surgery Technique) 121280 60640 48510 36380
2534 OP4542 Surgical Wound Closure - Simple ( By Plastic Surgery Technique) 60640 30320 24260 18190
2535 OP4488 Suture Removal In Day Care 1920
2536 OP3420 Tangential excision of burn wound - large 88600 44300 35440 26580
2537 OP3419 Tangential excision of burn wound - medium 70880 35440 28350 21260
2538 OP3418 Tangential excision of burn wound - small 53180 26590 21270 15950
2539 OP1738 Thoracic pedicle flap 94440 47220 37780 28330
2540 OP4232 Tube Flap Reconstruction (Large) 77040 38520 30820 23110
2541 OP4233 Tube Flap Reconstruction (Medium) 61640 30820 24660 18490
2542 OP4234 Tube Flap Reconstruction (Small) 46240 23120 18500 13870
2543 OP1733 Ulnar artery forearm free flap 136880 68440 54750 41060
2544 OP3421 Vaccum assisted wound closure ( VAC ) application 28360 14180 11340 8510
2545 OP4810 Vaccum assisted wound closure ( VAC ) application -Large 26260 13130 10500 7880
2546 OP4809 Vaccum assisted wound closure ( VAC ) application -Medium 19680 9840 7870 5900
2547 OP4808 Vaccum assisted wound closure ( VAC ) application -Small 13120 6560 5250 3940
2548 OP4481 Vascular Malformation Excision - Large 127340 63670 50940 38200
2549 OP4480 Vascular Malformation Excision - Medium 89140 44570 35660 26740
2550 OP4479 Vascular Malformation Excision - Small 63680 31840 25470 19100
2551 OP0464 V-Y flap cover of amputation stump 70880 35440 28350 21260
2552 OP4711 Webspace Contrature Release + local flap 70560 35280 28220 21170
2553 OP4710 Webspace Contrature Release + Z Plasty 57340 28670 22940 17200
2554 OP4712 Webspace Contrature Release with distal flap 92620 46310 37050 27790
2555 OP3354 Z-plasty repair of scar ( multiple ) 83660 41830 33460 25100
2556 OP3355 Z-plasty repair of scar ( single ) 38220 19110 15290 11470
170
Primary Arthroplasty
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2557 OP4139 Ankle joint replacement 135760 67880 54300 40730
2558 OP1540 Bipolar hip hemiarthroplasty - cemented 98700 49350 39480 29610
2559 OP1541 Bipolar hip hemiarthroplasty - non cemented 98700 49350 39480 29610
2560 OP1542 Bipolar shoulder hemiarthroplasty - cemented 98700 49350 39480 29610
2561 OP1543 Bipolar shoulder hemiarthroplasty - non cemented 98700 49350 39480 29610
2562 OP4132 Closed reduction of Bipolar / THR 20000 10000 8000 6000
2563 OP1526 Computer assisted total knee replacement - cemented 149380 74690 59750 44810
2564 OP1527 Computer assisted total knee replacement - hybrid 149380 74690 59750 44810
2565 OP1528 Computer assisted total knee replacement – non cemented 149380 74690 59750 44810
2566 OP3051 Excision arthroplasty of elbow 57700 28850 23080 17310
2567 OP1510 Finger joint replacement - per joint 67940 33970 27180 20380
2568 OP1572 Finger joint replacement - three joints or more 101900 50950 40760 30570
2569 OP1509 Finger joint replacement - two joints 101900 50950 40760 30570
2570 OP2997 Gap / implant arthroplasty 98760 49380 39500 29630
2571 OP2980 Girdle Stone Arthroplasty 49500 24750 19800 14850
2572 OP1523 Minimally invasive total hip replacement - cemented 149380 74690 59750 44810
2573 OP1524 Minimally invasive total hip replacement - hybrid 149380 74690 59750 44810
2574 OP1525 Minimally invasive total hip replacement - non cemented 149380 74690 59750 44810
2575 OP1529 Minimally invasive total knee replacement - cemented 149380 74690 59750 44810
2576 OP1530 Minimally invasive total knee replacement - hybrid 149380 74690 59750 44810
2577 OP1531 Minimally invasive total knee replacement – non cemented 149380 74690 59750 44810
2578 OP1511 Patellofemoral arthroplasty - cemented 67940 33970 27180 20380
2579 OP1512 Patellofemoral arthroplasty - non cemented 67940 33970 27180 20380
2580 OP3092 Patelloplasty with patellar surface replacement 102920 51460 41170 30880
2581 OP2988 THR with acetabuloplasty 158400 79200 63360 47520
2582 OP0183 TM joint ankylosis - arthroplasty + allograft 108620 54310 43450 32590
2583 OP0184 TM joint ankylosis - arthroplasty + prosthetic joint replacement 108620 54310 43450 32590
2584 OP0181 TM joint ankylosis - condylectomy / interposition gap arthroplasty 108620 54310 43450 32590
2585 OP0182 TM joint ankylosis - gap arthroplasty 108620 54310 43450 32590
2586 OP1514 Toe Joint Replacement - single joint 67940 33970 27180 20380
2587 OP1513 Toe Joint Replacement - three or more joints 101900 50950 40760 30570
2588 OP2820 Toe Joint Replacement - two joints 101900 50950 40760 30570
2589 OP1515 Total elbow replacement - cemented 149380 74690 59750 44810
2590 OP1516 Total elbow replacement - hybrid 149380 74690 59750 44810
2591 OP1517 Total elbow replacement - non cemented 149380 74690 59750 44810
2592 OP1518 Total hip replacement - cemented 149380 74690 59750 44810
2593 OP1519 Total hip replacement - hybrid 149380 74690 59750 44810
2594 OP1520 Total hip replacement - non cemented 149380 74690 59750 44810
2595 OP1521 Total hip replacement - non cemented stem - metal on metal 149380 74690 59750 44810
2596 OP1522 Total hip replacement - resurfacing - metal on metal 149380 74690 59750 44810
2597 OP3050 Total Hip Replacement with acetabular reconstruction- cemented ( Primary ) 158400 79200 63360 47520
2598 OP3048 Total Hip Replacement with acetabular reconstruction - uncemented (Primary) 158400 79200 63360 47520
2599 OP1532 Total knee replacement - cemented 149380 74690 59750 44810
2600 OP1533 Total knee replacement - hybrid 149380 74690 59750 44810
2601 OP1534 Total knee replacement - non cemented 149380 74690 59750 44810
2602 OP3046 Total Knee Replacement with tibial condyle reconstruction ( Primary) 158400 79200 63360 47520
2603 OP1535 Total shoulder replacement - cemented 149380 74690 59750 44810
2604 OP1536 Total shoulder replacement - hybrid 149380 74690 59750 44810
2605 OP1537 Total shoulder replacement - non cemented 149380 74690 59750 44810
2606 OP1538 Unicondylar knee replacement - cemented 149380 74690 59750 44810
2607 OP1539 Unicondylar knee replacement - non cemented 149380 74690 59750 44810
2608 OP1544 Unipolar hip hemiarthroplasty - cemented 98700 49350 39480 29610
2609 OP1545 Unipolar hip hemiarthroplasty - non cemented 98700 49350 39480 29610
171
2610 OP1546 Unipolar shoulder hemiarthroplasty - cemented 98700 49350 39480 29610
2611 OP1574 Vascularised Joint Replacement - multiple joints 135780 67890 54310 40730
2612 OP1573 Vascularised Joint Replacement - single joint 113160 56580 45260 33950
2613 OP4916 Total Bilateral knee replacement - cemented 298760 149380 119500 89630
2614 OP4917 Total Bilateral knee replacement – non cemented 298760 149380 119500 89630
Procedures
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2615 OP4421 Beside Decannulation of Tracheostomy 16040 8020 6420 4810
2616 OP4422 Endo - Laryngoscopy ( Bedside ) 8020 4010 3210 2410
2617 OP4303 Tonsillar Fossa Hemostasis 16040 8020 6420 4810
Psychiatry
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2618 OP1366 Modified ECT (electro convulsive therapy) 9780 4890 3910 2930
2619 OP1367 Narco analysis 10860 5430 4340 3260
Reimplantation Revascularisation Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2620 OP3435 Exploration for reimplantation - arm / forearm 64720 32360 25890 19420
2621 OP3434 Exploration for reimplantation - single digit 48560 24280 19420 14570
2622 OP0741 Reimplantation of ear 215460 107730 86180 64640
2623 OP0830 Reimplantation of finger - single 131260 65630 52500 39380
2624 OP1694 Reimplantation of fingers - four or more fingers 262500 131250 105000 78750
2625 OP1693 Reimplantation of fingers - three fingers 236260 118130 94500 70880
2626 OP0831 Reimplantation of fingers - two fingers 183760 91880 73500 55130
2627 OP0748 Reimplantation of lip 215460 107730 86180 64640
2628 OP0832 Reimplantation of lower limb at ankle level 262500 131250 105000 78750
2629 OP0833 Reimplantation of lower limb at lower leg level 262500 131250 105000 78750
2630 OP0747 Reimplantation of nose 215460 107730 86180 64640
2631 OP0742 Reimplantation of penis 215460 107730 86180 64640
2632 OP0749 Reimplantation of scalp 215460 107730 86180 64640
2633 OP0743 Reimplantation of testis 215460 107730 86180 64640
2634 OP0836 Reimplantation of upper limb at forearm level 262500 131250 105000 78750
2635 OP0837 Reimplantation of upper limb at palm level 262500 131250 105000 78750
2636 OP0838 Reimplantation of upper limb at upper arm level 262500 131250 105000 78750
2637 OP0839 Reimplantation of upper limb at wrist level 262500 131250 105000 78750
2638 OP4717 Reimplantation Single Finger (Crush avulsed with vein graft) 176400 88200 70560 52920
2639 OP0718 Revascularisation of finger - single 72940 36470 29180 21880
2640 OP0739 Revascularisation of fingers - four or more fingers 145860 72930 58340 43760
2641 OP1696 Revascularisation of fingers - three fingers 121560 60780 48620 36470
2642 OP1695 Revascularisation of fingers - two fingers 97260 48630 38900 29180
2643 OP0750 Revascularisation of lower limb at ankle level 129320 64660 51730 38800
2644 OP0751 Revascularisation of lower limb at lower leg level 129320 64660 51730 38800
2645 OP0752 Revascularisation of lower limb at thigh level 129320 64660 51730 38800
2646 OP0745 Revascularisation of upper limb at forearm level 129320 64660 51730 38800
172
2647 OP0746 Revascularisation of upper limb at palm level 129320 64660 51730 38800
2648 OP0744 Revascularisation of upper limb at upper arm level 129320 64660 51730 38800
2649 OP0740 Revascularisation of upper limb at wrist level 129320 64660 51730 38800
Revision Arthroplasty
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2650 OP1562 Computer assisted total knee Replacement - 174180 87090 69670 52250
Cemented ( Revision arthroplasty )
2651 OP1563 Computer assisted Total Knee Replacement - Hybrid (Revision 174180 87090 69670 52250
arthroplasty )
2652 OP1564 Computer assisted Total Knee Replacement - non 174180 87090 69670 52250
cemented ( Revision arthroplasty )
2653 OP1549 Patellofemoral Arthroplasty - Cemented ( Revision arthroplasty ) 67940 33970 27180 20380
2654 OP1550 Patellofemoral Arthroplasty - non cemented ( Revision arthroplasty ) 67940 33970 27180 20380
2655 OP1551 Total Elbow Replacement - Cemented ( Revision arthroplasty ) 174180 87090 69670 52250
2656 OP1552 Total Elbow Replacement - Hybrid ( Revision arthroplasty ) 174180 87090 69670 52250
2657 OP1553 Total Elbow Replacement - non cemented ( Revision arthroplasty ) 174180 87090 69670 52250
2658 OP1554 Total Hip Replacement - Cemented ( Revision arthroplasty ) 174180 87090 69670 52250
2659 OP1555 Total Hip Replacement - Hybrid ( Revision arthroplasty) 174180 87090 69670 52250
2660 OP1556 Total Hip Replacement - non cemented ( Revision arthroplasty ) 174180 87090 69670 52250
2661 OP1557 Total Hip Replacement - non cemented stem - Metal 174180 87090 69670 52250
on metal ( Revision arthroplasty )
2662 OP1558 Total Hip Replacement - Resurfacing - Metal on metal 174180 87090 69670 52250
( Revision arthroplasty )
2663 OP3049 Total Hip Replacement with acetabular reconstruction 158400 79200 63360 47520
- cemented ( Revision )
2664 OP3047 Total Hip Replacement with acetabular reconstruction 158400 79200 63360 47520
- uncemented ( Revision )
2665 OP1559 Total Hip Replacement with acetabuloplasty / Femoral 174180 87090 69670 52250
reconstruction - Cemented ( Revision arthroplasty )
reconstruction - Hybrid ( Revision arthroplasty )
reconstruction - non cemented ( Revision arthroplasty)
2668 OP1565 Total Knee Replacement - Cemented ( Revision arthroplasty ) 174180 87090 69670 52250
2669 OP1566 Total Knee Replacement - Hybrid ( Revision arthroplasty ) 174180 87090 69670 52250
2670 OP1567 Total Knee Replacement - non cemented ( Revision arthroplasty ) 174180 87090 69670 52250
2671 OP3043 Total Knee Replacement with tibial condyle reconstruction (Revision) 158400 79200 63360 47520
2672 OP1568 Total Shoulder Replacement - Cemented ( Revision arthroplasty ) 174180 87090 69670 52250
2673 OP1569 Total Shoulder Replacement - Hybrid ( Revision arthroplasty ) 174180 87090 69670 52250
2674 OP1570 Total Shoulder Replacement - non cemented (Revision arthroplasty) 174180 87090 69670 52250
2675 OP1547 Unicondylar Knee Replacement - Cemented ( Revision arthroplasty ) 174180 87090 69670 52250
2676 OP1548 Unicondylar Knee Replacement - non cemented Revision arthroplasty) 174180 87090 69670 52250
Salivary Gland Operations

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

2677 OP0629 Excision of sublingual gland tumour 47540 23770 19020 14260
2678 OP1048 Excision of submandidular gland / tumour 47540 23770 19020 14260
2679 OP0805 Extended parotidectomy 127960 63980 51180 38390
2680 OP3506 Sialoendoscopy: Parotid duct diagnostic - bilateral 30180 15090 12070 9050
2681 OP3505 Sialoendoscopy: Parotid duct diagnostic - unilateral 21160 10580 8460 6350
2682 OP3508 Sialoendoscopy: Parotid duct dillatation - bilateral 30180 15090 12070 9050
173
2683 OP3507 Sialoendoscopy: Parotid duct dillatation - unilateral 21160 10580 8460 6350
2684 OP3511 Sialoendoscopy: Parotid duct multiple calculi removal simple 38040 19020 15220 11410
2685 OP3510 Sialoendoscopy: Parotid duct single calculi removal simple 30180 15090 12070 9050
2686 OP3509 Sialoendoscopy: Parotid duct stenting 20560 10280 8220 6170
2687 OP3500 Sialoendoscopy: Submandibular duct diagnostic -bilateral 30180 15090 12070 9050
2688 OP3499 Sialoendoscopy: Submandibular duct diagnostic -unilateral 21160 10580 8460 6350
2689 OP3502 Sialoendoscopy: Submandibular duct dialatation -bilateral 30180 15090 12070 9050
2690 OP3501 Sialoendoscopy: Submandibular duct dialatation -unilateral 21160 10580 8460 6350
2691 OP3504 Sialoendoscopy: Submandibular duct multiple calculi removal simple 38040 19020 15220 11410
2692 OP3503 Sialoendoscopy: Submandibular duct single calculi removal simple 30180 15090 12070 9050
2693 OP0995 Submandibular duct calculus removal 47540 23770 19020 14260
2694 OP1049 Superficial parotidectomy 94900 47450 37960 28470
2695 OP0631 Superficial parotidectomy for Recurrent tumour 94900 47450 37960 28470
2696 OP0804 Total parotidectomy 127960 63980 51180 38390
2697 OP1052 Total parotidectomy ( nerve preserving ) 127960 63980 51180 38390
2698 OP0031 Total parotidectomy ( with nerve grafting ) 170660 85330 68260 51200
2699 OP0632 Total parotidectomy for Recurrent tumour ( nerve preserving ) 127960 63980 51180 38390
2700 OP0633 Total parotidectomy for Recurrent tumour ( with nerve grafting ) 170660 85330 68260 51200
Spinal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2701 OP2055 Anterior and posterior fusion for vertebral deformity correction 213360 106680 85340 64010
2702 OP2056 Anterior and posterior fusion with instrumentation for 223040 111520 89220 66910
vertebral deformity correction
2703 OP3414 Anterior cervical corpectomy for DPLL 221340 110670 88540 66400
2704 OP3412 Anterior cervical corpectomy with stabilization and instrumentation 221340 110670 88540 66400
2705 OP2087 Anterior cervical discectomy - Multiple Level 180160 90080 72060 54050
2706 OP2088 Anterior cervical discectomy - Single Level 170660 85330 68260 51200
2707 OP0501 Anterior cervical discectomy with instrumentation /bone grafting 189640 94820 75860 56890
2708 OP2129 Anterior decompression + anterior interbody fusion of lumbar spine 189640 94820 75860 56890
2709 OP2138 Anterior decompression + Fusion + Anterior 189640 94820 75860 56890
instrumentation of lumbar spine
2710 OP2137 Anterior decompression + posterior decompression + 213360 106680 85340 64010
fusion + instrumentation of lumbar spine
2711 OP2057 Anterior fusion for vertebral deformity correction 180160 90080 72060 54050
2712 OP2058 Anterior fusion with instrumentation for vertebral deformity correction 180160 90080 72060 54050
2713 OP2134 Anterolateral decompression + Fusion + anterior 189640 94820 75860 56890
instrumentation of dorsal / thoracic spine
2714 OP2139 Anterolateral decompression + Fusion + anterior 189640 94820 75860 56890
2715 OP2135 Anterolateral decompression + Fusion + Posterior 213360 106680 85340 64010
instrumentation of dorsal / thoracic spine
2716 OP2140 Anterolateral decompression + Fusion + Posterior 213360 106680 85340 64010
2717 OP2094 Anterolateral decompression of Dorsal spine 180160 90080 72060 54050
2718 OP2107 Anterolateral decompression of Lumbar Spine 137480 68740 54990 41240
2719 OP2045 Aspiration of spinal abscess 7860 3930 3140 2360
2720 OP2079 Bone grafting for spinal dysraphism 91260 45630 36500 27380
2721 OP2089 Cervical decompression laminectomy - multiple levels 240000 120000 96000 72000
2722 OP2090 Cervical decompression laminectomy - single level 170660 85330 68260 51200
2723 OP0500 Cervical laminoplasty with instrumentation / bone graft 180160 90080 72060 54050
2724 OP2048 Cervical vertebral corpectomy 180160 90080 72060 54050
2725 OP4525 COCCYX Manipulation Under GA 34740 17370 13900 10420
2726 OP3192 Coccyxdectomy 117480 58740 46990 35240
2727 OP4863 Complex multi level Cervical Spine decompression 230000 115000 92000 69000
174
2728 OP4864 Complex multi level Cervical Spine decompression +Fixation 250000 125000 100000 75000
2729 OP4867 Complex multi level Lumbar Spine Decompression 230000 115000 92000 69000
2730 OP4868 Complex multi level Lumbar Spine Decompression +Fixation 250000 125000 100000 75000
2731 OP4865 Complex multi level Thoracic Spine Decompression 230000 115000 92000 69000
2732 OP4866 Complex multi level Thoracic Spine Decompression +Fixation 250000 125000 100000 75000
2733 OP2059 Convex epiphysiodesis of the curve for vertebral deformity correction 180160 90080 72060 54050
2734 OP2060 Costoplasty of rib hump for vertebral deformity correction 113800 56900 45520 34140
2735 OP3451 Debridement spine 31060 15530 12420 9320
2736 OP2066 Discogram 19020 9510 7610 5710
2737 OP2095 Dorsal / thoracic discectomy - Microscopic ( 1 level ) 151660 75830 60660 45500
2738 OP2096 Dorsal / thoracic discectomy - Microscopic ( 2 levels ) 170660 85330 68260 51200
2739 OP2097 Dorsal / thoracic discectomy - Microscopic ( More than 2 levels ) 170660 85330 68260 51200
2740 OP2103 Dorsal / thoracic laminoplasty with instrumentation 180160 90080 72060 54050
2741 OP2098 Dorsal / thoracic lamintectomy and discectomy – Open ( 1 level ) 170660 85330 68260 51200
2742 OP2099 Dorsal / thoracic lamintectomy and discectomy – Open ( 2 levels ) 170660 85330 68260 51200
2743 OP2100 Dorsal / thoracic lamintectomy and discectomy - Open 170660 85330 68260 51200
( More than 2 levels )
2744 OP2049 Dorsal / thoracic vertebral corpectomy 180160 90080 72060 54050
2745 OP0507 Endoscopic laminectomy + discectomy for lumbar disc prolapse 151200 75600 60480 45360
2746 OP3223 Endoscopic lumbar laminotomy - Multiple Levels 187680 93840 75070 56300
2747 OP3197 Endoscopic Lumbar laminotomy + Fenestration + 187680 93840 75070 56300
facetectomy - Multiple Levels
2748 OP3198 Endoscopic Lumbar laminotomy + Fenestration + 166820 83410 66730 50050
facetectomy - Single Level
2749 OP3199 Endoscopic Lumbar laminotomy and Fenestration -Multiple levels 187680 93840 75070 56300
2750 OP3200 Endoscopic Lumbar laminotomy and Fenestration -Single Level 166820 83410 66730 50050
2751 OP3305 Endoscopic spinal decompression 254540 127270 101820 76360
2752 OP3302 Endoscopic spinal fenestration with bilateral foraminotomy 196220 98110 78490 58870
2753 OP3304 Endoscopic spinal fenestration with discectomy & bilateral foraminotomy 227080 113540 90830 68120
2754 OP3303 Endoscopic spinal fenestration with discectomy & foraminotomy 215360 107680 86140 64610
2755 OP3301 Endoscopic spinal fenestration with foraminotomy 174540 87270 69820 52360
2756 OP2143 Excision of extradural spinal cord tumour 180160 90080 72060 54050
2757 OP2144 Excision of intradural spinal cord tumour 180160 90080 72060 54050
2758 OP2145 Excision of intramedullary spinal cord tumour 189640 94820 75860 56890
2759 OP3407 Excision of large spinal tumor with duraplasty 274100 137050 109640 82230
2760 OP2973 Excision of spinal AVM 201160 100580 80460 60350
2761 OP3409 Foramen magnum decompression and duraplasty 213740 106870 85500 64120
2762 OP3452 Growing rods 163740 81870 65500 49120
2763 OP3453 Growing rods distraction 39300 19650 15720 11790
2764 OP2051 Kyphoplasty of the kyphotic vertebra 59340 29670 23740 17800
2765 OP0477 Laminectomy & decompression for extradural bony spinal tumours 180160 90080 72060 54050
2766 OP0478 Laminectomy & decompression for extradural soft tissue spinal tumours 180160 90080 72060 54050
2767 OP1106 Laminectomy & decompression for intradural, 180160 90080 72060 54050
extramedullary spinal tumours
2768 OP0476 Laminectomy & decompression for intradural, 189640 94820 75860 56890
intramedullary spinal tumours
2769 OP0506 Laminectomy / discectomy for lumbar disc prolapse (microscopic ) 137480 68740 54990 41240
2770 OP1115 Laminectomy / discectomy for lumbar disc prolapse (open ) 137480 68740 54990 41240
2771 OP2108 Lumbar discectomy - Endoscopic ( 1 level ) 151200 75600 60480 45360
2772 OP2109 Lumbar discectomy - Endoscopic ( 2 levels ) 151200 75600 60480 45360
2773 OP2110 Lumbar discectomy - Endoscopic ( More than 2 levels ) 151200 75600 60480 45360
2774 OP2111 Lumbar discectomy - Microscopic ( 1 level ) 137480 68740 54990 41240
2775 OP2112 Lumbar discectomy - Microscopic ( 2 levels ) 137480 68740 54990 41240
2776 OP2113 Lumbar discectomy - Microscopic ( More than 2 levels) 137480 68740 54990 41240
2777 OP2116 Lumbar interspinous fenestration - Multiple Levels 170660 85330 68260 51200
2778 OP2117 Lumbar interspinous fenestration - Single Level 137480 68740 54990 41240
2779 OP2106 Lumbar laminectomy - Multiple Levels 170660 85330 68260 51200
2780 OP2118 Lumbar laminectomy - Single Level 137480 68740 54990 41240
2781 OP2126 Lumbar laminectomy and discectomy - Open ( 1 level ) 137480 68740 54990 41240
175
2782 OP2114 Lumbar laminectomy and discectomy - Open ( 2 levels) 137480 68740 54990 41240
2783 OP2115 Lumbar laminectomy and discectomy - Open ( More than 2 levels ) 180160 90080 72060 54050
2784 OP2119 Lumbar laminoplasty 137480 68740 54990 41240
2785 OP2120 Lumbar laminotomy - Multiple Levels 170660 85330 68260 51200
2786 OP2122 Lumbar laminotomy + Fenestration + facetectomy -Multiple Levels 170660 85330 68260 51200
2787 OP2123 Lumbar laminotomy + Fenestration + facetectomy -Single Level 151660 75830 60660 45500
2788 OP2124 Lumbar laminotomy and Fenestration - Multiple levels 170660 85330 68260 51200
2789 OP2125 Lumbar laminotomy and Fenestration - Single Level 151660 75830 60660 45500
2790 OP2050 Lumbar vertebral corpectomy 189640 94820 75860 56890
2791 OP2955 Non fusion surgery of lumbar spine ( Diam spacer insertion ) 137480 68740 54990 41240
2792 OP3056 Occipito-cervical fusion ( posterior only ) 163840 81920 65540 49150
2793 OP3091 Open biopsy of spine 25980 12990 10390 7790
2794 OP3193 Percutaneous fixation of dorsal spine 180160 90080 72060 54050
2795 OP3194 Percutaneous fixation of lumbar spine 180160 90080 72060 54050
2796 OP2091 Posterior cervical foraminotomy - Multiple Levels 180160 90080 72060 54050
2797 OP2092 Posterior cervical foraminotomy - Single Level 170660 85330 68260 51200
2798 OP2093 Posterior cervical laminoplasty 180160 90080 72060 54050
2799 OP2131 Posterior decompression + anterior interbody fusion of lumbar spine 189640 94820 75860 56890
2800 OP2136 Posterior decompression + fusion + instrumentation of 189640 94820 75860 56890
dorsal / thoracic spine
2801 OP2142 Posterior decompression and posterolateral fusion + 189640 94820 75860 56890
2802 OP2133 Posterior decompression and posterolateral fusion of lumbar Spine 189640 94820 75860 56890
2803 OP2141 Posterior decompression and transforaminal 189640 94820 75860 56890
interbody fusion + instrumentation of lumbar spine
2804 OP2132 Posterior decompression and transforaminal 189640 94820 75860 56890
Interbody fusion of Lumbar Spine
2805 OP2104 Posterior decompression of dorsal Spine – Multiple levels 180160 90080 72060 54050
2806 OP2105 Posterior decompression of dorsal Spine - Single level 170660 85330 68260 51200
2807 OP2128 Posterior decompression of dorsal Spine and fusion 180160 90080 72060 54050
2808 OP2061 Posterior fusion for vertebral deformity correction 180160 90080 72060 54050
2809 OP2062 Posterior fusion with instrumentation for vertebral deformity correction 206920 103460 82770 62080
2810 OP0714 Repair of diastometomyelia ( spinal dysraphism ) 91260 45630 36500 27380
2811 OP0712 Repair of lipo - meningomyelocele ( spinal dysraphism) 91260 45630 36500 27380
2812 OP0711 Repair of lipo - meningomyelocele with untethering of 137980 68990 55190 41390
cord ( spinal dysraphism )
2813 OP0713 Repair of meningocele ( spinal dysraphism ) 91240 45620 36500 27370
2814 OP1117 Repair of meningomyelocele ( spinal dysraphism ) 91740 45870 36700 27520
2815 OP0512 Repair of meningomyelocele with untethering of cord 172040 86020 68820 51610
& excision of intradural lipoma ( spinal dysraphism )
2816 OP0511 Repair of meningomyelocele with untethering of cord ( spinal dysraphism) 137980 68990 55190 41390
2817 OP2972 Repair of spinal arteriovenous fistula 201160 100580 80460 60350
2818 OP0715 Repair of sub-occipital meningomyelocele ( spinal dysraphism ) 91260 45630 36500 27380
2819 OP2074 Revision spine surgery - Instrumentated 199040 99520 79620 59710
2820 OP2075 Revision spine surgery - non-instrumentated 189640 94820 75860 56890
2821 OP3306 Revision surgery for cervical disc 177980 88990 71190 53390
2822 OP3307 Revision surgery for lumbar disc 177980 88990 71190 53390
2823 OP0497 Spinal decompression with pedicle screw fixation (instrumentation ) 189640 94820 75860 56890
2824 OP1113 Spinal decompression with sublaminar wiring (instrumentation ) 189640 94820 75860 56890
2825 OP2067 Total cervical disc replacement 189640 94820 75860 56890
2826 OP2146 Total cervical spondylectomy 213360 106680 85340 64010
2827 OP2147 Total dorsal spondylectomy 213360 106680 85340 64010
2828 OP2068 Total lumbar disc replacement 213360 106680 85340 64010
2829 OP2148 Total lumbar spondylectomy 213360 106680 85340 64010
2830 OP0505 Transabdominal anterolateral spinal decompression 189640 94820 75860 56890
with instrumentation / bone grafting
2831 OP3228 Transoral decompression and posterior fusion of 274100 137050 109640 82230
cranio-vertebral junction
2832 OP1108 Trans-oral odontoid removal 180160 90080 72060 54050
176
2833 OP2956 Trans-oral odontoid removal with posterior instrumentation 213360 106680 85340 64010
2834 OP3041 Transpedicular biopsy of spine 25980 12990 10390 7790
2835 OP0504 Transthoracic anterolateral spinal decompression with 189640 94820 75860 56890
instrumentation / bone grafting
2836 OP4870 unilateral Laminectomy and Bilateral Decompression (Multi Level ) 250000 125000 100000 75000
2837 OP4869 Unilateral Laminectomy and Bilateral Decompression (Single Level ) 230000 115000 92000 69000
2838 OP0710 Untethering of cord ( spinal dysraphism ) 137980 68990 55190 41390
2839 OP3187 Vertebral corporectomy and fusion for OPLL 234920 117460 93970 70480
2840 OP3188 Vertebral Nucleoplasty ( cervical ) 78340 39170 31340 23500
2841 OP3189 Vertebral Nucleoplasty ( lumbar ) 78340 39170 31340 23500
2842 OP3454 Vertebral Transforaminal endoscopy 170600 85300 68240 51180
2843 OP3455 Vertebral Transforaminal foraminoplasty 170600 85300 68240 51180
2844 OP2052 Vertebroplasty of kyphotic vertebra 59340 29670 23740 17800
Sympathectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2845 OP0259 Cervical sympathectomy - open 76660 38330 30660 23000
2846 OP0260 Cervical sympathectomy - thoracoscopic 216260 108130 86500 64880
2847 OP3044 Dorsal sympathectomy - open 69700 34850 27880 20910
2848 OP0292 Laparoscopic lumbar sympathectomy 72160 36080 28860 21650
2849 OP0291 Lumbar sympathectomy - open 54080 27040 21630 16220
2850 OP0583 Thoracoscopic dorsal sympathectomy 72160 36080 28860 21650
Tendon / Muscle Transfers
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2851 OP1725 David Chuangs muscle transfer procedure 198240 99120 79300 59470
2852 OP1731 Functioning free muscle transfer - Gracilis muscle 297320 148660 118930 89200
2853 OP1732 Functioning free muscle transfer - Latisimus dorsi muscle 297320 148660 118930 89200
2854 OP1730 Pedicle latisimus dorsi transfer 148720 74360 59490 44620
2855 OP1660 Tendon transfer for median nerve injuries - multiple 97260 48630 38900 29180
2856 OP1659 Tendon transfer for median nerve injuries - single (opponensplasty ) 72940 36470 29180 21880
2857 OP3059 Tendon transfer for polio 63160 31580 25260 18950
2858 OP1658 Tendon transfer for radial nerve injuries - multiple 97260 48630 38900 29180
2859 OP1657 Tendon transfer for radial nerve injuries - single 72940 36470 29180 21880
2860 OP1662 Tendon transfer for ulnar nerve injuries - multiple 97260 48630 38900 29180
2861 OP1661 Tendon transfer for ulnar nerve injuries - single 72940 36470 29180 21880
2862 OP1962 Tendon transfer of tibialis posterior to dorsum of foot 59520 29760 23810 17860
2863 OP1727 Trapezius muscle transfer 148720 74360 59490 44620
2864 OP3069 Trapezius transfer 144240 72120 57700 43270
2865 OP1726 Triceps to biceps muscle transfer 148720 74360 59490 44620
Tendon Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

2866 OP1965 Quadriceplasty 84760 42380 33900 25430
2867 OP1286 Release of torticollis ( sterno-mastoid tenotomy ) 60780 30390 24310 18230
2868 OP3272 Tendo-achilles reconstruction 93340 46670 37340 28000
2869 OP3273 Tendo-achilles repair 81780 40890 32710 24530
177
2870 OP1963 Tendo-Achillles ( TA ) lengthening 47620 23810 19050 14290
2871 OP1651 Tenolysis of flexor / extensor tendons - multiple 118980 59490 47590 35690
Thoracic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
2872 OP4527 Allied Assistance - Major 115780 57890 46310 34730
2873 OP4526 Allied Assistance - Minor 57880 28940 23150 17360
2874 OP4515 Bronchial Sleeve Resection & Repair 237540 118770 95020 71260
2875 OP4022 Bronchoplasty fistula closure 250400 125200 100160 75120
2876 OP4304 Bullet injury - retrival of bullet and reconstruction face / head and neck 314020 157010 125610 94210
2877 OP4044 Cervical Mediastinoscopy 83320 41660 33330 25000
2878 OP0261 Cervical rib excision 188040 94020 75220 56410
2879 OP1414 Chest ( pleural ) aspiration in OT 12140 6070 4860 3640
2880 OP4076 Chest tube insertion & Pleurodesis 41180 20590 16470 12350
2881 OP4010 Chest wall tumour resection (with rib resection) and 160500 80250 64200 48150
chest wall reconstruction (Methyl methacrylate plate)
2882 OP4013 Chest wall tumour resection (with rib resection) and chest wall 214500 107250 85800 64350
reconstruction (Prolene mesh + Large Muscle flap
reconstruction (Prolene mesh + Medium Muscle flap
reconstruction (Prolene mesh + Small Muscle flap
2885 OP4009 Chest wall tumour resection (with rib resection) and 145900 72950 58360 43770
chest wall reconstruction (Prolene mesh)
2886 OP4008 Chest wall window for empyema thoracis 188040 94020 75220 56410
2887 OP4025 Clamshell Thoracotomy 104980 52490 41990 31490
2888 OP1254 Decortication for empyema thoracis 94820 47410 37930 28450
2889 OP1245 Diagnostic bronchoscopy ( with or without biopsy ) 23520 11760 9410 7060
2890 OP0576 Diagnostic thoracoscopy and drainage 34540 17270 13820 10360
2891 OP0575 Diagnostic thoracoscopy with biopsy 43200 21600 17280 12960
2892 OP4026 Emergency Thoracotomy for Chest Trauma 132280 66140 52910 39680
2893 OP4030 Esophageal Exclusion in Chest Trauma 145900 72950 58360 43770
2894 OP1417 Excision of cervical rib / scalenotomy 64700 32350 25880 19410
2895 OP2825 Excision of chest wall tumour (excluding ribs) 131340 65670 52540 39400
2896 OP2826 Excision of chest wall tumour (including ribs) 94820 47410 37930 28450
2897 OP0594 Excision of mediastinal tumour ( open ) 120680 60340 48270 36200
2898 OP4081 Flexible fiber optic bronchoscopy (with or without biopsy) 17640 8820 7060 5290
2899 OP1246 Foreign body removal by flexible bronchoscope 30180 15090 12070 9050
2900 OP0891 Foreign body removal by rigid bronchoscope 47080 23540 18830 14120
2901 OP4019 Harvesting of muscle pedicled graft & reinforcement of Bronchial stump 188040 94020 75220 56410
2902 OP4027 Intercostal Block 20960 10480 8380 6290
2903 OP1415 Intercostal chest tube insertion ( ICD ) in OT 42340 21170 16940 12700
2904 OP4028 IVC Tumour Resection 250400 125200 100160 75120
2905 OP4042 Lung volume reduction surgery 230160 115080 92060 69050
2906 OP4029 Median Sternotomy 209440 104720 83780 62830
2907 OP4035 Open carinal pneumonectomy 323580 161790 129430 97070
2908 OP4002 Open Diaphragmatic eventration/hernia repair 209440 104720 83780 62830
2909 OP4519 Open Diaphragmatic Plication 153740 76870 61500 46120
2910 OP4051 Open excision of invasive Anterior Mediastinal mass (including 330540 165270 132220 99160
Thymoma) with lung resection and vascular repair.
2911 OP4049 Open excision of invasive Anterior Mediastinal mass 302940 151470 121180 90880
(including Thymoma) with lung resection.
(including Thymoma) with pericardiectomy
178
(including Thymoma) with vascular repair.
2914 OP4516 Open Excision of Large Hemithorax Mass 269040 134520 107620 80710
2915 OP4047 Open excision of non-invasive Anterior Mediastinal 250400 125200 100160 75120
mass (including Thymoma)
2916 OP4036 Open Extrapleural Pneumonectomy in Mesothelioma 250400 125200 100160 75120
2917 OP4039 Open Lobectomy + Mediastinal LN dissection 292780 146390 117110 87830
2918 OP4079 Open Lobectomy in life threatening hemoptysis 281920 140960 112770 84580
2919 OP1419 Open lung biopsy 104980 52490 41990 31490
2920 OP4034 Open lung cyst surgery 261680 130840 104670 78500
2921 OP4053 Open PMT excision with rib resection 275460 137730 110180 82640
2922 OP4052 Open PMT excision without rib resection 250400 125200 100160 75120
2923 OP4037 Open Pneumonectomy + Mediastinal LN dissection 313200 156600 125280 93960
2924 OP4041 Open segmental resection of bronchial tumour 250400 125200 100160 75120
2925 OP4038 Open Sleeve lobectomy 292780 146390 117110 87830
2926 OP4056 Open Tracheo-esophageal fistula repair 209440 104720 83780 62830
2927 OP4031 Pleroperitoneal Shunt 125200 62600 50080 37560
2928 OP1426 Pleural biopsy 44880 22440 17950 13460
2929 OP4517 Pleurocutaneous Window 88380 44190 35350 26510
2930 OP1430 Pleurodesis 9580 4790 3830 2870
2931 OP4032 Posterolateral Thoracotomy 104980 52490 41990 31490
2932 OP4043 Pulmonary AVM 263580 131790 105430 79070
2933 OP1421 Rib resection & drainage of collection 64700 32350 25880 19410
2934 OP4074 Rigid bronchoscopy + Bronchial stenosis dilation 47080 23540 18830 14120
2935 OP4075 Rigid bronchoscopy + Debulking of tracheo-bronchial tumor 58820 29410 23530 17650
2936 OP4073 Rigid bronchoscopy + tracheal stenosis dilation 47080 23540 18830 14120
2937 OP4069 Robotic Cardiomyotomy for Achalasia Cardia 162800 81400 65120 48840
2938 OP4060 Robotic Diaphragmatic eventration/hernia repair 272260 136130 108900 81680
2939 OP4068 Robotic Enucleation of leiomyoma of esophagus 325520 162760 130210 97660
2940 OP4067 Robotic esophagectomy + Gastric pull-up with neck anastomosis 355920 177960 142370 106780
2941 OP4065 Robotic excision of Anterior mediastinal tumour 325520 162760 130210 97660
2942 OP4510 Robotic Excision of Invasive Anterior Mediastinal Mass or Thymoma 326700 163350 130680 98010
2943 OP4513 Robotic Excision of Invasive Anterior Mediastinal Mass 365120 182560 146050 109540
or Thymoma with Lung & Pericardial Resection
or Thymoma with Lung Resection
2945 OP4514 Robotic Excision of Invasive Anterior Mediastinal Mass or Thymoma 360480 180240 144190 108140
with Pericardial & Lung Resection +Vascular Repair
or Thymoma with Pericardial Resection
2947 OP4062 Robotic lobectomy 346020 173010 138410 103810
2948 OP4063 Robotic mediastinal LN sampling 136440 68220 54580 40930
2949 OP4066 Robotic PMT excision 325520 162760 130210 97660
2950 OP4061 Robotic pneumonectomy 346020 173010 138410 103810
2951 OP4064 Robotic Radical thymectomy for MG or small/non-invasive Thymoma 325520 162760 130210 97660
2952 OP4023 Sinus Excision Chest 83320 41660 33330 25000
2953 OP4016 Sternal Resection Partial with (reconstruction Prolene 299980 149990 119990 89990
Mesh &/or Methyl Methacrylate plate) with Muscle flap
2954 OP4015 Sternal Resection Partial with Methyl methacrylate plate reconstruction 226500 113250 90600 67950
2955 OP4014 Sternal Resection Partial with Prolene mesh reconstruction 205920 102960 82370 61780
2956 OP4018 Sternal Resection Total with reconstruction (Prolene Mesh &/or 358820 179410 143530 107650
Methyl methacrylate plate) with Muscle flap reconstruction
2957 OP4082 Sternal Resection Total with Methyl methacrylate plate reconstruction 291200 145600 116480 87360
2958 OP4017 Sternal Resection Total with Prolene Mesh reconstruction 264740 132370 105900 79420
2959 OP1289 Thoracic pneumonectomy 115540 57770 46220 34660
2960 OP4020 Thoracoplasty 145900 72950 58360 43770
2961 OP4506 Thoracoscopic Blebectomy 96100 48050 38440 28830
2962 OP0577 Thoracoscopic decortication 319100 159550 127640 95730
2963 OP0596 Thoracoscopic excision of bronchogenic cyst of lung 314020 157010 125610 94210
179
2964 OP0581 Thoracoscopic fenestration of pericardium for pericardial effusion 73540 36770 29420 22060
2965 OP0578 Thoracoscopic lobectomy 319380 159690 127750 95810
2966 OP0579 Thoracoscopic lung nodule excision 94820 47410 37930 28450
2967 OP0580 Thoracoscopic mediastinal lymph node biopsy 104980 52490 41990 31490
2968 OP1429 Thoracoscopic mediastinal tumour excision 300460 150230 120180 90140
2969 OP0582 Thoracoscopic pneumonectomy 319380 159690 127750 95810
2970 OP0590 Thoracoscopic removal of hydatid cyst of lung 314020 157010 125610 94210
2971 OP0595 Thoracoscopic segmental resection of lung 153600 76800 61440 46080
2972 OP4509 Thoracoscopic Segmentectomy 249840 124920 99940 74950
2973 OP0584 Thoracoscopic thymectomy 122380 61190 48950 36710
2974 OP4507 Thoracoscopic Wedge Resection 57660 28830 23060 17300
2975 OP1416 Thoracotomy & decortication of lung 265900 132950 106360 79770
2976 OP1427 Thoracotomy & evacuation of hematoma 68980 34490 27590 20690
2977 OP1428 Thoracotomy & lobectomy 266160 133080 106460 79850
2978 OP1418 Thoracotomy & mediastinal lymph node biopsy 43200 21600 17280 12960
2979 OP4021 Thoracotomy & Pericardial window construction 156700 78350 62680 47010
2980 OP1420 Thoracotomy & pneumonectomy 266160 133080 106460 79850
2981 OP0458 Thoracotomy & segmental resection of lung 128000 64000 51200 38400
2982 OP0463 Thoracotomy and excision of bronchogenic cyst of lung 261680 130840 104670 78500
2983 OP0462 Thoracotomy and excision of dermoid cyst of lung 103440 51720 41380 31030
2984 OP0461 Thoracotomy and excision of hydatid cyst of lung 261680 130840 104670 78500
2985 OP0459 Thoracotomy and re-exploration for bleeding 94820 47410 37930 28450
2986 OP1422 Thoracotomy for anterolateral decompression 103440 51720 41380 31030
2987 OP0460 Thoracotomy for penetrating injury chest 125200 62600 50080 37560
2988 OP0457 Thoracotomy, pleurectomy & excision of emphysematous bullae 188040 94020 75220 56410
2989 OP3034 Thoroscopic lung bullectomy 225620 112810 90250 67690
2990 OP1423 Thymectomy ( open ) 250400 125200 100160 75120
2991 OP4071 Tracheal stenosis - resection + EEA 235320 117660 94130 70600
2992 OP4072 Tracheal tumour - resection + EEA 258840 129420 103540 77650
2993 OP4070 Tracheotomy and Foreign body removal 43340 21670 17340 13000
2994 OP4058 Transaxillary First Rib Resection in Thoracic Outlet Syndrome 188040 94020 75220 56410
2995 OP4045 VATS biopsy of mediastinal mass 104980 52490 41990 31490
2996 OP4508 VATS Debridement of Empyema Thoracic 115300 57650 46120 34590
2997 OP4518 VATS Diaphragmatic Plication 219080 109540 87630 65720
2998 OP4003 VATS Diaphragmatic rupture repair 251340 125670 100540 75400
2999 OP4024 VATS ligation of Thoracic duct for Chylothorax 261680 130840 104670 78500
3000 OP4040 VATS Lobectomy + Mediastinal LN dissection 351360 175680 140540 105410
3001 OP4033 VATS lung biopsy 104980 52490 41990 31490
3002 OP4004 VATS Pleural Biopsy (under GA) 58820 29410 23530 17650
3003 OP4077 VATS Pleural Biopsy (under LA) 52940 26470 21180 15880
3004 OP4007 VATS Pleurodesis (Mechanical/Talc) 64720 32360 25890 19420
3005 OP4005 VATS pleurodesis (under GA) 64720 32360 25890 19420
3006 OP4078 VATS pleurodesis (under LA) 58820 29410 23530 17650
3007 OP4054 VATS PMT excision 300460 150230 120180 90140
3008 OP4046 VATS Radical thymectomy for MG or small/non-invasive Thymoma 300460 150230 120180 90140
3009 OP4006 VATS removal of foreign body chest 314020 157010 125610 94210
3010 OP4059 VATS resection of Cervical rib for Thoracic outlet syndrome 225620 112810 90250 67690
3011 OP4057 VATS Tracheo-esophageal fistula repair 251340 125670 100540 75400
3012 OP4319 VATS/ thoracoscopic drainage of empyema - Paed 96260 48130 38500 28880
3013 OP4520 Video Assisted Mediastinoscopic Lymphadenectomy 230600 115300 92240 69180
Urology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

