SGR Ram Rate List PDF

Sir
Ganga Ram Hospital

Schedule of Charges (2017‐18)
Bed Charges
SNo Bed Category Amount (Rs.)
1 Birthing Suite (LR) 12000

2 Category 1-A (Premium Suite) 19000
3 Category 1-B (Suite) 16000
4 Category 1-C (Deluxe) 12000
5 Category 1-D (Single Room) 9000
6 Category 2 6700
7 Category 3 5000
8 Category 3 ( Paediatric ) 3150
9 Daycare 3000
10 Daycare ( Paediatric ) 1850
11 OT Daycare Over Night Stay 6000
12 Joint Replacement Category 1 10000
13 Joint Replacement Category 3 6000
14 Kidney Transplant 10000
15 Medical Treatment Room 3000
16 Nursery Category 1 5250
Intensive care charges 4 Bedded
All Cat
Cat-1D
Double
Single
Cat-2
Cat-3
SNo Service Area Code
1 CCU / IMCU monitoring charges INTMONCHCCU 13300 11100 8900

2 HDU monitoring charges INTMONCHHDU 11600 9200 7100
3 ICU monitoring charges INTMONCHICU 13300 11100 8900
4 Liver Transplant unit monitoring charges INTMONCHLTU 13300
5 Paediatric ICU monitoring charges INTMONCHPICU 13300 11100 8900
6 Post-operative ICU monitoring charges INTMONCHPOICU 13300 11100 8900
7 Thoracic HDU monitoring charges INTMONCHTHDU 9200 9200 9200
Note: All these charges are for providing intensive care monitoring including the bed charges, which will
be applicable depending upon the category of accommodation at the time of admission or at the time of
shifting i n these areas.
1
Other Special Care Charges
Cat-1C / D
Premium
All Cat
Cat-1A
Cat-1B
Cat-2
Cat-3
Suite
SNo Service Area
1 Labour room charges for delivery 4400 4400 4400 2500 1250
INTMONCHLR
2 NNU charges - level 1 1900

NNULEV1
3 NNU charges - level 2 2900

NNULEV2
4 NNU charges - level 3 4600 4600 4600 4400 4100

NNULEV3
5 Observation nursery charges 720

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

Intensive Care monitoring charges include bed to bed nursing care round the clock, critical care consultants cover round the clock,
continuous state of the art monitoring for all vital parameters, CVP monitoring, arterial line monitoring and PA catheter, etc.
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 according to the 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, nursing care 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. 5500/-
1. Checking In / Out

1. If patient is discharged within 24 hrs. of admission, room/bed charges are charged only for one day.
2. 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
3. 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. General Information on Procedure/ Investigation Charges
 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).
 Daycare patients will be charged at Category 2 rates, unless otherwise specified.
 Rates marked as common will apply to all categories.
General Ward (Free ward). No room rent or any intensive care charges are levied for patients admitted in General Ward.
2
3. General Information regarding operation charges
1. There will be no operation charges for General ward (free ward) patients.
2. In case more than one surgeon performs a single procedure, total operation charges will not exceed those fixed for that particular
surgery except where there is written request and consent from the patient or his relative desiring the presence or participation of
another surgeon. In such event, both surgeons would be entitled to charge their full fees.
3. In case a surgeon feels that in the best interests 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. It is implied that this is conveyed to the patient’s relatives and recorded in the case sheet.
4. 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.
5. For re-exploratory surgery at different sittings, the operation charges will not exceed 50% of that procedure.
6. Surgeons can charge for visits after the 5th Post Operative day.
7. The operation/procedure charges for patients admitted in Category 1A / B will be double the charges of Category 1C/D.
8. The charges for Category 2 / 3 will be 80% / 60% of Category 1D charges respectively.
9. The charges for Operation theatre will be 65% of Surgeons Fee for patients operated under General Anaesthesia and patients operated
under Regional Blocks.
10. The charges for Operation theatre will be 45% of Surgeons Fee for patients operated under Local Anaesthesia.
11. The charges for Cath lab will be 43% of Consultants Fee for patients undergoing procedure in Cath lab.
12. The Hospital charges for general anaesthesia (consumables) will be 14% of Surgeons Fee.
13. The Hospital charges for local anaesthesia (consumables) will be Rs. 300/- per procedure.
14. The charges for Anaesthetist Fee will be 30% of Surgeons Fee for patients operated under General Anaesthesia.
15. Anaesthetist Fee will be 20% of Surgeons Fee for patients operated under Local Anaesthesia (minor cases) with stand by.
16. The Cardiologist’s charges for monitoring (if required / requested) will be 20% of Surgeons Fee.
17. The Neurologist / Neurosurgeon charges for standby/monitoring (if required / requested) will be 20% of Surgeons Fee.
18. 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.
19. In case one surgeon performs a procedure / operation and another procedure / operation of the same type is also required, the charges of the
higher cost surgery will be charged at actual and the lower cost surgery will be charged at 50% rates.
20. If surgery is assisted by Robotic Surgery, additional Robotic Surgery charges as per Schedule of charges will be payable.
21. All TPA/ Corporate patients will bear all the charges not approved by respective TPAs/ Corporates and will have to be paid at actual at the time
of discharge of the patient.
4. ADVANCE BOOKING CHARGES & ADVANCES AT THE TIME OF ADMISSION
i) Room booking / maternity booking

S.NO. Type of accommodation Amount
1. Category 1A 19000
2. Category 1B 16000
3. Category 1C 12000
4. Category 1D 9000
5. Category - 2 6700
7. Category - 3 5000
Note :
1. Maternity Advance : Non-refundable
2. Room booking advance/cancellation of the booking should be before the date of admission. After the due date advance is non-refundable.
ii) Advance deposit at the time of admission:
S.NO. Type of accommodation Amount
1. Categroy 1A/ 1B 100000

2. Categroy 1C/ 1D 80000
3. Category 2 70000
5. Category 3 50000
3
6. Day Care Cases AS PER OPERATION
7. ICU/PICU/CCU/IMCU/NNU (All Intensive care areas) 120000
In surgical cases (confirmed booking)
S.NO. Department Category 1 Category 2 Category 3
1. GI Surgery 120000 100000 70000
2. General Surgery 50000 40000 30000
3. Neuro Surgery 120000 100000 70000
4. Ortho-Surgery 70000 60000 50000
5. Kidney Transplantation 750000
6. Cardiac Package 100% 100% 100%
7. Liver Transplant (adult) 100% (as per package)

8. Liver Transplant (Paediatrics) 1700000
Blood Transfusion Services
Blood bank crossmatch charges
Cat‐1B Suite
All Category
Cat‐1D NH/
Gen.Ward
Cat‐2 SNH
Cat‐4 Bed
Premium
Gen.OPD
Casualty
Pvt.OPD
Cat‐1A
SNo Description [Code]
1 X‐match brought from outside 150
hospital [CROOUTBLD]
2 BLOOD DONOR SCREENING TESTS
[BLOODDS]
Anti HBc ‐ IgM ( hepatitis B virus serology ) 1720 1040
[ANTIHBC]
HBsAg ( Australia antigen ) [HBSAG] 780 470
Hepatitis C virus serology antibody test [HCV] 1040 620
HIV antibody test [HIV] 780 470
RPR [VDRL] 330 200
3 CROSSMATCH OF BLOOD / RED CELLS
[CMBROS]
ABO & Rh D and Antibody screening of patient's 660
blood ( pre‐transfusion ) WITH X‐MATCH
[ABSCREEN]
BLOOD GROUP ‐ 1 FOR BLOOD / PACKED CELL 150
X‐MATCH (mention quantity) [BG1CM]
BLOOD GROUPING ‐2 FOR X‐MATCH [BG2]
4 CROSSMATCH OF FFP / PLATELETS /
CRYOPRECIPITATE / GRANULOCYTES
[XMATCHBLPR]
[ABSCREEN]
BLOOD GROUPING‐1 FFP / PLATELETS Etc. FOR 150
X‐MATCH (Mention quantity) [BG1]
4
5 CROSSMATCH FOR ALL BLOOD
COMPONENT [XMATCHPAOS]
[ABSCREEN]
BLOOD GROUP ‐ 1 FOR BLOOD / PACKED CELL 150
X‐MATCH (mention quantity) [BG1CM]
BLOOD GROUP ‐ 1 FOR CRYOPRECIPITATE 150
X‐MATCH [BGCRO]
BLOOD GROUP ‐ 1 FOR FFP X‐MATCH [BGFP] 150
BLOOD GROUP ‐ 1 FOR GRANULOCYTES X‐MATCH 150
[BGRAN]
BLOOD GROUP ‐ 1 FOR PLATELET APHERESE 150
X‐MATCH [BGPLP]
BLOOD GROUP ‐ 1 FOR PLATELETS X‐MATCH 150
[BGPLA]
BLOOD BANK ISSUE
Cat‐1B Suite
All Category
Cat‐1D NH/
Gen.Ward
Cat‐2 SNH
Cat‐4 Bed
Premium
Gen.OPD
Casualty
Pvt.OPD
Cat‐1A
1 Issue Fresh Frozen Plasma (FFP)
leukocyte reduced (NAT Tested) +
Additional transfusion Charges
[FFPNATOS]
Additional Transfusion Charges [ATCB] 3100 3100 2550 1600 2350 1350
Issue Fresh Frozen Plasma (FFP) leukocyte reduced 880
(NAT Tested) [FFPNAT]
2 Issue Cryoprecipitate leucocyte reduced
(AHF ‐ factor VIII) per unit + Additional
transfusion Charges [ICRYOLROS]
Issue Cryoprecipitate leucocyte reduced (AHF ‐ 1240
factor VIII) per unit [ICRYOLR]
3 Issue packed red cells (Only for Cardiac
Surgery Packages) + Additional
transfusion Charges [IPRCCSTHDIAOS]
Issue packed red cells (Only for Cardiac Surgery 3680
Packages) [IPRCCSTHDIA]
4 Issue Red Blood Cells leukocytes
depleted ( NAT Tested) excluding X
Match + Additional transfusion charges
[IRCBLDROS]
Issue Red Blood Cells leukocytes depleted ( NAT 3680
Tested) excluding X Match [RBCNAT]
5 Issue red cells (Paed Cardiac Surgery +
Additional transfusion charges)
[IRCPATCOS]
Issue red cells (Paed Cardiac Surgery) [IRCPCS] 3350
6 Issue single donor platelet concentrate
INCLUDING SCREENING TESTS ( platelet
apheresis by cell separator ) +
Additional transfusion Charges
[ISCPLATOS]
5
Issue single donor platelet concentrate INCLUDING 16000
SCREENING TESTS ( platelet apheresis by cell
separator ) [ISCPLAT]
7 Issue Platelets concentrate leukocyte
reduced ( NAT tested) + Additional
transfusion Charges [PCNATOS]
Issue Platelets concentrate leukocyte reduced ( NAT 900
tested) [PCNAT]
Blood bank issue charges
Cat‐1B Suite
All Category
Cat‐1D NH/
Gen.Ward
Cat‐2 SNH
Cat‐4 Bed
Premium
Gen.OPD
Casualty
Pvt.OPD
Cat‐1A
1 Additional Transfusion Charges 3100 3100 2550 1600 2350 1350 0

[ATCB]
2 Infectious marker test ( donor 3850 3850 3630 2750 3300 2750 1650
refused for apheresis ) [IMTDR]
3 Issue Cryoprecipitate leucocyte 1240
reduced (AHF ‐ factor VIII) per unit
[ICRYOLR]
4 Issue Fresh Frozen Plasma (FFP) 880
leukocyte reduced (NAT Tested)
[FFPNAT]
5 Issue packed red cells ( Dialysis ) 1540
[IPRCCSD]
6 Issue packed red cells (Only for 3680
Cardiac Surgery Packages)
[IPRCCSTHDIA]
7 Issue Platelets concentrate leukocyte 900
reduced ( NAT tested) [PCNAT]
8 Issue Red Blood Cells leukocytes 3680
depleted ( NAT Tested) excluding X
Match [RBCNAT]
9 Issue red cells (Paed Cardiac Surgery) 3350
[IRCPCS]
10 Issue single donor platelet 16000
concentrate INCLUDING SCREENING
TESTS ( platelet apheresis by cell
separator ) [ISCPLAT]
11 Issue single donor platelet 11000
concentrate with prior SCREENING
TESTS ( platelet apheresis by cell)
[ISCPLATES]
12 Single Donor Platelet apheresis with 14000
Additive Solution ( PAS )
[PLAAPEASO]

6
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 71500 71500 66000 60500 41800
without processing ( Up to one year
in LN2 at ‐80oC ) [CRPBMWP1]
3 Granulocyte apheresis procedure 25650 25650 23450 19710 23450 19710 12450
[GRAPPR]
4 Phlebotomy for polycythemia vera 1450 1450 1450 1260 1640 730 730
[PHEPOLV]
5 Plasma exchange procedure by cell 36300 36300 30250 24200 30250 24200 18150
separator ( Charges of FFP extra )
[PLEXPR]
6 PLASMAPHERESIS WITH ANTIBODY 66000 66000 63000 55000 63000 55000 52000
FILTER [AWANF]
7 Pooling of blood products by sterile 330 330 280 220 280 220 190
connecting device [POPLSTCON]
8 PRP (Platelet Rich Plasma) [PRP] 3000 2300
9 Stem cell harvesting and 78650 78650 72600 60500 40350
preservation at ‐80 C ( upto to 1 Year
) [STEMCELLPR]
10 Stem cells harvesting without 33000 33000 30800 24200 30800 24200 13310
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 770 650
3 Anti body identification ABI 4240 3600
4 Anti body titer ( IgM ) ABTIGM 520 360
5 Anti body titer ( IgM + IgG ) ABTIGMG 1150 820
6 Antibody Screening ANTIS 660 330
7 Antibody Tier ( IgM & IgG ) (Anti A , Anti B ) ATIGMI 1980 1680
8 Antibody Tier ( IgM ) (Anti A , Anti B ) ATIGM 990 840
9 BLOOD GROUP ‐ 1 FOR BLOOD / PACKED CELL BG1CM
X‐MATCH (mention quantity)
10 Blood group ‐ ABO + Rh(D) BGROUP 500 300
11 Compatibility testing with irregular antibody ( One CTI 900 900
Card )
12 Compatibility testing with irregular antibody ( Two CTTWO 1800 1800
Card )
13 DAT Titre DATT 2200 1540
14 Direct Antihuman Globulin Test ( DAT ) DCT 910 720
15 Indirect Antihuman Globulin Test ( IAT ) ICT 1210 940
16 Minor Blood Grouping ( Blood Bank )/Red Cell RCEP 4840 4070
Extended Phenoype
17 Monospecific Coombs Test (IgG, IgM, C3d) MCIGMC 1640 1260
18 Red Cell Rh & Kell Phenotype ( patient ) RCRHK 1160 920
19 Screening of cold antibodies SCAB 610 360
7
20 Subclasses IgG ( IgG1 , IgG2 & IgG3 ) SUBIG 1210 1030
21 Titre of cold antibodies at room temp and 4 degree C TITCART4 1320 990
22 Titre of incomplete antibody by ICT ICTRE 1100 940

Alternative medicine charges
Ayurveda charges
SNo Code Description POPD GOPD All CAT
1 AYURYCC Ayurveda consultation charge 250
2 AYURDHA Ayurveda treatment ‐ Dhara ( per sitting ) 2170
3 AYURELNA Ayurveda treatment ‐ Elakizhi / Navarakazhi ( per sitting ) 500
4 AYURNAS Ayurveda treatment ‐ Nasyam ( per sitting ) 500
5 AYURZL Ayurveda treatment ‐ Pizhichil ( per sitting ) 2040
6 AYURPODI Ayurveda treatment ‐ Podikizhi ( per sitting ) 500
7 AYURTAR Ayurveda treatment ‐ Tarpanam ( per sitting ) 380
8 AYURUPMO Ayurveda treatment ‐ Upanaham ( per sitting ) 330
9 AYURUTV Ayurveda treatment ‐ Uttara Vasti ( per sitting ) 500
10 AYURYTUPS Ayurveda treatment ‐ Uzhichil ( per sitting ) 640
11 AYURVAS Ayurveda treatment ‐ Vasti ( per sitting ) 380
Homeopathy charges
12 HOMMEDCH Homeopathy Medicines charges (1 week) 130 110
13 HOMMEDCH Homeopathy Medicines charges (2 weeks) 250 230
2
3
4
PIP scan charges
16 PIPS PIP scan 700 700
Yoga charges
Cat‐1D Single
Cat‐2 Double
Cat 1B Suite
Cat 1A‐Pre/
All Category
Cat‐4 Bed
SNo Code Description

1 YCRPSS Yoga ‐ cardiac rehabilitation and prevention ( for 9710 4860 3640 2440
six sessions )
2 YCRPSGRS Yoga ‐ cardiac rehabilitation and prevention for 740
SGRH staff ( for six sessions )
3 YGSMSS Yoga ‐ general stress management ( for six 3260 1630 1230 820
sessions )
4 YGSMSGS Yoga ‐ general stress management for SGRH staff ( 740
for six sessions )
5 YTC3S YOGA ‐ Training charges ( 3 sessions ) 1150
6 YTC6S YOGA ‐ Training charges ( 6 sessions ) 2300
8
7 YTCHC YOGA ‐ Training charges for health Checkup 0
patients
8 YTCVC YOGA Visit Charges 100

Anaesthetists PAC charges
Cat‐1D Single/
Cat‐2 Double
OT Day Case
Thalassemia
Cat 1B Suite
Cat 1A‐Pre/
All Category
Cat‐4 Bed/
GOPD
POPD
1 PACCHARGES Anaesthetists charges for PAC 3320 1660 1330 1000
Doctor monitoring charges
2 CSADS Cardiac Surgery Assistance During Chest 27600 22100 16600
Surgery ( Minor ) ‐ Doctors monitoring
charges
3 CCCSC Critical care consultant standby charges 3320 1660 1330 1000
Doctor visit charges
4 CLPSCC Clinical psychologist consultation charges 810
5 DOCVISITCHA Doctor visit charges 3320 1660 1330 1000 300
RGE1
6 DOCVISITCHA Doctor visit charges (category 2 units only) 2640 1320 1060 800
RGE2
7 DOCVISITDEVP Doctor visit charges (development 960 480 380 290
ED paediatrics)
8 LACSTDF Lactation / Stress consultation ( per visit ) ‐ 1960 980 780 590
Neonatology
9 NEPHKTCHRG Nephrologists charges for kidney 88000 44000 44000 44000
transplant patient care
10 PAEDVISITFEE Paediatric / Neonatologists visit charges 3320 1660 1330 1000
for newborns
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.

9
Laboratory and Imaging Charges
CT Scan Charges
SNo Description Code POPD/ GOPD/

CAT 1/CAT2 CAT3
1 CT 3D surface rendering (plain) CTGBI 2240 2240
2 CT abdomen to ankle joint CTABDANK 25400 25400
3 CT angiography (non‐ionic contrast) lower abdomen CTANGLO 19300 19300
& pelvis
4 CT angiography (non‐ionic contrast) upper abdomen CTAN 19300 19300
5 CT angiography abdomen & chest CTAAC 25400 25400
6 CT angiography brain CTANGIOB 13720 13720
7 CT angiography neck CTANGION 13720 13720
8 CT angiography neck & brain CTANGIONB 17880 17880
9 CT angiography thorax and descending/thoracic aorta CTANGIO 17880 17880
10 CT angiography whole abdomen and abdominal aorta CTANGIOA 19300 19300
11 CT ankle joint (non‐ionic contrast) both sides CTANKCTBS 7620 7620
12 CT ankle joint (non‐ionic contrast) left side CTANKCTLS 7620 7620
13 CT ankle joint (non‐ionic contrast) right side CTANKCTRS 7620 7620
14 CT ankle joint (plain) both sides CTANKPLBS 5280 5280
15 CT ankle joint (plain) left side CTANKPLLS 5280 5280
16 CT ankle joint (plain) right side CTANKPLRS 5280 5280
17 CT bronchoscopy CTBRP 8940 8940
18 CT cardiac calcium scoring CTCCSP 6100 6100
19 CT cisternography CTCIST 8330 8330
20 CT colonoscopy CTCP 8940 8940
21 CT coronary angiograpy CTCTAP 13210 13210
22 CT denta scan ( OPG ) CTDSP 8940 8940
23 CT elbow joint (non‐ionic contrast) both sides CTELBCTBS 7620 7620
24 CT elbow joint (non‐ionic contrast) left side CTELBCTLS 7620 7620
25 CT elbow joint (non‐ionic contrast) right side CTELBCTRS 7620 7620
26 CT elbow joint (plain) both sides CTELBPLBS 5280 5280
27 CT elbow joint (plain) left side CTELBPLLS 5280 5280
28 CT elbow joint (plain) right side CTELBPLRS 5280 5280
29 CT extended study for body scan CTES 1880 1880
30 CT extended study for single scan CTESSS 3760 3760
31 CT face (extended) (non‐ ionic contrast) CTFACECE 8640 8640
32 CT face / salivary glands (non‐ionic contrast) CTFACENI 6810 6810
33 CT face / salivary glands (plain) CTFACEP 4570 4570
34 CT face angiography CTFACEANG 13720 13720
35 CT FNAC procedure (scan done from our hospital) CTFNACIN 5280 5280
36 CT FNAC procedure (scan provided from outside CTFNACOUT 7620 7620
hospital)
37 CT foot (non‐ionic contrast) both sides CTFTCTBS 7620 7620
38 CT foot (non‐ionic contrast) left side CTFTCTLS 7620 7620
39 CT foot (non‐ionic contrast) right side CTFTCTRS 7620 7620
40 CT foot (plain) both sides CTFTPLBS 5280 5280
41 CT foot (plain) left side CTFTPLLS 5280 5280
42 CT foot (plain) right side CTFTPLRS 5280 5280
43 CT full abdomen (non‐ionic contrast) CTFANI 9750 9750
44 CT full abdomen (oral contrast only) CTFACT 8130 8130
45 CT full abdomen (plain) CTFAP 7620 7620
46 CT full thorax (non‐ionic contrast) CTFTNI 8640 8640
47 CT full thorax (plain) CTFTP 6100 6100
10
48 CT guided aspiration procedure CTASPIR 5280 5280
49 CT guided drain placement procedure CTDRAIN 5280 5280
50 CT guided pigtail catheter drain placement procedure CTPIG 5280 5280
51 CT hand (non‐ionic contrast) both sides CTHACTBS 7620 7620
52 CT hand (non‐ionic contrast) left side CTHACTLS 7620 7620
53 CT hand (non‐ionic contrast) right side CTHACTRS 7620 7620
54 CT hand (plain) both sides CTHAPLBS 5280 5280
55 CT hand (plain) left side CTHAPLLS 5280 5280
56 CT hand (plain) right side CTHAPLRS 5280 5280
57 CT head (bone window) CTHBW 3050 3050
58 CT head (extended) (non‐ ionic contrast) CTHEADEXTDN 4570 4570
59 CT head (extended) (plain) CTHEADEXTDP 4060 4060
60 CT head (non‐ionic contrast) CTHNI 4170 4170
61 CT head (plain) CTHP 2640 2640
62 CT head (plain) with 3D scan CTHP3D 6100 6100
63 CT high resolution pituitary (non‐ionic contrast) CTHRNI 8330 8330
64 CT high resolution pituitary (plain) CTHRPP 4570 4570
65 CT high resolution pns coronal (plain) CTRPNS 3050 3050
66 CT hip joint (non‐ionic contrast) both sides CTHIPCTBS 7620 7620
67 CT hip joint (plain) both sides CTHIPPLBS 5280 5280
68 CT knee joint (non‐ionic contrast) both sides CTKNCTBS 7620 7620
69 CT knee joint (non‐ionic contrast) left side CTKNCTLS 7620 7620
70 CT knee joint (non‐ionic contrast) right side CTKNCTRS 7620 7620
71 CT knee joint (plain) both sides CTKNPLBS 5280 5280
72 CT knee joint (plain) left side CTKNPLLS 5280 5280
73 CT knee joint (plain) right side CTKNPLRS 5280 5280
74 CT KUB (non‐ionic contrast) CTKUBCT 10670 10670
75 CT KUB (plain) CTKUBPL 7210 7210
76 CT KUB extended (non‐ionic contrast) CTKUBECT 12290 12290
77 CT KUB extended (plain) CTKUBEPL 9040 9040
78 CT Liver donor evaluation CTLIVDONEVAL 20830 20830
79 CT Low Dose Screening Chest CTLDC 2440 2440
80 CT lower abdomen (non‐ionic contrast) CTLANI 7620 7620
81 CT lower abdomen (oral contrast only) CTLACT 4470 4470
82 CT lower abdomen (plain) CTLAP 3810 3810
83 CT lower thorax (non‐ionic contrast) CTLTNI 6100 6100
84 CT lower thorax (plain) CTLTP 3810 3810
85 CT myclo CTMYCLO 8230 8230
86 CT neck (extended) (non‐ ionic contrast) CTNECKCE 10260 10260
87 CT neck / larynx (non‐ionic contrast) CTNECKNI 6810 6810
88 CT neck / larynx (plain) CTNECKP 4570 4570
89 CT orbit (extended) (non‐ ionic contrast) CTOCE 10260 10260
90 CT orbit (non‐ionic contrast) CTONI 6810 6810
91 CT orbit (plain) CTOP 5280 5280
92 CT perfusion studies CTPSP 13720 13720
93 CT peripheral angiography (non‐ionic contrast) CTFACTBS 17880 17880
forearm both sides
94 CT peripheral angiography (non‐ionic contrast) CTFACTLS 17880 17880
forearm left side
95 CT peripheral angiography (non‐ionic contrast) CTFACTRS 17880 17880
forearm right side
96 CT peripheral angiography (non‐ionic contrast) upper CTUACTBS 17880 17880
arm both sides
11
97 CT peripheral angiography (non‐ionic contrast) upper CTUACTLS 17880 17880
arm left side
98 CT peripheral angiography (non‐ionic contrast) upper CTUACTRS 17880 17880
arm right side
99 CT peripheral angiography (non‐ionic contrast) whole CTWULCTBS 17880 17880
upper limb both sides
100 CT peripheral angiography (non‐ionic contrast) whole CTWULCTLS 17880 17880
upper limb left side
101 CT peripheral angiography (non‐ionic contrast) whole CTWULCTRS 17880 17880
upper limb right side
102 CT peripheral angiography hip and thigh both sides CTHATBS 17880 17880
103 CT peripheral angiography hip and thigh left side CTHATLS 17880 17880
104 CT peripheral angiography hip and thigh right side CTHATRS 17880 17880
105 CT peripheral angiography lower leg both sides CTLLBS 17880 17880
106 CT peripheral angiography lower leg left side CTLLLS 17880 17880
107 CT peripheral angiography lower leg right side CTLLRS 17880 17880
108 CT peripheral angiography whole lower limb both CTWLLBS 17880 17880
sides
109 CT peripheral angiography whole lower limb left side CTWLLLS 17880 17880
110 CT peripheral angiography whole lower limb right CTWLLRS 17880 17880
side
111 CT peripheral venography (non‐ionic contrast) CTVFACTBS 17880 17880
forearm both sides
112 CT peripheral venography (non‐ionic contrast) CTVFACTLS 17880 17880
forearm left side
113 CT peripheral venography (non‐ionic contrast) CTVFACTRS 17880 17880
forearm right side
114 CT peripheral venography (non‐ionic contrast) upper CTVUACTBS 17880 17880
arm both sides
115 CT peripheral venography (non‐ionic contrast) upper CTVUACTLS 17880 17880
arm left side
116 CT peripheral venography (non‐ionic contrast) upper CTVUACTRS 17880 17880
arm right side
117 CT peripheral venography (non‐ionic contrast) whole CTVWULCTBS 17880 17880
upper limb both sides
118 CT peripheral venography (non‐ionic contrast) whole CTVWULCTLS 17880 17880
upper limb left side
119 CT peripheral venography (non‐ionic contrast) whole CTVWULCTRS 17880 17880
upper limb right side
120 CT peripheral venography hip and thigh both sides CTVHATBS 17880 17880
121 CT peripheral venography hip and thigh left side CTVHATLS 17880 17880
122 CT peripheral venography hip and thigh right side CTVHATRS 17880 17880
123 CT peripheral venography lower leg both sides CTVLLBS 17880 17880
124 CT peripheral venography lower leg left side CTVLLLS 17880 17880
125 CT peripheral venography lower leg right side CTVLLRS 17880 17880
126 CT peripheral venography whole lower limb both CTVWLLBS 17880 17880
sides
127 CT peripheral venography whole lower limb left side CTVWLLLS 17880 17880
128 CT peripheral venography whole lower limb right side CTVWLLRS 17880 17880
129 CT PNS axial / coronal (non‐ionic contrast) CTACNI 6810 6810
130 CT PNS axial / coronal (plain) CTACP 4570 4570
131 CT PNS axial / coronal / sagittal (non‐ionic contrast) CTACSNI 7620 7620
132 CT PNS axial / coronal / sagittal (plain) CTACSP 5280 5280
133 CT renal angiography CTRENANG 17880 17880
12
134 CT sacro iliac joints (non‐ionic contrast) CTSIJCT 7620 7620
135 CT sacro iliac joints (plain) CTSIJPL 5280 5280
136 CT scan / MRI images on compact disc CTSMCD 510 510
137 CT scanogram (plain) CTSCP 1930 1930
138 CT sella (plain) CTSELLAP 4570 4570
139 CT shoulder joint (non‐ionic contrast) both sides CTSJCTBS 7620 7620
140 CT shoulder joint (non‐ionic contrast) left side CTSJCTLS 7620 7620
141 CT shoulder joint (non‐ionic contrast) right side CTSJCTRS 7620 7620
142 CT shoulder joint (plain) both sides CTSJPLBS 5280 5280
143 CT shoulder joint (plain) left side CTSJPLLS 5280 5280
144 CT shoulder joint (plain) right side CTSJPLRS 5280 5280
145 CT spine (3 vertebral levels) (non‐ionic contrast) CTSNIV 7620 7620
146 CT spine (3 vertebral levels) (plain) CTSPV 5280 5280
147 CT spine extended study CTSES 6810 6810
148 CT spine extended study (with contrast) CTSEC 10260 10260
149 CT sterotactic localization CTSLP 3050 3050
150 CT temporal bone ( package ) CTTBPK 4570 4570
151 CT temporal bone (non‐ionic contrast) CTTBNI 8330 8330
152 CT temporal bone (plain) high resolution CTTBP 6100 6100
153 CT Trucut biopsy procedure (scan done from our CTTBIN 5280 5280
hospital)
154 CT Trucut biopsy procedure (scan provided from CTTBOUT 7620 7620
outside hospital)
155 CT upper abdomen & liver volumetery (non‐ionic CTUALVCT 21340 21340
contrast)
156 CT upper abdomen (dual phase non‐ionic contrast) CTUACT 19300 19300
157 CT upper abdomen (non‐ionic contrast) CTUANI 7620 7620
158 CT upper abdomen (oral contrast only) CTUAOCT 4370 4370
159 CT upper abdomen (plain) CTUAP 3760 3760
160 CT upper abdomen (triple phase non‐ionic contrast) CTUATCT 19300 19300
161 CT upper abdomen (triple phase non‐ionic contrast) ‐ CTUATCTDO 17270 17270
FOR DONOR
162 CT upper thorax (non‐ionic contrast) CTUTNI 6100 6100
163 CT upper thorax (plain) CTUTP 3760 3760
164 CT venography brain CTVBR 13720 13720
165 CT venography neck CTVNE 13720 13720
166 CT venography neck & brain CTVNAB 17880 17880
167 CT venography thorax and descending/thoracic aorta CTVTAD 19300 19300
168 CT venography whole abdomen and abdominal aorta CTVWA 19300 19300
169 CT Visipaque add‐on 30 ml CTVISI30 1490 1490
170 CT Visipaque add‐on 60 ml CTVISI60 2990 2990
171 CT wrist (non‐ionic contrast) both sides CTWRCTBS 7620 7620
172 CT wrist (non‐ionic contrast) left side CTWRCTLS 7620 7620
173 CT wrist (non‐ionic contrast) right side CTWRCTRS 7620 7620
174 CT wrist (plain) both sides CTWRPLBS 5280 5280
175 CT wrist (plain) left side CTWRPLLS 5280 5280
176 CT wrist (plain) right side CTWRPLRS 5280 5280

CT Scan Dye Charges

CAT 1/CAT2 CAT3
1 Additional CT non‐ionic contrast (10 ml) CTADCT10 300 300
13
6 Additional CT rectal contrast CTADCT 300 300
7 Additional film (CT scan) CTADFILM 510 510
8 CT additional oral contrast CTAOC 300 300
9 Pressure injector usage in CT scan CTPI 410 410

Biochemical Genetics Charges

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

CAT 1/CAT2 CAT3
1 Abortus Material chromosomal analysis ( Long Term CPOC 7300 5100
Culture )
2 Amniotic fluid chromosomal analysis ( Cell Culture ) CAF 10900 7650
3 Ataxia Telengiectasia chromosomal analysis ( CAT 7300 5100
Bieomycin Assay )
4 Blood chromosome analysis CBLD 3650 2550
5 Bone Marrow chromosomal analysis CBM 5500 3900
6 Chorionic villi chromosomal analysis ( Long Term CVS 10900 7650
Culture )
7 Cord blood prenatal chromosomal analysis CCB 5500 3900
8 Fanconi's syndrome chromosomal analysis ( CFA 7300 5100
Mitomycin Assay )
9 Fibroblast Culture for other tests CFB 4250 3000
10 FISH ‐ 1p & 19q co deletion for oligodendroglial F1P19Q 6050 4250
tumors
11 FISH ‐ 6q21 for CLL F6Q21 6050 4250
12 FISH ‐ 8q24 for Langer‐Giedion syndrome F8Q24 6050 4250
13 FISH ‐ ALK (2p23) FALK 9650 7250
14 Fish ‐ All (8 probe panel) FALL 40000 35000
16
15 FISH ‐ AML ‐ (10 probe panel) FAML 50000 35000
16 FISH ‐ AML/ETO [t8;21)] for AML FETO 6050 4250
17 FISH ‐ BCR/ABL [t(9;22)] for CML FBCRABL 6050 4250
18 FISH ‐ Burkitt's Lymphoma t8;14 FBL 6050 4250
19 FISH ‐ CLL Panel (8 probe panel) FCLL 40000 32000
20 FISH ‐ CML (4 probe panel) FCML 20000 16000
21 FISH ‐ del13q for myeloid malignancies, nonhodgkin F13Q 6050 4250
lymphoma, multiple myloma and CLL
22 FISH ‐ del17p for myeloid malignancies F17Q 6050 4250
23 FISH ‐ del20q myeloid malignancies F20Q 6050 4250
24 FISH ‐ del5q (monosomy 5) for MDS F5Q 6050 4250
25 FISH ‐ del7q (monosomy 7) for AML and MDS F7Q 6050 4250
26 FISH ‐ EGFR (7p12), (7p11.1‐q11.1) FEGFR 9650 7250
27 FISH ‐ HER2/Neu (CEP17) FHER2 9650 7250
28 FISH ‐ inv16 for AML FINV16 6050 4250
29 FISH ‐ MDS (6 probe panel) FMDS 30000 24000
30 FISH ‐ Multiple Myeloma (8 probe panel) FMM 40000 32000
31 FISH ‐ N‐MYC/CEP2 for neuroblastoma FMYC 9650 7250
32 FISH ‐ PML/RARA [t(15;17)] for AML FPMLRARA 6050 4250
33 FISH ‐ RBI for Retinoblastoma (13q14) FRBI 6050 4250
34 FISH ‐ t(11;14) for multiple myeloma F1114 6050 4250
35 FISH ‐ t(11;22) for Ewings Sarcoma F1122 6050 4250
38 FISH ‐ TEL/AML1 [t(12;21)] F1221 6050 4250
39 FISH ‐ Trisomy 8 F8 6050 4250
40 FISH ‐ X,Y Chimerism Screening FCXY 6050 4250
41 Fish 5 probe (13, 18, 21, X, Y) FISH5P 8500 6050
42 FISH ALL Panel FALLP 15000 10500
43 FISH AML Panel FAMLP 15000 10500
44 Fish chromosome 13, 21 FISH1321 6050 4250
45 Fish chromosome 16 FISHC16 6050 4250
46 Fish chromosome 21 FISHC21 6050 4250
47 Fish chromosome X, Y,18 FISHXY18 6050 4250
48 FISH CLL Panel FCLLP 35000 24500
49 FISH CML Panel FCMLP 15000 10500
50 Fish Di George syndrome ‐ N 25 probe FISHDGSN25P 6050 4250
51 Fish Di George syndrome ‐ Tuple 1 probe FISHDGST1P 6050 4250
52 FISH MDS Panel FMDSP 30000 21000
53 Fish microdeletion FISH1P 6050 4250
54 Fish Miller Decker / Lis gene FISHMDLG 6050 4250
55 FISH Multiple myeloma Panel FMMP 30000 21000
56 Fish Prader Willi syndrome FISHPWS 6050 4250
57 Fish Smith ‐ Magenis FISHSM 6050 4250
58 Fish williams syndrome FISHWS 6050 4250
59 Microarray postnatal (180K) CMIC‐POST 30000 30000
60 Microarray‐prenatal(60K) CMIC‐PRE 25000 25000
61 Recurrent Abortion chromosomal analysis ‐ Husband CRACH 0 0
62 Recurrent Abortion chromosomal analysis ‐ Wife CRAC 6050 4250
63 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
17
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 AB HAB 3850 2640
2 AB + DR ‐ One Person HABR1 13500 9500
3 AB+DR ‐ Additional person (beyond 2 persons) HABR3 10000 7000
4 AB+DR ‐ Two persons HABR2 25000 17500
5 ABC+DR+DQ HBCRQ 17000 12000
6 Antibody Immune Profile (HIMMUNP) HIMMUNP 9000 7000
7 Anti‐paternal Cytotoxic antibodies ‐ APCA HAP 6000 4500
8 DNA ‐ Isolation & storage (HLA Genetics) HDNA 750 500
9 DNA FINGERPRINTING (Additional Person) HDNAFP3 7000 5000
10 DNA FINGERPRINTING STUDY HDNAFP 20000 15000
11 DQ2 / DQ8 Celiac Disease ( High Risk Genotype ) HDCEL 6500 4500
12 DQB1‐06, Narcolepsy HDQ6 2500 1750
13 DR2‐Narcolepsy, M.S. Goodpasture syndrome HDR2 4500 3150
14 DR3‐ , Addison disease, Derm Nerp‐ HDR3 4500 3150
15 DR4‐Pemphigus Rhd A, Giant cell Art ‐ HDR4 4500 3150
16 DR5‐ Pauciart Rhd A, Scleroderma, Hashimotos Thyr, HDR5 4500 3150
17 DR7‐ PS., MCGN, Antiphospholipid AB Sy, Behcets ‐ HDR7 4500 3150
18 HLA ABC DNA HABC 15000 10500
19 HLA B27 HB27 2000 1400
20 HLA DQ Alpha ( HQA ) HLADQA 3500 2400
21 HLA DQ Alpha / Beta ( DNA ) HDRQ 6500 4550
22 HLA DQ Beta ( HQB ) HLADQB 2500 1750
23 HLA DSA ( BY LUMINEX ) HDSA 7000 5500
24 HLA Mitochondrial DNA Polymorphism HMITDNAPOL 0 0
25 HLA PRA % HPRAC1C2 8500 6500
26 HLA PRA Q‐SCREEN HQPRA 4000 2800
27 HLA tissue cross match serology ‐ Donor HCMD 0 0
28 HLA tissue cross match serology ‐ Patient / Recipient HCM 6000 4500
29 HLA Typing ‐ AB ( DNA ) HABM 9500 7000
18
30 HLA Typing ‐ ABC+DR+DQ ( Two Persons) HABCRQ2 30000 21000
31 HLA Typing ‐ C and DQ (DNA) HLACDQ 5500 3850
32 HLA Typing ‐ DR ( DNA ) HDRM 5000 3500
33 HLA Typing ( 2 persons ) and Tissue cross match ( HCRMATD 0 0
serology ) ‐ Donor
34 HLA Typing ( 2 persons ) and Tissue cross match ( HCRMAT 25000 20000
serology ) ‐ Patient / Recipient
35 HLA Y‐STR Polymorphism ( SECOND OF TWO ) HYSTRPOL 7000 5000
36 HLA‐B5, Behcet's disease HLAB5 5500 4000
37 Luminex Single Antigen HLA ‐ Class I HLSA I 22500 20000
38 Luminex Single Antigen HLA ‐ Class II HLSA II 20500 18000
39 Merosin / Dysferlin staining / Alpha dystroglycan HMA 3000 2000
40 Merosin staining ‐ Prenatal diagnosis ( Immunostain HMMP 15000 10500
and DNA Studies )
41 Muscle biopsy ‐ Calpain Staining ( Western Blot ) HMBCSWB 4400 3080
42 Muscle biopsy ‐ Dysferlin staining HMUDF 2970 1980
43 Muscle biopsy ‐ Dystrophin staining HMUDT 3500 2450
44 Muscle biopsy ‐ Merosin staining HMUM 3000 2000
45 Muscle biopsy ‐ Sacrogylcan staining HMUS 6000 4000
46 Muscular dystrophy staining profile ( Muscle biopsy ‐ HMDSP 9000 6300
Dystrophin staining and Sacrogylcan staining )
47 PRA % class 1 HPRA% 9000 6500
48 SKIN BIOPSY ‐ EPIDERMOLYSIS BULLOSA SCREENING HSKINBIO 5000 3500
Molecular Genetics Charges