3014 OP1494 Anastomotic Urethroplasty (Anterior Urethra) 133340 66670 53340 40000
3015 OP4877 Antegrade DJ Stenting 53340 26670 21340 16000
180
3016 OP1489 Augmentation cystoplasty 183340 91670 73340 55000
3017 OP2316 Auto-augmentation cystoplasty 166660 83330 66660 50000
3018 OP1431 Balloon dialation of ureter 35600 17800 14240 10680
3019 OP4429 Balloon Dilatation of PUJ 43760 21880 17500 13130
3020 OP0097 Bladder diverticulectomy ( bilateral ) 116340 58170 46540 34900
3021 OP1244 Bladder diverticulectomy ( unilateral ) 133340 66670 53340 40000
3022 OP4182 Bladder Injury repair 41180 20590 16470 12350
3023 OP1432 Bladder neck incision ( BNI ) 53980 26990 21590 16190
3024 OP4427 Bladder Rupture Repair Major 83340 41670 33340 25000
3025 OP4428 Bladder Rupture Repair Minor 50000 25000 20000 15000
3026 OP4173 Boari Flap Repair 150000 75000 60000 45000
3027 OP4441 Botulinum Toxin Injection Bladder 50500 25250 20200 15150
3028 OP3019 Change of PCN tube 19720 9860 7890 5920
3029 OP1262 Chordee correction 60780 30390 24310 18230
3030 OP1434 Circumcision 24820 12410 9930 7450
3031 OP3018 Closure of ureterostomy 19720 9860 7890 5920
3032 OP1435 Closure of urethral fistula 52940 26470 21180 15880
3033 OP0359 Corporo-cavernosal penile shunt 28660 14330 11460 8600
3034 OP1438 Cystocopy with retrograde catheterisation - bilateral 27640 13820 11060 8290
3035 OP1437 Cystocopy with retrograde ureteric catheterisation -unilateral 22480 11240 8990 6740
3036 OP1440 Cystoscopic stent removal 15160 7580 6060 4550
3037 OP1253 Cystoscopy 15660 7830 6260 4700
3038 OP1252 Cystoscopy and fulguration of posterior uretheral valves 63220 31610 25290 18970
3039 OP1436 Cystoscopy with bladder biopsy 22480 11240 8990 6740
3040 OP4183 Cystoscopy with Clot Evacuation 26660 13330 10660 8000
3041 OP4178 Cystoscopy with Retrograde pyelography - RGP (Bilateral ) 47080 23540 18830 14120
3042 OP4177 Cystoscopy with Retrograde pyelography - RGP (Unilateral ) 23520 11760 9410 7060
3043 OP1290 De-torsion and fixation of involved testis 47500 23750 19000 14250
3044 OP4179 Diagnostic Ureteroscopy 35300 17650 14120 10590
3045 OP1441 Dilatation of stricture urethra 16040 8020 6420 4810
3046 OP1485 Dismembered pyeloplasty ( Anderson Hynes ) 129180 64590 51670 38750
3047 OP4878 DJ Stent Replacement Unilateral 66660 33330 26660 20000
3048 OP3017 Dorsal slit of prepuce 19720 9860 7890 5920
3049 OP1443 Double J stent placement in ureter - bilateral 50060 25030 20020 15020
3050 OP1442 Double J stent placement in ureter - unilateral 31400 15700 12560 9420
3051 OP1257 Ectopic vesicae - bladder turn in 116660 58330 46660 35000
3052 OP2314 Endoincision of ureteric stricture 53980 26990 21590 16190
3053 OP2315 Endopyelotomy 116660 58330 46660 35000
3054 OP1444 Endoscopic removal of stone in bladder -Cystolitholapaxy 60000 30000 24000 18000
3055 OP1446 Endoscopic teflon injection - bilateral 53980 26990 21590 16190
3056 OP1445 Endoscopic teflon injection - unilateral 34400 17200 13760 10320
3057 OP4167 Epididymectomy 41940 20970 16780 12580
3058 OP1487 Epispadias reconstruction / repair 150000 75000 60000 45000
3059 OP0263 Epispadias with ectopic vesicae - complete repair 166660 83330 66660 50000
3060 OP1488 Extended pyelolithotomy ( Gil Vernet ) 126020 63010 50410 37810
3061 OP4168 Fournier's Gangrene 58820 29410 23530 17650
3062 OP4160 Fracture Penis repair 117660 58830 47060 35300
3063 OP4162 Graft repair of Peyronies Disease 110720 55360 44290 33220
3064 OP4890 Harvesting of Buccal Mucosa 26660 13330 10660 8000
3065 OP1258 Hemi-nephroureterectomy ( open ) 133340 66670 53340 40000
3066 OP4170 High Orchidectomy 58820 29410 23530 17650
3067 OP4425 Hormonal Therapy injection for Cancer Prostate 7300 3650 2920 2190
3068 OP1496 Hydrocele sac eversion / excision - bilateral 49860 24930 19940 14960
3069 OP1497 Hydrocele sac eversion / excision - unilateral 35360 17680 14140 10610
3070 OP1263 Hypospadias MAGPI 48620 24310 19450 14590
3071 OP1261 Hypospadias second stage correction 85380 42690 34150 25610
3072 OP4885 Hypospadias single staged Repair - Distal 140000 70000 56000 42000
3073 OP4886 Hypospadias single staged Repair - Mid penile 160000 80000 64000 48000
3074 OP4887 Hypospadias single staged Repair - Proximal or perineal 170000 85000 68000 51000
181
3075 OP4894 Ideal Ureteric Interposition 166660 83330 66660 50000
3076 OP4426 Impacted Foley's Removal 9720 4860 3890 2920
3077 OP4895 Lap. Auto-augmentation cystoplasty 191660 95830 76660 57500
3078 OP4897 Lap. Boari Flap Repair 165000 82500 66000 49500
3079 OP4899 Lap. Hemi-nephroureterectomy ( open ) 146660 73330 58660 44000
3080 OP4881 Lap. Open Orchidopexy 91660 45830 36660 27500
3081 OP4872 Lap. Open Radical cystectomy with ileal conduit 383340 191670 153340 115000
3082 OP4875 Lap. Open Radical cystectomy with neobladder 498340 249170 199340 149500
3083 OP4909 Lap. Resection of Bowel End to End Anastomosis 88000 44000 35200 26400
3084 OP4905 Lap. Vesicovaginal fistula (VVF) repair (Trans Abdominal) 161000 80500 64400 48300
3085 OP0358 Laparoscopic excision of bladder diverticulum 133340 66670 53340 40000
3086 OP0268 Laparoscopic lymphatic disconnection for chyluria 92260 46130 36900 27680
3087 OP4891 Laparoscopic Nephroureterectomy 130000 65000 52000 39000
3088 OP0362 Laparoscopic partial cystectomy 116660 58330 46660 35000
3089 OP0266 Laparoscopic pyeloplasty 129180 64590 51670 38750
3090 OP0361 Laparoscopic radical cystectomy 161780 80890 64710 48530
3091 OP0270 Laparoscopic radical prostatectomy 169160 84580 67660 50750
3092 OP0357 Laparoscopic renal cyst de-roofing 86260 43130 34500 25880
3093 OP0570 Laparoscopic transperitoneal simple nephrectomy 107620 53810 43050 32290
3094 OP0267 Laparoscopic ureteric re-implantation 150000 75000 60000 45000
3095 OP0573 Laparoscopic varicocelectomy - bilateral 56920 28460 22770 17080
3096 OP0574 Laparoscopic varicocelectomy - unilateral 41400 20700 16560 12420
3097 OP1174 Laparoscopic ventri-suspension ( Burch's colposuspension ) 88260 44130 35300 26480
3098 OP0356 Laparoscopic, transperitoneal partial nephrectomy 150000 75000 60000 45000
3099 OP0269 Laparoscopic, transperitoneal radical nephrectomy 117660 58830 47060 35300
3100 OP4879 Laproscopic Ureterolithotomy 83340 41670 33340 25000
3101 OP4433 Lumber Sinus Excision 116700 58350 46680 35010
3102 OP3180 Marshalls Marchetti Kantz ( MMK ) Open colposuspension 64720 32360 25890 19420
3103 OP4902 Meatoplasty 50000 25000 20000 15000
3104 OP4586 Mitomycin C intilation 5340 2670 2140 1600
3105 OP4320 Mitrofanoff's (appendicovesicostomy) 90900 45450 36360 27270
3106 OP1462 Nephrectomy ( open ) 88800 44400 35520 26640
3107 OP0264 Nephrolithotomy 78240 39120 31300 23470
3108 OP0116 Nephro-pyelolithotomy 78240 39120 31300 23470
3109 OP4155 Nephroureterectomy 150000 75000 60000 45000
3110 OP4430 Nesbit Procedure greater than 2cm 34040 17020 13620 10210
3111 OP4880 Open Orchidopexy 83340 41670 33340 25000
3112 OP1461 Open pyelolithotomy 77620 38810 31050 23290
3113 OP4871 Open Radical cystectomy with ileal conduit 333340 166670 133340 100000
3114 OP4874 Open Radical cystectomy with neobladder 433340 216670 173340 130000
3115 OP4888 Open Radical Nephrectomy with IVC thrombus 200000 100000 80000 60000
3116 OP4889 Open radical nephrectomy with IVC thrombus with liver mobilization 250000 125000 100000 75000
3117 OP1273 Optical internal uretherotomy ( OIU ) 53980 26990 21590 16190
3118 OP1451 Orchidectomy - bilateral 53980 26990 21590 16190
3119 OP1452 Orchidectomy - unilateral 46160 23080 18460 13850
3120 OP1453 Orchidopexy for undescended testis - bilateral 69020 34510 27610 20710
3121 OP1454 Orchidopexy for undescended testis - unilateral 53980 26990 21590 16190
3122 OP1456 Palomo’s operation for varicocele - unilateral 32980 16490 13190 9890
3123 OP1455 Palomos operation for varicocele - bilateral 46160 23080 18460 13850
3124 OP4442 Para Phimosis Reduction 9720 4860 3890 2920
3125 OP0363 Partial amputation of penis 110000 55000 44000 33000
3126 OP1491 Partial nephrectomy ( open ) 150000 75000 60000 45000
3127 OP1460 PCNL ( second stage ) 52920 26460 21170 15880
3128 OP1486 PCNL (less than 2 cm or single tract PCNL 116660 58330 46660 35000
3129 OP4901 PCNL (more than 2 cm or single tract PCNL) 133340 66670 53340 40000
3130 OP2313 Penile frenuloplasty 12280 6140 4910 3680
3131 OP4159 Penile Implant 200000 100000 80000 60000
3132 OP1498 Penile venous ligation 57240 28620 22900 17170
3133 OP1458 Percutaneous nephrostomy ( PCN ) 37940 18970 15180 11380
3134 OP4431 Peri Nephric Abscess Drainage Open 97260 48630 38900 29180
182
3135 OP4432 Peri Nephric Abscess Drainage Pigtail like PCN 34500 17250 13800 10350
3136 OP1459 Perineal urethrostomy 69360 34680 27740 20810
3137 OP0262 Photo vaporisation of prostate Green light HOLEP 100000 50000 40000 30000
Laser size less than 80 gm
3138 OP4903 Photo vaporisation of prostate Green light HOLEP 116660 58330 46660 35000
Laser size more than 80 gm
3139 OP4161 Plication for Peyronies Disease 76460 38230 30580 22940
3140 OP1295 Prepucioplasty 24820 12410 9930 7450
3141 OP4164 Priapism ( Major ) 88260 44130 35300 26480
3142 OP4163 Priapism ( Minor ) 70580 35290 28230 21170
3143 OP4883 Priapism Distal Shunt 83340 41670 33340 25000
3144 OP0265 Prophylactic orchidopexy for prevention of torsion 41400 20700 16560 12420
3145 OP4907 Proximal Shunt for Priapism 140000 70000 56000 42000
3146 OP4184 Radical Cystectomy with Neobladder 199900 99950 79960 59970
3147 OP1495 Radical cystectomy with urinary diversion 169160 84580 67660 50750
3148 OP1490 Radical nephrectomy ( open ) 150000 75000 60000 45000
3149 OP1472 Reimplantation of ureter ( ureteroneocystostomy ) -unilateral 116660 58330 46660 35000
3150 OP0098 Reimplantation of ureter ( ureteroneocystostomy ) 150000 75000 60000 45000
with bladder diverticulectomy - unilateral
3151 OP1492 Reimplantation of ureters ( ureteroneocystostomy ) -bilateral 166660 83330 66660 50000
3152 OP0002 Reimplantation of ureters ( ureteroneocystostomy ) 183340 91670 73340 55000
with bladder diverticulectomy - bilateral
3153 OP0113 Repair of distal hypospadias - single stage correction 97260 48630 38900 29180
3154 OP1259 Repair of hypospadias with large fistula 60780 30390 24310 18230
3155 OP0112 Repair of hypospadias with multiple fistulae 72940 36470 29180 21880
3156 OP1260 Repair of hypospadias with small fistula 48620 24310 19450 14590
3157 OP1264 Repair of proximal hypospadias - single stage correction 138760 69380 55500 41630
3158 OP4908 Resection of Bowel End to End Anastomosis 80000 40000 32000 24000
3159 OP4893 Retrocaval Ureter 116660 58330 46660 35000
3160 OP4175 Retrograde intrarenal surgery ( RIRS ) for Kidney 106980 53490 42790 32090
3161 OP4174 Retrograde intrarenal surgery ( RIRS ) for ureter 80220 40110 32090 24070
3162 OP0572 Retroperitoneoscopic ureterolithotomy 81880 40940 32750 24560
3163 OP4896 Robotic Auto-augmentation cystoplasty 183340 91670 73340 55000
3164 OP4898 Robotic Boari Flap Repair 172500 86250 69000 51750
3165 OP4900 Robotic Hemi-nephroureterectomy ( open ) 153340 76670 61340 46000
3166 OP4882 Robotic Open Orchidopexy 95840 47920 38340 28750
3167 OP4873 Robotic Open Radical cystectomy with ileal conduit 383340 191670 153340 115000
3168 OP4876 Robotic Open Radical cystectomy with neobladder 498340 249170 199340 149500
3169 OP4910 Robotic Resection of Bowel End to End Anastomosis 92000 46000 36800 27600
3170 OP4906 Robotic Vesicovaginal fistula (VVF) repair (Trans Abdominal) 161000 80500 64400 48300
3171 OP1447 Scrotal exploration 37940 18970 15180 11380
3172 OP4172 Scrotal Sebaceous Cysts 47080 23540 18830 14120
3173 OP4169 Scrotoplasty 58820 29410 23530 17650
3174 OP1463 Seminal vasiculogram ( SVG ) 23800 11900 9520 7140
3175 OP1464 Seminal vasiculogram ( SVG ) + Vasoepididymal 77620 38810 31050 23290
anastomosis ( VEA ) - bilateral
3176 OP1465 Seminal vasiculogram ( SVG ) + Vasoepididymal 53980 26990 21590 16190
anastomosis ( VEA ) - unilateral
3177 OP4892 Skene's Duct Cyst Excision 40000 20000 16000 12000
3178 OP4176 Stage II Ureterenoscopy ( URS ) 35300 17650 14120 10590
3179 OP3090 Subinguinal varicocelectomy - bilateral 56420 28210 22570 16930
3180 OP3089 Subinguinal varicocelectomy - unilateral 41120 20560 16450 12340
3181 OP1439 Suprapubic cystolithotomy 41400 20700 16560 12420
3182 OP1468 Suprapubic trocar cystostomy ( SPC ) 31560 15780 12620 9470
3183 OP1187 Tension free vaginal tape insertion ( TVT ) for urinary incontinence 45180 22590 18070 13550
3184 OP1466 Testicular biopsy 16040 8020 6420 4810
3185 OP4171 Testicular Implant 58820 29410 23530 17650
3186 OP0364 Total amputation of penis 103680 51840 41470 31100
3187 OP1069 Total amputation of penis with block dissection –bilateral 183340 91670 73340 55000
3188 OP1068 Total amputation of penis with block dissection –unilateral 116340 58170 46540 34900
183
3189 OP1467 Transurethral resection of bladder tumour ( TURBT ) less than 5 cm 116660 58330 46660 35000
3190 OP4904 Transurethral resection of bladder tumour ( TURBT )more than 5 cm 126660 63330 50660 38000
3191 OP0360 Trucut prostatic biopsy in OT 10020 5010 4010 3010
3192 OP1470 TURP & TUR(BT) 117660 58830 47060 35300
3193 OP1471 TURP + cystolithotripsy ( CLT ) 117660 58830 47060 35300
3194 OP1469 TURP less than 80 gm 100000 50000 40000 30000
3195 OP4884 Ureteric reimplantation with Psoas Hitch 133340 66670 53340 40000
3196 OP4156 Ureterocalicostomy 132360 66180 52940 39710
3197 OP4434 Ureterocoele Incision U/L 48620 24310 19450 14590
3198 OP1478 Ureterolithotomy 69020 34510 27610 20710
3199 OP1493 Ureterolysis for retroperitoneal fibrosis ( IRPF ) -bilateral 126020 63010 50410 37810
3200 OP1474 Ureterolysis for retroperitoneal fibrosis ( IRPF ) -unilateral 94820 47410 37930 28450
3201 OP1475 Ureteroscopic removal of stone ( URS ) 74880 37440 29950 22460
3202 OP4435 Ureteroscopy Biopsy 47520 23760 19010 14260
3203 OP1269 Uretheral meatal dilatation 8680 4340 3470 2600
3204 OP1448 Uretheral meatoplasty 16380 8190 6550 4910
3205 OP1270 Uretheral meatotomy 10900 5450 4360 3270
3206 OP1476 Uretheroplasty - first stage 73340 36670 29340 22000
3207 OP1477 Uretheroplasty - second stage 86660 43330 34660 26000
3208 OP4438 Urethral Caruncle 24320 12160 9730 7300
3209 OP4439 Urethral Diverticulum 24320 12160 9730 7300
3210 OP4440 Urethrectomy 24320 12160 9730 7300
3211 OP4158 Urethroplasty for PIDD 147100 73550 58840 44130
3212 OP4436 Urethroplasty I Stage 21300 10650 8520 6390
3213 OP4437 Urethroplasty II Stage 22620 11310 9050 6790
3214 OP4157 Urethroplasty with Buccal Mucosa 147100 73550 58840 44130
3215 OP1433 Urinary catheterisation 9600 4800 3840 2880
3216 OP1479 Vasectomy 10200 5100 4080 3060
3217 OP1480 Vasectomy reversal - bilateral 97260 48630 38900 29180
3218 OP1481 Vasectomy reversal - unilateral 72940 36470 29180 21880
3219 OP1293 Vesicostomy 31580 15790 12630 9470
3220 OP4180 Vesicovaginal fistula (VVF) repair (Trans Abdominal) 140000 70000 56000 42000
3221 OP4181 Vesicovaginal Repair ( Vaginal approach ) 140000 70000 56000 42000
Varicose Vein Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

3222 OP4211 Endovenous ablation of varicose veins - Bilateral 188260 94130 75300 56480
3223 OP4210 Endovenous ablation of varicose veins - Unilateral 164740 82370 65900 49420
3224 OP3461 Foam sclerotherapy for varicose veins 58820 29410 23530 17650
3225 OP2912 High ligation, stripping & multiple avulsions for LSV 80680 40340 32270 24200
varicose veins - bilateral
3226 OP0286 High ligation, stripping & multiple avulsions for LSV 71100 35550 28440 21330
varicose veins - unilateral
3227 OP2913 High ligation, stripping & multiple avulsions for 80680 40340 32270 24200
Recurrent LSV varicose veins - bilateral
3228 OP0289 High ligation, stripping & multiple avulsions for 71100 35550 28440 21330
Recurrent LSV varicose veins - unilateral
3229 OP3246 Laser ablation of varicose veins in OT (Bilateral) 188260 94130 75300 56480
3230 OP3245 Laser ablation of varicose veins in OT (Unilateral) 164740 82370 65900 49420
3231 OP2916 Multiple avulsions for varicose veins - bilateral 80680 40340 32270 24200
3232 OP0288 Multiple avulsions for varicose veins - unilateral 71100 35550 28440 21330
3233 OP2914 Sapheno - popliteal junction ligation for Recurrent SSV 80680 40340 32270 24200
varicose veins - bilateral
3234 OP0290 Sapheno - popliteal junction ligation for Recurrent SSV 71100 35550 28440 21330
varicose veins - unilateral
184
3235 OP2915 Sapheno - popliteal junction ligation for SSV varicose 80680 40340 32270 24200
veins - bilateral
3236 OP0287 Sapheno - popliteal junction ligation for SSV varicose 71100 35550 28440 21330
veins - unilateral
Vascular Access Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
3237 OP0308 Chemoport insertion 44120 22060 17650 13240
3238 OP0309 Chemoport removal 29440 14720 11780 8830
3239 OP4203 Duplex guided central venous line insertion 20580 10290 8230 6170
3240 OP0310 Hickman line insertion 44120 22060 17650 13240
3241 OP0311 Permacath placement / insertion 44120 22060 17650 13240
Vascular Bypass Grafting
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
3242 OP0218 Aorto - Bifemoral bypass using synthetic graft 182380 91190 72950 54710
3243 OP2917 Aorto - femoral bypass using synthetic graft 182380 91190 72950 54710
3244 OP0231 Axillary - brachial bypass using synthetic graft 142260 71130 56900 42680
3245 OP0232 Carotid - axillary bypass using synthetic graft 151660 75830 60660 45500
3246 OP4189 Carotid carotid bypass using synthetic graft 182380 91190 72950 54710
3247 OP4188 Carotid subclavian bypass using synthetic graft 182380 91190 72950 54710
3248 OP0220 Common iliac - bifemoral bypass graft 142260 71130 56900 42680
3249 OP0219 Common iliac - bilateral external iliac bypass graft 142260 71130 56900 42680
3250 OP4186 Complex aorto bifemoral bypass 241200 120600 96480 72360
3251 OP4185 Complex aorto femoral bypass 241200 120600 96480 72360
3252 OP4190 Complex axillo distal bypass 241200 120600 96480 72360
3253 OP4191 Complex Femoro - popliteal ( above knee ) bypass using reversed LSV 241200 120600 96480 72360
3254 OP4192 Complex Femoro - popliteal( below knee ) bypass using reversed LSV 241200 120600 96480 72360
3255 OP4193 Complex Femoro - popliteal above knee bypass using synthetic graft 241200 120600 96480 72360
3256 OP4194 Complex Femoro - popliteal above knee bypass using 241200 120600 96480 72360
synthetic graft intervening vein collar
3257 OP4196 Complex iliodistal bypass 241200 120600 96480 72360
3258 OP0223 External iliac - common femoral bypass graft 151660 75830 60660 45500
3259 OP0224 Extra - anatomical (extra-peritoneal) femoro – femoral bypass graft 182380 91190 72950 54710
3260 OP0237 Extra - anatomical axillo - bifemoral bypass using synthetic graft 142260 71130 56900 42680
3261 OP0238 Extra - anatomical axillo - femoral bypass using synthetic graft 142260 71130 56900 42680
3262 OP0236 Extra - anatomical bilateral axillo - femoral bypass using synthetic graft 142260 71130 56900 42680
3263 OP0235 Extra - anatomical bilateral subclavian - femoral 142260 71130 56900 42680
bypass using synthetic graft
3264 OP0233 Extra - anatomical subclavian - bifemoral bypass using synthetic graft 142260 71130 56900 42680
3265 OP0234 Extra - anatomical subclavian - femoral bypass using synthetic graft 142260 71130 56900 42680
3266 OP1504 Femoro - popliteal ( above knee ) bypass using reversed LSV 182380 91190 72950 54710
3267 OP0214 Femoro - popliteal ( below knee ) bypass using reversed LSV 182380 91190 72950 54710
3268 OP0225 Femoro - popliteal above knee bypass using synthetic graft 182380 91190 72950 54710
3269 OP0226 Femoro - popliteal above knee bypass using synthetic 182380 91190 72950 54710
graft intervening vein collar
3270 OP0227 Femoro - popliteal below knee bypass using synthetic graft 182380 91190 72950 54710
3271 OP0228 Femoro - popliteal below knee bypass using synthetic 182380 91190 72950 54710
graft intervening vein collar
3272 OP4195 Femoro distal bypass 241200 120600 96480 72360
3273 OP3021 Graft thrombectomy 123040 61520 49220 36910
185
3274 OP0585 Laparoscopic assisted aorto-distal vascular anastomosis 94820 47410 37930 28450
3275 OP0586 Laparoscopic assisted ilio-distal vascular anastomosis 94820 47410 37930 28450
3276 OP0217 Popliteal - anterior tibial bypass using reversed LSV 151660 75830 60660 45500
3277 OP0216 Popliteal - posterior tibial bypass using reversed LSV 151660 75830 60660 45500
3278 OP0313 Re-exploration for bleeding at vascular anastomotic site 37940 18970 15180 11380
3279 OP0312 Removal of infected graft 45300 22650 18120 13590
3280 OP0222 Retroperitoneal, common iliac to common femoral bypass graft 142260 71130 56900 42680
3281 OP0221 Retroperitoneal, common iliac to external iliac bypass graft 142260 71130 56900 42680
3282 OP4187 Robotic aortic bypass 379420 189710 151770 113830
3283 OP0215 SFA - popliteal bypass using reversed LSV 151660 75830 60660 45500
3284 OP0230 Subclavian - brachial bypass using synthetic graft 142260 71130 56900 42680
3285 OP0229 Subclavian - subclavian cross neck bypass using synthetic graft 182380 91190 72950 54710
Vascular Embolectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
3286 OP0351 Brachial embolectomy - primary closure 182380 91190 72950 54710
3287 OP0352 Brachial embolectomy - PTFE patch closure 182380 91190 72950 54710
3288 OP0353 Brachial embolectomy - vein patch closure 182380 91190 72950 54710
3289 OP4199 Brachial embolectomy with endarterectomy 241200 120600 96480 72360
3290 OP2920 Femoral embolectomy - primary closure ( bilateral ) 247080 123540 98830 74120
3291 OP0345 Femoral embolectomy - primary closure ( unilateral ) 182380 91190 72950 54710
3292 OP2919 Femoral embolectomy - PTFE patch closure ( bilateral ) 247080 123540 98830 74120
3293 OP0346 Femoral embolectomy - PTFE patch closure ( unilateral) 182380 91190 72950 54710
3294 OP2921 Femoral embolectomy - vein patch closure ( bilateral ) 247080 123540 98830 74120
3295 OP0347 Femoral embolectomy - vein patch closure ( unilateral) 182380 91190 72950 54710
3296 OP4200 Femoral embolectomy with endarterectomy 241200 120600 96480 72360
3297 OP4212 Fluoroscopic guided peripheral embolectomy 182380 91190 72950 54710
3298 OP4241 Fluoroscopic guided peripheral embolectomy with endarterectomy 241200 120600 96480 72360
3299 OP0348 Popliteal embolectomy - primary closure 182380 91190 72950 54710
3300 OP0349 Popliteal embolectomy - PTFE patch closure 182380 91190 72950 54710
3301 OP0350 Popliteal embolectomy - vein patch closure 182380 91190 72950 54710
3302 OP4201 Popliteal embolectomy with endarterectomy 241200 120600 96480 72360
Vascular Endarterectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

3303 OP0282 Brachial endarterectomy with PTFE patch plasty 164740 82370 65900 49420
3304 OP0283 Brachial endarterectomy with vein patch plasty 205920 102960 82370 61780
3305 OP0271 Carotid endarterectomy with primary closure 205920 102960 82370 61780
3306 OP0246 Carotid endarterectomy with PTFE patch plasty 205920 102960 82370 61780
3307 OP0272 Eversion carotid endarterectomy 164740 82370 65900 49420
3308 OP0276 Femoral endarterectomy with PTFE patch plasty 164740 82370 65900 49420
3309 OP0277 Femoral endarterectomy with vein patch plasty 164740 82370 65900 49420
3310 OP4197 Graft exploration and endarterectomy 182380 91190 72950 54710
3311 OP0275 Iliac endarterectomy with PTFE patch plasty 164740 82370 65900 49420
3312 OP0280 Popliteal endarterectomy with PTFE patch plasty 164740 82370 65900 49420
3313 OP0281 Popliteal endarterectomy with vein patch plasty 164740 82370 65900 49420
3314 OP0278 SFA endarterectomy with PTFE patch plasty 164740 82370 65900 49420
3315 OP0279 SFA endarterectomy with vein patch plasty 164740 82370 65900 49420
3316 OP0284 Subclavian endarterectomy with PTFE patch plasty 164740 82370 65900 49420
3317 OP0285 Subclavian endarterectomy with vein patch plasty 164740 82370 65900 49420
186
Vascular Injury Repair
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite
3318 OP3446 Anterior tibial artery / vein repair by vein graft – large defect 88260 44130 35300 26480
3319 OP3445 Anterior tibial artery / vein repair by vein graft – small defect 58820 29410 23530 17650
3320 OP0274 Carotid artery repair (post traumatic) – primary closure 182380 91190 72950 54710
3321 OP0273 Carotid artery repair (post traumatic) using PTFE patch 182380 91190 72950 54710
3322 OP4198 Explantation of infected graft with vascular repair 182380 91190 72950 54710
3323 OP0330 Exploration & repair of axillary arterial injury – primary repair 182380 91190 72950 54710
3324 OP0332 Exploration & repair of axillary arterial injury – using vein graft 241200 120600 96480 72360
3325 OP0331 Exploration & repair of axillary arterial injury – using vein patch 182380 91190 72950 54710
3326 OP0333 Exploration & repair of brachial arterial injury -primary repair 182380 91190 72950 54710
3327 OP0335 Exploration & repair of brachial arterial injury – using vein graft 182380 91190 72950 54710
3328 OP0334 Exploration & repair of brachial arterial injury – using vein patch 182380 91190 72950 54710
3329 OP0342 Exploration & repair of carotid arterial injury – primary repair 182380 91190 72950 54710
3330 OP0344 Exploration & repair of carotid arterial injury – using vein graft 182380 91190 72950 54710
3331 OP0343 Exploration & repair of carotid arterial injury – using vein patch 182380 91190 72950 54710
3332 OP0324 Exploration & repair of femoral arterial injury -primary repair 182380 91190 72950 54710
3333 OP0326 Exploration & repair of femoral arterial injury – using vein graft 241200 120600 96480 72360
3334 OP0325 Exploration & repair of femoral arterial injury – using vein patch 182380 91190 72950 54710
3335 OP0321 Exploration & repair of iliac arterial injury – primary repair 182380 91190 72950 54710
3336 OP0323 Exploration & repair of iliac arterial injury - using vein graft 241200 120600 96480 72360
3337 OP0322 Exploration & repair of iliac arterial injury - using vein patch 182380 91190 72950 54710
3338 OP0327 Exploration & repair of popliteal arterial injury -primary repair 182380 91190 72950 54710
3339 OP0329 Exploration & repair of popliteal arterial injury – using vein graft 241200 120600 96480 72360
3340 OP0328 Exploration & repair of popliteal arterial injury – using vein patch 182380 91190 72950 54710
3341 OP0336 Exploration & repair of radial arterial injury – primary repair 182380 91190 72950 54710
3342 OP0338 Exploration & repair of radial arterial injury – using vein graft 241200 120600 96480 72360
3343 OP0337 Exploration & repair of radial arterial injury – using vein patch 182380 91190 72950 54710
3344 OP0339 Exploration & repair of subclavian arterial injury -primary repair 182380 91190 72950 54710
3345 OP0341 Exploration & repair of subclavian arterial injury -using vein graft 241200 120600 96480 72360
3346 OP0340 Exploration & repair of subclavian arterial injury -using vein patch 182380 91190 72950 54710
3347 OP0314 Exploration and ligation for bleeding due to traumatic 44120 22060 17650 13240
(unnamed) arterial injury
3348 OP3440 Other artery / vein repair by vein graft - large defect 88260 44130 35300 26480
3349 OP3439 Other artery / vein repair by vein graft - small defect 58820 29410 23530 17650
3350 OP3444 Posterior tibial artery / vein repair by vein graft – large defect 88260 44130 35300 26480
3351 OP3443 Posterior tibial artery / vein repair by vein graft – small defect 58820 29410 23530 17650
3352 OP3442 Ulnar artery / vein repair by vein graft - large defect 88260 44130 35300 26480
3353 OP3441 Ulnar artery / vein repair by vein graft - small defect 58820 29410 23530 17650
3354 OP4202 Vascular repair for hemostasis 147100 73550 58840 44130
Vertebral Fusion
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
Cat-2
Cat-3
Suite

3355 OP2069 C1 - C2 vertebral fusion 180160 90080 72060 54050
3356 OP2070 C1 - C2 vertebral screw fixation 180160 90080 72060 54050
3357 OP2071 Odontoid screw fixation 180160 90080 72060 54050
3358 OP2073 Posterior cervico - occipital vertebral fusion 199040 99520 79620 59710
3359 OP2072 Trans-oral odontoid screw and posterior fixation 187680 93840 75070 56300
187
Ophthalmology Procedure Charges

1 AUTOPERID Automated Perimetery ( Double eyed patient ) 2260 1360
2 AUTOPERIO Automated Perimetery ( One eyed patient ) 1130 680
3 BIBLBI Botox Injection Blepharospasam - Bilateral 8660 5200
4 BIBLUNI Botox Injection Blepharospasam - Unilateral 5780 3470
5 BOIEBI Botox Injection Epiphora - Bilateral 4340 2600
6 BOIEUNI Botox Injection Epiphora - Unilateral 2890 1730
7 BISTPBI Botox Injection Squint/Lid retraction/ Four inducing temporary Ptosis- Bilateral 4340 2600
8 BISTPUNI Botox Injection Squint/Lid retraction/ Four inducing temporary Ptosis- Unilateral 2890 1730
9 DIARETSCR Diabetic retiniopathy screening in OPD 240 140
10 ULTRASOAB Eye Ultrasonography A & B scan 2070 1240
11 ULTRASOB Eye Ultrasonography B scan 1240 740
12 ULTRASONA Eye Ultrasonography Biometeric A scan 830 500
13 HOSSS Lee's screen charting 780 470
14 CORSCOPD Ophthalmology OPD - Corneal Scraping 1000
15 EXUSED Ophthalmology OPD - Examination under sedation 1000
16 FBOREMOPD Ophthalmology OPD - Foreign body removal 800
17 GONIOPD Ophthalmology OPD - Gonioscopy 500
18 PSUBINJOPD Ophthalmology OPD - Post Subtenon's Injection 1200
19 ROPSCR Ophthalmology OPD - ROP Screening 1500
20 SCHOPD Ophthalmology OPD - Schirmer's Test 500
21 SUBCONINJ Ophthalmology OPD - Sub Conjuctival Injection 500
22 SUTUROPD Ophthalmology OPD - Suture Removal 500
23 SYRIN Ophthalmology OPD - Syringing 500
24 ORTHOE Orthoptic exercise 100 70
25 RORTHO Refraction and Orthoptic checkup 100 70
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 2540 2540 2540 2540 2540 2540
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 ) 1010 860 510 510 860 510
3 BUSIP Biodex Unweighing System ( Inpatient Physiotherapy ) 1010 860 510 510
4 EMGBIOIP EMG Biofeedback ( Inpatient Physiotherapy) 1010 860 510 510
5 GTIP Gait Trainer ( Inpatient Physiotherapy ) 1010 860 510 510
6 MOTOMED Motomed 860 670 330 330 670 330
7 PYCPMEIP Physiotherapy - continuous passive mobilisation 940 510 430 430
exercises ( CPM ) – for inpatients
8 PYESTIP Physiotherapy - electrical stimulation 940 510 430 430
therapy - for inpatients
9 PYECLTIP Physiotherapy - electronic cervical / lumbar 940 510 430 430
traction - for inpatients
10 PYELIP Physiotherapy - exercise ( long ) – for inpatients 1010 670 510 510
11 PYESIP Physiotherapy - exercise ( short ) – for inpatients 860 430 330 330
12 PYITIP Physiotherapy - interferential therapy – for inpatients 860 510 430 430
188
13 PYLTIP Physiotherapy - laser therapy – for inpatients 860 510 430 430
14 PYLWDIP Physiotherapy - long wave diathermy – for inpatients 860 510 430 430
15 PYMPDIP Physiotherapy - microwave / pulsed 860 510 430 430
diathermy - for inpatients
16 PYMHPCIP Physiotherapy - moist hot packs / 670 330 260 260
cryotherapy - for inpatients
17 PYTMIDT Physiotherapy - more than 3 modalities ( 10 8120 4860
days package ) - outpatients
18 PY3MIP Physiotherapy - more than three modalities 1360 1010 510 510
- for inpatients
19 PYPWBIP Physiotherapy - paraffin wax bath – for inpatients 670 330 260 260
20 PYSWDIP Physiotherapy - short wave diathermy – for inpatients 670 330 260 260
21 PYTTTIP Physiotherapy - tilt table therapy – for inpatients 770 510 430 430
22 PYUTIP Physiotherapy - ultrasonic therapy – for inpatients 610 330 260 260
23 PYPCCD Physiotherapy package charge following 2370 1530 940 940
caesarean delivery / Surgery
24 PYPCND Physiotherapy package charge following 1530 940 670 670
normal delivery
Physiotherapy Opd Tests Charges
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
SNo Code Description Suite
25 PHYANC5 ANTE NATAL CLASS PACKAGE (FIVE VISITS) 2800 1600

26 BSOP7 Balance System ( Outpatient Physiotherapy) - 7 Visits 4220 2540
27 BSOP1 Balance System ( Outpatient Physiotherapy) - Single Visit 670 410
28 BUSOP14 Biodex Unweighing System ( Outpatient 8470 5070
Physiotherapy ) - 14 Visits
Physiotherapy ) - Single Visit
32 CMPOP30 CPM ( Outpatient ) - 30 Visits 8470 5070
33 CMPOP14 CPM ( Outpatient Physiotherapy ) - 14 Visits 5070 3040
34 CMPOP7 CPM ( Outpatient Physiotherapy ) - 7 Visits 2540 1530
35 CMPOP1 CPM ( Outpatient Physiotherapy ) - Single Visit 430 260
36 EMGBIOOP EMG Biofeedback ( Outpatient 8470 5070
14 Physiotherapy ) - 14 Visits
1 Physiotherapy ) - Single Visit
40 PHYS10 Excercise-Short case Package - (10 day package) 3740 2310
41 PHYS5 Excercise-Short case Package - (5 day package) 1910 1190
42 GTOP14 Gait Trainer ( Outpatient Physiotherapy ) -14 Visits 8470 5070
43 GTOP30 Gait Trainer ( Outpatient Physiotherapy ) -30 Visits 16910 10150
44 GTOP7 Gait Trainer ( Outpatient Physiotherapy ) – 7 Visits 4220 2540
45 GTOP1 Gait Trainer ( Outpatient Physiotherapy ) -Single Visit 670 410
189
46 PHYTAPE Kineso Taping 300 180
47 CAOTH Occupational Therapy - Consultation and Asssessment 1010 610 330 330 610 330
48 LEXOTHE Occupational Therapy - Long Exercise 1010 860 510 510 860 510
49 SEXOTHE Occupational Therapy - Short Exercise 860 430 260 260 430 260
50 PHYANC4 Physiotheraphy Antenatal Classes ( 5 Visits ) 3000 1900
51 PHYANC1 Physiotheraphy Antenatal Classes ( Per Visit) 700 430
52 PYCASOP Physiotherapy - consultation and 670 410
assessment charges - outpatients
53 PY3MOP Physiotherapy - more than three modalities- 940 550
outpatients
54 PHYELOPD Physiotherapy exercise (long) - outpatients 700 430
55 PHYESOPD Physiotherapy exercise (short) - outpatients 430 260
56 PHYFSMOD Physiotherapy first & second modality -outpatients 630 380
57 PHYFSMOD Physiotherapy first & second modality ( 10 6000 3600
10 day package ) - outpatients
58 PHYFMOD Physiotherapy first modality - outpatients 350 220
59 PHYFMOD1 Physiotherapy first modality ( 10 day package ) - 3050 1830
0 outpatients
60 PHYFSTMO Physiotherapy first, second & third modality- 880 520
D outpatients
61 PHYFSTMO Physiotherapy first, second & third modality 6800 4400
D10 ( 10 day package ) - outpatients
62 PHYCBCOS Physiotherapy charges for Care of back clinic
PHYCONCBC Physiotherapy Care of back clinic - consultant charges
610
PHYCHA Physiotherapy speciality clinic - department charges
610 430
63 PHYHCOS Physiotherapy charges for Hand clinic
PHYCONHC Physiotherapy Hand Clinic - consultant charges
610
PHYCHA Physiotherapy speciality clinic - department charges 610 430
64 PHYNBLSCO Physiotherapy first,second & third modality -
S Treatment for Neck & Back (LS)
PHYNSHOSC Physiotherapy first,second & third modality - Treatment for 1330
Neck & Back (LS) - Hospital Charges
PHYNSHC Physiotherapy first,second & third modality - Treatment for
800
Neck & Back (LS) - Professional Charges
65 PHYSPCLCH Physiotherapy charges for Rheumatoid arthritis clinic

PHYCON Physiotherapy - Rheumatoid arthritis clinic – consultant charges
610
PHYCHA Physiotherapy speciality clinic - department charges
610 430
Physiotherapy Package
Single Bed
Premium/
2 Bedded
4 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Suite

66 PHYELOPD1 Physiotherapy exercise (long) - outpatients 6450 3950
0 - ( 10 day package )
67 PHYELOPD5 Physiotherapy exercise (long) - outpatients 3210 1930
- ( 5 day package )
Health Check-up Program
EHCCOMPOS Add on for EHC - Comprehensive Breast Imaging Package