CAT 1/CAT2 CAT3
1 1p36 MLPA ML1p36 7000 5000
2 Achondroplasia Gene Sequencing FGFR3 MACS 30000 22500
3 Achondroplasia mutation study MACH 5000 3500
4 Achondroplasia with Acantharis Nigricans ‐ SADDAN MSAD 5000 3500
mutation Lys 650 Met in FGFR3 gene
5 ACTN3 GENOTYPING MACTP 3300 2300
6 Acute necrotizing encephalopathy ( ANE ) RANBP2 MANE 5500 4400
gene mutation T585M
7 Adenosine Deaminase Deficiency‐ SCID ? ADA gene MADA 25000 20000
sequencing
8 Adrenoleukodystrophy (X‐linked ALD) sequencing of MXALD 30000 22500
ABCD1 gene
9 ADSpastic paraplegia 4, (SPG4) ‐ SPAST gene targeted MSPASTT 5500 4000
exon 12
10 Aicardi‐Goutieres syndrome 3 (AGS3) ‐ RNASEH2C MRNASEH2CT 5500 4000
gene, targeted exon 2
11 AICARDI‐GOUTIERES SYNDROME ex 2+3 MRNASEH2C 10000 7000
12 Alagille syndrome 1 targeted exon 12 MJAG 1 5500 4000
13 Albinism ‐ common Indian mutation MALB 5000 3500
14 Albinism ‐ OCA1 sequencing tyrosinase gene MAOSTG 20000 16000
15 Albinism ‐ OCA2 P gene‐Common deletion MAOGCD 5000 3500
16 Albinism ‐ OCA2 sequencing P gene MOCA2SQ 30000 27000
17 Albinism ‐ OCA3 sequencing TYRP1 gene MOCA3SQ 20000 16000
18 Albinism (All 3 genes) MACBNGS 40000 35000
19
19 Alkaptonuria gene sequencing (NGS) MALK1 35000 35000
20 Allgrove Syndrome ‐AAAS gene sequencing MAAS 26000 22000
21 Alpha 1 anti‐trypsin ( Z, X & M mutations ) MAAT 35000 30000
22 Alpha Thalassemia ‐ Deletions MATH 6000 4200
23 Androgen Insentivity‐ AR MLPA MLARA 7000 5000
24 Androgen receptor gene sequencing MARC 20000 16000
25 Aneuploidy screening (21, 18, 13,X,Y, chm) ‐ MANU 5000 3500
Additional to other PND
26 Aneuploidy screening by MLPA MLPA 7000 5000
27 Angelman syndrome DNA test ‐ Methylation MANG 6000 4200
28 APC gene analysis for Adenomatous Polyposis MAPCNGS 35000 35000
Syndrome (APC) (By NGS)
29 Apert syndrome mutation study (2 mutation) MAPE 5000 3500
30 Apo E genotyping MAPO 3600 2500
31 Arginosuccinicaciduria ‐ASL gene sequencing MASL 35000 27000
32 ARKPD ARKPD 35000 35000
33 ARKPD‐NGS panel MARNG 3500 35000
34 Atrial Septal Defect + Atrioventricular Block‐ NKX2 MNKX2 15000 12000
gene sequencing
35 Autosomal Dominant Polycystic Kidney Disease ‐ ADPKD 40000 40000
ADPKD 1+2 sequencing‐ NGS
36 Barth syndrome (3‐methylglutaconic aciduria type II) MTAZ 22000 17000
TAZ gene sequencing
37 Bartter syndrome type 2 ‐ KCNJ1 TARGETED MKCNJ1T 5500 4000
MUTATION
38 BASAL CELL NEVUS CARCINOMA, MPTCH1 7000 5000
HOLOPROSENCEPHALY (Exon 20)
39 BCR ‐ ABL Qualitative ( Molecular Genetics ) CBA 3600 2500
40 BCR ‐ ABL Quantitative ( Molecular Genetics ) CBAR 7000 5000
41 Beckwith‐Weidemann / Silver Russel (Chr11 UPD MBWS11 8800 6600
–MLPA)
42 Beta ‐ Ketothiolase sequencing ‐ ACAT1 Gene MBKT 22000 17000
43 BILATERAL FRONTOPARIETAL POLYMICROGYRIA ex6 MGPR56 7000 5000
44 Biotinidase Deficiency‐ BTD gene sequencing MBTD 19000 14500
45 Biotin‐responsive basal ganglia disease (BBGD), MSLC19A3 19800 15000
SLC19A3 gene sequencing
46 Blepharophimosis ?ptosis‐epicanthus inversion MFOXL2 22000 17000
syndrome ( BPES) FOXL2 gene sequencing
47 BPES‐ FOXL2/TWIST1 MLPA MLFOX 7000 5000
48 BRAF exon 15 gene sequencing MBRAF 6000 4200
49 BRANCHIOOTORENAL (BOR) SYNDROME MEYA1 7000 5000
50 BRCA 1 and 2 gene analysis (BY NGS) MBRANGS 36750 31500
51 BRCA 1 and 2 gene analysis (BY NGS) + MLPA MBRANGSD 48000 40000
52 BRCA1 DELETION / DUPLICATION CBRD 7000 5000
53 BRCA2 DELETION / DUPLICATION CBR2D 7000 5000
54 BRCA2 MUTATION ( 27 EXONS BY SEQUENCING ) CBR2 50000 38000
55 Breast cancer‐ BRCA2/CHEK2 MLPA MLBRCH 7000 5000
56 Bruton type X‐linked Agammaglobulinemia (XLA)‐ MBTK 35000 27000
BTK gene sequencing
57 C ‐ KITGene Mutations ( 4 Exons ) MCKIT 10000 7200
58 Calpainopathy ‐ CAPN3 gene sequencing MCAPN 36000 32000
59 Calpainopathy‐ CAPN3 2 common mutations MCAL 8800 6600
60 Calpainopathy‐CAPN3 MLPA MLCAP 7000 5000
61 Camurati‐Engelmann disease ‐ TGFB‐1 gene MTGFB1 22000 17000
sequencing
62 Canavan disease ‐ASPA, MLPA MLCAN 7000 5000
63 Canavan disease gene sequencing MSCG 20000 16000
20
64 Carpenter syndrome‐ RAB23 gene sequencing MRAB23 20000 16000
65 Cataract‐2 congenital Autosomal recessive (FYCO1 MFYO1 33000 26000
gene)
66 Catecholaminergic polymorphic ventricular MTRDN 7000 5000
tachycardia (TRIADIN) (Exon 5)
67 CFTR gene analysis (By NGS) MCFTRNGS 30000 25000
68 CFTR gene analysis (By NGS) + dosage MCFTRNGSD 37000 30000
69 Charcot ‐ Marie tooth Disease‐ EGR2 gene MEGR2 13000 11000
sequencing
70 Charcot ‐ Marie tooth Disease‐ GDAP1 gene MGDAP1 16500 13200
sequencing
71 Charcot ‐ Marie tooth Disease‐ MFN2 gene MMFN2 28000 22000
sequencing
72 Charcot ‐ Marie tooth Disease‐ MPZ gene sequencing MMPZ 16500 13200
73 Charcot ‐ Marie tooth Disease‐ PRX gene sequencing MPRX 25000 20000
74 Charcot ‐ Marie tooth Disease/ HNPP ( PMP 22 gene ) MCMT 7000 5000
dosage
75 Charcot Marie Tooth disease X‐linked ‐GJB1 MLPA MLCMX 7000 5000
76 Charcot‐Marie‐Tooth ‐ X‐Linked GJB1 gene MCMTX 17000 13500
sequencing
77 Charcot‐Marie‐Tooth disease, type 4J targeted MFIG4 11000 7700
mutations exon 16 and IVS7
78 Chicken Pox Infection‐ Varicella PCR (AF) MVA 4000 2700
79 Chicken Pox Infection‐ Varicella PCR (blood) MVB 3000 2100
80 Chimerism analysis (quantitative )per sample MCHIMER 7000 5000
81 Chronic granulomatous disease (CGD) x linked CYBB MCYBB 25000 20000
gene sequencing
82 Chronic granulomatous disease CDG1‐ Targeted MPMM2 9000 7000
PMM2 gene mutation analysis
83 CHRONIC GRANULOMATOUS DISEASE exon 5 MCYBB1 7000 5000
84 Citrullinemia type 1‐ASS1 gene sequencing MASS1 35000 27000
85 Cleidocranial dysplasia ‐ RUNX2 gene sequencing MRUNX2 28000 22000
86 COLD‐INDUCED SWEATING SYNDROME (exon 2) MCRLF 1 7000 5000
87 Colon Cancer (NRAS/KRAS gene Exon 2,3,4 gene MNRAS 13000 10000
sequencing)
88 COMBINED OXIDATIVE PHOSPHORYLATION MMTO1 7000 5000
DEFICIENCY 10 (COXPD10)ex 7
89 COMBINED OXIDATIVE PHOSPHORYLATION MAARS2T 7000 5000
DEFICIENCY 8 (COXPD8),
LEUKOENCEPHALOPATHYWITH OVARIAN FAILURE
(LKENP)exon3
90 Combined pituitary hormone deficiency 3 ‐ LHX3 MLHX3 19800 15000
GENE
91 Complex I, mitochondrial respiratory chain, MNDUFS6 5500 4000
deficiency, NDUFS6 targeted single exon
92 Cong Adernal Hyperplasia CYP ‐ 21A2 Gene MCAS 20000 17000
Sequencing
93 Cong. Adrenal hyperplasia ‐ Deletions by dosage test MCHD 7000 5000
94 Cong. Adrenal hyperplasia ‐CYP21A 1 gene MCAHC 25000 20000
sequecing+ deletion/duplication
95 Congenital adrenal hyperplasia ( Prenatal diagnosis ‐ MCAPF 0 0
linkage analysis ) ‐ family member
96 CONGENITAL GLYCOSYLATION 1Q disorder( KAHRIZI MSRD5A3 7000 5000
SYNDROME)exon1
97 Congenital Insensitivity to Pain with Anhidrosis (CIPA) MCIPA 15000 12000
‐( Prenatal Diagnosis by Linkage )TRKA( NTRK1) gene
98 CONGENITAL MYASTHENIC SYNDROME (exon 14) MCOLQ 7000 5000
21
99 Congenital Myasthenic Syndrome‐RAPSN gene RAPSN 7000 5000
Common mutation(p. N88K)
100 Conradi Hunermann syndrome‐ EBP gene sequencing MEBP 16500 13200
101 Corneal Dystrophy‐CHST gene sequencing MCHST 20000 16000
102 Cortical dysplasia (Exon 24) MKIF5C 7000 5000
103 Craniosynostosis ( non specific ) FGFR3 mutation ‐ MCNS 5000 3500
Pro250Arg
104 Crigler Najjar Syndrome (Sequencing) UGT1A1 gene MCNJS 22000 16000
105 Crouzon Disease : FGFR 2 gene (2 Mutation) MCRZ 10000 7000
106 Cyclical Neutropenia‐ELA2 gene sequencing MELA2 20000 16000
107 CYP2C9 ( 1,2,3 ) VKORC1(1639G>A) GENOTYPING MCYY 5500 4000
108 Cystic fibrosis ‐ CF Diagnosis ( Delta 508 mutation ) MCF1 4000 2500
109 Cystic Fibrosis ‐CFTR MLPA MLCF 7000 5000
110 Cystic Fibrosis, Gene sequencing MCFS 30000 25000
111 Cystic Megalencephaly ‐ MLC1 Gene Sequencing MLCS 22000 17000
112 Cystic Megalencephaly (MLC2) HEPACAM gene MPEPACAM 22000 17000
sequencing
113 Cystic megalencephaly MLC 1 gene mutation MLC1 5000 3500
114 Cystic megalencephaly MLC 1 prenatal diagnosis MLC1‐P 15000 12000
115 Deafness ‐ Connexin 26 ‐ Gene Sequencing MD2S 7000 5500
116 Deafness ‐(Non syndromic X linked Hearing loss gene MXNSHL 15000 12000
sequencing‐POU3F4 gene )
117 Deafness Connexin 30 Gene Deletion MSD 3600 3000
118 Deafness ‐Connexin 30 gene sequencing MDD30 9000 7000
119 Deafness Connexin 31 Gene Sequencing MD31 7000 5000
120 Deafness Dystonia Optic Neuronopathy Syndrome‐ MMTS 16500 13200
Mohr Tranebjaerg syndrome. TIMM8A gene
sequencing
121 Deafness ‐Mondini defect‐KCNJ10 gene sequencing MMD 15000 12000
122 Deafness ‐SLC26A4 Gene Sequencing MSLC26A4 35000 35000
123 Deafness‐Mondini defect‐FOXI1 gene sequencing MFOXI 1 12000 9000
124 Deletion ‐ 22q deletion ‐ ( Conotruncal Heart disease MD22D 12000 9000
)
125 Dengue fever ‐ Molecular diagnosis MDENG 4200 3000
126 DENT DISEASE 2, LOWE SYNDROMEex 22 MOCRL 7000 5000
127 Dentatorubral ‐ Pallidoluysian atrophy ( Triplet repeat MDRPLA 5000 3500
)
128 Desbuquois Dysplasia‐ CANT1 gene sequencing MCANT 16500 13200
129 Desbuquois Dysplasia‐ CHST3 gene sequencing MCHSTT 22000 18000
130 Diabetes Mellitus ‐Type 1 ‐ SIRTI gene sequencing MSIRT 25000 20000
131 Diastrophic Dysplasia‐SLC26A2 gene sequencing MSLC26A2 20000 16000
132 Dilated Cardiomyopathy, Hypertrophic MYBPC3T 5500 4000
cardiomyopathy‐ MYBPC3 targeted 1 exon
133 DMD ‐ Dosage Studies in Females MDDF 9000 7000
134 DMD gene analysis (By NGS) MDMDNGS 30000 25000
135 DNA ‐ Isolation & storage (Molecular Genetics) MDNA 700 500
136 DNA ‐ Isolation & storage for POC MDNAPOC 1200 800
137 DNA isolation and storage of fetal sample MDNAFETAL 1200 800
138 Donnai‐Barrow syndrome‐ LRP2 gene targeted MLRP2 11000 7700
mutation exon 23 & 27
139 Duchenne muscular dystrophy ( DMD ) deletion DMDMLPA 9000 7000
analysis by MLPA ( 79 exons )
140 Duchenne muscular dystrophy ( DMD ) deletion MDD 4200 3000
testing
141 Duchenne muscular dystrophy ( DMD ) prenatal MDP 15000 12000
diagnosis
22
142 Dyschromatosis Symmetrica hereditaria 1 (DSH1) hot MADAR 11000 7700
spot
143 Dystonia ( DYT5 gene sequencing ) MDYT5 15000 11000
144 Dystonia (DYT1 gene sequencing) MDYT1 15000 11000
145 Dystonia (DYT1,6,12,16) MLPA MLDYT 7000 5000
146 Dystrophic Epidermolysis Bullosa (AD)‐COL7A1 MEBAD 15000 11000
‐EXONS72‐75 gene sequencing
147 Ectodermal Dysplasia ‐ hypohidrotic X ‐ linked EDA MEDS 20000 16000
gene
148 EGFR Gene Mutations ( 4 Exons ) MEGFR 10000 7200
149 Emery Driefuss Muscular Dystrophy ‐EMD gene MEMD 15000 11000
sequencing
150 Emery‐Dreifuss muscular dystrophy 2, autosomal MLMNAS 5500 4000
dominant (EDMD2) targeted exon 11
151 Enterovirus PCR (Genetics) MEV 3300 2300
152 Epidermolysis bulllosa simplex ‐ KRT14 (exons1,4 MEBKRT14 15000 11000
and6)
153 Epidermolysis bulllosa simplex ‐ KRT5(exons1,4 and6) MEBKRT5 15000 11000
154 Epidermolysis bullosa dystrophica, autosomal MCOL7A1 11000 7700
dominant (DDEB) hotspot exons 105, 116
155 Epidermolysis Bullosa panel (NGS) MEBPP 35000 35000
156 Epilepsy ‐ SCN1a gene sequencing MSCN 35000 35000
157 Establishment and validation of known mutation MEVKM 19000 14500
158 Establishment and validation of known mutation‐ MEVKMSGRH 13000 10000
sgrh only
159 Ethylmalonic encephalopathy METHE‐1 22000 17000
160 Fabry disease GLA gene sequensing MGLA 22000 17000
161 Factor V Leiden mutation MFVL 2700 1900
162 Factor XIII deficiency (Exon 10) MF13A1 7000 5000
163 Familial Exudative Vitreoretinopathy ‐ FZD4 exon2 MFZD4 5000 3500
mutation
164 FAMILIAL HEMOPHAGOCYTIC LYMPHOHISTIOCYTOSIS MPRF1 13000 10000
165 Familial Hypercholesteriemia‐APOB gene (exon 26 MFHAPOB 9000 7000
and exon 29)
166 Familial Hypercholesterolemia‐ LDLR gene MFHLDLR 28000 22000
sequencing
167 Familial Hypercholesterolemia‐ PCSK9 gene MFHPCSK9 22000 17000
sequencing
168 Familial Juvenile Nephronophthisis‐ NPHP1 MLPA MLNPH 7000 5000
169 Familial renal glucosuria SLC5A2 gene sequencing MSLC5A2 25000 20000
170 Family Member of Patient MFMD
171 Farber lipogranulomatosis (Exon 6,12) MASAH1 10000 7000

172 FGFR1 +FGFR2+FGFR3 gene analysis (By NGS) MFGFRNGS 40000 35000
173 FGFR2 probemix MLPA MLFGR2 9000 7000
174 FGFR2 sequencing ( Crouzon, Jackson Weiss, Pfeiffer, MFGFR2S 30000 22500
AD craniosynostosis)
175 FGFR3 Gene Sequencing ( Achondroplasia , MFGS 30000 22500
Hypochondroplasia Thonotrophic Dwarfism )
176 Fibrodysplasia ossificans progressiva (FOP), ACVR1 MACVR1 22000 17000
gene sequencing
177 FLT3 mutations(AML) MFLT3 4000 2700
178 Folate polymorphism 3'5 MTHFR ‐ ( 677C>T, 1298A>C MFOL 4200 3000
)
179 Fragile X in Females MSXF 8800 6600
180 Fragile X syndrome ( Methylation test ‐ confirmatory MFXM 6000 4200
)
181 Fragile X syndrome screen MFXS 3300 2300
23
182 Friedreich ataxia ‐ molecular diagnosis MFAMD 5500 4000
183 Frontotemporal lobar dimentia ( MAPT ) exons 9‐13 ) MMAPT 15000 11000
sequencing
184 Fructose intolerance Aldolase B deficiency ? ALDOB MALDOB 19800 15000
gene sequencing
185 Fukutin related protein‐Fukuyama congenital MFKRP 19000 14500
muscular dystrophy‐ FKRP gene sequencing
186 Fukuyama congenital muscular dustrophy‐FKTN gene MFKTN 28000 22000
sequencing
187 G‐6‐ PD ONE MUTATION MGP1 3300 2300
188 G‐6‐PD ( Mediterranean & Orissa types ) ‐ G6PD MG6PD 6000 4200
189 Galactosemia Gene sequencing ( GALT ) GALTSEQ 22000 17000
190 Gaucher disease ‐ GBA gene sequencing MGDSG 30000 22500
191 Gilbert's disease ( UGT1A1 Promoter polymorphism ) MGDP 3600 2500
192 Gilbert's Disease Sequencing ‐ UGT1A1 Gene MGDS 22000 18000
193 GLUTARIC ACIDEMIA TYPE II, exon6 METFB 7000 5000
194 Glutaric acidemia type II‐ETFB gene, targeted exon 6 METFBT 5500 4000
195 Glutaric Aciduria‐GCDH gene sequencing MGCDH 20000 16000
196 Glycogen Storage 1A Gene Sequencing MGSDS 15000 11000
197 Glycogen Storage disease III‐ known targeted MGSD3 7000 5000
mutation AGL gene
198 GM1 Gangliosidosis‐GLB1 gene sequencing MGLB1 28000 22000
199 Goldberg‐Sphrintzen syndrome‐KIAA1279 gene MKIAA1279 28000 22000
sequencing
200 Grebe syndrome‐ GDF5 gene sequencing MGDF5 16500 13200
201 Gyrate Atrophy of Choroid and Retina‐ OAT gene MOAT 28000 22000
sequencing
202 HADDAD syndrome‐ PHOX2B gene sequencing MHADDAD 15000 11000
203 Haemochromatosis ( 2 mutations ) MHACM 5000 3500
204 Hallermann Strieff Syndrome‐GJA1 gene sequencing MHSS 8800 6600
205 Hallervorden Spatz ‐ PANK2 Common mutation MHSC 6600 4500
206 Hallervorden‐Spatz Syndrome ‐ PANK2 gene MHSDSEQ 28000 22000
sequencing
207 Hb D Iran MHBD 3300 2300
208 Hb D Punjab MHBP 3300 2300
209 Hb E MHBE 3300 2300
210 Hb Q India MHBQI 3300 2300
211 Hb Sickle MHBSI 3300 2300
212 Heme oxygenase 1 deficiency HO 1 gene targeted MHO 1 5500 4000
mutation
213 Hemolytic uremic syndrome atypical 1 (AHUS1) ‐ CFH MCFHT 5500 4000
214 Hemophilia A ‐ Gene sequencing MHAS 35000 27000
215 Hemophilia A Inversions 1/22 MHAI 6000 4200
216 Hemophilia B ‐ Gene sequencing MHBS 22000 17000
217 Hemophilia B‐ MLPA MLF9 7000 5000
218 HEPATOCEREBRAL MITOCHONDRIAL DNA DEPLETION MMPV17 10000 7000
SYNDROMEex5+6
219 Herpes virus infection PCR MHER 3300 2300
220 HFI ‐ ALDOB ‐ Agarwal mutaion MHFIA 5500 4000
221 HLA‐B 1502 GENOTYPING, CARBAMAZEPINE, HB1502 3600 2500
PHENYTOIN
222 HLA‐B 5701, GENOTYPING, ABACAVIR HB5701 1800 1200
223 HNPCC ‐ MLH1 / MSH2 DELETION / DUPLIATIONS MID 7000 5000
224 HNPCC ‐ MLH1 Gene Sequencing MMLH1 35000 27000
225 HNPCC ‐ MLH1/ MSH2 MICRO SATELLLTE INSTABILITY MIT 8000 5600
( MSI )
24
226 HNPCC ‐ MSH2 Gene Sequencing MMSH2 26000 22000
227 HNPCC ‐ MSH6 Gene Sequencing MMSH6 19000 14500
228 Holocarboxylase deficiency HLCS full gene MHLCS 25000 20000
229 Human Telomere‐7 (dosage ch9p,10p,11p and MLTEL7 7000 5000
12p)MLPA
230 Huntington disease gene analysis MHD 4200 3000
231 Hyperoxaluria AGXT gene sequencing MHO 22000 17000
232 Hyperoxaluria‐AGXT MLPA MLAGX 7000 5000
233 Hypochondroplasia common mutation MHCM 6000 4200
234 Hypomyelination with Congenital Cataract‐ FAM126A MHCF 26000 22000
gene sequencing
235 IDH1(R132) IDH2 (R172) Mutations in Gliomas MIDH 10000 7000
236 IDUA Full gene (Hurler Syndrome) all 14 exons MIDUA 30000 22500
237 Iminitib Resistance mutation analysis CIR 9000 7000
238 INCONTINENTIA PIGMENTI NEMO GENE COMMON MNEMO 5000 3500
DELETION
239 Infantile neuroaxonal dystrophy ( INAD ) PLA2G6 MPLA2G6 25000 20000
gene sequencing
240 Infection ‐ Cytomegalovirus ( CMV ) PCR ‐ Genetic MCMV 3300 2300
Medicine
241 Infection ‐ PCR for Rubella Virus ( Genetics ) MR41 4200 3000
242 IPEX syndrome (immunodysregulation MFOXP3 6600 4400
polyendocrinopathy enteropathy X‐linked syndrome)
Targeted mutation FOXP3 gene
243 isovaleryl‐CoA dehydrogenase DEFICIENCY (Exon 2) MIVD 7000 5000
244 JAK‐2 mutation ( Molecular Genetics ) MJACK2 3300 2300
245 Jarcho levin syndrome ‐ MESP2 gene sequencing MMESP2 20000 16000
246 Joubert Syndrome ‐21 (exon 19 and 23) MCSPP1 10000 7000
247 JUNCTIONAL EPIDERMOLYSIS BULLOSA, MLAMA3 7000 5000
LARYNGO‐ONYCHO‐CUTANEOUS SYNDROME,
(exon55)
248 Kallman syndrome gene (FGFR1) sequencing MKAL 28000 22000
249 Klippel ‐ Feil syndrome 2 ‐ MEOX1 gene MEOX1 16500 13200
250 Known Mutation ( By Sequencing ) MSQ 5000 3500
251 KRABBE S DISEASE GALC COMMON DELETION MKD 5000 3500
252 Krabbes ‐ GALC gene sequencing MGALC 28000 22000
253 KUFS DISEASE, LATE‐INFANTILE NEURONAL CEROID MCLN6T1 7000 5000
LIPOFUSCINOSIS, exon3
254 Lafora Disease‐EPM2A gene sequencing MLD1 20000 16000
255 Lafora Disease‐NHLRC1 gene sequencing NHLRC1 20000 16000
256 LBSL ‐ DARS 2 gene sequencing MDARS2 33000 26000
257 Leb Hered Optic atrophy ‐ (LHON) 3 mutations MLHO 6000 4200
258 LEBER CONGENITAL AMAUROSIS, CONE‐ROD MGUCY2D 7000 5000
DYSTROPHYex 11
259 LEIGH SYNDROME (LS), MITOCHONDRIAL COMPLEX I MNDUFV1 10000 7000
DEFICIENCY (MT‐C1D)ex8+9
260 Leigh syndrome with cytochrome c oxidase (COX) MLSCOX 20000 16000
deficiency‐SURF1gene sequencing
261 LEPRE1‐Related Osteogenesis Imperfecta ( targeted MLEPRE 11000 7700
mutations exons 13 / 14)
262 Leri‐Weill dyschondrosteosis and Langer mesomelic MSHOX 19800 15000
dysplasia SHOX gene sequencing
263 Lesch Nyhan syndrome HPRT1 gene sequencing MLN 30000 22500
264 LEUKOCYTE ADHESION DEFICIENCY TYPE 1 MITGB2 7000 5000
265 Leukocyte adhesion deficiency type I (LAD1) ‐ ITGB2 MITGB2T 5500 4000
266 Linkage analysis MLA 12000 9000
25
267 Lissencephaly (Exon 35) MDYNC1H1 7000 5000
268 Lissencephaly DCX gene sequencing MDCX 25000 20000
269 Long QT / Cardiomyopathies / Premature CAD by MCQTNGS 40000 40000
NGS
270 Long QT package (KCNQ1, KCNH2, SCN5A) MLQT 35000 35000
271 Long QT2‐ KCNH2 gene sequencing MKCNH2 44000 32000
272 Long QT3‐ SCN5A gene sequencing MSCN5A 65000 45000
273 LOWE SYNDROME LINKAGE STUDIES ‐ FAMILY MLSLF 0 0
MEMBER
274 Lymphedema (Congenital)‐FLT4 gene sequencing MCL 20000 16000
275 Lynch syndrome gene panel (by NGS) MLYNCHNGS 40000 35000
276 Machado ‐ Joseph disease ‐ Spino cerebellar ataxia ( MJD 5000 3500
SCA3 )
277 Mandibuloacral dysplasia‐ LMNA (Lamin A/C) gene MLMNA 6600 4400
targeted mutation
278 Maple Syrup Urine Disease‐ BCKDHA gene MMSUDA 28000 22000
sequencing
279 Maple Syrup Urine Disease‐ BCKDHB gene sequencing MMSUDB 28000 22000
280 Maple Syrup Urine Disease‐ DBT gene sequencing MMSUDDBT 28000 22000
281 Marfan syndrome‐ FBN1 MLPA MLMAR 9000 7000
282 Marfan Syndrome, Loeys‐Deitz Aortic Aneurysm MTGFBR2 7000 5000
Syndrome (Exon8)
283 Maroteaux‐Lamy syndrome‐ MPS VI ASRB gene MASRB 25000 20000
sequencing
284 Maternal cell contamination (MCC) of fetal sample by MMCC 7000 5000
molecular analysis
285 MCAD gene sequencing (ACADM gene) MACADM 25000 20000
286 MCAD mutation ( Medium chain Acyl‐coA MCAD 3300 2300
dehydrogenase )
287 McArdle disease gene sequencing ‐PYGM gene MPYGM 35000 27000
288 Meckel Gruber‐ TMEM67 gene targeted analysis MTMEM67 11000 7700
289 MEMBRANOPROLIFERATIVE GLOMERULONEPHRITIS MCFHT1 7000 5000
TYPE II exon 21
290 MEN1 GENE MUTATION ( 7 EXONS BY SEQUENCING ) CMEN 22000 17000
291 Menke?s Disease ‐ ATP7A gene targeted mutations MATP7A 8800 6600
292 MENKES, exon 4+5 MATP7AT 10000 7000
293 Mental Retardation ‐ X Linked ‐ Panel MRX 7000 5000
Deletions/Duplications
294 Mental Retardation Panel1 ‐ Multiple MR1 7000 5000
295 Mental Retardation Panel2 ‐ Multiple MR2 7000 5000
296 Merosin‐deficient congenital muscular dystrophy 1A MLAMA2S 11000 7700
(MDC1A) targeted exons 27 & 56
297 Metachromatic Leukodystrophy gene sequencing MMLD 22000 17000
298 Metaphyseal Dysplasia ‐ COL 10A1 Gene Sequencing MC10S 22000 17000
299 Methyl Malonic Aciduria‐ MMAA gene sequencing MMMAA 17000 13500
300 Methyl Malonic Aciduria‐ MMAB gene sequencing MMMMA 17000 13500
301 Methylmalonic acedimia‐ MUT gene sequencing MMUT 28000 22000
302 Methylmalonic aciduria and homocystinuria type MMACHC 22000 17000
cbIC full gene
303 MGMT Methylation MMGMT 15000 13000
304 Microcephalic Osteodysplastic Primordial Dwarfism MRNU4ATAC 5500 4000
type 1 (MOPD)
305 Microcephaly ‐ASPM gene sequencing MASPM 35000 35000
306 Microcephaly ‐PQBP1 gene sequencing MPQBP1 17000 13500
307 Microdeletion panel MLPA any 1 MMICRO 7000 5000
26
308 Microdeletion panel MLPA any ‐2 MMICRO2 11000 8000
309 Microdeletion‐1 MLPA (Probe‐P245) MLDL1 7000 5000
310 Microdeletion‐5 MLPA (Confirmation P245) MLDL5 7000 5000
311 Microdeletion‐6 MLPA(Confirmation P245) MLDL6 7000 5000
314 Micropthalmia/ Anopthalmia‐ FOXE3 gene MFOXE3 9000 7000
sequencing
315 Mitochindrial DNA Genome sequencing MMITOSQ 40000 40000
316 Mitochondrial / LEIGHS ‐ 3 mutations MLE 8000 6000
317 Mitochondrial / MELAS ‐ 3 mutations MEL 8000 6000
318 Mitochondrial / MERRF ‐ 2 mutations MER 7000 5000
319 Mitochondrial / NARP ‐ 2 mutations MNAR 7000 5000
320 Mitochondrial Deafness‐2 mutations(A1555G, MMDEAF 5500 4000
7445G)
321 Mitochondrial DNA depletion syndrome 6 (MDDS6) ‐ MMDDS6T 11000 7700
MPV17 gene, targeted exons 5 & 6
322 Mitochondrial Genome ‐ Deletion/Duplication MGDD 7000 5000
323 Mitochondrial mutations package ( ALL ) MT4 12000 9000
324 Mowat Wison syndrome /deletion duplication MMWSDD 9000 7000
325 Mowat Wison syndrome‐ZEB2 gene sequencing MMWS 28000 22000
326 MPS II Gene Sequencing MMPSII 28000 22000
327 MPS II Hunter syndrome ( IDS gene deletions ) MHUNTD 7000 5000
328 MPS IIIA Sanfillipo Disease‐SGSH gene sequencing MMPS3A 28000 22000
329 MPS IIIB gene sequencing ( NAGLU gene ) MMPS3B 22000 17000
330 Mucolipidosis II alpha/beta.‐ GNPTAB gene targeted MGNPTAB 6600 4400
mutation analysis (Exon 13, 19)
331 Mucopolysaccharidosis IVA (Morquio A) ‐ GALNS full MGALNSF 35000 27000
gene
332 Multiple endocrine neoplasia‐ MEN1 MLPA MLMEN 7000 5000
333 Multiple epiphyseal dysplasia targeted exon 17 MCOL9A2 5500 4000
334 Multiple epiphyseal dysplasia type 3 targeted exon 5 MCOL9A3 5500 4000
335 Multiple Sulphatases‐ SUMF1 gene sequencing MMS 20000 16000
336 Mutation analysis ( single ) MMAS 5000 3000
337 Myoadenylate Deaminase Deficiency‐AMPD1 exon 2 MAMPD1 7000 5000
&3 gene sequencing
338 Myopathy, centronuclear , X‐linked targeted MMTM1 5500 4000
mutation
339 Myotonic dystrophy ‐ Type 1 ( 19q 13.3 ) MDM 5500 4000
340 Myotonic dystrophy ‐ Type 2 ( 3q 21 ) MMDT2 5500 4000
341 Nail Patella syndrome ‐ex4+5 MLMX1B 10000 7000
342 NBIA Neurodegeneration with brain iron MNBIA 25000 20000
accumulation‐PLA2G gene targeted mutations by
sequencing
343 NBIA‐ PANK2/PLA2G6 MLPA MLPANK 7000 5000
344 NCL ‐ Infantile ( 2 Mutaiton Assay ) ( We advice MNCLH 3300 2300
enzyme assay before this test )
345 NCL ‐ Juvenile ( 1 Mutation ‐ common deletion ) MNCLJ 4000 3000
346 NCL ‐ Late infantile ( 2 Mutations ) MNCLL 4000 3000
347 Neonatal Diabetes Mellitus ABCC8 gene targeted MABCC8 8800 6600
mutation
348 Nephropathic Cystinosis CTNS gene (one mutation) / MCTNST 5500 4000
(exon 10)
349 Nephrotic syndrome (NPHS1 and NPHS2 gene MNPHS 40000 40000
sequcencing)
350 Neurofibromatosis (Exon 16) MNF1 7000 5000
351 Neurofibromatosis type 2 NF2 22q12 MLPA MLNF2 7000 5000
27
352 Neuronal ceriod lipo fucinosis ( NCL ) or Batten MNCLF 9000 7000
disease
353 Neuronal Ceroid Lipofuscinosis(NCL) CLN8 (one MCLN8T 5500 4000
mutation exon 2)
354 Neuronal ceroid‐lipofuscinoses 6‐CLN 6 gene, MCLN6T 5000 4000
targeted exon3
355 Neuronal Ceroid‐Lipofuscinosis 2 (CLN2).‐ TPP1 gene MTPP1 25000 20000
sequencing
356 NGS panel Deafness MDFNG 35000 35000
357 Niemann Pick disease gene sequencing MNP 30000 22500
358 Niemann‐Pick type C disease‐ NPC MLPA MLNPC 7000 5000
359 Non‐ketotic hyperglycinemia (NKH) MGLDC 7000 5000
360 Norrie disease ‐ NDP gene sequencing MNDP 16500 13200
361 NOTCH3 gene sequencing ( cadASIL ) 5 exons MNOT 15000 11000
362 NPM1 gene Mutations(AML) MNPM1 3000 2000
363 Obesity due to leptin deficiency Leptin gene MLEPTIN 13000 11000
sequencing
364 Ocular albinism ( X‐linked), GPR143 gene gene MGPR143 25000 20000
sequencing
365 OSTEOGENESIS IMPERFECTA ex13,14,18 MLEPRE1OI 13000 10000
366 Osteogenesis imperfecta type VIII ‐ targeted exon 14 MLEPRE1T 5500 4000
367 Osteopetrosis TCIRG gene common mutations ( exon MTCIRG 8800 6600
13 & 18)
368 OSTEOPETROSIS,common +14‐15 MTCIRG1 10000 7000
369 OTC deficiency‐ MLPA MLOTC 7000 5000
370 OTC gene sequencing MOTC 30000 22500
371 Otopalato digital syndrome FLNA gene (3 exons) MFLNA 11000 7700
372 Pancreatitis‐ PRSS1 gene sequencing MPRSS 17000 13500
373 Pancreatitis‐ SPINK1 gene sequencing MSPINK 17000 13500
374 Paramyotonia common mutations Arg 1448 His Thr MPM 7000 5000
1313 Met
375 Parvo virus infection ( PCR ) MPAR 3300 2300
376 Pelizaeus Merzbacher Deletion/Duplication MPZD 7000 5000
377 Pelizaeus‐Merzbacher disease‐PLP1 gene sequencing MPMD 20000 16000
378 Permanent neonatal diabetes mellitus ‐ INS gene MINS 8800 6600
targeted mutation
379 PEROXISOME BIOGENESIS DISORDER 5A/5B exon3 MPEX2 7000 5000
380 PFIC1‐Progressive familial intrahepatic cholestasis MATP8B1 35000 35000
type 1 ‐ ATP8B1 gene sequencing
381 PFIC1‐Progressive familial intrahepatic cholestasis MATB123 40000 40000
type 1 +2+3
382 PFIC2‐Progressive familial intrahepatic cholestasis MABCB11 35000 35000
type 2 ‐ABCB11 gene Sequencing
383 PFIC3‐Progressive familial intrahepatic cholestasis MABCB4 35000 35000
type 3 ‐ ABCB4 gene Sequencin
384 PML‐RARA (APML) MPMLRARA 3600 2500
385 POLYCYSTIC KIDNEY AND HEPATIC DISEASE 1 MPKDH1 10000 7000
(AUTOSOMAL RECESSIVE)ex4+61
386 Polycystic kidney disease, autosomal recessive MPKHD‐1 11000 7700
(ARPKD) targeted exon 11 & 19
387 Pompe disease ‐ GAA gene sequencing MGAA 33000 26000
388 Pompe MLPA MLPOM 7000 5000
389 Pontocerebellar hypoplasia‐TSEN54 gene sequencing MTSEN54 40000 40000
390 PORPHYRIA SEQUENCING MPSQ 22000 17000
391 Prader willi syndrome molecular test MPWS 6000 4500
392 preconception screening by NGS‐ six hotspot agarwal M1AGG 22000 18000
mutations
28
393 Preconception screening by NGS‐common genes‐ MPRNG 30000 22000
MAGG+ HBB, DMD ,CF, Gauher,Criggler najjar,
GALT,Deaf,OCA, Wilson disease
394 preconception screening by NGS‐common genes‐ M2PRESCREEN 30000 22000
MAGG+ HBB, DMD ,CF,Gauhcer,CJ, GALT,Deaf,OCA,
wilson
395 preconception screening cmpehensive MPRESCREEN M3SCREEND 44000 38000
by NGS‐+Fx, DOSAGE SMA,DMD,
396 Preconception screening comprehensive Prescreen MSCREN 44000 38000
by NGS‐+Fx, Dosage SMA, DMD
397 Prenatal diagnosis ( Includes test for MCC ) MPND 15000 12000
398 Prenatal diagnosis by gene sequencing MPNDSEQ 20000 16500
399 Primary Congenital Glaucoma/ Buphthalmos‐ CYP1B1 MCYP1B1 15000 11000
gene sequencing
400 PROGRESSIVE PSEUDORHEUMATOID DYSPLASIA MWISP3 7000 5000
(PPRD) ex 2
401 Propionic academia‐ PCCA MLPA MLPCC 7000 5000
402 Propionic aciduria‐ PCCA gene sequencing MPCCA 35000 35000
403 Propionic aciduria‐ PCCA gene sequencing‐ A+B NGS MPCCAB 35000 35000
404 Propionic aciduria‐ PCCB gene sequencing MPCCB 28000 22000
405 Prothrombin gene polymorphism ( G20210A ) MPRO 3300 2300
406 Pseudoachondroplasia ‐ COMP gene sequencing of MCOMP 17000 13500
exons 10‐14, 16
407 PTEN gene sequencing MPTEN 25000 20000
408 Pyknodysostosis‐CTSK sequencing MCTSK 25000 20000
409 Pyruvate Carboxylase deficiency ‐ gene sequencing MPCD 35000 27000
410 Pyruvate Dehydrogenase Deficiency (PDH)X‐linked ‐ MPDH 28000 22000
PDHA1 gene sequencing
411 RAG1 deficiency MRAG1 21000 16500
412 Rapid‐onset dystonia parkinsonism (RDP) (also MATP1A3 33000 26000
known as DYT12)‐ ATP1A3 gene sequencing
413 RB gene analysis (By NGS) MRBNGS 40000 35000
414 Recessive forms of osteogenesis imperfecta (Intron MPPIB 7000 5000
2)
415 Renpenning Syndrome‐PQBP1 gene sequencing MRSPQBP1 21000 16500
416 Respiratory distress syndrome (RDS) due to MRDS 11000 7700
Surfactant Deficiency( three common mutations ‐
SFTPB, SP‐C and ABCA3 gene mutations
417 RET Gene Mutations ( 6 Exons ) MRET 15000 11000
418 Retinoblastoma ‐ Deletion/Duplication MRBDD 7000 5000
419 RETINOBLASTOMA GENE SEQUENCING MRBS 35000 35000
420 Rett syndrome ( MECP2 sequencing and Deletion / MRS 30000 22500
duplication )
421 Rett syndrome atypical ‐CDKL5 MLPA MLCDK 7000 5000
422 RETT Syndrome MECP2 Deletion/Duplication MRTSQ 7000 5000
423 Rett syndrome MECP2 Sequencing MRSS 28000 22000
424 RH genotyping ‐ Both alleles ( +/+ or ‐/‐ ) MRH 6000 4200
425 RH typing ( Rh+ or Rh‐ ) MMRHT 3300 2300
426 Rh Typing On Fetal DNA in Maternal Blood MRHMB 5000 3500
427 RPE65 Gene Sequencing MRPE65 28000 22000
428 Russel Silver ‐ Methylatio H ‐ 19 MRSS19 8800 6600
429 Russel Silver – UPD chr7 MRSS7 8800 6600
430 Saethre‐ Chotzen syndrome ‐ TWIST gene Dosage MTWISTSD 18000 14000
+sequencing
431 Saethre‐ Chotzen syndrome ‐ TWIST gene sequencing MTWISTS 13000 11000
432 Sandhoff disease‐ HEXB gene sequencing MHEXB 25000 20000
29
433 Sanjad Sakati syndrome/common mutation ‐ TBCE MTBCE 7000 5000
gene
434 SCID Radiosensitive ‐ DCLRE1C MLPA MLDCLR 7000 5000
435 Sengers Syndrome (Mitochondrial ) exon 13,14 MAGK 10000 7000
436 Sequencing Parkinson ( Gly19 ser mutation ) SGLY19 5500 4000
437 Sequencing restrictive dermopathy ( specific SRD 5500 4000
mutation )
438 Severe Combined Immunodeficiency (Exon 1) MRFXAP 7000 5000
439 short rib‐polydactyly syndrome type 5 MWDR35 7000 5000
440 Sialidosis (Exon 4) MNEU1 7000 5000
441 Simpson‐Golabi‐Behmel syndrome 1 targeted MGPC3 5500 4000
mutation
442 Sjogren‐Larsson syndrome ‐ ALDH3A2 gene targeted MALDH3A2 6600 4400
mutation
443 SJORGEN‐ LARSSON SYNDROME LINKAGE‐ALDH3A2 MSLS 12000 9000
444 SMA carrier screening by MLPA SMAMLPA 7000 5000
445 SMA with respiratory distress1‐ SMARD1 gene MSMARD 28000 22000
sequencing
446 SPASTIC PARAPLEGIA TYPE 4, exon 12 MSPAST 7000 5000
447 SPG 11 ‐ Q906fs Agrawal mutaion MSPG11A 5500 4000
448 SPINAL BULBAR MUSCULAR ATROPHY CAG REPEATS MSBM 5000 3500
449 Spinal cerebellar ataxia ( SCA ) ‐ one gene MSCA 5000 3500
450 Spinal cerebellar ataxia ( SCA ) ‐ two gene MSCATG 7000 5000
451 Spinal cerebellar ataxia package ( 1, 2, 3, 12 ) MSCA4 12000 9000
452 Spinal cerebellar ataxia package ( 1, 2, 3, 6, 7, 12, 17 ) MSC4 21000 16500
453 Spinal Muscular Atrophy ‐ SMN 1 Gene Sequencing MSMNS 25000 22000
454 Spinal muscular atrophy ( SMA ) ‐ molecular diagnosis MSMA 4000 2700
455 Spinal muscular atrophy ( SMA ) ‐ prenatal diagnosis MSMP 15000 12000
456 Spinal muscular atrophy ‐SMN2 copy number analysis MSMC 7000 5000
457 Spinocerebellar ataxia with peripheral MSCAN 7000 5000
neuropathy‐autosomal recessive‐SCAN1 targeted
mutation analysis
458 Spinocerebellar ataxia with peripheral MTDP1 28000 22000
neuropathy‐autosomal recessive‐TDP1 gene
sequenicng
459 Spondyloepimetaphaseal dysplaisa ‐ KIF22 exon 4 MKIF22 6600 4400
460 Spondyloepiphyseal Dysplasia X‐Linked gene MSEDS 17000 13500
Sequencing
461 Sry + Amxy gene study ( Y chromosome ) MSAGS 5000 3000
462 SSjogren‐Larsson syndrome( Prenatal Diagnosis by MSJOL 15000 12000
Linkage )
463 Subtelomeric Deletions / Duplications ‐ All MTELD 7000 5000
Autosomes
464 Surfactant B gene sequencing MSURFB 28000 22000
465 Surfactant C gene sequencing MSURFC 22000 17000
466 Tay‐Sachs disease (TSD) /GM2 gangliosidosis variant MHEXA 28000 22000
B‐ HEXA gene sequencing
467 TGM1 GENE SEQ A R CONG ICHTH AND LAMELLAR MIGMS 28000 22000
ICHTHYOSIS
468 Thalassemia ‐ XMN, Bcl1 and HBSIL‐ MYB MXM3 8800 6600
polymorphism
469 Thalassemia ALPHA globin gene sequencing MALPHAGS 8500 6000
470 Thalassemia Beta globin gene large deletions (HPFH) MBGLD 8500 6000
471 Thalassemia BETA globin gene sequencing MBETAGS 8500 6000
472 Thalassemia beta mutation study ‐ couple MTHC1 8500 6000
473 Thalassemia beta mutation study ‐child MTHPRO 5000 3500
474 Thalassemia beta mutation study ‐child and parents MTHCP 8500 6000
30
475 Thalassemia beta prenatal diagnosis ( Repeat test ) MTPR 13000 10000
476 Thalassemia Intermedia ‐ Bcl1 and HBSIL‐ MYB MXM2 6600 4400
polymorphism
477 Thalassemia prenatal diagnosis MTHP 15000 12000
478 Thalassemia prenatal diagnosis ( Thalassemia society MTHPTS 12500 10000
patient )
479 Thanatophoric dwarfism ( common mutation ) MTD 5000 3500
480 THROMBOPHILIA DUE TO PROTEIN C DEFICIENCY MPROC 10000 7000
(Exon 7,9)
481 Thrombophilia profile ( DNA ) ‐ 3 polymorphisms MTHR 7000 5000
482 THROSENEMIA ‐ FAH GENE SEQUENCING MTYS 21000 16500
483 Torsion dystonia 1 ( DYT 1 ) deletion analysis MDYT 3600 2500
484 Toxoplasmosis infection PCR ( Genetics ) MTOX 3300 2300
485 TP53 DELETION/ DUPLICATION C53D 7000 5000
486 TP53 SEQUENCING CP53 15000 11000
487 TPMT ( 1,2,3A,3B,3C ) GENOTYPING, AZA, MTP5 5500 4000
6MP,6‐THIOGUANINE
488 TPMT ( 1,2,3C ) GENOTYPING, MTP3 3300 2300
AZA,6MP,6‐THIOGUANINE
489 Tricho hepatoenteric syndrome‐ TTC37 exon 28 MTTC 5000 3500
common mutation
490 TSC1 and TSC2 gene analysis( By NGS)+ dosage MTCSNGSD 40000 37000
491 Tuberculosis mycobacterium infection ( PCR )‐ MTBINF 4200 3000
qualitative
492 Tuberous sclerosis ( TSC1 ) deletion / duplication MDTS1 7000 5000
493 Tuberous sclerosis ( TSC1+2)‐ NGS TUBES 35000 35000
494 Tuberous sclerosis ( TSC2 ) deletion / duplication MDTS2 7000 5000
495 UGT1A1 28 GENOTYPING IRINOTECAN MUGG 3300 2300
496 Unverricht?Lundborg disease MEPM1 8800 6600
497 Usher syndrome and nonsyndromic AR deafness MCDH23 7000 5000
(Exon 58)
498 Usher syndrome type IIa and retinitis pigmentosa MUSH2A 11000 7700
targeted exons 38 & 53
499 validation of NGS mutation‐ SGRH only MVALSGRH 7000 5000
500 Very Long Chain Fatty Acid Dehydrogenase MACADVL 28000 22000
Deficiency‐ACADVL gene
501 VGT1A1 28 ( (TA) ) GENOTYPING, IRINOTECAN MUGT 2500 1750
502 VHL GENE DELETION/ DUPLICATION CVHL 7000 5000
503 VHL GENE MUTATION ( 3 EXONS BY SEQUENCING, CVHS 15000 11000
MLPA )
504 Waardenburg Syndrome ‐ PA X 3 Gene Sequencing MWSS 22000 17000
505 Waardenburg syndrome type 2 (Hirschsprung ) EDN3 MEDN3 19800 15000
gene sequencing
506 WILMS TUMOR 1, ex 9+7 MWT 1 10000 7000
507 Wilson Disease ‐ ATP7B Gene Sequencing MWDS 30000 22500
508 Winchester Syndrome ‐ MMP2 gene targeted MMMP2 6600 4400
mutations
509 Wiskott Aldrich gene sequencing‐ WAS gene MWAS 28000 22000
510 X ‐ L Chondrodysplasia punctata Arse gene MXLCDP 22000 17000
511 X ‐ linked ichthyosis ( deletion in Steroid sulfatase MXIC 5000 3500
gene )
512 X ‐ linked ichthyosis ‐carrier screening by dosage MXICD 7000 5000
analysis of STS gene
513 X ‐ linked ichthyosis ‐extent of deletion MXICEXT 7000 5000
514 X‐ severe combined immunodeficiency MXSCID 28000 22000
(X‐SCID)‐IL2RG gene sequencing
515 Xeroderma pigmentosum ‐ XPC gene sequencing MXPC 35000 27000
31
516 XERODERMA PIGMENTOSUM,exon3 MXPA 7000 5000
517 X‐linked congenital adrenal hypoplasia‐ DAX gene MDAX 17000 13500
sequencing
518 X‐linked dyserythropoietic anemia and MGATA‐1 5500 4000
thrombocytopenia GATA 1 hotspot
519 X‐Linked Hydrocephalus ‐ L1CAM gene sequencing ML1CAM 35000 35000
520 X‐LINKED MYOTUBULAR MYOPATHY3,12,13 MMTMX 13000 10000
521 XMN polymorphism Gr gene ( thalassemia child ) MXM1 4000 2700
522 Y ‐ chromosome deletions ( DNA ) ‐ 10 MYDL 6000 4200
IVF Investigations Charges

CAT 1/CAT2 CAT3
1 Anti Mullarian Hormone ( AMH ) AMH 1280 1000
2 Hormone estimation of TSH (IVF Lab) IVFTSH 400 240
3 Post Coital Test PCT 170 100
4 Semen Analysis SANAL 400 240
5 Semen Fructose Test SFRUCK 80 80
6 Semen Processing for IUI / AIH SPFAIH 2100 1280
7 Semen Pus Cells Test (IVF Lab) PUSIVF 80 80
8 Serum Beta hCG (IVF Lab) SHCG 650 400
9 Serum FSH ( Baseline ‐ Day 1 / 2 / 3 of menses ) SFSHBDM 700 420
10 Serum FSH ( Random ) FSH 700 420
11 Serum LH ( Baseline ‐ Day 1 / 2 / 3 of menses ) SLHBDM 700 420
12 Serum LH ( Random ) LH 700 420
13 Serum Oestradiol ( E2 ) ‐ Random OESTR 700 420
14 Serum Oestradiol ( E2 ) ( Baseline ‐ Day 1 / 2 / 3 of SOBDM 700 420
menses )
15 Serum Progesterone PROGEST 700 420
16 Serum Prolactin SPROLAC 700 420
IVF Procedures

CAT 1/CAT2 CAT3
1 CULTURE AND EMBRYO TRANSFER CHARGES ( AFTER CETCPDCHOS
CRYOPRESERVATION ) (EMBRYOLOGIST FEE + HOSPITAL
CHARGES)
Culture and embryo transfer charges ( after cryopreservation ) ‐ Clinical CETCDFCL 9800 9800
doctor fees
Culture and embryo transfer charges ( after cryopreservation ) ‐ CETCDFEMBR 3300 3300
Embryologist fee
Culture and embryo transfer charges ( after cryopreservation ) ‐ hospital CETCDFAHC 17000 17000
service charges
2 DIAGNOSTIC SPERM EXTRACTION ( TESA / PESA ) DSEPCADCHOS

(PACKAGE CHARGES + ALL DOCTOR FEES)
Diagnostic sperm extraction ( TESA / PESA ) ‐ Embryologist's fee DSEEF 2050 2050
Diagnostic sperm extraction ( TESA / PESA ) ‐ Hospital service charges DSEHC 1550 1550
Diagnostic sperm extraction ( TESA / PESA ) ‐ Surgeon fee DSEUF 6200 6200
3 Embryo Biopsy 3‐4 Embryos (Embryologists fee + Hospital EMBOS
charges + Clinician Charges)
32
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
4 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
5 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
6 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
7 Intra‐cytoplasmic sperm injection ( ICSI ) ‐ (Embryologists ICSIOS

fee + Hospital charges)
Intra‐cytoplasmic sperm injection ( ICSI ) ‐ Embryologists fee ICSIEMB 5000 5000
Intra‐cytoplasmic sperm injection ( ICSI ) ‐ hospital charges ICSINJ 15000 15000
8 IVF PROCEDURE ( 1ST CYCLE ) ‐ PACKAGE + ALL DOCTOR IVF1OS
FEES + HOSPITAL CHARGES
IVF procedure ( 1st Cycle ) ‐ Anaesthetists Charges IVF1SCAC 4700 4100
IVF procedure ( 1st Cycle ) ‐ Clinician Charges IVFSC1CL 24500 19500
IVF procedure ( 1st cycle ) ‐ Embryologists Fee IVFSC1EMBF 11500 9000
IVF procedure ( 1st Cycle ) ‐ Hospital Charges IVF1SCHC 37800 30400
IVF procedure ( 1st cycle ) ‐ package charges IVF1PC 81000 65000
IVF procedure ( 1st Cycle ) ‐ Ultasound Charges IVF1SCUC 2500 2000
9 Inpatients Only ‐ IVF package procedure 2nd installment ‐ IVF2IN
all charges
IVF procedure ( 2nd installment ) ‐ Anaesthetists fees IVF2NDAF 4500 3600
IVF procedure ( 2nd installment ) ‐ clinical doctor fee IVF2NDDFCL 17500 14000
IVF procedure ( 2nd installment ) ‐ embryologists fee IVF2NDEMBRY 5800 4600
IVF procedure ( 2nd installment ) ‐ hospital amount IVF2NDHA 24000 19500
IVF procedure ( 2nd installment ) ‐ PAC charges IVF2PAC 620 620
IVF procedure ( 2nd installment ) ‐ ultrasound charges IVF2NDUC 2600 2100
10 IVF PROCEDURE ( 2ND CYCLE ) ‐ PACKAGE + ALL DOCTOR IVF2OS
FEES + HOSPITAL CHARGES
IVF procedure ( 2nd Cycle ) ‐ Anaesthetists Charges IVF2SCAC 3600 3400
IVF procedure ( 2nd Cycle ) ‐ Clinician Charges IVFSC2CL 17000 15500
IVF procedure ( 2nd cycle ) ‐ Embryologists Fee IVFSC2EMBF 8100 7300
IVF procedure ( 2nd Cycle ) ‐ Hospital Charges IVF2SCHC 26300 24500
IVF procedure ( 2nd cycle ) ‐ package charges IVF2PC 57500 53000
IVF procedure ( 2nd Cycle ) ‐ Ultasound Charges IVF2SCUC 2500 2300
11 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
12 Egg Freezing (Non Fertility Preservation :upto 9 oocytes) IVFEN
Egg Freezing (Non Fertility Preservation :upto 9 oocytes) ‐ Embryologists EFDCN 6400 6400
Charges
Egg Freezing (Non Fertility Preservation :upto 9 oocytes) ‐ Hospital EFHCN 19000 19000
Charges
13 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
33
Oocyte Cryopreservation cycle (upto 9 oocytes) ‐ Ultrasound Charges OCUC 2650 2650
14 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
15 IVF procedure ( Registration ) IVFROS
IVF procedure ( Registration ) ‐ Packages Charges IVFRPC 10000 10000
IVF procedure ( Registration) ‐ Clinician Charges IVFRC 1100 1100
IVF procedure ( Registration) ‐ Embryologists Fee IVDEM 370 370
IVF procedure ( Registration) ‐ Hospital Charges IVFHC 7300 7300
IVF procedure ( Registration) ‐ Ultasound Charges IVFULT 1600 1600
16 Oocyte aspiration (no oocytes retrieved and further IVF OOCYTEASPOS
suspended) (Package charges + all doctor fees + Hospital
charges)
Oocyte aspiration (no oocytes retrieved and further IVF suspended) ‐ OAAF 3700 3000
Anaesthetist fee
Oocyte aspiration (no oocytes retrieved and further IVF suspended) ‐ OAHA 8500 8000
Hospital amount
Oocyte aspiration (no oocytes retrieved and further IVF suspended) ‐ OAUC 2200 1750
Ultrasound charges
Oocyte aspiration (no oocytes retrieved and further IVF suspended) Clinical OACF 10500 8700
Doctor fee
17 Renewal charges for embryo cryopreservation (for every RENCRYOOS

six months) ‐ (Embryologist fee + Hospital charges)
Renewal charges for embryo cryopreservation (for every six months) ‐ RCSCRYOEMBR 1250 1250
embryologists fee
Renewal charges for embryo cryopreservation (for every six months) ‐ RCSCRYO 3700 3700
hospital charges
18 Re‐Vitrification (Embryologists fee + Hospital charges) REVITEOS

Re‐Vitrification ‐ Embryologist fee REVITEMB 2760 2760
Re‐Vitrification ‐ Hospital Charges REVITEHC 7875 7875
19 Embryo cryopreservation for 1‐3 bactes (Embryologist fee SPERMCRYO
+ hospital charges)
Embryo cryopreservation ( freezing ) charges (Embryologists fee) SCRYCEMB 5400 5400
Embryo cryopreservation ( freezing ) charges (Hospital amount) SCRYC 16000 16000
20 Embryo cryopreservation for 4‐6 bactes (Embryologist fee SPERMCRYO46
+ hospital charges)
21 Embryo cryopreservation for 7‐9 bactes (Embryologist fee SPERMCRYO79
+ hospital charges)
22 REPEAT DIAGNOSTIC SPERM EXTRACTION ( TESA / PESA ) TESADHCHCOS
(PACKAGE CHARGES + ALL DOCTOR FEES + HOSPITAL
CHARGES)
Repeat diagnostic sperm extraction ( TESA / PESA ) ‐ Anasthesia fee RDTPA 1750 1750
Repeat diagnostic sperm extraction ( TESA / PESA ) ‐ Embryologist's fee RDSEEF 680 680
Repeat diagnostic sperm extraction ( TESA / PESA ) ‐ Hospital charges RDSEHC 620 620
Repeat diagnostic sperm extraction ( TESA / PESA ) ‐ Surgeon fee RDSEUF 2000 2000
IVF PACKAGE
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

1 FETALRED Fetal reduction in IVF lab (All
OS charges)
FETALREDAC Fetal reduction in IVF lab ‐ Anaesthetist fee 2580
FETALREDDF Fetal reduction in IVF lab ‐ Surgeon fee 9240
FETALREDUL Fetal reduction in IVF lab ‐ Ultrasound 3770
charges
34
2 IVFR2OS IVF procedure ( Registration 2)
IVFREG2 IVF procedure ( Registration 2) ‐ Clinician 2180 2180
Charges
IVFEMB2 IVF procedure ( Registration 2) ‐ 720 720
Embryologists Fee
IVFREGHC2 IVF procedure ( Registration 2) ‐ Hospital 14500 14500
Charges
IVFR2PC IVF procedure ( Registration 2) ‐ Packages 20000 20000
Charges
CDS Ultrasound colour doppler follicle 640 390
monitoring (single day)
Biochemistry Laboratory Charges
S No Description Code POPD/ GOPD/

CAT 1/CAT2 CAT3
1 24 Hours Urine ( Calcium, Phosphorus ) 24CPU 400 260
2 24 Hours Urine Calcium 24C 200 130
3 24 Hours Urine Chloride 24CHLO 200 130
4 24 Hours Urine Creatinine 24UCR 190 120
5 24 Hours Urine Micro Albumin 24URINALB 400 250
6 24 Hours Urine Phosphorous 24P 200 120
7 24 Hours Urine Potassium 24UP 200 120
8 24 Hours Urine Protein (Excludes Albumin) 24URINPROT 300 180
9 24 Hours Urine Protein (Excludes Albumin) ‐ ( Kidney KT‐24URINPROT 150 90
Transplant )
10 24 Hours Urine Protein (Excludes Albumin) ‐ ( Liver LT‐24URINPROT 150 90
Transplant )
11 24 Hours Urine Sodium 24US 200 120
12 24 Hours Urine Uric Acid 24U 200 120
13 Active B12 ACTIVEB12 1200 900
14 Acute Cardiac Profile CPA 3150 1890
15 Adenosine Deaminase ( ADA ) ‐ CSF ADAC 550 330
16 Adenosine Deaminase ( ADA ) ‐ Fluid ( Enter ADA 550 330
Specimen in Processing Notes )
17 Adenosine Deaminase ( ADA ) ‐ Serum ADAS 550 330
18 Alkaline Phosphatase ( ALP ) ALKP 200 130
19 Alphafetoprotein (AFP) AFP 800 700
20 ALT / SGPT SGPT 200 130
21 ALT / SGPT ( Kidney Transplant ) KT‐SGPT 100 100
22 ALT / SGPT ( Liver Transplant ) LT‐SGPT 100 100
23 Amikacin levels AMICA 2000 1200
24 Ammonia SEA 900 540
25 Amylase AMYL 400 250
26 Anaemia Profile ( Biochemical ) ENP 2500 1500
27 Angiotensin Converting Enzyme ( ACE ) ACE 950 680
28 Animal Allergen Mix ANIM 1100 660
29 Anti Mullerian Hormone BAMH 1800 1570
30 Apolipoprotein A1 APA1 1000 600
31 Apolipoprotein B APAB 1000 600
32 AST / SGOT SGOT 200 130
33 AST / SGOT ( Kidney Transplant ) KT‐SGOT 100 100
34 AST / SGOT ( Liver Transplant ) LT‐SGOT 100 100
35 Bence Jones Proteins ( Urine ) BJP 300 180
36 Beta 2 Microglobulin (Serum) B2MICROS 1300 800
37 Bicarbonate BCAR 300 180
38 Bilirubin ( Total & Direct ) BILL 300 180
39 Bilirubin ( Total & Direct ) ‐ ( Kidney Transplant ) KT‐BILL 150 150
35
40 Bilirubin ( Total & Direct ) ‐ ( Liver Transplant ) LT‐BILL 150 150
41 Blood Glucose 1 Hour After 50gm Glucose ( Glucose BLGL1 120 75
Spot Test )
42 Blood Lead Test BLT 700 475
43 BUN BUN 160 100
44 BUN ( Dialysis ) D‐BUN 80 80
45 BUN ( Kidney Transplant ) KT‐BUN 80 80
46 BUN ( Liver Transplant ) LT‐BUN 80 80
47 CA 125 CA125 1200 750
48 CA 15‐3 CA153 1200 750
49 CA 19‐9 CA199 1200 750
50 Calcium CALC 200 130
51 Calcium ( Dialysis) D‐CALC 100 100
52 CAPD Fluids ( 24 Hrs Protein ) C‐UPRO 300 180
53 Carbamazepine ( CPZ ) / Tegretol Assay CPZA 1160 700
54 Cardiac Checkup Extended Profile CCUE 5000 3000
55 Cardiac Profile CPC 2000 1200
56 CCR ‐ Creatinine Clearance CCR 420 250
57 CCR ‐ Creatinine Clearance ( Liver Transplant ) LT‐CCR 350 210
58 CEA ( Carcino‐Embryonic Antigen ) CEA 750 450
59 Chloride CHLO 185 110
60 CK ( CPK ) CPK 400 250
61 CKMB ( Activity ) CKMB ( ACTIVITY ) 450 270
62 CKMB ( MASS ) CKMBM 475 290
63 Comprehensive Allergy Panel Mixes ( CAPMIX ) ALLERGYP 12500 7600
64 Comprehensive Individual Allergy Panel ( COMPALL ) EXTENSIVE 32000 19300
65 Creatinine Clearance including serum creatinine, KT‐CCR 300 300
proteins & CCR ( Kidney Transplant )
66 CRP ( HS ) High Sensitivity C‐Reactive Protein HS 500 300
67 CSF ( Glucose/Protein/Chloride ) BCSF 500 300
68 CSF Albumin CSFALB 400 250
69 CSF Chloride CSFC 185 110
70 CSF Glucose CSFS 120 75
71 CSF IgA ( Immunoglobulin ) CSFIGA 800 480
72 CSF LDH CSFLDF 300 180
73 CSF Methotrexate Level METHOCSF 1800 1100
74 CSF Protein CSFP 300 180
75 Cystatin C CYSTC 750 600
76 Dehydroepiandrosterone Sulfate ( DHEA‐S ) DHEAS 950 650
77 Diabetes Monitoring Profile (Glu F,PP Insulin F,PP DIAMP 1500 1200
HbA1c)
78 Diabetes Screening Profile (Glu F,PP Insulin F,PP) DIASP 1200 1000
79 Diabetic Profile DP 850 510
80 Digoxin Level (SGRH Bioch.) DIGO 900 600
81 Drug Panel DRUGP 4600 2800
82 D‐Xylose Excretion Test ‐ 25 grams (5 hours sample) DXYL25 750 450
83 D‐Xylose Excretion Test ‐ 5 grams (5 hours sample) DXYL 750 450
84 Eczema Mini Panel ECZEMAM 6600 4000
85 Eczema Panel Extensive ( EXZEMA EX ) ECZEMA 15000 9000
86 Extended Lipid Profile ELIPP 3500 2100
87 Extended Metabolic Profile (Diabetic Profile, Insulin EMETP 6500 6500
F+PP, C Peptide F+PP, Renal Function, Liver Function,
Lipid Profile, Homocystine, Magnesium, hsCRP, Bile
Acids, Anemia Profile, Vitamin D, TSH, fT3, fT4)
88 Ferritin FERI 900 540
89 Fluid Alkaline Phosphatase ( ALP ) ALKPF 200 130
90 Fluid Amylase FLUAMY 400 250
36
91 Fluid Bilirubin ( Total & Direct ) FLUBIL 300 180
92 Fluid Bilirubin ( Total & Direct ) ‐ for Kidney KT‐FLUBIL 150 150
Transplant
93 Fluid Bilirubin ( Total & Direct ) ‐ for Liver Transplant LT‐FLUBIL 150 150
94 Fluid Bun FLUMIS 160 100
95 Fluid Calcium FLUCAL 200 130
96 Fluid Chloride FLUCHL 185 110
97 Fluid Cholesterol FLUCHOL 190 120
98 Fluid Creatinine FLUCREAT 180 110
99 Fluid Glucose FLUGLU 120 75
100 Fluid LDH PFLDH 300 180
101 Fluid Lipase FLULIP 360 220
102 Fluid Lipid Profile FLIPP 1200 720
103 Fluid Osmolality FLUOSM 600 360
104 Fluid Potassium FLUPOT 185 110
105 Fluid Protein & albumin PFPROT 420 250
106 Fluid Sodium FLUIDSOD 185 110
107 Fluid Triglycerides FLUTRIG 310 190
108 Fluid Uric Acid FLUUA 180 110
109 Folic Acid FACID 820 490
110 Food Allergen Mix FOOD 1100 660
111 Food Intolerance Test FIT 5500 5500
112 Food Panel Extensive ( FPEX ) ASTHMA 10300 6200
113 Free/Total PSA Ratio FTPA 850 510
114 FRUCTOSAMINE FRUCT 750 450
115 Galactosemia ‐ Galactitol estimation in urine by BGLTT 2000 1600
GC‐MS
116 Galactosemia ‐ GALT enzyme (Quantitative) + Urine BGGLT 4500 3600
Galactitol (GC‐MS) urine by GC‐M5
117 Gamma GT GAMMA GT 275 165
118 Gentamicin Level ( Gentamycin ) GENTA 950 570
119 Glucose F GLUF 120 80
120 Glucose F ( Dialysis ) D‐GLUF 60 60
121 Glucose F ( Kidney Transplant ) KT‐GLUF 60 60
122 Glucose F ( Liver Transplant ) LT‐GLUF 60 60
123 Glucose F + Glucose PP ( 75 g Glucose ) GTT6 250 150
124 Glucose PP GLUP 120 80
125 Glucose PP ( Dialysis ) D‐GLUP 60 60
126 Glucose PP ( Kidney Transplant ) KT‐GLUP 60 60
127 Glucose PP ( Liver Transplant ) LT‐GLUP 60 60
128 Glucose Random GLUR 120 80
129 Glucose Random ( Dialysis ) D‐GLUR 60 60
130 Glucose Random ( Kidney Transplant ) KT‐GLUR 60 60
131 Glucose Random ( Liver Transplant ) LT‐GLUR 60 60
132 Glucose Tolerance Test ( 100 g ) ‐ ½ hrly x 3 hrs GTT8 700 420
133 Glucose Tolerance Test ( 100 g ) ‐ 1 hrly x 3 hrs GTT3 450 280
134 Glucose Tolerance Test ( 75 g ) ‐ ½ hrly x 2½ hrs GTT4 700 420
135 Glucose Tolerance Test ( 75 g ) ‐ ½ hrly x 3 hrs GTT5 750 450
138 Glucose Tolerance Test ( Standard GTT ) ( 75 g ) ‐ ½ GTT1 650 390
hrly x 2 hrs
139 Glycosylated Haemoglobin ( HbA1c ) GLYCOHA 650 390
140 Grass Allergen Mix GRASS 1100 660
141 HDL Cholesterol HDL 310 190
142 HE ‐ 4 HE4 3500 3500
143 HE ‐ 4 And CA 125 HE4CA 4000 4000
37
144 Homocysteine HMYT 1100 660
145 hS Troponin I TROP 1100 660
146 Immunoglobulin A ( IgA ) IGA 780 470
147 Immunoglobulin E ( IgE ) IGE 700 420
148 Immunoglobulin G ( IgG ) IGG 780 470
149 Immunoglobulin M ( IgM ) IGM 780 470
150 Immunological profile ( IgA, IgG, IgM ) IMMPROF 1980 1190
151 Immunological profile ( IgA, IgG, IgM, IgE ) IMMPROF‐I 2200 1320
152 Individual Allergen INDIVIDUALA 1100 660
153 Interleukin 6 ( IL6 ) INTER 1100 660
154 Lactate SLACTALI 450 270
155 LACTATE (FLUID) LACFLU 450 270
156 LDH LDH 300 180
157 LDL Cholesterol LDL 430 260
158 Legume Allergen Mix LEGUM 1100 660
159 LFT ‐ Liver Function Test ( Hepatic Profile ) HEPA 1150 690
160 LFT ‐ Liver Function Test ( Hepatic Profile ) ‐ ( Liver LT‐HEPA 575 575
Transplant )
161 Lipase SLIPASE 400 250
162 Lipid Profile LIPP 1200 720
163 Lipoprotein ( a ) LP 1000 600
164 Magnesium SMAG 275 165
165 Metabolic Profile (Ca,Phos, ALP, Lipid Profile, Vitamin METAPRO 4000 2500
B12, Glu F,PP, HbA1C, TSH, Uric Acid, Insulin F)
166 Mold Allergen Mix MOLD 1100 660
167 NAGL ( Urine ) ‐ Thesis Paed NAGLPRO
168 NGAL (Plasma) NGALP 1840 1100

169 NGAL (Urine) NGALU 1840 1100
170 NT‐ proBNP ( Biochemistry Lab ) NTPRO 1550 930
171 Ostase (Bone Alkaline Phosphatase) OSTASE 1800 1800
172 Phadiatop Atopic Screening Test ATOPIC 1100 660
173 Phenytoin / Dilantin Assay PHEN 1200 720
174 Phosphorus PHOS 185 110
175 Phosphorus ( Dialysis ) D‐PHOS 90 90
176 Porphyria ‐ Porphobilinogen in urine & plasma ( BPORUPL 1800 1450
Qualitative )
177 Porphyria ‐ Porphobilinogen in urine ( Qualitative + BPORQNQL 2500 2000
Quantitative )
178 Potassium POTA 185 110
179 Potassium ( Dialysis ) D‐POTA 90 90
180 Potassium ( Kidney Transplant ) KT‐POTA 90 90
181 Potassium ( Liver Transplant ) LT‐POTA 90 90
182 Prostatic Specific Antigen ( PSA ) PROST 700 450
183 Renal Anaemia Profile ( Biochemical ) ARENP 1250 750
(Fe,TIBC,Transferrin,Ferretin)
184 Renal Biochemical Profile ‐ Basic RENPI 1200 720
(BUN,Creat,Ca,PO,4,Na,K,Bicarbonate)
185 Renal Biochemical Profile ‐ Complete RENPP 1600 960
(BUN,Creat,Ca,PO4,Na,K,RBS,Uric,Prot,AlkPo4,Choles
t,Bicarbonate)
186 Respiratory Panel Extensive ( RESPEX ) WHEEZE 14000 8500
187 Respiratory Panel‐Mini (RESPMINI) WHEEZERM 8000 5000
188 Serum Cortisol SRC 550 330
189 Serum Creatinine CREA 180 110
190 Serum Creatinine ( Dialysis ) D‐CREA 95 95
191 Serum Creatinine ( Kidney Transplant ) KT‐CREA 95 95
192 Serum Creatinine ( Liver Transplant ) LT‐CREA 95 95
38
193 Serum Iron IRON 375 225
194 Serum Iron Binding Capacity ( TIBC ) TIBC 450 270
195 Serum Methotrexate Level METHO 1500 900
196 Serum Osmolality SEROSM 600 360
197 Serum Pre ‐ albumin level SPAL 1200 720
198 Serum procalcitonin SPROC 2200 1320
199 Serum total bile acids STBA 1000 600
200 Sodium SODI 185 110
201 Sodium ( Dialysis ) D‐SODI 90 90
202 Sodium ( Kidney Transplant ) KT‐SODI 90 90
203 Sodium ( Liver Transplant ) LT‐SODI 90 90
204 Sodium + Potassium + Chlorides + Bicarbonate SPC 700 420
205 Soluble Transferrin Receptor STRAREC 2500 2500
206 Stone Qualitative Analysis STON 700 420
207 Tacrolimus test TACRO 1800 1800
208 Tandem Mass Screening in newborn ‐ High Risk BTMSH 3000 3000
209 Tandem Mass Screening in newborn ( Outsourced ) BTMSN 2000 2000
210 Tandem Mass Screening in newborn ( Outsourced ) + BTMSNBNBSG 3000 2700
NBS (SGRH)
211 Theophylline THEO 1000 800
212 Thesis_Ferritin FERITHESIS 0 0
213 Total Antioxidant Status ( TAS ) TAS 1000 600
214 Total Beta‐ hCG ( Biochemistry ) BHC 640 380
215 Total Cholesterol CHOL 190 120
216 Total Proteins TPRO 300 180
217 Total Proteins ( Dialysis ) D‐TPRO 150 150
218 Transferrin TF 700 420
219 Tree Allergen Mix ‐ Juniperus TREEJ 1100 660
220 Tree Allergen Mix ‐ Pines TREEP 1100 660
221 Triglycerides TRIG 310 190
222 Tumor Necrosis Factor Alpha ( TNF Alpha ) TUFA 1200 720
223 Uric Acid URIA 180 110
224 Urinary ( Urine ) VMA (24 hours) UVMA 2000 1200
225 Urinary Albumin creatinine ratio UACR 350 210
226 Urine Osmolality OSMLU 600 360
227 Urine Spot Calcium : Creatinine Ratio SPOTCC 350 210
228 Urine Spot Test for Calcium USCA 200 130
229 URINE SPOT TEST FOR CHLORIDE CHLOSP 185 110
230 Urine Spot Test for Creatinine USCREAT 180 110
231 Urine Spot Test for Microalbumin ( Biochemistry ) MA 375 230
232 Urine Spot Test for Phosphorus USPOTPH 185 110
233 Urine Spot Test for Potassium UK 185 110
234 Urine Spot Test for Protein & Creatinine ( PC Ratio ) USPRCR 375 230
235 Urine Spot Test for Protein ( Excludes Albumin ) USPROT 300 180
236 Urine Spot Test for Sodium UNA 185 110
237 Urine Spot Test for Uric Acid USUR 180 110
238 Vancomycin Level VANCO 1000 800
239 Veg. Food Panel ( VEGFP ) ASTHMAR 8000 5000
240 Vegetable Allergen Mix VEGE 1100 660
241 Vitamin B 12 ( B12 ) VB12 900 540
242 VLDL Cholesterol VLDL 900 540
243 Weed Allergen Mix WEED 1100 660
244 Zinc Serum ZINCZN 800 500
245 Zinc Urine ZINCU 800 500
246 Glucose F + Glucose PP GLUCP 180 90
Glucose F GLUF
Glucose PP GLUP
39
247 Obesity Screening Package for Bariatric Surgery OSPBS 3000 3000
CBC ‐ Complete blood count CBC
Glucose F GLUF
Glycosylated Haemoglobin ( HbA1c ) GLYCOHA
Insulin Level ‐ Fasting INSULINLF
Lipid Profile LIPP
Thyroid Profile ( T3, T4, TSH ) T3T4TSH
248 Urine spot test for sodium & potassium URINSODPOTOS

Urine Spot Test for Potassium UK 185 110
Urine Spot Test for Sodium UNA 185 110
Blood gas analysis charges

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

Cardiac Laboratory

CAT 1/CAT2 CAT3
1 Screening Echo Cardiology SECAROS 1660

CAT 1/CAT2 CAT3
1 Diagnosis of Acute Myocardial Infarcation ( AMI ) CARAMI 1360 1100
Cardiac Dept
2 Diagnosis of Pulmonary Embolisation ( Cardiac Dept ) CARPE 950 680
3 Panel for diagnosis of breathlessness ( Cardiac Dept. ) CARBL 1950 1630
4 Prothrombin Time INR ( Cardiac Dept ) CARPT 400 270
5 Triage cardio profiler panel (Cardiac Dept.) CATCPP 1630 1300
Clinical Pathology Charges

CAT 1/CAT2 CAT3
1 Urine examination ( Routine / Microscopy ) URINERE 250 150
2 Urine for Acetone UROK 200 120
3 Urine for albumin / protein UROP 200 120
4 Urine for Bile pigment / salt BPIG 250 150
5 Urine for chyle URC 250 150
6 Urine for Dysmorphic RBCs UDYRBC 250 150
7 Urine for haemoglobin URHEM 280 170
8 Urine for myoglobin URMYO 280 170
9 Urine for porphobilinogen URP 360 220
10 Urine for sugar / reducing substance UROG 250 150
11 Urine for urobilinogen UROB 360 220
12 Urine pH URINEPH 160 100
13 Urine specific gravity URINESPGR 160 100
Diabetology Laboratory Charges

40
CAT 1/CAT2 CAT3
1 Blood Ketone Test BKT 370 320
2 Lipid Profile (Endocrinology) TCTT 1070 800
3 Spot Finger Prick Blood Glucose ( Endocrinology ) BGLU 120 90
4 Spot HbA1c ( Endocrinology ) HB‐1C 750 540
5 Spot Urine Micro‐Albuminuria ( Endocrinology ) UMA 750 540