ADDEHC2D3DM Add on for EHC - Advanced 1160
BRULTMAM Breast Ultrasound ( Mammography )
190
Comprehensive breast imaging package bilateral (2D + 3D Mammography +
MMCOBR2D3DMRI Breast MRI) - MRI Department Charges 13230
MMCOBR2D3D Breast MRI) - X-Ray Department Charges 3970
ADDEHCCOMPOS Add on for EHC - Comprehensive Breast Imaging Package - Complete
EHCCOMPLETE Add on for Eexecutive Health - Complete 1620
MBRANGS BRCA 1 and 2 gene analysis (BY NGS) 34730
MMCOBR2D3DMRI Breast MRI) - MRI Department Charges 13230
MMCOBR2D3D Breast MRI) - X-Ray Department Charges 3970
ADDR2DMOS Add on for EHC - Routine (2D Mammography) - Basic
ADDEHC Add on for EHC - Basic 590
MAMMOP Mammography (bilateral) ( Xray dept charges ) 2320
ADDEHCTOMOS Add on for EHC - Tomosynthesis ( 2D + 3D Mammography ) - Advanced
ADDEHC2D3DM Add on for EHC - Advanced 1160
MAMMBT3D Breast Tomosynthesis (3D Mammography) 3970
HCP-CCC Comprehensive Cardiac Check-up with TMT & ECHO ( Package ) 6840
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
EHCINFSHEOS EHC - INFECTION SCREENING ( Female ) 4420
CBC CBC - Complete blood count
EHCIS EHC - Infection Screening
ECHPATHC EHC - Patient handling charges
GTT6 Glucose F + Glucose PP ( 75 g Glucose )
HBSAG HBsAg ( Australia antigen )
HCV Hepatitis C virus serology antibody test
HIV HIV antibody test
RCULTUREVAS Routine culture and sensitivity ( Vaginal swab )
VDRL RPR
EHCINFHEOS EHC - INFECTION SCREENING ( Male ) 4420
EHCIS EHC - Infection Screening
RCULTUREURSW Routine culture and sensitivity ( Uretheral Swab )
VDRL RPR
EHCOSTEOS EHC - OSTEOPOROSIS PLAN 11880
25OHVIT 25-OH VIT D Level (Nuclear RIA)
ALKP Alkaline Phosphatase ( ALP )
ANTICPP Anti CCP ( Immunoscan R A )
CALC Calcium
191
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
VB12 Vitamin B 12 ( B12 )
EHCPREPACOBOS EHC - PRE/PAC OBESITY SURGERY 24480
PEPTIDE C - Peptide Test
CPST Coagulation profile screening (PT / APTT/ TT / CBC / PS )
EHCPREPOBSUR EHC - Preop/Pac obesity surgery
FERI Ferritin
FACID Folic Acid
GLYCOHA Glycosylated Haemoglobin ( HbA1c )
INSULINFPP Insulin Level ( Fasting + PP )
LIPP Lipid Profile
RENPI Renal Biochemical Profile - Basic (BUN,Creat,Ca,PO4,Na,K,Bicarbonate,Cl)
FSH Serum FSH ( Random )
IRON Serum Iron
LH Serum LH ( Random )
SPROLAC Serum Prolactin
SPIROM Spirometery
SECHOOS Stress Echo (Echo Deparment)
T3T4TSH Thyroid Profile ( T3, T4, TSH )
URIA Uric Acid
CHAP Xray chest AP
EHCVITPOS EHC - VITAMIN PROFILE 4470
EHCVTP EHC - Vitamin Profile
FACID Folic Acid
EHCPLSOS EHC -POLYCYSTIC OVARIAN SYNDROME/ACNE 9800
DHEAS Dehydroepiandrosterone Sulfate ( DHEA-S )
EHCPOSA EHC - Polycystic Ovarian Syndrome/Acne
LIPP Lipid Profile
TESTF Testesterone (Free)
TESTT Testesterone (Total)
EHCOBOS EHC- Screening for obesity 10730
PEPTIDE C - Peptide Test
EHCSCOB EHC - Obesity
INSULINFPP Insulin Level ( Fasting + PP )
LIPP Lipid Profile
192
LH Serum LH ( Random )
URIA Uric Acid
HCP-CC Executive Health Check-up with TMT ( Package ) 5090
BUN BUN
HCP3 Executive Health Check-up
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
URIA Uric Acid
HCPBJFOS HCP - BONE & JOINT CONSULTATION FEMALE 11070
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
HCPBJMOS HCP - BONE & JOINT CONSULTATION MALE 9740
CALC Calcium
EHCBJC EHC - Bone & Joint Consultation
PHOS Phosphorus
PTH PTH Level
RF Rheumatoid factor - RF ( blood )
URIA Uric Acid
HCPWOMENOS HCP - HEALTH CHECKS FOR WOMEN 11940
CA125 CA 125
EHCHCWOM EHC - Health checks for women
HPVDNAH HPV-DNA ( High Risk ) Cervical Sample
LIPP Lipid Profile
193
Renal Biochemical Profile - Complete (BUN,Creat,Ca,PO4,Na,K,RBS,Uric,Prot,Alk
RENPP PO4,Cholest,Bicarbonate,Cl)
LBC Vaginal / cervical cytology by liquid base cytology ( LBC )
CHAP Xray chest AP
HCPMHCOS HCP - MALE HEALTH CHECKUP 15070
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
URIA Uric Acid
HCP1 Whole Body Check-up
HCPMENOPOS HCP - MENOPAUSAL PLAN 21630
CA125 CA 125
CALC Calcium
BD2 DEXA Three Site bone densitometry
EHCMENP EHC - Menopausal Plan
GLUR Glucose Random
MAMMOP Mammography (bilateral) ( Xray dept charges )
PHOS Phosphorus
OESTR Serum Oestradiol ( E2 ) - Random
CHOL Total Cholesterol
EHCCCIEOS HCP - ROUTINE MEDICAL CHECK UP (CCIE) 1560
BUN BUN
GLUF Glucose F
GLUP Glucose PP
194
HCP2 Routine Medical Check-up
HCPTHYOS HCP - THYROID PLAN 5460
EHCTHY EHC - Thyroid Plan
T3T4 Free T3 / Free T4
TANTIBODIES Thyroid Antibodies - Nuclear Medicine
TSH TSH (Nuclear)
SPT Ultrasound thyroid
EHCMIGROS HEADACHE/MIGRANE - EXECUTIVE HEALTH CHECKUP 6330
CTHP CT head (plain)
EHCHMIG EHC - Headache/Migrane
TSH TSH (Nuclear)
EHCHYPEROS HYPERTENSION PROFILE - EXECUTIVE HEALTH CHECKUP 7680
EHCHP EHC - Hypertension profile
LIPP Lipid Profile
EHCNEUROS NEUROPATHY PROFILE- EXECUTIVE HEALTH CHECKUP 7470
EHCNEUP EHC - Neuropathy Profile
NCV NCV / NCS ( Nerve conduction velocity / study )
HCP-PRC Pre employment checkup ( Package ) 920
GLUR Glucose Random
HCP6 Pre Employment Check-up
EHCLUNGOS PULMONARY (CHEST) CHECK UP - EXECUTIVE HEALTH CHECKUP 11560
SGPT ALT / SGPT
SGOT AST / SGOT
BUN BUN
EHCLH EHC - Lungs & Heart Check ups
IGE Immunoglobulin E ( IgE )
SPIROM Spirometery
STOOLRE Stool examination ( Routine / Microscopy )
195
CHAP Xray chest AP
PNSWAT Xray paranasal sinus Waters view
HCP-RMC Routine Medical Check-up ( Package ) 1740
BUN BUN
GLUF Glucose F
GLUP Glucose PP
HCP2 Routine Medical Check-up
HCP-SRCF Sr. Citizen Health Check-up ( Package for female ) 3590
BUN BUN
GLUF Glucose F
GLUP Glucose PP
HCP5 Sr. Citizen Health Check-up
URIA Uric Acid
HCP-SRC Sr. Citizen Health Check-up ( Package for male ) 3130
BUN BUN
GLUF Glucose F
GLUP Glucose PP
HCP5 Sr. Citizen Health Check-up
URIA Uric Acid
HCP-IRCTCF Whole body check-up IRCTC ( Package for Female ) 12130
BUN BUN
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
SPIROM Spirometery
196
URIA Uric Acid
HCP-IRCTC Whole body check-up IRCTC ( Package for male ) 11030
BUN BUN
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
SPIROM Spirometery
URIA Uric Acid
HCP-WBCM Whole body check-up with TMT and ECHO ( Package for male ) 10310
BUN BUN
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
SPIROM Spirometery
URIA Uric Acid
HCP-WBCF Whole body check-up with TMTand ECHO ( Package for female ) 9260
BUN BUN
GLUF Glucose F
GLUP Glucose PP
197
LIPP Lipid Profile
SPIROM Spirometery
URIA Uric Acid
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 220
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

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
198
19 GOPDC General OPD registration (Rs.20) 20
20 GOPDSCONS General OPD Sticker alone ( NO CHARGE ) 0
21 HOMCARD Homeopathy opd registration charges (Registration ONLY) 50
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 ER Smart Card Sticker Only 25
Telephone charges

27 TCP Telephone charges from patients 5
FOB usage charges

1 AMBUVIDEOS Ambu Videoscope - Equipment Charges 4860
2 CMACOS C-mac ( Equipment Charges + Procedure charges ) 1500
3 FOBCOS Fibre Optic Bronchoscopy ( FOB ) - ( Equipment 2550
Charges + Procedure charges )
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 Charges 220
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)
11 FOBDLT FOB - Equipment Charges 1550
Medical monitor usage charges
12 CFM Cerebral Brain Functioning 1000 780 490
13 PCRMC Paediatric cardio-respiratory monitor charges 1660 830 610 440
14 PPOC Paediatric pulse oximetry charges 1330 670 470 350
15 TCO2 Transcutaneous CO2 Monitor 1220 1100 1000
Nebulisation charges
16 PNEBC Nebulisation charges 170 100 170
199
NIGS usage charges
17 NIGSUCH Navigation image guide system (NIGS) 4080
Usage Charges
Nitric Oxide Therapy

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

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

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

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

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

30 UROURSD f URS (d) - Ureteroscope usage charges 30000
31 UROVIDEO Video f URS - Ureteroscope usage 35000
FURS charges
32 UROVIDEO Video f URS - Ureteroscope usage 20000
RE charges (Reuse)
Ventilator charges
33 BIPAPUCH Bipap usage charges per day - Adult 2820
34 PVCICU Paediatric ventilator usage charges per 2580
day (in PICU / NNU)
35 MICROVEN TCHR Ventilator usage charges per day - Adult 2810
Bedside Procedure
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1 AFGEDHC AUTOPSY FOR FOETAL GENETIC EVALUATION
AFGEDF Autopsy for foetal genetic evaluation -Doctor fee 19580 19580 9790 7830 5870
AFGEHC Autopsy for foetal genetic evaluation -hospital charges 1960 1960 980 780 590
2 AKAEPCA Above knee /above elbow plaster cast
OS application (Doctor fee + Hospital Charges)
AKAEPCADF Above-knee / above-elbow plaster cast 10600 10600 5300 4240 3180 5300 3180
application - Doctor Fees
AKAEPCABSP Above-knee / above-elbow plaster cast 1060 1060 530 420 320 530 320
application - Hospital Charges
200
3 BBDHCOS BEDSIDE FLEXIBLE BRONCHOSCOPY
BRONHC Bedside bronchoscopy - Additional hospital charges 1710 1710 860 680 510
BRONDF Bedside bronchoscopy - Doctor fees 17100 17100 8550 6840 5130
4 BEDFIOPL Bedside fibreoptic laryngoscopy
AOS (Doctor fee + Hospital charges)
OP1000 Fibreoptic laryngoscopy 8120 8120 4060 3250 2440
FIBOPTLARHC Fibreoptic Laryngoscopy - Hospital charges 810 810 410 330 240
5 BIDDHCO BEDSIDE INCISION & DRAINAGE
S (DOCTOR FEE + HOSPITAL CHARGES)
IDDF Bedside incision & drainage - Doctor fees 13300 13300 6650 5320 3990
IDHC Bedside incision & drainage - Additional 1330 1330 670 530 400
hospital charges
6 BKBEPCA Below-knee / Below-elbow
OS plaster cast application -
(Doctor fee + Hospital Charges)
BKBEPCPDF Below-knee / Below-elbow plaster cast 7840 7840 3920 3140 2350
application - Doctor Fees
BKBEPCPBSP Below-knee / Below-elbow plaster cast 780 780 390 310 240
application - Hospital Charges
7 BLIGOS Band ligation of haemorrhoids
( bedside )
BLIGDC Band ligation of haemorrhoids ( bedside ) - 14220 14220 7110 5690 4270
doctor charges
BLIGHC Band ligation of haemorrhoids ( bedside ) - 1420 1420 710 570 430
Hospital charges
8 BMADHC BONE MARROW ASPIRATION
BMAHC Bone marrow aspiration - Additional 740 740 370 300 220
hospital charges
BMADF Bone marrow aspiration - Doctor fees 7440 7440 3720 2980 2230
9 BMBADH BONE MARROW BIOPSY + ASPIRATION
COS (DOCTOR FEE +HOSPITAL CHARGES)
BMBAHC Bone marrow biopsy & aspiration - 1330 1330 670 530 400
BMBADF Bone marrow biopsy & aspiration – Doctor fees 13300 13300 6650 5320 3990
10 BMBDHC BONE MARROW BIOPSY (DOCTOR FEE
OS + HOSPITAL CHARGES)
BMBHC Bone marrow biopsy - Additional hospital charges 980 980 490 390 290
BMBDF Bone marrow biopsy - Doctor fees 9780 9780 4890 3910 2930
11 BOmAHA Bone marrow harvesting
ROS (Doctor fee + Hospital charges)
BOMARHARD Bone marrow harvesting - doctor fee (if 51680 51680 25840 20670 15500
F done bedside)
BOMAHARHC Bone marrow harvesting - hospital charges 5170 5170 2580 2070 1550
(if done bedside)
12 BOMATRB Bone Marrow Transplantation
EDOS (Doctor fee + Hospital Charges)
BOMATRBED Bone marrow transplantation procedure - 234920 234920 117460 93970 70480
doctor fee (if done bedside)
BOMATRHC Bone marrow transplantation procedure - 23490 23490 11750 9400 7050
hospital charges (if done bedside)
13 BSSDHCO BED SIDE SUTURING (DOCTOR
S FEE + HOSPITAL CHARGES)
BSSDF Bed side suturing - Doctor fees 6460 6460 3230 2580 1940
BSSHC Bed side suturing - Hospital Charges 650 650 320 260 190
14 BWDLOS Burn wound dressing LARGE -
Bedside Procedure
OP1318 Burn wound dressing ( large ) 47320 47320 23660 18930 14200
BWDLBSP Burn wound dressing large – Bedside charges 4730 4730 2370 1890 1420
201
15 BWDMIO Burn wound dressing MINOR -
S Bedside Procedure
OP1316 Burn wound dressing ( minor ) 18960 18960 9480 7580 5690
BWDMIBSP Burn wound dressing minor – Bedside charges 1900 1900 950 760 570
16 BWDMOS Burn wound dressing MEDIUM
- Bedside Procedure
OP1317 Burn wound dressing ( medium ) 28400 28400 14200 11360 8520
BWDMBSP Burn wound dressing medium – Bedside charges 2840 2840 1420 1140 850
17 CENTDIAL ICU-Central Venous Line/Dialysis
OS Catheter Insertion - (Doctor Fee+
Hospital Charges)
CENTDIALDF ICU-Central Venous Line/Dialysis Catheter 21000 21000 10500 8400 6300
Insertion - Doctor Fee
CENTDIALHC ICU-Central Venous Line/Dialysis Catheter 2100 2100 1050 840 630
Insertion - Hospital Charges
18 COMDHC CARDIAC OUTPUT MONITORING BY
OS THORACIC BIO-IMPEDANCE METHOD
COMTBIDF Cardiac output monitoring by thoracic 22340 22340 11170 8940 6700
bio-impedance method - Doctor fee
COMTBIHC Cardiac output monitoring by thoracic 2230 2230 1120 890 670
bio-impedance method - hospital charges
19 CVLIDFHC CENTRAL VENOUS LINE INSERTION
OS (DOCTOR FEE +HOSPITAL CHARGES)
CVLIHC Central venous line insertion - Additional 1170 1170 590 470 350
hospital charges
CVLIDF Central venous line insertion - Doctor fees 11740 11740 5870 4700 3520
USCCVLI Central Venous Line Insertion - Ultrasound 230
Machine Usage Charges
20 DEBLARW Debridement ( large ) in ward
DOS (Doctor fee + Hospital charges)
DEBRIDEMEN TLH Debridement ( large ) in ward – hospital charges 2860 2860 1430 1140 860
DEBRIDEMEN TL Debridement ( large ) in ward - doctor fee 28580 28580 14290 11430 8570
21 DEBMED Debridement ( medium ) in ward
WDOS (Doctor fee + Hospital Charges)
DEBRIDEMEN TM Debridement ( medium ) in ward – doctor fee 19000 19000 9500 7600 5700
DEBRIDEMENTMH Debridement ( medium ) in ward – hospital charges 1900 1900 950 760 570
22 DEBSMW Debridement ( small ) in ward
D (Doctor fee + Hospital charges)
DEBRIDEMEN T Debridement ( small ) in ward - doctor fee 9360 9360 4680 3740 2810
DEBRIDEMEN TS Debridement ( small ) in ward – hospital charges 940 940 470 370 280
23 DMDFHC DRESSING IN WARD / DRESSING
HOS ROOM ( MAJOR ) (DOCTOR FEE +
HOSPITAL CHARGES)
DWDMJAHC Dressing in ward / dressing room ( Major ) - 1220 1220 610 490 370
DWDMJDF Dressing in ward / dressing room ( Major ) -Doctor fee 12220 12220 6110 4890 3670
24 DMIPDHC DRESSING IN WARD /DRESSING ROOM
DWDMIAHC Dressing in ward / dressing room - 670 670 340 270 200
DWDMIDF Dressing in ward / dressing room – Doctor fee 6720 6720 3360 2690 2020
25 DOCHERE HIGH DOSE CHEMOTHERAPY AND
OS RESCUE (Doctor fee +Hospital Charges)
DOREDOCF HIGH DOSE CHEMOTHERAPY AND RESCUE - 234920 234920 117460 93970 70480
Doctor Fee
HIDORFEOS HIGH DOSE CHEMOTHERAPY AND RESCUE - 23490 23490 11750 9400 7050
Hospital Charges
27 ECMODOS ECMO DIALY charges
ECMOPLSDDF ECMO DAILY charges - Doctors fees 23160 23160 11580 9260 6950
ECMODHC ECMO DAILY charges - Hospital Charges 2320 2320 1160 930 700
202
28 ECMOPLS ECMO initiation charges (inlcudes PLS
OS circuit & ECMO cannula)
ECMOPLSDF ECMO initiation charges (includes PLS circuit 57890 46310 34730
and ECMO cannul ) - Doctors fees
ECMOPLSHC ECMO initiation charges (includes PLS circuit 289410 289410 289410
and ECMO cannul ) - Hospital Charges
29 EPANLAB Epidural analgesia for labour
OS patients
EAFLPDF Epidural analgesia for labour patient - Doctor fees 9640 9640 4820 3860 2890
EAFLPHC Epidural analgesia for labour patient -Hospital charges 960 960 480 390 290
30 FANCDFH Needle biopsy / FNAC (Doctor
CHOS fee + Hospital charges)
FNACHC FNAC / Needle biopsy - Additional hospital charges 650 650 320 260 190
FNACDF FNAC / Trucut needle biopsy - Doctor fees 6460 6460 3230 2580 1940
31 HSSTDHC HORMONAL STIMULATION
HOS SUPPRESSION TEST (DOCTOR
HSSTHC Hormonal stimulation suppression test - 620 620 310 250 190
HSSTDF Hormonal stimulation suppression test - 6160 6160 3080 2460 1850
Doctor fees
32 IAIDHCHO INTRA ARTICULAR INJECTIONS OF
S STEROIDS / HYALURONIDASE INTO
SMALL JOINT (DOCTOR FEE +
HOSPITAL CHARGES)
IAISSJHC Intra articular injections of steroids /hyaluronidase into 350 350 180 140 110
small joint - Additional hospital charges
IAISSJDF Intra articular injections of steroids / 3520 3520 1760 1410 1060
hyaluronidase into small joint - Doctor fees
33 IAISHDHC INTRA ARTICULAR INJECTIONS OF
HOS STEROIDS / HYALURONIDASE INTO
LARGE JOINT (DOCTOR FEE +
HOSPITAL CHARGES)
IAISLJHC Intra articular injections of steroids /hyaluronidase into 590 590 290 240 180
large joint - Additional hospital charges
IAISLJDF Intra articular injections of steroids / 5880 5880 2940 2350 1760
hyaluronidase into large joint - Doctor fees
34 ICDIDHCH INTERCOSTAL CHEST TUBE (
OS ICD ) INSERTION (DOCTOR FEE
+ HOSPITAL CHARGES)
ICDHC Intercostal chest tube ( ICD ) insertion - 1650 1650 820 660 490
ICDDF Intercostal chest tube ( ICD ) insertion -Doctor fees 16460 16460 8230 6580 4940
35 ICDTTCOS ICD / Trachostomy tube
change IN WARD (DOCTOR FEE
+ HOSPITAL CHAGES)
ICDTCDF ICD / Trachostomy tube Change IN WARD (Doctor fees) 4300 4300 2150 1720 1290
ICDTCHC ICD / Trachostomy tube Change IN WARD 430 430 220 170 130
(Hospital Charges)
36 INJSCLOS Injection sclerotherapy of
haemorrhoids / piles ( bedside)
INSCHDF Injection sclerotherapy of haemorrhoids / 13540 13540 6770 5420 4060
piles ( bedside) - Doctor charges
INJSCLHAHC Injection sclerotherapy of haemorrhoids / 1350 1350 680 540 410
piles ( bedside) - Hospital charges
37 IVPCOS IV / Peripheral cannulation IN WARD
(DOCTOR FEE +HOSPITAL CHAGES)
IVPCDF IV / Peripheral cannulation IN WARD (Doctor fees) 3820 3820 1910 1530 1150
IVPCHC IV / Peripheral cannulation IN WARD(Hospital Charges) 380 380 190 150 120
38 JALDHCOS JOINT ASPIRATION ( LARGE ) (DOCTOR
JALHC Joint aspiration ( large ) - Additional hospital charges 650 650 320 260 190
JALDF Joint aspiration ( large ) - Doctor fees 6460 6460 3230 2580 1940
203
39 JASDHCH JOINT ASPIRATION ( SMALL ) (DOCTOR
JASHC Joint aspiration ( small ) - Additional hospital charges 420 420 210 170 130
JASDF Joint aspiration ( small ) - Doctor fees 4160 4160 2080 1660 1250
40 KBDHCHO KIDNEY BIOPSY (DOCTOR FEE +
S HOSPITAL CHARGES)
KBHC Kidney biopsy - Additional hospital charges 1760 1760 880 710 530
KBDF Kidney biopsy - Doctor fees 17640 17640 8820 7060 5290
41 LBDHCHO LIVER BIOPSY (DOCTOR FEE +
S HOSPITAL CHARGES)
LBHC Liver biopsy - Additional hospital charges 1540 1540 770 620 460
LBDF Liver biopsy - Doctor fees 15440 15440 7720 6180 4630
42 LPCSFDHC LUMBAR PUNCTURE/ CSF ASPIRATION
LPCSFDF Lumbar Puncture / CSF aspiration – Doctor fees 9360 9360 4680 3740 2810
LPCSFHC Lumbar Puncture / CSF aspiration – hospital charges 940 940 470 370 280
43 LSBOS Lumbar sympathetic block -
OP0864 Lumbar sympathetic block 16540 16540 8270 6620 4960
LSBBSP Lumbar sympathetic block - Additional 1650 1650 830 660 500
Hospital Charges
44 MEFOS Manual evacuation of faeces
MEFDF Manual evacuation of faeces – Doctor charges 13160 13160 6580 5260 3950
MEOFHC Manual evacuation of faeces – Hospital charges 1320 1320 660 530 400
45 MNBDHC MUSCLE / NERVE BIOPSY ( BEDSIDE )
HOS (DOCTOR FEE + HOSPITAL CHARGES)
MNBAHC Muscle / nerve biopsy ( bedside ) - 1170 1170 590 470 350
MNBDF Muscle / nerve biopsy ( bedside ) – Doctor fee 11740 11740 5870 4700 3520
46 NMECHOS Neuro Monitoring Charges
NMECH Neuro Monitoring Electrode charges 18290
NMEQCH Neuro Monitoring Euipment charges 1830
47 NOSOS Nitrous Oxide Sedation
NOSCON Nitrous Oxide Sedation - Consumables 1400
NOSDF Nitrous Oxide Sedation - Doctor fee 7840 7840 3920 3140 2350
NOSHC Nitrous Oxide Sedation - Hospital charges 780 780 390 310 240
48 NPDWDH NASAL PACKING ( DONE IN WARD )
NPAHC Nasal packing ( done in ward ) - Additional 1140 1140 570 460 340
hospital charges
NPDF Nasal packing ( done in ward ) - Doctor fee 11380 11380 5690 4550 3410
49 OIBOS Oral Incisional biospy (bedside)
- Doctor fee + Hospital service charges
OP1001 Oral incisional biopsy 10500 10500 5250 4200 3150
OIBBSP Oral incisional biopsy - Hospital service charges 1050 1050 530 420 320
50 OSBGSAM BLOOD GAS SAMPLING (DOCTOR FEE +
PL HOSPITAL CHARGES)
DOCCHBGSA MP Charges for taking blood gas sample -doctor charges 5700 5700 2850 2280 1710
BSPCHBGSAM P Charges for taking blood gas sample -Hospital charges 570 570 290 230 170
51 OSVTAP Ventricular Tapping (bedside
procedure) (DOCTOR FEE +
HOSPITAL CHARGES)
HCVTAP Ventricular Tapping ( Bedside Procedure ) - 1890 1890 950 760 570
Hospital charges
DOCHVTAP Ventricular Tapping ( Bedside Procedure ) 18940 18940 9470 7580 5680
Doctor charges
52 PACCLOS PULMONARY ARTERY CATHERISATION
( SWAN GANZ) IN CATH LAB
PACCLC Pulmonary artery catheterisation ( Swan 9780 9780 4890 3910 2930
ganz ) - Cath lab charges
PACDF Pulmonary artery catheterisation ( Swan 20380 20380 10190 8150 6110
Ganz ) - Doctor fee
204
53 PACOS PULMONARY ARTERY CATHERISATION
( SWAN GANZ) - BEDSIDE
PACAHC Pulmonary artery catheterisation ( Swan 2040 2040 1020 820 610
Ganz ) - Additional hospital charges
Ganz ) - Doctor fee
54 PAEDECM Paediatric ECMO Monitoring Charges
ODOS (Doctors fees + Hospital Charges)
PAEDECMODF Paediatric ECMO Monitoring - Doctors fees 23160 23160 11580 9260 6950
PAEDECMOHC Paediatric ECMO Monitoring – Hospital Charges 2320 2320 1160 930 700
55 PASPDHC PERICARDIAL TAPPING / ASPIRATION
HOS (DOCTOR FEE +HOSPITAL CHARGES)
PADF Pericardial aspiration - Doctor fees 11380 11380 5690 4550 3410
PAHC Pericardial aspiration- hospital charges 1140 1140 570 460 340
56 PEPCLOS Pocket for endocardial pacemaker
under GA in Cath lab
PEPCLAF Pocket for endocardial pacemaker under GA 17610 17610 8810 7040 5280
in Cath lab - Anaesthetists charges
PEPCLCF Pocket for endocardial pacemaker under GA 28180 28180 14090 11270 8450
in Cath lab - Cath Lab Charges
PEPCLSF Pocket for endocardial pacemaker under GA 58700 58700 29350 23480 17610
in Cath lab - Surgeon fee
57 PERTDFHC Enzyme therapy infusion (Doctor Fee +
Hospital Charges )
PERTDF Enzyme therapy infusion - Doctor fee 8640 8640 4320 3460 2590
PERTHF Enzyme therapy infusion - Hospital charges 860 860 430 350 260
58 PGHDFHC Growth hormone stimulation test (
Doctor fee + Hospital Charges )
PGHDF Growth hormone stimulation test – Doctor fee 8640 8640 4320 3460 2590 4320 3340
PGHHC Growth hormone stimulation test – Hospital charges 860 860 430 350 260 430
59 PGSDDFH Glycogen storage disease stimulation
C test ( Doctor fee +Hospital charges )
PGSDDF Glycogen storage disease stimulation test (Doctor fee ) 8640 8640 4320 3460 2590 4320 3340
PGSDHC Glycogen storage disease stimulation test (Hospital 860 860 430 350 260 430
charges )
60 PHLDHCO Phlebotomy (Doctor fee +
S Hospital charges)
PHLHC Phlebotomy - Additional hospital charges 780 780 390 310 240
PHLDF Phlebotomy - Doctor fees 7840 7840 3920 3140 2350
61 PIVGDFHC IVIG therapy ( Doctor fee +
Hospital Charges )
PIVGDF IVIG therapy - Doctor Fee 8640 8640 4320 3460 2590 4320 3340
PIVGHC IVIG therapy - Hospital charges 860 860 430 350 260 430
62 PLEDCHC PLEURODESIS - BEDSIDE UNDER LA
PLEHC Pleurodesis - Additional hospital charges 620 620 310 250 190
PLEDF Pleurodesis - Doctor fees 6160 6160 3080 2460 1850
63 PLGAOS Pleurodesis - Bedside under GA
PLGAAF Pleurodesis - Bedside under GA -Anaesthetists charges 1540 1540 770 620 460
PLGAHF Pleurodesis - Bedside under GA – Hospital service charges 620 620 310 250 190
PLGASF Pleurodesis - Bedside under GA – Surgeon fee 6160 6160 3080 2460 1850
64 PMINBOS Pulse monitoring infusion - Non Biological -
PMINBDF Pulse monitoring infusion - Non Biological - 2590
Doctor fee
PMINBHC Pulse monitoring infusion - Non Biological - 260
Hospital charges
65 PMIOS Pulse monitoring infusion -
Biological - Doctor fee
PMIDF Pulse monitoring infusion - Biological - 6300
Doctor fee
PMIBHC Pulse monitoring infusion - Biological - 630
Hospital charges
205
66 PPDAOS Premie PDA clipping under GA-
Bedside
PPDAAF Premie PDA clipping - Bedside under GA - 52820 52820 26410 21130 15850
Anaesthetists charges
PPDAHF Premie PDA clipping - Bedside under GA - 17610 17610 8800 7040 5280
Hospital service charges
PPDASF Premie PDA clipping - Bedside under GA - 176080 176080 88040 70430 52820
Surgeon fee
67 PPDFHC Pamidronate infusion ( Doctor
fee + Hospital Charges )
PPDF Pamidronate infusion - Doctor Fee 5520 5520 2760 2210 1660
PPHC Pamidronate infusion - Hospital charges 550 550 280 220 170
68 PULPUSO Pigtail placement under usg
S guidance - PULMONOLOGY
PULPUSGDF Pigtail placement under usg guidance - 16220 16220 8110 6490 4870
Pulmonology Doctor Fee
PULPUSHC Pigtail placement under usg guidance - 1620 1620 810 650 490
Pulmonology Hospital Charges
69 PULULTR Screening ultrasound of thorax
AOS - PULMONOLOGY
PULULTRADF Screening ultrasound of thorax - 2320 2320 1160 930 700
PULULTRAHC Screening ultrasound of thorax - 230 230 120 90 70
70 PULUSGO Intercoastal tube drainge under usg
S guidance -PULMONOLOGY
PULUSGDF Intercoastal tube drainge under usg 16220 16220 8110 6490 4870
guidance - Pulmonology Doctor Fee
PULUSGHC Intercoastal tube drainge under usg 1620 1620 810 650 490
guidance - Pulmonology Hospital Charges
71 SCRULTD ICU-Screening ultrasound of Thorax/
VTOS DVT - (Doctor Fee + Hospital charges)
SCRULTDVTDF ICU-Screening ultrasound of Thorax/DVT - 4840 4840 2420 1940 1450
Doctor Fee
SCRULTDVTHC ICU-Screening ultrasound of Thorax/DVT - 480 480 240 190 150
Hospital Charges
72 SKBISHCH SKIN BIOPSY (DOCTOR FEE +
OS HOSPITAL CHARGES)
SBHC Skin biopsy - Additional hospital charges 650 650 320 260 190 320 190
SBDF Skin biopsy - Doctor fees 6460 6460 3230 2580 1940 3230 1940
73 SPCAOS Spica plaster cast application
SPCABSP Spica plaster cast application in ward - 1840 1840 920 740 550
Bedside Procedure Chargers
SPCADF Spica plaster cast application in ward - 18440 18440 9220 7380 5530
Doctor Fees
74 STADCHC SKULL TRACTION APPLICATION
STAAHC Skull traction application - Additional 1710 1710 850 680 510
hospital charges
STADF Skull traction application - Doctor fee 17080 17080 8540 6830 5120
75 TAALVDH Ascites tapping / aspiration done in WARD
COS ( therapeutic ) - large volume paracentesis
(doctor fee + hospital charges)
TAALVDF Therapeutic ascites aspiration ( large 6960 6960 3480 2780 2090
volume paracentesis ) - Doctor fees
TAALVHC Therapeutic ascites aspiration ( large volume 700 700 350 280 210
paracentesis ) done in WARD -
76 TAASVPD Ascites tapping / aspiration -
HCOS small volume paracentesis
(doctor fee + hospital charges)
TAASVHC Therapeutic ascites aspiration ( small volume 650 650 320 260 190
paracentesis ) - Additional hospital charges
TAASVDF Therapeutic ascites aspiration ( small 6460 6460 3230 2580 1940
206
77 TARLOCO Target localisation in MRI / CT for
S stereotactic surgery (Doctor fee +
Hospital charges + Equipment charges)
STEEQUUSECH Stereotactic equipment usage charges 12480 12480 6240 4990 3740
TARLOCDF Target localisation in MRI / CT for 35260 35260 17630 14100 10580
stereotactic surgery - doctor fee
TARLOCHC Target localisation in MRI / CT for 3530 3530 1760 1410 1060
stereotactic surgery - hospital charges
78 TBDHCHO TRACHEOSTOMY ( BEDSIDE ) (DOCTOR
TRACDF Tracheostomy ( bedside ) - Doctor fees 37960 37960 18980 15180 11390
TRACHC Tracheostomy ( bedside ) - hospital charges 3800 3800 1900 1520 1140
79 TIVSOPOS Total Intra Venous Sedation (
TIVS ) - OUTPATIENT
TIVSOP Total Intra Venous Sedation ( TIVS ) -OUTPATIENT 3920 2350
80 TIVSOS Total Intra Venous Sedation ( TIVS ) -
(Professional fee +Hospital charges)
TIVSDF Total Intra Venous Sedation ( TIVS ) – Doctor fee 7840 7840 3920 3140 2350
TIVSHC Total Intra Venous Sedation ( TIVS ) -Hospital Charges 780 780 390 310 240
81 TPADCHC THERAPEUTIC PLEURAL FLUID
OS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
TPADF Therapeutic pleural aspiration - Doctor fees 9060 9060 4530 3620 2720
TPFAHC Therapeutic pleural fluid aspiration - 910 910 450 360 270
82 TPNSONS TPN CONSULTATION CHARGES
ULTOS (DOCTOR FEE + HOSPITAL CHARGES)
TPNHOSCHRG TPN consultation - Additional hospital charges 380 380 190 150 120
TPNDOCFEE TPN consultation - Doctor fee 3820 3820 1910 1530 1150
83 TRCRNDO Transcranial doppler (doctor
POS fee + hospital charges)
TRCRNDOPDF Transcranial doppler - Doctor charges 7840 7840 3920 3140 2350 3400 2040
TRCRNDOPHC Transcranial doppler - Hospital service charges 780 780 390 310 240 1700 1020
84 UFCINOS Urinary Foleys catheterisation IN
WARD (Docter fee + Hospital Charges)
UFCIW Urinary foley's catheterisation – Hospital Charges 1050 1050 520 420 310
UFCINDF Urinary Foley's catheterisation in ward - Doctor Fees 10480 10480 5240 4190 3140
85 ULTRAICU ICU-Ultrasound guided pigtail/Inter
OS Costal Tube - (Doctor Fee + Hospital
Charges)
ULTRAICUDF ICU-Ultrasound guided pigtail/Inter Costal 16800 16800 8400 6720 5040
Tube - Doctor Fee
ULTRAICUHC ICU-Ultrasound guided pigtail/Inter Costal 1680 1680 840 670 500
Tube - Hospital Charges
86 VACBAS Vaccum assisted wound closure ( VAC)
application Bedside Procedure
VACBA Vaccum assisted would closure (VAC) 2840 2840 1420 1130 850
application Bedside Procedure Charges
OP3421 Vaccum assisted wound closure ( VAC ) application 28360 28360 14180 11340 8510
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 charges 860 860 430 340 260
AMDF Anorectal manometery - Doctor fees 2160 2160 1080 860 650
207
88 BRAPCOS Bronchoscopic tumor debulking (
Cautery / APC ) - (Doctor Fee +
Hospital Charges)
BRAPCDF Bronchoscopic tumor debulking ( Cautery / 34740 34740 17370 13900 10420
APC ) - Doctor Fee
BRAPCPACS Bronchoscopic tumor debulking ( Cautery / APC ) - For
PACS - NOT FOR BILLING PURPOSE
BRAPCHC Bronchoscopic tumor debulking ( Cautery / 13900 13900 6950 5560 4170
APC ) - Hospital Charges
89 BREBUSO Bronchoscopy + EBUS - (Doctor
S Fee + Hospital Charges)
BREBUSDF Bronchoscopy + EBUS - Doctor Fee 30700 30700 15350 12280 9210
BREBUSPACS Bronchoscopy + EBUS - For PACS - NOT FOR
BILLING PURPOSE
BREBUSHC Bronchoscopy + EBUS - Hospital Charges 12280 12280 6140 4910 3680
90 BRFBROS Bronchoscopic foreign body removal -
(Doctor Fee+Hospital Charges)
BRFBRDF Bronchoscopic foreign body removal -Doctor Fee 24000 24000 12000 9600 7200
BRFBRPACS Bronchoscopic foreign body removal - For
BRFBRHC Bronchoscopic foreign body removal -Hospital Charges 9600 9600 4800 3840 2880
91 BRGINJOS Bronchoscopic glue injection - (Doctor
BRGINJDF Bronchoscopic glue injection - Doctor Fee 25200 25200 12600 10080 7560
BRGINJPACS Bronchoscopic glue injection - For PACS -
NOT FOR BILLING PURPOSE
BRGINJHC Bronchoscopic glue injection – Hospital Charges 10080 10080 5040 4030 3020
92 BRONDHC BRONCHOSCOPY - Done in Endoscopy
BRONPACS BRONCHOSCOPY - Done in Endoscopy - For
BRONDFN Bronchoscopy (Done in endoscopy) – Doctor fees 15500 15500 7750 6200 4650
BRONENHC Bronchoscopy (Done in endoscopy)- 6200 6200 3100 2480 1860
93 BRONTHO Bronchial Thermoplasty Procedure
S ( Doctor Fee Hospital Charges )
BRONTHDOC Bronchial Thermoplasty Procedure – Doctor Fee 21000
BRONTHHOS Bronchial Thermoplasty Procedure - Hospital Charges 26250
94 BRTBSDO Tracheal/Bronchial stricture dilation -
S (Doctor Fee + Hospital Charges)
BRTBSDDF Tracheal/Bronchial stricture dilation -Doctor Fee 24000 24000 12000 9600 7200
BRTBSDPACS Tracheal/Bronchial stricture dilation - For
BRTBSDHC Tracheal/Bronchial stricture dilation -Hospital Charges 9600 9600 4800 3840 2880
95 BRTRSTOS Bronchoscopic tracheal/bronchial
stenting - (Doctor Fee + Hospital
Charges)
BRTRSTDF Bronchoscopic tracheal/bronchial stenting - 38320 38320 19160 15330 11500
Doctor Fee
BRTRSTPACS Bronchoscopic tracheal/bronchial stenting -
For PACS - NOT FOR BILLING PURPOSE
BRTRSTHC Bronchoscopic tracheal/bronchial stenting - 15340 15340 7670 6140 4600
Hospital Charges
96 DIATHOO Diagnostic Thoracoscopy with
S biopsy in Endoscopy Room -
DTHOR BIO Diagnostic Thoracoscopy with biopsy in 39140 39140 19570 15660 11740
Endoscopy Room Doctor fee
DIATHOPACS Diagnostic Thoracoscopy with biopsy in
Endoscopy Room - For PACS - NOT FOR
BILLING PURPOSE
DIATHORBIOH Diagnostic Thoracoscopy with biopsy in 15660 15660 7830 6260 4700
C Endoscopy Room - Hospital Charges
208
97 DNSEPOE Diagnostic nasal & sinus endoscopy /
COS postoperative endoscopic cleaning
DNSEPOECDF Diagnostic nasal & sinus endoscopy / 4200 4200 2100 1680 1260 2100 1260
postoperative endoscopic cleaning - Doctor fee
DNSEPOECHC Diagnostic nasal & sinus endoscopy /postoperative 210 130
endoscopic cleaning - hospital charges
98 EBUSOS EBUS - (Doctor Fee + Hospital Charges)
EBUSDF EBUS - Doctor Fee 23240 23240 11620 9300 6970
EBUPACS EBUS - For PACS - NOT FOR BILLING PURPOSE
EBUSHC EBUS - Hospital Charges 9300 9300 4650 3720 2790
99 IFSTKOS Intrapleural Fibronolysis with STK
(Doctor fee +Additional hospital charges)
INSTKA Intrapleural Fibronolysis with STK - 3660 3660 1830 1460 1100
IFSTKD Intrapleural Fibronolysis with STK – Doctor Fee 9120 9120 4560 3650 2740
100 MADHEO Medical thoracoscopy with
S Adhesiolysis ( Doctor fee +
Additional hospital charges )
MTHADI Medical thoracoscopy with Adhesiolysis - 20380 20380 10190 8150 6110
MADHED Medical thoracoscopy with Adhesiolysis -Doctor Fee 50940 50940 25470 20380 15280
101 MTHDOS Medical thoracoscopy
Diagnostic ( Doctor Fee +
Additional hospital charges )
MCTHA Medical thoracoscopy Diagnostic - 16440 16440 8220 6580 4930
MTHD Medical thoracoscopy Diagnostic – Doctor Fee 41100 41100 20550 16440 12330
102 PADIADO Pleural aspiration diagnostic (Doctor
S fee + Additional hospital charges )
PADIAD Pleural aspiration diagnostic - Additional 2220 2220 1110 890 670
hospital charges
PADIADF Pleural aspiration diagnostic - Doctor Fee 5560 5560 2780 2220 1670
103 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
104 REBUSOS Radial EBUS charges - (Doctor
REBUSDF Radial EBUS charges - Doctor Fee 23240 23240 11620 9300 6970
REBUSHCPACS Radial EBUS charges - For PACS - NOT FOR
BILLING PURPOSE
REBUSHC Radial EBUS charges - Hospital Charges 9300 9300 4650 3720 2790
105 RFAOS Radio frequency ( RF ) ablation
- Gastroenterology (Doctor fee
+ Hospital charges)
RFAHC Radio frequency ablation ( Gastroenterology) - 12920 12920 6460 5170 3880
RFADF Radio frequency ablation ( Gastroenterology) - Doctor 32280 32280 16140 12910 9680
Fee
RFAHCPACS Radio frequency ablation ( Gastroenterology) - For
106 RGBRDOS Rigid Bronchoscopy Diagnostic
- (Doctor Fee + Hospital Charges)
RGBRDDF Rigid Bronchoscopy Diagnostic - Doctor Fee 24000 24000 12000 9600 7200
RGBRDHCPAC Rigid Bronchoscopy Diagnostic - For PACS -
S NOT FOR BILLING PURPOSE
RGBRDHC Rigid Bronchoscopy Diagnostic – Hospital Charges 9600 9600 4800 3840 2880
107 RGBRFBR Rigid Bronchoscopy - Foreign body removal
OS - (Doctor Fee + Hospital Charges)
209
RGBRFBRDF Rigid Bronchoscopy - Foreign body removal - 33080 33080 16540 13230 9920
Doctor Fee
RGBRFBRPACS Rigid Bronchoscopy - Foreign body removal -
RGBRFBRHC Rigid Bronchoscopy - Foreign body removal - 13240 13240 6620 5300 3970
Hospital Charges
108 RGBRSTT Rigid Bronchoscopy + stenting+ tumor
DBOS de-bulking - (Doctor Fee + Doctor Fee)
RGBRSTTDBPA Rigid Bronchoscopy + stenting + tumor de-bulking - For
CS PACS - NOT FOR BILLING PURPOSE
RGBRSTTDBHC Rigid Bronchoscopy + stenting + tumor 16540 16540 8270 6620 4960
de-bulking - Hospital Charges
RGBRSTTDBDF Rigid Bronchoscopy = stenting + tumor 41380 41380 20690 16550 12410
de-bulking - Doctor Fee
109 RGBRTBS Rigid Bronchoscopy + tracheal/
TOS bronchial stenting - (Doctor Fee +
Hospital Charges)
RGBRTBSTDF Rigid Bronchoscopy + tracheal/bronchial 41380 41380 20690 16550 12410
stenting - Doctor Fee
RGBRTBSTPAC Rigid Bronchoscopy + tracheal/bronchial stenting - For
S PACS - NOT FOR BILLING PURPOSE
RGBRTBSTHC Rigid Bronchoscopy + tracheal/bronchial 16540 16540 8270 6620 4960
stenting - Hospital Charges
110 RGBRTDB Rigid Bronchoscopy + Tumor de-bulking -
OS (Doctor Fee + Hospital Charges)
RGBRTDBDF Rigid Bronchoscopy + Tumor de-bulking -Doctor Fee 32020 32020 16010 12810 9610
RGBRTDBPACS Rigid Bronchoscopy + Tumor de-bulking -
RGBRTDBHC Rigid Bronchoscopy + Tumor de-bulking - 12820 12820 6410 5130 3850
Hospital Charges
111 TRANBOS Transjuglar Biopsy
TRANBCC Transjuglar Biopsy - Consumable Charges 19060 19060 9530 9530 9530
TRANBDF Transjuglar Biopsy - Doctor fee 55040 55040 27520 22020 16510
TRANBFC Transjuglar Biopsy - Fluroscopy charges 19260 19260 9630 7700 5780
TRANBPACS Transjuglar Biopsy - For PACS - NOT FOR
BILLING PURPOSE
TRANBHC Transjuglar Biopsy - Hospital charges 22000 22000 11000 8800 6600
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
Code Description
CARREHCH Cardiac Rehabilitation charges (Rs.970) 970
CRREHCH Cardiac Rehabilitation charges(Rs.1160) 1160
CREOPPRCIP Cardiac Rehabilitation Heart 670 670 670
Failure Program for inpatients
CREOPPROH Cardiac Rehabilitation Heart 4000 4000
F Failure Program for outpatients
CREOPPRO1 Cardiac Rehabilitation outpatient 4000 4000
program ( one month )
program ( three month )
program ( two month )
CRPACABG Cardiac Rehabilitation Package after CABG 2670 2670 2670
CRPAPTCA Cardiac Rehabilitation Package after PTCA 1330 1330 1330
HYCRECH Hybrid Package rehabilitation Charge 1100
210
CARDIAC SURGERY 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
ENDOBOS Endomyocardial Package PostHeart Tx
– Package Charges
ENDOPKC Endomyocardial Package – Package Charges 32000
HTPKOS HEART TRANSPLANT PACKAGE
HTPCH Heart Transplant Package Charges 2920000
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
Code Description
HRCARDP HIGH RISK ADD ON FOR CARDIAC
OS (PACKAGE CHARGES + DOCTOR FEES)
HRADDCSPC High risk ADD ON for cardiac surgery package charges 56000
LVADOS LVAD / Heart Transplant