Haematology Laboratory Charges

CAT 1/CAT2 CAT3
1 Absolute eosinophil count ( AEC ) AEC 300 180
2 Absolute Lymphocyte Count ( ALC ) ALC 300 180
3 Absolute neutrophil count ( ANC ) ANC 300 180
4 Acid phosphatase cytochemistry ( AP ) with/without CYTOAP 1800 1100
tartrate
5 AJAY AJAY 20 10
6 ANA Profile 3 ANA 2800 1700
7 Antibodies to ds ‐ DNA ( Enzyme Immuno Assay ) DNA 1300 800
8 Anti‐c ANCA ( anti ‐ PR3 ) AANCA‐AP 1850 1100
9 Anticardiolipin antibodies ( ACA ) ‐ IgG ACLG 1300 800
10 Anticardiolipin antibodies ( ACA ) ‐ IgM ACLM 1300 800
11 Anti‐p ANCA ( anti ‐ MPO ) AANCA‐AM 1850 1100
12 Antithrombin functional assay (Haematology) ANTITHROH 4000 2400
13 APT test APTS 320 200
14 APTT ( Activated partial thromboplastin time ) APTT 650 400
15 APTT based inhibitor screen APPTIN 1200 720
16 APTT mixing experiment APTTMIX 1100 720
17 Ascitic fluid cell counts ASF 520 310
18 B2 Glycoprotein 1 ( GPI ) IgG ELISA B2IGG 1700 1000
19 B2 Glycoprotein 1 ( GPI ) IgM ELISA B2IGM 1700 1000
20 Bethesda Assay BETH 16000 9500
21 Bone marrow and peripheral smear examination BMARROW1 2650 1600
22 Bone marrow slides for issue to patient ( 1 slide ) BMSFITP1S 340 200
23 CAPD fluid cell counts CAPD 520 310
24 CBC ‐ Complete blood count CBC 420 250
25 CBC , DLC with Peripheral smear CBCDLCPBF 700 420
26 CD 19 / CD 20 / CD45 by flowcytometry CD1945 3200 1900
27 Cell count CELLC 520 310
28 Cerebrospinal fluid ( CSF ) cell count CSF 520 310
29 Clot retraction test CRT 300 200
30 Clot solubility test ( Factor‐XIII ) CST 600 360
31 Coagulation factor IX assay COAGF9 2700 1600
32 Coagulation factor VIII assay COAGF8 2700 1600
33 Coagulation profile screening (PT / APTT/ TT / CBC / CPST 3700 2200
PS )
34 Complete blood count ( CBC ) ‐ ( Dialysis ) DCBC 320 250
35 Complete blood count ( CBC ) ‐ ( Kidney Transplant ) KT‐CBC 320 250
36 Complete blood count ( CBC ) ‐ ( Liver Transplant ) LT‐CBC 320 250
37 Complete blood count ( CBC ) with Differential CBCDLC 550 350
leukocyte count ( DLC )
38 Complete blood count ( CBC ) with Differential DCBCDLC 400 360
leukocyte count ( DLC ) ‐ ( Dialysis )
41
39 Complete blood count ( CBC ) with Differential KT‐CBCDLC 400 360
leukocyte count ( DLC ) ‐ ( Kidney Transplant )
40 Complete blood count ( CBC ) with Differential LT‐CBCDLC 400 360
leukocyte count ( DLC ) ‐ ( Liver Transplant )
41 D‐dimer D‐DIMER 1800 1100
42 Differential leukocyte count ( DLC ) DLC 350 210
43 Dihydrorhodamine Assay by Flow Cytometry DAFC 2400 1440
44 dRVVT screen dRVVT confirm LACC 2500 1500
45 Erythrocyte sedimentation rate ( ESR ) ESR 350 220
46 Factor II assay FACTOR2 3700 2600
47 Factor V assay FACTOR5 3200 2100
48 Factor V Leiden ( APC‐R) FVLEDN 4200 2500
49 Factor VII assay FACTOR7 3600 2600
50 Factor X assay FACTOR10 3200 2100
51 Factor Xa Heparin for Enoxaparin FXAENO 4200 2500
52 Factor XI assay FACTOR11 3700 2600
53 Factor XII assay FACTOR12 3700 2600
54 Factor XIII assay FACTOR13 10000 8000
55 Fibrinogen (Quantitative) FIBEST 1350 800
56 FLOW CYTOMETRIC FOR ANY SINGLE PANEL OF FCSLL 3600 2300
LEUKEMIA / LYMPHOMA
57 Flow Cytometry for Leucocyte adhesion defect type 1 FCFL 3200 2100
58 Flowcytometery ( CD 19 and CD 45 ) FLOWCD1945 2000 1250
59 Flowcytometery ( CD 20 and CD 45 ) FLOWCD2045 2000 1250
60 Flowcytometric DHR Assay and NBT slide Test DHRNBT 3100 2200
61 FLOWCYTOMETRIC HLA ‐ CROSS MATCH FCXM 12000 7200
62 Flowcytometric MDS Panel FMYMDS 8200 6100
63 Flowcytometry for Myeloma FMY 6000 4000
64 G‐6‐PD screening ( G6PD ) G6PD 530 320
65 Gastric aspirate for neutrophilis GAS 300 200
66 Haemoglobin ( Hb ) HB 240 140
67 Haemoglobin ( Hb ) ‐ Dialysis DHB 130 120
68 Haemoglobin ( Hb ) ‐ Transplant KT‐HB 130 120
69 Haemoglobin electrophoresis ‐ acid pH ( 6.0 ) HBELECACI 1000 600
70 Haemoglobin electrophoresis ‐ alkaline pH ( 8.6 ) HBELECALK 1000 600
71 Haemoglobin electrophoresis ( alkaline & acid pH ) HBELEC 2000 1200
72 Haemoglobin F cytochemistry ( Kleihauer test ) HBFCYTO 700 420
73 HB / PCV HBPCV 350 220
74 HbH Inclusion HBHI 470 280
75 Heinz bodies HZB 300 180
76 Hemosiderin in urine HSU 470 300
77 Heparin induced thrombocytopenia (gel card) HITA 2200 1600
78 Immature Platelet Fraction IPF 650 400
79 Immunodeficiency / HIV panel ( CD3 / CD4 / CD8 HIVIMM 3300 1950
counts )
80 Immunodeficiency / Non HIV panel BTCELL 3300 1950
81 Immunofixation electrophoresis ‐ 24 hrs urine IMMUNOU 10000 6000
82 Immunofixation electrophoresis ‐ serum IMMUNOS 9000 5400
83 Immunophenotyping ( flow cytometry ) ‐ Acute ACLP 17000 14000
leukemia panel (cMPO, cCD79a, c3, CD45, 19, 10, 5,
7, 3, 14, 13, 34, 33)
84 Immunophenotyping ( flow cytometry ) ‐ Chronic CLLPANEL 17000 14000
lymphocytic leukemia panel ( CLL ) ‐
k,l,CD45,19,5,10,FMC7,23,103,11c,38,56
85 Immunophenotyping ( flow cytometry ) ‐ Lymphoma LYMPHPANEL 17000 14200
panel (CD45, 19, 10, 5, 7, 3, 4, 8, k, l)
42
86 Immunophenotyping ( flow cytometry ) ‐ NK / NKCELL 5100 3050
Obstetric Panel
87 Immunophenotyping ( flow cytometry ) ‐ PNH panel PNHPAN 7500 4500
88 Incubation osmotic fragility ( CBC / PS / Retic) IOFT 1600 950
89 Iron Stain Bone Marrow ISBM 700 420
90 Leukocyte alkaline phosphatase ( LAP ) score CYTOLAP 1700 1000
91 Malaria antigen test ‐ Plasmodium falciparum / P. PLAS 870 520
vivax ( Immunochromatography )
92 Methaemoglobin estimation MHB 470 280
93 Microfilaria ( Peripheral smear ) MF 420 250
94 Myeloperoxidase ( MPO ) CYTOMPO 650 390
95 Myositis Profile 3 MSA 3200 1900
96 Nonspecific esterase ( NSE ) ‐ CAE CYTONSE 1800 1080
97 Osmotic fragility test ( CBC / PS / Retic) OST 1600 950
98 Pericardial fluid cell count PESF 520 310
99 Periodic acid schiff ( PAS ) CYTOPAS 1600 960
100 Peripheral smear for malaria ( MP ) MP 550 330
101 Platelet aggregation test for HIT (confirmatory PAT 1100 900
functional Assay)
102 Platelet count PLT 150 90
103 Platelet function test for bleeding disorders PFTFBD 8500 6000
104 Platelet function test for drug monitoring PFTFDM 6200 3900
105 Platelet function test for von Willebrand disease PFTFVWD 8500 6000
106 Pleural fluid cell count PLSF 520 310
107 Protein C functional assay PROTEINC 4200 2500
108 Protein S functional assay PROTEINS 4200 2500
109 Prothrombin time ( PT ) Haematology Lab PT 400 240
110 PT mixing experiment PTMIX 550 350
111 Renal/BMT Reticulocyte Count RBRC 600 360
112 Reticulocyte count RTIC 540 320
113 Review of stained bone biopsy section received from HBBS 1350 800
outside ( Hematology )
114 Screening for beta thalassemia / BTHAL 1500 900
haemoglobinopathies ( CBC / HbF / HbA2 )
115 Serum Freelight Chain Assay SFLCA 5000 3000
116 Serum protein electrophoresis ( SPE ) PROELECT 2000 1200
117 Sickling test SLT 400 250
118 Specific esterase ( SE ) ‐ ANAE / ANBE CYTOSE 1800 1080
119 STEM CELL ENUMERATION ( CD34 + CELL COUNT ) SCEN34 7600 4550
120 Synovial fluid cell count SYSF 520 310
121 Synovial fluid for crystals by Polarizer SYFLD 580 350
122 T‐B‐NK with CD4 & CD8 counts TBNK 6600 4100
123 Test for HbH Inclusion HBH 550 330
124 Thrombin time ( TT ) TT 770 460
125 Total leukocyte count ( TLC ) TC 250 150
126 Total leukocyte count ( TLC ) ‐ Transplant KT‐TLC 180 150
127 Urine For Eosinophils UFE 420 250
128 Urine protein electrophoresis URIELECTRO 3150 1900
129 Von Willebrand factor VONWILL 6400 3830
130 Von Willebrand Ristocetin Cofactor activity VWRCA 8200 6600
131 Complete blood count ( CBC ) with Erythrocyte CBCESR 650 400
sedimentation rate ( ESR )
CBC ‐ Complete blood count CBC
Erythrocyte sedimentation rate ( ESR ) ESR
132 Thromobophilia Panel ( Molecular + Coagulant assays ) ( THROMMH 18500 16000

Mutations of Factor V ( leiden ), Prothrombin, MTHFR
genes, Proteins C, Protein S, AT III, APCR, Lupus
Anticoagulant, Anti phospholipid antibody )
43
Anticardiolipin antibodies ( ACA ) ‐ IgG ACLG
Anticardiolipin antibodies ( ACA ) ‐ IgM ACLM
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
133 Von Willebrand factor & Von Willebrand Ristocetin VONWOS 13000 9000

Cofactor activity
Von Willebrand factor VONWILL
Von Willebrand Ristocetin Cofactor activity VWRCA
Histopathology Laboratory Charges

CAT 1/CAT2 CAT3
1 1 pathology slide for issue to patient ‐ NO Barcode FPSR 280 280
2 1 pathology slide for issue to patient (2nd time) ‐ NO PSIP21 430 430
Barcode
3 2 pathology slides for issue to patient ‐ NO Barcode FPSR2 430 430
4 2 pathology slides for issue to patient (2nd time) ‐ NO PSIP22 700 700
Barcode
5 3 pathology slides for issue to patient ‐ NO Barcode PSIP3 600 600
Barcode
Barcode
Barcode
Barcode
13 ANA , ASMA , ALKMA and AMA ‐ WITH Barcode ANASMALKMA 4960 2970
14 ANA , ASMA and ALKMA ‐ WITH Barcode ANASMALK 4150 2490
15 ANA with titration ANAWTIT 3850 2310
16 ANCA ‐ WITH Barcode ANCA 1100 660
17 Anti liver & kidney microsomal antibody ( ALKMA ) ‐ ALKMA 1530 920
WITH Barcode
18 Anti mitochondrial antibody ( AMA ) ‐ WITH Barcode AMA 1310 780
19 Anti nuclear antibodies ( ANA ) ‐ WITH Barcode HANA 1310 780
20 Anti nuclear antibodies ( ANA ) and Anti parietal cell ANAAPOA 2020 1210
antibody ( APCA ) ‐ WITH Barcode
21 Anti nuclear antibodies ( ANA ) and Anti smooth ANASMA 2020 1210
muscle antibody ( ASMA ) ‐ WITH Barcode
22 Anti nuclear antibodies ( ANA ) and Anti thyroid ANAATA 1740 1050
antibodies ( ATA ) ‐ WITH Barcode
23 Anti parietal cell antibody ( APCA ) ‐ WITH Barcode APOA 1310 780
44
24 Anti PLA2R antibody by indrect immunofluorescene PLA2R 6550 3930
25 Anti smooth muscle antibody ( ASMA ) ‐ WITH ASMA 1310 780
Barcode
26 Anti thyroid antibodies ( ATA )‐ WITH Barcode ATA 1310 780
(Histopathology)
27 ASMA , ALKMA and AMA ‐ WITH Barcode SMALKMA 2730 1640
28 Bile Duct Brushing for malignant cells ‐ Cytology MCBILE 970 590
29 Biopsy ( Extra large ) ‐ WITH Barcode BIOX 3930 2350
30 Biopsy ( Large ) ‐ WITH Barcode BIOL 2730 1640
31 Biopsy ( Medium ) ‐ WITH Barcode BIOM 2080 1240
32 Biopsy ( Small ) ‐ WITH Barcode BIOS 1370 820
33 Biopsy medium with IF study with 7 IF markers with BIOIMM7 6550 3930
barcodes
34 Biopsy Medium with Immuno fluroscent study ‐ WITH BIOIMM 5460 3270
Barcode
35 Block For Patient BFP 960 960
36 Bronchial washing/BAL/ET secretions for malignant MCBRO 1220 760
cells ‐ Cytology
37 CSF for malignant cells ‐ Cytology MCCSF 800 480
38 Cyst Fluid for malignant cells ‐ Cytology MCCYST 800 480
39 Cytology of aspirate /any smear for cytology WITH FNACN 1100 660
Barcode
40 DSDNA ‐ WITH Barcode DSDNA 1100 660
41 Enzyme Histochemistry ‐ Each additional enzyme ENZHISE 1370 820
stain ‐ Histopathology
42 Enzyme Histochemistry ‐ One enzyme stain ‐ ENZHIS 2430 1460
Histopathology
43 FNAC Cytology of aspirate (DONE IN PATHOLOGY ASFNAC 1940 1170
LAB) WITH Barcode
44 FNAC for Endoscopic ultrasound specimen ( EUSFNAC MCEUS 3320 1990
) ‐ Cytology
45 Frozen section (including subsequent paraffin FSECTPS 2080 1240
processing) ( 1 to 2 samples)‐ WITH Barcode
46 Frozen section (including subsequent paraffin FSECTPSB 2940 1770
47 Frozen section (including subsequent paraffin FSECTPSC 4580 2750
48 Frozen section (including subsequent paraffin FSECTPSC7 6760 4060
processing) ( 7 or more samples) ‐ WITH barcode
49 HPV‐DNA ( High Risk ) Cervical Sample HPVDNAH 3190 1940
50 IHC 10 markers and above / ADD ON without barcode IHS10H 15280 9170
51 IHC 10 markers and above with barcode IHS10 15280 9170
52 IHC 7 markers / ADD ON without barcode IHS7H 11570 6940
53 IHC 7 markers with barcode IHS7 11570 6940
54 IHC 8 Markers ‐ With Barcode IHC8 11340 6810
55 IHC 8 markers ‐ Without Barcode IHC8H 11340 6810
56 IHC 9 markers / ADD ON without barcode IHS9H 12880 7730
57 IHC 9 markers with barcode IHS9 12880 7730
58 Immuno fluroscent staining ( 1 stain ) ‐ WITH Barcode IFS1 1090 650
59 Immuno fluroscent staining ( 2 stains ) ‐ WITH IFS2 1850 1480
Barcode
Barcode
Barcode
Barcode
45
63 Immuno histochemistry ADD ON staining ( IHISTCHEM1C 1680 1010
Cytopathology ) ‐ 1 stain NO Barcode
Cytopathology ) ‐ 2 stains NO Barcode
66 Immuno histochemistry ADD ON staining ( IHS4C 6080 3650
67 Immuno histochemistry ADD ON staining ( IHISTCHEM1H 2080 1240
Histopathology ) ‐ 1 stain ‐ NO Barcode
Histopathology ) ‐ 2 stains ‐ NO Barcode
70 Immuno histochemistry ADD ON staining ( IHS4H 6390 3830
71 Immuno histochemistry staining ( 1 stain ) WITH IHISTCHEM 1970 1180
barcode
72 Immuno histochemistry staining ( 2 stain ) ‐ WITH IHISTCHEM2 3930 2350
Barcode
73 Immuno histochemistry staining ( 3 stain ) ‐ WITH IHISTCHEM3 5560 3340
Barcode
74 Immuno histochemistry staining ( 4 stains ) WITH IHS4 6330 3800
barcode
75 Immuno histochemistry staining ( 5 stain ) WITH IHS5 8950 5370
barcode
76 Immuno histochemistry staining ( 5 stain ) WITHOUT IHS5H 7640 4580
barcode
77 Microwave processing for rapid diagnosis (small MPRD 4370 2620
biopsies)
78 One to two stained histopathology slide(s) from FPS1 820 820
outside for opinion ‐ WITH Barcode
79 PAP smear / Hormonal smear / Vault smear / Cervical PAPS 590 350
smear WITH Barcode
80 Paraffin Blocks / Unstained slides received from PBUSM3 2080 1240
outside (more than 3) ‐ WITH Barcode
81 Paraffin Blocks / Unstained slides received from PBUS 1640 980
outside (up to 3) ‐ WITH Barcode
82 Pleural / Ascitic / Pericardial / Peritoneal wash /any MCPLE 970 590
other fluid for malignant cells ‐ Cytology
83 Remaining of frozen tissue ( Extra Large ) ‐ NO REMXLARGE 4150 2490
Barcode
84 Remaining of frozen tissue ( Large ) ‐ NO Barcode REMLARGE 2730 1970
85 Remaining of frozen tissue ( Medium ) ‐ NO Barcode REMMEDIUM 2080 1240
86 Remaining of frozen tissue ( Small ) ‐ NO Barcode REMSMALL 1370 820
87 Six and more stained histopathology slide(s) from FPS6 1640 1640
88 Sputum for malignant cells ‐ Cytology MCSPU 800 480
89 Stained pathology slide (s) from outside for opinion ( STPHCY3 830 830
Cytopathology ) ‐ More than 2 WITH Barcode
90 Stained pathology slide (s) from outside for opinion ( STPHCY2 490 490
Cytopathology ) ‐ Up to 2 WITH Barcode
91 Three to five stained histopathology slide(s) from FPS3‐5 1090 1090
92 Trans bronchial needle aspiration ( TBNA ) Reporting MCTBNA 1220 760
for malignant cells ‐ Cytology
46
93 Ultrasound/CT guided FNAC Reporting for malignant MCFNAC 1660 1000
cells ‐ Cytology
94 Urine for malignant cells ( 1 sample ) ‐ Cytology MCURI 800 480
95 Urine for malignant cells ( 3 samples ) ‐ Cytology MCURI3 2200 1330
96 Vaginal / cervical cytology by liquid base cytology ( LBC 1240 750
LBC )
Microbiology Laboratory Charges

CAT 1/CAT2 CAT3
1 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTASP 1970 1180
Method ( Aspirate )
2 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTASPF 1970 1180
Method ( Aspiration fluid )
3 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTBLF 1970 1180
Method ( Blister fluid )
4 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTBRW 1970 1180
Method ( Bronchial washing )
5 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTBRL 1970 1180
Method ( Bronchoalveolar lavage )
6 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTCIF 1970 1180
Method ( Chest irrigation fluid )
7 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTCSF 1970 1180
Method ( CSF )
8 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTDRF 1970 1180
Method ( Drainage fluid )
9 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULET 1970 1180
Method ( ET Secretion )
10 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTGTA 1970 1180
Method ( Gastric aspirate )
11 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULT 1970 1180
Method ( Miscellaneous )
12 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTMTV 1970 1180
Method ( Mitral valve )
13 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTPDF 1970 1180
Method ( P.D. fluid )
14 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTPCF 1970 1180
Method ( Pericardial fluid )
15 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTPNF 1970 1180
Method ( Peritoneal fluid )
16 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTPLF 1970 1180
Method ( Pleural fluid )
17 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTPUS 1970 1180
Method ( Pus )
18 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTRVF 1970 1180
Method ( Romovac fluid )
19 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTSPM 1970 1180
Method ( Sputum )
20 (OPD case only) AFB culture and sensitivity ‐ LJ AFPCULTSTL 1970 1180
Method ( Stool )
21 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTSYF 1970 1180
Method ( Synovial fluid )
22 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTTIS 1970 1180
Method ( Tissue )
47
23 (OPD case only) AFB culture and sensitivity ‐ LJ AFBCULTURI 1970 1180
Method ( Urine )
24 Active Hepatitis B profile AHBP 6560 3940
25 Adenovirus Quantitative real time PCR (BAL) AVQBAL 6970 4180
26 Adenovirus Quantitative real time PCR (BLOOD) AVQBLD 6970 4180
27 Adenovirus Quantitative real time PCR (MIS) AVQMIS 6970 4180
28 Adenovirus Quantitative real time PCR (NASAL SWAB) AVQNALS 6970 4180
29 Adenovirus Quantitative real time PCR (THROAT AVQTHS 6970 4180
SWAB)
30 Aerobic blood culture and sensitivity AEROBLD 870 520
31 Albert staining ( C. diphtheria ) ALBSTCDT 470 280
32 Anaerobic culture ( Aspiration fluid ) ANAECULTASPF 1970 1180
33 Anaerobic culture ( CSF ) ANAECULTCSF 1970 1180
34 Anaerobic culture ( Drainage fluid ) ANAECULTDRF 1970 1180
35 Anaerobic culture ( Miscellaneous ) ANAECULT 1970 1180
36 Anaerobic culture ( Mitral valve ) ANAECULTMIV 1970 1180
37 Anaerobic culture ( P. D. fluid ) ANAECULTPDF 1970 1180
38 Anaerobic culture ( Pericardial fluid ) ANAECULTPEF 1970 1180
39 Anaerobic culture ( Peritoneal fluid ) ANAECULTPRF 1970 1180
40 Anaerobic culture ( Pleural fluid ) ANAECULTPLF 1970 1180
41 Anaerobic culture ( PUS ) ANAECULTPUS 1970 1180
42 Anaerobic culture ( Synovial Fluid ) ACSSF 1970 1180
43 Anaerobic culture ( Tissue ) ANAECULTTIS 1970 1180
44 Anaerobic culture ( Urine ) ANAECULTURN 1970 1180
45 Anaerobic culture and sensitivity ( Aspirate ) ANAECULTASP 1970 1180
46 Anti CCP ( Immunoscan R A ) ANTICPP 2210 1330
47 Anti HAV ‐ IgM ( hepatitis A virus serology ) HAVT 1550 930
48 Anti HBc ‐ IgM ( hepatitis B virus serology ) ANTIHBC 1720 1040
49 Anti HBeAg serology ANTIHBE 1880 1130
50 Anti HEV ‐ IgM ( hepatitis E virus serology ) HEVT 2210 1330
51 Anti yeast sensitivity ( Blood ) CANDIFBLD 1430 860
52 Anti yeast sensitivity ( Bone marrow ) CANDIFBOM 1430 860
53 Anti yeast sensitivity ( Bronchial washing ) CANDIFBRW 1430 860
54 Anti yeast sensitivity ( Bronchoalveolar lavage ) CANDIFBRL 1430 860
55 Anti yeast sensitivity ( CSF ) CANDIFCSF 1430 860
56 Anti yeast sensitivity ( Drain Fluid ) CANDIDRA 1430 860
57 Anti yeast sensitivity ( E. T. secretion ) CANDIFETS 1430 860
58 Anti yeast sensitivity ( Miscellaneous ) CANDIF 1430 860
59 Anti yeast sensitivity ( P.D. fluid ) CANDIFPDF 1430 860
60 Anti yeast sensitivity ( Pericardial fluid ) CANDIFPEF 1430 860
61 Anti yeast sensitivity ( Peritoneal fluid ) CANDIFPRF 1430 860
62 Anti yeast sensitivity ( Pleural fluid ) CANDIFPLF 1430 860
63 Anti yeast sensitivity ( Pus ) CANDIFPUS 1430 860
64 Anti yeast sensitivity ( Sputum ) CANDIFSPU 1430 860
65 Anti yeast sensitivity ( Tissue ) CANDIFTIS 1430 860
66 Anti yeast sensitivity ( Urine ) CANDIFURN 1430 860
67 Antibody titre serology for HBsAg ANTIHBSAG 780 470
68 Antistreptolyson O titre ASO 1240 750
69 BacT/Alert aerobic culture ( Aspirate ) AERBTA+B‐ASP 2200 1330
70 BacT/Alert aerobic culture ( Blood ) AERBTA+B‐BLD 2200 1330
71 BacT/Alert aerobic culture ( Bone Marrow ) AERBTA+B‐BM 2200 1330
72 BacT/Alert aerobic culture ( Bronchial washing ) AERBTA+B‐BRO 2200 1330
73 BacT/Alert aerobic culture ( CSF ) AERBTACSF 2200 1330
74 BacT/Alert aerobic culture ( Drainage fluid ) AERBTA+B‐DRA 2200 1330
75 BacT/Alert aerobic culture ( Miscellaneous ) AERBTA+B 2200 1330
76 BacT/Alert aerobic culture ( P.D. fluid ) AERBTA+B‐PDF 2200 1330
77 BacT/Alert aerobic culture ( Pericardial fluid ) AERBTA+B‐PEC 2200 1330
48
78 BacT/Alert aerobic culture ( Peritoneal fluid ) AERBTA+B‐PET 2200 1330
79 BacT/Alert aerobic culture ( Pleural fluid ) AERBTA+B‐PLE 2200 1330
80 BacT/Alert aerobic culture ( Pus ) AERBTA+B‐PUS 2200 1330
81 BacT/Alert aerobic culture ( Synovial fluid ) AERBTA+B‐SYN 2200 1330
82 BacT/Alert anaerobic culture ( Aspirate ) ANABTA+BASP 2200 1330
83 BacT/Alert anaerobic culture ( Aspiration fluid ) ANABTA+BASF 2200 1330
84 BacT/Alert anaerobic culture ( Blood ) ANABTA+BBLD 2200 1330
85 BacT/Alert anaerobic culture ( Bone Marrow) ANABTA+BBON 2200 1330
86 BacT/Alert anaerobic culture ( CSF ) ANABTA+BCSF 2200 1330
87 BacT/Alert anaerobic culture ( Miscellaneous ) ANABTA+B 2200 1330
88 BacT/Alert anaerobic culture ( P. D. fluid ) ANABTA+BPDF 2200 1330
89 BacT/Alert anaerobic culture ( Pericardial fluid ) ANABTA+BPER 2200 1330
90 BacT/Alert anaerobic culture ( Peritoneal fluid ) ANABTA+BPEF 2200 1330
91 BacT/Alert anaerobic culture ( Pleural fluid ) ANABTA+BPLE 2200 1330
92 BacT/Alert anaerobic culture ( Pus ) ANABTA+BPUS 2200 1330
93 BacT/Alert anaerobic culture ( Tissue ) ANABTA+BTIS 2200 1330
94 BacT/Alert anaerobic culture ( Urine ) ANABTA+BURI 2200 1330
95 BK Polyomavirus Quantitative real time PCR (BLOOD) BKPQBLD 6970 4180
96 BK Polyomavirus Quantitative real time PCR (CSF) BKPQCSF 6970 4180
97 BK Polyomavirus Quantitative real time PCR (MISC) BKPQMIS 6970 4180
98 BK Polyomavirus Quantitative real time PCR (URINE) BKPQURI 6970 4180
99 Brucella antibody assay BAS 890 540
100 C ‐ Reactive protein ( CRP ) CRP 890 540
101 CAPD Fluid Microscopy ( Cell count + Gram Stain + CAPDFCUL 620 370
KOH )
102 Charges for screening tests for blood donor BLOODDS 4560 2740
103 Chikungunya & Dengue Real Time Qualitative PCR CDRTPCQ 3210 3210
104 Chikungunya IgM spot assay (Microbiology dept) CHGUIGMSPOT 640 640
105 Chikungunya Real Time Qualitative PCR CRTQPCR 1610 1610
106 Clostridium Difficile toxin A & B CDTAB 2010 1210
107 CMV antibody IgG CMVAG 780 470
108 CMV antibody IgM CMVAM 730 440
109 CMV avidity IgG CMVAVIGG 1440 870
110 CMV Quantitative Real Time PCR ‐ Microbiology CMVQRTP 6970 4990
111 Cryptococcus antigen test ( Cryptola ) ‐ Blood CDT 2210 1330
112 Cryptococcus antigen test ( Cryptola ) ‐ CSF CDTCSF 2210 1330
113 CSF bacterial antigen test for meningitis causing CSFBATM 2900 1740
organsims
114 CSF VDRL VDRLCSF 330 200
115 Cysticercosis antibody test ( ELISA ) CYSTICER 1880 1130
116 Dengue antibody serology (IgM) DENGU 640 640
117 Dengue Duo spot plus test ( IgG / IgM / NS ‐ 1 ) DDSTPLIGGIGM 3010 1810
118 Dengue Duo spot test ( IgG / IgM ) DDSTIGGIGM 2420 1460
119 Dengue NS 1 Antigen Assay DENGUNS1 640 640
120 Dengue Real Time PCR DENREATPC 1610 1610
121 Direct Fluorescent staining for AFB ( Aspirate ) FLUOREAFBASP 1130 680
122 Direct Fluorescent staining for AFB ( Aspirate ) FLUOREAFBASPN
Northern Railway
123 Direct Fluorescent staining for AFB ( Aspiration fluid ) FLUOREAFBASPF 1130 680
124 Direct Fluorescent staining for AFB ( Aspiration FLUOREAFBASPS 1130 680
smears )
125 Direct Fluorescent staining for AFB ( Bone marrow ) FLUOREAFBBOM 1130 680
126 Direct Fluorescent staining for AFB ( Bronchial FLUOREAFBBRW 1130 680
washing )
127 Direct Fluorescent staining for AFB ( Bronchoalveolar FLUOREAFBBRL 1130 680
lavage )
49
128 Direct Fluorescent staining for AFB ( Chest irrigatin FLUOREAFBCIF 1130 680
fluid )
129 Direct Fluorescent staining for AFB ( CSF ) FLUOREAFBCSF 1130 680
130 Direct Fluorescent staining for AFB ( Drainage fluid ) FLUOREAFBDRF 1130 680
131 Direct Fluorescent staining for AFB ( E. T. secretion ) FLUOREAFBETS 1130 680
132 Direct Fluorescent Staining for AFB ( Gastrtric FLUOREAFBGAS 1130 680
aspirate )
133 Direct Fluorescent staining for AFB ( Miscellaneous ) FLUOREAFB 1130 680
134 Direct Fluorescent staining for AFB ( P. D. fluid ) FLUOREAFBPDF 1130 680
135 Direct Fluorescent staining for AFB ( Pericardial fluid ) FLUOREAFBPEF 1130 680
136 Direct Fluorescent staining for AFB ( Peritoneal fluid ) FLUOREAFBPRF 1130 680
137 Direct Fluorescent staining for AFB ( Pleural fluid ) FLUOREAFBPLF 1130 680
138 Direct Fluorescent staining for AFB ( PUS ) FLUOREAFBPUS 1130 680
139 Direct Fluorescent staining for AFB ( Sputum ) FLUOREAFBSPU 1130 680
140 Direct Fluorescent staining for AFB ( Stool ) FLUOREAFBSTO 1130 680
141 Direct Fluorescent staining for AFB ( Synovial fluid ) FLUOREAFBSYF 1130 680
142 Direct Fluorescent staining for AFB ( Tissue ) FLUOREAFBTIS 1130 680
143 Direct Fluorescent staining for AFB ( Urine ) FLUOREAFBURN 1130 680
144 E histolytica antibody test (IgG) ‐ Amoebic serology IGGEHIST 1410 850
145 EBV Quantitative Real Time PCR EBQRTP 6970 4990
146 Echinococcus antibody test ( ELISA ) ‐ Hydatid ECHINOIGG 1270 760
serology
147 ELISA for Chikungunya IgM EFCI 640 640
148 Enterovirus real time PCR (Microbiology) ERTN 7450 4470
149 Fungal culture ( Aspiration fluid ) FUNGCULTAPF 1130 680
150 Fungal culture ( Blister fluid ) FUNGCULTBTF 1130 680
151 Fungal culture ( Bronchial washing ) FUNGCULTBRW 1130 680
152 Fungal culture ( Bronchoalveolar lavage ) FUNGCULTBRL 1130 680
153 Fungal culture ( CSF ) FUNGCULTCSF 1130 680
154 Fungal culture ( Drainage fluid ) FUNGCULTDRF 1130 680
155 Fungal culture ( E. T. secretion ) FUNGCULTETS 1130 680
156 Fungal culture ( Faecal fluid ) FUNGCULTFLF 1130 680
157 Fungal culture ( Hair ) FUNGCULTHAIR 1130 680
158 Fungal culture ( Miscellaneous ) FUNGCULT 1130 680
159 Fungal culture ( Nail ) FUNGCULTNAIL 1130 680
160 Fungal culture ( P. D. fluid ) FUNGCULTPDF 1130 680
161 Fungal culture ( Percardial fluid ) FUNGCULTPCF 1130 680
162 Fungal culture ( Peritoneal fluid ) FUNGCULTPTF 1130 680
163 Fungal culture ( Pleural fluid ) FUNGCULTPLF 1130 680
164 Fungal culture ( PUS ) FUNGCULTPUS 1130 680
165 Fungal culture ( Skin scrapings ) FUNGCULTSKIN 1130 680
166 Fungal culture ( Sputum ) FUNGCULTSPU 1130 680
167 Fungal culture ( Stool ) FUNGCULTSTL 1130 680
168 Fungal culture ( Synovial fluid ) FUNGCULTSYF 1130 680
169 Fungal culture ( Tissue ) FUNGCULTTIS 1130 680
170 Fungal culture ( Urine ) FUNGCULTURN 1130 680
171 Fungal culture by Bact Alert ( Blood ) FUNGCULBLD 2200 1330
172 Fungal culture by Bact Alert ( Bone Marrow ) FUNGCULBONE 2200 1330
173 Fungal smear ‐ India ink preparation for cryptococcus INDINK 300 180
174 Fungal smear ‐ KOH preparation ( Ascitic fluid ) KOHMEFATF 270 160
175 Fungal smear ‐ KOH preparation for fungus ( Aspirate KOHMEFASP 270 160
)
176 Fungal smear ‐ KOH preparation for fungus ( KOHMEFAPS 270 160
Aspiration fluid )
177 Fungal smear ‐ KOH preparation for fungus ( Blister KOHMEFBLF 270 160
fluid )
50
178 Fungal smear ‐ KOH preparation for fungus ( Bone KOHMEFBMW 270 160
marrow )
179 Fungal smear ‐ KOH preparation for fungus ( KOHMEFBRW 270 160
Bronchial washing )
180 Fungal smear ‐ KOH preparation for fungus ( KOHMEFBRL 270 160
Bronchoalveolar lavage )
181 Fungal smear ‐ KOH preparation for fungus ( Chest KOHMEFCIF 270 160
irrigation fluid )
182 Fungal smear ‐ KOH preparation for fungus ( Chest KOHMEFCWS 270 160
wound swab )
183 Fungal smear ‐ KOH preparation for fungus ( Drainage KOHMEFDRF 270 160
fluid )
184 Fungal smear ‐ KOH preparation for fungus ( E.T. KOHMEFETS 270 160
secretion )
185 Fungal smear ‐ KOH preparation for fungus ( Ear swab KOHMEFERS 270 160
)
186 Fungal smear ‐ KOH preparation for fungus ( Eye KOHMEFEYS 270 160
swab )
187 Fungal smear ‐ KOH preparation for fungus ( Gastric KOHMEFGTS 270 160
aspirate )
188 Fungal smear ‐ KOH preparation for fungus ( Hair ) KOHMEFHAIR 270 160
189 Fungal smear ‐ KOH preparation for fungus ( KOHMEFLYS 270 160
Laryngeal swab )
190 Fungal smear ‐ KOH preparation for fungus ( KOHMEF 270
Miscellaneous )
191 Fungal smear ‐ KOH preparation for fungus ( Nail ) KOHMEFNAIL 270 160
192 Fungal smear ‐ KOH preparation for fungus ( P.D. fluid KOHMEFPDF 270 160
)
193 Fungal smear ‐ KOH preparation for fungus ( KOHMEFPCF 270 160
Pericardial fluid )
194 Fungal smear ‐ KOH preparation for fungus ( KOHMEFPTF 270 160
Peritoneal fluid )
195 Fungal smear ‐ KOH preparation for fungus ( Pleural KOHMEFPLF 270 160
fluid )
196 Fungal smear ‐ KOH preparation for fungus ( Pus ) KOHMEFPUS 270 160
197 Fungal smear ‐ KOH preparation for fungus ( KOHMEFRVF 270 160
Romovac fluid )
198 Fungal smear ‐ KOH preparation for fungus ( Skin KOHMEFSKIN 270 160
scrapings )
199 Fungal smear ‐ KOH preparation for fungus ( Sputum ) KOHMEFSPU 270 160
200 Fungal smear ‐ KOH preparation for fungus ( Stool ) KOHMEFSTOOL 270 160
201 Fungal smear ‐ KOH preparation for fungus ( Synovial KOHMEFSYF 270 160
fluid )
202 Fungal smear ‐ KOH preparation for fungus ( Tissue ) KOHMEFTIS 270 160
203 Fungal smear ‐ KOH preparation for fungus ( Urine ) KOHMEFURN 270 160
204 Fungal smear ‐ KOH preparation for fungus ( Vaginal KOHMEFVGS 270 160
swab )
205 Galactomannam test for aspergillus PAG 2080 1240
206 Gen Probe for T.B. TBGENPROBE 4390 3570
207 Giemsa stain ( Aspiration smears ) ‐ Inclusion bodies GIEMSAASP 300 180
in CMV or herpes
208 Giemsa stain ( Blister fluid ) ‐ Inclusion bodies in CMV GIEMSABLF 300 180
or herpes
209 Giemsa stain ( Bronchial washing ) ‐ PCP / Inclusion GIEMSABRW 300 180
bodies in CMV or herpes
210 Giemsa stain ( E.T. secretion ) ‐ PCP GIEMSAETS 300 180
51
211 Giemsa stain ( Miscellaneous ) ‐ Inclusion bodies in GIEMSA 300 180
CMV or herpes
212 Giemsa stain ( Sputum ) ‐ PCP GIEMSASPU 300 180
213 Giemsa stain ( Tissue ) ‐ Inclusion bodies in CMV or GIEMSATIS 300 180
herpes
214 Gram stain ( Aortic valve ) GRMSTAINAOV 300 180
215 Gram stain ( Ascitic fluid) GRMSTAINASC 300 180
216 Gram stain ( Aspirate) GRMSTAINASE 300 180
217 Gram stain ( Aspiration fluid ) GRMSTAINASF 300 180
218 Gram stain ( Aspiration smears) GRMSTAINASP 300 180
219 Gram stain ( Blister fluid ) GRMSTAINBLF 300 180
220 Gram stain ( Bronchial washing ) GRMSTAINBRW 300 180
221 Gram stain ( Bronchoalveolar lavage ) GRMSTAINBVL 300 180
222 Gram stain ( Chest irrigation fluid ) GRMSTAINCIF 300 180
223 Gram stain ( CSF ) GRMSTAINCSF 300 180
224 Gram stain ( CT guided aspirate ) GRMSTAINCTGA 300 180
225 Gram stain ( Drainage fluid ) GRMSTAINDRF 300 180
226 Gram stain ( E.T. secretion ) RCULTUREETS 300 180
227 Gram stain ( Laryngeal swab ) GRMSTAINLAS 300 180
228 Gram stain ( Miscellaneous ) GRMSTAIN 300 180
229 Gram stain ( P.D. fluid ) GRMSTAINPDF 300 180
230 Gram stain ( Pericardial fluid ) GRMSTAINPEF 300 180
231 Gram stain ( Peritoneal fluid ) GRMSTAINPER 300 180
232 Gram stain ( Pleural fluid ) GRMSTAINPLF 300 180
233 Gram stain ( Pus ) GRMSTAINPUS 300 180
234 Gram stain ( Romovac fluid ) GRMSTAINROF 300 180
235 Gram stain ( Semen ) GRMSTAINSEM 300 180
236 Gram stain ( Sputum ) GRMSTAINSPU 300 180
237 Gram stain ( Stool ) GRMSTAINSTO 300 180
238 Gram stain ( Throat swab ) GRMSTAINTHS 300 180
239 Gram stain ( Tissue ) GRMSTAINTIS 300 180
240 Gram stain ( Urine ) GRMSTAINURN 300 180
241 Gram stain ( Vaginal swab / High vaginal swab ) GRMSTAINVAS 300 180
242 Gram stain ( Venticular fluid ) GRMSTAINVEF 300 180
243 Gram stain ( Wound swab ) GRMSTAINWOS 300 180
244 Group B Streptococci Screening GBSS 1060 630
245 H1N1 / 09 SWINE FLU Qualitative Real Time PCR H1N1 5300 3730
246 Hanging Drop examination ( Stool ) HDROP 260 150
247 HBeAg for hepatitis B HBE 1860 1110
248 HBsAg ( Australia antigen ) HBSAG 780 470
249 HBsAg ( Australia antigen ) ( Dialysis ) DHBSAG 390 390
250 HBsAG SPOT HBSAGSPOT 1340 800
251 HBV Monitor ( Quantitative ) HBVM 11910 7150
252 HBV Qualitative HBVQ 7040 4230
253 HCV Monitor ( Quantitative ) HCVM 12950 7770
254 HCV Qualitative HCVQ 6470 3880
255 HCV Spot test HCVSPOT 1550 930
256 Hepatitis B core specific antibody ( total ) HEPBCSAT 1340 800
257 Hepatitis C virus serology antibody test HCV 1040 620
258 Hepatitis C virus serology antibody test ( Dialysis ) DHCV 510 510
259 Hepatitis E Virus Quantitative Real Time PCR HENRNA 5410
260 Herpes antibody ( IgG ) ‐ Blood HERPAN 1440 870
261 Herpes antibody ( IgG ) ‐ CSF HERPANCSF 1440 870
262 Herpes antibody ( IgM ) ‐ Blood HERPA 1440 870
263 Herpes antibody ( IgM ) ‐ CSF HERPACSF 1440 870
264 HIC Screen Blood Culture Aerobic HICBCA 2210 1330
265 HIC Screen Endotracheal secretion culture HICESC 1240 750
52
266 HIC Screen Stool Culture HICST 1240 750
267 HIC Screen Urine Culture HICUC 1130 680
268 HIV antibody test HIV 780 470
269 HIV antibody test ( Dialysis ) DHIV 390 390
270 HIV Qualitative HIVQ 7770 4670
271 HIV Spot test HIVSPOT 1030 620
272 HSV 1 & 2 and VZV real time PCR (CSF) HSVCSF 9020 5410
273 HSV 1 & 2 real time PCR (BLOOD) HSVBLD 9020 5410
274 HSV 1 & 2 real time PCR (MIS) HSVMIS 9020 5410
275 IgG4 Serum Levels IGG4 3210 2140
276 Influenza A and B Qualitative PCR INABQL 7380 4430
277 JC Polyomavirus Qualitative real time PCR (BLOOD) JCVQBLD 6970 4180
278 JC Polyomavirus Qualitative real time PCR (CSF) JCVQCSF 6970 4180
279 JC Polyomavirus Qualitative real time PCR (MIS) JCVQMIS 6970 4180
280 JC Polyomavirus Qualitative real time PCR (URINE) JCVQURI 6970 4180
281 Kidney Transplant Urine Routine Microscopy KTURMCRO 50 30
282 Kinyoun Stain ( Nocardia / Cryptospordium ) ‐ KINYOUNBRW 430 260
Bronchial washing
283 Kinyoun Stain ( Nocardia / Cryptospordium ) ‐ KINYOUNBRO 430 260
Bronchoalvcolar lavage
284 Kinyoun Stain ( Nocardia / Cryptospordium ) ‐ E.T. KINYOUNETS 430 260
Secretion
285 Kinyoun Stain ( Nocardia / Cryptospordium ) ‐ Other KINYOUN 430 260
fluids (NOT FOR CSF)
286 Kinyoun Stain ( Nocardia / Cryptospordium ) ‐ Pleural KINYOUNPLF 430 260
fluid
287 Kinyoun Stain ( Nocardia / Cryptospordium ) ‐ Pus KINYOUNPUS 430 260
288 Kinyoun Stain ( Nocardia / Cryptospordium ) ‐ Sputum KINYOUNSPU 430 260
289 Kinyoun Stain ( Nocardia / Cryptospordium ) ‐ Stool KINYOUNSTO 430 260
290 Legionella urinary antigen test LUAT 2460 1480
291 Leptospira IgM LEPTOIGM 1610 960
292 Mantoux test MONTOUX 200 120
293 Modified ZN stain ( M. leprae ) ‐ Slit smears nasal ZNMLEPNASAL 420 250
septum
294 Modified ZN stain ( M. leprae ) ‐ Slit smears skin ZNMLEPSKIN 420 250
295 Monospot test MSPOT 660 400
296 Nasba HIV QT (Quantitative) HIVQT 8200 5490
297 Pneumocystis carinii Immunoflourescent PCI 2210 1330
298 Quantiferon Gold QUQNGOLD 5490 4390
299 Rapid AFB culture ‐ (BacT/ALERT 3D) + Accuprobe AFB4DRUGBLD 7930 5550
identification and sensitivity 4 drugs BLOOD ‐
Streptomycin, Isoniazid, Rifampicin and Ethambutol
(SIRE)
300 Rapid AFB culture ( BacT/Alert 3D ) with accuprobe RAPIDWITHOUTSEN 2010 1410
identification without sensitivity
301 Rapid AFB culture ( BacT/Alert 3D ) with accuprobe RAPIDWITHOUTSEN
identification without sensitivity Northern Railway
302 Rapid AFB culture (BacT/ALERT 3D) + Accuprobe AFB10DRUGBLD 17850 13880
identification and sensitivity 10 drugs BLOOD ‐ SIRE ,
Ofloxacin, Amikacin, kanamycin, Capreomycin, PAS
and D‐ Cycloserine
303 Rapid anti mycobacteria sensitivity 2nd line , Single MTBSINGLE 3390 3010
drug sensitivity ( MTB )
304 Rapid anti mycobacterial sensitivity 2nd line, 6 drugs ‐ RAP6DRUG 7060 5300
Ofloxacin, Amikacin, kanamycin, Capreomycin, PAS
and D‐ Cycloserine
305 Rapid antimycobacterial sensitivity to 4 drugs (SIRE) RAS4D 5650 4710
53
306 Rapid Biofire Gastrointestinal Panel RBGP 16000 13000
307 Rapid Biofire Meningitis / Encephalitis Panel RBFM 16000 13000
308 Rapid Biofire Positive Blood Culture Panel RBFP 13940 11760
309 Rapid Biofire Respiratory Panel RBFR 16000 13000
310 Respiratory ‐ panel (Real Time Qualitative PCR) RESPIRATORY 22 12500 10000
311 Rheumatoid factor ‐ RF ( blood ) RF 780 470
312 Rheumatoid factor ‐ RF ( Synovial fluid ) RFSF 780 470
313 Rota Virus Antigen Test RVAT 1290 780
314 Routine culture and sensitivity ( Ascitic fluid ) RCULTUREASF 1240 750
315 Routine culture and sensitivity ( Aspiration fluid ) RCULTUREASP 1240 750
316 Routine culture and sensitivity ( Blister fluid ) RCULTUREBLF 1240 750
317 Routine culture and sensitivity ( Bone marrow ) RCULTUREBOM 1240 750
318 Routine culture and sensitivity ( Bronchial washing ) RCULTUREBRW 1240 750
319 Routine culture and sensitivity ( Bronchoalveolar RCULTUREBRL 1240 750
lavage )
320 Routine culture and sensitivity ( Chest irrigation fluid RCULTURECIF 1240 750
)
321 Routine culture and sensitivity ( CSF ) RCULTURECSF 1240 750
322 Routine culture and sensitivity ( CT guided aspirate ) RCULTURECTG 1240 750
323 Routine culture and sensitivity ( Drain tip ) RCULTUREDRT 1240 750
324 Routine culture and sensitivity ( Drainage fluid ) RCULTUREDRF 1240 750
325 Routine culture and sensitivity ( Ear swab ) RCULTUREESW 1240 750
326 Routine Culture and Sensitivity ( Endotracheal RCULTUREES 1240 750
Secretion )
327 Routine culture and sensitivity ( Eye swab ) RCULTUREEYS 1240 750
328 Routine culture and sensitivity ( Faecal fluid ) RCULTUREFAF 1240 750
329 Routine culture and sensitivity ( Line tip ) RCULTURELIT 1240 750
330 Routine culture and sensitivity ( Miscellaneous ) RCULTURE 1240 750
331 Routine culture and sensitivity ( Nail ) RCULTURENAIL 1240 750
332 Routine culture and sensitivity ( P.D. fluid ) RCULTUREPDF 1240 750
333 Routine culture and sensitivity ( Pericardial fluid ) RCULTUREPEF 1240 750
334 Routine culture and sensitivity ( Peritoneal fluid ) RCULTUREPER 1240 750
335 Routine culture and sensitivity ( Pleural fluid ) RCULTUREPLF 1240 750
336 Routine culture and sensitivity ( Pus ) RCULTUREPUS 1240 750
337 Routine culture and sensitivity ( Romovac fluid ) RCULTUREROF 1240 750
338 Routine culture and sensitivity ( Semen ) RCULTURESEM 1240 750
339 Routine culture and sensitivity ( Skin scraping swab ) RCULTURESKS 1240 750
340 Routine culture and sensitivity ( Sputum ) RCULTURESPU 1240 750
341 Routine culture and sensitivity ( Stool ) RCULTURESTO 1240 750
342 Routine culture and sensitivity ( Throat swab ) RCULTURETHS 1240 750
343 Routine culture and sensitivity ( Tissue ) RCULTURETIS 1240 750
344 Routine culture and sensitivity ( Vaginal swab ) RCULTUREVAS 1240 750
345 Routine culture and sensitivity ( Venticular fluid ) RCULTUREVEF 1240 750
346 Routine culture and sensitivity ( Wound swab ) RCULTUREWOS 1240 750
347 RPR VDRL 330 200
348 RSV Qualitative NASBA RSVQL 7450 4470
349 Rubella antibody serology ( IgG ) ‐ Blood RUBVAG 1440 870
350 Rubella antibody serology ( IgG ) ‐ CSF RUBVAGCSF 1440 870
351 Rubella antibody serology ( IgM ) ‐ Blood RUBVAM 1440 870
352 Rubella antibody serology ( IgM ) ‐ CSF RUBVAMCSF 1440 870
353 Rubella IgG Avidity Test RUBEAV 2010 1410
354 Scrub Typhus IgM Elisa STIGM 2620 1570
355 Serum complement C‐3 (Nephelometric method) C3 1060 630
356 Serum complement C‐4 (Nephelometric method) C4 1060 630
357 Stool examination ( Routine / Microscopy ) STOOLRE 140 100
358 Stool Examination for Parasites ( Conc. Method ) SEFP 240 140
359 Stool fat globules STOOLFG 140 100
54
360 Stool Occult blood STOB 200 120
361 Stool pH STPH 130 90
362 Stool reducing substance STRED 140 100
363 SUPPLEMENTARY Direct Fluorescent staining for AFB FLUREAF 0 0
( Bronchoalveolar lavage )
364 TB ‐ Xpert MTB / Rif TBXPERT 3880 3240
365 TB‐HAINS Genotypic test MTB/INH,Rif TBHAINS 3240 2590
366 TORCH complex IgG serology ( Blood ) TORCHPROG 2210 1330
367 TORCH complex IgG serology ( CSF ) TORCHPROGCSF 2210 1330
368 TORCH complex IgM serology ( Blood ) TORCHPROM 2210 1330
369 TORCH complex IgM serology ( CSF ) TORCHPROMCSF 2210 1330
370 Toxoplasma antibody serology ( IgG ) TOXOPLAG 1240 750
371 Toxoplasma antibody serology ( IgM ) TOXOPLAM 1240 750
372 Toxoplasma avidity ( IgG ) TOXOAVIGG 1240 750
373 Treponema pallidum haemagglutination test ( TPHA ) TPHA 660 400
‐ Blood
374 Treponema pallidum haemagglutination test ( TPHA ) TPHACSF 660 400
‐ CSF
375 Typhi Dot Assay ( IgG ) TDAIGG 650 400
376 Typhi Dot Assay ( IgM ) TDAIGM 650 400
377 Urine culture URNCULT 1170 700
378 Urine culture ( Kidney Transplant ) KT‐URNCULT 560 560
379 Urine culture ( Liver Transplant ) LT‐URNCU 560 560
380 Urine Pregnancy test ( Beta HCG ) ‐ Microbiology PREG.TST 480 290
381 VZV IgG VZVIGG 1880 1130
382 VZV Real time PCR VZV 9020 5410
383 Weil ‐ felix Test WFELIX 820 490
384 Wet mount examination ( Ameobic liver abcess ) WETMEALA 280 170
385 Wet mount examination ( Aspirate for scolicls / WETMEASH 280 170
hooklets )
386 Wet mount examination ( Miscellaneous ) WETMEMIS 280 170
387 Wet mount examination ( Stool / faecal fluid ) WETME 280 170
388 Widal test for Typhoid WIDAL 480 290
389 ZN staining for A.F.B. ( Aortic Valve ) AFBSNAVE 420 250
390 ZN staining for A.F.B. ( Aspirate ) AFBSNASP 420 250
391 ZN staining for A.F.B. ( Aspiration Fluid ) AFBSNASF 420 250
392 ZN staining for A.F.B. ( Body Fluid ) AFBSNBFD 420 250
393 ZN staining for A.F.B. ( Bronchial Washing ) AFBSNBRW 420 250
394 ZN staining for A.F.B. ( Bronchoalveolar Lavage ) AFBSNBRO 420 250
395 ZN staining for A.F.B. ( CAPD Fluid ) AFBSNCAP 420 250
396 ZN staining for A.F.B. ( Chest Irrigation Fluid ) AFBSNCHE 420 250
397 ZN staining for A.F.B. ( CSF ) AFBSNCSF 420 250
398 ZN staining for A.F.B. ( Drainage Fluid ) AFBSNDRA 420 250
399 ZN staining for A.F.B. ( E.T. Secretion ) AFBSNETS 420 250
400 ZN staining for A.F.B. ( Gastric Aspirate ) AFBSNGAS 420 250
401 ZN staining for A.F.B. ( Miscellaneous ) AFBSN 420 250
402 ZN staining for A.F.B. ( Mitral Valve ) AFBSNMIT 420 250
403 ZN staining for A.F.B. ( P.D. Fluid ) AFBSNPDF 420 250
404 ZN staining for A.F.B. ( Pericardial Fluid ) AFBSNPER 420 250
405 ZN staining for A.F.B. ( Peritoneal Fluid ) AFBSNPEF 420 250
406 ZN staining for A.F.B. ( Pleural Fluid ) AFBSNPLE 420 250
407 ZN staining for A.F.B. ( Pus ) AFBSNPUS 420 250
408 ZN staining for A.F.B. ( Sputum ) AFBSNSPU 420 250
409 ZN staining for A.F.B. ( Synovial Fluid ) AFBSNSYN 420 250
410 ZN staining for A.F.B. ( Tissue ) AFBSNTIS 420 250
411 ZN staining for A.F.B. ( Urine ) AFBSNURI 420 250
55
412 Rapid AFB culture ( BacT/ALERT 3D) + Accuprobe AFB10DRUGOS 17850 13880
identification and sensitivity 10 drugs + DF ‐ SIRE ,
Ofloxacin, Amikacin, kanamycin, Capreomycin, PAS and
D‐ Cycloserine
Direct Fluorscence Staining for AFB DIRFLU
Rapid AFB culture (BacT/ALERT 3D) + Accuprobe identification and AFB10DRUG
sensitivity 10 drugs ‐ SIRE , Ofloxacin, Amikacin, kanamycin, Capreomycin,
PAS and D‐ Cycloserine
413 Rapid AFB culture ( BacT/ALERT 3D) + Accuprobe AFB4DRUG 7930 5550