Assessment Package
LVADPC LVAD / Heart Transplant Assessment 192000
Package - 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
Code Description
CABGOAD CABG (OFF PUMP) (PACKAGE
COS CHARGES + ALL DOCTOR FEES)
CABGOFFP CABG (off pump) package charges 456000 428000 389000 336000 260000
Package Includes :
 Stay up to 8 days including ICCU monitoring charges for 5 days
 Investigations limited to Rs. 17020/- in category 3 and Rs. 34030/- in other categories
 Blood Bank crossmatch charges.
 Cardiac Rehabilitation
211
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
Code Description
CHSPCDC CLOSED HEART SURGERY (PACKAGE
OS CHARGES + ALL DOCTOR FEES)
CHSPC Closed heart surgery package charges 249000 237000 205000 184000 145000
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
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
Code Description
HPPROOS HYBRID PROCEDURE PACKAGE
HPPC Hybrid procedure package charges 613000 577000 521000 460000 371000
Package Includes :
 Consumables limited to Rs. 42000/- (including GST)
 In case of reexploration no separate charges for Cardiac Surgeon, Cardioligist & Anaesthetist.
212
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
Code Description
OHSDHCH OPEN HEART SURGERY / CABG
OS (ON PUMP) (PACKAGE
CHARGES + ALL DOCTOR FEES)
OHSPC Open Heart Surgery/CABG (On Pump) package charges 551000 488000 423000 379000 283000
Package Includes :
 Cardiac Rehabilitation
Package Excludes :
 Cost of valve
 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
Code Description
PPDHCHO PACEMAKER PROGRAMMING
S (PACKAGE CHARGES + DOCTOR FEE)
PACEPROG Pacemaker Programming package charges 2420 2290 2160 1910 1650
TPPDHCH TEMPORARY PACEMAKER PACKAGE

OS CHARGES (PACKAGE CHARGES +
DOCTOR FEE)
TPPC Temporary pacemaker package charges 12200 11690 11180 9150 8390
213
127 IABPOS IABP INSERTION CARDIOLOGY
( Doctor fee + Hospital Charges)
IABPPC IABP INSERTION-PACKAGE CHARGES 60000
128 IVUSOS IVUS (Doctor fee + Hospital Charges)
IVUSPC IVUS - Package Charges 35500
CARDIOLOGY PACKAGE
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Day Care
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
CARWITHI CARDIAC CATHETERISATION WITH
NVOS INVESTIGATION CATH LAB (PACKAGE
CHARGES + DOCTOR FEE)
CARWITH CARDIAC CATHETERISATION WITH 40900 37900 30300 26800 19100 16600
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
Cardiology package charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
PEASAOS PERICARDIAL ASPIRATION (PACKAGE
PRTION PERICARDIAL ASPIRATION - Package charges 43500 43500 34800 29300 26300
Includes Prof fees. and Hospital charges. All other charges towards medicines, medical consumables and investigations will be charged extra at actuals.
FFRPKCH FFR - Packages charges 34000
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
Code Description
CARCATET CARDIAC CATHETERISATION
IONOS WITHOUT INVESTIGATION
CATH LAB (PACKAGE CHARGES
+ DOCTOR FEE)
CARPACKN CARDIAC CATHETERISATION WITHOUT 33600 31600 23600 20500 15400 14400
INVESTIGATION PACKAGE CHARGES
214
Package includes :
 One day stay (day care stay for day care category)
Package excludes :
 Any investigation and other incidental procedures.
CEAONCS[ CAROTID ENDARTERECTOMY ADD ON

DCOS FOR CARDIAC SURGERY (PACKAGE
CEADDCS Carotid endarterectomy ADD ON for cardiac 48300
surgery package charges
CESMAPD CARDIAC ELECTROPHYSIOLOGY

COS STUDIES (MAJOR) (PACKAGE
CESMPC Cardiac electrophysiology studies (Major) 48500 46300 43000 38800 34300
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.
 Any other incidental procedures & investigations.
CESMIPDC CARDIAC ELECTROPHYSIOLOGY

OS STUDIES (MINOR) (PACKAGE
CELSMPC Cardiac electrophysiology studies (Minor) 29700 28700 26600 23600 22600
package charges
Package includes :
 1 night stay including ICCU monitoring charges
Package excludes :
CRAPDCO CARDIAC RADIO FREQUENCY ( RF )

S ABLATION (PACKAGE
CRAPC Cardiac radiofrequency ablation package charges 130700 120300 109900 93900 88200
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.
215
CRAPDCO COMPLEX CARDIAC RADIO REQUENCY
S3D ( RF ) ABLATION 3D MAPPING
(PACKAGE CHARGES + DOCTOR FEE)
CRAPC3D Complex cardiac radiofrequency ablation 3D 448400 448400 386500 346000 301500
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 :
IABPSPDC IABP - ADD ON FOR CARDIAC SURGERY

HOS (PACKAGE CHARGES + DOCTOR FEE)
IABPSPC IABP - ADD ON for cardiac surgery package charges 57750
OCTCARDI OCT (Cardiology) - (PACKAGE

OOS CHARGES + DOCTOR FEE)
OCTPACK OCT (Cardiology) - Package Charges 45000
Includes Prof fees. and consumables limited to Rs. 24000/-.
Cardiology Packages - ASD / PDA Closure
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
ASDPDCO S ASD / PDA / RSOU/ VSD CLOSURE
ASDCPDACPC ASD / PDA / RSOU / VSD DEVICE CLOSURE - 249500 217100 176700 148600 100800
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
Code Description
CAPCDHC CORONARY ANGIOGRAPHY
OS WITHOUT INVESTIGATION
(PACKAGE CHARGES + DOCTOR
FEE)
CAWOPC Coronary angiography without investigation 34100 30800 22700 19600 14800 13400
package charges
216
CAWIPCH CORONARY ANGIOGRAPHY WITH
DHCOS INVESTIGATION (PACKAGE CHARGES +
DOCTOR FEE)
CAWIPC Coronary angiography with investigation 38500 35500 27900 24700 17000 15500
package charges
CCAPPDC CHECK CORONARY ANGIOGRAM
CCAPC Check coronary angiogram package charges 16940 15130 13200 12100 9680
Package includes :
 One day stay.
Package excludes :
Cardiology Packages - Coronary Angioplasty
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
CAFRPDH CORONARY ANGIOPLASTY FOR
COS RESTENOSIS (PACKAGE
CAFSPC Coronary angioplasty for restenosis package charges 112040 103950 98180 90090 76230
ECAWSPD ELECTIVE CORONARY ANGIOPLASTY
CHOS (PACKAGE CHARGES + ALL DOCTOR FEE)
ECAWSPC Elective Coronary Angioplasty Package 228600 212800 178800 149000 132000
EPCIOS EMERGENCY PRIMARY PCI PACKAGE
EPPCIPKC EMERGENCY PRIMARY PCI PACKAGE CHARGES 245500 230600 194200 164200 147000
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.
Cardiology Packages - Embolisation / Thrombolysis
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
EOTPCDC EMBOLISATION (PACKAGE
HOS CHARGES + DOCTOR FEE)
ETRHOMPC Embolisation package charges 71800 65300 59200 53900 48900
Package includes Professional fee and Cath Lab charges. Room rent and other charges will be billed at actual
217
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
Code Description
EBOS ENDOMYOCARDIAL BIOPSY (PACKAGE
EBPC ENDOMYOCARDIAL BIOPSY PACKAGE CHARGES 71400 66900 63500 57900 48000
Package Includes :
 Stay up to one day including ICCU monitoring charges.
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
Code Description
AICDIPDC AICD SINGLE CHAMBER
HOS IMPLANTATION PACKAGE (
Doctor Fee + Hospital Charges )
AICDIPC AICD SINGLE CHAMBER IMPLANTATION 174600 162200 145800 131400 115000
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
BPIPCOS BIVENTRICULAR PACEMAKER

IMPLANTATION (PACKAGE
BPIPC BIVENTRICULAR PACEMAKER 213700 197200 169700 153400 131500
IMPLANTATION PACKAGE CHARGES
Package Includes :
 Stay up to five days including ICCU monitoring charges for three days.
Package Excludes :
218
CDAICDIP CRTD PACKAGE ( Doctor Fee +
DCHOS Hospital Charges )
CDAICDIPC CRTD PACKAGE - Package Charges 239100 222600 197100 176700 153100
Package Includes :
 Stay up to five days including ICCU monitoring charges for three days.
Package Excludes :
DAICDIPD AICD DOUBLE CHAMBER

CHOS IMPLANTATION PACKAGE (
Doctor Fee + Hospital Charges )
DAICDIPC AICD DOUBLE CHAMBER IMPLANTATION 195600 180100 163600 148200 128600
PACKAGE - Package Charges
Package Includes :
Package Excludes :
ICDIPDCH ICD IMPLANTATION (PACKAGE

OS CHARGES + DOCTOR FEE)
ICDIPC ICD implantation package charges 147000 126000 115500 94500 83160
LRIOS LOOP RECORDER IMPLANTATION

(PACKAGE CHARGES + DOCTOR FEE)
LRIPC LOOP RECORDER IMPLANTATION PACKAGE CHARGES 71400 66900 63500 57900 48000
Package Includes :
 Stay for one day including ICCU monitoring charges.
Package Excludes :
 Cost of medicines and consumables
PDCPDHC PACEMAKER - DOUBLE

HOS CHAMBER (PACKAGE CHARGES
+ DOCTOR FEE)
PDCPC Pacemaker - double chamber package 142100 130700 118500 106200 93900
charges
Package Includes :
219
Package Excludes :
PGREPOS PG - REPLACEMENT (PACKAGE

PGPC PG Replacement - Package Charges 135500 124200 104000 91800 77400
Package includes :
 Three days stay including ICCU monitoring charges for 1 day
 Medicines limited to Rs. 7500/- (including GST).
Package excludes :
 All Consumables
PSCPDHC PACEMAKER - SINGLE CHAMBER

PSCPC Pacemaker - single chamber package charges 140800 129500 109300 97000 82600
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
Code Description
IVCOS IVC FILTER DEVICE INSERTION
(PACKAGE CHARGES + DOCTOR
FEES)
IVCPC IVC Filter Device Insertion - Package Charges 153200 153200 76700 61300 46000
Package includes Professional fee and Cath Lab charges. Room rent and other charges will be billed at actual
220
Cardiology Packages - Renal/Carotid Angiography
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
RAWIDHC RENAL / PERIPHERAL ANGIOGRAPHY
HCOS PACKAGE (WITH INVESTIGATIONS)
RAWIPC Renal angiography with investigations 36400 32400 24800 21500 15700
package charges
Package includes :
 One day stay.
Package excludes :
RAWIODH RENAL / PERIPHERAL

CHCOS ANGIOGRAPHY PACKAGE
(WITHOUT INVESTIGATIONS)
RAWOIPC Renal angiography without investigations 32000 26800 19300 16100 12900
package charges
Package includes :
 One day stay.
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
Code Description
ROTDAOS ROTABLATION (PACKAGE
ROTDAPC ROTABLATOR / DIRECTIONAL 52000

ATHERECTOMY New -Package Charges
Package includes :
Package excludes :
 All expenses for stay.
 Medicines & consumables
221
Cardiology Packages - Thrombolytic Therapy
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
THTDFHC CORONARY THROMBOLYTIC THERAPY
OS (DOCTOR FEES + HOSPITAL CHARGES)
THTDF Coronary Thrombolytic Therapy – Doctor fees 43400 43400 21700 17360 13020
THTHC CoronaryThrombolytic Therapy – Hospital charges 4340 4340 2170 1740 1300
Cardiology Packages - Valvoplasty
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
CVPDCHO CARDIAC VALVOPLASTY (CATH LAB)
S (PACKAGE CHARGES +DOCTOR FEE)
CVCPC Cardiac valvoplasty (Cath lab) package charges 122100 109700 100600 96600 82200
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
Code Description
CSMLAOS Cataract Surgery MULTI FOCAL LENS (
Restor & Technis Multifocal ) - (PACKAGE
CATMFL Cataract surgery package - Multi Focal Lens 78000
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.
CSPCHOS Cataract Surgery Package for GOPD

card holders ( with Indian foldable
lens) - (PACKAGE CHARGES + ALL
DOCTOR FEES)
CSPFINDIOLPC Cataract surgery package ( for GOPD patients ) - with 18200
Indian foldable lense IOL package charges
CSPIOLPD CATARACT SURGERY - WITH

COS FOLDABLE IOL (PACKAGE
CSPNIOLPC Cataract surgery package - with foldable IOL 32100
package charges
222
CSPWIOLP CATARACT SURGERY -
DCOS WITHOUT IOL (PACKAGE
CSPFIOLPC Cataract surgery package - without IOL 27500
package charges
CSPWNFP CATARACT SURGERY - WITH
DCOS NON-FOLDABLE IOL (PACKAGE
CSPWNFIOLPC Cataract surgery package - with 29500
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.
CSTLOS Cataract Surgery TORIC LENS -

(PACKAGE CHARGES + ALL
DOCTOR FEES)
CATTORIC Cataract surgery package - Toric Lens 60000
package charges
applicable rates.
CSTLSYOS Cataract Surgery SYMFONY

LENS - (PACKAGE CHARGES +
ALL DOCTOR FEES)
CATTORICSY Cataract surgery package - Symfony Lens 93000
package charges
applicable rates.
CSTLSYTM Cataract Surgery MULTIFOCAL

FOS TORIC LENS - (PACKAGE
CATTORICMF Cataract surgery package - Multifocal Toric 101000
Lens package charges
applicable rates.
CSTLSYTO Cataract Surgery SYMFONY

S TORIC LENS - (PACKAGE
CATTORICST Cataract surgery package - Symfony Toric 116500
Lens package charges
applicable rates.
MICSOS Micro Incision Cataract Surgery

( including high viscosity visco
elastic ) - (PACKAGE CHARGES
+ ALL DOCTOR FEES)
MICINCCATPK Micro Incision Cataract Surgery (Including high 45000
viscosity visco elastic) – Package Charges
223
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.
Cataract\ophthalmic surgery package charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
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 - Bilateral with Rehabiltation
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
CIPBWRO COCHLEAR IMPLANTATION BILATERAL
S (WITH AUDIOLOGY- PACKAGE
CHARGES + ALL DOCTORS FEES
CIPCBS Cochlear implantation Bilateral (with 263000 230000 193000
audiology) - Package Charges
Cochlear Implantation - Bilateral without Rehabiltation
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
CIPBWOR COCHLEAR IMPLANTATION BILATERAL
OS (WITHOUT Audiology) - PACKAGE
CHARGES + ALL DOCTORS FEES
CIPCBNS Cochlear implantation Bilateral (without 209000 173000 135500
audiology) - Package Charges
Package includes:
1. 2 days stay.
2. Medicines limited to Rs. 2000/-(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 2 days
3. Additional medicines and consumables over and above prescribed limit.
4. Any investigations.
5. Professional charges of other Consultants.
224
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
Code Description
CIPWROS COCHLEAR IMPLANTATION (WITHOUT
OS AUDIOLOGY) (ONLY /REVISION
SURGERY) - PACKAGE CHARGES + ALL
DOCTORS FEES
CIPCOS Cochlear implantation (Excluding speech therapy) Only 144000 115000 87000
/ 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
Code Description
CIPLDDAC COCHLEAR IMPLANTATION (WITH
HCOS AUDIOLOGY)- POST LINGUAL DEAF
CHILD/ADULT (PACKAGE CHARGES +
ALL DOCTOR FEES)
CIPLDACPC Cochlear implantation (including speech therapy) - 157000
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
225
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
Code Description
CIPLDDHC COCHLEAR IMPLANTATION (WITH
OS AUDIOLOGY)- PRE LINGUAL DEAF
CHILD (PACKAGE CHARGES + ALL
DOCTOR FEES)
CIPLDCPC Cochlear implantation (with audiology) - pre 179000 150000 122000
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).
4. Professional Fees of Surgeon, Speech therapist, Anasthetist, Anasthesia and OT Charges
Package excludes:
1. Cost of implant
GYNAECOLOGY PACKAGE
Day Care Package Procedures
S.No. Investigation Limit on medicines & consumables

Total Charges (including GST)
1. Colposcopy/Cautery 5500 100

2. Colposcopy/LEEP 9300 700
3. Diagnostic Hyster/D&C 15100 1000
4. Colpo/Hystero/D&C 17700 1000
5. Colpo/Hystero/LEEP 20000 1000
6. MTP 12000 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.
PCS Packages - Angiography
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1 CAPCOS Paediatric Cardiac angiography
CAPK Paediatric Cardiac angiography – package charges 78000 68500 51000 35100 25400
Package Includes :
 2 days stay.
 Investigations limited to Rs. 2610/- in cat 3 & Rs.5240/- in other categories.
 Medicines and consumables limited to Rs. 7700/-(including GST)
Package Excludes :
 Blood Bank charges
226
PCS Packages - ASD Device
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
2 ASDOS Paediatric ASD Device
ASDPPC Paediatric ASD Device - package charges 240500 208300 168600 140600 92400
Package Includes :
 2 days stay including Intensive Care for 1 day
 Investigations limited to Rs. 5850/- in cat 3 & Rs. 11680/- in other catagories.
Package Excludes :
 Blod Bank charges
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
3 PBSEPOS Paediatric Balloon Septostomy
PBSEPC Paediatric Balloon Septostomy – package charges 124600 109000 93900 79900 68000
Package Includes :
 2 days stay including Intensive Care for 1 day.
Package Excludes :
PCS Packages - Closed Heart Surgery Level 1

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

4 PCHSL1OS Paediatric Closed Heart Surgery Level One
PCHSL1P Paediatric Closed Heart Surgery Level One 229000 199000 154000 126000 92000
package charges
Package Includes :
 3 days stay including Intensive Care for 1 day.
227
Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
5 PCHSL2OS PAEDIATRIC CLOSED HEART SURGERY
LEVEL TWO ( ALL CHARGES)
PCHSL2P Paediatric Closed Heart Surgery Level Two 331000 287000 236000 193000 136000
package charges
Package Includes :
 7 days stay including Intensive Care for 3 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

6 PCHSL3OS Paediatric Closed Heart
Surgery Level Three
PCHSL3P Paediatric Closed Heart Surgery Level Three 462000 404000 315000 264000 198000
package charges
Package Includes :
 9 days stay including Intensive Care for 4 days.
Package Excludes :
228
PCS Packages - Coil Embloisation
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
7 CCEPCOS Paediatric Cardiac coil Embolisation
CCEPPC Paediatric Cardiac coil Embolisation -package charges 97300 84600 75500 58500 38300
Package Includes :
 1 day stay.
 Investigations limited to Rs. 2850/-in cat 3 & Rs. 5690/- in other catagories.
Package Excludes :
 All hospital charges for the stay beyond the package stay of 1 day.
PCS Packages - Open Heart Surgery Level 1
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
8 POHSL1O Paediatric Open Heart Surgery
S Level One
POHSL1P Paediatric Open Heart Surgery Level One 443000 384000 321000 262000 212000
package charges
Package Includes :
 Investigations limited to Rs. 14480/- in cat 3 Rs. 28930/- 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 523000 461000 384000 318000 234000
package charges
Package Includes :
229
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 723000 641000 518000 445000 346000
package charges
Package Includes :
 10 days stay including Intensive Care for 5 days.
Package Excludes :
PCS Packages - PDA Device
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

11 PDAOS Paediatric PDA Device
PDAPC Paediatric PDA Device - package charges 185700 162300 133400 96100 58800
Package Includes :
Package Excludes :
230
PCS Packages - Valvuloplasty
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
12 PVALOS Paediatric Valvuloplasty
PVALPPC Paediatric Valvuloplasty - package charges 172900 149600 126900 104300 71100
Package Includes :
 Investigations limited to Rs. 4620/- in cat 3 & Rs. 9230/-in other catagories.
 Medicines and consumables limited to Rs. 20200/-(including GST))
Package Excludes :
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
1 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.
2 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.
3 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/-.
231
Package Excludes
charges, etc.
LIVER TRANSPLANTATION PACKAGE
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
4 LIVPAEDO Liver Transplant Package
S (Paediatrics)
LTPPPC Liver Transplant Package (Paediatrics- 1053000
Recepient) - Package 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
1 BIPAPINIT BIPAP Initiation (Doctor +
NOS Hospital Charges)
BIPAPINITNDF BIPAP Initiation - Doctor Fee 3640 3640 1820 1460 1090
BIPAPINITNHC BIPAP Initiation - Hospital service charges 360 360 180 140 110
2 BIPAPMO BIPAP Monitoring (Doctor +
BIPAPMONITD F BIPAP Monitoring - Doctor Fee 3640 3640 1820 1460 1090
BIPAPMONNH C BIPAP Monitoring - Hospital service charges 360 360 180 140 110
3 COMEVOS Cardiac Output Monitoring By
EV 1000 (Doctor + Hospital Charges)
COMEV1000D F Cardiac output monitoring by EV 1000 -doctor fee 12740
COMEVBPC Cardiac output monitoring by EV1000 - 1280
bedside procedure charges
COMEV1000 Cardiac output monitoring by EV1000 - 1910
special equipment charges
4 CPAMOS Cardio-Pulmonary Assessment and
Monitoring by Ultrasound-(Doctor
Fee+Hospital Charges)
CPAMH Cardio-Pulmonary Assessment and Monitoring by 840
Ultrasound-Additional Hospital Charges
CPAMD Cardio-Pulmonary Assessment and 16000 16000 8000 6400 4800
Monitoring by Ultrasound-Doctor Fee
CPAMHM Cardio-Pulmonary Assessment and Monitoring by 1260
Ultrasound-Hospital Charges (Machine usage)
5 NOTOS Nitric Oxide Therapy - (Doctor
NOTDF Nitric Oxide Therapy - Doctor Fee 13240 13240 6620 5300 3970
NOTHC Nitric Oxide Therapy - Hospital Charges 3310
(Machine usage)
6 VENTINIT Ventilator Initiation (Doctor +
232
VENTINITNDF Ventilator Initiation - Doctor Fee 3640 3640 1820 1460 1090
VENTINITNHC Ventilator Initiation - Hospital service charges 360 360 180 140 110
7 VENTMO Ventilator Monitoring (Doctor
NOS + Hospital Charges)
VENTIMONITD F Ventilator Monitoring - Doctor Fee 3640 3640 1820 1460 1090
VENTIMONNH C Ventilator Monitoring - Hospital service charges 360 360 180 140 110
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
1 COCADIJO Contact cast application for diabetic
DEOS joint deformity (OUTPATIENT Doctor +
Hospital Charges )
COCADIJODED Contact cast application for diabetic joint 2440 2440
F deformity (doctor fee)
COCADIJODEH Contact cast application for diabetic joint 2240 2240
C deformity (hospital charges)
2 CONCSTO Contact cast application for diabetic
S joint deformity (INPATIENT Doctor +
Hospital charges)
COCADIJODED Contact cast application for diabetic joint 2440 2440
F deformity (doctor fee)
COCADIJODEH Contact cast application for diabetic joint 2240 2240
C deformity (hospital charges)
3 DIFOASPR Diabetic foot assessment -
IPOS primary (INPATIENT Doctor +
Hospital charges)
DIFOASPRDF Diabetic foot assessment ( primary 250 250
preventive ) - doctor fee
DIFOASPRHC Diabetic foot assessment (primary) - 570 570
hospital charges
4 DIFOASPR Diabetic foot assessment - primary
OS preventive (OUTPATIENT Doctor +
Hospital Charges)
DIFOASPRDF Diabetic foot assessment ( primary 250 250
preventive ) - doctor fee
DIFOASPRHC Diabetic foot assessment (primary) - 570 570
hospital charges
5 DIFOASSE Diabetic foot assessment -
OS secondary (OUTPATIENT
Doctor + Hospital Charges )
DIFOASSEDF Diabetic foot assessment (secondary) -doctor fee 480 480
DIFOASSEHC Diabetic foot assessment (secondary) - 1140 1140
hospital charges
6 DIFODRM Diabetic foot care major dressing (
J INPATIENT Doctor +Hospital charges)
DFDRESSMAJ Diabetic foot clinic ( major dressing ) -doctor fee 890 890
DFCMAJHC Diabetic foot clinic ( major dressing ) -Hospital Charges 200 200 200
7 DIFOMIN Diabetic foot care minor dressing (
DROS INPATIENT Doctor +Hospital charges)
DIFMINHC Diabetic foot clinic ( minor dressing ) - 150
bedside procedure charges
DFDRESSMIN Diabetic foot clinic ( minor dressing ) -doctor fee 510 510
8 DIFOMIP Diabetic foot - minor outpatient procedure
OPROS (Doctor Fee + Hospital Charges )
DIFOMIPOPRD Diabetic foot - minor outpatient procedure 1140 1140
F (doctor fee)
233
DIFOMIPOPRH Diabetic foot - minor outpatient procedure 1370 1370 1370
C (hospital charges)
9 DIFOSECO Diabetic foot assessment - secondary
S (INPATIENT Doctor + Hospital charges)
DIFOASSEDF Diabetic foot assessment (secondary) -doctor fee 480 480
DIFOASSEHC Diabetic foot assessment (secondary) -hospital charges 1140 1140
10 ETIPOS Extensor tenotomy ( INPATIENT
Doctor + Hospital charges)
OUEXTEDF Outpatient extensor tenotomy (doctor fee) 1940 1940
OUEXTEHC Outpatient extensor tenotomy (hospital charges) 1770 1770
11 FOOPSOS FOOT PRESSURE SCAN (DOCTOR FEE +
HOSPITAL CHARGES)
FOOSCADF Foot scan ( foot pressure analysis ) – Doctor fee 420 420
FOOSCA Foot scan ( foot pressure analysis ) Hospital charges 820 820
12 INSHOEPS IN - SHOE PRESSURE SCAN (DOCTOR
INSHOEPCDF In-shoe pressure scan - Doctor fee 650 650
INSHOEPC In-shoe pressure scan - Hospital charges 970 970
13 LSINJOS Liquid silicone heel injection
(INPATIENT Doctor + Hospital charges)
OULISIINJDF Outpatient liquid silicone heel injection (doctor fee) 1940 1940
OULISIINJHC Outpatient liquid silicone heel injection 1770 1770
(hospital charges)
14 OUEXTEO Outpatient extensor tenotomy
S (Doctor Fee + Hospital Charges)
OUEXTEDF Outpatient extensor tenotomy (doctor fee) 1940 1940
OUEXTEHC Outpatient extensor tenotomy (hospital charges) 1770 1770
15 OULISIINJ Outpatient liquid silicone heel injection
OS (Doctor Fee + Hospital Charges)
OULISIINJDF Outpatient liquid silicone heel injection (doctor fee) 1940 1940
OULISIINJHC Outpatient liquid silicone heel injection 1770 1770
(hospital charges)
Diabetology and Endocrinology
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1 ANASDHC AUTONOMIC NEUROPATHY
OS ASSESSMENT SPOT TEST (DOCTOR FEE
+ HOSPITAL CHARGES)
ANASTDF Autonomic neuropathy assessment spot test 240
- Doctor fee
ANASTHC Autonomic neuropathy assessment spot test 800 800 400 320 240 400 240
- hospital charges
2 CGMPDH CONTINUOUS GLUCOSE MONITORING
COS - (DOCTOR FEE +HOSPITAL CHARGES)
CGMSRTDWP Continuous glucose monitoring - real time (CGMS-RT ) - 3860 3860 1930 1540 1160
doctor fee
CGMSRTAHC Continuous glucose monitoring - real time ( CGMS-RT ) - 30820 30820 15410 12330 9250
hospital charges
234
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
Code Description
HEMOFRE5 Online Hemodiafiltration (Fresenius5008-5) 4000
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
1 ADDCOBI Add on package for Audiology & 126000
Speech Therapy ? Bilateral
2 ADDCUNI Add on package for Audiology & 105000
Speech Therapy ? Unilateral
3 ABLDS Angiography of B/L Dorsolumbar Spinal 72760 72760 36380 29100 21830
Radicular Arteries - Doctor Fee
4 ARHEVE AORTIC HEMIARCH REPLACEMENT 73500 73500 36750 29400 22050
5 ACHENT AORTIC ARCHH REPLACEMENT 183760 183760 91880 73500 55130
6 ARRENT AORTIC ROOT REPLACEMENT 238880 238880 119440 95550 71660
7 ARAOHIA AORTIC ROOT, ASCENDING AORTA 385880 385880 192940 154350 115760
AND HEMIARCH REPLACEMENT
8 AOCLX AORTIC VALVE REPAIR COMPLEX 128620 128620 64310 51450 38590
9 AOVSI AORTIC VALVE REPAIR SIMPLE 91880 91880 45940 36750 27560
10 AVRNT AORTIC VALVES REPLACEMENT 73500 73500 36750 29400 22050
11 ASEART ASCENDING AORTAA REPLACEMENT 128620 128620 64310 51450 38590
12 GEATSDF Ascitic Tab subsequent – Doctor Fee 5800 5800 2900 2320 1740
13 ABLR ATERIAL BYPASS LIMA-RIMA/RADIAL 110260 110260 55130 44100 33080
14 ATMAS ATRIAL MAZE PROCEDURE-SINGLE 91880 91880 45940 36750 27560
15 SERER ATRIAL SEPTAL DEFECT 36760 36760 18380 14700 11030
REPAIR-DIRECT CLOSURE
16 PREAL ATRIAL SEPTAL DEFECT 55120 55120 27560 22050 16540
REPAIR-PERICARDIAL PATCH
17 RICEAL ATRILA MAZE 147000 147000 73500 58800 44100
PROCEDURE-BIATRIAL
18 AUTISM AUTISM ASSESSMENT 9720 9720 4860 3890 2920
19 BASCD Balloon Angioplasty & Stenting in 218300 218300 109150 87320 65490
Cervical ICA/Vertebral - Doctor Fee
20 BACEDF Balloon Assisted Coil Embolization 242560 242560 121280 97020 72770
of a Direct/Indirect Cavernous
Fistula - Doctor Fee
21 BFNACRF Breast FNAC under Radiological 2500 2500 2500 2500 2500 2500 2500
guidance - Radiologist fee
22 BIIR Broken Impacted Implant Removal 57860 57860 28930 23140 17360
23 DIAEXO CARDIAC TUMORR EXCISION 73500 73500 36750 29400 22050
24 CHOCED CHORDAL PROCEDURE 55120 55120 27560 22050 16540
25 CAVRCE COMPLEX AORTIC VALVE REPLACEMENT 91880 91880 45940 36750 27560
26 CPCIDF Complex Cardiology procedure charges 11030
27 CNDDF Conduction of normal delivery -Doctor fee 54240 54240 27120 21700 16270
28 DSC Delayed sternal closure 87500 87500 43750 35000 26250
29 DEBSIDL2 Developmental evaluation using 11580 11580 5790 4630 3470
BSID (<2 years)
30 DEBSIDG2 Developmental evaluation using 15280 15280 7640 6110 4580
BSID (greater than 2 years)
31 DFDRESSMA Diabetic foot clinic ( major dressing) - 890 890
J doctor fee
235
32 DFDRESSMI Diabetic foot clinic ( minor dressing) - 510 510
N doctor fee
33 EDUASS EDUCATIONAL ASSESSMENT 9720 9720 4860 3890 2920
34 ESPFD Embolization of Spinal Pial/dural 242560 242560 121280 97020 72770
Fistula - Doctor Fee
35 EMBRCF Embryo Biopsy (1-2 Embryos) - 5100 5100
Clinician Charges
36 EMBRF Embryo Biopsy (1-2 Embryos) - 2550 2550
Embryologist fee
37 EMBRYOCL Embryo Biopsy (3-4 Embryos) - 10000 10000
Clinician Charges
38 EMBRY Embryo Biopsy (3-4 Embryos) - 5100 5100
Embryologist fee
39 EMBCLIN Embryo Biopsy (5-8 Embryos) - 10000 10000
Clinician Charges
40 EMBYOEF Embryo Biopsy (5-8 Embryos) - 7600 7600
Embryologist fee
41 EMPR EMERGENCY PROCEDURE 183760 183760 91880 73500 55130
42 ESO Emergency sternal opening 122500 122500 61250 49000 36750
43 EPALNT EPICARDIAL PACING WIRE IMPLANTATION 183760 183760 91880 73500 55130
44 EPICR EPIGASTRIC HERNIA REPAIR 110260 110260 55130 44100 33080
45 ESMYO EXTENDED SEPTAL MYECTOMY FOR HOCM 350000 350000 175000 140000 105000
46 EXSTENTCF Extra stent placement 5510
47 FDPIA Flow Divertor Placement for 291060 291060 145530 116420 87320
Intracranial Aneurysm - Doctor Fee
48 FBR Foreign body retrieval 101640 101640 50820 40660 30490
49 GEPOEMDF Gastroenterology Procedures 196800 196800 98400 78720 59040
Poem - Doctor Fee
50 PCD Genetic counseling & Documentation 7000
(Samples sent abroad )
51 PRC Genetics report Interpretation & 8400
counseling ( Patients / sample
coming from abroad )
52 PULGPA Guided pleural aspiration (Diagnostic) 6960 6960 3480 2780 2090
53 HSC Hand sewn coil making charges 26700 26700 13350 10680 8010
54 DOREDOCF HIGH DOSE CHEMOTHERAPY AND 234920 234920 117460 93970 70480
RESCUE - Doctor Fee
55 IAERTN IABP INSERTION 36760 36760 18380 14700 11030
56 IARVAL IABP REMOVAL 22060 22060 11030 8820 6620
57 IAVDF Intracranial Angioplasty for 145540 145540 72770 58220 43660
Vasaspasm - Doctor Fee
58 IVMEC Intracranial AVM Embolization 291060 291060 145530 116420 87320
(Complex) - Doctor Fee
59 IAELE Intracranial AVM Embolization using Liquid 242560 242560 121280 97020 72770
Embolic material -Doctor Fee
60 ICPPF Intracranial pressure monitoring device 30820 30820 15410 12330 9250
insertion charges (Professional fees)
61 ISRDF Intracranial Stenting in Stroke 242560 242560 121280 97020 72770
Revascularization - Doctor Fee
62 IQASS IQ ASSESSMENT 15280 15280 7640 6110 4580
63 ITDF Iron therapy - Doctor fee 1370
64 IMISE ISCHEMIC VENTRICULAR SEPTAL 220500 220500 110250 88200 66150
RUPTURE REPAIR
65 RHSD Joint injection with US guidance - RHS - 1890 1890 1890 1890 1890 1580 0
Subsequent per joint (Doctors Charges )
66 KTPSS KTP Surcharge - Surgeon Fee 5830
67 LETURE LEAFLET PROCEDURE 55120 55120 27560 22050 16540
68 LTROC LEFT ATRIAL APPENDAGE OCCLUSION 36760 36760 18380 14700 11030
69 LFTTRO LEFT ATRIAL TROMBUS REMOVAL 29420 29420 14710 11770 8830
236
70 LEVNE LEFT VENTRICULAR ANEURYSM REPAIR 220500 220500 110250 88200 66150
71 MECS100 Melanocyte Eidermal Cell suspension (for 49020
covering at max 100 sq. cm)
72 MICS MICS 128620 128620 64310 51450 38590
73 MRAPR MITRAL LEAFLET PRESERVATION 38600 38600 19300 15440 11580
74 MVRP MITRAL VALVEE REPLACEMENT 77180 77180 38590 30870 23150
75 MTP2TRIM MTP in 2nd trimester in Labour 54340 54340 27170 21740 16300
Room - Doctor fee
76 NPPNCDF Neonatologist / paediatrician 7440 7440 3720 2980 2230
post-natal charges following
Caesarean delivery - Doctor fee
77 NPPNNDF Neonatologist / paediatrician 5340 5340 2670 2140 1600
post-natal charges following
normal delivery - Doctor fee
78 NNPNRESCS Neonatologist / paediatrician 5340 5340 2670 2140 1600
DF resuscitation charges following
caesarian delivery - Doctor fee
79 NNPNRESCH Neonatologist / paediatrician 4420 4420 2210 1770 1330
ADF resuscitation charges following
normal delivery - Doctor fee
80 NPCRCCDF Neonatology / paediatric consultant 12760 12760 6380 5100 3830
attendance + resuscitation charges of
newborn during Caesarean delivery –
Doctor fee
81 NPCRNDDF Neonatology / paediatric consultant 9800 9800 4900 3920 2940
attendance + resuscitation charges of
newborn during normal delivery –
Doctor fee
82 NOSOP Nitrous Oxide Sedation for 3730 2240
OUTPATIEN
83 OTRPIP Occupational therapy for 1280 1280 640 510 380
paediatric / rheumatology patients
84 OPPCSSC Off Pump PCS surgical charges 96800 96800 48400 38720 29040
85 OMLST OMENTOPLASTY 183760 183760 91880 73500 55130
86 IAMMV Open excision of invasive Anterior 286660 286660 143330 114660 86000
Mediastinal mass (including Thymoma)
Vascular repair – Add On
87 IAMML Open excision of invasive Anterior 286660 286660 143330 114660 86000
With lung resection -Add On
88 IAMMLV Open excision of invasive Anterior 308700 308700 154350 123480 92610
With lung resection and
vascular repair - Add On
89 IAMM Open excision of invasive Anterior 260200 260200 130100 104080 78060
Mediastinal mass (including Thymoma) with
pericardiectomy -Add On
90 NIAMM Open excision of non - invasive 238140 238140 119070 95260 71440
Anterior Mediastinal mass
(including Thymoma) - Add On
91 THYOAD Open Thymectomy - Add on 238140 238140 119070 95260 71440
92 OAFSVLDF Outpatient Arterial flow studies in 560 560 560
vascular lab - Doctor fee
93 OVFSVLDF Outpatient venous flow studies in 930
vascular lab - Doctor fee
94 ONVEEG12D Overnight Video EEG for 12 hours - 2540 1520
Doctor Fee
95 OTHDF Ozone Therapy (Doctor fee) 4840
96 PAWVA PACING WIRE REMOVAL 17500 17500 8750 7000 5250
97 PCSBEDSC PCS - Bedside Pleural Sclerosis 5260 5260 2630 2100 1580
237
98 CHW PCS Chest Wall repair 160080 160080 80040 64030 48020
99 PCSVA2 PCS Procedure Access in Neonate 105000 105000 52500 42000 31500
and Infant
100 PCSVA4 PCS Procedure Complex Surgical 315000 315000 157500 126000 94500
101 PCSVA3 PCS Procedure Pericariocentesis 70000 70000 35000 28000 21000
102 PCSVA1 PCS Procedure Vascular Access 70000 70000 35000 28000 21000
103 PEIVASDIAG Peipheral Vascular Angiography 28000 28000 14000 11200 8400
DF (Diagnostic) - Doctor Fee
104 GEFNADF Percutaneous USG guided FNA -Doctor Fee 6960 6960 3480 2780 2090
105 PEDFPSDF Portable Echocardiography ( Paediatric 1820 1820
Cardiac Sciences ) - Doctor Fees ( If Done
Outside Working Hrs )
106 PEDF Portable echocardiography in 1820
emergency hours - Doctor fees
107 PCDBG Posterior Cervical Discectomy with 172000 172000 86000 68800 51600
Instrumentation / Bone Grafting
108 NEUDBS Programming of DBS (in OT) 38680 38680 19340 15470 11600
109 NEUDBSW Programming of DBS (in Ward) 19340 19340 9670 7740 5800
110 PUMBR PULMONARY THROMBOENDARTERECTOMY 275620 275620 137810 110250 82690
BOTH SIDE
111 PTHROT PULMONARY THROMBOENDARTERECTOMY 183760 183760 91880 73500 55130
ONE SIDE
112 RASCUINTRF Radiological guidance charges for Ascites / 530 530 530 530 530 530 530
Effusion tapping / Drainage ( interventional)
-Radiologist fee
113 RDFNACINTR Radiological guidance charges for 530 530 530 530 530 530 530
F FNAC / Biopsy ( interventional) -
Radiologist Fee
114 RSMS Redo sternotomy / Mini sternotomy 210000 210000 105000 84000 63000
115 REERY REDO SURGERY 183760 183760 91880 73500 55130
116 REVITEMB Re-Vitrification - Embryologist fee 2900
117 RATYMI RING ANNULOPLASTY-MITRAL 73500 73500 36750 29400 22050
118 SECARDF Screening Echo Cardiology – Doctor Fee 700
119 SVCAD Six Vessel Cerabral Angiogram -Doctor fee 60640 60640 30320 24260 18190
120 SACEI Stent Assisted Coil Embolization of 242560 242560 121280 97020 72770
Intracranial ICA Aneurysm – Doctor Fee
121 STEWL STERNAL WIRE REMOVAL 91880 91880 45940 36750 27560
122 SBEG Suction Blister Epidermal Grafting 35020
(for covering at max 60 sq. cm.)
123 TIVSOPD Total Intra Venous Sedation ( TIVS ) 2800 2800
- MRI/CT
124 TIVSOP Total Intra Venous Sedation ( TIVS ) 3920 2350
- OUTPATIENT
125 TRIPVRER Tricuspid Valve Repair - Add on 73500 73500 36750 29400 22050
126 USEMGHRSD Ultrasound during emergency hours (done 4000 4000 2000 1600 1200 2000 1200
F in U/S room) – doctor fee
127 USAVFDF Ultrasound guided venous mapping for I/J 630
catheter insertion and A.V Fistula creation
– Doctor Fee
128 VCCC Valved Conduit Construction Charges 175000 175000 87500 70000 52500
129 VCAU Vertebral Cement Augmentation 71820 71820 35910 28730 21550
130 OWCSTDF Wound care therapy charges FOR 640 640 640
OUTPATIENTS ( Intermittent pneumatic
limb compression ) -Doctor fee
131 WRETU WOUND RESUTURE 36760 36760 18380 14700 11030
132 YSBAD Y-Stenting in a Basilar Top 291060 291060 145530 116420 87320
Aneurysm - Doctor Fee
133 PCSSHUNTOS Shunt Occluder package (Simple) 140000 111000 83000
134 PCSCHUTOS Shunt Occluder package (Complex) 279000 222000 166000
238
135 PCSOPENOS Open Heart Surgery Level (IV) 274000 219000 164000
136 PCSCLOSOS Close Heart Surgery Level (IV) 265000 211000 145000
137 PHLEBDF Phlebotomy for CHD 9160 7330 5500
138 PCSBALOS Balloon Dilatation (simple) 140000 111000 83000
139 PCSBDCOS Balloon Dilatation (complex) 209000 167000 126000
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
1 UFNACDF Breasr FNAC under ultrasound 1660 1000
guidance - Consultant Fee
2 BRGINJDF Bronchoscopic glue injection -Doctor Fee 25200 25200 12600 10080 7560
3 BRAPCDF Bronchoscopic tumor debulking ( Cautery / 34740 34740 17370 13900 10420
APC ) - Doctor Fee
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
1 IFSTKD Intrapleural Fibronolysis with STK - 9120 9120 4560 3650 2740
Doctor Fee
2 MTHD Medical thoracoscopy Diagnostic - 41100 41100 20550 16440 12330
Doctor Fee
3 MADHED Medical thoracoscopy with 50940 50940 25470 20380 15280
Adhesiolysis -Doctor Fee
4 PADIADF Pleural aspiration diagnostic - Doctor Fee 5560 5560 2780 2220 1670
Gastroenterology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3