identification and sensitivity 4 drugs + DF ‐ Streptomycin,
Isoniazid, Rifampicin and Ethambutol (SIRE)
Direct Fluorscence Staining for AFB DIRFLU
Rapid AFB culture (BacT/ALERT 3D) + Accuprobe identification and AFB4DRUG
sensitivity 4 drugs ‐ Streptomycin, Isoniazid, Rifampicin and Ethambutol
(SIRE)
414 CAPD Fluid Package ( Cell count + Gram Stain + KOH + CAPDFCUL 3990 2400

Culture Senstivity )
CAPD fluid culture/ABST RCULTURECAPD
CAPD Fluid Microscopy ( Cell count + Gram Stain + KOH ) CAPDFCUL
415 CMV antibody IgG & IgM CMVAGAM 2620 1570

CMV antibody IgG CMVAG
CMV antibody IgM CMVAM
416 Enterically transmitted hepatitis profile ( IgM HAV, IgM ENTHEP 3010 1810

HEV )
Anti HAV ‐ IgM ( hepatitis A virus serology ) HAVT
Anti HEV ‐ IgM ( hepatitis E virus serology ) HEVT
417 Herpes antibody ( IgG & IgM ) ‐ Blood HERPANGM 2620 1570

Herpes antibody ( IgG ) ‐ Blood HERPAN
Herpes antibody ( IgM ) ‐ Blood HERPA
418 Herpes antibody ( IgG & IgM ) ‐ CSF HERPANGMCSF 2620 1570

Herpes antibody ( IgG ) ‐ CSF HERPANCSF
Herpes antibody ( IgM ) ‐ CSF HERPACSF
419 Rubella antibody serology ( IgG & IgM) ‐ Blood RUBVAGM 2620 1570

Rubella antibody serology ( IgG ) ‐ Blood RUBVAG
Rubella antibody serology ( IgM ) ‐ Blood RUBVAM
420 Rubella antibody serology ( IgG & IgM) ‐ CSF RUBVAGMCSF 2620 1570

Rubella antibody serology ( IgG ) ‐ CSF RUBVAGCSF
Rubella antibody serology ( IgM ) ‐ CSF RUBVAMCSF
421 Stool microbiology workup ( Culture, Wetmount, Kinyoun STWORK 1210 730

)
Kinyoun Stain ( Nocardia / Cryptospordium ) ‐ Stool KINYOUNSTO
Routine culture and sensitivity ( Stool ) RCULTURESTO
Wet mount examination ( Stool / faecal fluid ) WETME
422 TORCH complex IgG & IgM serology ( CSF ) TORCHPRCSF

TORCH complex IgG serology ( CSF ) TORCHPROGCSF 2210 1330
TORCH complex IgM serology ( CSF ) TORCHPROMCSF 2210 1330
423 TORCH complex IgG & IgM serology ( Blood ) TORCHPROGM 5960 3570
TORCH complex IgG serology ( Blood ) TORCHPROG
TORCH complex IgM serology ( Blood ) TORCHPROM
424 Toxoplasma antibody serology ( IgG & IgM ) TOXOPLAGM 2010 1210

Toxoplasma antibody serology ( IgG ) TOXOPLAG
Toxoplasma antibody serology ( IgM ) TOXOPLAM
425 VIRAL MARKER ( ACUTE HEPATITIS PANEL) VIRAHEP 3400 2040

Anti HAV ‐ IgM ( hepatitis A virus serology ) HAVT
HBsAg ( Australia antigen ) HBSAG
Hepatitis E Virus Quantitative Real Time PCR HENRNA
426 VIRAL MARKER (CHRONIC HEPATITIS SCREEN PANEL) VIRCHGAS 1370 820

Hepatitis C virus serology antibody test HCV
427 VIRAL MARKER (DIALYSIS) VIRDIA 1290 1290
56
HBsAg ( Australia antigen ) ( Dialysis ) DHBSAG
Hepatitis C virus serology antibody test ( Dialysis ) DHCV
HIV antibody test ( Dialysis ) DHIV
428 VIRAL MARKER ‐ HBV PANEL (HBSAG PROFILE) VIRHBSAG 11750 7050

Anti HBc ‐ IgM ( hepatitis B virus serology ) ANTIHBC
HBeAg for hepatitis B HBE
HBV Qualitative HBVQ
429 VIRAL MARKER(NON PREGNANT / GASTRO) VIRNONP 1950 1170

HIV antibody test HIV
430 VIRAL MARKER (PREGNANT PANEL) VIRP 4370 2620

RPR VDRL
Rubella antibody serology ( IgG ) ‐ Blood RUBVAG
Rubella antibody serology ( IgM ) ‐ Blood RUBVAM
431 VIRAL MARKER (PAED. THAL ASSEEMIA) VIRPTHAL 1950 1170

432 Viral marker profile (Transplant) VMP 2080 2080

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

CAT 1/CAT2 CAT3
1 ALL Translocation Panel ATPMH 6700 5700
2 AML PCR Panel (Any 4) AMLMH 8800 7500
3 AML1 ‐ ETO Translocation ( Molecular Haematogy ) AML1 7000 4500
4 BCR ‐ ABL Qualitative ( Molecular Haematology ) MMBCRABL 6500 4000
5 BCR ‐ ABL Quantitative ( Molecular Haematology ) BCRABL 8500 7500
6 CALR Mutation (Type 1 and Type2) CALRMH 6080 4600
7 Composite Thrombophilia Mutation Panel CTMPMH 7700 5800
8 Factor V ( Leiden ) Gene mutations ‐ Molecular FVLGMMH 5200 3400
Haematology
9 FLT3 Mutation ( D835 & IDT ) ( Molecular FLTMH 6000 4000
Haemtology )
10 Inversion 16 translocation ( Molecular Haemtology ) INVERSIONMH 7000 4500
11 JAK‐2 mutation ( Molecular Haematology ) MMPCR 6500 4500
12 MPL mutation MPLMMH 4000 3000
13 MPN Reflex Panel MPNMH 8500 7500
14 MTHFR ( C677T ) Gene Polymorphism ‐ Molecular MTHFRGMMH 3800 2200
Haematology
15 Prothrombin ( G20210A ) Gene Mutation ‐ Molecular PGMMH 3800 2200
Haematology
16 Qualitative Reverse Transcriptase PCR (RT‐PCR) for MMPMLRARA 6500 4000
PML‐RARA ( Molecular Haematology Laboratory )
17 Qualitative Reverse Transcriptase PCR (RT‐PCR) for MMTELAML1 6500 4000
TEL‐AML1 ( Molecular Haematology Laboratory )
18 TPMT Genotyping ( Molecular Hematology ) TGMH 5500 4200
57
Research Lab Charges

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

CAT 1/CAT2 CAT3
1 Liver recipient preoperative workup LIVRECPOWU
$$ Alpha feto protein ‐ AFP ( Serum / Amniotic fluid ) BAFP 800 650
24 Hours Urine Protein (Excludes Albumin) 24URINPROT 300 180
24 Hours Urine Sodium 24US 200 120
Anti mitochondrial antibody ( AMA ) ‐ WITH Barcode AMA 1310 780
Anti nuclear antibodies ( ANA ) and Anti smooth muscle antibody ( ASMA ) ANASMA 2020 1210
‐ WITH Barcode
Anti‐p ANCA ( anti ‐ MPO ) AANCA‐AM 1850 1100
APTT ( Activated partial thromboplastin time ) APTT 650 400
BacT/Alert aerobic culture ( Blood ) AERBTA+B‐BLD 2200 1330
Blood group ‐ ABO + Rh(D) BGROUP 500 300
BUN BUN 160 100
CA 19‐9 CA199 1200 750
Calcium CALC 200 130
CBC ‐ Complete blood count CBC 420 250
CCR ‐ Creatinine Clearance CCR 420 250
CEA ( Carcino‐Embryonic Antigen ) CEA 750 450
Ceruloplasmin (Serum) BCPL 1250 1000
CMV antibody IgG CMVAG 780 470
CMV antibody IgM CMVAM 730 440
Electrocardiogram ( ECG ) ECG 350 250
Ferritin FERI 900 540
Fibrinogen (Quantitative) FIBEST 1350 800
Glucose Random GLUR 120 80
HBsAg ( Australia antigen ) HBSAG 780 470
Hepatitis C virus serology antibody test HCV 1040 620
HIV antibody test HIV 780 470
LFT ‐ Liver Function Test ( Hepatic Profile ) HEPA 1150 690
Magnesium SMAG 275 165
Prothrombin time ( PT ) Haematology Lab PT 400 240
RPR VDRL 330 200
Serum Creatinine CREA 180 110
Serum Iron IRON 375 225
Serum Iron Binding Capacity ( TIBC ) TIBC 450 270
Sodium + Potassium + Chlorides + Bicarbonate SPC 700 420
Spirometery SPIROM 1800 1100
Thyroid Profile ( T3, T4, TSH ) T3T4TSH 1250 1250
Transferrin TF 700 420
Ultrasound lower abdomen / pelvis LA 1460 880
Ultrasound upper abdomen & doppler study ABDO 3800 2280
Urine culture URNCULT 1170 700
Urine examination ( Routine / Microscopy ) URINERE 250 150
Xray chest PA ( CXR ) CHPA 520 310
58
MRI Charges

CAT 1/CAT2 CAT3
1 Ankylosing Spondylosis Screening Package ‐ for 2 ASSP2 6970 6970
parts
2 Ankylosing Spondylosis Screening Package ‐ for 3 ASSP3 9750 9750
parts
3 Breast MRI ‐ MRI Dept.Charges BRMRI 12120 12120
4 Contrast enhanced MRI brain MRICEMRIB 14510 14510
5 MR Venography Neck ( Plain ) MRIMRVNP 8860 8860
6 MR Venography Neck with contrast ( double dose ) MRIMRVNCDD 20000 20000
7 MR Venography Neck with contrast ( single dose ) MRIMRVNCSD 14510 14510
8 MRI 3D ( Extra ) MRI3D 9750 9750
9 MRI add on anaesthesia MRIADDANAES 4450 4450
10 MRI add on charges for CD MRICD 640 640
11 MRI add on double dose contrast MRISODDC 11300 11300
12 MRI add on extended study MRIAOES 5360 5360
13 MRI add on extra film charges MRIEXTFILM 460 460
14 MRI add on scout both ankles MRIAOSBA 8890 8890
15 MRI add on scout both arms MRIAOSBF 8890 8890
16 MRI add on scout both feet MRIAOSFO 8890 8890
17 MRI add on scout both knee joints MRIAOSBKJ 8890 8890
18 MRI add on scout both lower legs MRIAOSLLB 8890 8890
19 MRI add on scout both shoulders MRIAOSSBS 8890 8890
20 MRI add on scout both thighs MRIAOSTB 8890 8890
21 MRI add on scout brain MRIAOSB 4850 4850
22 MRI add on scout cervical spine MRIAOSCS 4850 4850
23 MRI add on scout dorsal/thoracic spine MRIAOSDTS 4850 4850
24 MRI add on scout hip joints MRIAOSHJ 4850 4850
25 MRI add on scout left ankle MRIAOSLA 4850 4850
26 MRI add on scout left arm MRIAOSRUA 4850 4850
27 MRI add on scout left feet MRIAOSF 4850 4850
28 MRI add on scout left knee joint MRIAOSLKJ 4850 4850
29 MRI add on scout left lower leg MRIAOSLL 4850 4850
30 MRI add on scout left shoulder MRIAOSLS 4850 4850
31 MRI add on scout left thigh MRIAOST 4850 4850
32 MRI add on scout lumbo‐sacral spine MRIAOSLSS 4850 4850
33 MRI add on scout of neck MRISNK 4850 4850
34 MRI add on scout of wrist MRISWR 4850 4850
35 MRI add on scout orbit MRIAOSO 4850 4850
36 MRI add on scout right ankle MRIAOSRA 4850 4850
37 MRI add on scout right arm MRIAOSRF 4850 4850
38 MRI add on scout right feet MRIAOSFR 4850 4850
39 MRI add on scout right knee joint MRIAOSRKJ 4850 4850
40 MRI add on scout right lower leg MRIAOSLLR 4850 4850
41 MRI add on scout right shoulder MRIAOSRS 4850 4850
42 MRI add on scout right thigh MRIAOSTR 4850 4850
43 MRI add on scout sacro‐iliac joints MRIAOSSIJ 4850 4850
44 MRI add on single dose contrast MRIAOSDC 5570 5570
45 MRI angiography both forearms MRASFB 19500 19500
46 MRI angiography both forearms (double dose MRASFDDCB 31930 31930
contrast)
47 MRI angiography both lower legs MRABLL 15960 15960
48 MRI angiography both lower legs (double dose MRABLLDDC 15960 15960
contrast)
49 MRI angiography both thighs MRABT 31930 31930
59
50 MRI angiography both thighs (double dose contrast) MRABTDDC 15960 15960
51 MRI angiography both upper arms MRASUAB 15960 15960
52 MRI angiography both upper arms (double dose MRASUADDCB 31930 31930
contrast)
53 MRI angiography left forearm MRASFL 9750 9750
54 MRI angiography left forearm (double dose contrast) MRASFDDCL 15960 15960
55 MRI angiography left upper arm MRASUA 15960 15960
56 MRI angiography left upper arm (double dose MRASUADDC 15960 15960
contrast)
57 MRI angiography lower abdomen / pelvis MRALAP 15960 15960
58 MRI angiography lower abdomen / pelvis (double MRALAPDDC 15960 15960
dose contrast)
59 MRI angiography lower thorax MRALT 9750 9750
60 MRI angiography lower thorax (double dose contrast) MRALTDDC 15960 15960
61 MRI Angiography Peripheral With Contrast ( Single MRIANGIO 15960 15960
Part )
62 MRI angiography right forearm MRASFR 19500 19500
63 MRI angiography right forearm (double dose MRASFDDCR 15960 15960
contrast)
64 MRI angiography right upper arm MRASUAR 25680 25680
65 MRI angiography right upper arm (double dose MRASUADDCR 15960 15960
contrast)
66 MRI angiography upper abdomen MRAUA 9750 9750
67 MRI angiography upper abdomen (double dose MRAUADDC 15960 15960
contrast)
68 MRI angiography upper thorax MRAUT 9750 9750
69 MRI angiography upper thorax (double dose contrast) MRAUTDDC 15960 15960
70 MRI Arthrography MRIARTH 19500 19500
71 MRI both ankles MRIA 19500 19500
72 MRI both ankles (contrast) MRBAC 25680 25680
73 MRI both elbows MRIESB 19500 19500
74 MRI both elbows (contrast) MRSECB 25680 25680
75 MRI both forearm (contrast) MRSCFCB 25680 25680
76 MRI both forearms MRFB 19500 19500
77 MRI both hand MRSHB 19500 19500
78 MRI both hand (contrast) MRSHCB 25680 25680
79 MRI both knee joints MRBNJ 19500 19500
80 MRI both knee joints (contrast) MRBNJC 25680 25680
81 MRI both shoulders MRISBS 19500 19500
82 MRI both shoulders (contrast) MRSSCB 25680 25680
83 MRI both wrist MRIWB 19500 19500
84 MRI both wrist (contrast) MRIWBC 25680 25680
85 MRI brachial plexus MRBP 9750 9750
86 MRI brachial plexus (contrast) MRBPC 15960 15960
87 MRI Brachial Plexus + Cervical Spine MRIBRCER 15960 15960
88 MRI brain MRIBRAIN 8860 8860
89 MRI brain (angiography) MRIBANGIO 8850 8850
90 MRI brain (venography) MRIBVEN 8850 8850
91 MRI Brain + Diffusion MRIBRDIF 13680 13680
92 MRI Brain + Diffusion + Perfusion + Contrast MRIBRDIPECON 28290 28290
93 MRI Brain + Dynamic CSF Flow Studies MRIBRDY 12870 12870
94 MRI Brain + Functional MRIBRFUN 14500 14500
95 MRI Brain + Orbits MRIBRORB 13680 13680
96 MRI Brain + Perfusion + Contrast MRIBRPERCON 19320 19320
97 MRI Brain + Sella MRIBRSELLA 13680 13680
98 MRI Brain + Spectroscopy MRIBRSP 13680 13680
99 MRI Brain Cisternography MRIBRCIS 13680 13680
60
100 MRI brain epilepsy protocol MRIBEP 11280 11280
101 MRI Cardiac Package Plain MRICARPKPL 15960 15960
102 MRI cervical spine MRICS 8860 8860
103 MRI cervical spine (contrast) MRCSC 15960 15960
104 MRI Contrast For Cardiac MRICONCAR 8850 8850
105 MRI Diffusion Weighted MRIDFW 4680 4680
106 MRI dorsal / thoracic spine MRIDS 8850 8850
107 MRI dorsal / thoracic spine (contrast) MRDTSC 15960 15960
108 MRI Dynamic CSF study MRIDCSF 8560 8560
109 MRI ear MRIEAR 9750 9750
110 MRI face MRIFACE 9750 9750
111 MRI feet MRBF 19500 19500
112 MRI feet (contrast) MRBFC 25680 25680
113 MRI Foetus MRIFOETUS 9750 9750
114 MRI foot MRF 9750 9750
115 MRI foot (contrast) MRFC 15960 15960
116 MRI hip joints MRIHJ 9750 9750
117 MRI hip joints (contrast) MRHJC 15960 15960
118 MRI left ankle MRSAL 9750 9750
119 MRI left ankle (contrast) MRSACL 15960 15960
120 MRI left elbow MRIESL 9750 9750
121 MRI left elbow (contrast) MRSECL 15960 15960
122 MRI left forearm MRFL 9750 9750
123 MRI left forearm (contrast) MRSCFCL 15960 15960
124 MRI left hand MRSHL 9750 9750
125 MRI left hand (contrast) MRSHCL 15960 15960
126 MRI left knee joint MRIKJSL 9750 9750
127 MRI left knee joint (contrast) MRSKJCL 15960 15960
128 MRI left shoulder MRISL 9750 9750
129 MRI left shoulder (contrast) MRSSCL 15960 15960
130 MRI left upper arm MRSUAL 9750 9750
131 MRI left upper arm (contrast) MRSUACL 15960 15960
132 MRI left wrist MRIWL 9750 9750
133 MRI left wrist (contrast) MRSWCL 15960 15960
134 MRI Liver Transplant Package MRILIVPK 23920 23920
135 MRI lower abdomen / pelvis MRLAP 9750 9750
136 MRI lower abdomen / pelvis (contrast) MRLAPC 15960 15960
137 MRI lower legs MRLL 9750 9750
138 MRI lower legs (contrast) MRLLC 15960 15960
139 MRI lumbar plexus MRLP 9750 9750
140 MRI lumbar plexus (contrast) MRLPC 15960 15960
141 MRI lumbo‐sacral spine MRILSS 8860 8860
142 MRI lumbo‐sacral spine (contrast) MRLSSC 15960 15960
143 MRI mammogram both breasts MRMBB 14200 14200
144 MRI mammogram both breasts (contrast) MRMBBC 20410 20410
145 MRI MRCP MRIMRCP 9750 9750
146 MRI neck MRINECK 9750 9750
147 MRI neck carotid angiography MRIENCKANGIO 8850 8850
148 MRI neck carotid angiography (double dose contrast) MRINADD 14500 14500
149 MRI neck with contrast MRINECKC 15960 15960
150 MRI Oncology Package MRIONCOPK 34450 34450
151 MRI orbit MRIORBIT 9750 9750
152 MRI orbit with (contrast) MRIORBITWC 15960 15960
153 MRI para nasal sinuses ( PNS ) MRPNS 9750 9750
154 MRI para nasal sinuses ( PNS with contrast) MRPNSWC 15960 15960
155 MRI Parametric Map MRIPARA 3210 3210
156 MRI pelvis MRIP 9750 9750
61
157 MRI pelvis with contrast MRIPWC 15960 15960
158 MRI perineum MRP 9750 9750
159 MRI perineum (contrast) MRPC 15960 15960
160 MRI pituitary fossa/sella MRIPFS 8850 8850
161 MRI pituitary fossa/sella contrast MRIPFSC 15960 15960
162 MRI Prostate Package ( Contrast ) MRIPROSPK 34450 34450
163 MRI Pyelography MRIPYE 4450 4450
164 MRI renal angiography MRIRA(CE‐S) 9750 9750
165 MRI renal angiography (double dose contrast) MRIRA(CE‐D) 15960 15960
166 MRI right ankle MRSAR 9750 9750
167 MRI right ankle (contrast) MRSACR 15960 15960
168 MRI right elbow MRIESR 9750 9750
169 MRI right elbow (contrast) MRSECR 15960 15960
170 MRI right forearm MRFR 9750 9750
171 MRI right forearm (contrast) MRSCFCR 15960 15960
172 MRI right hand MRSHR 9750 9750
173 MRI right hand (contrast) MRSHCR 15960 15960
174 MRI right knee joint MRIKJSR 9750 9750
175 MRI right knee joint (contrast) MRSKJCR 15960 15960
176 MRI right shoulder MRISR 9750 9750
177 MRI right shoulder (contrast) MRSSCR 15960 15960
178 MRI right upper arm MRSUAR 9750 9750
179 MRI right upper arm (contrast) MRSUACR 15960 15960
180 MRI right wrist MRIWR 9750 9750
181 MRI right wrist (contrast) MRSWCRL 15960 15960
182 MRI sacro‐iliac joints MRISIJ 9750 9750
183 MRI sacro‐iliac joints (contrast) MRSIJC 15960 15960
184 MRI screening of brain & MRA MRISB 12080 12080
185 MRI Screening of Lower abdomen MRISLAB 4450 4450
186 MRI Screening of upper abdomen MRISUAB 4450 4450
187 MRI screening with contrast MRISC 9750 9750
188 MRI screening without contrast MRISWC 4450 4450
189 MRI Spectroscopy MRISPE 9750 9750
190 MRI Spine screening MRISPSC 4450 4450
191 MRI Thalassemia Package MRITHALPK 0 0
192 MRI Thalassemia Protocol MRITHALPR 5560 5560
193 MRI thigh MRT 9750 9750
194 MRI thigh (contrast) MRTC 15960 15960
195 MRI thorax MRITHORAX 9750 9750
196 MRI thorax (contrast) MRTHOC 15960 15960
197 MRI TM joint/temporo‐mandibular joint MRITMJTMJ 9750 9750
198 MRI TM joint/temporo‐mandibular joint contrast MRITMJTMJC 15960 15960
199 MRI Tractography MRITRAC 3540 3540
200 MRI upper abdomen MRIUA 9750 9750
201 MRI upper abdomen (contrast) MRUAC 15960 15960
202 MRI upper abdomen with MRCP MRUAMRCP 15960 15960
203 MRI venography both forearm MRVSFB 19500 19500
204 MRI venography both forearm (double dose contrast) MRVSFDDCB 31930 31930
205 MRI venography both lower legs MRVBLL 9750 9750
206 MRI venography both lower legs (double dose MRVBLLDDC 15960 15960
contrast)
207 MRI venography both thighs MRVBT 9750 9750
208 MRI venography both thighs (double dose contrast) MRVBTDDC 15960 15960
209 MRI venography both upper arm MRVSUAB 19500 19500
210 MRI venography both upper arm (double dose MRVSUADDCB 31930 31930
contrast)
211 MRI venography left forearm MRVSFL 9750 9750
62
212 MRI venography left forearm (double dose contrast) MRVSFDDCL 15960 15960
213 MRI venography left upper arm MRVSUAL 9750 9750
214 MRI venography left upper arm (double dose MRVSUADDCL 15960 15960
contrast)
215 MRI venography lower abdomen / pelvis MRVLAP 9750 9750
216 MRI venography lower abdomen / pelvis (double MRVLAPDDC 15960 15960
dose contrast)
217 MRI venography lower thorax MRVLT 9750 9750
218 MRI venography lower thorax (double dose contrast) MRVLTDDC 15960 15960
219 MRI venography right forearm MRVSFR 9750 9750
220 MRI venography right forearm (double dose contrast) MRVSFDDCR 15960 15960
221 MRI venography right upper arm MRVSUAR 9750 9750
222 MRI venography right upper arm (double dose MRVSUADDCR 15960 15960
contrast)
223 MRI venography upper abdomen MRVUA 9750 9750
224 MRI venography upper abdomen (double dose MRVUADDC 15960 15960
contrast)
225 MRI venography upper thorax MRVUTHO 9750 9750
226 MRI venography upper thorax (double dose contrast) MRVUTHODDC 15960 15960
227 MRI whole abdomen MRIWHAB 19500 19500
228 MRI whole abdomen with contrast MRIWAWC 25660 25660
229 MRI Whole Body MRIWHBD 26520 26520
230 MRI Whole Body Angio ( Plain ) MRIWHBDANGIO 26520 26520
231 MRI Whole Body Diffusion MRIWHBDIF 13340 13340

CAT 1/CAT2 CAT3
1 MRI BRAIN + MRA BRAIN MRIMRA 10890 10890
MRI brain MRIBRAIN
MRI brain (angiography) MRIBANGIO
2 MRI BRAIN + MRA BRAIN + MRV BRAIN MRIMRAMRV 14520 14520

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

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

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

MRI brain MRIBRAIN
MRI brain (venography) MRIBVEN
1 Total Intra Venous Sedation ( TIVS ) ‐ MRI/CT TIVSOPDOS
Anaeshesia consumables used in MRI/CT for TIVS TIVSMC 1500 1500
Total Intra Venous Sedation ( TIVS ) ‐ MRI/CT TIVSOPD 2670 2670

Neonatology Test

CAT 1/CAT2 CAT3
1 NEONATOLOGY FUNCTIONAL ECHO ( TEST + DOCTOR FEE ) NEOFEOS 2850 1790
2 NEONATOLOGY ULTRASOUND (TEST+DOCTOR FEE) NEOULTRAOS 2140 1070
63
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 ‐ 1850 1850 920 740 550
Additional hospital charges
AVADDF Acute vascular access for dialysis ‐ Doctor 18480 18480 9240 7390 5540
fees
CADKIDD Cadaveric Kidney Donation
OS (Bench Surgery) ‐ Doctor fee +
Hospital charges
CADKDHC Cadaveric kidney donation (Bench Surgery) ‐ 2670
CADKDF Cadaveric kidney donation (Bench Surgery) ‐ 26670
Doctor fee
CAPD1WD CAPD 1 week daycase training
COS (Doctor fee + Hospital charges)
CAPD1WDCDF CAPD 1 week daycase training ‐ doctor fee 16520
CAPD1WDCHC CAPD 1 week daycase training ‐ hospital 1650
charges
CAPDTDH CAPD training (doctor charges
COS + hospital service charges)
CAPDAHC CAPD training ‐ Additional hospital charges 1890 1510 1130
CAPDDF CAPD training ‐ Doctor fees 18900 15120 11340
CRRTPPD CRRT ‐ PLANNING AND
CHOS MONITORING (DOCTOR FEE +
HOSPITAL CHARGES)
CRRTPMDF CRRT ‐ planning and monitoring ‐ Doctor fee 13860 13860 7620 6090 4570
CRRTPMAHC CRRT ‐ planning and monitoring ‐ hospital 1390 1390 760 610 460
charges
HAEM48S Haemodialysis charges for
OS Daycare patients (Doctor +
Hospital + Kit charges) 4008S
HEMODIALDO Haemodialysis ‐ amount given to doctor 735
CCH
HEMODIALKIT Haemodialysis ‐ kit charges 295
CH
HAEPC48S Haemodialysis package charges 4008S 2450
HAEHOS4SN Haemodialysis procedure (4008S) ‐ Hospital 1715
charges
HAEMDH Haemodialysis charges for
OS INPATIENTS 4008S ( Doctor +
Hospital )
CCH
HAEHOS4SN Haemodialysis procedure (4008S) ‐ Hospital 1715
charges
HAEMIPD Haemodialysis charges for
HOS INPATIENTS 5008S ( Doctor +
Hospital )
CCH
HAEHC8S Haemodialysis procedure (5008S) ‐ hospital 2215
charges
HAEMPAC Haemodialysis charges for
8SOS Daycare patients (Doctor +
Hospital + Kit charges) 5008S
BLBINAV $$BLOODLINE AV SET (TUBING) 5008S 238
DIAFLSL $$DIALYSER FX60 HIGH FLUX SINGLE USE 467
64
CCH
CH
HAEOCHS Haemodialysis package charges 5008S 2950
HAEHC8S Haemodialysis procedure (5008S) ‐ hospital 2215
charges
HEMODIA Haemodialysis ( emergency )
LEORDSET charges for daycare patient (all
charges)
CH
HEMODIALEP Haemodialysis (emergency) package 4500
C charges
HEMOEDF Haemodialysis Emergency ‐ amount given to 1300 1300
doctor
HEEHC Haemodialysis procedure emergency ‐ 3200 3200
hospital charges
IJCSBOS Internal jugular ( IJ ) catheter /
subclavion catheter insertion
in Dialysis Room (Doctor fee +
Hospital Charges)
IJCATHC Internal jugular ( IJ ) catheter / subclavion 1390 1390 760 610 460
catheter insertion in Dialysis Room ‐
Hospital Charges
IJCSCATDF Internal jugular ( IJ ) catheter / subclavion 13860 13860 7620 6090 4570
catheter 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 ‐ 260
Vancomycin, Solumedrol, Endoxan ) in
Dialysis Room ‐ Hospital Charges
INJDF Charges for giving injection (I/V infusion ‐ 530
Vancomycin, Solumedrol, Endoxan ) in
Dialysis Room ( Doctor Fee )
IPDDHCH PERITONEAL DIALYSIS ‐
OS INTERMITTENT (DOCTOR FEE +
HOSPITAL CHARGES)
IPDAHC Intermittent peritoneal dialysis ‐ Additional 1390 1390 770 610 460
hospital charges
IPDDF Intermittent peritoneal dialysis ‐ Doctor fees 13860 13860 7670 6130 4600
KTPSOS KTP Surcharge ( Surgeon +
Hospital + Anastheist )
KTPSA KTP Surcharge ‐ Anasthesist fee 2650
KTPSH KTP Surcharge ‐ Hospital charges 5290
KTPSS KTP Surcharge ‐ Surgeon Fee 5290
ONHOS Online Haemodialysis (Doctor
fee + Hospital Charges + kit
charges)
AVSET $$ AV SET ONLINE 530
BIBAG $$ Bibag 960 gm 215
CH
HEDFON Online Haemodialysis ‐ amount given to 650
doctor
HHCON Online Haemodialysis ‐ Hospital Charges 1710
HEPPCON Online Haemodialysis package charges 2360
PLPEROS Pleural / Peritoneal tapping in
Dialysis Room ( Doctor Fee +
Hospital charges)
PLEPERHC Pleural / Peritoneal tapping in Dialysis Room 530
‐ Hospital Charges
65
PTAPPERDF Pleural / Peritoneal tapping in Dialysis Room 2630 2630 2630 2630
( Doctor Fee )
SLEEDDHC SLEDD ‐ PLANNING AND
HOS MONITORING CHARGES
(DOCTOR FEE + HOSPITAL
CHARGES)
SLEDDAHC SLEDD ‐ Planning and monitoring charges by 1530 1530 760 610 380
nephrologist ‐ Additional hospital charges
SLEDDNDF SLEDD ‐ Planning and monitoring charges 15250 15250 7620 6090 3810
for Nephrologist ‐ Doctor fee
KBDHCHO KIDNEY BIOPSY (DOCTOR FEE +
S HOSPITAL CHARGES)
KBHC Kidney biopsy ‐ Additional hospital charges 1680 1680 840 670 500
KBDF Kidney biopsy ‐ Doctor fees 16800 16800 8400 6720 5040
UGRBOD Ultrasound guided renal biopsy
OS
UGRBDC Ultrasound guided renal biopsy ‐ Dept. 1760 1410 1060 1760 1650
charges
UGRBDF Ultrasound guided renal biopsy ‐ Doctor fee 1760 1410 1060 1760
UGRBOS Ultrasound guided renal biopsy
(Outside dept.)
UGRBODDC Ultrasound guided renal biopsy (Outside 2040 2040 1010 2040 2040
dept.) ‐ Dept. charges
UGRBODDF Ultrasound guided renal biopsy (Outside 2040 2040 1010 2040
dept.) ‐ Doctor fee
Ultrasound transplant ( graft ) kidney (without doppler) TK 660 400
KBSET Kidney biopsy set usage charges 390
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