1 ATDOS Ascitic Tap Diagnostic (Doctor
fee + Hospital charges)
ATDHC Ascitic Tap Diagnostic - Additional hospital charges 2210 2210 1100 880 660
ATDDF Ascitic Tap Diagnostic - Doctor Fee 5520 5520 2760 2210 1660
ATDPACS Ascitic Tap Diagnostic - For PACS - NOT FOR
BILLING PURPOSE
2 BATOS Breath Analyser Test
BATDF Breath Analyser Test - Doctor fee 13240 13240 6620 5300 3970
BATPACS Breath Analyser Test - For PACS - NOT FOR
BILLING PURPOSE
BATHC Breath Analyser Test - Hospital charges 5300 5300 2650 2120 1590
BATCH Breath Anlyser Test - Consumable charges 2420 2420 1210 1210 1210
3 BPWLOS BALLOON PLACEMENT FOR WEIGHT
FOR WEIGHT LOSS - (Doctor Fee +
Hospital Charges)
BPWLHC BALLOON PLACEMENT FOR WEIGHT FOR 17640 17640 8820 7060 5290
WEIGHT LOSS - Additional Hospital Charges
BPWLDC BALLOON PLACEMENT FOR WEIGHT FOR 44100 44100 22050 17640 13230
WEIGHT LOSS - Doctor Fee
4 BRCOS BALLOON REPLACEMENT (BRT) CHARGES -
(Doctor fee +Hospital Charges)
BRCHC BALLON REPLACEMENT (BRT) CHARGES - 2650 2650 1320 1060 800
Additional Hospital Charges
239
BRCDC BALLON REPLACEMENT (BRT) CHARGES -Doctor Fee 6620 6620 3310 2650 1990
FLCX FLUROSCOPY CHARGES (X-RAY) 1100 1100 1100 1100 1100
5 BRTDSTO Bronchoscoic tumor debulking
S + stenting - (Doctor Fee + Hospital Charges)
BRTDSTDF Bronchoscoic tumor debulking + stenting -Doctor Fee 55120 55120 27560 22050 16540
BRTDSTPACS Bronchoscopic tumor debulking + stenting -
BRTDSTHC Bronchoscopic tumor debulking + stenting - 22050 22050 11020 8820 6620
Hospital Charges
6 BRWLLOS Bronchoscopic whole lung lavage -
(Doctor Fee + Hospital Charges)
BRWLLDF Bronchoscopic whole lung lavage – Doctor Fee 55120 55120 27560 22050 16540
BRWLLPACS Bronchoscopic whole lung lavage - For PACS
- NOT FOR BILLING PURPOSE
BRWLLHC Bronchoscopic whole lung lavage – Hospital Charges 22050 22050 11020 8820 6620
7 CEDHCOS CAPSULE ENDOSCOPY (DOCTOR FEE +
HOSPITAL CHARGES)
CEHC Capsule endoscopy - Additional hospital charges 13230 13230 6620 5290 3970
CEDF Capsule endoscopy - Doctor fee 33080 33080 16540 13230 9920
CEPACS Capsule endoscopy - For PACS - NOT FOR
BILLING PURPOSE
8 CLLSDHCO COLONOSCOPY ( LIMITED TO
S LEFT SIDE ) - (DOCTOR FEE +
HOSPITAL CHARGES)
CLSHC Colonoscopy ( limited to left side ) - 4410 4410 2200 1760 1320
CLSDF Colonoscopy ( limited to left side ) – Doctor fee 11020 11020 5510 4410 3310
CLSDPACS Colonoscopy ( limited to left side ) - For PACS
9 COLOS Colonoscopy done outside endoscopy
suite (Doctor fee +Hospital Charges)
COLOSHC Colonoscopy done outside endoscopy suite - 7690 7690 3840 3080 2310
COLOS Colonoscopy done outside endoscopy suite - 19220 19220 9610 7690 5770
doctor fee
COLOSPACS Colonoscopy done outside endoscopy suite -
10 CTSTOS Colonic Transit Study - (Doctor
CTSTH Colonic Transit Study - Additional hospital charges 1050 1050 1050 1050 1050
CTSTD Colonic Transit Study - Doctor Fee 2630 2630 2630 2630 2630
CTSTPACS Colonic Transit Study - For PACS - NOT FOR
BILLING PURPOSE
11 CWDFHC COLONOSCOPY ( WHOLE ) - (DOCTOR
CWHC Colonoscopy ( whole ) - Additional hospital charges 6180 6180 3090 2470 1850
CWDF Colonoscopy ( whole ) - Doctor fee 15440 15440 7720 6180 4630
CWDPACS Colonoscopy ( whole ) - For PACS - NOT FOR
BILLING PURPOSE
12 DBEBOS Double Balloon Enteroscopy Both side
DBEBSHC Double Balloon Enteroscopy Both side - 19410 19410 9700 7760 5820
DBEBSDF Double Balloon Enteroscopy Both side -Doctor Fee 48520 48520 24260 19410 14560
DBEBSPACS Double Balloon Enteroscopy Both side - For
13 DBESSOS Double Balloon Enteroscopy Single
side (Doctor fee + Hospital charges)
DBESSHC Double Balloon Enteroscopy Single side - 15880 15880 7940 6350 4760
DBESSDF Double Balloon Enteroscopy Single side -Doctor Fee 39700 39700 19850 15880 11910
DBESSPACS Double Balloon Enteroscopy Single side - For
14 EBDHCHO ENDOSCOPIC BANDING(FIRST SESSION)
240
EBFSHC Endoscopic banding ( first session ) - 8820 8820 4410 3530 2650
EBFSDF Endoscopic banding ( first session ) – Doctor fee 22060 22060 11030 8820 6620
EBFSPACS Endoscopic banding ( first session ) - For
15 EBSDCHO ENDOSCOPIC BILIARY STENTING
S (DOCTOR FEE +HOSPITAL CHARGES)
EBSHC Endoscopic biliary stenting - Additional 17640 17640 8820 7060 5290
hospital charges
EBSDF Endoscopic biliary stenting - Doctor fee 44100 44100 22050 17640 13230
EBSPACS Endoscopic biliary stenting - For PACS - NOT
FOR BILLING PURPOSE
16 EBSDHCH ENDOSCOPIC BANDING ( SUBSEQUENT
OS SESSION ) (DOCTOR FEE + HOSPITAL
CHARGES)
EBSSHC Endoscopic banding ( subsequent session ) - 6180 6180 3090 2470 1850
EBSSDF Endoscopic banding ( subsequent session ) - 15440 15440 7720 6180 4630
Doctor fee
EBSSPACS Endoscopic banding ( subsequent session ) -
17 EBUSTBN EBUS and TBNA ( For Northern
A Railway )
FNANEED $$ FNA Needle 5250
FLUOREAFBAS Direct Fluorescent staining for AFB ( 660
PN Aspirate ) Northern Railway
ENDOBROULN Endobronchial Ultrasound ( Northern 6640
DC Railway ) - Doctor Fee
ENDOBROULN Endobronchial Ultrasound ( Northern 2880
HC Railway ) - Hospital charges
MCEUSN FNAC for Endoscopic ultrasound specimen ( 1600
EUSFNAC ) Northern Railway - Cytology
RAPIDWITHO Rapid AFB culture ( BacT/Alert 3D ) with 1550
UTSENN accuprobe identification without sensitivity
Northern Railway
18 EDNUDFH ENDOSCOPIC ULTRASOUND (DOCTOR
CHOS FEE + HOSPITAL CHARGES)
EUHC Endoscopic ultrasound - Additional hospital charges 5300 5300 2650 2120 1590 2650 1590
EUDF Endoscopic ultrasound - Doctor fee 13240 13240 6620 5300 3970 6620 3970
EUHCPACS Endoscopic ultrasound - For PACS - NOT FOR
BILLING PURPOSE
19 EDSDSSD ENDOSCOPIC OESOPHAGEAL
HCHOS STRICTURE DILATATION (SUBSEQUENT
SESSION ) (DOCTOR FEE + HOSPITAL
CHARGES)
EOSDSSHC Endoscopic oesophageal stricture dilatation 5300 5300 2650 2120 1590
( subsequent session ) - Additional hospital charges
EOSDSSDF Endoscopic oesophageal stricture dilatation 13240 13240 6620 5300 3970
( subsequent session ) - Doctor fee
EOSDSSPACS Endoscopic oesophageal stricture dilatation
( subsequent session ) - For PACS - NOT FOR BILLING
PURPOSE
20 EEPDFDC ENDOSCOPIC ENDO-PROSTHESIS
HOS PLACEMENT (DOCTOR FEE + HOSPITAL
CHARGES)
EEPPHC Endoscopic endo-prosthesis placement - 13230 13230 6620 5290 3970
EEPPDF Endoscopic endo-prosthesis placement -Doctor fee 33080 33080 16540 13230 9920
EEPPACS Endoscopic endo-prosthesis placement - For
21 EFBRDHC ENDOSCOPIC FOREIGN BODY REMOVAL
EFBRHC Endoscopic foreign body removal - 10580 10580 5290 4230 3180
EFBRDF Endoscopic foreign body removal – Doctor fee 26460 26460 13230 10580 7940
EFBRPACS Endoscopic foreign body removal - For PACS
241
22 EMLDFHC ENDOSCOPIC MECHANICAL
HOS LITHOTROPSY (DOCTOR FEE +
HOSPITAL CHARGES)
EMLHC Endoscopic mechanical lithotropsy - 17640 17640 8820 7060 5290
EMLDF Endoscopic mechanical lithotropsy – Doctor fee 44100 44100 22050 17640 13230
EMLPACS Endoscopic mechanical lithotropsy - For
23 EMROS Endoscopy Mucosal Resection
EMRHC Endoscopy Mucosal Resection - Additional 22050 22050 11020 8820 6620
hospital charges
EMRDF Endoscopy Mucosal Resection - Doctor Fee 55120 55120 27560 22050 16540
EMRHCPACS Endoscopy Mucosal Resection - For PACS -
24 ENDOBAD Endoscopic banding done
OS outside endoscopy suite
ENDOBAN Endoscopic banding done outside endoscopy 10680 10680 5340 4270 3200
suite - Additional hospital charges
ENDBAOS Endoscopic banding done outside endoscopy 26700 26700 13350 10680 8010
suite - doctor fee
ENDBAPACS Endoscopic banding done outside endoscopy suite - For
25 ENDOSCL Endoscopic sclerotherapy done
OS outside endoscopy suite
ENDSCLHC Endoscopic sclerotherapy done outside endoscopy 10680 10680 5340 4270 3200
suite - Additional hospital charges
ENDSCLOS Endoscopic sclerotherapy done outside 26700 26700 13350 10680 8010
endoscopy suite - doctor fee
ENDSCLOSPAC Endoscopic sclerotherapy done outside endoscopy
S suite - For PACS - NOT FOR BILLING PURPOSE
26 ENTDHCH ENTEROSCOPY (DOCTOR FEE +
OS HOSPITAL CHARGES)
EHC Enteroscopy - Additional hospital charges 8820 8820 4410 3530 2650
EDF Enteroscopy - Doctor fee 22060 22060 11030 8820 6620
EHCPACS Enteroscopy - For PACS - NOT FOR BILLING PURPOSE
27 ENTEROS Enteroscopy done outside endoscopy

ENTEROHC Enteroscopy done outside endoscopy suite - 12450 12450 6220 4980 3740
ENTEROS Enteroscopy done outside endoscopy suite - 31120 31120 15560 12450 9340
doctor fee
ENTEROSPACS Enteroscopy done outside endoscopy suite -
28 EODADHC ENDOSCOPIC OESOPHAGEAL
HOS DILATATION FOR ACHALASIA (DOCTOR
EODAHC Endoscopic oesophageal dilatation for 10580 10580 5290 4230 3180
achalasia - Additional hospital charges
EODADF Endoscopic oesophageal dilatation for 26460 26460 13230 10580 7940
achalasia - Doctor fee
EODAPACS Endoscopic oesophageal dilatation for achalasia - For
29 EOSDFSD ENDOSCOPIC OESOPHAGEAL STRICTURE
HCHOS DILATATION ( FIRST SESSION ) (DOCTOR
FEE +HOSPITAL CHARGES)
EOSDFSHC Endoscopic oesophageal stricture dilatation 8820 8820 4410 3530 2650
( first session ) - Additional hospital charges
EOSDFSDF Endoscopic oesophageal stricture dilatation 22060 22060 11030 8820 6620
( first session ) - Doctor fee
EOSDFSPACS Endoscopic oesophageal stricture dilatation
( first session ) - For PACS - NOT FOR BILLING
PURPOSE
242
30 EPDHCHO ENDOSCOPIC POLYPECTOMY (DOCTOR
EPHC Endoscopic polypectomy - Additional 17640 17640 8820 7060 5290
hospital charges
EPDF Endoscopic polypectomy - Doctor fee 44100 44100 22050 17640 13230
EPHCPACS Endoscopic polypectomy - For PACS - NOT
FOR BILLING PURPOSE
31 EPEPTDHC ENDOSCOPIC PAPILLOTOMY ( EPT )
EPTHC Endoscopic papillotomy ( EPT ) - Additional 15880 15880 7940 6350 4760
hospital charges
EPTDF Endoscopic papillotomy ( EPT ) - Doctor fee 39700 39700 19850 15880 11910
EPTPACS Endoscopic papillotomy ( EPT ) - For PACS -
32 EPRTDHC ENDOSCOPIC PLACEMENT OF RYLES TUBE
EPRTHC Endoscopic placement of Ryles tube - 5160 5160 2580 2060 1550
EPRTDF Endoscopic placement of Ryles tube – Doctor fee 12900 12900 6450 5160 3870
33 EPSDFHC ENDOSCOPIC PANCREATIC STENTING
EPSHC Endoscopic pancreatic stenting - Additional 17640 17640 8820 7060 5290
hospital charges
EPSDF Endoscopic pancreatic stenting - Doctor fee 44100 44100 22050 17640 13230
34 ERCHDFH ERCP (DOCTOR FEE + HOSPITAL
COS CHARGES)
ERCPHC ERCP - Additional hospital charges 6620 6620 3310 2650 1980
ERCPDF ERCP - Doctor fee 16540 16540 8270 6620 4960
ERCPHCPACS ERCP - For PACS - NOT FOR BILLING PURPOSE
35 ERCPCOS ERCP Cystogastromy (Doctor

fee + Hospital charges)
ERCPCHC ERCP Cystogastromy - Additional hospital charges 20290 20290 10140 8120 6090
ERCPCDF ERCP Cystogastromy - Doctor Fee 50720 50720 25360 20290 15220
ERCPCHCPACS ERCP Cystogastromy - For PACS - NOT FOR
BILLING PURPOSE
36 ERCPOS ERCP done outside endoscopy suite
ERCPOSHC ERCP done outside endoscopy suite - 8540 8540 4270 3420 2560
ERCPOS ERCP done outside endoscopy suite – doctor fee 21340 21340 10670 8540 6400
ERCPOSHCPAC ERCP done outside endoscopy suite - For
S PACS - NOT FOR BILLING PURPOSE
37 ERMDHC OESOPHAGEAL AND RECTAL MANOMETRY
ERMHC Esophageal and Rectal manometery - 6180 6180 3090 2470 1850
ERMDF Esophageal and Rectal manometery -Doctor fees 15440 15440 7720 6180 4630
ERMDPACS Esophageal and Rectal manometery - For
38 ESDOS Endoscopy submucosal dissection
CCGRAP $$ Co - Grasper 2640
INJTORM $$ Injector Force Max 25G 1510
ITNAM $$ IT Nano 11330
ILYCAP $$ Olympus Cap 1230
SPRACAT $$ Spray Cathetar 1630
ESDHC Endoscopy submucosal dissection - 74970 74970 37480 29990 22490
ANAANAF Endoscopy submucosal dissection -Anaesthetists Fee 56230 56230 28110 22490 16870
ENDOANAC Endoscopy submucosal dissection - 28110 28110 14060 11250 8430
Anasthesia Consumable
ESDDF Endoscopy submucosal dissection – Doctor Fee 187420 187420 93710 74970 56230
ESDHCPACS Endoscopy submucosal dissection - For PACS
243
39 ESFSDHCH ENDOSCOPIC SCLEROTHERAPY
ESFSHC Endoscopic sclerotherapy – Additional hospital charges 8560 8560 4280 3420 2570
ESAPC Endoscopic sclerotherapy - APC probe charges 4200 4200 4200 4200 4200
ESFSDF Endoscopic sclerotherapy - Doctor fee 21400 21400 10700 8560 6420
ESFSDFPACS Endoscopic sclerotherapy - For PACS - NOT
FOR BILLING PURPOSE
40 EUSCOS EUS Coiling - (Doctor Fee +
Hospital Charges)
EUSCPACS EUS Coiling - For PACS - NOT FOR BILLING PURPOSE
EUSCH EUS Coiling - Additional hospital charges 13230 13230 6620 5290 3970
EUSCD EUS Coiling - Doctor fee 33080 33080 16540 13230 9920
41 EUSGCOS Endoscopic ( EUS ) guided
cystogastromy (Doctor fee +
Hospital charges)
EUSGCHC Endoscopic ( EUS ) guided cystogastromy - 19410 19410 9700 7760 5820
EUSGCDF Endoscopic ( EUS ) guided cystogastromy - 48520 48520 24260 19410 14560
Doctor Fee
EUSGPACS Endoscopic ( EUS ) guided cystogastromy -
42 EUSGOS Endoscopic ultrasound ( EUS )
guided celiac block (Doctor fee
+ Hospital charges)
EUSGHC Endoscopic ultrasound ( EUS ) guided celiac 13230 13230 6620 5290 3970
block - Additional hospital charges
EUSGDF Endoscopic ultrasound ( EUS ) guided celiac 33080 33080 16540 13230 9920
block - Doctor Fee
EUSGHCPACS Endoscopic ultrasound ( EUS ) guided celiac block - For
43 EUTOS Endoultrasound therapeutic
EUTHC Endoultrasound therapeutic - Additional 8820 8820 4410 3530 2650
hospital charges
EUTDF Endoultrasound therapeutic - Doctor Fee 22060 22060 11030 8820 6620
EUTHCPACS Endoultrasound therapeutic - For PACS -
44 FIBSOS FIBROSCAN
FIBSHC Fibroscan - Collection charges (Hospital) 2650 2650 1320 1060 800 1320
FIBSDF Fibroscan - Doctor fee 6620 6620 3310 2650 1990 3310
FIBPAC Fibroscan - For PACS - NOT FOR BILLING PURPOSE
45 FLXSIGOS Flexible sigmoidoscopy done

outside endoscopy suite
FLEXSIGHC Flexible sigmoidoscopy done outside endoscopy suite - 3520 3520 1760 1410 1060
FSIGOS Flexible sigmoidoscopy done outside 8800 8800 4400 3520 2640
endoscopy suite - doctor fee
FLEXSIGHCPA Flexible sigmoidoscopy done outside endoscopy suite -
CS For PACS - NOT FOR BILLING PURPOSE
46 FSDFHCH FLEXIBLE SIGMOIDOSCOPY (DOCTOR

FSHC Flexible sigmoidoscopy - Additional hospital charges 2910 2910 1460 1160 870
FSDF Flexible sigmoidoscopy - Doctor fee 7280 7280 3640 2910 2180
FSDFHPACS Flexible sigmoidoscopy - For PACS - NOT
FOR BILLING PURPOSE
47 GASBIO4I Gastroenterology Procedures
NOS Biofeedback 4 Session - (Doctor Fee +
Hospital Charges)
GASBIO4INHC Gastroenterology Procedures Biofeedback 4 4200
Session - Additional Hospital Charges
GASBIO4INDF Gastroenterology Procedures Biofeedback 4 10500
Session - Doctor Fee
244
48 GASBIOSI Gastroenterology Procedures
NOS Biofeedback - Single Session (Doctor
GASBIOSINHC Gastroenterology Procedures Biofeedback - 1050
GASBIOSINDF Gastroenterology Procedures Biofeedback - 2630
Doctor Fee
49 GASTBRO Gastroenterology Procedures Breath
S Test for H-Pylori (DOCTOR FEE +
HOSPITAL CHARGES)
BREATHIND $$Disposables (Breath Test Indicator) 790
GASTBRHC Gastroenterology Procedures Breath Test 1050
for H-Pylori - Additional Hospital Charges
GASTBRDF Gastroenterology Procedures Breath Test 2630
for H-Pylori - Doctor Fee
50 GEATSOS Ascitic Tab subsequent (DOCTOR FEE +
HOSPITAL CHARGES)
GEATSHC Ascitic Tab subsequent - Additional Hospital Charges 2320 2320 1160 930 700
GEATSDF Ascitic Tab subsequent - Doctor Fee 5800 5800 2900 2320 1740
51 GEFNAOS Percutaneous USG guided FNA
GEFNAHC Percutaneous USG guided FNA - Additional 2780 2780 1390 1110 840
Hospital Charges
GEFNADF Percutaneous USG guided FNA - Doctor Fee 6960 6960 3480 2780 2090
52 GEPOEMA Gastroenterology Procedures Poem
CCGRAP $$ Co - Grasper 2640
FUJICAP $$ Fujinon Cap 1230
INJTORM $$ Injector Force Max 25G 1510
LIPSCAPEM $$ Olympus Cap Poem 620
SPRACAT $$ Spray Cathetar 1630
KNITT $$ TT Knife J 7910
GEPOEMAHC Gastroenterology Procedures Poem - 78720 78720 39360 31490 23620
PROANACHAC Gastroenterology Procedures Poem - 29520 29520 14760 11810 8860
Anasthesia Consumable
GASPROPOEM Gastroenterology Procedures Poem -Anasthetist Fee 59040 59040 29520 23620 17710
GEPOEMDF Gastroenterology Procedures Poem – Doctor Fee 196800 196800 98400 78720 59040
53 GSOS GASTROGRAFFIN STUDY - (Doctor Fee
+ Hospital Charges)
GSHC GASTROGRAFFIN STUDY – Additional Hospital Charges 1770 1770 880 710 530
GSDC GASTROGRAFFIN STUDY - Doctor Fee 4420 4420 2210 1770 1330
54 HVPGOS HVPG
HVPGCH HVPG - Consumable charges 4460 4460 4460 4460 4460
HVPGDF HVPG - Doctor Fee 15440 15440 7720 6180 4630
HVPGFC HVPG - Fluroscopy charges 5140 5140 2570 2060 1540
HVPGHC HVPG - Hospital charges 6180 6180 3090 2470 1850
HVPGCHPACS HVPGCH - For PACS - NOT FOR BILLING PURPOSE
55 LACTTOS Gastroenterology Procedures Lactose

Tolerance Test - (Doctor Fee + Hospital
Charges)
LACTTDFHC Gastroenterology Procedures Lactose 630
Tolerance Test - Additional Hospital Charges
LACTTDF Gastroenterology Procedures Lactose 1580
Tolerance Test - Doctor Fee
56 LBHCHEO LIVER BIOPSY - DONE IN ENDOSCOPY
LBDF Liver biopsy - Doctor fees 15440 15440 7720 6180 4630
LBDPACS Liver biopsy - For PACS - NOT FOR BILLING PURPOSE
LBEHC Liver biopsy (done in endoscopy) - Additional 6180 6180 3090 2470 1850
hospital charges
245
57 MAPSSOS Microlith analysis of pre-supplied
samples (Doctor fee + Hospital Charges)
MAPSSHC Microlith analysis of pre-supplied samples - 1000 1000 500 400 300
MAPSSDF Microlith analysis of pre-supplied samples -Doctor Fee 2500 2500 1250 1000 750
MAPSSHCPAC Microlith analysis of pre-supplied samples -
S For PACS - NOT FOR BILLING PURPOSE
58 NASJEJFL NASO-JEJUNAL TUBE INSERTION -
UOS FLUROSCOPIC (DOCTOR FEE +
HOSPITAL CHARGES)
NASJEJTUNFLS Naso-jejunal tube insertion ( Fluroscopic ) - 13240 13240 6620 5300 3970
DOC doctor fee
NASJEJTUNFLS Naso-jejunal tune insertion ( Fluroscopic) - 5300 5300 2650 2120 1590
HOS Hospital service charges
59 NASJEJTU NASO-JEJUNAL TUBE INSERTION
BINSOS (DOCTOR FEE +
HOSPITAL SERVICE CHARGES)
NASJEJTUNINS Naso-jejunal tube insertion ( endoscopic ) - 13240 13240 6620 5300 3970
DOC doctor fee
NASJEPACS Naso-jejunal tune insertion ( endoscopic ) -
NASJEJTUNINS Naso-jejunal tune insertion ( endoscopic )- 5300 5300 2650 2120 1590
HOS Hospital service charges
60 NBDDHCH NASO-BILIARY DRAINANGE ( NBD )
NBDHC Naso-biliary drainange ( NBD ) - Additional 15440 15440 7720 6180 4630
hospital charges
NBDDF Naso-biliary drainange ( NBD ) - Doctor fee 38600 38600 19300 15440 11580
NBDHCPACS Naso-biliary drainange ( NBD ) - For PACS -
61 NFTOS NASOJEJUNAL FEEDING TUBE
REPOSITIONING CHARGES - (Doctor
NFTHC NASOJEJUNAL FEEDING TUBE REPOSITIONING 2650 2650 1320 1060 800
CHARGES – Additional Hospital Charges
NFTDC NASOJEJUNAL FEEDING TUBE 6620 6620 3310 2650 1990
REPOSITIONING CHARGES - Doctor Fee
62 OPHDHCH OESOPHAGEAL PH MONITORING
OPMHC Oesophageal pH monitoring - Additional 7060 7060 3530 2820 2120
hospital charges
OPMDF Oesophageal pH monitoring - Doctor fee 17640 17640 8820 7060 5290
OPMHCPACS Oesophageal pH monitoring - For PACS -
63 PBROS PEG/BRT REMOVAL CHARGES - (Doctor
PBRHC PEG/BRT REMOVAL CHARGES - Additional 880 880 440 350 260
Hospital Charges
PBRDC PEG/BRT REMOVAL CHARGES - Doctor Feee 2200 2200 1100 880 660
64 PEGDHCH PERCUTANEOUS ENDOSCOPIC
OS GASTROSTOMY ( PEG ) (DOCTOR FEE +
HOSPITAL CHARGES)
PEGHC Percutaneous endoscopic gastrostomy ( PEG) - 12350 12350 6180 4940 3700
PEGDF Percutaneous endoscopic gastrostomy ( PEG) - Doctor 30880 30880 15440 12350 9260
fee
PEGHCPACS Percutaneous endoscopic gastrostomy ( PEG) - For
65 SBOWTRA Small bowel transplant recipient
SUROS operation (NORMAL RISK) (Package
charges + Gastroenterologist fee)
246
SBTSAGAS Small bowel transplant surgery (Normal / 66000
Early)- amount given to gastroenterology
from within the package
SBTSPCN Small bowel transplant surgery (Normal)- 2365000
66 SBTSPCEO Small bowel transplant recipient
S 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
67 SPGCBOS Spy Glass Cholangioscopy+
Consumables (Optical Fiber-Spy
Scope) - (Doctor Fee+ Hospital
Charges)
COFSPY Consumables ( Optical fiber + Spyscope ) charges 18900
SBBIO Spy bite biopsy charges 6620
SPGCH Spy Glass Cholangioscopy – Additional hospital charges 14110 14110 7060 5640 4230
SPGCD Spy Glass Cholangioscopy - Doctor Fee 35280 35280 17640 14110 10580
SGXR X-Ray ( Spy Glass ) 4410
68 SPGCLOS Spy Glass Cholangioscopy+
Consumables (Optical Fiber-Spy Scope)
- (Doctor Fee+Hospital Charges)
- Laser Lithotripsy
COFSPY Consumables ( Optical fiber + Spyscope ) charges 18900
LASLI Laser Lithotripsy 13230
SPGCH Spy Glass Cholangioscopy – Additional hospital charges 14110 14110 7060 5640 4230
SPGCD Spy Glass Cholangioscopy - Doctor Fee 35280 35280 17640 14110 10580
SGXR X-Ray ( Spy Glass ) 4410
69 STPDHCH SENGSTAKEN TUBE PLACEMENT
DTPHC Sengstaken tube placement. - Additional 6180 6180 3090 2470 1850
hospital charges
STPDF Sengstaken tube placement. - Doctor fee 15440 15440 7720 6180 4630
70 TAALVHC Ascites tapping / aspiration done in
ENDOS ENDOSCOPY ( therapeutic ) - large
volume paracentesis (doctor fee +
hospital charges)
TAALVDF Therapeutic ascites aspiration ( large 6960 6960 3480 2780 2090
TAALVHCEND Therapeutic ascites aspiration ( large volume 2780 2780 1390 1110 840
paracentesis ) done in ENDOSCOPY
room - Additional hospital charges
71 TJLBEOS Transjuglar liver biopsy (done in
endoscopy) (Doctor fee +
Hospital Charges)
TJLBE Transjuglar liver biopsy (done in endoscopy) 8820 8820 4410 3530 2650
- Additional hospital charges
TJLBEDF Transjuglar liver biopsy (done in endoscopy) 22060 22060 11030 8820 6620
- Doctor Fee
TJLBEPACS Transjuglar liver biopsy (done in endoscopy)
- For PACS - NOT FOR BILLING PURPOSE
72 UGGGIED UPPER GASTROINTESTINAL (
CHOS UGI ) ENDOSCOPY (DOCTOR
UGIPACS Upper gastrointestinal ( UGI ) endoscopy -
UGIHC Upper gastrointestinal ( UGI ) endoscopy - 3980 3980 1990 1590 1190
UGIDF Upper gastrointestinal ( UGI ) endoscopy -Doctor fee 9940 9940 4970 3980 2980
247
73 UGIOS Upper gastrointestinal (UGI )
endoscopy done outside endoscopy
UGIOSHC Upper gastrointestinal (UGI ) endoscopy done outside 5160 5160 2580 2060 1550
endoscopy suite – Additional hospital charges
UGIOS Upper gastrointestinal (UGI ) endoscopy 12900 12900 6450 5160 3870
done outside endoscopy suite - doctor fee
74 ULTIOS Ultroid Injection - (Doctor Fee
+ Hospital Charges)
ULTIH Ultroid Injection - Additional hospital charges 7060 7060 3530 2820 2120
ULTID Ultroid Injection - Doctor Fee 17640 17640 8820 7060 5290
ULTIPACS Ultroid Injection - For PACS - NOT FOR
BILLING PURPOSE
75 USCOS USG FOR SIZE OF COLLECTION
/ USG FOR ASCITES - (Doctor
USCHC USG FOR SIZE OF COLLECTION / USG FOR 880 880 440 350 260
ASCITES - Additional Hospital Charges
USCDC USG FOR SIZE OF COLLECTION / USG FOR 2200 2200 1100 880 660
ASCITES - Doctor Fee
76 USGOS USG GUIDED SINGLE TIME ASPIRATION -
UGSHC USG GUIDED SINGLE TIME ASPIRATION - 2650 2650 1320 1060 800
UGSDC USG GUIDED SINGLE TIME ASPIRATION - Doctor Fee 6620 6620 3310 2650 1990
Interventional Neurology
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
1 ABLDSOS Angiography of B/L Dorsolumbar
Spinal Radicular Arteries
ABLDAF Angiography of B/L Dorsolumbar Spinal 14560 14560 7280 5820 4370
Radicular Arteries - Anasthetist fee
ABLDS Angiography of B/L Dorsolumbar Spinal 72760 72760 36380 29100 21830
Radicular Arteries - Doctor Fee
ABLDSLA Angiography of B/L Dorsolumbar Spinal 34920 34920 17460 13970 10480
Radicular Arteries - Lab charges
2 ATHOS Intracranial stenting for Atherosclerosis -
INTERVENTION NEUROLOGY
ATHDF Intracranial stenting for Atherosclerosis -Surgeon Fee 200100 200100 100050 80040 60030
3 AVMOS Complex AVM/AVF Embolization via
trans arterial and transvenous route -
AVMLC Complex AVM/AVF Embolization via trans arterial and 96060 96060 48030 38420 28820
transvenous route – Intervention lab charges
AVMDF Complex AVM/AVF Embolization via trans arterial and 200100 200100 100050 80040 60030
transvenous route – Surgeon Fee
4 BACEDOS Balloon Assisted Coil Embolization of a

Direct/Indirect Cavernous Fistula
BACEDAN Balloon Assisted Coil Embolization of a 48520 48520 24260 19410 14560
Direct/Indirect Cavernous Fistula - Anasthetist fee
BACEDF Balloon Assisted Coil Embolization of a Direct/Indirect 242560 242560 121280 97020 72770
Cavernous Fistula – Doctor Fee
BACEDLB Balloon Assisted Coil Embolization of a Direct/Indirect 116420 116420 58210 46570 34930
Cavernous Fistula - Lab charges
5 BASCIOS Balloon Angioplasty & Stenting
in Cervical ICA/Vertebral
BASCAN Balloon Angioplasty & Stenting in Cervical 43660 43660 21830 17460 13100
ICA/Vertebral - Anasthetist Fee
BASCD Balloon Angioplasty & Stenting in Cervical 218300 218300 109150 87320 65490
ICA/Vertebral - Doctor Fee
248
BASCLC Balloon Angioplasty & Stenting in Cervical 104800 104800 52400 41920 31440
ICA/Vertebral - Lab charges
6 BTOUMO Balloon test occlusion ( Under
S2 Monitoring )
BTOANM2 Balloon test occlusion - anaesthetists 17760 17760 8880 7100 5330
charges for monitoring
BTODF2 Balloon test occlusion - doctor fee 88780 88780 44390 35510 26630
BTOLC2 Balloon test occlusion - intervention lab 42600 42600 21300 17040 12780
charges
7 CASUMOS Carotid angioplasty & stenting
2 ( Under Monitoring )
CASANM2 Carotid angioplasty & stenting - 28420 28420 14210 11370 8530
anaesthetists charges for monitoring
CASDF2 Carotid angioplasty & stenting - doctor fee 142040 142040 71020 56820 42610
CASLC2 Carotid angioplasty & stenting - intervention 68180 68180 34090 27270 20450
lab charges
8 CCDSAOS 2 Check cerebral DSA ( Under LA)
CCDSADF2 Check cerebral DSA - doctor fee 31980 31980 15990 12790 9590
CCDSALC2 Check cerebral DSA - intervention lab charges 15360 15360 7680 6140 4610
9 CCDSAUG Check cerebral DSA ( Under GA)
AOS2
CCDANGA2 Check cerebral DSA - anaesthetists charges for GA 9600 9600 4800 3840 2880
10 CCDSAUM Check cerebral DSA ( Under
OS2 Monitoring )
CCDANM2 Check cerebral DSA - anaesthetists charges 6400 6400 3200 2560 1920
for monitoring
11 CCFEUGA CCF embolisation ( Under GA )
OS2
CCFEANGA2 CCF embolisation - anaesthetists charges for GA 47940 47940 23970 19180 14380
CCFEDF2 CCF embolisation - doctor fee 159820 159820 79910 63930 47950
CCFELC2 CCF embolisation - intervention lab charges 76720 76720 38360 30690 23020
12 CDSAGAO S Cerebral DSA ( Under GA )
CDANGA2 Cerebral DSA - anaesthetists charges for GA 10640 10640 5320 4260 3190
CDANM2 Cerebral DSA - anaesthetists charges for monitoring 7100 7100 3550 2840 2130
CDSADF2 Cerebral DSA - doctor fee 35520 35520 17760 14210 10660
LC2 Cerebral DSA - intervention lab charges 17060 17060 8530 6820 5120
13 CDSALAO S2 Cerebral DSA ( Under LA )
CDSADF2 Cerebral DSA - doctor fee 35520 35520 17760 14210 10660
LC2 Cerebral DSA - intervention lab charges 17060 17060 8530 6820 5120
14 CHBOS Intraarterial chemotherapy for
malignant brain tumours -
CHBLC Intraarterial chemotherapy for malignant 102460 102460 51230 40980 30740
brain tumours - Intervention Lab charges
CHBDF Intraarterial chemotherapy for malignant 213440 213440 106720 85380 64030
brain tumours - Surgeon Fee
15 CHHNOS Intra-arterial chemotherapy of head
and neck tumours -
CHHNLC Intra-arterial chemotherapy of head and 96060 96060 48030 38420 28820
neck tumours - Intervention Lab charges
CHHNDF Intra-arterial chemotherapy of head and 200100 200100 100050 80040 60030
neck tumours - Surgeon Fee
16 CIATUGA Cerebral intra-arterial
OS2 thrombolysis ( Under GA )
CIATANGA2 Cerebral intra-arterial thrombolysis - 31960 31960 15980 12780 9590
anaesthetists charges for GA
CIATDF2 Cerebral intra-arterial thrombolysis – doctor fee 106540 106540 53270 42620 31960
249
CIATLC2 Cerebral intra-arterial thrombolysis - 51140 51140 25570 20460 15340
intervention lab charges
17 CIATUMO Cerebral intra-arterial thrombolysis (
S2 Under Monitoring )
CIATANM2 Cerebral intra-arterial thrombolysis - 21320 21320 10660 8530 6400
CIATDF2 Cerebral intra-arterial thrombolysis – doctor fee 106540 106540 53270 42620 31960
CIATLC2 Cerebral intra-arterial thrombolysis - 51140 51140 25570 20460 15340
18 CVSTUGA Cerebral venous sinus
OS2 thrombolysis ( Under GA )
CVSTANGA2 Cerebral venous sinus thrombolysis - 42600 42600 21300 17040 12780
CVSTDF2 Cerebral venous sinus thrombolysis – doctor fee 142040 142040 71020 56820 42610
CVSTLC2 Cerebral venous sinus thrombolysis - 68180 68180 34090 27270 20450
19 CVSTUMO Cerebral venous sinus thrombolysis (
S2 Under Monitoring )
CVSTANM2 Cerebral venous sinus thrombolysis - 28410 28410 14200 11360 8520
CVSTDF2 Cerebral venous sinus thrombolysis – doctor fee 142040 142040 71020 56820 42610
CVSTLC2 Cerebral venous sinus thrombolysis - 68180 68180 34090 27270 20450
20 ESPFDOS Embolization of Spinal
Pial/dural Fistula
ESPFDNA Embolization of Spinal Pial/dural Fistula - 48520 48520 24260 19410 14560
Anasthetist fee
ESPFD Embolization of Spinal Pial/dural Fistula -Doctor Fee 242560 242560 121280 97020 72770
ESPFDLA Embolization of Spinal Pial/dural Fistula -Lab charges 116420 116420 58210 46570 34930
21 FDPIAOS Flow Divertor Placement for
Intracranial Aneurysm
FDPIANA Flow Divertor Placement for Intracranial 58220 58220 29110 23290 17470
Aneurysm - Anasthetist fee
FDPIA Flow Divertor Placement for Intracranial 291060 291060 145530 116420 87320
Aneurysm - Doctor Fee
FDPIALC Flow Divertor Placement for Intracranial 139720 139720 69860 55890 41920
Aneurysm - Lab charges
22 IACMUGA Intracranial aneurysm coiling (multiple
OS2 / complex ) ( Under GA )
IACMANGA2 Intracranial aneurysm coiling ( multiple / 63920 63920 31960 25570 19180
complex ) - anaesthetists charges for GA
IACMDF2 Intracranial aneurysm coiling ( multiple / 213080 213080 106540 85230 63920
complex ) - doctor fee
IACMLC2 Intracranial aneurysm coiling ( multiple / 102300 102300 51150 40920 30690
complex ) - intervention lab charges
23 IACSUGA Intracranial aneurysm coiling
OS2 (single) ( Under GA )
IACSANGA2 Intracranial aneurysm coiling (single) - 47940 47940 23970 19180 14380
IACSDF2 Intracranial aneurysm coiling (single) - 159820 159820 79910 63930 47950
doctor fee
IACSLC2 Intracranial aneurysm coiling (single) - 76720 76720 38360 30690 23020
24 IADUGAO Intracranial angioplasty (
S2 Under GA )
IAANGA2 Intracranial angioplasty - anaesthetists 53280 53280 26640 21310 15980
charges for GA
IADF2 Intracranial angioplasty - doctor fee 177580 177580 88790 71030 53270
IALC2 Intracranial angioplasty - intervention lab charges 85240 85240 42620 34100 25570
25 IAELEOS Intracranial AVM Embolization
using Liquid Embolic material
IAELNA Intracranial AVM Embolization using Liquid 48520 48520 24260 19410 14560
Embolic material - Anasthetist fee
IAELE Intracranial AVM Embolization using Liquid 242560 242560 121280 97020 72770
Embolic material - Doctor Fee
IAELLC Intracranial AVM Embolization using Liquid 116420 116420 58210 46570 34930
Embolic material - Lab charges
250
26 IAVDOS Intracranial Angioplasty for
Vasaspasm
IAVDNA Intracranial Angioplasty for Vasaspasm - 29100 29100 14550 11640 8730
Anasthetist fee
IAVDF Intracranial Angioplasty for Vasaspasm - 145540 145540 72770 58220 43660
Doctor Fee
IAVDLA Intracranial Angioplasty for Vasaspasm - 69840 69840 34920 27940 20950
Lab charges
27 IAVLAOS2 Intra arterial vasodialation
(interventional neurology) (Under LA )
IAVDF2 Intra arterial vasodialation (interventional 49700 49700 24850 19880 14910
neurology) - doctor fee
IAVLC2 Intra arterial vasodialation (interventional 23860 23860 11930 9540 7160
neurology) - intervention lab charges
28 IAVMEUG Intracranial AVM embolisation
AOS2 ( Under GA )
IAVMEANGA2 Intracranial AVM embolisation - 47940 47940 23970 19180 14380
IAVMEDF2 Intracranial AVM embolisation - doctor fee 159820 159820 79910 63930 47950
IAVMELC2 Intracranial AVM embolisation - 76720 76720 38360 30690 23020
29 IAVUGAO Intra arterial vasodialation
S2 (interventional neurology) (Under GA )
IAVANGA2 Intra arterial vasodialation (interventional 14920 14920 7460 5970 4480
neurology) - anaesthetists charges for GA
30 IAVUMOS Intra arterial vasodialation
2 (interventional neurology) (Under
Monitoring )
IAVANM2 Intra arterial vasodialation (interventional neurology) - 9940 9940 4970 3980 2980
31 ISRDOS Intracranial Stenting in Stroke
Revascularization
ISRNA Intracranial Stenting in Stroke 48520 48520 24260 19410 14560
Revascularization - Anasthetist fee
ISRDF Intracranial Stenting in Stroke 242560 242560 121280 97020 72770
Revascularization - Doctor Fee
ISRLC Intracranial Stenting in Stroke 116420 116420 58210 46570 34930
Revascularization - Lab charges
32 ISUGAOS2 Intracranial stenting ( Under GA )
ISANGA2 Intracranial stenting - anaesthetists charges for GA 53280 53280 26640 21310 15980
ISDF2 Intracranial stenting - doctor fee 177580 177580 88790 71030 53270
ISLC2 Intracranial stenting - intervention lab charges 85240 85240 42620 34100 25570
33 ITEUGAOS Intracranial tumour
2 embolisation ( Under GA )
ITEANGA2 Intracranial tumour embolisation - 26620 26620 13310 10650 7990
ITEDF22 Intracranial tumour embolisation – doctor fee 88780 88780 44390 35510 26630
ITELC2 Intracranial tumour embolisation - 42600 42600 21300 17040 12780
34 ITEUMOS Intracranial tumour embolisation (
2 Under Monitoring )
ITEANM2 Intracranial tumour embolisation - 17760 17760 8880 7100 5330
ITEDF22 Intracranial tumour embolisation – doctor fee 88780 88780 44390 35510 26630
ITELC2 Intracranial tumour embolisation - 42600 42600 21300 17040 12780
251
35 IVMECOS Intracranial AVM Embolization
(Complex)
IVMECNA Intracranial AVM Embolization (Complex) - 58220 58220 29110 23290 17470
Anasthetist fee
IVMEC Intracranial AVM Embolization (Complex) - 291060 291060 145530 116420 87320
Doctor Fee
IVMECLC Intracranial AVM Embolization (Complex) - 139720 139720 69860 55890 41920
Lab charges
36 IVSUGAO Intracranial Venous stenting (Under
S2 GA )
IVSANGA2 Intracranial Venous stenting - anaesthetists 42600 42600 21300 17040 12780
charges for GA
IVSDF2 Intracranial Venous stenting - doctor fee 142040 142040 71020 56820 42610
IVSLC2 Intracranial Venous stenting - intervention 68180 68180 34090 27270 20450
lab charges
37 MTASROS Mechanical thrombectomy for actue
stroke using stent retrievers –
MRASRLC Mechanical thrombectomy for actue stroke using stent 96060 96060 48030 38420 28820
retrievers - intervention lab charges
MTASRDF Mechanical thrombectomy for actue stroke 200100 200100 100050 80040 60030
using stent retrievers - Surgeon Fee
38 PSTEUGA Percutaneous Spinal tumour
OS2 embolisation ( Under GA )
PSTEANGA2 Percutaneous Spinal tumour embolisation - 17060 17060 8530 6820 5120
PSTEDF2 Percutaneous Spinal tumour embolisation - 56820 56820 28410 22730 17050
doctor fee
PSTELC2 Percutaneous Spinal tumour embolisation - 27280 27280 13640 10910 8180
39 PSTEUMO Percutaneous Spinal tumour
S2 embolisation ( Under Monitoring )
PSTEANM2 Percutaneous Spinal tumour embolisation - 11360 11360 5680 4540 3410
PSTEDF2 Percutaneous Spinal tumour embolisation - 56820 56820 28410 22730 17050
doctor fee
PSTELC2 Percutaneous Spinal tumour embolisation - 27280 27280 13640 10910 8180
40 PSUMOS2 Percutaneous Sclerotherapy
(interventional neurology) ( Under
Monitoring )
PSANM2 Percutaneous Sclerotherapy (interventional neurology) 9940 9940 4970 3980 2980
- anaesthetists charges for monitoring
PSDF2 Percutaneous Sclerotherapy (interventional 49700 49700 24850 19880 14910
PSLC2 Percutaneous Sclerotherapy (interventional 23860 23860 11930 9540 7160
41 PVUMOS2 Percutaneous Vertebroplasty
(interventional neurology) ( Under
Monitoring )
PVANM2 Percutaneous Vertebroplasty (interventional 11360 11360 5680 4540 3410
neurology) - anaesthetists charges for monitoring
PVDF2 Percutaneous Vertebroplasty (interventional 56820 56820 28410 22730 17050
PVLC2 Percutaneous Vertebroplasty (interventional 27280 27280 13640 10910 8180
42 SACEIOS Stent Assisted Coil Embolization of
Intracranial ICA Aneurysm
SACEAN Stent Assisted Coil Embolization of 48520 48520 24260 19410 14560
Intracranial ICA Aneurysm - Anasthetist fee
SACEI Stent Assisted Coil Embolization of 242560 242560 121280 97020 72770
Intracranial ICA Aneurysm - Doctor Fee
SACELC Stent Assisted Coil Embolization of 116420 116420 58210 46570 34930
Intracranial ICA Aneurysm - Lab charges
252
43 SACEOS Stent assisted coil embolization of
intracranial aneurysms –
SADELC Stent assisted coil embolization of intracranial 102460 102460 51230 40980 30740
aneurysms - intervention lab charges
SACEDF Stent assisted coil embolization of 213440 213440 106720 85380 64030
intracranial aneurysms - Surgeon Fee
44 SAVMEUG Spinal AVM embolisation (
AOS2 Under GA )
SAVMEANGA2 Spinal AVM embolisation - anaesthetists 47940 47940 23970 19180 14380
charges for GA
SAVMEDF2 Spinal AVM embolisation - doctor fee 159820 159820 79910 63930 47950
SAVMELC2 Spinal AVM embolisation - intervention lab charges 76720 76720 38360 30690 23020
45 SDSAUGA Spinal DSA ( Under GA )
OS2
SDSAANGA2 Spinal DSA - anaesthetists charges for GA 12780 12780 6390 5110 3830
SDSADF2 Spinal DSA - doctor fee 42640 42640 21320 17060 12790
SDSALC2 Spinal DSA - intervention lab charges 20460 20460 10230 8180 6140
46 SVCAOS Six Vessel Cerabral Angiogram
SVCAAC Six Vessel Cerabral Angiogram – Anasthetist Fee 12140 12140 6070 4860 3640
SVCAD Six Vessel Cerabral Angiogram - Doctor fee 60640 60640 30320 24260 18190
SVCALB Six Vessel Cerabral Angiogram - Lab charges 29100 29100 14550 11640 8730
47 VSSLAOS2 Venous sinus sampling ( Under LA )
VSSDF2 Venous sinus sampling - doctor fee 88780 88780 44390 35510 26630
VSSLC2 Venous sinus sampling - intervention lab charges 42600 42600 21300 17040 12780
48 VSSUGAO Venous sinus sampling ( Under
S2 GA )
VSSANGA2 Venous sinus sampling - anaesthetists 26620 26620 13310 10650 7990
charges for GA
49 VSSUMOS Venous sinus sampling ( Under
2 Monitoring )
VSSANM2 Venous sinus sampling - anaesthetists 17760 17760 8880 7100 5330
charges for monitoring
50 YSBAOS Y-Stenting in a Basilar Top Aneurysm
YSBAN Y-Stenting in a Basilar Top Aneurysm -Anasthetist fee 58220 58220 29110 23290 17470
YSBAD Y-Stenting in a Basilar Top Aneurysm -Doctor Fee 291060 291060 145530 116420 87320
YSBALC Y-Stenting in a Basilar Top Aneurysm - Lab charges 139720 139720 69860 55890 41920
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