267 HEMOFRE5 Online Hemodiafiltration 4000
(Fresenius5008‐5)
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 20000

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

66
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) 5780

2 SLEDDMPD SLEDD ‐ Use of machine (per day) 5780
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 ) 20330 10160 8140 6100
2 AVFISSF AV Fistula ‐ Surgen Fee
3 OP3397 Basilic vein transposition in OT 60980 30490 24400 18290
4 OP0240 Brachio ‐ basilic loop AV graft for haemodialysis 40610 20310 16250 12180
5 OP0242 Brachio ‐ basilic straight ( above elbow ) AV graft for 40610 20310 16250 12180
haemodialysis
6 OP0239 Brachio ‐ cephalic loop AV graft for haemodialysis 40610 20310 16250 12180
7 OP0241 Brachio ‐ cephalic straight ( above elbow ) AV graft for 40610 20310 16250 12180
haemodialysis
8 OP0245 Brachio AV fistula at elbow for haemodialysis 29230 14620 11700 8770
9 OP0443 CAPD placement ( laparosopic ) 24650 12330 9870 7390
10 OP1080 CAPD placement ( open ) 24650 12330 9400 7390
11 OP0448 CAPD removal & placement ( laparosopic ) 32340 16170 12320 9700
12 OP0445 CAPD removal & placement ( open ) 32340 16170 12940 9700
13 OP0447 CAPD removal ( laparosopic ) 15460 7730 6180 4640
14 OP0444 CAPD removal ( open ) 15460 7730 6180 4640
15 OP0446 CAPD revision ( laparosopic ) 12350 6170 4950 3710
16 OP0449 CAPD revision ( open ) 12350 6170 4710 3710
17 OP0437 Conversion of arteriovenous ( AV ) shunt to 29230 14620 11700 8770
arteriovenous ( AV ) fistula
18 OP0440 Creation of arteriovenous ( AV ) fistula at axillary 36960 18480 14780 11090
artery
19 OP0433 Creation of arteriovenous ( AV ) fistula at elbow ( 35200 18480 14780 11090
brachial artery )
20 OP1077 Creation of arteriovenous ( AV ) fistula at wrist ( radial 36960 18480 14780 11090
artery )
21 OP4205 GSV translocation for AV access 60980 30490 24400 18290
22 OP0320 Ligation of ruptured AV fistula 15460 7730 6180 4640
23 OP0319 Ligation of ruptured AV graft 20330 10160 8140 6100
24 OP0436 Placement of arteriovenous ( AV ) shunt at ankle ( 20330 10160 8140 6100
posterior tibial artery )
25 OP1078 Placement of arteriovenous ( AV ) shunt at wrist ( 20330 10160 8140 6100
radial artery )
26 OP0243 Radio ‐ basilic straight ( below elbow ) AV graft for 40610 20310 16250 12180
haemodialysis
27 OP0244 Radio ‐ cephalic straight ( below elbow ) AV graft for 40610 20310 16250 12180
haemodialysis
28 OP4204 Repair of A.V.Fistula aneurysm 41580 20790 16630 12470
29 OP0441 Revision of arteriovenous ( AV ) fistula at axillary 15460 7730 6180 4640
artery
30 OP0435 Revision of arteriovenous ( AV ) fistula at elbow ( 15460 7730 6180 4640
brachial artery )
67
31 OP0434 Revision of arteriovenous ( AV ) fistula at wrist ( radial 15490 7730 6180 4640
artery )
32 OP0439 Revision of arteriovenous ( AV ) shunt at ankle ( 10160 5080 4070 3050
33 OP0438 Revision of arteriovenous ( AV ) shunt at wrist ( radial 10160 5080 3880 3050
artery )
34 OP1083 Vascular prosthetic graft in forearm 46200 23100 18480 13860
35 OP0526 Vascular prosthetic graft in thigh 46200 23100 18480 13860
36 OP0525 Vascular prosthetic graft in upper arm 46200 23100 18480 13860
ECG Charges

CAT 1/CAT2 CAT3
1 Electrocardiogram ( ECG ) ECG 350 250
Echo Lab Charges

CAT 1/CAT2 CAT3
1 Ambulatory B.P. Monitoring for 24 Hrs. ( Echo ) AMBPMONIT 3300 2200
2 Carotid doppler (ECHO ROOM) CARODOP 3500 2400
3 Dobutamine stress echo (Echo Department) DECHO 5830 4400
4 Echocardiogram with Doppler ( Echo ) ECHODOP 3300 2400
5 Fetal cardiac assessment ( Echo ) FECHO 4030 2050
6 Holter test (cardiac lab) ( Echo ) HOLTER 3300 2400
7 Portable Echo Additional Charges ECHO_BS 1100 660
8 Stress Echo (Echo Deparment) SECHOOS 5400 3850
9 Tilt table test ( Cardiology ) ( Echo ) TILT 5600 3600
10 Transoeophageal ‐ Echocardiography / Multiplane TEE 6050 3300
TEE ( Echo )
11 Treadmill test ( TMT) TMT 3100 2400
12 V‐Scan Screening Echo SCRECHO 770 770
13 Dobutamine Stress Echo with Contrast DOBUSECHOWD
Contrast for Echocardiography COFOEC 1100 1100
Dobutamine stress echo (Echo Department) DECHO 5830 4400
14 Echocardiogram with Doppler ( with Contrast ) ECHODOPWD
Contrast for Echocardiography COFOEC 1100 1100
Echocardiogram with Doppler ( Contrast charged extra) ECHODOPWD 3300 2420
15 Stress Echo with Contrast SECHOSETWD 6500 5000
Contrast for Echocardiography COFOEC
Stress Echo (Echo Deparment) SECHOOS

Echo Lab Contrast Charges

CAT 1/CAT2 CAT3
1 Contrast for Echocardiography COFOEC 1100 1100
68
EEG/EMG lab charges

CAT 1/CAT2 CAT3
1 Bedside EEG (less than 1 hr) EEG_BS 3510 2100
2 Bedside EMG EMG_BS 5080 3050
3 Bedside EMG & NCV EMGNCV_BS 8200 4920
4 Bedside Evoked Potential ‐ Auditory ( AEP / BAER / AUDIT_BS 3910 2340
BERA )
5 Bedside Evoked Potential ‐ Somatosensory ( SSEP ) EVOPOTSSEP_BS 3910 2340
6 Bedside Evoked Potential ‐ Visual ( VEP / VER ) VISUAL_BS 3910 2340
7 Bedside NCV / NCS ( Nerve conduction velocity / NCV_BS 4280 2560
study )
8 Bedside Repetitive nerve stimulation / Decremental REPNERSTI_BS 3910 2340
response ( RNST )
9 Botox injection under EMG control BIEMGC 1000 610
10 EEG EEG 2340 1410
11 Electroretinography ERG 2940 1760
12 EMG EMG 3510 2100
13 EMG / NCV EMGNCV 6630 3980
14 Evoked Potential ‐ Auditory ( AEP / BAER / BERA ) AUDIT 2930 1760
15 Evoked potential ‐ P300 EVOPOTP300 2660 1600
16 Evoked Potential ‐ Somatosensory EVOPOTSSEP 3140 1880
17 Evoked Potential ‐ Visual ( VEP / VER ) VISUAL 2930 1760
18 Long term bedside EEG ( 6 ‐ 24 hrs ) LTEEG24H 8060 4840
19 Long term video EEG (6 to 24 hrs) ‐ charges for video LTVEEG 9670 5800
recording
20 NCV / NCS ( Nerve conduction velocity / study ) NCV 3330 2000
21 Overnight Video EEG for 12 hour ‐ Lab Charges ONVEEG12LAB 8800 5280
22 Repetitive nerve stimulation / Decremental response REPNERSTI 2930 1760
( RNST )
23 Short term bedside EEG ( 1 ‐ 6 hrs ) STEEG6H 4830 2890
24 Short term video EEG monitoring (less than 6 hrs) VMT 4830 2890
25 Sleep deprivation EEG SDEEG 3140 1880
26 DIAGNOSTIC SLEEP STUDIES WITH OVERNIGHT VIDEO DSSWONVEEGOS
EEG(LABORATRY CHARGES + DOCTOR CHARGES)
Diagnostic sleep studies with overnight video EEG ‐ Doctor fee DSSWONVEEGDF 10500 6350
Diagnostic sleep studies with overnight video EEG ‐ Test charges DSSWONVEEG 8470 5080
27 Electrocorticography ECOGOS
Electrocorticography ‐ charges for procedure ECOGPC 16100 9660
Electrocorticography ‐ Doctor Fee ECOGDF 8060 4840
28 Intraoperative Neurophysiology monitoring INOPMONOS
Intraoperative Neurophysiology monitoring ‐ Charges for procedure INOPMONPC 16100 9660
Intraoperative Neurophysiology monitoring ‐ Doctor Fee INOPMONDF 8060 4840
29 Overnight Video EEG for 12 hours ‐(LABORATORY ONVEEG12OS
CHARGES + DOCTOR CHARGES)
Overnight Video EEG for 12 hour ‐ Lab Charges ONVEEG12LAB 8800 5280
Overnight Video EEG for 12 hours ‐ Doctor Fee ONVEEG12D 2200 1320
Note: for EMG procedures Rs. 250/‐ will be charged in addition to EMG charges for disposable needles.

69
Paediatric cardiac sciences lab charges

CAT 1/CAT2 CAT3
1 Ambulatory B.P. Monitoring for 24 Hrs. ( Paediatric AMBPMONITPS 2640 1840
Cardiac Sciences )
2 Echocardiogram with Doppler ( Paedtriatric Cardiac ECHODOPPS 2660 1670
Sciences )
3 Electrocardiogram ECG ( Paedtriatric Cardiac Sciences ECGPS 310 190
)
4 Fetal Cardiac Assessment ( Paedtriatric Cardiac FECHOPS 3660 2420
Sciences )
5 Holter Test ( Paedtriatric Cardiac Sciences ) HOLTERPS 2640 1840
6 Review Echo for LV Function RELVF 1000 600
7 Review Follow up Fetal Echo RFEH 2000 1200
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 8000 8000
3 Bone Scan SS 6000 6000
4 Brain SPECT ( Epilepsy Protocol ) SPECT 17000 17000
5 Captopril DTPA Study For Screening of Renal HT GS4 11000 11000
6 DEXA bone densitometry with IVA BD5 2610 2610
7 DEXA Hip And Spine bone densitometry BD1 3500 3500
8 DEXA Single Site bone densitometry BD4 2250 2250
9 DEXA Three Site bone densitometry BD2 4000 4000
10 DEXA Three Sites ( Thalassemia Patient ) BD2TP 2250 2250
11 DEXA Whole Body BD3 4500 4500
12 DEXA Whole Body Fat Assessment BD6 4700 4700
13 Direct Radionucleotide Cystogram with uroflometery GS6 5500 5500
( DRCG )
14 DMSA renal scan GS5 6000 6000
15 DTPA Scan GS1 6000 6000
16 Dynamic Sailo Scintigrapgy DSCIN 10000 10000
17 ECD Brain SPECT ECDB 10500 10500
18 Gallium Scan TI1 14370 14370
19 Gastric Emptying ( Liquid ) GEL 6000 6000
20 Gastric Emptying ( Solid ) GES 6000 6000
21 Gastric Emptying ( Solid and Liquid ) GESL 8000 8000
22 Gastro Esophageal Reflux Study ( GER ) GT2 5000 5000
23 Gated Stress Myocardial Perusion Study CVS1 13000 13000
24 GER and swallow GT4 5500 5500
25 Hepatobiliary Scan GT5 7500 7500
26 Hepatosplenic Scan HTSS 5000 5000
27 HMPAO Brain SPECT B1 11500 11500
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 6500 6500
31 Infection ( Ciprofloxacin ) Scan for Infection ICSI 12650 12650
32 Leukocyte scan for Infection II1 22000 22000
70
33 Lung Perfusion RES3 5000 5000
34 Lung Ventilation RES2 5000 5000
35 Lung Ventilation & Perfusion RES1 9000 9000
36 Lung Ventilation, Perfusion and Venography VQ 11500 11500
37 Lymphagiography CVS3 7500 7500
38 Meckel Study GT6 5000 5000
39 Parathyroid Scan TI4 9000 9000
40 Radionuclide cisternnography for CSF Leak ‐ Scan B2 8500 8500
charges
41 Radionuclide Peritoneography RNPG 6500 6500
42 RBC Scan ( Heat Denatured ) RBCSC 6500 6500
43 Renal transplant evaluation GS7 5000 5000
44 Rest Myocardial Perfusion Imaging ( MPI ) RMPI 6500 6500
45 Resting MUGA CVS5 5250 5250
46 Scintimammography SMGPY 8000 8000
47 Sentinel Node SENN 5000 5000
48 SPECT Bone Scan SS2 4600 4600
49 Spect for Brain Tumor recurrence GHA B4 9000 9000
50 Spect for Brain Tumor recurrence MIBI B5 9500 9500
51 Stress MUGA CVS4 6000 6000
52 Swallow Study SWAS 2500 2500
53 Tecktroyd Scan (technetium octreotide scan) TECKTROYD 57480 57480
54 Testicular Scan GS8 5000 5000
55 Trodat + FDG PET Brain TROPS 15680 15680
56 TRODAT BRAIN TRODAT2 21000 21000
57 TRODAT BRAIN PET TRODAT1 15680 15680
58 Venography CVS2 5500 5500
59 Yttrium (Medicine Cost Only) RS1 16720 16720
Nuclear Medicine Laboratory Charges

CAT 1/CAT2 CAT3
1 17‐OHP (Progesterone) (Nuclear RIA) ‐ 1 Sample 17OHP 840 840
2 17‐OHP (Progesterone) (Nuclear RIA) ‐ 2 Samples 17OHP2 1640 1640
3 25‐OH VIT D Level (Nuclear RIA) 25OHVIT 1900 1900
4 Anti ‐ TG ( Thyroid Antibody ) ‐ Nuclear Medicine TG 700 700
5 Anti ‐ TPO ( Thyroid Antibody ) ‐ Nuclear Medicine TPO 700 700
6 C ‐ Peptide Test PEPTIDE 700 700
7 Chromogranin A NCA 7470 7470
8 Cyclosporin Level ( C0 and C2 ) CYCLOSPORINC 2240 2240
9 Cyclosporin Level ( C2 ) CYCLOSPC2 1390 1390
10 Cyclosporin Level ( CO ) CYCLOSPCO 1390 1390
11 Free T3 T3 500 500
12 Free T3 / Free T4 T3T4 980 980
13 Free T4 T4 500 500
14 Free T4 / TSH T4TSH 980 980
15 Growth Hormone (HGH) ( Nuclear RIA ) GHORMONE 840 840
16 Growth Hormone Stimulation Test ( Clonidine ) ( GHORMONES 3490 3490
Nuclear RIA )
17 IGF 1 (Nuclear Medicine) IGF1 3200 3200
18 IGF BP3 (Nuclear Medicine) IGFBP3 3200 3200
19 Insulin Estimation (5 Samples) INSULINC 2090 2090
20 Insulin Level ‐ Fasting INSULINLF 450 450
21 Insulin Level ‐ PP INSULIPP 450 450
22 Insulin Level ‐ Random INSULINLR 450 450
71
23 Insulin Level ( Fasting + PP ) INSULINFPP 880 880
24 Insulin Level ( Fasting, 1 hourly and 2 hourly ) INSULINF12 1330 1330
25 Neonatal TSH TSHN 320 320
26 PTH Level PTH 1340 1340
27 Renin Levels RENIN 4430 4430
28 Testesterone (Free) TESTF 1770 1770
29 Testesterone (Total) TESTT 760 760
30 Thyroglobulin assay THGLOA 4430 4430
31 Thyroid Antibodies ‐ Nuclear Medicine TANTIBODIES 1260 1260
32 Thyroid Profile ( T3, T4, TSH ) T3T4TSH 1250 1250
33 TSH (Nuclear) TSH 450 450
34 Thyroid profile ( T3 , T4 , TSH ) with Anti ‐ TPO THYTPO
Anti ‐ TPO ( Thyroid Antibody ) ‐ Nuclear Medicine TPO 700 700
Thyroid Profile ( T3, T4, TSH ) T3T4TSH 1250 1250
Nuclear Medicine Therapy Charges

CAT 1/CAT2 CAT3
1 10‐20 mCi TH5 12000 12000
2 High Dose I‐131 Therapy TH6 16000 16000
3 I‐131 Theraphy for thyrotoxicosis upto 10mCi TH4 9000 9000
4 P‐32 Therapy for Bone Metastasis SS5 5750 5750
5 Samarium Therapy for Bone Pain Palliation STFBPP 13790 13790
6 Strontium 89 Therapy Bone Metastasis SS6 89660 89660
7 Theraspheres/Sirspheres THENUC 783750 783750
Nuclear Imaging

CAT 1/CAT2 CAT3
1 FDG PET CT Cardiac plain ( FOR COMPANY PATIENTS ) CPCTPOS
FDG isotope charges F18FDGISO 10500 10500
FDG PET CT Cardiac plain (FDG isotope charges extra) CPCTP 6500 6500
2 FDG PET CT Angiography Whole Body with Contrast ( FOR PCTAWBCOS
COMPANY PATIENTS )
FDG PET CT Angiography Whole Body with Contrast (FDG isotope charges PCTAWBC 18500 18500
extra)
3 FDG PET CT Brain plain ( FOR COMPANY PATIENTS ) PCTBPos
FDG PET CT Brain plain (FDG isotope charges extra) PCTBP 3500 3500
4 FDG PET CT Brain plain with Contrast ( FOR COMPANY PCTBWCOS
PATIENTS )
FDG PET CT Brain plain with Contrast (FDG isotope charges extra) PCTBWC 5500 5500
5 Whole body PET CT scan with TRODAT brain (With PCTTROBROS
Contrast)
Whole body PET CT Scan with TRODAT brain (With Contrast) PCTTROBR 28500 28500
6 Whole body PET CT Scan with TRODAT brain (Plain) PCTTROBRPOS
Whole body PET CT Scan with TRODAT brain (Plain) PCTTROBRP 24500 24500
7 FDG PET CT Whole Body Plain ( FOR COMPANY PATIENTS) PCTWBPOS
FDG PET CT Whole Body Plain (FDG isotope charges extra) PCTWBP 10500 10500
72
8 FDG PET CT Whole Body with Contrast ( FOR COMPANY PETCTWBOS
PATIENTS)
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 PCTABWC 8998 8998
isotope charges extra)
9 FDG PET CT Angiography Whole Body with Contrast PCTAWBC 18500 18500
(FDG isotope charges extra)
10 FDG PET CT Brain plain (FDG isotope charges extra) PCTBP 3500 3500
11 FDG PET CT Brain plain with Contrast (FDG isotope PCTBWC 5500 5500
charges extra)
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 PCTMVPAWC 16874 16874
CT Coronary Angiography with Contrast (FDG isotope
charges extra)
15 FDG PET CT Whole Body Plain (FDG isotope charges PCTWBP 10500 10500
extra)
16 FDG PET CT Whole Body with Contrast (FDG isotope PCTWBC 13500 13500
charges extra)
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 DOTANOC 8180 8180
imaging ( regional )
22 PET CT ‐ Whole body somatostatin receptor imaging ( PCTSRI 15340 15340
DOTONOC 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 PCTTROBR 28500 28500
Contrast)
73
Allergy Tests

CAT 1/CAT2 CAT3
1 Aeroallergen ( Respiratory ) Common Panel AERESCOMOS
Aeroallergen ( Respiratory ) Common Panel AERESCOM 4820 2890
Aeroallergen ( Respiratory ) Common Panel ‐ Hospital Charges AERESCOMH 1600 960
2 Aeroallergen ( Respiratory ) Comprehensive Panel AERESCPOS
Aeroallergen ( Respiratory ) Comprehensive Panel AERESCP 8025 4810
Aeroallergen ( Respiratory ) Comprehensive Panel ‐ Hospital Charges AERESCPH 2670 1605
3 Food Allergy Common Panel ALLCOMOS
Food Allergy Common Panel ALLCOM 3200 1930
Food Allergy Common Panel ‐ Hospital Charges ALLCOMHOSP 1070 640
4 Food Allergy Comprehensive Panel ALLCOMPOS
Food Allergey Comprehensive Panel ALLCOMPR 7220 4330
Food Allergy Comprehnsive Panel ‐ Hospital Charges ALLCOMPHOSP 2400 1450

Fetal Medicine Charges

CAT 1/CAT2 CAT3
1 Portable ultrasound hospital service charges ( Fetal FETAL_BS 900 550
Medicine )
2 Ultrasound 3 D Reconstruction of face 3DRF 5500 3300
3 Ultrasound Amino infusion AMINOINF 4700 3000
4 Ultrasound AVI & Doppler only UAVID 1700 1120
5 Ultrasound bio‐physical scoring BPSC 900 550
6 Ultrasound BPS with doppler + AVI BPSDOP 1800 1100
7 Ultrasound colour doppler Fetal echo with 4 D UFED4 3850 2310
8 Ultrasound colour doppler Fetal echo with doppler UFED 3300 1980
9 Ultrasound colour doppler Twins UTDS 3700 2200
10 Ultrasound colour doppler Twins with growth scan UCDTGS 5000 3000
11 Ultrasound CVS chorionic villus sampling UCVS 10000 7500
12 Ultrasound CVS chorionic villus sampling ( UCVSTS 6000 4500
Thalassemia society patient )
13 Ultrasound Evaluation of AVI / Scar thickness / UEAVI 800 480
presentation / placental localisation
14 Ultrasound fetal blood sampling UFBS 13000 8200
15 Ultrasound fetal For cardiac activity UFCA 800 500
16 Ultrasound fetal Portable charges for fetal medicine UFPCH 950 600
17 Ultrasound fetal reduction in Fetal Medicine Dept FRED 16500 9900
18 Ultrasound fetal skin sampling (Fetal medicine FETALSKIN 4300 2600
charges)
19 Ultrasound fetal Triplet BPS UFTRBPS 1500 900
20 Ultrasound fetal Triplet BPS ‐ colour Doppler UFTRBPSCD 4600 2760
21 Ultrasound fetal Triplet Growth scan UFTRGS 3700 2220
22 Ultrasound fetal Triplet Growth scan Doppler flows UFTRGSDF 5800 3500
23 Ultrasound fetal Triplet Level II ‐ Doppler flows UFTRLII 5800 3500
24 Ultrasound fetal Triplet MCA / UA / Umblical / UFTRMCA 2000 1200
uterine artery
25 Ultrasound fetal Twin anamoly scan ‐ doppler flows UFTACDF 5500 3300
26 Ultrasound fetal Twin biophysical score UFTBPS 1500 900
27 Ultrasound fetal Twin Genetic sonogram UFTGS 3800 2300
28 Ultrasound fetal Twin MCA/UA/Umblical/uterine UFTMCA 1500 900
artery‐Doppler
74
29 Ultrasound fetal urine sampling FETALURI 6000 3600
30 Ultrasound for Genetic Sonogram (16‐18 weeks) UANEU 2500 1500
31 Ultrasound guided Aminocentesis (Twins) FETAMINOTWIN 9000 6000
32 Ultrasound guided amniocentesis UGAMINO 6000 4000
33 Ultrasound guided Amniocentesis and UGAAF 8000 4800
Amnioinfusiuon
34 Ultrasound guided CVS (Twins) FETCVSTWIN 12000 8000
35 Ultrasound Intrauterine transfusion INTRATRA 19000 12000
36 Ultrasound obstetric growth scan + colour doppler OBSTDOP 4200 2600
flow study + AVI
37 Ultrasound Obstetric Intervention OBSINTER 7000 4200
38 Ultrasound obstetrics ‐ MCA / UA / Umblical / Uterine FETOBSMCAUA 1500 900
artery ‐ Doppler
39 Ultrasound obstetrics ‐ Mid trimester anomaly scan FETMTAS 4000 2400
(MTAS / Level II / TIFFA) with Doppler
40 Ultrasound obstetrics ‐ Miscellaneous FETOBSMIS 1300 800
41 ULTRASOUND OBSTETRICS ‐ NUCHAL SCAN WITH UONSUAD 3000 1800
UTERINE ARTERY DOPPLER
42 Ultrasound obstetrics ‐ viability / dating scan ( upto UO10 1500 900
10 weeks )
43 Ultrasound obstetrics ( Twins ) ( After 18 weeks UOT 3000 1800
without Level II )
44 Ultrasound obstetrics (Triplets) ‐ Level II / MTAS / FETOBSTRI 5200 3150
TIFFA
45 Ultrasound obstetrics Dating + cervical length UTDCL 1200 750
46 Ultrasound obstetrics growth scan ( 26 weeks till UOGS26 2000 1200
term )
47 Ultrasound obstetrics Quadruplets NT Scan UTQTMT 4700 2820
48 Ultrasound obstetrics Triplet Dating cardiac activity UTTRIDCA 2100 1260
49 Ultrasound obstetrics Triplet extended screening UTTRIEX 4200 2600
50 Ultrasound obstetrics Twins AVI Doppler UTTWAVID 2100 1300
51 Ultrasound obstetrics Twins Dating cardiac activity UTTWDCA 1750 1050
52 Ultrasound obstetrics Twins extended screening UTTWEX 3800 2300
53 ULTRASOUND OBSTETRICS WITH DETAILED STUDY OF UODFKS 3700 2350
FETAL KUB (KIDNEYS‐SIZES, PELVICALYCED
DILATATION, CORTICAL THICKNESS, URETERS AND
URINARY BLADDER) SINGLETON
54 ULTRASOUND OBSTETRICS WITH MATERNAL KIDNEYS UOWMK 2000 1200
55 Ultrasound placental biopsy ULPLABIO 10000 7000
56 AMNIO DRAINAGE AMNIODR 5000 3000
57 FETAL REDUCTION QUADRUPLETS FETALRED 25000 15000
58 DOCTORS VISIT CHARGES FOR IUT FETALIUT 1500 1500

75
Ultrasound Charges

CAT 1/CAT2 CAT3
1 Breasr FNAC under ultrasound guidance ‐ Ultrasound UFNACULC 1650 990
Department Charges
2 IVF procedure ( Registration 2) ‐ Ultasound Charges IVFREGUC2 3190 3190
3 IVF procedure ( Registration) ‐ Ultasound Charges IVFULT 1600 1600
4 LIVER TRANSPLANT PACKAGE ‐ Ultrasound charges LTRULT
5 Portable ultrasound hospital service charges ULTRA_BS 1110 670

(Ultrasound Dept)
6 Ultrasound Extra Film Charges ULTEF 500 500
7 Ultrasound & colour doppler of transplanted kidney KT 1820 1090
8 Ultrasound 3D / 4D upper abdomen lower abdomen U3DUA 4200 2520
9 Ultrasound breast SPB 2200 1320
10 Ultrasound carotid doppler UCARODOP 3220 1940
11 Ultrasound colour doppler eye UEYE 1680 1010
12 Ultrasound colour doppler follicle monitoring (single CDS 640 390
day)
13 Ultrasound colour doppler orthosonography UOSONO 2090 1250
14 Ultrasound colour doppler renal artery RENAL 3500 2100
15 Ultrasound colour doppler thyroid THYROID 1960 1180
16 Ultrasound colour doppler vessel / vein mapping / VLM 1210 730
marking
17 Ultrasound Elastography ‐ Breast ULELASB 2040 1220
18 Ultrasound Elastography ‐ Liver ULELASLIV 2790 1670
19 Ultrasound Elastography ‐ Prostate ULELASPRRO 2040 1220
20 Ultrasound Elastography ‐ Scrotum ULELASSCR 2040 1220
21 Ultrasound Elastography ‐ Thyroid ULELASTTHY 2040 1220
22 Ultrasound follicle monitoring ( single day ) UFMSD 480 290
23 Ultrasound follicle study full FSF 2240 1340
24 Ultrasound for detection of ascitis UFDA 560 340
25 Ultrasound for detection of pleural effusion ULDPE 560 340
26 Ultrasound for residual urine RU 430 250
27 Ultrasound for undescended testis UUT 1890 1130
28 Ultrasound guidance charges for Ascites / Effusion UASCUINT 1210 730
tapping ( interventional)
29 Ultrasound guidance charges for FNAC / Biopsy ( UFNACINT 1210 730
interventional)
30 Ultrasound gynae with colour doppler UGCD 2090 1250
31 Ultrasound joints UJTS 2240 1340
32 Ultrasound KUB KUB 1540 920
33 Ultrasound KUB + doppler scrotum ( without TRS ) UKUBDS 2790 1670
34 Ultrasound KUB + pelvis ( Female ) UKUBPF 2040 1220
35 Ultrasound KUB + prostate ( TRUS ) KUBP 2040 1220
36 Ultrasound KUB + prostate + scrotum (without KUBPROSC 2520 1510
doppler)
37 Ultrasound KUB + prostate + TRS + doppler scrotum UKUBPTRS 3500 2100
38 Ultrasound KUB + residual urine KUBRU 1540 920
39 Ultrasound lower abdomen / pelvis LA 1460 880
40 Ultrasound monitoring ( PICU / ICU / OT ) UMBOT 380 380
41 Ultrasound musculoskeletal system UMUSCU 2420 1450
42 Ultrasound Neck UNECK 1650 990
43 Ultrasound neurosonography ( cranial ultrasound in SPN 1330 800
babies )
44 Ultrasound of a focal swelling FOCALSW 840 510
45 Ultrasound pelvis with colour doppler GCD 2240 1340
76
46 Ultrasound penile colour doppler PLD 3070 1840
47 Ultrasound peripheral arterial colour doppler both PBLU 5870 3520
arms
48 Ultrasound peripheral arterial colour doppler both PBLL 5870 3520
legs
49 Ultrasound peripheral arterial colour doppler left arm PLA 3770 2270
50 Ultrasound peripheral arterial colour doppler left leg PLL 3770 2270
51 Ultrasound peripheral arterial colour doppler right PRA 3770 2270
arm
52 Ultrasound peripheral arterial colour doppler right leg PRL 3770 2270
53 Ultrasound scrotum ULTRASCROT 1540 920
54 Ultrasound scrotum with colour doppler OSONO 2380 1430
55 Ultrasound small parts ULSMP 1410 850
56 Ultrasound thorax SPCH 1110 670
57 Ultrasound thyroid SPT 1450 870
58 Ultrasound transplant ( graft ) kidney (without TK 660 400
doppler)
59 Ultrasound Transplant kidney with scrotum (with ULKWISCR 3070 1840
colour doppler)
60 Ultrasound Transplant kidney with scrotum (without ULKWSCR 2090 1250
colour doppler)
61 Ultrasound transrectal + pelvis ultrasound (Male) TRUS 1470 880
62 Ultrasound upper abdomen UA 1540 920
63 Ultrasound upper abdomen & doppler study ABDO 3800 2280
64 Ultrasound venous colour doppler both arms PBLUV 6290 3770
65 Ultrasound venous colour doppler both legs PBLLV 6290 3770
66 Ultrasound venous colour doppler left arm PLAV 3770 2270
67 Ultrasound venous colour doppler left leg PLLV 3770 2270
68 Ultrasound venous colour doppler neck PNV 2450 1470
69 Ultrasound venous colour doppler right arm PRAV 3770 2270
70 Ultrasound venous colour doppler right leg PRLV 3770 2270
71 Ultrasound whole abdomen & pelvis ( Adult ) WA 2420 1450
72 Ultrasound whole abdomen & pelvis (age less than 12 WA12 1540 920
years)
73 Ultrasound whole abdomen with scrotum ULWBWSCR 3500 2100
74 Ultrasound whole abdomen with TRUS UWAWTRUS 2790 1670
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
77
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
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 12120 12120 12120 12120 12120 12120 12120
TOMOMAM Tomosynthesis Charges ‐ Mammography 5000 5000 5000 5000 5000 3000
Dept.Charges
7 CUBTAOS Contrast Ultrasound for Blunt
Trauma abdomen
CUBTADC Contrast Ultrasound for Blunt Trauma 7000 7000 4200 7000 3180
abdomen ‐ U/S dept. charges
CUBTADF Contrast Ultrasound for Blunt Trauma 1410 1410 850 1410 850
abdomen ‐ Ultrasonologist fee
8 ENDOBRO ENDOBRONCHIAL
ULOS ULTRASOUND ‐ (DOCTOR FEE +
HOSPITAL CHARGES +
DISPOSABLES CHARGES +
CYTOLOGY CHARGES)
ENDOBROULD Endobronchial Ultrasound ‐ Doctor Fee 22140 22140 11070 8860 6640 11070 6640
F
ENDOBROPAC Endobronchial Ultrasound ‐ For PACS ‐ NOT
S FOR BILLING PURPOSE
ENDOBROULH Endobronchial Ultrasound ‐ Hospital charges 8840 8840 4420 3540 2650 4420 2650
C
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 8800 8800 4750
Fee
FRUUD Fetal Reduction by Ultrasound Dept ‐ 8800 8800 4750
Ultrasound Deptt. Charges
10 SALSONO Salpingo sonography
OS
USALSODF Salpingo sonography ‐ Ultrasonologist fee 1390 1390 690 1390
USALSODC Salpingo sonography ‐ Ultrasound dept. 1390 1390 690 1390 1390
charges
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 ( 1100 1100 660 1100 660
12 UADOS Ultrasound diagnostic needle
aspiration for Ascitis
UADDF Ultrasound diagnostic needle aspiration for 910 910 610 910
Ascitis ‐ ultrasonologist fee
UAD Ultrasound diagnostic needle aspiration for 910 910 610 910 910
Ascitis ( Ultrasound dept charges )
13 UAEOS Ultrasound guided aspiration
in the department
UAEDF Ultrasound guided aspiration in the 1530 1530 760 1530
department ‐ ultrasonologist fee
UAE Ultrasound guided aspiration in the 1530 1530 760 1530 1530
78
14 UAODOS Ultrasound guided aspiration
outside the U/S department
UAODDF Ultrasound guided aspiration outside the 2090 2090 1060 2090
U/S department ‐ ultrasonologist fee
UAOD Ultrasound guided aspiration outside the 2090 2090 1060 2090 2090
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
OS abscess aspiration (outside
dept.)
UGLAAODDC Ultrasound guided liver abscess aspiration 2240 2240 1330 2240 2240
(outside dept.) ‐ Dept. charges
UGLAAODDF Ultrasound guided liver abscess aspiration 2240 2240 1330 2240
(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
UGLBODDF Ultrasound guided liver biopsy (outside the 2240 2240 1110 2240
19 UGLBOS Ultrasound guided liver biopsy
UGLBDC Ultrasound guided liver biopsy ‐ Dept. 1820 1820 1210 1820 1820
charges
UGLBDF Ultrasound guided liver biopsy ‐ Doctor fee 1820 1820 1210 1820
20 UGMTPOS Ultrasound guided MTP
UGMTPDF Ultrasound guided MTP ‐ ultrasonologist fee 2090 2090 1210 2090
UGMTP Ultrasound guided MTP ( Ultrasound dept 2090 2090 1210 2090 2090
charges )
21 UGOCAOS Ultrasound guided ovarian cyst
aspiration
UGOCADC Ultrasound guided ovarian cyst aspiration ‐ 2090 2090 1210 2090 2090
Dept. charges
UGOCADF Ultrasound guided ovarian cyst aspiration ‐ 2090 2090 1210 2090 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 ‐ 1060 1060 520 1060 1060 1060
Dept. charges
UGPADF Ultrasound guided perigraft aspiration ‐ 1060 1060 520 1060
Doctor fee
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 2420 2420 1210 2420 2420
aspiration / biopsy ( Ultrasound dept
charges )
25 UGRBOD Ultrasound guided renal biopsy
OS
UGRBDC Ultrasound guided renal biopsy ‐ Dept. 1760 1410 1060 1760 1650
charges
UGRBDF Ultrasound guided renal biopsy ‐ Doctor fee 1760 1410 1060 1760
79
26 UGRBOS Ultrasound guided renal biopsy
(Outside dept.)
UGRBODDC Ultrasound guided renal biopsy (Outside 2040 2040 1010 2040 2040
UGRBODDF Ultrasound guided renal biopsy (Outside 2040 2040 1010 2040
27 UGTAFAO Ultrasound guided therapeutic
S aspiration for ascitis
UGTAFADC Ultrasound guided therapeutic aspiration 1820 1820 920 1820 1820
for ascitis ‐ Dept. charges
UGTAFADF Ultrasound guided therapeutic aspiration 1820 1820 920 1820
for ascitis ‐ Doctor fee
28 UGTAFPF Ultrasound guided therapeutic
OS aspiration for pleural fluid
UGTAFPFDC Ultrasound guided therapeutic aspiration 1820 1820 920 1820 1820
for pleural fluid ‐ Dept. charges
UGTAFPFDF Ultrasound guided therapeutic aspiration 1820 1820 920 1820
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
30 ULCON Contrast ultrasound
CULTRA Contrast Ultrasound ‐ Ultrasonologist fee 1410 1410 850 1410
CONULHC Contrast ultrasound ‐ Ultrasound dept. 7000 7000 4200 7000 4200
charges
31 ULGYNOS Contrast ultrasound Gynae
ULGYNDF Contrast Ultrasound Gynae ‐ Ultrasonologist 1410 1410 850 1410
fee
ULGYNDC Contrast Ultrasound Gynae ‐ Ultrasound 7000 7000 4200 7000 4200
dept. charges
32 ULHEPLTO Contrast Ultrasound Hepatic
S artery for liver transplant
ULHALIVDF Contrast Ultrasound Hepatic artery for liver 1410 1410 850 1410
transplant ‐ Ultrasonologist fee
ULHALIVDC Contrast Ultrasound hepatic artery for liver 7000 7000 4200 7000 4200
transplant ‐ Ultrasound dept. charges
33 ULKIDOS Contrast ultrasound Kidney
ULKIDDF Contrast ultrasound Kidney ‐ Ultrasonologist 1410 1410 850 1410
fee
ULKIDDC Contrast ultrasound Kidney ‐ Ultrasound 7000 7000 4200 7000 4200
dept. charges
34 ULLIVOS Contrast ultrasound Liver
ULLIVDF Contrast Ultrasound Liver ‐ Ultrasonologist 1410 1410 850 1410
fee
ULLIVDC Contrast ultrasound Liver ‐ Ultrasound dept. 7000 7000 4200 7000 4200
charges
35 ULOESOS Contrast ultrasound
Oesophagus
ULOESDF Contrast Ultrasound Oesophagus ‐ 1410 1410 850 1410
Ultrasonologist fee
ULOESDC Contrast ultrasound Oesophagus ‐ 3500 3500 2100 3500 2100
Ultrasound dept. charges
36 ULPROOS Contrast ultrasound Prostate
ULPRODF Contrast Ultrasound Prostate ‐ 1410 1410 850 1410
Ultrasonologist fee
ULPRODC Contrast ultrasound Prostate ‐ Ultrasound 7000 7000 4200 7000 4200
dept. charges
37 ULRFAOS Contrast ultrasound charges
for Radio frequency ablation
ULRFADF Contrast ultrasound charges for Radio 3500 3500 2100 3500
frequency ablation ‐ Ultrasonologist fee
ULRFADC Contrast ultrasound charges for Radio 13980 13980 8390 13980 8390
frequency ablation ‐ Ultrasound dept.
charges
38 ULSPLOS Contrast ultrasound Spleen
ULSPLDF Contrast Ultrasound Spleen ‐ Ultrasonologist 1410 1410 850 1410
fee
80
ULSPLDC Contrast Ultrasound Spleen ‐ Ultrasound 7000 7000 4200 7000 4200
dept. charges
39 ULTHYOS Contrast ultrasound Thyoid
ULTHYDF Contrast Ultrasound Thyroid ‐ 1410 1410 850 1410 850
Ultrasonologist fee
ULTHYDC Contrast ultrasound Thyroid ‐ Ultrasound 7000 7000 4200 7000 4200
dept. charges
40 ULUVROS Contrast Ultrasound for U V
Reflux
ULUVRDF Contrast Ultrasound for UV reflux ‐ 1410 1410 850 1410
Ultrasonologist fee
ULUVRDC Contrast Ultrasound for UV reflux ‐ 3500 3500 2100 3500 2100
Ultrasound dept. charges
41 USAVFC Ultrasound guided venous
mapping for I/J catheter
insertion and A.V Fistula
creation
USAVFDF Ultrasound guided venous mapping for I/J 600
catheter insertion and A.V Fistula creation ‐
Doctor Fee
USAVFHS Ultrasound guided venous mapping for I/J 600
catheter insertion and A.V Fistula creation ‐
Machine Charges
42 USBRSTBP Ultrasound guided breast
SYOS biopsy
USBRSTBPSYD Ultrasound guided breast biopsy ‐ 1680 1680 840 1680
F ultrasonologist fee
USBRSTBPSY Ultrasound guided breast biopsy ( 1680 1680 840 1680 1680
43 USSKBRO Ultrasound skin marking for
T lesion in OT
SKINMARKOT Ultrasound skin marking for lesion in OT ‐ 2200 2200 1320 2200 1320
Ultrasonologist fee
SKINMARKOT Ultrasound skin marking for lesion in OT ‐ 2200 2200 1320 2200 1320
US Ultrasound dept charges

81
X‐Ray Charges

CAT 1/CAT2 CAT3
1 Additional charge for BEDSIDE portable X‐ray done in XRAY_BS 580 350
WARD/Recovery
2 Additional Xray Contrast AXCONTRAST 150 150
3 Additional Xray film charges for vascular / neuro lab XFCVAS
4 Additional Xray gastrographin contrast (100 ml) AXGC100 1300 1300