1 BEMBOS Bronchial a embolization (Intervention
Radiology ) - Doctor Fee + Hospital
Charges
BEMBDF Bronchial a embolization (Intervention 96860 96860 48430 38740 29060
Radiology ) - Doctor Fee
BEMBHC Bronchial a embolization (Intervention 46500 46500 23250 18600 13950
2 BEXOS Biliary externalization (Intervention
Radiology ) - Doctor Fee + Hospital
Charges
BEXHC Biliary externalization (Intervention 34080 34080 17040 13630 10220
BEXDF Biliary externalization Intervention 71020 71020 35510 28410 21310
253
3 BIXOS Biliary internalization
(Intervention Radiology) -
Doctor fee + Hospital Charges
BIXHC Biliary internalization (Intervention 34080 34080 17040 13630 10220
BIXDF Biliary internalization (Intervention 71020 71020 35510 28410 21310
Radiology) - Doctor Fee
4 BPCNOS Bilateral PCN (IR) in Vascular Cath Lab
- Interventional Radiology - ( Doctor
Fee + Hospital Charges )
BPCNDF Bilateral PCN (IR) in Vascular Cath Lab - 70360 70360 35180 28140 21110
Interventional Radiology - Doctor Fee
BPCNHC Bilateral PCN (IR) in Vascular Cath Lab - 33760 33760 16880 13500 10130
Interventional Radiology - Hospital Charges
5 BRTOIROS Balloon occluded retrograde
transvenous obliteration of varices
(BRTO) IT (Doctor +Hospital Charges)
BRTOIRDC Balloon occluded retrograde transvenous obliteration 217080 217080 108540 86830 65120
of varices (BRTO) IT – Doctor Charges
BRTOIRHC Balloon occluded retrograde transvenous obliteration 104200 104200 52100 41680 31260
of varices (BRTO) IT – Hospital Charges
6 CABIROS Chemical Ablation of Tumour
IR (Doctor+Hospital Charges)
CABIRDC Chemical Ablation of Tumour IR Doctor Charges 73880 73880 36940 29550 22160 36940
CABIRHC Chemical Ablation of Tumour IR Hospital Charges 35460 35460 17730 14180 10640 17730
7 CGRFAOS CT Guided RFA of Tumour IR Cath Lab
(Doctor + Hospital Charges)
CGRFADC CT Guided RFA of Tumour Cath Lab IR - 125240 125240 62620 50100 37570 62620
Doctor Charges
CGRFAHC CT Guided RFA of Tumour Cath Lab IR - 60120 60120 30060 24050 18040 30060
Hospital Charges
8 COILEMB Coil embolization ( Interventional
OLOS radiology ) (Doctor fee + Hospital
service charges)
COILEMBOLDF Coil embolization ( Interventional radiology ) 78120 78120 39060 31250 23440 39060 23440
- Doctor Fee
COILEMBOLHC Coil embolization ( Interventional radiology ) 37500 37500 18750 15000 11250 18750 11250
- Hospital charges
9 COIVESTC Coiling of vessels + TC 99 infusion
99OS (Interventional Radiology) (Doctor fee
+ Hospital charges)
COIVESTC99D Coiling of vessels + TC 99 infusion - 110080 110080 55040 44030 33020 55040 33020
F Interventional radiology (Doctor fee)
COIVESTC99H Coiling of vessels + TC 99 infusion - 52840 52840 26420 21140 15850 26420 15850
C Interventional radiology (Hospital charges)
10 COMBIRO Complex Biliary Externalization
S (Two/Three System ) IR
COMBIRDC Complex Biliary Externalization (Two/Three 158760 158760 79380 63500 47630
System ) IR - Doctor Fee
COMBIRHC Complex Biliary Externalization (Two/Three 76200 76200 38100 30480 22860
System ) IR - Hospital Charges
11 COMINTIR Complex Biliary internalization
OS (Two/Three System ) IR -
(Doctor + Hosptal Charges)
COMINTIRDC Complex Biliary internalization (Two/Three 185220 185220 92610 74090 55570
System ) IR - Doctor Fee
COMINTIRHC Complex Biliary internalization (Two/Three 88920 88920 44460 35570 26680
System ) IR - Hospital Charges
12 CONECTIR Cone Beam CT assisted TACE IR
OS - (Doctor + Hospital Charges)
CONECTIRDC Cone Beam CT assisted TACE IR – Doctor Charges 211680 211680 105840 84670 63500
CONECTIRHC Cone Beam CT assisted TACE IR – Hospital Charges 101600 101600 50800 40640 30480
254
13 CTBIOS CT Guided Biopsy - IR ( Interventional
radiology ) (Doctor Fee + Hospital
service charges)
CTBIOD CT Guided Biopsy - IR ( Interventional 23100 23100 11550 9240 6930 11550
radiology ) (Doctor Fees)
CTBIOHC CT Guided Biopsy - IR ( Interventional 2320 2320 1160 930 700 1160
radiology ) (Hospital service charges)
14 CTBONOS CT Guided Bone Biopsy - IR
(Interventional radiology ) (Doctor Fee
+ Hospital service charges)
CTBODC CT Guided Bone Biopsy - IR ( Interventional 26260 26260 13130 10500 7880 13130
CTGUHC CT Guided Bone Biopsy - IR ( Interventional 2620 2620 1310 1050 790 1310
15 CTGOS CT guided aspiration / drainage
(Interventional radiology) (Doctor Fee
+ Hospital Charges)
CTGDC CT guided aspiration / drainage - Doctor Fee 14920 14920 7460 5970 4480
CTGHC CT guided aspiration / drainage – Hospital Charges 1500 1500 750 600 450
16 CTPMULO CT Guided PCD Multiple
S (Interventional radiology) (Doctor Fee
PCDMULD CT Guided PCD Multiple ( Interventional 38600 38600 19300 15440 11580 19300
CTPCHOS CT Guided PCD Multiple ( Interventional 3860 3860 1930 1540 1160 1930
17 DIAGPLEO USG Guided Ascitic / Pleural
S Diagnostic Tapping - IR (Interventional
service charges)
PLEDIAGD USG Guided Ascitic / Pleural Diagnostic Tapping - IR ( 9240 9240 4620 3700 2770 4620
Interventional radiology ) (Doctor Fees)
GUITAPPIRH USG Guided Ascitic / Pleural Diagnostic Tapping - IR ( 920 920 460 370 280 460
Interventional radiology ) (Hospital service charges)
18 DOXOTAC Doxorubicin loaded bead TACE
EIROS IR (Doctor + Hospital Charges)
DOXOTACEIRD C Doxorubicin loaded bead TACE IR – Doctor Charges 185220 185220 92610 74090 55570
DOXOTACEIRH C Doxorubicin loaded bead TACE IR – Hospital Charges 88920 88920 44460 35570 26680
19 EMBABDT Embolization of abdominal tumours
UMOS (Interventional radiology) - (Doctor fee
EMBABDTUM Embolization of abdominal tumours 78120 78120 39060 31250 23440
DF (Interventional radiology) - Doctor fee
EMBABDTUM Embolization of abdominal tumours 37500 37500 18750 15000 11250
HC (Interventional radiology) - Hospital charges
20 GPCIDOS Guided PCD/ICD done in Cath Lab IR
GPCIDC Guided PCD/ICD done in Cath Lab IR Doctor Fee 24260 24260 12130 9700 7280 12130
GPCIHC Guided PCD/ICD done in Cath Lab IR Hospial Charges 11640 11640 5820 4660 3490 5820
21 GUIDRAN CT Guided Drainage - IR
OS (Interventional radiology ) (Doctor Fee
GUIDEDD CT Guided Drainage - IR ( Interventional 19740 19740 9870 7900 5920 9870
CTHOSN CT Guided Drainage - IR ( Interventional 1980 1980 990 790 590 990
22 GUIPLEM USG Guided Ascitic / Pleural Diagnostic
OBOS Tapping (Mob) - IR ( Interventional
radiology ) (Doctor Fee + Hospital service
charges)
GUIPLE USG Guided Ascitic / Pleural Diagnostic Tapping (Mob) 13440 13440 6720 5380 4030
- IR ( Interventional radiology ) (Doctor Fees)
255
TAPPHOSIR USG Guided Ascitic / Pleural Diagnostic 1340 1340 670 540 400
Tapping (Mob) - IR ( Interventional radiology) (Hospital
service charges)
23 INCYTOS Intraductal Cytology/Biopsy IR Cath
Lab (Doctor + Hospital Charges)
INCYTOB Intraductal Cytology/Biopsy IR Cath Lab -Doctor Fee 33080 33080 16540 13230 9920 16540
INCYTOBHC Intraductal Cytology/Biopsy IR Cath Lab - 15880 15880 7940 6350 4760 7940
Hospital Charges
24 IRRDCOS Irrigation of Drain / Change of
Dressing - IR (Interventional radiology)
(Doctor Fee + Hospital service charges)
IRR Irrigation of Drain / Change of Dressing - IR 5260 5260 2630 2100 1580
(Interventional radiology ) (Doctor Fees)
IRRDESHC Irrigation of Drain / Change of Dressing - IR 520 520 260 210 160
(Interventional radiology ) (Hospital service
charges)
25 IRRDERM Irrigation of Drain / Change of
OBOS Dressing (Mob) - IR ( Interventional
radiology ) (Doctor Fee Hospital
service charges)
IRRCHADC Irrigation of Drain / Change of Dressing 7360 7360 3680 2940 2210
(Mob) - IR ( Interventional radiology ) (Doctor Fees)
IRRCHAHC Irrigation of Drain / Change of Dressing 740 740 370 300 220
(Mob) - IR ( Interventional radiology )
(Hospital service charges)
26 LYMDEOS Lymphatic Duct embolization
(Interventional Radiology ) -
(Doctor Fee + Hospital Chares )
LYMDEDF Lymphatic Duct embolization (IR) – Doctor Fee 151200 151200 75600 60480 45360
LYMDEHC Lymphatic Duct embolization (IR) – Hospital Charges 72580 72580 36290 29030 21770
27 LYMIROS Lymphangiography ( Interventional
Radiology ) - (Doctor Fee + Hospital
Charges )
LYMIRDF Lymphangiography (IR) - Doctor Fee 44100 44100 22050 17640 13230
LYMIRHC Lymphangiography (IR) - Hospital Charges 21160 21160 10580 8460 6350
28 PAIROS PAIR Interventinal Radiology IR
- (Doctor + Hospital Charges)
PAIRDC PAIR Interventinal Radiology IR – Doctor Charges 73880 73880 36940 29550 22160 36940
PAIRHC PAIR Interventinal Radiology IR – Hospital Charges 35460 35460 17730 14180 10640 17730
29 PBEMOS Percutaenous Biopsy with tract
embolization ath Lab IR
PBEMCF Percutaenous Biopsy with tract embolization 13240 13240 6620 5300 3970 6620
- Cath Lab Charges
PBEMB Percutaenous Biopsy with tract embolization 27580 27580 13790 11030 8270 13790
- Doctor Charges
30 PCDCHCO Percutaneous Cholecystotomy
S - Doctor Fee + Hospital Charges
PCDF Percutaneous Cholecystotomy - Doctor Fee 26700 26700 13350 10680 8010
PCHC Percutaneous Cholecystotomy – Hospital Charges 12820 12820 6410 5130 3850
31 PCDCTOS CT Guided PCD - IR ( Interventional
service charges)
PCDDOCC CT Guided PCD - IR ( Interventional radiology) (Doctor 27580 27580 13790 11030 8270 13790
Fees)
PCDHOSPI CT Guided PCD - IR ( Interventional radiology) (Hospital 2760 2760 1380 1100 830 1380
service charges)
32 PCDMOB USG Guided PCD (Mob) - IR
(Interventional radiology ) (Doctor Fee
PCDDOC USG Guided PCD (Mob) - IR ( Interventional 27300 27300 13650 10920 8190
256
PCSDHC USG Guided PCD (Mob) - IR ( Interventional 2740 2740 1370 1100 820
33 PDEBOS Precision TACE by drug eluting beads
(Intervention Radiology ) - Doctor Fee
+ Hospital Charges
PDEBDF Precision TACE by drug eluting beads 116240 116240 58120 46500 34870
PDEBHC Precision TACE by drug eluting beads 55800 55800 27900 22320 16740
(Intervention Radiology) - Hospital Charges
34 PDSPOS Partial devascularization of
spleen ( for hypersplenism)
(Intervention Radiology ) -
Doctor Fee + Hospital Charges
PDSPDF Partial devascularization of spleen ( for hypersplenism) 96860 96860 48430 38740 29060
PDSPHC Partial devascularization of spleen (for hypersplenism) 46500 46500 23250 18600 13950
35 PEADSNE Percutaenous Esophagostomy/
WOS Gastrostomy/ Jejunostomy/ Caecostomy -
IR (Interventional radiology ) (Doctor Fee +
Hospital service charges)
PEGJDOC Percutaenous Esophagostomy/ 93500 93500 46750 37400 28050
Gastrostomy/ Jejunostomy/ Caecostomy - IR
( Interventional radiology ) (Doctor Fee)
IPFGPJHC Percutaenous Esophagostomy/ Gastrostomy/ 44880 44880 22440 17950 13460
Jejunostomy/ Caecostomy - IR ( Interventional
36 PERANGIR Percutaenous Endovascular Angioplasty IR
OS
PERANGIRDC Percutaenous Endovascular Angioplasty IR - 217200 217200 108600 86880 65160
Doctor Charges
PERANGIRHC Percutaenous Endovascular Angioplasty IR - 104260 104260 52130 41700 31280
Hospital Charges
37 PROSIROS Prostatic Artery Embolization
IR (Doctor + Hospital Charges)
PROSIRDH Prostatic Artery Embolization IR – Doctor Charges 136720 136720 68360 54690 41020
PROSIRHC Prostatic Artery Embolization IR – Hospital Charges 65620 65620 32810 26250 19690
38 PVFDOS Portal vein flow diversion (Intervention
Radiology ) - Doctor Fee + Hospital Charges
PVFDDF Portal vein flow diversion (Intervention 116240 116240 58120 46500 34870
PVFDHC Portal vein flow diversion (Intervention 55800 55800 27900 22320 16740
39 RABTUOS Radiofrequency ablation of Tumour
Interventional Radiology IR Cath Lab
RABTUDC Radiofrequency ablation of Tumour Interventional 125240 125240 62620 50100 37570 62620
Radiology IR Cath Lab - Doctor Charges
RABTUHC Radiofrequency ablation of Tumour Interventional 60120 60120 30060 24050 18040 30060
Radiology IR Cath Lab - Hospital Charges
40 RFAIROS RFA of Osteiod Osteoma IR -
RFAIRDC RFA of Osteiod Osteoma IR - Doctor Charges 93500 93500 46750 37400 28050 46750
RFAIRHC RFA of Osteiod Osteoma IR – Hospital Charges 44880 44880 22440 17950 13460 22440
41 STHROIRO Selective Thrombolysis IR
S (Hospital + Doctor Charges)
STHROIRDC Selective Thrombolysis IR - Doctor Charges 136720 136720 68360 54690 41020
STHROIRHC Selective Thrombolysis IR - Hospital Charges 65620 65620 32810 26250 19690
42 TACEOS TACE (Trans arterial chemo embolization)
(Intervention Radiology) - Doctor Fee +
Hospital Charges
TACEDF TACE (Trans arterial chemo embolization) 96860 96860 48430 38740 29060
(Intervention Radiology ) Doctor Fee
TACEHC TACE (Trans arterial chemo embolization) 46500 46500 23250 18600 13950
257
43 TAPPASO USG Guided Ascitic / Pleural Therapeutic
S Tapping - IR ( Interventional radiology )
THEPLED USG Guided Ascitic / Pleural Therapeutic Tapping – IR 11760 11760 5880 4700 3530 5880
( Interventional radiology ) (Doctor Fees)
THEPLERAHC USG Guided Ascitic / Pleural Therapeutic Tapping – IR 1180 1180 590 470 350 590
( Interventional radiology ) (Hospital service charges)
44 TBIOPOS Transjugular Trucut Biopsy in Cath Lab
IR (Doctor + Hospital Charges )
TBIOPDC Transjugular Trucut Biopsy in Cath Lab IR - 46300 46300 23150 18520 13890
Doctor Charge
TBIOPHC Transjugular Trucut Biopsy in Cath Lab IR - 22220 22220 11110 8890 6670
Hospital Charge
45 THABOS Thermal Ablation of Liver Tumours (
Interventional Radiology ) - ( Doctor
THABDF Thermal Ablation of Liver Tumours (IR) -Doctor Fee 151200 151200 75600 60480 45360
THABHC Thermal Ablation of Liver Tumours (IR) - Hospital 72580 72580 36290 29030 21770
Charges
46 THTPOS Thermal Ablation of Thyroid/ Parathyroid
Nodule ( Interventional Radiology ) -
(Doctor Fee + Hospital Charges )
THTPDC Thermal Ablation of Thyroid/Parathyroid 151200 151200 75600 60480 45360
Nodule (IR) - Doctor Fee
THTPHC Thermal Ablation of Thyroid/Parathyroid 72580 72580 36290 29030 21770
Nodule (IR) - Hospital Charges
47 TIPPSOS TIPSS (Doctor fee + Hospital charges)
TIPSARWP TIPSS - Interventional radiology - amount 230840 230840 115420 92340 69250
given to doctor
TIPSPC TIPSS - Interventional radiology – hospital charges 110800 110800 55400 44320 33240
48 TIPSSROS TIPSS Revision(Intervention Radiology)
- Doctor Fee + Hospital Charges
TIPPSRDF TIPSS Revision (Intervention Radiology ) -Doctor Fee 71020 71020 35510 28410 21310
TIPPSRHC TIPSS Revision (Intervention Radiology) -Hospital 34080 34080 17040 13630 10220
Charges
49 TRUSGUO TRUS Guided Prostate Biopsy - IR (
S Interventional radiology ) (Doctor Fee
TRUSDOC TRUS Guided Prostate Biopsy - IR (Interventional 23100 23100 11550 9240 6930 11550
TRUSNHC TRUS Guided Prostate Biopsy - IR ( Interventional 2320 2320 1160 930 700 1160
50 TRUSTVS TRUS/TVS Guided Drainage - IR
TVSUSGD TRUS/TVS Guided Drainage - IR ( 22680 22680 11340 9070 6800 11340
USDETVSH TRUS/TVS Guided Drainage - IR (Interventional 2260 2260 1130 900 680 1130
51 TUBEUPO Tube Change / Tube Upsizing / Tube
S Repositioning - IR ( Interventional
service charges)
TUBERESD Tube Change / Tube Upsizing / Tube Repositioning – IR 13440 13440 6720 5380 4030 6720
TUPERESHC Tube Change / Tube Upsizing / Tube Repositioning – IR 1340 1340 670 540 400 670
( Interventional radiology ) (Hospital service charges)
52 TVSTRUS TVS or TRUS Guidedsampling - IR

TVSTQSD TVS or TRUS Guidedsampling - IR (Interventional 19740 19740 9870 7900 5920 9870
TVSUSHC TVS or TRUS Guidedsampling - IR ( Interventional 1980 1980 990 790 590 990
258
53 USGASIPL USG Guided Ascitic / Pleural Therapeutic
TAOS Tapping (Mob) - IR ( Interventional
radiology ) (Doctor Fee + Hospital service
charges)
USGMOBDC USG Guided Ascitic / Pleural Therapeutic Tapping 15960 15960 7980 6380 4790
(Mob) - IR ( Interventional radiology) (Doctor Fees)
USGMOBHCC USG Guided Ascitic / Pleural Therapeutic Tapping 1600 1600 800 640 480
(Mob) - IR ( Interventional radiology)
54 USGASPRI USG Guided Aspiration / Drainage - IR

OS ( Interventional radiology ) (Doctor Fee
USGASPID USG Guided Aspiration / Drainage - IR ( 10720 10720 5360 4290 3220 5360
USGPIDRAH USG Guided Aspiration / Drainage - IR ( Interventional 1080 1080 540 430 320 540
55 USGBION USG Guided Biopsy Multiple - IR
USGBIOD USG Guided Biopsy Multiple - IR (Interventional 31980 31980 15990 12790 9590 15990
USGBIOHC USG Guided Biopsy Multiple - IR ( Interventional 3200 3200 1600 1280 960 1600
56 USGBIOS USG Guided Biopsy - IR (Interventional
service charges)
USGBID USG Guided Biopsy - IR ( Interventional
radiology ) (Doctor Fees) 21600 21600 10800 8604 6480 10800
USGBHC USG Guided Biopsy - IR ( Interventional
radiology ) (Hospital service charges) 2160 2160 1080 870 650 1080
57 USGDEPO USG Making in dept - (IR)
S (Interventional radiology ) (Doctor Fee
USGDEPDOC USG Making in dept - (IR) ( Interventional 7560 7560 3780 3020 2270
USGDEPHC USG Making in dept - (IR) ( Interventional 760 760 380 300 230
58 USGFLUD USG and Fluoroscopic Guided PCD
OOS done in Cath Lab - IR ( Interventional
service charges)
USGPCIRD USG and Fluoroscopic Guided PCD done in 33600 33600 16800 13440 10080 16800
Cath Lab - IR ( Interventional radiology ) (Doctor Fees)
USGDAHC USG and Fluoroscopic Guided PCD done in 16120 16120 8060 6450 4840 8060
Cath Lab - IR ( Interventional radiology )
59 USGFNA USG Guided FNAC Multiple- IR (
MOS Interventional radiology ) (Doctor Fee
USGFNADOC USG Guided FNAC Multiple- IR ( 9460 9460 4730 3780 2840 4730
USGFNAHC USG Guided FNAC Multiple- IR ( Interventional 940 940 470 380 280 470
60 USGGUIO USG Guided FNAC - IR ( Interventional
S radiology ) (Doctor fee + Hospital
service charges)
USGDOC USG Guided FNAC - IR ( Interventional
radiology ) (Doctor Fee ) 6100 6100 3050 2440 1830 3050
USGHOSPI USG Guided FNAC - IR ( Interventional
radiology ) Hospital service charges) 610 610 310 250 190 310
259
61 USGGUM USG Guided Biopsy (Mob) - IR
Hospital service charges)
USGMOD USG Guided Biopsy (Mob) - IR 26880 26880 13440 10750 8060
MOBNEWHC USG Guided Biopsy (Mob) - IR 2680 2680 1340 1070 800
(Interventional radiology ) (Hospital service
charges)
62 USGICDOS USG Guided ICD - IR ( Interventional
service charges)
USGICDD USG Guided ICD - IR ( Interventional 23100 23100 11550 9240 6930 11550
USGICDHC USG Guided ICD - IR ( Interventional 2320 2320 1160 930 700 1160
63 USGMOB USG Guided Aspiration / Drainage
1OS (Mob) - IR ( Interventional radiology )
MOBUSGIRD USG Guided Aspiration / Drainage (Mob) - IR 14920 14920 7460 5970 4480
MOBDOSHC USG Guided Aspiration / Drainage (Mob) - IR 1500 1500 750 600 450
(Interventional radiology ) (Hospital service charges)
64 USGMOB USG Guided FNAC (Mob) - IR
SGGDOCC USG Guided FNAC (Mob) - IR ( Interventional 10600 10600 5300 4240 3180
USGMH USG Guided FNAC (Mob) - IR ( Interventional 1080 1080 540 430 320
65 USGMUL USG Guided PCD Multiple - IR
USGMULD USG Guided PCD Multiple - IR 30460 30460 15230 12180 9140 15230
USGHOSM USG Guided PCD Multiple - IR 3040 3040 1520 1220 910 1520
(Interventional radiology ) (Hospital service charges)
66 USGMULT USG Guided ICD Multiple - IR
IOS (Interventional radiology ) (Doctor Fee
USGMOLTID USG Guided ICD Multiple - IR ( Interventional 30460 30460 15230 12180 9140 15230
USGDOCN USG Guided ICD Multiple - IR ( Interventional 3040 3040 1520 1220 910 1520
67 USGOTOS USG Making in Ward / OT - (IR) (
Interventional radiology ) (Doctor Fee
USGOTDOC USG Making in Ward / OT - (IR) (Interventional 11760 11760 5880 4700 3530
USGOTHC USG Making in Ward / OT - (IR) (Interventional 1180 1180 590 470 350
68 USGPCDO USG Guided PCD - IR ( Interventional
S radiology ) (Doctor Fee + Hospital
service charges)
USGPCDH USG Guided PCD - IR ( Interventional 2320 2320 1160 930 700 1160
USGPCD USG Guided PCD - IR( Interventional 23100 23100 11550 9240 6930 11550
69 USGPLBO Usg Guided Paediatric Liver Biopsy (IR)
S - (Doctor Fee + Hospital Charges)
UGPLBDC Usg Guided Paediatric Liver Biopsy (IR) -Doctor Fee 14920 14920 7460 5970 4480
UGPLBHC Usg Guided Paediatric Liver Biopsy (IR) -Hospital 1500 1500 750 600 450
Charges
260
70 USSGBOM USG Guided ICD (Mob) - IR
DOS (Interventional radiology ) (Doctor Fee
USGMOBHC USG Guided ICD (Mob) - IR ( Interventional 2740 2740 1370 1100 820
USGMOBD USG Guided ICD (Mob) - IR ( Interventional 27300 27300 13650 10920 8190
71 XAOBIOP Abdominal Organ Biopsy -
OS Interventional Radiology (Doctor Fee +
Hospital Charges)
XAOBIOPDF Abdominal Organ Biopsy - Interventional 14680 14680 7340 5870 4400
Radiology (Doctor Fee)
XAOBIOPHC Abdominal organ biopsy - Interventional 7060 7060 3530 2820 2120
Radiology (Hospital charges)
72 XBAAOS Bronchial Artery Angiography -
Interventional Radiology (Doctor Fee +
Hospital Charges)
XBAADF Bronchial Artery Angiography - 29360 29360 14680 11740 8810
Interventional Radiology (Doctor Fee)
XBAAHC Bronchial Artery Angiography - 14100 14100 7050 5640 4230
Interventional Radiology (Hospital charges)
73 XBDJSVCL Bilateral DJ Stenting (IR) in Vascular
OS Cath Lab - Interventional Radiology
XBDJSVCLDF Bilateral DJ Stenting (IR) in Vascular Cath 88060 88060 44030 35220 26420
Lab - Interventional Radiology (Doctor Fee)
XBDJSVCLHC Bilateral DJ stenting (IR) in Vascular Cath 42280 42280 21140 16910 12680
Lab - Interventional Radiology (Hospital charges)
74 XCBAEOS Complex Bronchial Artery Embolization

- Interventional Radiology (Doctor
Fee +Hospital Charges)
XCBAEDF Complex Bronchial Artery Embolization - 146740 146740 73370 58700 44020
XCBAEHC Complex Bronchial Artery Embolization - 70440 70440 35220 28180 21130
75 XCBEOS Complex Biliary Externalization
- Interventional Radiology (Doctor Fee
+ Hospital Charges)
XCBEDF Complex Biliary Externalization - 117400 117400 58700 46960 35220
XCBEHC Complex Biliary Externalization - 56340 56340 28170 22540 16900
76 XCBIOS Complex Biliary Internalization
+ Hospital Charges)
XCBIDF Complex Biliary Internalization - 117400 117400 58700 46960 35220
XCBIHC Complex Biliary Internalization - 56340 56340 28170 22540 16900
77 XEVOS Embolization for varicocele -
Hospital Charges)
XEVDF Embolization for Varicocele - Interventional 117400 117400 58700 46960 35220
XEVHC Embolization for Varicocele - Interventional 56340 56340 28170 22540 16900
78 XMACDOS Multiple Abscess / Collection drainage
+ Hospital Charges)
XMACDDF Multiple Abscess / Collection Drainage - 29360 29360 14680 11740 8810
XMACDHC Multiple Abscess / Collection Drainage - 14100 14100 7050 5640 4230
261
79 XMBIOPO Miscellaneous biopsy - Interventional
S Radiology (Doctor Fee + Hospital
Charges)
XMBIOPDF Miscellaneous Biopsy - Interventional 14680 14680 7340 5870 4400
XMBIOPHC Miscellaneous Biopsy - Interventional 7060 7060 3530 2820 2120
80 XMCTACE Multiple / Complex TACE -
Hospital Charges)
XMCTACEDF Multiple / Complex TACE - Interventional 176080 176080 88040 70430 52820
XMCTACEHC Multiple / Complex TACE - Interventional 84520 84520 42260 33810 25360
81 XPCNVCL PCN (IR) in Vascular Cath Lab -
Hospital Charges)
XPCNVCLDF PCN (IR) in Vascular Cath Lab - 58700 58700 29350 23480 17610
XPCNVCLHC PCN (IR) in Vascular Cath Lab - 28180 28180 14090 11270 8450
82 XPPVEOS Presurgical portal vein embolization -
Hospital Charges)
XPPVEDF Presurgical Portal Vein Embolization - 146740 146740 73370 58700 44020
XPPVEHC Presurgical Portal Vein Embolization - 70440 70440 35220 28180 21130
83 XRYANGA ANGIOPLASTY OF ABDOMINAL
BVSOS VESSELS (Doctor fee + hospital
service charges)
XRAYANGPLA Angioplasty of abdominal vessels - Interventional 78120 78120 39060 31250 23440 39060 23440
BDVSL radiology (done in X-ray dept) - doctor fee
XRAYANGPLST Angioplasty of abdominal vessels - Interventional 37500 37500 18750 15000 11250 18750 11250
ABVSHSP radiology (done in X-ray dept)- hospital service charges
84 XRYSELAB Selective Abdominal Angiography
DANGOS (Doctor fee +hospital service charges)
XRYSELABDAN Selective Abdominal Angiography - 23100 23100 11550 9240 6930 11550 6930
GDF Interventional radiology - doctor fee
XRYSELABDAN Selective Abdominal Angiography - Interventional 11080 11080 5540 4430 3320 5540 3320
GHC radiology - hospital service charges
85 XSIRTLTII Selective Internal Radiation Therapy
OS for Liver Tumors Part II (SIRT) -
Hospital Charges)
XSIRTLTIIDF Selective Internal Radiation Therapy for 88060 88060 44030 35220 26420
Liver Tumors Part II (SIRT) - Interventional
XSIRTLTIIHC Selective Internal Radiation Therapy for 42280 42280 21140 16910 12680
Liver Tumors Part II (SIRT) - Interventional
86 XSIRTLTIO Selective Internal Radiation Therapy
S for Liver Tumors Part I (SIRT) -
Hospital Charges)
XSIRTLTIDF Selective Internal Radiation Therapy for Liver Tumors 223060 223060 111530 89220 66920
Part I (SIRT) – Interventional Radiology (Doctor Fee)
XSIRTLTIHC Selective Internal Radiation Therapy for Liver Tumors 107080 107080 53540 42830 32120
Part I (SIRT) – Interventional Radiology (Hospital
Charges)
87 XUDJSVCL Unilateral DJ Stenting (IR) in Vascular

OS Cath Lab - Interventional Radiology
262
XUDJSVCLDF Unilateral DJ Stenting (IR) in Vascular Cath 70440 70440 35220 28180 21130
Lab - Interventional Radiology (Doctor Fee)
XUDJSVCLHC Unilateral DJ stenting (IR) in Vascular Cath Lab - 33820 33820 16910 13530 10150
88 USCHOS USG guided PCD in Cath Lab - IR -
Hospital Charges + Cath Lab Charges
USCDF USG guided PCD in Cath Lab - IR - Doctor Fee 22000 22000 11000 8800 6600
USCH USG guided PCD in Cath Lab - IR - Cath Lab Charges 10560 10560 5280 4220 3170
89 USGIROS USG guided ICD in Cath Lab - IR -
(Doctor Fee + Cath Lab Charges)
USGIRHC USG guided ICD in Cath Lab - IR - Cath Lab Charges 22000 22000 11000 8800 6600
USGIRDF USG guided ICD in Cath Lab - IR - Doctor Fee 10560 10560 5280 4220 3170
90 USGPCOS USG guided PCD Multiple in Cath Lab -
IR - (Doctor Fee + Cath Lab Charges)
USGPCDF USG guided PCD Multiple in Cath Lab - IR - Doctor Fee 29000 29000 14500 11600 8700
USGPCHC USG guided PCD Multiple in Cath Lab - IR - Cath Lab Charges 13920 13920 6960 5570 4180
91 USGICOS USG guided Biopsy in Cath Lab - IR -
Doctor Fee + Cath Lab Charges
USGICDDF USG guided Biopsy in Cath Lab - IR - Doctor Fee 21600 21600 10800 8640 6480
USGICHC USG guided Biopsy in Cath Lab - IR - Cath Lab Charges 10370 10370 5180 4150 3110
92 USGIOS USG guided Biopsy multiple in Cath Lab
- IR - Doctor Fee + Cath Lab Charges
USGBIODF USG guided Biopsy multiple in Cath Lab - IR - Doctor Fee 29000 29000 14500 11600 8700
USGIOHC USG guided Biopsy multiple in Cath Lab - IR-Cath Lab charges 13920 13920 6960 5570 4180
93 UTRUSBOS TRUS guided Prostate Biopsy in Cath
Lab - IR - Doctor Fee + Cath Lab Charges
UTRUSBDF TRUS guided Prostate Biopsy in Cath Lab - IR-Doctor Fee 22000 22000 11000 8800 6600
UTRUSBHC TRUS guided Prostate Biopsy in Cath Lab-IR-Cath Lab Charges 10560 10560 5280 4220 3170
94 UTRUSIROS TRUS/TVS guided drainage in Cath Lab -
IR - Doctor Fee + Cath Lab Charges
UTRUSIRDF TRUS/TVS guided drainage in Cath Lab - IR - Doctor Fee 21600 21600 10800 8640 6480
UTRUSIRHC TRUS/TVS guided drainage in Cath Lab - IR - Cath Lab 10370 10370 5180 4150 3110
Charges
95 UTVSGIROS TVS or TRUS guided sampling in Cath
UTVSGIRDF TVS or TRUS guided sampling in Cath Lab - IR-Doctor Fee 18800 18800 9400 7520 5640
UTVSGIRHC TVS or TRUS guided sampling in Cath Lab - IR - Cath Lab 9020 9020 4510 3610 2710
Charges
96 USGADIROS USG guided aspiration/drainage in Cath
USGADIRDF USG guided aspiration/drainage in Cath Lab - IR - Doctor 10200 10200 5100 4080 3060
Fee
USGADIRHC USG guided aspiration/drainage in Cath Lab - IR - Cath 4900 4900 2450 1960 1470
Lab Charges
97 UTCURIROS Tube change/Tube upsizing/Tube
repositioning in Cath Lab - IR - Doctor
UTCURIRDF Tube change/Tube upsizing/Tube repositioning in Cath 12800 12800 6400 5120 3840
Lab - IR - Doctor Fee
UTCURIRHC Tube change/Tube upsizing/Tube repositioning in Cath 6140 6140 3070 2460 1840
Lab - IR - Cath Lab Charges
98 UCTQCIROS CT guided FNAC in Cath Lab - IR - Doctor
Fee + Cath Lab Charges
UCTQCIRDF CT guided FNAC in Cath Lab - IR - Doctor Fee 18800 18800 9400 7520 5640
UCTQCIRHC CT guided FNAC in Cath Lab - IR - Cath Lab Charges 9020 9020 4510 3610 2710
99 UCTQIROS CT guided FNAC - IR (bedside) - Doctor
Fee + Hospital Charges
UCTQIRDF CT guided FNAC - IR (bedside) - Doctor Fee 18800 18800 9400 7520 5640
UCTQIRHC CT guided FNAC - IR (bedside) - Hospital charges 1880 1880 940 750 560
LITHOTRIPSY PACKAGE
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
2 Bedded
Cat-1D
GOPD
Single
POPD
SNo
Cat-2
Cat-3
Code Description
1 LITHOFSPC Lithotripsy follow-up session 0