7 Additional Xray ionic contrast (20 ml) AXIC20 320 320
8 Additional Xray non‐ionic contrast (10 ml) AXNIC10 480 480
12 B/L Ankle Mortice View ‐ Xray XRAYAMV 520 310
13 B/L Femur Oblique view‐ Xray XRAYBLFOV 1010 610
14 B/L Forearm Oblique view ‐ Xray XRAYBLFROV 1010 610
15 B/L Hip Joint Outlet & Inlet views‐ Xray XRAYHINV 2000 1200
16 B/L Humerus Oblique view ‐ Xray XRAYBLHOV 1010 610
17 B/L Knees Merchant View ‐ Xray XRAYBL 520 310
18 B/L Knees Tunnel View ‐ Xray XRAYBLT 520 310
19 B/L Legs Oblique view‐ Xray XRAYBLOV 1010 610
20 B/L Shoulder True AP View ‐ Xray XRAYBLSTAPV 520 310
21 Base of Skull ‐ Xray XRAYBSK 520 310
22 Both lower limb length measurement by Xray LOWLIMB 2660 2660
23 Breast ductography / galactography ( excluding dye BDG 3910 3910
charges )
24 Clinch fist view (AP) XRAYFV 520 310
25 Clinch fist view (B/L) XRAYFVBL 520 310
26 Clinch fist View (Lat.) XRAYFVLT 520 310
27 Digital image in CD XRAYCD 220 130
28 Duplicate film (each film) XRAYDF 330 200
29 Enface view of scapula (B/L) XRAYSCBL 1010 610
30 Enface view of scapula (Lt.) XRAYSCLT 520 310
31 Enface view of scapula (Rt.) XRAYSCR 520 310
32 Foetogram AP / Lat. ‐ Xray XRAYFOAPL 1010 610
33 For OT ONLY ‐ Additional charge for portable X‐ray BOTPX 2500 1500
done in OT
34 Frog Leg View XRAYLV 520 310
35 Intra oral Xray IORAL 240 140
36 Lt. Ankle Mortice View‐ Xray XRAYLTAMV 520 310
37 Lt. Femur Oblique view Xray XRAYLFV 520 310
38 Lt. Forearm Oblique view ‐ Xray XRAYLFROV 520 310
39 Lt. Hip Joint Outlet & Inlet views‐ Xray XRAYHLINV 1010 610
40 Lt. Humerus Oblique view ‐ Xray XRAYLTHOV 520 310
41 Lt. Knee Merchant View ‐ Xray XRAYLTFNEE 520 310
42 Lt. Knee Tunnel View ‐ Xray XRAYLFTV 520 310
43 Lt. Legs Oblique view‐ Xray XRAYLFOV 520 310
44 Lt. Shoulder True AP View ‐ Xray XRAYLFTSTAPV 520 310
45 Lumbosacral Spine ‐ Lateral view in lying down LUMSLD 520 310
position
46 Lumbosacral Spine ‐ Lateral view in sitting position LUMST 520 310
47 Lumbosacral spine AP in sitting position ‐ XRAY XRAYAP 520 310
48 Lumbosacral spine AP/ Lat. In sitting position ‐ Xray XRAYAPLAT 1010 610
49 Lumbosacral spine Lat. In sitting position ‐ Xray XRAYLAT 520 310
82
50 OPG Xray OPG 720 430
51 Pericatheteric RGU ‐ Dye charges XRAYRGUDY 320 320
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 320 320
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
96 Xray ankle stress view (bilateral) ANKSVB 520 310
97 Xray ankle stress view (L) ANKSVL 520 310
98 Xray ankle stress view (R) ANKSVR 520 310
99 Xray arm / humerus AP & lateral (bilateral) ARAPLTB 2000 1200
100 Xray arm / humerus AP & lateral (L) ARAPLTL 1010 610
101 Xray arm / humerus AP & lateral (R) ARAPLTR 1010 610
102 Xray arm / humerus AP & lateral with elbow ARAPLEB 2000 1200
(bilateral)
103 Xray arm / humerus AP & lateral with elbow (L) ARAPLEL 1010 610
104 Xray arm / humerus AP & lateral with elbow (R) ARAPLER 1010 610
83
105 Xray arm / humerus AP & lateral with shoulder ARAPLSB 2000 1200
(bilateral)
106 Xray arm / humerus AP & lateral with shoulder (L) ARAPLSL 1010 610
107 Xray arm / humerus AP & lateral with shoulder (R) ARAPLSR 1010 610
108 Xray arm / humerus AP (bilateral) ARAPB 1010 610
109 Xray arm / humerus AP (L) ARAPL 520 310
110 Xray arm / humerus AP (R) ARAPR 520 310
111 Xray arm / humerus AP with elbow (bilateral) ARAPELB 1010 610
112 Xray arm / humerus AP with elbow (L) ARAPELL 520 310
113 Xray arm / humerus AP with elbow (R) ARAPELR 520 310
114 Xray arm / humerus AP with shoulder (bilateral) ARAPSHB 1010 610
115 Xray arm / humerus AP with shoulder (L) ARAPSHL 520 310
116 Xray arm / humerus AP with shoulder (R) ARAPSHR 520 310
117 Xray arm / humerus lateral (bilateral) ARLTB 1010 610
118 Xray arm / humerus lateral (L) ARLTL 520 310
119 Xray arm / humerus lateral (R) ARLTR 520 310
120 Xray arm / humerus lateral with elbow (bilateral) ARLTELB 1010 610
121 Xray arm / humerus lateral with elbow (L) ARLTELL 520 310
122 Xray arm / humerus lateral with elbow (R) ARLTELR 520 310
123 Xray arm / humerus lateral with shoulder (bilateral) ARLTSHB 1010 610
124 Xray arm / humerus lateral with shoulder (L) ARLTSHL 520 310
125 Xray arm / humerus lateral with shoulder (R) ARLTSHR 520 310
126 Xray arm for foreign body localisation (bilateral) ARFBLB 1010 610
127 Xray arm for foreign body localisation (L) ARFBLL 520 310
128 Xray arm for foreign body localisation (R) ARFBLR 520 310
129 Xray aspiration biopsy under image intensifier ABUIIF 3910 2340
130 Xray barium swallow + barium meal (upper GI) BSBMUGI 4870 2930
131 Xray Bilateral lower limb length AP & Lateral (Digital) XBLLLAPLD 2660 2660
132 Xray Bilateral lower limb length AP (Digital) XBLLLAPD 1770 1770
133 Xray Bilateral lower limb length Lateral (Digital) XBLLLLD 1770 1770
134 Xray both lower limbs complete (bilateral) ‐ children BLLBC 520 310
135 Xray breast specimen radiography BRSRAD 1180 700
136 Xray bronchogram (bilateral) BRONCBS 7280 4540
137 Xray bronchogram (L) BRONCSSL 4800 2830
138 Xray bronchogram (R) BRONCSSR 4800 2830
139 Xray calcaneum axial & lateral (bilateral) CALAXLB 1010 610
140 Xray calcaneum axial & lateral (L) CALAXLL 520 310
141 Xray calcaneum axial & lateral (R) CALAXLR 520 310
142 Xray calcaneum axial (bilateral) CALAXB 520 310
143 Xray calcaneum axial (L) CALAXL 520 310
144 Xray calcaneum axial (R) CALAXR 520 310
145 Xray calcaneum lateral (bilateral) CALLTB 520 310
146 Xray calcaneum lateral (L) CALLTL 520 310
147 Xray calcaneum lateral (R) CALLTR 520 310
148 Xray cephalogram CEPGRAM 720 430
149 Xray cervical spine (lateral) in extension CSPRE 520 310
150 Xray cervical spine (lateral) in flexion CSPLF 520 310
151 Xray cervical spine AP & lateral view CSAPLTV 1010 610
152 Xray cervical spine AP view CSPAP 520 310
153 Xray cervical spine in flexion, extension & neutral CSPFEFC 1490 890
154 Xray cervical spine lateral for cranio‐vertebrae CSPLCV 520 310
junction
155 Xray cervical spine lateral view CSPL 520 310
156 Xray cervical spine oblique (bilateral) CSPOB 1010 610
157 Xray cervical spine oblique (L) CSPOL 520 310
158 Xray cervical spine oblique (R) CSPOR 520 310
159 Xray cervical spine open mouth for CV junction CSPOM 520 310
84
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 ear pinna ‐ soft tissue (bilateral) EARPSTB 1010 610
197 Xray ear pinna ‐ soft tissue (L) EARPSTL 520 310
198 Xray ear pinna ‐ soft tissue (R) EARPSTR 520 310
199 Xray elbow AP & lateral (bilateral) ELBAPLB 1010 610
200 Xray elbow AP & lateral (L) ELBAPLL 520 310
201 Xray elbow AP & lateral (R) ELBAPLR 520 310
202 Xray elbow AP (bilateral) ELBAPBIL 520 310
203 Xray elbow AP (L) ELBAPL 520 310
204 Xray elbow AP (R) ELBAPR 520 310
205 Xray elbow lateral (bilateral) ELBLTB 520 310
206 Xray elbow lateral (L) ELBLTL 520 310
207 Xray elbow lateral (R) ELBLTR 520 310
208 Xray ERCP ERCP 3540 2120
209 Xray ERCP with papillotomy (includes one ampoule ERCPWPT 4620 2770
ionic contrast)
210 Xray ERCP with papilotomy & dormia basketing of ERCPPDB 4620 2770
stone
211 Xray ERCP with stenting ERCPST 4250 2550
212 Xray ethmoid sinus (bilateral) ETHSB 520 310
213 Xray ethmoid sinus (L) ETHSL 520 310
214 Xray ethmoid sinus (R) ETHSR 520 310
85
215 Xray feet (bilateral) AP FTAP 520 310
216 Xray feet (bilateral) AP & lateral FTBAPLT 1010 610
217 Xray feet (bilateral) AP & oblique FTBAPOB 1010 610
218 Xray feet (bilateral) lateral FTLAT 520 310
219 Xray feet (bilateral) oblique FTBOBL 520 310
220 Xray feet for arch lateral (bilateral) FTALTB 520 310
221 Xray femur (including hip joint) AP & lateral (bilateral) FRHJAPLTB 2000 1200
222 Xray femur (including hip joint) AP & lateral (L) FRHJAPLTL 1010 610
223 Xray femur (including hip joint) AP & lateral (R) FRHJAPLTR 1010 610
224 Xray femur (including hip joint) AP (bilateral) FRHJAPBIL 1010 610
225 Xray femur (including hip joint) AP (L) FRHJAPL 520 310
226 Xray femur (including hip joint) AP (R) FRHJAPR 520 310
227 Xray femur (including hip joint) lateral (bilateral) FRHJLTBIL 1010 610
228 Xray femur (including hip joint) lateral (L) FRHJLTL 520 310
229 Xray femur (including hip joint) lateral (R) FRHJLTR 520 310
230 Xray femur (including knee joint) AP & lateral FRKJAPLTB 2000 1200
(bilateral)
231 Xray femur (including knee joint) AP & lateral (L) FRKJAPLTL 1010 610
232 Xray femur (including knee joint) AP & lateral (R) FRKJAPLTR 1010 610
233 Xray femur (including knee joint) AP (bilateral) FRKJAPBIL 1010 610
234 Xray femur (including knee joint) AP (L) FRKJAPL 520 310
235 Xray femur (including knee joint) AP (R) FRKJAPR 520 310
236 Xray femur (including knee joint) lateral (bilateral) FRKJLTB 1010 610
237 Xray femur (including knee joint) lateral (L) FRKJLTL 520 310
238 Xray femur (including knee joint) lateral (R) FRKJLTR 520 310
239 Xray femur AP & lateral (bilateral) THAPLFB 2000 1200
240 Xray femur AP & lateral (L) THAPLFL 1010 610
241 Xray femur AP & lateral (R) THAPLFR 1010 610
242 Xray femur AP (bilateral) FEAPB 1010 610
243 Xray femur AP (L) FEAPLT 520 310
244 Xray femur AP (R) FEAPRT 520 310
245 Xray femur lateral (bilateral) FELAB 1010 610
246 Xray femur lateral (L) FELALT 520 310
247 Xray femur lateral (R) FELART 520 310
248 Xray first carpo metacarpal joint (bilateral) FTCMJB 520 310
249 Xray first carpo metacarpal joint (L) FTCMJL 520 310
250 Xray first carpo metacarpal joint (R) FTCMJR 520 310
251 Xray floor of orbit (bilateral) FLORBB 520 310
252 Xray floor of orbit (L) FLORBL 520 310
253 Xray floor of orbit (R) FLORBR 520 310
254 Xray Foetogram INTOGRMF 520 310
255 Xray foot AP & lateral (L) FTAPLL 520 310
256 Xray foot AP & lateral (R) FTAPLR 520 310
257 Xray foot AP & oblique (L) FTAPOBL 520 310
258 Xray foot AP & oblique (R) FTAPOBR 520 310
259 Xray foot AP (L) FOOTAPL 520 310
260 Xray foot AP (R) FOOTAPR 520 310
261 Xray foot AP , Lateral & oblique (Bilateral) FAPLTOBB 1490 890
262 Xray foot AP , Lateral & oblique (L) FAPLTOBL 1010 610
263 Xray foot AP , Lateral & oblique (R) FAPLTOBR 1010 610
264 Xray foot for arch lateral (L) FTAHLTL 520 310
265 Xray foot for arch lateral (R) FTAHLTR 520 310
266 Xray foot for foreign body localisation (bilateral) FOTFBLB 520 310
267 Xray foot for foreign body localisation (L) FOTFBLL 520 310
268 Xray foot for foreign body localisation (R) FOTFBLR 520 310
269 Xray foot lateral (L) FOTLTL 520 310
270 Xray foot lateral (R) FOTLTR 520 310
86
271 Xray foot oblique (L) FOTOBL 520 310
272 Xray foot oblique (R) FOTOBR 520 310
273 Xray for foreign body in orbit (bilateral) FFBORBB 520 310
274 Xray for foreign body in orbit (L) FFBORBL 520 310
275 Xray for foreign body in orbit (R) FFBORBR 520 310
276 Xray forearm AP & lateral (bilateral) FAPLB 1010 610
277 Xray forearm AP & lateral (L) FAPLL 520 310
278 Xray forearm AP & lateral (R) FAPLR 520 310
279 Xray forearm AP (bilateral) FARMAPB 520 310
280 Xray forearm AP (L) FARMAPL 520 310
281 Xray forearm AP (R) FARMAPR 520 310
282 Xray forearm for foreign body localisation (bilateral) FARMFBLB 520 310
283 Xray forearm for foreign body localisation (L) FARMFBLL 520 310
284 Xray forearm for foreign body localisation (R) FARMFBLR 520 310
285 Xray forearm for soft tissue AP & lateral (bilateral) FSTAPB 1010 610
286 Xray forearm for soft tissue AP & lateral (L) FSTAPL 520 310
287 Xray forearm for soft tissue AP & lateral (R) FSTAPR 520 310
288 Xray forearm with elbow AP & lateral (bilateral) FAEALB 1010 610
289 Xray forearm with elbow AP & lateral (L) FAEALL 520 310
290 Xray forearm with elbow AP & lateral (R) FAEALR 520 310
291 Xray forearm with wrist AP & lateral (bilateral) FWAPLB 1010 610
292 Xray forearm with wrist AP & lateral (L) FWAPLL 520 310
293 Xray forearm with wrist AP & lateral (R) FWAPLR 520 310
294 Xray hand ‐ soft tissue AP view (bilateral) HDSTAPB 520 310
295 Xray hand ‐ soft tissue AP view (L) HDSTAPL 520 310
296 Xray hand ‐ soft tissue AP view (R) HDSTAPR 520 310
297 Xray hand ( ball catcher view ) HBRA 520 310
298 Xray hand AP & Lateral (bilateral) HAPLTB 1010 610
299 Xray hand AP & Lateral (L) HAPLTL 520 310
300 Xray hand AP & Lateral (R) HAPLTR 520 310
301 Xray hand AP & oblique (bilateral) HLOBLB 1010 610
302 Xray hand AP & oblique (L) HLOBLL 520 310
303 Xray hand AP & oblique (R) HLOBLR 520 310
304 Xray hand AP (bilateral) HPOBL 520 310
305 Xray hand AP (L) HPA 520 310
306 Xray hand AP (R) HPAL 520 310
307 Xray hand AP , Lateral & oblique (bilateral) HAPLTOBB 1010 610
308 Xray hand AP , Lateral & oblique (L) HAPLTOBL 1010 610
309 Xray hand AP , Lateral & oblique (R) HAPLTOBR 1010 610
310 Xray hand for foreign body localisation (bilateral) HDFBLB 520 310
311 Xray hand for foreign body localisation (L) HDFBLL 520 310
312 Xray hand for foreign body localisation (R) HDFBLR 520 310
313 Xray hand lateral (bilateral) HDLTB 520 310
314 Xray hand lateral (L) HLATL 520 310
315 Xray hand lateral (R) HLATR 520 310
316 Xray hand oblique (bilateral) HOBLB 520 310
317 Xray hand oblique (L) HOBLL 520 310
318 Xray hand oblique (R) HOBLR 520 310
319 Xray hand ulnar deviation (for scaphoid) (bilateral) HDUDSB 520 310
320 Xray hand ulnar deviation (for scaphoid) (L) HDUDSL 520 310
321 Xray hand ulnar deviation (for scaphoid) (R) HDUDSR 520 310
322 Xray heel axial (bilateral) HLAXB 520 310
323 Xray heel axial (L) HLAXL 520 310
324 Xray heel axial (R) HLAXR 520 310
325 Xray heel lateral & axial (bilateral) HLLAXB 1010 610
326 Xray heel lateral & axial (L) HLLAXL 520 310
327 Xray heel lateral & axial (R) HLLAXR 520 310
87
328 Xray heel lateral (bilateral) HLLTB 520 310
329 Xray heel lateral (L) HLLTL 520 310
330 Xray heel lateral (R) HLLTR 520 310
331 Xray heel pads lateral view (bilateral) HLPLTBIL 520 310
332 Xray hip AP & lateral (bilateral) HIPAPLTB 2000 1200
333 Xray hip AP & lateral (L) HIPAPLTL 1010 610
334 Xray hip AP & lateral (R) HIPAPLTR 1010 610
335 Xray hip AP (L) HIPAPL 520 310
336 Xray hip AP (R) HIPAPR 520 310
337 Xray hip for acetabulum AP view (L) HIPAAPL 520 310
338 Xray hip for acetabulum AP view (R) HIPAAPR 520 310
339 Xray hip lateral (bilateral) HIPLTB 1010 610
340 Xray hip lateral (L) HIPLTL 520 310
341 Xray hip lateral (R) HIPLTR 520 310
342 Xray hips for acetabulum AP view (bilateral) HIPAAPB 1010 610
343 Xray hips including thighs (AP view for hip HIPITHB 1010 610
dislocation) ‐ bilateral
344 Xray iliac crest for bone age ( pelvis AP view ) ILCBPAP 520 310
345 Xray index finger AP & lateral (L) IXFRAPLTL 520 310
346 Xray index finger AP & lateral (R) IXFRAPLTR 520 310
347 Xray infantogram INTOGRM 520 310
348 Xray inferior orbital fissure (bilateral) INFORBFB 520 310
349 Xray inferior orbital fissure (L) INFORBFL 520 310
350 Xray inferior orbital fissure (R) INFORBFR 520 310
351 Xray invertogram INVTOGRM 1010 610
352 Xray IVP non‐ionic contrast with lasix challenge XNILC 4430 2660
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
371 Xray KUB AMENKUB 1010 610
372 Xray KUB ( single film ) AMENKUBS 520 310
373 Xray left elbow for bone age (AP & lateral view) LELBAPLTV 520 310
374 Xray left hand for bone age (PA view) LTHDBAPA 520 310
375 Xray Left lower limb length AP & Lateral (Digital) XLLLLAPLD 1770 1770
376 Xray Left lower limb length AP (Digital) XLLLLAPD 1070 1070
377 Xray Left lower limb length Lateral (Digital) XLLLLLD 1070 1070
378 Xray leg AP & lateral (bilateral) LEGAPLTB 1010 610
379 Xray leg AP & lateral (L) LEGAPLL 520 310
380 Xray leg AP & lateral (R) LEGAPLR 520 310
381 Xray leg AP & lateral with ankle (bilateral) LEGAPAB 1010 610
382 Xray leg AP & lateral with ankle (L) LEGAPAL 520 310
383 Xray leg AP & lateral with ankle (R) LEGAPAR 520 310
88
384 Xray leg AP & lateral with knee (bilateral) LEGAPKB 1010 610
385 Xray leg AP & lateral with knee (L) LEGAPKL 520 310
386 Xray leg AP & lateral with knee (R) LEGAPKR 520 310
387 Xray leg AP (bilateral) LEGAPB 520 310
388 Xray leg AP (L) LEGAPL 520 310
389 Xray leg AP (R) LEGAPR 520 310
390 Xray leg AP with ankle (bilateral) LEGAPANKB 520 310
391 Xray leg AP with ankle (L) LEGAPANKL 520 310
392 Xray leg AP with ankle (R) LEGAPANKR 520 310
393 Xray leg AP with knee (bilateral) LEGAPKNEB 520 310
394 Xray leg AP with knee (L) LEGAPKNEL 520 310
395 Xray leg AP with knee (R) LEGAPKNER 520 310
396 Xray leg lateral (bilateral) LEGLTB 520 310
397 Xray leg lateral (L) LEGLTL 520 310
398 Xray leg lateral (R) LEGLTR 520 310
399 Xray leg lateral with ankle (bilateral) LEGLANKB 520 310
400 Xray leg lateral with ankle (L) LEGLANKL 520 310
401 Xray leg lateral with ankle (R) LEGLANKR 520 310
402 Xray leg lateral with knee (bilateral) LEGLKNEB 520 310
403 Xray leg lateral with knee (L) LEGLKNEL 520 310
404 Xray leg lateral with knee (R) LEGLKNER 520 310
405 Xray little finger AP & lateral (L) LITFRAPLTL 520 310
406 Xray little finger AP & lateral (R) LITFRAPLTR 520 310
407 Xray lower leg for foreign body localisation (bilateral) LLEGFBLB 520 310
408 Xray lower leg for foreign body localisation (L) LLEGFBLL 520 310
409 Xray lower leg for foreign body localisation (R) LLEGFBLR 520 310
410 Xray lumbar spine AP & lateral view LRSAPLT 1010 610
411 Xray lumbar spine AP erect (Lt & Rt bending) LRSAPLTRT 1010 610
412 Xray lumbar spine AP erect (Lt bending) LSAPELB 520 310
413 Xray lumbar spine AP erect (Rt bending) LSAPERB 520 310
414 Xray lumbar spine AP view LSPAP 520 310
415 Xray lumbar spine lateral erect extension LSPLEPE 520 310
416 Xray lumbar spine lateral erect flexion LSPLEPF 520 310
417 Xray lumbar spine lateral erect flexion & extension LSPLEFE 1010 610
418 Xray lumbar spine lateral view LSPL 520 310
419 Xray lumbar spine oblique (bilateral) LSPOB 1010 610
420 Xray lumbar spine oblique (L) LSPOL 520 310
421 Xray lumbar spine oblique (R) LSPOR 520 310
422 Xray lumbosacral spine AP & lateral view LLSAPLT 1010 610
423 Xray lumbosacral spine AP erect (Lt & Rt bending) LLSAPRT 1010 610
424 Xray lumbosacral spine AP erect (Lt bending) LLSAPLTB 520 310
425 Xray lumbosacral spine AP erect (Rt bending) LLSAPRTB 520 310
426 Xray lumbosacral spine AP view including SI joints LLSAPV 520 310
427 Xray lumbosacral spine lateral erect extension LLSAEEXT 520 310
428 Xray lumbosacral spine lateral erect flexion LLSLTEF 520 310
429 Xray lumbosacral spine lateral erect flexion & LLSLTEFE 1010 610
extension
430 Xray lumbosacral spine lateral view LTSLTV 520 310
431 Xray lumbosacral spine oblique (bilateral) LTSOBLB 1010 610
432 Xray lumbosacral spine oblique (L) LTSOBLL 520 310
433 Xray lumbosacral spine oblique (R) LTSOBLR 520 310
434 Xray lunate (bilateral) LUNB 520 310
435 Xray lunate (L) LUNL 520 310
436 Xray lunate (R) LUNR 520 310
437 Xray mandible AP MABAPPA 520 310
438 Xray mandible oblique (bilateral) MABOBB 1010 610
439 Xray mandible oblique (L) MABOBL 520 310
89
440 Xray mandible oblique (R) MABOBR 520 310
441 Xray mastoid lateral oblique (bilateral) MASLOB 1010 610
442 Xray mastoid lateral oblique (L) MASLOL 520 310
443 Xray mastoid lateral oblique (R) MASLOR 520 310
444 Xray mastoid stenvers view (bilateral) MASSVB 1010 610
445 Xray mastoid stenvers view (L) MASSTEN 520 310
446 Xray mastoid stenvers view (R) MASSVR 520 310
447 Xray mastoid townes view MASTOW 520 310
448 Xray mastoid view schuller (bilateral) MASVSB 1010 610
449 Xray mastoid view schuller (L) MASVSC 520 310
450 Xray mastoid view schuller (R) MASVSR 520 310
451 Xray middle finger AP & lateral (L) MIDFAPLTL 520 310
452 Xray middle finger AP & lateral (R) MIDFAPLTR 520 310
453 Xray modified stenvers view for cochlear implant ) (L) MODSCIMPL 520 310
454 Xray modified stenvers view for cochlear implant ) (R) MODSCIMPR 520 310
455 Xray myelogram ( cervical ) MYELOC 8500 5100
456 Xray myelogram ( lumbar ) MYELOL 7460 4480
457 Xray nasal bone lateral (bilateral) NASBLTB 520 310
458 Xray nasal bone lateral (L) NASBLL 520 310
459 Xray nasal bone lateral (R) NASBLR 520 310
460 Xray nasopharynx lateral for adenoids NASADE 520 310
461 Xray neck for foreign body localisation NKFBL 520 310
462 Xray oesophageal dilatation under fluoroscopy ODUTVC 3540 2120
463 Xray oesophageal dilatation under fluoroscopy + ODUTVEI 3540 2120
endo prosthesis insertion
464 Xray oesophagus for foreign body localisation OFBL 520 310
465 Xray optic foramen (bilateral) OPTFORB 1010 610
466 Xray optic foramen (L) OPTFORL 520 310
467 Xray optic foramen (R) OPTFORR 520 310
468 Xray orbit AP & lateral (bilateral) OBITAPLTB 1490 890
469 Xray orbit AP & lateral (L) ORLTAP 1010 610
470 Xray orbit AP & lateral (R) OBITAPLTR 1010 610
471 Xray orbit AP (bilateral) OBITAPB 520 310
472 Xray orbit AP (L) OBITAPL 520 310
473 Xray orbit AP (R) ORRTAP 520 310
474 Xray orbit caldwel (bilateral) ORBITCB 520 310
475 Xray orbit caldwel (L) ORBITCL 520 310
476 Xray orbit caldwel (R) ORBITCR 520 310
477 Xray orbit for foreign body localisation (bilateral) ORBITFBLB 520 310
478 Xray orbit for foreign body localisation (L) ORBITFBLL 520 310
479 Xray orbit for foreign body localisation (R) ORBITFBLR 520 310
480 Xray orbit lateral (bilateral) ORBITLTB 1010 610
481 Xray orbit lateral (L) ORLTLA 520 310
482 Xray orbit lateral (R) ORRTLA 520 310
483 Xray orbit PA (bilateral) OBITPAB 520 310
484 Xray orbit PA (L) OBITPAL 520 310
485 Xray orbit PA (R) OBITPAR 520 310
486 Xray pacemaking (any procedure under fluoroscopy) PMAPTVF 5850 3510
487 Xray paranasal sinus Waters view PNSWAT 520 310
488 Xray patella PA & lateral (bilateral) PATPALB 1010 610
489 Xray patella PA & lateral (L) PATPALL 520 310
490 Xray patella PA & lateral (R) PATPALR 520 310
491 Xray patella tangential (bilateral) PATTANB 520 310
492 Xray patella tangential (L) PATTANL 520 310
493 Xray patella tangential (R) PATTANR 520 310
494 Xray pelvis AP (including both hips) PELAP 520 310
495 Xray penis ( soft tissue ) PEN 520 310
90
496 Xray percutaneous biliary baloon dilatation POUSBBD 17710 10630
497 Xray pisiform (bilateral) PISIB 520 310
498 Xray pisiform (L) PISIL 520 310
499 Xray pisiform (R) PISIR 520 310
500 Xray PTC PTC 6200 3720
501 Xray right hypochondrium for gall bladder RHYPOGB 520 310
502 Xray Right lower limb length AP & Lateral (Digital) XRLLLAPLD 1770 1770
503 Xray Right lower limb length AP (Digital) XRLLLAD 1070 1070
504 Xray Right lower limb length Lateral (Digital) XRLLLLD 1070 1070
505 Xray ring finger AP & lateral (L) RGFRAPLTL 520 310
506 Xray ring finger AP & lateral (R) RGFRAPLTR 520 310
507 Xray roof of orbit (bilateral) ROOFOB 520 310
508 Xray roof of orbit (L) ROOFOL 520 310
509 Xray roof of orbit (R) ROOFOR 520 310
510 Xray sacro coccyx spine / junction ‐ AP & Lateral SCSAL 1010 610
511 Xray sacro coccyx spine / junction ‐ lateral SCSL 520 310
512 Xray sacroiliac joint AP (bilateral) SIJTAPB 520 310
513 Xray sacroiliac joint AP (L) SIJTAPL 520 310
514 Xray sacroiliac joint AP (R) SIJTAPR 520 310
515 Xray sacroiliac joint oblique (bilateral) SIJTOBB 1010 610
516 Xray sacroiliac joint oblique (L) SIJTOBL 520 310
517 Xray sacroiliac joint oblique (R) SIJTOBR 520 310
518 Xray sacrum AP SSPAP 520 310
519 Xray sacrum AP & lateral SSAPLT 1010 610
520 Xray sacrum lateral SSPL 520 310
521 Xray scapula AP & lateral (bilateral) SCPLAPLB 2000 1200
522 Xray scapula AP & lateral (L) SCPLAPLL 1010 610
523 Xray scapula AP & lateral (R) SCPLAPLR 1010 610
524 Xray scapula AP (bilateral) SCPLAPB 1010 610
525 Xray scapula AP (L) SCPLAPL 520 310
526 Xray scapula AP (R) SCPLAPR 520 310
527 Xray scapula axial (bilateral) SCPAB 1010 610
528 Xray scapula axial (L) SCPAL 520 310
529 Xray scapula axial (R) SCPAR 520 310
530 Xray scapula lateral (bilateral) SCPLB 1010 610
531 Xray scapula lateral (L) SCPLL 520 310
532 Xray scapula lateral (R) SCPLR 520 310
533 Xray scapula Y ‐ view (bilateral) SCPYB 1010 610
534 Xray scapula Y ‐ view (L) SCPYL 520 310
535 Xray scapula Y ‐ view (R) SCPYR 520 310
536 Xray screening fluoroscopy SFLURO 1070 640
537 Xray shoulder AP & lateral (bilateral) SHOAPLTB 2000 1200
538 Xray shoulder AP & lateral (L) SHOAPLTL 1010 610
539 Xray shoulder AP & lateral (R) SHOAPLTR 1010 610
540 Xray shoulder AP (bilateral) SHAPB 1010 610
541 Xray shoulder AP (L) SHAPL 520 310
542 Xray shoulder AP (R) SHAPR 520 310
543 Xray shoulder axial (axillary) (bilateral) SHAXB 1010 610
544 Xray shoulder axial (axillary) (L) SHAXL 520 310
545 Xray shoulder axial (axillary) (R) SHAXR 520 310
546 Xray shoulder lateral (bilateral) SHLATB 1010 610
547 Xray shoulder lateral (L) SHLATL 520 310
548 Xray shoulder lateral (R) SHLATR 520 310
549 Xray shoulder lateral transthoracic (bilateral) SHLTTHB 1010 610
550 Xray shoulder lateral transthoracic (L) SHLTTHL 520 310
551 Xray shoulder lateral transthoracic (R) SHLTTHR 520 310
552 Xray skeletal survey ( extended ‐ 11 films) SKELSE11 5510 3310
91
553 Xray skeletal survey ( standard ‐ 5 films ) SKELSS5 2500 1500
554 Xray skull AP SKUAP/PA 520 310
555 Xray skull AP & lateral SKUAPLT 1010 610
556 Xray skull AP for styloid process SKUAPSP 520 310
557 Xray skull base / basal view / submento‐vertebral SKUBAS 520 310
view
558 Xray skull cone down lateral for sella ( pitutary fossa ) SKUCDS 520 310
559 Xray skull for jugular foramen SKJF 520 310
560 Xray skull lateral (bilateral) SKULB 1010 610
561 Xray skull lateral (L) SKULL 520 310
562 Xray skull lateral (R) SKULR 520 310
563 Xray skull maxilla SKUMAX 520 310
564 Xray skull oblique for optic foramina (bilateral) SKUOOFB 1010 610
565 Xray skull oblique for optic foramina (L) SKUOOFL 520 310
566 Xray skull oblique for optic foramina (R) SKUOOFR 520 310
567 Xray skull occipito‐frontal view SKOCCF 520 310
568 Xray skull perorbital view SKUPERIV 520 310
569 Xray skull tangential view SKTGV 520 310
570 Xray skull Towne's / fronto‐occipital 15 deg SKUTOW 520 310
571 Xray skull Townes / fronto‐occipital 20 deg SKUTOW20 520 310
572 Xray skull Townes / fronto‐occipital 30 deg SKUTOW30 520 310
573 Xray soft tissue neck AP NAP 520 310
574 Xray soft tissue neck AP & lateral NAPL 1010 610
575 Xray soft tissue neck lateral NLA 520 310
576 Xray soft tissue neck lateral ( adenoids / nasopharynx NLAA 520 310
)
577 Xray sphenoid sinus (lateral) SSINLT 520 310
578 Xray sterno clacicular joint AP (bilateral) STCJAPB 520 310
579 Xray sterno clavicular joint AP (L) STCJAPL 520 310
580 Xray sterno clavicular joint AP (R) STCJAPR 520 310
581 Xray sterno clavicular joint oblique (bilateral) STCJOBB 1010 610
582 Xray sterno clavicular joint oblique (L) STCJOBL 520 310
583 Xray sterno clavicular joint oblique (R) STCJOBR 520 310
584 Xray sternum AP STERAP 520 310
585 Xray sternum lateral STERLT 520 310
586 Xray sternum oblique (L) STEROBL 520 310
587 Xray sternum oblique (R) STEROBR 520 310
588 Xray styloid processes AP STLPAP 520 310
589 Xray submandibular gland area (L) SMABGOL 520 310
590 Xray submandibular gland area (R) SMABGOR 520 310
591 Xray subtalar joint (bilateral) SJB 1010 610
592 Xray subtalar joint (L) SJL 520 310
593 Xray subtalar joint (R) SJR 520 310
594 Xray superior orbital fissure (bilateral) SOFISB 520 310
595 Xray superior orbital fissure (L) SOFISL 520 310
596 Xray superior orbital fissure (R) SOFISR 520 310
597 Xray temporo mandibular joints (closed mouth) TMJCMB 1010 610
(bilateral)
598 Xray temporo mandibular joints (closed mouth) (L) TMJCML 520 310
599 Xray temporo mandibular joints (closed mouth) (R) TMJCMR 520 310
600 Xray temporo mandibular joints (open & closed TMJOCMB 2000 1200
mouth) (bilateral)
601 Xray temporo mandibular joints (open & closed TMJOCML 1010 610
mouth) (L)
602 Xray temporo mandibular joints (open & closed TMJOCMR 1010 610
mouth) (R)
92
603 Xray temporo mandibular joints (open mouth) TMJOMB 1010 610
(bilateral)
604 Xray temporo mandibular joints (open mouth) (L) TMJOML 520 310
605 Xray temporo mandibular joints (open mouth) (R) TMJOMR 520 310
606 Xray thigh for foreign body localisation (bilateral) THFBLB 1010 610
607 Xray thigh for foreign body localisation (L) THFBLL 520 310
608 Xray thigh for foreign body localisation (R) THFBLR 520 310
609 Xray thigh for soft tissue AP & lateral (bilateral) THSTAPLTB 2000 1200
610 Xray thigh for soft tissue AP & lateral (L) THSTAPLTL 1010 610
611 Xray thigh for soft tissue AP & lateral (R) THSTAPLTR 1010 610
612 Xray thigh for soft tissue AP (bilateral) THSTAPB 1010 610
613 Xray thigh for soft tissue AP (L) THSTAPL 520 310
614 Xray thigh for soft tissue AP (R) THSTAPR 520 310
615 Xray thoracic inlet view THIAP 520 310
616 Xray thumb AP & lateral (L) THUAPLTL 520 310
617 Xray thumb AP & lateral (R) THUAPLTR 520 310
618 Xray Thumb AP (bilateral) THUALB 520 310
619 Xray trapezium (bilateral) TZIUB 520 310
620 Xray trapezium (L) TZIUL 520 310
621 Xray trapezium (R) TZIUR 520 310
622 Xray venogram lower limb (bilateral) VENOLLB 8870 5320
623 Xray venogram lower limb (L) VENOLLL 5310 3190
624 Xray venogram lower limb (R) VENOLLR 5310 3190
625 Xray venogram upper limb (bilateral) VENOULB 8870 5320
626 Xray venogram upper limb (L) VENOULL 5310 3190
627 Xray venogram upper limb (R) VENOULR 5310 3190
628 Xray Whole spine digital film AP XWSDAP 1070 1070
629 Xray Whole spine digital film AP & Lateral XWSDAPL 1770 1770
630 Xray Whole spine digital film AP & Lateral (Left XWSDFAPLLB 1770 1770
Bending)
631 Xray Whole spine digital film AP & Lateral (Right XWSDFAPLRB 1770 1770
Bending)
632 Xray Whole spine digital film AP ( Right & Left XWSDFAPLRLB 2660 2660
Bending )
633 Xray Whole spine digital film AP (Left Bending) XWSDFAPLB 1070 1070
634 Xray Whole spine digital film AP (Right Bending) XWSDFAPRB 1070 1070
635 Xray Whole spine digital film Lateral XWSDL 1070 1070
636 Xray wrist and hand for bone age WRHBA 520 310
637 Xray wrist AP & lateral (bilateral) WRPALB 1010 610
638 Xray wrist AP & lateral (L) WRPALL 520 310
639 Xray wrist AP & lateral (R) WRPALR 520 310
640 Xray wrist AP & oblique (bilateral) WRAPLATB 520 310
641 Xray wrist AP & oblique (L) WRAPLATL 520 310
642 Xray wrist AP & oblique (R) WRAPLATR 520 310
643 Xray wrist AP (bilateral) WRPAB 520 310
644 Xray wrist AP (L) WRPAL 520 310
645 Xray wrist AP (R) WRPAR 520 310
646 Xray wrist AP, lateral & oblique (bilateral) WRAPLOBB 1490 890
647 Xray wrist AP, lateral & oblique (L) WRAPLOBL 1010 610
648 Xray wrist AP, lateral & oblique (R) WRAPLOBR 1010 610
649 Xray wrist carpal tunnel (bilateral) WRCTNLB 520 310
650 Xray wrist carpal tunnel (L) WRCTNLL 520 310
651 Xray wrist carpal tunnel (R) WRCTNLR 520 310
652 Xray wrist lateral (bilateral) WRLATB 520 310
653 Xray wrist lateral (L) WRLATL 520 310
654 Xray wrist lateral (R) WRLATR 520 310
655 Xray zygomatic arch base ZYGABAS 520 310
93
656 Xray zygomatic arch oblique tangential ZYGAOBLT 520 310
657 Xray zygomatic arch Townes ZYGATOW 520 310
658 Xray barium enema (double contrast) BEDCON
Xray barium dye Charges ( Rs. 320 ) BEDCONDYE 320 320
Xray barium enema (double contrast) BEDCON 5510 3310
659 Xray barium enema BELBOW
Xray barium dye Charges ( Rs. 320 ) BEDCONDYE 320 320
Xray barium enema BELBOW 4260 2550
660 Xray barium meal follow through BHFT
Xray barium dye Charges BHFTDYE 150 150
Xray barium meal follow through BHFT 3740 2240
661 Xray barium meal upper GI BMUGIT
Xray barium meal upper GI BMUGIT 3110 1870
662 Xray barium swallow for foreign body localisation BSFBL
Xray barium swallow for foreign body localisation BSFBL 2150 1290
663 Xray barium swallow (for heart) with fluoroscopy BSHFLS
Xray barium swallow (for heart) with fluoroscopy BSHFLS 2150 1290
664 Xray barium distal cologram COLOD
Xray barium distal cologram COLOD 2150 1290
Xray barium distal cologram ( dye Charges ) COLODDYE 150 150
665 Xray gastrografin cologram COLOG
Xray gastrografin cologram COLOG 2830 1690
Xray gastrografin dye Charges ‐ 3 Ampoules ( Rs. 970 ) COLOGDYE 970 970
666 Xray Colonic transit time COLOTTOS
Xray Colonic transit time COLTT 3910 2340
667 Xray penile cavernosogram CONG
Xray gastrografin dye Charges ‐ Vial ( Rs. 640 ) GAST2DYE 640 640
Xray penile cavernosogram CONG 4260 2550
668 Xray barium upper GI and follow through CUGITAF
Xray barium upper GI and follow through CUGITAF 5510 3310
669 Xray cystouretherogram ( MCU ) CYSTOMCU
Xray cystouretherogram ( MCU ) CYSTOMCU 4430 2830
Xray gastrografin dye Charges ( Rs. 1130) CYSTOMCVDYE 1130 1130
670 Xray cystogram ( MCU ) CYSTOMCV
Xray cystogram ( MCU ) CYSTOMCV 4430 2830
Xray gastrografin dye Charges ( Rs. 1130) CYSTOMCVDYE 1130 1130
671 Xray Dacrocystogram DACROOS
Xray Dacrocystogram DACROCYS 2500 1500
Xray gastrografin dye charges ‐ Ampoule ( Rs. 320 ) BDGDYE 320 320
672 Xray Defaecography DAFGRAOS
Xray Barium paste charges ( Rs. 250 ) BARPAST 250 250
Xray Defaecography DEFAGRA 6740 4050
673 Xray Distal cologram with RGU ( Barium + Gastrografin ) DISRGUBGOS
Xray Distal cologram with RGU ( Barium + Gastrografin ) DISCOLORGU 3540 2120
674 Xray Distal cologram with RGU ( Gastrografin ) DISRGUGASOS
Xray Distal cologram with RGU ( Gastrografin ) DISCOLORGUGAS 3540 2120
675 Xray gastric band adjustment under image intensifier GASBANDOS
Xray Gastric band adjustment under image intensifier GASBAND 1960 1180
94
676 Xray gastrografin upper GI GAST
Xray gastrografin upper GI GAST 3990 2400
677 Xray gastrografin swallow GAST2
Xray gastrografin swallow GAST2 1960 1170
678 Xray gastrografin follow through GAST3
Xray gastrografin follow through GAST3 3740 2240
679 Xray gastrografin upper GI & follow through GAST4
Xray gastrografin upper GI & follow through GAST4 5850 3510
680 Xray gastrografin enema GASTENE
Xray gastrografin enema GASTENE 4260 2550
681 Xray genitogram GENT
Xray genitogram GENT 3740 2240
682 Xray hysterosalpingogram ( HSG ) HSG
Xray hysterosalpingogram ( HSG ) HSG 3540 2150
683 Xray Ileostogram with barium ILEOBAROS
Xray Ileostogram with barium ILEOBAR 2220 1330
684 Xray Ileostogram with gastrografin ILEOGASOS
Xray Ileostogram with gastrografin ILEOGAS 3910 2340
685 Xray IVP (non‐ionic contrast) IVPA
Xray IVP (non‐ionic contrast) IVPA 3910 2340
Xray IVP (non‐ionic contrast) ( dye Charges ) IVPADYE 2090 2090
686 Xray IVP (non‐ionic contrast) child IVPC2
Xray IVP (non‐ionic contrast) child IVPC2 4620 2770
Xray IVP (non‐ionic contrast) child ( dye Charges ) IVPC2DYE 810 810
687 Xray Loopogram with barium LOOPOBAROS
Xray Loopogram with Barium LOOPOGRAM 2220 1330
688 Xray Loopogram with gastrografin LOOPOGASOS
Xray Loopogram with Gastrografin LOOPOGAS 3540 2120
689 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
690 Xray nephrostogram (bilateral) NEPB
Xray nephrostogram (bilateral) NEPB 5150 3090
691 Xray nephrostogram (L) NEPL
Xray nephrostogram (L) NEPL 3740 2240
692 Xray nephrostogram (R) NEPR
Xray nephrostogram (R) NEPR 3740 2240
693 Xray barium swallow OPBSLOW
Xray barium swallow OPBSLOW 2150 1290
694 Xray pouchogram (with barium) POUWBAR
Xray pouchogram (with barium) POUWBAR 2150 1290
95
695 Xray pouchogram (with gastrografin) POUWGAS
Xray pouchogram (with gastrografin) POUWGAS 2150 1290
696 Xray PTBD gram PTBDGRAM
Xray PTBD gram PTBDGRAM 3540 2120
697 Xray RGP in Xray department RGPIDM
Xray RGP in Xray department RGPIDM 3540 2120
698 Xray RGP in OT RGPIOT
Xray RGP in OT RGPIOT 4620 2770
699 Xray RGU RGU
Xray RGU RGU 3740 2240
700 Xray small bowel barium enema ( enteroclysis ) SBBEMA
Xray small bowel barium enema ( enteroclysis ) SBBEMA 7280 4370
701 Xray parotid sialogram (bilateral) SIALBS
Xray parotid sialogram (bilateral) SIALBS 3100 1860
702 Xray parotid sialogram (R) SIALOR
Xray parotid sialogram (R) SIALOR 1770 1070
703 Xray parotid sialogram (L) SIALOS
Xray parotid sialogram (L) SIALOS 1770 1070
704 Xray sinogram / fistulogram SINOG
Xray sinogram / fistulogram SINOG 2310 1390
705 Xray submandibular sialogram (bilateral) SMABSB
Xray submandibular sialogram (bilateral) SMABSB 3100 1860
706 Xray submandibular sialogram (L) SMABSL
Xray submandibular sialogram (L) SMABSL 1770 1070
707 Xray submandibular sialogram (R) SMABSR
Xray submandibular sialogram (R) SMABSR 1770 1070
708 Xray T ‐ tube cholangiogram TTCG
Xray T ‐ tube cholangiogram TTCG 2940 1760
709 Xray VP shuntogram VENOVPS
Xray VP shuntogram VENOVPS 3300 1980
710 Pericatheteric RGU( including dye charges ) ‐ XRAY XRAYRGOS
Pericatheteric RGU ‐ Dye charges XRAYRGUDY 320 320
Pericatheteric RGU ‐ Xray XRAYRGU 3740 2240
711 Stentogram ( including dye charges ) XRAYSCOS
Stentogram charges ‐ Xray XRAYSC 2940 1760
Stentogram Dye charges ‐ Xray XRAYDYE 320 320