package charges
263
2 LITPDHCH LITHOTRIPSY PROCEDURE (STONE < 1 CM)
OS1 (PACKAGE CHARGES + DOCTOR FEE)
LITHO1PC Lithotripsy procedure (stone < 1 cm) package charges 30000
3 LITPDHCH LITHOTRIPSY PROCEDURE (STONE 1.6 - 2.5
OS12 CM) (PACKAGE CHARGES + DOCTOR FEE)
LITHO12PC Lithotripsy procedure (stone 1.6 - 2.5 cm) 40000
package charges
4 LITPDHCH LITHOTRIPSY PROCEDURE
OS15 (STONE 1 - 1.5 CM) (PACKAGE
LITHO15PC Lithotripsy procedure (stone 1 - 1.5 cm) 35000
package charges
5 LITPDHCH LITHOTRIPSY PROCEDURE (STONE 2.6 -
OS23 3.0 CM) (PACKAGE CHARGES +
DOCTOR FEE)
LITHO23PC Lithotripsy procedure (stone 2.6 - 3.0 cm) 53000
package charges
Minor OT Procedures
4 Beddded
Cat 1A-Pre
2 Bedded
Category
Cat 1B
GOPD
POPD
Cat-2
Cat-3
Suite
Cat-
1D
All
1 ABJMOTO Maxillofacial-Alveolectomy
S (Both jaws) For Minor OT
ABJMOTAC Alveolectomy (Both jaws) For Minor OT (Anaesthetists 2430
Charges )
ABJMOTHC Alveolectomy (Both jaws) For Minor OT (Hospital Charges ) 4040
ABJMOTSC Alveolectomy (Both jaws) For Minor OT (Surgeon Charges ) 9700
2 AFDFOS Maxillofacial -Archbar fixation
dentoalveolar fracture segment For
Minor OT
AFDFAC Archbar fixation dentoalveolar fracture segment For 1460
Minor OT ( Anaesthetistsb Charges )
AFDFHC Archbar fixation dentoalveolar fracture 2430
segment For Minor OT ( Hospital Charges )
AFDFSF Archbar fixation dentoalveolar fracture 5810
segment For Minor OT ( Surgeon Charges )
3 ALPMOTO S Maxillofacial-Alveoloplasty For Minor OT
ALPMOTAC Alveoloplasty For Minor OT ( Anaesthetists Charges ) 1350
ALPMOTHC Alveoloplasty For Minor OT ( Hospital Charges ) 2270
ALPMOTSF Alveoloplasty For Minor OT ( Surgeon Charges ) 5430
4 ANDLOS Anal Dilatation For Minor OT
ANDLANA Anal Dilatation For Minor OT ( Anaesthetists Charges ) 910
ANDLHC Anal Dilatation For Minor OT ( Hospital Charges ) 1530
ANDL Anal Dilatation For Minor OT ( Surgeon Charges ) 3650
5 ASJNOS Maxillofacial-Alveolectomy
(one jaws) For Minor OT
ASJNMOTAC Alveolectomy (one jaws) For Minor OT (Anaesthetists 1370
Charges )
ASJNMOTHC Alveolectomy (one jaws) For Minor OT (Hospital 2280
Charges )
ASJNOTAC Alveolectomy (one jaws) For Minor OT (Surgeon 5480
Charges )
6 ATEBJOS Maxillofacial-All teeth extractions
(both jaws) For Minor OT
ATEBJMOTAC All teeth extractions (both jaws) For Minor 3890
ATEBJMOTHC All teeth extractions (both jaws) For Minor 6460
OT ( Hospital Charges )
ATEBJMOTDC All teeth extractions (both jaws) For Minor 15500
OT ( Surgeon Charges )
264
7 AULAOS Maxillofacial-Apicectomy
(Under LA) For Minor OT
AULAC Apicectomy (Under LA) For Minor OT (Anaesthetists 1940
Charges )
AULAHC Apicectomy (Under LA) For Minor OT (Hospital Charges) 3230
AULASC Apicectomy (Under LA) For Minor OT (Surgeon Charges) 7740
8 BAVOS Brachio AV fistula at elbow for
hemodialysis
BAVAC Brachio AV fistula at elbow for hemodialysis 2540
- Anaesthetists Charges
BAVHC Brachio AV fistula at elbow for hemodialysis 4260
- Hospital Charges
BAVDF Brachio AV fistula at elbow for hemodialysis 10150
- Surgeon Charges
9 CARAVFO Conversion of arteriovenous(AV) shunt
S to arteriovenous (AV) fistula
CARAVFAC Conversion of arteriovenous (AV) shunt to 2540
arteriovenous (AV) fistula – Anaesthetists Charges
CARAVFHC Conversion of arteriovenous (AV) shunt to 4260
arteriovenous (AV) fistula - Hospital Charges
CARAVFDC Conversion of arteriovenous (AV) shunt to 10150
arteriovenous (AV) fistula - Surgeon Charges
10 CAREVFB Creation of arteriovenous (AV) Fistula
OS at elbow ( Brachial artery )
CAREVFBHC Creation of arteriovenous (AV) Fistula at 5390
elbow ( Brachial artery ) - Hospital Charges
CAREVFBDC Creation of arteriovenous (AV) Fistula at 12830
elbow ( Brachial artery ) - Surgeon Charges
CAREVFBAC Creation of arteriovenous (AV) Fistula at elbow 3210
(Brachial artery ) – Anaesthetists Charges
11 CAREVFB Creation of arteriovenous (AV) Fistula
WOS at wrist ( Radial Artery)
CAREVFWBAC Creation of arteriovenous (AV) Fistula at wrist ( Radial 3210
Artery ) – Anaesthetists Charges
CAREVFBWHC Creation of arteriovenous (AV) Fistula at 5390
wrist ( Radial Artery ) - Hospital Charges
CAREVFBWDC Creation of arteriovenous (AV) Fistula at 12830
wrist ( Radial Artery ) - Surgeon Charges
12 CAREVFO Creation of arteriovenous (AV)
S Fistula at axillary artery
CAREVFHC Creation of arteriovenous (AV) Fistula at 5390
axillary artery - Hospital Charges
CAREVFDC Creation of arteriovenous (AV) Fistula at 12830
axillary artery - Surgeon Charges
CAREVFAC Creation of arteriovenous (AV) Fistula at 3210
axillary artery - Anaesthetists Charges
13 CCMINPL CARPAL TUNNEL RELEASE (PLASTIC
ASDBOS SURGERY) For Minor OT
CCMINPLASBK CARPAL TUNNEL RELEASE (PLASTIC SURGERY) For 4730
N Minor OT ( Anaesthetists Charges )
CCMINPLASBK CARPAL TUNNEL RELEASE (PLASTIC 7880
H SURGERY) For Minor OT ( Hospital Charges )
CCMINPLASBD CARPAL TUNNEL RELEASE (PLASTIC 18900
SURGERY) For Minor OT ( Surgeon Charges )
14 CCMOS Circumcision For Minor OT
CCMANA Circumcision For Minor OT ( Anaesthetists Charges ) 1640
CCMHC Circumcision For Minor OT ( Hospital Charges ) 2760
CCM Circumcision For Minor OT ( Surgeon Charges ) 6560
15 CDMINPL MEDIUM DRESSING (PLASTIC
ASDBOS SURGERY) For Minor OT
CDMINPLASBK MEDIUM DRESSING (PLASTIC SURGERY) For 790
CDMINPLASBK MEDIUM DRESSING (PLASTIC SURGERY) For 1310
H Minor OT ( Hospital Charges )
CDMINPLASB MEDIUM DRESSING (PLASTIC SURGERY) For 3150
D Minor OT ( Surgeon Charges )
265
16 CIMCPLA CIRCUMCISION + PHRENULOPLASTY (
OS Doctor Charges + Hospital Charges)
CIRLASTYA Circumcision + Phrenuloplasty For Minor OT 4350
( Anaesthetists Charges )
PLALASTY Circumcision + Phrenuloplasty For Minor OT 17370
( Doctor Charges )
CIRPHEH Circumcision + Phrenuloplasty For Minor OT 7300
( Hospital Charges )
17 CMRMOT Chemoport Removal For Minor
OS OT
CMRMOTSF Chemoport Removal For Minor OT - Anaesthetists charges 2210
CMRMOTHC Chemoport Removal For Minor OT – Hospital charges 3710
CMRMOTDF Chemoport Removal For Minor OT – Surgeon Charges 8830
18 COEOSKG Scar Revision Complex ( Doctor
RAOS Charges + Hospital Charges )
COATKGRAA Scar Revision Complex For Minor OT (Anaesthetists 6080
Charges )
COATKGRAD Scar Revision Complex For Minor OT (Doctor Charges ) 24310
COATKGRAH Scar Revision Complex For Minor OT (Hospital Charges ) 10210
19 COMREOS Complex Fistula Closure For Minor OT
COMREAF Complex Fistula Closure For Minor OT - 3060
Anaesthetists charges
COMREHC Complex Fistula Closure For Minor OT - 5130
Hospital Charges
COMREDF Complex Fistula Closure For Minor OT - 12220
Surgeon Charges
20 CROSKGR Crossfinger Flap ( Doctor
AOS Charges + Hospital Charges )
CROATKGRAA Crossfinger Flap For Minor OT (Anaesthetists Charges) 4350
CROATKGRAH Crossfinger Flap For Minor OT ( Hospital Charges ) 7300
CROATKGRAD Crossfinger Flap For Minor OT ( Doctor Charges ) 17370
21 CTZOS Catheterization For Minor OT
CTZANA Catheterization For Minor OT (Anaesthetists Charges ) 550
CTZHC Catheterization For Minor OT ( Hospital Charges ) 910
CTZ Catheterization For Minor OT ( Surgeon Charges ) 2180
22 DBFMOS Diagnostic Bronchoscopy For Minor OT
DBFMNA Diagnostic Bronchoscopy For Minor OT (Anaesthetists 2030
Charges )
DBFMHC Diagnostic Bronchoscopy For Minor OT (Hospital 3400
Charges )
DBFM Diagnostic Bronchoscopy For Minor OT (Surgeon 8110
Charges )
23 DBWBOS Diagnostic Bronchoscopy with
Biopsy For Minor OT
DBWBNA Diagnostic Bronchoscopy with Biopsy (Anaesthetists 2950
Charges)
DBWBHC Diagnostic Bronchoscopy with Biopsy (Hospital 3940

Charges)
DBWB Diagnostic Bronchoscopy with Biopsy (Surgeon 9850
Charges)
24 DCDROS Dressing change/drain removal
For Minor OT
DCDRA Dressing change/drain removal For Minor 460
OT (Anaesthetists Charges)
DCDRH Dressing change/drain removal For Minor 770
OT (Hospital Charges)
DCDR Dressing change/drain removal For Minor 1830
OT (Surgeon Charges)
25 DENIMPO Maxillofacial- Implant (first
S stage) For Minor OT
DENIMPAC Dental Implant (first stage) For Minor OT 9680
DENIMHC Dental Implant (first stage) For Minor OT (Hospital 16140
Charges )
DENIMSC Dental Implant (first stage) For Minor OT (Surgeon 38750
Charges )
266
26 DISTMJOS Maxillofacial-Dislocation of
TMJ For Minor OT
DISTMJAC Dislocation of TMJ For Minor OT (Anaesthetists 1220
Charges )
DISTMJHC Dislocation of TMJ For Minor OT ( Hospital Charges ) 2020
DISTMJSC Dislocation of TMJ For Minor OT ( Surgeon Charges ) 4840
27 DOSOS Dorsal Slit For Minor OT
DOSANA Dorsal Slit For Minor OT ( Anaesthetists Charges ) 1280
DOSHC Dorsal Slit For Minor OT ( Hospital Charges ) 2140
DOS Dorsal Slit For Minor OT ( Surgeon Charges ) 5100
28 DREMOS Dressing (minor) For Minor OT
DREMA Dressing (minor) For Minor OT (Anaesthetists Charges ) 550
DREMH Dressing (minor) For Minor OT ( Hospital Charges ) 910
DREM Dressing (minor) For Minor OT ( Surgeon Charges ) 2180
29 ELRBOS Ear lobe repair BL For Minor OT
ELRBA Ear lobe repair BL For Minor OT(Anaesthetists Charges) 1090
ELRBH Ear lobe repair BL For Minor OT ( Hospital Charges ) 1840
ELRB Ear lobe repair BL For Minor OT ( Surgeon Charges ) 4380
30 ELRUOS Ear lobe repair UL For Minor OT
ELRUA Ear lobe repair UL For Minor OT(Anaesthetists Charges) 740
ELRUH Ear lobe repair UL For Minor OT ( Hospital Charges ) 1230
ELRU Ear lobe repair UL For Minor OT ( Surgeon Charges ) 2920
31 EXBIMOS Maxillofacial-Excisional biospy
For Minor OT
EXBIMAC Excisional biospy For Minor OT (Anaesthetists Charges ) 1460
EXBIMHC Excisional biospy For Minor OT ( Hospital Charges ) 2430
EXBIMOT Excisional biospy For Minor OT ( Surgeon Charges ) 5810
32 EXPFOS Maxillofacial-Excision of
pericoronal flap For Minor OT
EXPFAC Excision of pericoronal flap For Minor OT 960
EXPFHC Excision of pericoronal flap For Minor OT (Hospital 1600
Charges )
EXPFSC Excision of pericoronal flap For Minor OT (Surgeon 3820
Charges )
33 FATKGRA Fat Grafting Major ( Doctor
OS Charges + Hospital Charges )
FATKGRAA Fat Grafting Major For Minor OT (Anaesthetists 5210
Charges )
FATKGRAD Fat Grafting Major For Minor OT ( Doctor 20840
Charges )
FATKGRAH Fat Grafting Major For Minor OT ( Hospital 8760
Charges )
34 FLAMOTO Maxillofacial-Fracture mandible open
S reduction under LA (Cost of plates &
screws etc.) For Minor OT
FLAMOTAC Fracture mandible open reduction under LA 7270
(Cost of plates & screws etc.) For Minor OT
FLAMOTHC Fracture mandible open reduction under LA 12120
(Hospital Charges )
FLAMOTSC Fracture mandible open reduction under LA 29060
(Surgeon Charges )
35 FLDIMTOS Flap Division and Inset For Minot OT
FLDIMTAC Flap Division and Inset For Minor OT (Anaesthetists 3130
Charges)
FLDIMTHC Flap Division and Inset For Minor OT (Hospital Charges) 5250
FLDIMTSC Flap Division and Inset For Minor OT (Surgeon Charges) 12510
36 FLMTOS Flap Large For Minor OT
FLMTAC Flap Large For Minor OT ( Anaesthetists Charges ) 5210
FLMTHC Flap Large For Minor OT ( Hospital Charges ) 8760
FLMTSC Flap Large For Minor OT ( Surgeon Charges ) 20840
267
37 FNPOS Frenuloplasty For Minor OT
FNPANA Frenuloplasty For Minor OT ( Anaesthetists Charges ) 820
FNPHC Frenuloplasty For Minor OT ( Hospital Charges ) 1380
FNP Frenuloplasty For Minor OT ( Surgeon Charges ) 3290
38 FOASOS Foam Sclerotherapy For Minor OT
FOASA Foam Sclerotherapy For Minor OT (Anaesthetists 3640
Charges )
FOASH Foam Sclerotherapy For Minor OT ( Hospital Charges ) 6120
FOAS Foam Sclerotherapy For Minor OT ( SurgeonCharges ) 14580
39 FRMOTOS Maxillofacial -Frenectomy For Minor
OT
FRMOTAC Frenectomy For Minor OT ( Anaesthetists Charges ) 1040
FRMOTHC Frenectomy For Minor OT ( Hospital Charges) 1740
FRMOTSC Frenectomy For Minor OT ( Surgeon Charges) 4170
40 FSBQOS Maxillofacial-Flap surgery with bone
graft (per quadrant) For Minor OT
FSBQAC Flap surgery with bone graft (per quadrant) 1940
FSBQHC Flap surgery with bone graft (per quadrant) 3230
For Minor OT ( Hospital Charges )
FSBQSC Flap surgery with bone graft (per quadrant) 7740
For Minor OT ( Surgeon Charges )
41 FSMTOS Flap Small For Minor OT
FSMTAC Flap Small For Minor OT ( Anaesthetists Charge) 4350
FSMTHC Flap Small For Minor OT ( Hospital Charges ) 7300
FSMTSC Flap Small For Minor OT ( Surgeon Charges ) 17370
42 GINPMOT Maxillofacial-Gingivoplasty For
OS Minor OT
GINPMOTSC Gingivoplasty For Minor OT ( Surgeon Charges ) 5810
GINPMOTAC Gingivoplasty For Minor OT ( AnaesthetistsCharges ) 1460
GINPMOTHC Gingivoplasty For Minor OT ( Hospital Charges ) 2430
43 IBSMOTO Maxillofacial-Impaction (Bony/soft
S tissue) For Minor OT
IBSMOTAC Impaction (Bony/soft tissue) For Minor OT 2740
IBSMOTHC Impaction (Bony/soft tissue) For Minor OT (Hospital 4570
Charges )
IBSMOTSC Impaction (Bony/soft tissue) For Minor OT (Surgeon 10960
Charges )
44 ICCPLOS ICD insertion for complex effusion/
pneumothorax For Minor OT
ICCPLNA ICD insertion for complex effusion/pneumothorax For 2030
Minor OT (Anaesthetists Charges )
ICCPLHC ICD insertion for complex effusion/pneumothorax For 3400
Minor OT (Hospital Charges )
ICCPL ICD insertion for complex effusion/pneumothorax For 8110
Minor OT (Surgeon Charges )
45 ICDSMOS ICD insertion for simple effusion/
pneumothorax For Minor OT
ICDSMNA ICD insertion for simple effusion/pneumothorax For 870
Minor OT (Anaesthetists Charges )
ICDSMHC ICD insertion for simple effusion/pneumothorax For 1460
Minor OT (Hospital Charges )
ICDSMOT ICD insertion for simple effusion/pneumothorax For 3480
Minor OT (Surgeon Charges )
46 IDLAOS Incision and Drainage of Multiple/
Large Superficial Abscess For Minor OT
IDLANA Incision and Drainage of Multiple/ Large Superficial 1460
Abscess For Minor OT ( Anaesthetists Charges )
IDLAHC Incision and Drainage of Multiple/ Large Superficial 2450
Abscess For Minor OT ( Hospital charges )
IDLA Incision and Drainage of Multiple/ Large Superficial 5830
Abscess For Minor OT ( Surgeon charges )
47 IDSAOS Incision And Drainage of Small/
Superficial Abscess For Minor OT
268
IDSANA Incision And Drainage of Small/Superficial Abscess For 740
Minor OT ( AnaesthetistsCharges )
IDSAHC Incision And Drainage of Small/Superficial 1230
Abscess For Minor OT ( Hospital Charges )
IDSA Incision And Drainage of Small/Superficial 2920
Abscess For Minor OT ( Surgeon Charges )
48 IMFMOTO Maxillofacial-Inter - Maxillary fixation
S with archbar For Minor OT
IMFMOTHC Inter - Maxillary fixation with archbar For 5660
Minor OT ( Hospital Charges )
IMFMOTDC Inter - Maxillary fixation with archbar For 13570
Minor OT ( Surgeon Charges )
IMFMOTAC Inter - Maxillary fixation with archbar For 3390
Minor OT( Anaesthetists Charges )
49 INADMOS Incision and drainage (major)
For Minor OT
INADMA Incision and drainage (major) For Minor OT 1460
INADMH Incision and drainage (major) For Minor OT (Hospital 2450
Charges )
INADM Incision and drainage (major) For Minor OT (Surgeon 5830
Charges )
50 INADOS Incision and drainage For Minor OT
INADA Incision and drainage (Minor) For Minor OT 740
INADH Incision and drainage (Minor) For Minor OT 1230
( Hospital Charges )
INAD Incision and drainage (Minor) For Minor OT 2920
(Surgeon Charges)
51 INDMOTO Maxillofacial - Incision and
S drainage For Minor OT
INDMOTHC Incision and drainage For Minor OT (Hospital Charges ) 1620
INDMOTSC Incision and drainage For Minor OT (Surgeon Charges ) 3890
INDMOTAC Incision and drainage For Minor OT(Anaesthetists 970
Charges )
52 IOTNOS Ingrowing toe nail For Minor OT
IOTNANA Ingrowing toe nail For Minor OT (Anaesthetists 2550
Charges )
IOTNHC Ingrowing toe nail For Minor OT ( Hospital Charges ) 4280
IOTN Ingrowing toe nail For Minor OT ( Surgeon Charges ) 10210
53 JFMOTOS Maxillofacial-Jaw fracture
closed reduction For Minor OT
JFMOTSC Jaw fracture closed reduction For Minor OT (Surgeon 15500
Charges )
JFMOTAC Jaw fracture closed reduction For Minor 3890
OT(Anaesthetists Charges )
JFMOTHC Jaw fracture closed reduction For Minor OT(Hospital 6460
Charges )
54 LAMINPL SKIN & SOFT TISSUE BIOPSY- LARGE
ASDBOS (PLASTIC SURGERY) For Minor OT
LAMINPLASBK SKIN & SOFT TISSUE BIOPSY- LARGE (PLASTIC SURGERY) 1580
N For Minor OT (Anaesthetists Charges )
LAMINPLASBK SKIN & SOFT TISSUE BIOPSY- LARGE (PLASTIC 2630
LAMINPLASBD SKIN & SOFT TISSUE BIOPSY- LARGE (PLASTIC SURGERY) 6300
55 LATKGRA Skin Lesion Large ( Doctor
LATKGRAA Skin Lesion Large For Minor OT (Anaesthetists 5550
Charges )
LATKGRAH Skin Lesion Large For Minor OT ( Hospital Charges ) 9330
LATKGRAD Skin Lesion Large For Minor OT ( Doctor Charges ) 22230
56 LLMINPLA BURN DRESSING - LARGE (PLASTIC
SDBOS SURGERY) For Minor OT
LLMINPLASBK BURN DRESSING - LARGE (PLASTIC SURGERY) For 1260
269
LLMINPLASBK BURN DRESSING - LARGE (PLASTIC 2100
LLMINPLASBD BURN DRESSING - LARGE (PLASTIC 5040
57 LNBMOS Lymph Node Biopsy For Minor OT
LNBMN Lymph Node Biopsy For Minor OT (Anaesthetists 870
Charges )
LNBMHC Lymph Node Biopsy For Minor OT ( Hospital Charges ) 1460
LNBM Lymph Node Biopsy For Minor OT ( Surgeon Charges ) 3480
58 MADMOS Major Debridement For Minor OT
MADMANA Major Debridement For Minor OT (Anaesthetists 1830
Charges )
MADMHC Major Debridement For Minor OT ( Hospital Charges ) 3070
MADM Major Debridement For Minor OT ( Surgeon Charges ) 7300
59 MATKGRA Fat Grafting Minor ( Doctor
MATKGRAD Fat Grafting Minor For Minor OT ( Doctor Charges ) 13890
MATKGRAA Fat Grafting Minor For Minor OT (Anaesthetists 3480
Charges )
MATKGRAH Fat Grafting Minor For Minor OT ( Hospital Charges ) 5840
60 MINDOS Minor debridement For Minor OT
MINDA Minor debridement For Minor OT (Anaesthetists 910
Charges )
MINDH Minor debridement For Minor OT ( Hospital Charges ) 1530
MIND Minor debridement For Minor OT ( SurgeonCharges ) 3650
61 Maxillofacial-Mini implant for
S anchorage (per implant) For Minor OT
MINIMPHC Mini implant for anchorage (per implant) 4850
MINIMPAC Mini implant for anchorage (per implant) 2910
For Minor OT( Anaesthetists Charges )
MINIMPDC Mini implant for anchorage (per implant) 11630
For Minor OT(Surgeon charges )
62 MMMINP BURN DRESSING - MEDIUM (PLASTIC

LASDBOS SURGERY) For Minor OT
MMMINPLASB BURN DRESSING - MEDIUM (PLASTIC SURGERY) For 950
KN Minor OT ( Anaesthetists Charges )
MMMINPLASB BURN DRESSING - MEDIUM (PLASTIC 1580
KH SURGERY) For Minor OT ( Hospital Charges )
MMMINPLASB BURN DRESSING - MEDIUM (PLASTIC 3780
D SURGERY) For Minor OT ( Surgeon Charges )
63 MMOTH Hymenoplasty for Minor OT (Doctors
MOS charges+ Hospital Charges)
MHOOT Hymenoplasty for Minor OT (Anasthetist charges) 5510
MMOTDOC Hymenoplasty for Minor OT (Doctors charges) 22050
MHOTM Hymenoplasty for Minor OT (Hospital charges) 9190
64 MTOS Meatotomy For Minor OT
MTANA Meatotomy For Minor OT ( Anaesthetists Charges ) 770
MTHC Meatotomy For Minor OT ( Hospital Charges) 1290
MT Meatotomy For Minor OT ( Surgeon Charges) 3070
65 NEDLAOS Needle aspiration For Minor OT
NEDLAA Needle aspiration For Minor OT (Anaesthetists Charges) 460
NEDLAH Needle aspiration For Minor OT (Hospital Charges ) 770
NEDLA Needle aspiration For Minor OT (Surgeon charges) 1830
66 NERBLOS Maxillofacial-Nerve block in
Neuralgias For Minor OT
NERBLAC Nerve block in Neuralgias For Minor OT (Anaesthetists 1460
Charges )
NERBLSC Nerve block in Neuralgias For Minor OT(Hospital 2430
Charges )
NERBLDC Nerve block in Neuralgias For Minor OT(Surgeon 5810
Charges )
67 ORANCOS Maxillofacial-Oro antral communication
closure For Minor OT
270
ORANCAC Oro antral communication closure For Minor 6780
ORANCDC Oro antral communication closure For Minor 27110
ORANCHC Oro antral communication closure For Minor 11300
OT (Hospital Charges )
68 PTBOS Prostatic Trucut Biopsy For Minor OT
PTBANA Prostatic Trucut Biopsy For Minor OT(Anaesthetistscharges) 740
PTBHC Prostatic Trucut Biopsy For Minor OT (Hosiptal charges) 1230
PTB Prostatic Trucut Biopsy For Minor OT (Surgeon Charges ) 2920
69 RATMOT Maxillofacial-Reimplantation
OS of avulsed tooth For Minor OT
RATMOTDC Reimplantation of avulsed tooth For Minor 5150
RATMOTAC Reimplantation of avulsed tooth For Minor 1280
OT( Anaesthetists Charges )
RATMOTHC Reimplantation of avulsed tooth For Minor 2140
OT( Hospital Charges )
70 REOSKGR Scar Revision Simple ( Doctor
REATKGRAA Scar Revision Simple For Minor OT (Anaesthetists 3480
Charges )
REATKGRAH Scar Revision Simple For Minor OT (Hospital Charges ) 5840
REATKGRAD Scar Revision Simple For Minor OT ( Doctor Charges ) 13890
71 RESUPOS Removal of superficial foreign
body (Single) - Minor OT
RESUPAC Removal of superficial foreign body (Single) - 2360
RESUPHC Removal of superficial foreign body (Single) - 3940
RESUPER Removal of superficial foreign body (Single) - 9450
72 RIOHOS Reduction of Irreducible Obstructed
Hernia For Minor OT
RIOHAN Reduction of Irreducible Obstructed Hernia 4560
RIOHC Reduction of Irreducible Obstructed Hernia 7670
For Minor OT ( Hospital charges )
RIOH Reduction of Irreducible Obstructed Hernia 18240
For Minor OT ( Surgeon charges )
73 RPMLAOS Maxillofacial-Removal of
plates of mandible and maxilla
(Under LA) For Minor OT
RPMLAAC Removal of plates of mandible and maxilla(Under LA) 3890
For Minor OT( Anaesthetists Charges )
RPMLAHC Removal of plates of mandible and maxilla (Under LA) 1620
For Minor OT( Hospital Charges)
RPMLADC Removal of plates of mandible and maxilla 15500
(Under LA) For Minor OT( Surgeon Charges )
74 RSPOS Reduction of Stomal Prolapsed
For Minor OT
RSPANA Reduction of Stomal Prolapsed For Minor OT 2740
RSPHC Reduction of Stomal Prolapsed For Minor OT 4600
( Hospital charges )
RSP Reduction of Stomal Prolapsed For Minor OT 10940
( Surgeon charges )
75 SATKGRA Skin Lesion Small ( Doctor
SATKGRAA Skin Lesion Small For Minor OT(Anaesthetists Charges) 3130
SATKGRAH Skin Lesion Small For Minor OT ( Hospital Charges ) 5250
SATKGRAD Skin Lesion Small For Minor OT ( Doctor Charges ) 12510
76 SCMOTOS Maxillofacial-Scaling full
mouth For Minor OT
SCMOTAC Scaling full mouth For Minor OT(Anaesthetists Charges) 1040
SCMOTDC Scaling full mouth For Minor OT ( Surgeon Charges ) 4170
SCMOTHC Scaling full mouth For Minor OT( Hospital Charges ) 1740
271
77 SCUBCUR Maxillofacial-Subgingival scaling &
OS curretage full mouth For Minor OT
SUBCURDC Subgingival scaling & curretage full mouth 5810
SUBCURAC Subgingival scaling & curretage full mouth 1460
For Minor OT (Anaesthetists Charges)
SUBCURHC Subgingival scaling & curretage full mouth 2430
For Minor OT (Hospital Charges)
78 SKGMTOS Skin Grafting For Minor OT
SKGMTAC Skin Grafting For Minor OT ( Anaesthetists Charges ) 3480
SKGMTHC Skin Grafting For Minor OT ( Hospital Charges ) 5840
SKGMTSC Skin Grafting For Minor OT ( Surgeon Charges ) 13890
79 SMALLSK OS Small skin graft for Minot OT
SMSKGRAA Small Skin Grafting For Minor OT (Anaesthetists 3480
Charges )
SMSKGRAD Small Skin Grafting For Minor OT ( Doctor Charges ) 13890
SMSKGRAH Small Skin Grafting For Minor OT ( Hospital Charges ) 5840
80 SMLOS Suturing of Medium Lacerations
(Large) For Minor OT
SMLANA Suturing of Medium Lacerations (Large) For 2550
SMLHC Suturing of Medium Lacerations (Large) For 4280
Minor OT ( Hospital charges )
SML Suturing of Medium Lacerations (Large) For 10210
Minor OT ( Surgeon charges )
81 SOFTSWE Soft Tissue Swelling Large ( Doctor
NOS Charges + Hospital Charges )
SOFTTSFD Soft Tissue Swelling Large For Minor OT (Doctor 20840
Charges )
SOFTTSACC Soft Tissue Swelling Large For Minor OT (Anaesthetists 5210
Charges )
SOFTTSHH Soft Tissue Swelling Large For Minor OT (Hospital 8760
Charges )
82 SOFTSWE Soft Tissue Swelling Small ( Doctor
SOFTTSD Soft Tissue Swelling Small For Minor OT (Doctor 13890
Charges )
SOFTTSAC Soft Tissue Swelling Small For Minor OT (Anaesthetists 3480
Charges )
SOFTTSH Soft Tissue Swelling Small For Minor OT (Hospital 5840
Charges )
83 SPMINPL SKIN & SOFT TISSUE BIOPSY-
ASDBOS MEDIUM (PLASTIC SURGERY)
For Minor OT
SPMINPLASBK SKIN & SOFT TISSUE BIOPSY- MEDIUM (PLASTIC 1260
N SURGERY) For Minor OT (Anaesthetists Charges )
SPMINPLASBK SKIN & SOFT TISSUE BIOPSY- MEDIUM (PLASTIC 2100
SPMINPLASBD SKIN & SOFT TISSUE BIOPSY- MEDIUM (PLASTIC 5040
84 SPREMOS Maxillofacial-Splint Removal
For Minor OT
SPREMOTAC Splint Removal For Minor OT ( Anaesthetists Charges ) 640
SPREMOTHC Splint Removal For Minor OT ( Hospital Charges ) 1070
SPREMOTSC Splint Removal For Minor OT ( Surgeon Charges ) 2560
85 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 8760
86 SSFTOS Secondary Suturing For Minor OT
SSFTNA Secondary Suturing For Minor OT (Anaesthetists 1160
Charges )
272
SSFTHC Secondary Suturing For Minor OT ( Hospital Charges ) 1940
SSFT Secondary Suturing For Minor OT ( Surgeon Charges ) 4630
87 SSLOS Suturing of Small Lacerations
For Minor OT
SSLANA Suturing of Small Lacerations For Minor OT 1460
SSLHC Suturing of Small Lacerations For Minor OT (Hospital 2450
Charges )
SSL Suturing of Small Lacerations For Minor OT (Surgeon 5830
Charges )
88 SSMINPLA BURN DRESSING - SMALL (PLASTIC
SDBOS SURGERY) For Minor OT
SSMINPLASBK BURN DRESSING - SMALL (PLASTIC SURGERY) For 560
SSMINPLASBK BURN DRESSING - SMALL (PLASTIC 910
SSMINPLASBD BURN DRESSING - SMALL (PLASTIC 2210
89 SSMINPLA SKIN TAG REMOVAL (PLASTIC
SDKOS SURGERY) For Minor OT
SSMINPLASDK SKIN TAG REMOVAL (PLASTIC SURGERY) For 1190
SSMINPLASDK SKIN TAG REMOVAL (PLASTIC SURGERY) For 1960
H Minor OT ( Hospital Charges )
SSMINPLASKD SKIN TAG REMOVAL (PLASTIC SURGERY) For 4730
90 SSMINPLA SECONDARY SUTURING (PLASTIC
SDOS SURGERY) For Minor OT
SSMINPLASDN SECONDARY SUTURING (PLASTIC SURGERY) 2360
SSMINPLASDH SECONDARY SUTURING (PLASTIC SURGERY) 3940
SSMINPLASD SECONDARY SUTURING (PLASTIC SURGERY) 9450
91 STMINPLA SKIN & SOFT TISSUE BIOPSY- SMALL
SDBOS (PLASTIC SURGERY) For Minor OT
STMINPLASBK SKIN & SOFT TISSUE BIOPSY- SMALL (PLASTIC 950
N SURGERY) For Minor OT (Anaesthetists Charges )
STMINPLASBK SKIN & SOFT TISSUE BIOPSY- SMALL (PLASTIC 1580
STMINPLASBD SKIN & SOFT TISSUE BIOPSY- SMALL (PLASTIC 3780
92 STSEOS Soft tissue swelling excision
For Minor OT
STSEA Soft tissue swelling excision for Minor OT 2550
STSEH Soft tissue swelling excision for Minor OT 4280
(Hospital Charges )
STSE Soft tissue swelling excision for Minor OT 10210
(Surgeon Charges )
93 STUMINI Stump Closure Major ( Doctor
OS Charges + Hospital Charges)
STUAINAC Stump Closure Major For Minor OT (Anaesthetists 5210
Charges )
STUMINIO Stump Closure Major For Minor OT ( Doctor Charges ) 20840
STUCLOMIN Stump Closure Major For Minor OT (Hospital Charges ) 8760
94 STUMINO Stump Closure Minor ( Doctor
S Charges + Hospital Charges)
STUANAC Stump Closure Minor For Minor OT (Anaesthetists 3480
Charges )
STUMINO Stump Closure Minor For Minor OT ( Doctor Charges ) 13890
STUCLMIN Stump Closure Minor For Minor OT (Hospital Charges ) 5840
95 SUEXTOS Maxillofacial-Surgical extraction of
tooth For Minor OT
SUEXTDC Surgical extraction of tooth For Minor OT (Surgeon 5790
Charges )
273
SUEXTAC Surgical extraction of tooth For Minor OT 1450
(Anaesthetists Charges)
SUEXTHC Surgical extraction of tooth For Minor OT 2420
(Hospital Charges)
96 SUTREOS Suture removal For Minor OT
SUTREA Suture removal For Minor OT (AnaesthetistsCharges) 460
SUTREH Suture removal For Minor OT (Hospital Charges) 770
SUTRE Suture removal For Minor OT (Surgeon Charges) 1830
97 TCBOS Teslicular Biopsy For Minor OT
TCBANA Teslicular Biopsy For Minor OT (Anaesthetists Charges ) 1090
TCBHC Teslicular Biopsy For Minor OT ( Hospital Charges ) 1840
TCB Teslicular Biopsy For Minor OT ( Surgeon Charges ) 4380
98 TPATKGR Finger Tip Injury ( Doctor
URLATKGRAA Finger Tip Injury For Minor OT (Anaesthetists Charges) 3480
URLATKGRAH Finger Tip Injury For Minor OT ( Hospital Charges ) 5840
URLATKGRAD Finger Tip Injury For Minor OT ( Doctor Charges ) 13890
99 TUEXOS Maxillofacial-Tumour Excision
For Minor OT
TUEXDC Tumour excision For Minor OT ( Surgeon Charges ) 19370
TUEXAC Tumour Excision For Minor OT (Anaesthetists Charges) 4840
TUEXHC Tumour excision For Minor OT (Hospital Charges) 8070
100 UCADOS Urethral Calibration and
Dilatation For Minor OT
UCADANA Urethral Calibration and Dilatation For 740
UCADHC Urethral Calibration and Dilatation For 1230
UCAD Urethral Calibration and Dilatation For 2920
101 URCAOS Uretheral Catheterization For Minor
OT
URCANA Uretheral Catheterization For Minor OT (Anaesthetists 550
Charges )
URCAHC Uretheral Catheterization For Minor OT (Hospital 910
charges )
URCA Uretheral Catheterization For Minor OT (Surgeon 2180
charges )
102 URDLOS Urethral dilatation For Minor OT
URDLA Urethral dilatation For Minor OT (Anaesthetists 910
Charges)
URDLH Urethral dilatation For Minor OT (Hospital Charges) 1530
URDL Urethral dilatation For Minor OT (Surgeon Charges) 3650
103 VAMSOS VAC Application For Minor OT
VAMHC VAC Application For Minor OT ( Hospital Charges ) 980
VAMSNA VAC Application For Minor OT (Anaesthetists Charges ) 580
VAMS VAC Application For Minor OT ( Surgeon Charges ) 2320
104 WDMTOS Wound Debridement For Minor OT
WDMTN Wound Debridement For Minor OT (Anaesthetists 580
Charges )
WDMTHC Wound Debridement For Minor OT (Hospital Charges ) 980
WDMT Wound Debridement For Minor OT 2320
(Surgeon Charges )
Oncology Procedures
Cat 1B Suite
4 Beddded
Cat 1A-Pre
2 Bedded
Category
SNo
GOPD
Code Description
POPD
Cat-2
Cat-3
Cat-
1D
All
1 CPSDHCO CHEMOTHERAPY PLANNING /

S SUPERVISION (DOCTOR FEE +
HOSPITAL CHARGES)
CPSAHC Chemotherapy planning / supervision - 380 380 190 150 110
CPSDF Chemotherapy planning / supervision - Doctor fee 3680 3680 1840 1470 1100
274
2 EDCF Early detection of cancer (Package of 1470
women )
MAMMOP Mammography (bilateral) ( Xray dept charges )

PAPS PAP smear / Hormonal smear / Vault smear
/ Cervical smear WITH Barcode
WA Ultrasound whole abdomen & pelvis ( Adult)
3 EDCM Early detection of cancer (Package of 1470
men )
WA Ultrasound whole abdomen & pelvis ( Adult)
Ophthalmology Procedures
4 Beddded
Cat 1A-Pre
2 Bedded
Category
Cat 1B
SNo
GOPD
Code Description
POPD
Cat-2
Cat-3
Suite
Cat-
1D
All
1 ACFOS AC Formation - (Doctor
ACFAC AC Formation - Anasthesia Consumables 340
ACFCO AC Formation - Consumables Charges 630
ACFDF AC Formation - Doctor Fee 1390
ACFTC AC Formation - Theatre Charges 690
ANPACCHSY Anaesthetist PAC charges for Daycare 640
Packages (Rs. 640)
MRDCHG MRD Charges 500 500 500 500 500
2 ALPDHCO RETINAL LASER PHOTOCOAGULATION
SDM - SINGLE SITTING (DOCTOR FEE +
HOSPITAL CHARGES)
ALPDMHC Argon laser photocoagulation ( single sitting) for 1870 1870
diabetic maculopathy - Additional hospital charges
ALPDMDF Argon laser photocoagulation ( single sitting) for 3210 3210
diabetic maculopathy - Doctor fees
3 BIBLBIOS Botox Injection - Bilateral
BIBLBI Botox Injection Blepharospasam - Bilateral 17320 17320 8660 6930 5200
BOIEBI Botox Injection Epiphora - Bilateral 8680 8680 4340 3470 2600
BISTPBI Botox Injection Squint/Lid retraction/ Four 8680 8680 4340 3470 2600
inducing temporary Ptosis - Bilateral
4 BIBUNIOS Botox Injection - Unilateral
BIBLUNI Botox Injection Blepharospasam - Unilateral 11560 11560 5780 4620 3470
BOIEUNI Botox Injection Epiphora - Unilateral 5780 5780 2890 2310 1730
BISTPUNI Botox Injection Squint/Lid retraction/ Four 5780 5780 2890 2310 1730
inducing temporary Ptosis - Unilateral
5 C3ROS C3R (laser room) - (Doctor
Fee+Hospital Charges )
C3RHC C3R (laser room) - Additional Hospital Charges 9240
C3RCC C3R (laser room) - Consumables Charges 5250
C3RDF C3R (laser room) - Doctor Fee 13860
C3REC C3R (laser room) - Equipment Charges 3470
6 CAGAOS Cyno Acrylate Glue Application
( Surgeon Fee + Hospital Charges )
CAGAHC Cyno Acrylate Glue Application ( Hospital Charges ) 610 370
CAGASC Cyno Acrylate Glue Application ( Surgeon Charges ) 910 550
7 CFBOS Corneal Foreign Body Removal
( Surgeon Fee + Hospital Charges )
CFBHC Corneal Foreign Body Removal ( Hospital Charges ) 610 370
CFBR Corneal Foreign Body Removal ( Surgen Charges ) 910 550
275
8 CFPSOS Colour Fundus Photography (Surgen
CFPHC Colour Fundus Photography ( Hospital Charges ) 580 350
CFPSF Colour Fundus Photography ( Surgeon Fee ) 990 590
9 CLIOLOS Glued IOL - (Doctor Fee+Hospital
Charges)
Packages (Rs. 640)
GLIOLCA Glued IOL - Anasthesia Consumables 340
GLIOLAC Glued IOL - Anasthetist Charges 4160
GLIOLCO Glued IOL - Consumables Charges 5250
GLIOLDF Glued IOL - Doctor Fee 20790
GLIOLTC Glued IOL - Theatre Charges 10400
10 CORSOS Corneal Scrapping - (Doctor
CORSDF Corneal Scrapping - Doctor Fee 690
CORSHC Corneal Scrapping - Hospital Charges 460
11 CRDFICGP COMBINED RETINAL DIGITAL
DCOS FLUORESCEIN & INDOCYANINE GREEN
( ICG ) IMAGING (DOCTOR FEE +
HOSPITAL CHARGES)
CRDFICGHC Combined retinal digital fluorescein &indocyanine 6510 3910
green ( ICG ) imaging angiography - Additional hospital
charges
CRDFICGDF Combined retinal digital fluorescein & indocyanine 2790 1670
green ( ICG ) imaging angiography - Doctor fees
12 DALKOS DALK - (Doctor Fee+Hospital Charges)
Packages (Rs. 640)
DALKCA DALK - Anasthesia Consumables 340
DALKAC DALK - Anasthetist Charges 8780
DALKCO DALK - Consumables Charges 7350
DALKDF DALK - Doctor Fee 43890
DALKTC DALK - Theatre Charges 21950
13 DECSDHC DIABETIC EYE CARE SERVICE (DOCTOR
DECHC Diabetic eye care service – Additional hospital charges 700 420
DECDF Diabetic eye care service - Doctor fee 420 250
14 DSEKOS Descemets's stripping Endothelial
Keraoplasty - (Doctor Fee+Hospital
Charges)
Packages (Rs. 640)
DSEKCA Descemets's stripping Endothelial 340
Keraoplasty - Anasthesia Consumables
DSEKAC Descemets's stripping Endothelial 8320
Keraoplasty - Anasthetist charges
DSEKCO Descemets's stripping Endothelial 7350
Keraoplasty - Consumables Charges
DSEKDF Descemets's stripping Endothelial 41580
Keraoplasty - Doctor Fee
DSEKTC Descemets's stripping Endothelial 20790
Keraoplasty - Theatre charges
15 EDBCLOS Epithelial Debridetment with
BCL - (Doctor Fee+Hospital Charges)
Packages (Rs. 640)
EDBCLCA Epithelial Debridetment with + BCL - 340
Anasthesia Consumables
EDBCLAC Epithelial Debridetment with + BCL - 2310
Anasthetist Charges
EDBCLCO Epithelial Debridetment with + BCL - 7350
Consumables Charges
276
EDBCLDF Epithelial Debridetment with + BCL – Doctor Fee 11550
EDBCLTC Epithelial Debridetment with + BCL – Theatre Charges 5780
16 ELTLOS Electrolysis - (Doctor
ELTLDF Electrolysis - Doctor Fee 3470
ELTLHC Electrolysis - Hospital Charges 2310
17 HALOS Chalazion ( Surgen Fee +
Hospital Charges )
CHALA Chalazion ( Surgen Charges ) 3810 2290
CHALHC Chalazion Hospital Charges 2540 1520
18 IITAOS Intravitreal Injection TA (OT) -
Packages (Rs. 640)
IITACO Intravitreal Injection TA (OT) - Anasthesiaconsumables 340
IITAAC Intravitreal Injection TA (OT) – Anasthetist charges 920
IITAOC Intravitreal Injection TA (OT) – Consumable charges 950
IITADF Intravitreal Injection TA (OT) - Doctor Fee 4620
IITATC Intravitreal Injection TA (OT) – Theatre usage charges 2310
19 KRTPOS Keratoprosthesis - (Doctor
Packages (Rs. 640)
KRTPCA Keratoprosthesis - Anasthesia Consumables 340
KRTPAC Keratoprosthesis - Anasthetist Charges 9240
KRTPCO Keratoprosthesis - Consumables Charges 14700
KRTPDF Keratoprosthesis - Doctor Fee 46200
KRTPTC Keratoprosthesis - Theatre Charges 23100
20 LBDOS Lid Abscess Drainage (Surgeon
LBDHC Lid Abscess Drainage ( Hospital Charges ) 3050 1830
LBDSC Lid Abscess Drainage ( Surgeon Charges ) 4580 2750
21 LBOOS Lid Biopsy (OT) - (Doctor
Packages (Rs. 640)
LBOCA Lid Biopsy (OT) - Anasthesia consumables 340
LBOAC Lid Biopsy (OT) - Anasthetist charges 1160
LBOCO Lid Biopsy (OT) - Consumables Charges 4200
LBODF Lid Biopsy (OT) - Doctor Fee 5780
LBOTC Lid Biopsy (OT) - Theatre charges 2890
22 LMMMOS Lid Margin Mucous Membrane
Graft Fibrin Glue - (Doctor
Packages (Rs. 640)
LMMMCA Lid Margin Mucous Membrane Graft + 340
Fibrin Glue - Anasthesia Consumables
LMMMAC Lid Margin Mucous Membrane Graft + 6930
Fibrin Glue - Anasthetist charges
LMMMCO Lid Margin Mucous Membrane Graft + 7350
Fibrin Glue - Consumables Charges
LMMMDF Lid Margin Mucous Membrane Graft + 34650
Fibrin Glue - Doctor Fee
LMMMTC Lid Margin Mucous Membrane Graft + 17330
Fibrin Glue - Theatre charges
23 LPARMDD Laser photocoagulation for ARMD -
FHC (Doctor fee+Hospital Charges)
277
LPARMDDF Laser photocoagulation for ARMD – doctor fee 6130 3680
LPARMDHC Laser photocoagulation for ARMD – hospital charges 3740 2240
24 LPLAT2DF Laser photocoagulation for
HC LATTICE ( 2 quadrants ) -
LPLAT2DF Laser photocoagulation for LATTICE ( 2 3210 3210
quadrants ) - doctor fee
LPLAT2HC Laser photocoagulation for LATTICE ( 2 1870 1870
quadrants ) - hospital charges
25 LPLAT3DF Laser photocoagulation for LATTICE ( 3
HC quadrants ) - (Doctor Fee + Hospital
Charges)
LPLAT3DF Laser photocoagulation for LATTICE ( 3 6130 6130
quadrants ) - doctor fee
LPLAT3HC Laser photocoagulation for LATTICE ( 3 3720 3720
quadrants ) - hospital charges
26 LPLATM3 Laser photocoagulation for LATTICE (
DFHC more than 3 quadrants ) - (Doctor Fee
+Hospital Charges)
LPLATM3DF Laser photocoagulation for LATTICE ( more 9310 9310
than 3 quadrants ) - doctor fee
LPLATM3HC Laser photocoagulation for LATTICE ( more 5590 5590
than 3 quadrants ) - hospital charges
27 LPPRPDFH Laser photocoagulation PRP Package (
C Doctor Fee +Hospital Charges)
LPPRPDF Laser photocoagulation ( PRP package ) -doctor fee 9310 9310
LPPRPHC Laser photocoagulation ( PRP package ) -hospital 5590 5590
charges
28 LPRBDFHC Laser photocoagulation for retinal
break - (Doctor Fee + Hospital Charges)
LPRBDF Laser photocoagulation for retinal break - 6130 6130
doctor fee
LPRBHC Laser photocoagulation for retinal break - 3720 3720
hospital charges
29 LPROPDF Laser photocoagulation for
HC retinopathy of prematurity ( ROP ) -
(Ddoctor Fee + Hospital Charges)
LPROPDF Laser photocoagulation for retinopathy of 9310 9310
prematurity ( ROP ) - doctor fee
LPROPHC Laser photocoagulation for retinopathy of 5590 5590
prematurity ( ROP ) - hospital charges
30 LPVMQDF Laser photocoagulation for vasculitis (
HC more than one quadrant ) - (Doctor
LPVMQDF Laser photocoagulation for vasculitis ( more 6130 6130
than one quadrant ) - doctor fee
LPVMQHC Laser photocoagulation for vasculitis ( more 3720 3720
than one quadrant ) - hospital charges
31 LPVOMQ Laser photocoagulation for vascular
DFHC occlusions ( more than one quadrant )
- (Doctor Fee +Hospital Charges)
LPVOMQDF Laser photocoagulation for vascular occlusions ( more 6130 6130
than one quadrant ) -doctor fee
LPVOMQHC Laser photocoagulation for vascular occlusions ( more 3720 3720
than one quadrant ) -hospital charges
32 LPVOOQD Laser photocoagulation for vascular

FHC occlusions ( one quadrant ) - (Doctor
LPVOOQDF Laser photocoagulation for vascular 3210 3210
occlusions ( one quadrant ) - doctor fee
LPVOOQHC Laser photocoagulation for vascular occlusions ( one 1870 1870
quadrant ) – hospital charges
278
33 LPVOQDF Laser photocoagulation for vasculitis (
HC one quadrant ) - (Doctor Fee +
Hospital Charges)
LPVOQDF Laser photocoagulation for vasculitis ( one 3210 3210
quadrant ) - doctor fee
LPVOQHC Laser photocoagulation for vasculitis ( one 1870 1870
quadrant ) - hospital charges
34 MLLOS Minor Lid Laceration ( Surgeon
MLLHC Minor Lid Laceration ( Hospital Charges ) 3050 1830
MLLSC Minor Lid Laceration ( Surgeon Charges ) 4580 2750
35 OBOS Orbital Biopsy (OT) - (Doctor
Packages (Rs. 640)
OBCA Orbital Biopsy (OT) – Anasthesia consumables 340
OBAC Orbital Biopsy (OT) - Anasthetist charges 1850
OBCO Orbital Biopsy (OT) - Consumables Charges 950
OBDF Orbital Biopsy (OT) - Doctor Fee 9240
OBTC Orbital Biopsy (OT) - Theatre charges 4620
36 OPTMAC OPTICAL COHERENCE
ULADFHC TOMOGRAPHY (MACULA)
OCTMACULAD Optical coherence tomography ( OCT ) 1300 1300
OC (MACULA) - doctor charges
OCTMACULAH Optical coherence tomography ( OCT ) 2790 2790
OS (MACULA) - hospital service charge
37 OPTRNFL OPTICAL COHERENCE
DFHC TOMOGRAPHY (RNFL)
OCTRNFLDOC Optical coherence tomography ( OCT ) 1300 1300
(RNFL) - doctor charges
OCTRNFLHOS Optical coherence tomography ( OCT ) 2790 2790
(RNFL) - hospital service charge
38 PHOTAC Photodynamic therapy – All Charges
PHOTDC Photodynamic therapy - doctor fee 18600 18600
PHOTTDYE Photodynamic therapy - dye charges 73500 73500
PHOTHC Photodynamic therapy - hospital charges 7430 7430
PHOTLRC Photodynamic therapy - laser rental charges 18600 18600
39 PSIOOS Punctal Snip with Intubation (OT) -
Packages (Rs. 640)
PSICA Punctal Snip with Intubation (OT) -Anasthesia 340
consumables
PSIAC Punctal Snip with Intubation (OT) -Anasthetist charges 1620
PSICO Punctal Snip with Intubation (OT) -Consumables 4200
Charges
PSIDF Punctal Snip with Intubation (OT) – Doctor Fee 8090
PSITC Punctal Snip with Intubation (OT) – Theatre charges 4040
40 PSIOS Posterior Subtenon Injection (Surgeon
PSIHC Posterior Subtenon Injection ( Hospital Charges ) 1160
PSISC Posterior Subtenon Injection ( Surgeon Charges ) 1730
41 RDFIDCHC RETINAL DIGITAL
HOS FLURORESCEIN IMAGING
RDFIHC Retinal digital flurorescein imaging 2050 2050
angiography - Additional hospital charges
RDFIDF Retinal digital flurorescein imaging 1300 1300
angiography - Doctor fees
42 RDICGDH RETINAL DIGITAL INDOCYANINE
CHOS GREEN ( ICG ) IMAGING (DOCTOR FEE
+HOSPITAL CHARGES)
279
RDICGHC Retinal digital indocyanine green ( ICG ) imaging 6510 6510
angiography - Additional hospital charges
RDICGDF Retinal digital indocyanine green ( ICG ) 1860 1860
imaging angiography - Doctor fees
43 SFIOLOS SF - IOL Scleral Fixated -
Packages (Rs. 640)
SFIOLCA SF - IOL Scleral Fixated – Anasthesia Consumables 340
SFIOLAC SF - IOL Scleral Fixated - Anasthetist Charges 4160
SFIOLCO SF - IOL Scleral Fixated – Consumables Charges 5250
SFIOLDF SF - IOL Scleral Fixated - Doctor Fee 20790
SFIOLTC SF - IOL Scleral Fixated - Theatre Charges 10400
44 SPECMICR Specular Microscope - (Doctor
OOS Fee+Hospital Charges)
SPECMICRODF Specular Microscope - Doctor Fee 320
SPECMICROHC Specular Microscope - Hospital Charges 480
45 SYPOS Syringing & Probing - (Doctor
SYPDF Syringing & Probing - Doctor Fee 690
SYPHC Syringing & Probing - Hospital Charges 460
46 TOS Trasorrhaphy ( Surgeon Fee +
Hospital Charges )
THC Trasorrhaphy ( Hospital Charges ) 3050 1830
TSC Trasorrhaphy ( Surgeon Charges ) 4580 2750
47 TROS Trasorrhaphy Release (Surgeon Fee +
Hospital Charges)
TRHC Trasorrhaphy Release ( Hospital Charges ) 1520 910
TRSC Trasorrhaphy Release ( Surgeon Charges ) 2290 1380
48 TRSPOS Tarasoraphy - (Doctor Fee+Hospital
Charges)
TRSPDF Tarasoraphy - Doctor Fee 5540
TRSPHC Tarasoraphy - Hospital Charges 3700
49 VITENDOL Vitrectomy (Endolaser) -
AOS Doctor fee + Hospital Charges
VITENDOLA Vitrectomy (Endolaser) - Doctor Fee 3840
VITENDOLAHC Vitrectomy (Endolaser) - Hospital Charges 3840
50 YAGLPDH YAG LASER PHOTOCOAGULATION
YAGHC YAG laser photocoagulation - Additional 1880 1880
hospital charges
YAGDF YAG laser photocoagulation - Doctor fees 2970 2970
Other Procedure
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
Single Bed
2 Bedded
Cat-1D
GOPD
POPD
Cat-2
Cat-3
Code Description
1 AATDHCO ANTIGEN ALLERGY PRICK TESTING
AATPTHC Antigen allergy testing ( prick testing ) - 2100 2100 2100
AATPTDF Antigen allergy testing ( prick testing ) -Doctor fees 4100 4100 4100
2 AATDHOS ANTIGEN ALLERGY INTRADERMAL TESTING
AATITHC Antigen allergy testing ( intradermal testing) - 1480 1480 1480
AATITDF Antigen allergy testing ( intradermal testing) - Doctor 3090 3090 3090
fees
280
3 CPAPDHC CPAP TITRATION (LABORATORY
OS CHARGES +PROFESSIONAL CHARGES)
CPAPDF CPAP titration - Doctor fee 12340 12340 6170 4940 3700 6170 3700
CPAPTC CPAP titration test charges 9260 9260 4630 3700 2780 4630 2780
4 ECOS ELECTIVE CARDIOVERSION (PACKAGE
ECPC ELECTIVE CARDIOVERSION PACKAGE CHARGES 14430 13380 12830 11240 7700
5 EPCATOS Epidural Catheter Insertion Charges
EPCATHC Epidural Catheter Insertion – Hospital Charges 900 900 450 360 270
EPCATIC Epidural Catheter Insertion Charges 9080 9080 4540 3630 2720
6 EPCTOS EUPHORBIA PROSTRATA
CLINICAL TRIAL
APTT APTT ( Activated partial thromboplastin time ) 750 450
CRT Clot retraction test 380 230
CBCDLC Complete blood count ( CBC ) with 660 400
Differential leukocyte count ( DLC )
GLUR Glucose Random 120 80
HEPA LFT - Liver Function Test ( Hepatic Profile ) 1500 900
PT Prothrombin time ( PT ) Haematology Lab 450 270
RENPI Renal Biochemical Profile - Basic 1450 870
(BUN,Creat,Ca,PO4,Na,K,Bicarbonate,Cl)
7 GRAOS Granulocyte transfusion ( GCSF
mobilized, third party) -Doctor fee +
Hospital vharges
GRADF Granulocyte transfusion ( GCSF mobilized, 48620 48620 24310 19450 14590
third party) - Doctor fee
GRAHC Granulocyte transfusion ( GCSF mobilized, 4880 4880 2440 1950 1460
third party) - Hospital Charges
8 HAPOS Haploidentical allogenic stem/bone
marrow transplantation - Doctor fee +
Hospital Charges
HAPDF Haploidentical allogenic stem/bone marrow 364660 364660 182330 145860 109400
transplantation - Doctor fee
HAPHC Haploidentical allogenic stem/bone marrow 36480 36480 18240 14590 10940
transplantation - Hospital Charges
9 HLITOS LIT therapy ( Doctor fee + lab charges)
HLITDF LIT therapy - Doctor fee 3870 3870 3870 3870 3870 3690 2760
HLIT LIT therapy - Lab charges 3870 3870 3870 3870 3870 3690 2580
10 MLSTDHC MULTIPLE SLEEP LATENCY TEST ( MLST
OS ) PACKAGE CHARGES Professional
Charges +HOSPITAL CHARGES)
MLSTDF Multiple sleep latency test ( MLST ) – Doctor fee 12340 12340 6170 4940 3700
MLSTTC Multiple sleep latency test ( MLST ) test charges 9260 9260 4630 3700 2780
11 PACSGDC PULMONARY ARTERY
HCHOS CATHETERISATION (SWAN-GANZ )
PACAHC Pulmonary artery catheterisation ( Swan 2040 2040 1020 820 610
Ganz ) - Additional hospital charges
Ganz ) - Doctor fee
12 PULFNAC Guided FNAC/Needle Biopsy -
OS PULMONOLOGY
PULFNACDF Guided FNAC/Needle Biopsy - Pulmonology 5800 5800 2900 2320 1740
Doctor Fee
PULFNACHC Guided FNAC/Needle Biopsy - Pulmonology 580 580 290 230 170
Hospital Charges
13 PULGAOS Guided Abscess drainage -
PULMONOLOGY
PULGAHC Guided Abscess drainage - Hospital Charges 700 700 350 280 210
PULGADF Guided Abscess drainage – Pulmonology Doctor Fee 6960 6960 3480 2780 2090
281
14 PULGPAO Guided pleural aspiration
S (Diagnostic ) - PULMONOLOGY
PULGPA Guided pleural aspiration (Diagnostic) 6960 6960 3480 2780 2090
PULGPAHC Guided pleural aspiration (Diagnostic) 700 700 350 280 210
15 PULGPOS Guided pleural aspiration
(Therapeutic ) - PULMONOLOGY
PULGTDF Guided pleural aspiration (Therapeutic) 10440 10440 5220 4180 3130
PULGTHC Guided pleural aspiration (Therapeutic) 1060 1060 530 420 320
16 PULGTBO Guided trucut biopsy (Small) -
S PULMONOLOGY
PULGTBDF Guided trucut biopsy (Small) - Pulmonology 10440 10440 5220 4180 3130
Doctor Fee
PULGTBHC Guided trucut biopsy (Small) - Pulmonology 1060 1060 530 420 320
Hospital Charges
Paediatric Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
2 Bedded
Cat-1D
GOPD
Single
POPD
Cat-2
Cat-3
1 ALBOS Aspiration of liver abscess -

(Docor Fee + Hospital Charges)
ALADF Aspiration of liver abscess - Docor Fee 11220 11220 5610 4490 3370
ALAHC Aspiration of liver abscess – Hospital Charges 1700 1700 850 680 510
2 ANOS Anal dilatation - (Docor Fee +
Hospital Charges)
ANDF Anal dilatation - Docor Fee 18240 18240 9120 7300 5470
ANHC Anal dilatation - Hospital Charges 2740 2740 1370 1100 820
3 BPVCDOS Bedside paediatric vascular cut
down under GA ( venesection )
BPVCDAF Bedside paediatric vascular cut down under 8020 8020 4010 3210 2410
GA ( venesection ) - Anaesthetists charges
BPVCDHF Bedside paediatric vascular cut down under 4020 4020 2010 1610 1210
GA ( venesection ) - Hospital service charges
BPVCDSF Bedside paediatric vascular cut down under 26760 26760 13380 10700 8030
GA ( venesection ) - Surgeon fee
4 ETDFHCH EXCHANGE TRANSFUSION (DOCTOR
ETHC Exchange transfusion - Additional hospital charges 2120 2120 1060 850 640
ETDF Exchange transfusion - Doctor fees 14100 14100 7050 5640 4230
5 PBMADC PAEDIATRIC BONE MARROW
HOS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
PBMAAD Paediatric bone marrow aspiration – Doctor fee 2100 2690
PBMAAHC Paediatric bone marrow aspiration - 410
hospital service charge
6 PBMBAD PAEDIATRIC BONE MARROW BIOPSY +
HCHOS ASPIRATION (DOCTOR FEE + HOSPITAL
CHARGES)
PBMBAD Paediatric bone marrow biopsy + aspiration 4790
- Doctor fee
PBMBAAHC Paediatric bone marrow biopsy + aspiration 710
- hospital service charge
7 PBMBDHC PAEDIATRIC BONE MARROW BIOPSY
PBMBADP Paediatric bone marrow biopsy - Doctor fee 3510
PBMBAHC Paediatric bone marrow biopsy - hospital 510
service charge
282
8 PBRPDHC PAEDIATRIC BRONCHOSCOPY
PBADWP Paediatric bronchoscopy - Doctor fee 6100
PBAHC Paediatric bronchoscopy - hospital service charge 910
9 PKBDCHC PAEDIATRIC KIDNEY BIOPSY (DOCTOR
HOS FEE + HOSPITAL CHARGES)
PKBADWP Paediatric kidney biopsy - Doctor fee 4900
PKBAHC Paediatric kidney biopsy - hospital service charge 640 740
10 PLBDCHC PAEDIATRIC LIVER BIOPSY (DOCTOR
PLBADWP Paediatric liver biopsy - Doctor fee 4900
PLBAHC Paediatric liver biopsy - hospital service charge 640 740
11 PLPDHCH PAEDIATRIC LUMBAR PUNCTURE
PLPADWP Paediatric lumbar puncture - Doctor fee 3370
PLPAHC Paediatric lumbar puncture – hospital service charge 430 500
12 PPTDCHC PAEDIATRIC PLEURAL TAP (DOCTOR
HOS FEE + HOSPITAL CHARGES)
PPTADWP Paediatric pleural tap - Doctor fee 3230
PPTAHC Paediatric pleural tap - hospital service charge 480
13 PVCDOS Paediatric vascular cut down
(venesection ) under GA in Cath Lab
PVCDAF Paediatric vascular cut down ( venesection ) 9560 9560 4780 3820 2870
under GA in Cath Lab - Anaesthetists charges
PVCDCF Paediatric vascular cut down ( venesection ) 15280 15280 7640 6110 4580
under GA in Cath Lab - Cath lab Charges
PVCDSF Paediatric vascular cut down ( venesection ) 31860 31860 15930 12740 9560
under GA in Cath Lab - Surgeon fee
14 RPOS Reduction of paraphimosis -
RPDF Reduction of paraphimosis - Docor Fee 14040 14040 7020 5620 4210
RPHC Reduction of paraphimosis – Hospital Charges 2100 2100 1050 840 630
15 SDPDHCH SURFACTANT DELIVERY PROCEDURE
COS (DOCTOR FEE +HOSPITAL CHARGES)
SDPAHC Surfactant delivery procedure - Additional 1820 1820 910 730 550
hospital charges
SDPDF Surfactant delivery procedure - Doctor fee 12220 12220 6110 4890 3670
16 SPOS Separation of prepucial/ labial adhesion -
SPLADF Separation of prepucial/ labial adhesion -Docor Fee 14040 14040 7020 5620 4210
SPLHC Separation of prepucial/ labial adhesion - 2120 2120 1060 850 640
Hospital Charges
17 SWTECFO S Sweat test (Doctor fee + lab charges)
BSWTBSP Sweat test for cystic fibrosis - Additional 800 800 400 320 240 400 240
hospital charges
BSWTDC Sweat test fot cystic fibrosis - doctor fee 5340 5340 2670 2140 1600 2670 1600
Pain Control Procedures

4 Beddded
Cat 1A-Pre
2 Bedded
Category
Cat 1B
GOPD
POPD
Cat-2
Cat-3
SNo
Suite
Code Description
Cat-
1D
All
1 EPCADHC ELECTRONIC PCA PUMP INSTALLATION

EPCAPI Electronic PCA pump installation – Doctor fees 11760 11760 5880 4700 3530
ELPCAINSTBSP Electronic PCA pump installation - hospital 1180 1180 590 470 350
service charges
2 MIBPINSD MECHANICAL INFUSOR ( BAXTER )
HCOS PUMP INSTALLATION (DOCTOR FEE +
HOSPITAL CHARGES)
283
MIBAXPIHC Mechanical infusor ( Baxter ) pump 720 720 360 290 220
installation - Additional hospital charges
MIBAXPI Mechanical infusor ( Baxter ) pump 7120 7120 3560 2850 2140
installation - Doctor fees
3 UGBPPRO Ultrasound Guided Block For
S Postop Pain Relief - ( Doctor
UGBPPRDF Ultrasound Guided Block For Postop Pain 2100
Relief - Procedure charges
UGBPPRHC Ultrasound Guided Block For Postop Pain 210
Relief - Hospital Charges
Plastic and Cosmetic Procedure Charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
2 Bedded
GOPD
POPD
Cat-2
Cat-3
Cat-
1D
1 Extebsi Expansion of Tissue Expander
by Saline Injection
Exte Expansion of Tissue Expander by Saline 2380
Injecion - Doctor Charges
EXteb Expansion of Tissue Expander by Saline 240
Injection - Hospital Charges
Psychiatry Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
2 Bedded
Cat-1D
GOPD
Single
POPD
Cat-2
Cat-3
1 ARTPAOS ARTERIAL PRESSURE ANALYSIS

ARTPNDF Arterial pressure analysis - Doctor fee 90 90
ARTPAHC Arterial pressure analysis - Hospital Charges 170 170 170 170 100 170 170
2 ATDHCOS AVERSION THERAPY (DOCTOR
AVTDF Aversion therapy - Doctor Fee 1600 1600 800 640 480 800 480
AVTPSC Aversion therapy - hospital charges 340 340 170 140 100 170 100
3 BTDHCOS BIOFEEDBACK THERAPY (DOCTOR FEE
+ HOSPITAL CHARGES)
BIT Biofeedback therapy - Doctor Fee 1600 1600 800 640 480 800 480
BITPSC Biofeedback therapy - hospital charges 340 340 170 140 100 170 100
4 GT1DHCH GROUP THERAPY ( 1 HOUR ) (DOCTOR
GT Group therapy ( 1 hour ) - Doctor Fee 3880 3880 1940 1550 1160 1940 1160
GTPSC Group therapy ( 1 hour ) - hospital charges 780 780 390 310 230 390 230
5 PSYDCHC PSYCHOTHERAPY ( 50 MINUTE SESSION )
PSHO Psychotherapy ( 50 minute session ) – Doctor Fee 1940 1940 970 780 580 970 580
PSHPSC Psychotherapy ( 50 minute session ) - 380 380 190 150 110 190 110
hospital charges
6 RTDHCHC RELAXATION THERAPY ( 30-40
OS MINUTE SESSION ) (DOCTOR
RET Relaxation therapy ( 30-40 minute session ) 1940 1940 970 780 580 970 580
- Doctor Fee
RETPSC Relaxation therapy ( 30-40 minute session ) 380 380 190 150 110 190 110
- hospital charges
7 VENRAOS VENOUS REFLUX ANALYSIS (DOCTOR
VENRADF Venous reflux analysis - Doctor fee 100 100
VENRAHC Venous reflux analysis - Hospital Charges 160 160 160
284
8 BTDFHCO S BEHAVIOUR THERAPY ( 50
MINUTE SESSION ) (DOCTOR FEE +
HOSPITAL CHARGES)
BET Behaviour therapy ( 50 minute session ) -Doctor Fee 1680 1680 840 670 500 840 500
BETPSC Behaviour therapy ( 50 minute session ) - 440 440 220 180 130 220 130
hospital charges
Respiratory medicine package charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
2 Bedded
Cat-1D
GOPD
Single
POPD
Cat-2
Cat-3
1 ENDOBRON Endobronchial Ultrasound - 46840 46840 23420 18740 14050 23420 14050
ULTAPC Package charges
Rheumatology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
2 Bedded
GOPD
POPD
Cat-2
Cat-3
Cat-
1D
1 RHESBOS Rheumatology Scan for POPD -
RHS (3 or more areas) - (Doctor
fee + Hospital Charges)
RHSBDF POPD - Rheumatology Scan - RHS - (3 or 1050
more areas) - Doctors Fee
RHSBHC Rheumatology Scan - RHS - ( 3 or more 1050 1050 1050 1050 1050 1050 530
areas ) ( Hospital Charges )
2 RHEUOS Rheumatology Scan for POPD -
RHS ( 1 - 2 areas) - (Doctor fee
+ Hospital Charges)
RHEOPDF POPD - Rheumatology Scan - RHS - (1 -2 790
areas) - Doctors charges
RHSAHC Rheumatology Scan - RHS - ( 1-2 areas ) - (Hospital 790 790 790 790 790 790 530
Charges )
3 RHSA Rheumatology Scan - RHS ( 1 -2 areas)
RHSADC Rheumatology Scan - RHS - ( 1-2 areas ) - (Doctors 1000 1000 1000 1000 1000 790
Charges )
RHSAHC Rheumatology Scan - RHS - ( 1-2 areas ) - (Hospital 790 790 790 790 790 790 530
Charges )
4 RHSB Rheumatology Scan - RHS ( 3 or
more areas )
RHSBHC Rheumatology Scan - RHS - ( 3 or more 1050 1050 1050 1050 1050 1050 530
areas ) ( Hospital Charges )
RHSBDC Rheumatology Scan - RHS - ( 3 or more 1310 1310 1310 1310 1310 1050
areas ) ( Doctors Charges )
5 RHSC Joint injection with US
guidance - RHS - first joint
RHSCDC Joint injection with US guidance - RHS - first 2630 2630 2630 2630 2630 2100
joint ( Doctors Charges )
RHSCHC Joint injection with US guidance - RHS - first 1050 1050 1050 1050 1050 1050 530
joint ( Hospital Charges )
6 RHSCOS Joint injection with US guidance for
POPD - RHS - first joint (Doctor Fee +
Hospital Charges)
RHSCHC Joint injection with US guidance - RHS - first 1050 1050 1050 1050 1050 1050 530
joint ( Hospital Charges )
RHSCDF Joint injection with US guidance for POPD 2100
-RHS- first joint - Doctors Fee
285
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
1 ROBSURG Robotic Surgery
ROBBDMF $$ Black Diamond Micro Forceps 17250
ROBBG30 $$ 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 $$ Harmonic ACE (requires Harmonic ACE Insert) 4400
ROBHACEI $$ Harmonic ACE Insert 34100
ROBHS $$ Hot Shears (Monopolar Curved Scissors - 25200
requires tip cover 400180)
ROBLCA $$ Large Clip Applier (used with Weck P/N 544240) 1100
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
ROBPS $$ Potts Scissors 20570
ROBPF $$ ProGrasp Forceps 17300
ROBSG $$ Small Graptor (Grasping Retractor) 18900
ROBSBB $$ Snap-fit Blue Blade 6630
ROBSSI $$ Snap-fit Scapel Instrument 7820
ROBSI $$ Suction/ Irrigator 17300
ROBTF $$ Tenaculum Forceps 17300
ROBSURCH Robot Usage - Hospital charges 48000
Vascular Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A-Pre
2 Bedded
Cat-1D
GOPD
Single
POPD
Cat-2
Cat-3
1 ABITMOS Ankle -brachial index (ABI) Atonometry

ABITM Ankle - brachial index ( ABI ) tonometry Doctor fee 530
ABITMHC Outpatient ankle - brachial index ( ABI ) 530 530
tonometry - Lab Charges
2 ACSFDHC ARTERIAL LINE CATHETERISATION
OS (SUBCLAVIAN / FEMORAL / ANY OTHER
) (DOCTOR FEE + HOSPITAL CHARGES)
BACHC Arterial catheterisation ( subclavian /femoral / any other 1180 1180 590 470 350
) - Additional hospital charges
BACDF Arterial catheterisation ( subclavian / 11760 11760 5880 4700 3530
femoral / any other ) - Doctor fees
3 AVAOS AV Access in cath lab
AVCLC AV Access in cath lab - Cath Lab Charges 22600 22600 11300 9040 6780
AVAC AV Access in cath lab - Doctor Fee 47080 47080 23540 18830 14120
4 BVTOS Basilic vein transposition in Cath lab
BVTDPCL Basilic vein transposition - Cath lab charges 37280 37280 18640 14910 11180
BVTDP Basilic Vein Transposition in Cath Lab -Doctor fee 77660 77660 38830 31060 23300
286
5 CARANGI Carotid Angiography (Intraop) -
OS Doctor Fee + Hospital Charges
CARANGIOHC Carotid Angiography (Intraop) - Cath Lab charges 16800 16800 8400 6720 5040
CARANGIODF Carotid Angiography (Intraop) - Doctor Fee 35000 35000 17500 14000 10500
6 CAROEND Carotic Endarterectomy in Cath
OS Lab - Doctor Fee + Cath Lab Charges
CAROENDHC Carotic Endarterectomy in Cath Lab – Cath Lab charges 117600 117600 58800 47040 35280
CAROENDODF Carotic Endarterectomy in Cath Lab – Doctor Fee 245000 245000 122500 98000 73500
7 CATHARB Vascular Cath Lab - Arterial Flow
LOS Studies (Both limb) - (Doctor Fee +
Hospital Charges)
CATHARBLDF Arterial Flow Studies (Both limb) – Doctor Fee 5780 5780 2890 2310 1730 2890
CATHARBLHC Arterial Flow Studies (Both limb) – Hospital Charges 2890 2890
8 CATHARO Vascular Cath Lab - Arterial Flow
S Studies (single limb) - (Doctor Fee +
Hospital Charges)
CATHARSL Arterial Flow Studies (single limb) – Doctor Fee 3160 3160 1580 1260 950 1580
CATHARHC Arterial Flow Studies (single limb) – Hospital Charges 3160 3160 1580 1260 950 1580 1580
9 CATHAVB Vascular Cath Lab - Venous
LNOS Flow Studies (Both limb) -
CATHVBLDF Venous Flow Studies (both limb) – Doctor Fee 5780 5780 2890 2310 1730 2890
CATHVBLHF Venous Flow Studies (Both limb) – Hospital Charges 5780 5780 2890 2310 1730 2890 2890
10 CATHAVN Vascular Cath Lab - Venous
OS Flow Studies (single limb) -
CATHVSLDF Venous Flow Studies (single limb) – Doctor Fee 3160 3160 1580 1260 950 1580
CATHVSLHF Venous Flow Studies (single limb) – Hospital Charges 1580 1580
11 CATHVM Vascular Cath Lab – Vein Mapping
OS Studies - Doctor Fee + Hospital Charges
CATHVMDF Vein Mapping Studies - Doctor Fee 1060 1060 530 420 320 530
CATHVMHC Vein Mapping Studies - Hospital Charges 530 530 530 530 530 530 530
12 CATHVNO Vascular Cath Lab - Neck Vessel
S Doppler - Docto Fee + Hospital Charges
CATHVNDF Neck Vessel Doppler - Doctor Fee 3160 3160 1580 1260 950 1580
CATHVNHC Neck Vessel Doppler - Hospital Charges 1580 1580 1580 1580 1580 1580 1580
13 CEBOS Complex endoluminal bypass
CEBCLC Complex endoluminal bypass - Cath Lab Charges 112960 112960 56480 45180 33890
CEBDF Complex endoluminal bypass - Doctor Fee 235320 235320 117660 94130 70600
14 CFANGPO Complex Fistula Angioplasty
S (Doctor fee + Cath Lab charges)
CFANGCLC Complex Fistula Angioplasty - Cath Lab charges 37040 37040 18520 14820 11110
CFANGDF Complex Fistula Angioplasty - Doctor fee 77180 77180 38590 30870 23150
15 CHRPOS Chemoport removal (Doctor
fee + Cath Lab charges)
CHRCLC Chemoport removal - Cath Lab charges 13900 13900 6950 5560 4170
CHRDF Chemoport removal - Doctor fee 28960 28960 14480 11580 8690
16 CIRETOS Caval Interruption using retrievable
device (Doctor Fee + Hospital charges)
CIRETDF Caval Interruption using retrievable device -Doctor Fee 103560 103560 51780 41420 31070
CIRETDBSP Caval Interruption using retrievable device - 49700 49700 24850 19880 14910
Hospital Charges
17 CLIPOS Chemoport/Permacath/Centra l Line
Insertion (Doctor fee + Cath Lab
charges)
CLICLC Chemoport/Permacath/Central Line 20380 20380 10190 8150 6110
Insertion - Cath Lab charges
CLIDC Chemoport/Permacath/Central Line 42440 42440 21220 16980 12730
Insertion - Doctor fee
287
18 CO2ANGI CO2 Angiography - Doctor Fee
OS Hospital Charges
CO2ANGIOHC CO2 Angiography - Cath Lab Charges 16800 16800 8400 6720 5040
CO2ANGIO CO2 Angiography - Doctor Fee 35000 35000 17500 14000 10500
19 CPEBOS Complex peripheral
embolisation for bleeding
CPECLC Complex peripheral embolisation for 70600 70600 35300 28240 21180
bleeding - Cath Lab Charges
CPEB Complex peripheral embolisation for 147100 147100 73550 58840 44130
bleeding - Doctor Fee
20 CPTEOS Complex peripheral tumor embolisation
CPTECLC Complex peripheral tumor embolisation - 70600 70600 35300 28240 21180
Cath Lab Charges
CPTMDF Complex peripheral tumor embolisation -Doctor Fee 147100 147100 73550 58840 44130
21 CRCOS Complex recanalisation for
chronic total vascular occlusion
CRCTVCLC Complex recanalisation for chronic total 112960 112960 56480 45180 33890
vascular occlusion - Cath Lab Charges
CRCTVDF Complex recanalisation for chronic total 235320 235320 117660 94130 70600
vascular occlusion - doctor fee
22 EMMALO Embolisation of vascular
S malformation in cath lab
EVMCLC Embolisation of vascular malformation in 42360 42360 21180 16940 12710
cath lab - cath lab charges
EVMCL Embolisation of vascular malformation in 88260 88260 44130 35300 26480
cath lab - doctor fee
23 ENDOANE Endovascular Aneurysm Repair in Cath
OS Lab - Doctor Fee +Hospital Charges
ENDOANEHC Endovascular Aneurysm Repair in Cath Lab - 193200 193200 96600 77280 57960
Cath Lab Charges
ENDOANEDF Endovascular Aneurysm Repair in Cath Lab -Doctor Fee 402500 402500 201250 161000 120750
24 ENDOBYO Endoluminal bypass (Doctor
S Fee + Hospital charges)
ENDOBYDF Endoluminal bypass - Doctor Fee 103560 103560 51780 41420 31070
ENDOBYBSP Endoluminal bypass - Hospital Charges 49700 49700 24850 19880 14910
25 ENRPSEOS Endovascular Repair of Pseudoaneurysm
ERPCLC Endovascular repair of pseudoaneurysm in 45180 45180 22590 18070 13550
ERPCL Endovascular repair of pseudoaneurysm in 94120 94120 47060 37650 28240
26 FANGPOS Fistula Angioplasty (Doctor fee
+ Cath Lab charges)
FANGCLC Fistula Angioplasty - Cath Lab charges 18520 18520 9260 7410 5560
FANGDF Fistula Angioplasty - Doctor fee 38600 38600 19300 15440 11580
27 FENANER Fenestrated / Complex
OS Aneurysm Repair in Cath Lab -
FENANERHC Fenestrated / Complex Aneurysm Repair in 394800 394800 197400 157920 118440
Cath Lab - Cath Lab Charges
FENANERDF Fenestrated / Complex Aneurysm Repair in 822500 822500 411250 329000 246750
Cath Lab - Doctor Fee
28 FGPOS Fluoroscopic guided percutanous tumor
embolisation
FGPCLC Fluoroscopic guided percutanous tumor 42360 42360 21180 16940 12710
embolisation - Cath Lab Charges
FGPTEDF Fluoroscopic guided percutanous tumor 88260 88260 44130 35300 26480
embolisation - Doctor Fee
29 FLVSCOS Fluroscopy guided vascular
sclerotherapy in cath lab
FLVSCLC Fluroscopy guided vascular sclerotherapy in 28220 28220 14110 11290 8470
FLVSCL Fluroscopy guided vascular sclerotherapy in 58820 58820 29410 23530 17650
288
30 HYBRIDA Hybrid Angioplasty - Doctor
NGIOS Fee + Hospital Charges
HYBRIDANGIO HC Hybrid Angioplasty - Cath Lab Charges 67200 67200 33600 26880 20160
HYBRIDANGIO DF Hybrid Angioplasty - Doctor Fee 140000 140000 70000 56000 42000
31 IABIOS Inpatient Ankle brachial index (ABI )
tonometry
IABIDF Inpatient Ankle brachial index ( ABI ) 530
tonometry - Doctor fee
IABIHC Inpatient Ankle brachial index ( ABI ) 530 530
tonometry - Lab Charges
32 ICVADPOS Implantable Central Venous Access
Device Placement (Doctor Fee +
Hospital Charges)
ICVADPDF Implantable Central Venous Access Device 32360 32360 16180 12940 9710
Placement - Doctor Fee
ICVENADPBSP Implantable Central Venous Access Device 15540 15540 7770 6220 4660
Placement - Hospital Charges
33 ICVAOS Implantable central venous
access device removal
ICVACLC Implantable central venous access device 14140 14140 7070 5660 4240
removal - Cath Lab Charges
ICVARDF Implantable central venous access device 29440 29440 14720 11780 8830
removal - Doctor Fee
34 IPASVLPD INPATIENT ARTERIAL FLOW STUDIES IN
HCOS VASCULAR LAB (DOCTOR FEE +
HOSPITAL CHARGES)
IAFSVLAHC Inpatient Arterial flow studies in vascular lab 530 500
IAFSVLDF Inpatient Arterial flow studies in vascular lab 530 530
- Doctor fee
35 IVFSVLDH INPATIENT VENOUS FLOW STUDIES IN
COS VASCULAR LAB (DOCTOR FEE +
HOSPITAL CHARGES)
IVFSVLAHC Inpatient venous flow studies in vascular lab 530 530
IVFSVLDF Inpatient venous flow studies in vascular lab 530 530
- Doctor fee
36 OVFSVLOS Outpatient venous flow studies
in vascular lab
OVFSVLDF Outpatient venous flow studies in vascular 930
lab - Doctor fee
OVFSVLHC Outpatient venous flow studies in vascular 930 930
lab - Lab Charges
37 PCGTCOS Peripheral catheter guided
thrombolysis in cath lab
PCGTCLC Peripheral catheter guided thrombolysis in 40340 40340 20170 16140 12100
PCGTCL Peripheral catheter guided thrombolysis in 84060 84060 42030 33620 25220
38 PEBOS Peripheral embolisation for bleeding
PEBCLC Peripheral embolisation for bleeding – Cath Lab Charges 42360 42360 21180 16940 12710
PEFB Peripheral embolisation for bleeding -Doctor Fee 88260 88260 44130 35300 26480
39 PEIVASDI Peipheral Vascular Angiography
AGOS (Diagnostic) - Doctor Fee + Hospital
Charges
PEIVASDIAGH Peipheral Vascular Angiography (Diagnostic) 13440 13440 6720 5380 4030
C - Cath Lab Charges
PEIVASDIAGD Peipheral Vascular Angiography (Diagnostic) 28000 28000 14000 11200 8400
F - Doctor Fee
40 PSEUREP Pseudoaneurysm Repair -
OS Doctor Fee + Doctor Fee
PSEUREPHC Pseudoaneurysm Repair - Cath Lab Charges 25200 25200 12600 10080 7560
PSEUREPDF Pseudoaneurysm Repair - Doctor Fee 52500 52500 26250 21000 15750
41 PTEOS Peripheral tumor embolisation
289
PTECLC Peripheral tumor embolisation - Cath Lab Charges 42360 42360 21180 16940 12710
PTEDF Peripheral tumor embolisation - Doctor Fee 88260 88260 44130 35300 26480
42 RCIDOS Removal of Caval Interruption Device
(Doctor Fee + Hospital charges)
RCINDBSP Removal of Caval Interruption Device - 16940 16940 8470 6780 5080
Bedside Procedure Charges
RCIDDF Removal of Caval Interruption Device -Doctor Fee 35300 35300 17650 14120 10590
43 RFCHTVO Recanalization for Chronic Total
OS Vascular Occlusion
RFCHTVODF Recanalization for Chronic Total Vascular 90600 90600 45300 36240 27180
Occlusion - Doctor Fee
RCHTVOBSP Recanalization for Chronic Total Vascular 43500 43500 21750 17400 13050
Occlusion - Hospital Charges
44 SKINOXY Tissue ischaemia monitoring (DOCTOR
OTISISCMOND F Tissue ischaemia monitoring - Doctor fee 170 170
SKINOXYHC Tissue ischaemia monitoring – Hospital Charges 410 410
45 UAECOS Uterine artery embolisation in cath lab
UAECLC Uterine artery embolisation in cath lab -cath lab charges 42360 42360 21180 16940 12710
UAECL Uterine artery embolisation in cath lab -doctor fee 88260 88260 44130 35300 26480
46 USGDHOS Ultrasound Guided Procedure in Cath
Lab - ( Doctor Fee +Hospital Charges )
USGD Ultrasound Guided Procedure in Cath Lab -Doctor Fee 590
USGH Ultrasound Guided Procedure in Cath Lab - 590
Hospital Charges
47 VASTPOS Vascular Cath Lab – Tumescent Pump
VASTPDF Vascular Cath Lab - Tumescent Pump -Doctor Fee 530 530
VASTPHC Vascular Cath Lab - Tumescent Pump -Hospital charges 530 530
48 VENGSVC Venography guide laser assited
BOS saphenous vein closure (B\L)
VENGSVCBBSP Venography guided laser assisted saphenous vein 54360 54360 27180 21740 16310
closure (B/L) – Hospital Charges
VENGSVCBDF Venography guided laser assisted saphenous vein 113280 113280 56640 45310 33980
closure (bilateral)- Doctor Fee
49 VENGSVC Venography guide laser assited
OS saphenous vein closure (U\L)
VENGSVCBSP Venography guided laser assisted saphenous vein 43500 43500 21750 17400 13050
closure (U/L)- Hospital Charges
VENGSVCDF Venography guided laser assisted saphenous 90600 90600 45300 36240 27180
vein closure (unilateral)- Doctor Fee
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
290
Homeopathy charges

12 HOMMEDCH Homeopathy Medicines charges (1 week) 130 110
13 HOMMEDCH2 Homeopathy Medicines charges (2 weeks) 250 230
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
1 YCRPSS Yoga - cardiac rehabilitation and prevention ( for six sessions ) 9710 4860 3640 2440
2 YCRPSGRS Yoga - cardiac rehabilitation and prevention for 1000
SGRH staff ( for six sessions )
3 YGSMSS Yoga - general stress management ( for six sessions ) 3260 1630 1230 820
4 YGSMSGS Yoga - general stress management for SGRH staff 1000
( for six sessions )
5 YTC3S YOGA - Training charges ( 3 sessions ) 1500
6 YTC6S YOGA - Training charges ( 6 sessions ) 2500
7 YTCVNEW YOGA - Training charges ( 12 sessions ) 4000
8 YTCHC YOGA - Training charges for health Checkup patients 0
9 YTCVC YOGA Visit Charges 100
291

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Sir Ganga Ram Hospital

Schedule of Charges (2019-20)

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

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

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 Transplant 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

HBsAg ( Australia antigen ) 820 490

Hepatitis C virus serology antibody test 1090 650

HIV antibody test 820 490

RPR 350 210

3 CROSSMATCH AND ANTIBODY SCREENING OF

ABO & Rh D and Antibody screening of patient's 770

BLOOD GROUPING-1 FFP / PLATELETS Etc. FOR 150

5 CROSSMATCH AND ANTIBODY SCREENING FOR

BLOOD GROUP - 1 FOR CRYOPRECIPITATE X-MATCH 150

BLOOD BANK ISSUE

SNo Description [Code]

1 Issue Platelets concentrate leukocyte

Blood bank issue charges

SNo Description [Code]

1 Filter For Platelets [PCWFIT] 1500

Blood bank procedure charges

1 Aphaeresis Collection & Storage 71500 71500 66000 55000 38500

Blood Bank Test Charges

Anaesthetists PAC charges

Doctor monitoring charges

Doctor visit charges

SNo Description Code POPD/ CAT GOPD/

CT Scan Dye Charges

SNo Description Code POPD/ GOPD/

Biochemical Genetics Charges

SNo Description Code POPD/ CAT GOPD/ CAT3

SNo Description Code POPD/ GOPD/

HLA - Serological & Molecular

HLA Serological & Molecular Charges

44 HLA Y-STR Polymorphism ( SECOND OF TWO ) HYSTRPOL 7000 5000

Molecular Genetics Charges

SNo Description Code POPD/ GOPD/

268 Farber lipogranulomatosis (Exon 6,12) MASAH1 10000 7000

IVF Investigations Charges