96
X‐Ray Mammography Charges

CAT 1/CAT2 CAT3
1 ADD ON 3D MAMMOGRAPHY CHARGES ADDMAMOG 2500 1500
2 Breast FNAC under Radiological guidance ‐ Radiology BFNACDF 1500
Dept. Charges
3 Breast Ultrasound ( Radiology ) BRERAD 2000 1200
4 Hook wire localisation under radiological guidance ‐ HKWLHC 0 3000
Radiology Dept. fee
5 Mammographic hook wire localisation HWLOCAL 7500 2000
6 Mammographic hook wire localizatio ( Hook wire and MAHWL 2000
film charges only)
7 Radiological evaluation of collection REVACOL 510 510
8 Radiological evaluation of stent patency REVASTPT 510 510
9 Radiological guidance charges for FNAC / Biopsy ( RDFNACINT 600 600
interventional) ‐ Dept Charges
10 Tomosynthesis Charges ‐ Mammography TOMOMAM 5000 3000
Dept.Charges
11 Breast FNAC under Radiological guidance BFNACOS
Breast FNAC under Radiological guidance ‐ Radiologist fee BFNACRF 1580
Breast FNAC under Radiological guidance ‐ Radiology Dept. Charges BFNACDF 1500
12 Breast core biopsy under radiological guidance BRBIOS
Breast core biopsy under radiological guidance ‐ Radiologist fee BRBIORF 2500
Breast core biopsy under radiological guidance ‐ Radiology Dept. Charges BRBIOHC 2500 1500
13 Hook wire localisation under radiological guidance HKWLOS
Hook wire localisation under radiological guidance ‐ Radiologist fee HKWLRF 2500 1500
Hook wire localisation under radiological guidance ‐ Radiology Dept. fee HKWLHC 3000
14 Breast Tomosynthesis (3D Mammography) ‐ Left Breast MAMMBT3DLOS
only
Breast Tomosynthesis (3D Mammography) ‐ Left Breast only MAMMBT3DL 3000 1800
Breast Ultrasound ( Mammography ) BRULTMAM
15 Breast Tomosynthesis ( 3D Mammography ) ‐ Bilateral MAMMBT3DOS

Breast Tomosynthesis (3D Mammography) MAMMBT3D 6000 3600
16 Breast Tomosynthesis (3D Mammography) ‐ Right Breast MAMMBT3DROS

only
Breast Tomosynthesis (3D Mammography) ‐ Right Breast only MAMMBT3DR 3000 1800
17 Mammography ‐ Bilateral MAMMOBL

Mammography (bilateral) ( Xray dept charges ) MAMMOP 3500 2100

18 Mammography ( Left ) MAMMOLTOS
Mammography ( Left ) ( Xray dept charges ) MAMMOPL 1750 1050

19 Mammography ( Right ) MAMMORTOS
Mammography (R) ( Xray dept charges ) MAMMOPR 1750 1050

20 Comprehensive Left breast imaging package bilateral (2D MM2D3DLMOS
+ 3D Left Mammogram + Breast MRI)
Comprehensive Left breast imaging package bilateral (2D + 3D Left MM2D3DRM 12000 12000

Mammogram + Breast MRI) ‐ MRI Department Charges
Comprehensive Left breast imaging package bilateral (2D + 3D Left MM2D3DLM 2500 1500
Mammogram + Breast MRI) ‐ X‐Ray Department Charges
21 Comprehensive breast imaging package bilateral (2D + 3D MMCOBR2D3DOS

Mammography + Breast MRI)
Comprehensive breast imaging package bilateral (2D + 3D Mammography MMCOBR2D3DMRI 12000 12000

+ Breast MRI) ‐ MRI Department Charges
97
Comprehensive breast imaging package bilateral (2D + 3D Mammography MMCOBR2D3D 5000 3000
+ Breast MRI) ‐ X‐Ray Department Charges
22 Comprehensive Right breast imaging package bilateral MMCOBR2D3DRO

(2D + 3D Right Mammogram + Breast MRI)
Comprehensive Right breast imaging package bilateral (2D + 3D Right MM2D3DRMRI 12000 1500

Mammogram + Breast MRI) ‐ MRI Department Charges
Comprehensive Right breast imaging package bilateral (2D + 3D Right MMCOBR2D3DR 2500 1500
Mammogram + Breast MRI) ‐ X‐Ray Department Charges
23 Radiological skin marking for lesion RAFSMAROS

Radiological skin marking for lesion ‐ Radiologist fee RAFSMARDF 1000 600
Radiological skin marking for lesion ‐ Radiology Dept. Charges RAFSMARHC 1000 600
24 Radiological skin marking for lesion in OT RAFSMOTOS
Radiological skin marking for lesion in OT ‐ Radiologist fee RAFSMOTDF 2000 1200
Radiological skin marking for lesion in OT ‐ Radiology Dept. Charges RAFSMOTHC 2000 1200
25 Radiological guidance charges for Ascites / Effusion RASCUINTOS
tapping / Drainage ( interventional)
Radiological guidance charges for Ascites / Effusion tapping / Drainage ( RASCUINT 600 600
interventional) ‐ Dept. Charges
Radiological guidance charges for Ascites / Effusion tapping / Drainage ( RASCUINTRF 500 500
interventional) ‐ Radiologist fee
26 Radiological guidance charges for FNAC / Biopsy ( RDFNACINTOS

interventional)
Radiological guidance charges for FNAC / Biopsy ( interventional) ‐ Dept RDFNACINT 600 600
Charges
Radiological guidance charges for FNAC / Biopsy ( interventional) ‐ RDFNACINTRF 500 500
Radiologist Fee

Respiratory & Chest Medicine Lab Charges

CAT 1/CAT2 CAT3
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
Respiratory medicine package charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

1 ENDOBRON Endobronchial Ultrasound ‐ 46840 46840 23420 18740 14050 23420 14050
ULTAPC Package charges

98
Urodynamic test charges
SNo Description Code POPD/ CAT GOPD/

1/CAT2 CAT3
1 Complete Urodynamic Study ( Uroflowmetery , UROCOMPLETE 2800 1680
Cystometrography and UPP )
2 Electromyography ( EMG ) urinary sphincter EMGU 400 240
3 Urethral profile pressure ( UPP ) UPP 490 300
4 Uroflowmetery ( UFM ) UFM 800 480
5 Voiding cystometery VOIDCYST 1340 800
6 Water cystometrography ( CMG ) CMG 2000 1200
7 Water cystometrography ( CMG ) with WATCYST 2800 1680
Electrmyography ( EMG )
URODYNAMICS PROCEDURES (OPD)
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 with any medicine ‐
Urodynamics ( OPD )
CATHMHC Catheterization with instillation with any 240 1330
medicine ‐ Hospital Charges
CATHMDF Catheterization with instillation with any 2430
medicine ‐ Procedure Charges
2 CATHOS Catheterization ‐ Urodynamics
( OPD )
CATHHC Catheterization ‐ Hospital Charges 190 1000
CATHDF Catheterization ‐ Procedure Charges ( OPD ) 1820
3 CESOS Cyst Excision ‐ Urodynamics (
OPD )
CESHC Cyst Excision ‐ Hospital Charges 370 2000
CESDF Cyst Excision ‐ Procedure Charges 3640
4 DMAJOS Dressing Major ‐ Urodynamics
( OPD )
DMAJHC Dressing Major ‐ Hospital Charges 130 670
DMAJDF Dressing Major ‐ Procedure Charges (OPD) 1220
5 DMOS Dressing Minor ‐ Urodynamics
( OPD )
DMINHC Dressing Minor ‐ Hospital Charges 60 340
DMDF Dressing Minor ‐ Procedure Charges (OPD) 610
6 FREOS Frenuloplasty ‐ Urodynamics (
OPD )
FREHC Frenuloplasty ‐ Hospital Charges 320 1730
FREDF Frenuloplasty ‐ Procedure Charges 3150
7 NSBWOS Bladder wash with catheter
removal ‐ Urodynamics (OPD)
BWHC Bladder wash with catheter removal ‐ 130 670
Hospital Charges
NSBWDF Bladder wash with catheter removal ‐ 1220
Procedure Charges
8 PBIOOS Prostatic Biopsy ‐ Urodynamics
(OPD)
PBIOHC Prostatic Biopsy ‐ Hospital Charges 370 2010
PBIODF Prostatic Biopsy ‐ Procedure Charges (OPD) 3580
99
9 SUPBIOOS Superficial Biopsy ‐
Urodynamics ( OPD )
SUPBIOHC Superficial Biopsy ‐ Hospital Charges 230 1270
SUPBIODF Superficial Biopsy ‐ Procedure Charges 2430
10 TBIOOS Testicular Biopsy ‐
Urodynamics ( OPD )
TBIOHC Testicular Biopsy ‐ Hospital Charges 440 2420
TBIODF Testicular Biopsy ‐ Procedure Charges 4390
11 UDILOS Uretheral Dilatation ‐
Urodynamics ( OPD )
UDILHC Urethral Dilatation ‐ Hospital Charges 340 1790
UDILDF Urethral Dilatation ‐ Procedure Charges 3240
(OPD)
Other Special Care Charges
Premium/
2 Bedded
4 Bedded
Cat‐1D
POPD/
All Cat
Single
GOPD
Cat‐2
Cat‐3
Suite
1 ATEBJMOTAC All teeth extractions (both jaws) For Minor OT ( 3700
Anaesthetists Charges )
2 ABJMOTAC Alveolectomy (Both jaws) For Minor OT ( 2310
3 ASJNMOTAC Alveolectomy (one jaws) For Minor OT ( 1160
4 ALPMOTAC Alveoloplasty For Minor OT ( Anaesthetists Charges 690
)
5 ALPDMANCH Anaesthetists charges for Argon laser 690
photocoagulation ( single sitting ) for diabetic
maculopathy ‐ Doctor fees
6 CRDFICGANCH Anaesthetists charges for Combined retinal digital 670
fluorescein & indocyanine green ( ICG ) imaging
angiography
7 ANADENTAL Anaesthetists charges for dental procedures 2910
8 RDFIANCH Anaesthetists charges for Retinal digital 320
flurorescein imaging angiography
9 RDICGANCH Anaesthetists charges for Retinal digital 440
indocyanine green ( ICG ) imaging angiography
10 YAGANCH Anaesthetists charges for YAG laser 700
photocoagulation ‐ Doctor fees
11 ANDLANA Anal Dilatation For Minor OT ( Anaesthetists 830
Charges )
12 ABLDAF Angiography of B/L Dorsolumbar Spinal Radicular 13200 6600 5280 3960
Arteries ‐ Anasthetist fee
13 ARCTAC Apexification + Root canal treatment (RCT) For 1160
Minor OT ( Anaesthetists Charges )
14 AULAC Apicectomy (Under LA) For Minor OT ( 1850
15 AFDFAC Archbar fixation dentoalveolar fracture segment 1390
For Minor OT ( Anaesthetists Charges )
16 BASCAN Balloon Angioplasty & Stenting in Cervical 39600 19800 15840 11880
ICA/Vertebral ‐ Anasthetist Fee
17 BACEDAN Balloon Assisted Coil Embolization of a 44000 22000 17600 13200
Direct/Indirect Cavernous Fistula ‐ Anasthetist fee
18 BAVAC Brachio AV fistula at elbow for hemodialysis ‐ 2300
Anaesthetists Charges
19 CSTLACSMF Cataract Surgery MULTIFOCAL TORIC LENS ‐ 2880
Anaesthetist Charges
100
20 CSTLACSY Cataract Surgery SYMFONY LENS ‐ Anaesthetist 3600
Charges
21 CSTLACSYT Cataract Surgery SYMFONY TORIC LENS ‐ 3960
Anaesthetist Charges
22 CTZANA Catheterization For Minor OT ( Anaesthetists 490
Charges )
23 CIRETDAC Caval Interruption using retrievable device ‐ Doctor 15960 7980 6380 3990
Anaesthesia Charges
24 CCMANA Circumcision For Minor OT ( Anaesthetists Charges 1490
)
25 CARAVFAC Conversion of arteriovenous (AV) shunt to 2300
arteriovenous (AV) fistula ‐ Anaesthetists Charges
26 CAREVFAC Creation of arteriovenous (AV) Fistula at axillary 2910
artery ‐ Anaesthetists Charges
27 CAREVFBAC Creation of arteriovenous (AV) Fistula at elbow ( 2910
Brachial artery ) ‐ Anaesthetists Charges
28 CAREVFWBAC Creation of arteriovenous (AV) Fistula at wrist ( 2910
Radial Artery ) ‐ Anaesthetists Charges
29 DENIMPAC Dental Implant (first stage) For Minor OT ( 9220
30 DBFMNA Diagnostic Bronchoscopy For Minor OT ( 1840
31 DBWBNA Diagnostic Bronchoscopy with Biopsy ( 2240
32 TESAAN Diagnostic sperm extraction ( TESA / PESA ) ‐ 1700
Anesthesist fee
33 DISTMJAC Dislocation of TMJ For Minor OT ( Anaesthetists 1160
Charges )
34 DOSANA Dorsal Slit For Minor OT ( Anaesthetists Charges ) 1180
35 DREMA Dressing (minor) For Minor OT ( Anaesthetists 490
Charges )
36 DCDRA Dressing change/drain removal For Minor OT 410
(Anaesthetists Charges)
37 ELRBA Ear lobe repair BL For Minor OT ( Anaesthetists 1000
Charges )
38 ELRUA Ear lobe repair UL For Minor OT ( Anaesthetists 660
Charges )
39 ESPFDNA Embolization of Spinal Pial/dural Fistula ‐ 44000 22000 17600 13200
Anasthetist fee
40 ENDOBYAC Endoluminal bypass ‐ Doctor Anaesthesia Charges 15960 7980 6380 3990
41 ANAANAF Endoscopy submucosal dissection ‐ Anaesthetists 53550 26780 21420 16070
Fee
42 EXPFAC Excision of pericoronal flap For Minor OT ( 460
43 EXBIMAC Excisional biospy For Minor OT ( Anaesthetists 1390
Charges )
44 FLDIMTAC Flap Division and Inset For Minor OT ( Anaesthetists 2840
Charges)
45 FLMTAC Flap Large For Minor OT ( Anaesthetists Charges ) 4730
46 FSMTAC Flap Small For Minor OT ( Anaesthetists Charge) 3940
47 FSBQAC Flap surgery with bone graft (per quadrant) For 1850
48 FDPIANA Flow Divertor Placement for Intracranial Aneurysm 52800 26400 21120 15840
‐ Anasthetist fee
49 FOASA Foam Sclerotherapy For Minor OT ( Anaesthetists 3310
Charges )
50 FLAMOTAC Fracture mandible open reduction under LA (Cost 6920
of plates & screws etc.) For Minor OT (
51 FRMOTAC Frenectomy For Minor OT ( Anaesthetists Charges ) 690
52 FNPANA Frenuloplasty For Minor OT ( Anaesthetists Charges 750
)
101
53 GASPROPOEM Gastroenterology Procedures Poem ‐ Anasthetist 53550 26780 21420 16070
Fee
54 GINPMOTAC Gingivoplasty For Minor OT ( Anaesthetists Charges 1390
)
55 HYBAC Hybrid Procedure‐ Anaesthetist Charge 23480 22730 19000 15270
56 ICCPLNA ICD insertion for complex effusion/pneumothorax 1840
57 ICDSMNA ICD insertion for simple effusion/pneumothorax 790
58 IBSMOTAC Impaction (Bony/soft tissue) For Minor OT ( 2310
59 ICVADPAC Implantable Central Venous Access Device 5000 2500 2010 1250
Placement ‐ Doctor Anaesthesia Charges
60 INADMA Incision and drainage (major) For Minor OT ( 1320
61 INADA Incision and drainage (Minor) For Minor OT ( 660
62 INDMOTAC Incision and drainage For Minor OT( Anaesthetists 920
Charges )
63 IDLANA Incision and Drainage of Multiple/ Large Superficial 1320
Abscess For Minor OT ( Anaesthetists Charges )
64 IDSANA Incision And Drainage of Small/Superficial Abscess 660
65 IMFMOTAC Inter ‐ Maxillary fixation with archbar For Minor 3230
OT( Anaesthetists Charges )
66 IAVDNA Intracranial Angioplasty for Vasaspasm ‐ 26400 13200 10560 7920
Anasthetist fee
67 IVMECNA Intracranial AVM Embolization (Complex) ‐ 52800 26400 21120 15840
Anasthetist fee
68 IAELNA Intracranial AVM Embolization using Liquid Embolic 44000 22000 17600 13200
material ‐ Anasthetist fee
69 ISRNA Intracranial Stenting in Stroke Revascularization ‐ 44000 22000 17600 13200
Anasthetist fee
70 JFMOTAC Jaw fracture closed reduction For Minor OT( 3700
71 KTPSA KTP Surcharge ‐ Anasthesist fee 2650
72 LIVHIAF Liver Transplant High ‐ Anaesthetist Charges 105000
73 LIVTANF Liver Transplant Low ‐ Anaesthetist Charges 75000
74 LINNRAF Liver Transplant Normal Risk ‐ Anaesthetist Charges 90000
75 LNBMN Lymph Node Biopsy For Minor OT ( Anaesthetists 790
Charges )
76 MADMANA Major Debridement For Minor OT ( Anaesthetists 1660
Charges )
77 MTANA Meatotomy For Minor OT ( Anaesthetists Charges ) 690
78 MINIMPAC Mini implant for anchorage (per implant) For Minor 2770
79 MINDA Minor debridement For Minor OT ( Anaesthetists 830
Charges )
80 NEDLAA Needle aspiration For Minor OT (Anaesthetists 410
Charges )
81 NERBLAC Nerve block in Neuralgias For Minor OT ( 1390
82 ORANCAC Oro antral communication closure For Minor OT ( 6460
83 PTBANA Prostatic Trucut Biopsy For Minor OT ( 660
84 RFCHTVOAC Recanalization for Chronic Total Vascular Occlusion 13970 6990 5590 3500
‐ Doctor Anaesthesia Charges
85 RIOHAN Reduction of Irreducible Obstructed Hernia For 4140
86 RSPANA Reduction of Stomal Prolapsed For Minor OT ( 2480
102
87 RATMOTAC Reimplantation of avulsed tooth For Minor OT( 920
88 RCIDAC Removal of Caval Interruption Device ‐ Doctor 5990 3000 2400 1500
Anaesthesia Charges
89 RPMLAAC Removal of plates of mandible and maxilla (Under 3700
LA) For Minor OT( Anaesthetists Charges )
90 MINPAC Root canal with Apicectomy For Minor OT ( 2310
91 SCMOTAC Scaling full mouth For Minor OT ( Anaesthetists 690
Charges )
92 SSFTNA Secondary Suturing For Minor OT ( Anaesthetists 1050
Charges )
93 SVCAAC Six Vessel Cerabral Angiogram ‐ Anasthetist Fee 11000 5500 4400 3300
94 SKGMTAC Skin Grafting For Minor OT ( Anaesthetists Charges 3150
)
95 SMSKGRAA Small Skin Grafting For Minor OT ( Anaesthetists 3150
Charges )
96 STSEA Soft tissue swelling excision for Minor OT 2320
(Anaesthetists Charges )
97 SPTCANA SPC (Suprapubic Trocar Cystostomy) For Minor OT ( 1980
98 SPREMOTAC Splint Removal For Minor OT ( Anaesthetists 460
Charges )
99 SACEAN Stent Assisted Coil Embolization of Intracranial ICA 44000 22000 17600 13200
Aneurysm ‐ Anasthetist fee
100 SUBCURAC Subgingival scaling & curretage full mouth For 1390
Minor OT (Anaesthetists Charges)
101 SUEXTAC Surgical extraction of tooth For Minor OT 920
102 SUTREA Suture removal For Minor OT (Anaesthetists 410
Charges)
103 SMLANA Suturing of Medium Lacerations (Large) For Minor 2320
OT ( Anaesthetists Charges )
104 SSLANA Suturing of Small Lacerations For Minor OT ( 1320
105 TCBANA Teslicular Biopsy For Minor OT ( Anaesthetists 1000
Charges )
106 THHYD Therapeutic Hypothermia for 24‐48 hrs ‐ Doctor 20000 10000 8000 6000
Fee
108 TUEXAC Tumour Excision For Minor OT (Anaesthetists 4610
Charges)
109 URCANA Uretheral Catheterization For Minor OT ( 490
110 UCADANA Urethral Calibration and Dilatation For Minor OT ( 660
111 URDLA Urethral dilatation For Minor OT (Anaesthetists 830
Charges)
112 VAMSNA VAC Application For Minor OT ( Anaesthetists 530
Charges )
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 WDMTN Wound Debridement For Minor OT ( Anaesthetists 530
Charges )
116 YSBAN Y‐Stenting in a Basilar Top Aneurysm ‐ Anasthetist 52800 26400 21120 15840
fee
103
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 DATEXT‐1 Cat‐ 1 ‐ All teeth extractions (both jaws) 11720 8790
4 DABJAW‐1 Cat‐ 1 ‐ Alveolectomy (both jaws) 7330 5850
5 DAOJAW‐1 Cat‐ 1 ‐ Alveolectomy (one jaws) 3660 2930
6 DALVPLS1 Cat‐ 1 ‐ Alveoloplasty 2200 1460
7 DARCT‐1 Cat‐ 1 ‐ Apexification + Root canal treatment ( RCT ) 3660 3330
8 DAULA‐1 Cat‐ 1 ‐ Apicectomy ( Under LA ) 5850 4390
9 DAPICE‐1 Cat‐ 1 ‐ Apicectomy (Endodontics) 5850 3990
10 DAPAT‐1 Cat‐ 1 ‐ Apicectomy per additional tooth 2200
11 DAFDDS‐1 Cat‐ 1 ‐ Archbar fixation dentoalveolar fracture segment 4390 2930
12 DARTMJ‐1 Cat‐ 1 ‐ Arthocentesis of TMJ 7330 5450
13 DBP‐1 Cat‐ 1 ‐ Bite plate 4400 2940
14 DBT‐1 Cat‐ 1 ‐ Bleaching of teeth 7330 7330
15 DCPD‐1 Cat‐ 1 ‐ Cast partial dentures (metal casting) 8790 6600
16 CSPT‐1 Cat‐ 1 ‐ Cavity sealant (per tooth) 940 940
17 DCERLAM1 Cat‐ 1 ‐ Ceramic laminate 5860 5140
18 CCPV‐1 Cat‐ 1 ‐ Chemical cauterisation (per visit) 750 590
19 DCULAR‐1 Cat‐ 1 ‐ Closure of upper & lower anterior spaces + 27820 17580
retainers
20 DENCDUL‐1 Cat‐ 1 ‐ Complete denture upper and lower (both) 17580 13180
21 DENCDUOL‐1 Cat‐ 1 ‐ Complete denture upper or lower (either one) 8790 7330
22 DCFILL‐1 Cat‐ 1 ‐ Composite filling 2200 2000
23 DCOMPVEN1 Cat‐ 1 ‐ Composite veneers 2210 2210
24 DCOVUCST1 Cat‐ 1 ‐ Core build up ( casting ) 2210 2210
25 DCOVUPREF1 Cat‐ 1 ‐ Core build up ( prefab ) 1470 750
26 DCBC‐1 Cat‐ 1 ‐ Crown / Bridge per unit (ceramic) 6600 5140
27 DCBM‐1 Cat‐ 1 ‐ Crown / Bridge per unit (metal) 4400 2940
28 DCBP‐1 Cat‐ 1 ‐ Crown / Bridge per unit (Procera) 19970
29 DCURRE‐1 Cat‐ 1 ‐ Curettage (per quadrant) 3660 1330
30 DCYSTMAR‐1 Cat‐ 1 ‐ Cyst Enucleation / Marsupialisation 11720 5850
31 DDIFS‐1‐C Cat‐ 1 ‐ Dental implant ( complete ) 66550 48400
32 DDIFS‐1 Cat‐ 1 ‐ Dental implant (first stage) 29280 11720
33 DDIMP2‐1 Cat‐ 1 ‐ Dental implant (second stage) 14640 10250
34 DIWC Cat‐ 1 ‐ Dental Implant with Crown 66550
35 DDTMJ‐1 Cat‐ 1 ‐ Dislocation of TMJ 3660 3030
36 DEPF‐1 Cat‐ 1 ‐ Excision of pericoronal flap 1460 1460
37 DEB‐1 Cat‐ 1 ‐ Excisional biopsy 4390 2340
38 DRPTO‐1 Cat‐ 1 ‐ Extraction (per tooth) 740 590
39 DEFDTO‐1 Cat‐ 1 ‐ Extraction of fractured / decayed tooth 1460 880
40 DFCS‐1 Cat‐ 1 ‐ Fabrication of Circummandibular splint 5860 4840
41 DFMASK‐1 Cat‐ 1 ‐ Face mask 10250 9530
42 DFAGI‐1 Cat‐ 1 ‐ Filling amalgam / Glass ionomer 2240 1600
43 DFFOCJ‐1 Cat‐ 1 ‐ Fixed Functional Appliance for Orthopedic 43920
correction of JAW
44 DFOCERN‐1 Cat‐ 1 ‐ Fixed Orthodontics ( Ceramic Braces ) ‐ First 21970 14640
installment
45 DFOCERS‐1 Cat‐ 1 ‐ Fixed Orthodontics ( Ceramic Braces ) ‐ 2940 2570
Subsequent installment
46 DFOCER‐1 Cat‐ 1 ‐ Fixed orthodontics (ceramic braces) ‐ Full amount 51250 49670
47 DFOSSN‐1 Cat‐ 1 ‐ Fixed orthodontics (steel braces) ‐ First installment 14640 14640
48 DFOSS‐1 Cat‐ 1 ‐ Fixed orthodontics (steel braces) ‐ Full amount 39930 36610
104
49 DFOSSS‐1 Cat‐ 1 ‐ Fixed orthodontics (steel braces) ‐ Subsequent 2570 2210
installment
50 DFRLB‐1 Cat‐ 1 ‐ Fixed Retainers ( Lingual Bonded ) 7330
51 DFOPFM‐1 Cat‐ 1 ‐ Flap operation (full mouth) 14640 13180
52 DFOPQ‐1 Cat‐ 1 ‐ Flap operation (per quadrant) 4390 3660
53 DFSBG‐1 Cat‐ 1 ‐ Flap surgery with bone graft (per quadrant) 5850 5850
54 DFAPP‐1 Cat‐ 1 ‐ Fluoride application 1180 1180
55 DFMORLA‐1 Cat‐ 1 ‐ Fracture mandible open reduction under LA ( Cost 21970 18150
of Plates & screws etc. )
56 DFRENE‐1 Cat‐ 1 ‐ Frenectomy 2200 1180
57 DGTOMY‐1 Cat‐ 1 ‐ Gingivectomy (per quadrant) 3660 2930
58 DGPLASTY‐1 Cat‐ 1 ‐ Gingivoplasty (per quadrant) 4390 3660
59 DHBA‐1 Cat‐ 1 ‐ Habit Breaking appliance 8790
60 DIMPACT‐1 Cat‐ 1 ‐ Impaction (Bony / soft tissue) 7330 6660
61 DIPW‐1 Cat‐ 1 ‐ Implant Prosthetic work up Stage 2 and Stage 3 35000 25000
62 DIDRAIN‐1 Cat‐ 1 ‐ Incision and drainage 2930 2340
63 DIBIOP‐1 Cat‐ 1 ‐ Incisional biopsy 2200 1180
64 DIMFA‐1 Cat‐ 1 ‐ Inter ‐ maxillary fixation with archbar 10250 8790
65 DIWSPIL‐1 Cat‐ 1 ‐ Interdental wiring + splinting (per quadrant) 4390 4390
66 DIAINJ‐1 Cat‐ 1 ‐ Intra articular injection 1180 1180
67 DIFF‐1 Cat‐ 1 ‐ Iodoform Dressing for CYST 590 530
68 DJFCR‐1 Cat‐ 1 ‐ Jaw fracture closed reduction 11720 10990
69 DLFREN‐1 Cat‐ 1 ‐ Lingual frenectomy 2200 1770
70 DENCDULL‐1 Cat‐ 1 ‐ Lucitone Denture 24630 24630
71 DMFCC‐1 Cat‐ 1 ‐ Metal free ceramic crown 10250 8790
72 DMIA‐1 Cat‐ 1 ‐ Mini ‐ implant for anchorage (per implant) 8790 7330
73 DMFA‐1 Cat‐ 1 ‐ Myfunctional Appliance ‐ Twin Block 9080 7260
74 DNBN‐1 Cat‐ 1 ‐ Nerve block in Neuralgias 4390 3630
75 DOBTU‐1 Cat‐ 1 ‐ Obturators 11720 10990
76 DOPER‐1 Cat‐ 1 ‐ Operculectomy 1460 1460
77 DOACC‐1 Cat‐ 1 ‐ Oro antral communication closure 20490
78 DPDAC‐1 Cat‐ 1 ‐ Partial dentures (acrylic) 2940 2660
79 DATD‐1 Cat‐ 1 ‐ per additional tooth in denture 750 590
80 DPIOSMF‐1 Cat‐ 1 ‐ Placentrax Inj for OSMF 1180
81 DPOS‐1 Cat‐ 1 ‐ Planning Orthognathic Surgery 7870 7260
82 DPLCENE‐1 Cat‐ 1 ‐ Porcelain laminate veneers 5860 5140
83 DPPSOCPN‐1 Cat‐ 1 ‐ Pre & post surgical orthodontics for cleft palate ‐ 17580 14640
First installment
84 DPPSOCP‐1 Cat‐ 1 ‐ Pre & post surgical orthodontics for cleft palate ‐ 32220 29280
Full amount
85 DPPSOCPS‐1 Cat‐ 1 ‐ Pre & post surgical orthodontics for cleft palate ‐ 1470 3670
86 DPSOSN‐1 Cat‐ 1 ‐ Pre & post surgical orthodontics for orthognathic 23430 20500
surgery ‐ First installment
87 DPSOS‐1 Cat‐ 1 ‐ Pre & post surgical orthodontics for orthognathic 36610 41000
surgery ‐ Full amount
88 DPSOSS‐1 Cat‐ 1 ‐ Pre & post surgical orthodontics for orthognathic 2210 2570
surgery ‐ Subsequent installment
89 DPUCAP‐1 Cat‐ 1 ‐ Pulp capping 2240 1330
90 DPULPO‐1 Cat‐ 1 ‐ Pulpotomy 1460 1460
91 DRME‐1 Cat‐ 1 ‐ Rapid maxillary expansion ( RME ) 10250 9530
92 DRCB‐1 Cat‐ 1 ‐ Recementation of crown / bridge 890 590
93 DRAT‐1 Cat‐ 1 ‐ Reimplantation of avulsed tooth 2930 2930
94 DREDENT‐1 Cat‐ 1 ‐ Relining of denture 890 890
95 DRORTHON‐1 Cat‐ 1 ‐ Removable orthodontics ‐ First installment 14640 14640
105
96 DRORTHO‐1 Cat‐ 1 ‐ Removable orthodontics ‐ Full amount 23430 23430
97 DRORTHOS‐1 Cat‐ 1 ‐ Removable orthodontics ‐ Subsequent installment 1470 1470
98 DRFW‐1 Cat‐ 1 ‐ Removal of Frontosuspension wiring 5850
99 DROCBU‐1 Cat‐ 1 ‐ Removal of old crown/bridge/unit 740
100 DRPMMLA‐1 Cat‐ 1 ‐ Removal of plates of mandible and maxilla ( Under 11720
LA )
101 DRDENT‐1 Cat‐ 1 ‐ Repair of dentures 890 530
102 DRRBA‐1 Cat‐ 1 ‐ Retainers replacement (both arches) 2940 2210
103 DRRPA‐1 Cat‐ 1 ‐ Retainers replacement (per arch) 1470 1110
104 DRCTANT‐1 Cat‐ 1 ‐ Root canal treatment ( RCT ) ‐ anterior 3660 2930
105 DRCTPOS‐1 Cat‐ 1 ‐ Root canal treatment ( RCT ) ‐ posterior 5850 3990
106 DRCAPIC‐1 Cat‐ 1 ‐ Root canal with Apicectomy 7330 5850
107 DSFMOU‐1 Cat‐ 1 ‐ Scaling full mouth 2200 2000
108 DSMEA‐1 Cat‐ 1 ‐ Slow Maxillary Expansion Appliance 7330
109 DSMAINT‐1 Cat‐ 1 ‐ Space maintainers 3670 3670
110 DSPREMO1 Cat‐ 1 ‐ Splint Removal 1460 1460
111 DSMODEL‐1 Cat‐ 1 ‐ Study model 450 390
112 DSSCFM‐1 Cat‐ 1 ‐ Subgingival scaling & curretage full mouth 4390 3660
113 DSETO‐1 Cat‐ 1 ‐ Surgical extraction of tooth 2930 2930
114 DSREMO‐1 Cat‐ 1 ‐ Suture removal 1460 1030
115 DTMJP‐1 Cat‐ 1 ‐ TMJ Physiotherapy 750
116 DTINLY‐1 Cat‐ 1 ‐ Tooth inlay 2210 2210
117 DTEXCI‐1 Cat‐ 1 ‐ Tumour excision 14640 8790
118 DVOSPL‐1 Cat‐ 1 ‐ Vacuum formed occlusal splint 4400 3670
119 FPD6 Cat‐ 1 ‐ Velaplast (Flexible Partial Dentures) ‐ Upto 6 15000 12000
missing teeth to be replaced
120 FPD9 Cat‐ 1 ‐ Velaplast (Flexible Partial Dentures) ‐ Upto or 18000 15000
more than 9 missing teeth to be replaced
121 FPD3 Cat‐ 1 ‐ Velaplast (Flexible Partial Dentures)‐ Upto 3 10000 7000
122 DZCFULA‐1 Cat‐ 1 ‐ Zygonatic Complex Fracture under LA 14640
123 CLEGNESD Clear Aligners Double 150000
124 CLEGNES Clear Aligners Single 120000
125 CULHIDR Complete ( U / L ) Hybrid Implant Dentures 750000 750000
126 CDWPLA Complete Denture With Implant Location 225000 225000
127 DLOSJA Denture with Implant Locators / Single Jaw 130000 130000
128 DSLLPA Direct Sinus Lift For Implant Placement 25000 25000
129 DRVGRAD DRVG ‐ Dental Radiovision Graphy 250 150
130 GRAPC Graft ( Per CC ) 7000 7000
131 HYIDRS Hybrid Implant Dentures / Single Jaw 375000 375000
132 IMCTDISG Impaction ( Distoangular ) 10000 10000
133 ISLFTP Indirect Sinus Lift For Implant Placement 10000 10000
134 LACLASRE LANAP (Laser Assisted New Attachment Procedure) ‐ per 7500 4500
quadrant
135 LACAEX Laser Canine Exposure 5000 3500
136 LACROQUA Laser Crown Lengthening (per Quadrant) 7500 5000
137 LACROLE Laser Crown Lengthening (per Tooth) 2000 2000
138 LASDISMO Laser Disinfection ( Full Mouth ) 10000 7500
139 LAFRETO Laser Frenectomy 7500 5000
140 LAGITOMX Laser Gingivectomy (per Quadrant) 7500 5000
141 LAGINTH Laser Gingivectomy (per Tooth) 2000 1500
142 LAGUMBLE Laser Gum Bleaching (per Quadrant) 10000 6000
143 LAPHRA Laser Physiotherapy 6 Sittings 5000 3000
144 LASERMAJ Laser Surgery Major 10000 7500
145 LASESUR Laser Surgery Minor 5000 3500
106
146 LASEFULL Laser Whitening ( Full Mouth ) 20000 15000
147 LASEWHI Laser Whitening (per Tooth) 2000 2000
148 LADC1 Local Anaesthesia Category 1 ‐ Dental 200 150
149 MEFOT Metal Free ONLAY / Tooth 15000 15000
150 PITFISRE Pit and Fissure Sealants (per Tooth) 1800 1500
151 RETNTCT Retreatment RCT 8000 8000
152 SEALICEBA Self Ligating Ceramic Braces 80000 70000
153 SELIBRAS Self Ligating Metal Braces 65000 55000
154 SIRCT Single Sitting RCT 10000 10000
155 SUTREMO Suture Removal For Dental 1000 1000
156 VSTDESJ Valplast Denture / Single Jaw 18000 18000
157 NGA Night Guard Appliance ( Dental )
NGA Cat‐ 1 ‐ Dental Night Guard Appliance 3670
DENLAB150 Dental Lab Charges Rs ‐ 210 210 210
158 DATEXT‐2 Cat‐ 2 ‐ All teeth extractions (both jaws) 6160
159 DABJAW‐2 Cat‐ 2 ‐ Alveolectomy (both jaws) 4100
160 DAOJAW‐2 Cat‐ 2 ‐ Alveolectomy (one jaws) 2060
161 DARCT‐2 Cat‐ 2 ‐ Apexification + Root canal treatment ( RCT ) 2060
162 DAULA‐2 Cat‐ 2 ‐ Apicectomy ( Under LA ) 3090
163 DAPICE‐2 Cat‐ 2 ‐ Apicectomy (Endodontics) 2570
164 DAPAT‐2 Cat‐ 2 ‐ Apicectomy per additional tooth 1030
165 DAFDDS‐2 Cat‐ 2 ‐ Archbar fixation dentoalveolar fracture segment 2060
166 DBP‐2 Cat‐ 2 ‐ Bite plate 2060
167 DBT‐2 Cat‐ 2 ‐ Bleaching of teeth 5140
168 DCPD‐2 Cat‐ 2 ‐ Cast partial dentures (metal casting) 4630
169 CSPT‐2 Cat‐ 2 ‐ Cavity sealant (per tooth) 530
170 DCERLAM2 Cat‐ 2 ‐ Ceramic laminate 3600
171 CCPV‐2 Cat‐ 2 ‐ Chemical cauterisation (per visit) 430
172 DCULAR‐2 Cat‐ 2 ‐ Closure of upper & lower anterior spaces + 12310
retainers
173 DENCDUL‐2 Cat‐ 2 ‐ Complete denture upper and lower (both) 9240
174 DENCDUOL‐2 Cat‐ 2 ‐ Complete denture upper or lower (either one) 5140
175 DCFILL‐2 Cat‐ 2 ‐ Composite filling 1030
176 DCOMPVEN2 Cat‐ 2 ‐ Composite veneers 1550
177 DCOVUCST2 Cat‐ 2 ‐ Core build up ( casting ) 1550
178 DCOVUPREF2 Cat‐ 2 ‐ Core build up ( prefab ) 530
179 DCBC‐2 Cat‐ 2 ‐ Crown / Bridge per unit (ceramic) 3600
180 DCBM‐2 Cat‐ 2 ‐ Crown / Bridge per unit (metal) 2060
181 DCURRE‐2 Cat‐ 2 ‐ Curettage (per quadrant) 530
182 DCYSTMAR‐2 Cat‐ 2 ‐ Cyst Enucleation / Marsupialisation 4100
183 DDIFS‐2‐C Cat‐ 2 ‐ Dental implant ( complete ) 24200
184 DDIFS‐2 Cat‐ 2 ‐ Dental implant (first stage) 8210
185 DDIMP3‐2 Cat‐ 2 ‐ Dental implant (second stage) 7190
186 NGA‐2 Cat‐ 2 ‐ Dental Night Guard Appliance 2570
187 DEPF‐2 Cat‐ 2 ‐ Excision of pericoronal flap 1030
188 DEB‐2 Cat‐ 2 ‐ Excisional biopsy 1650
189 DRPTO‐2 Cat‐ 2 ‐ Extraction (per tooth) 430
190 DEFDTO‐2 Cat‐ 2 ‐ Extraction of fractured / decayed tooth 630
191 DFMASK‐2 Cat‐ 2 ‐ Face mask 6680
192 DFAGI‐2 Cat‐ 2 ‐ Filling amalgam / Glass ionomer 530
193 DFOCERN‐2 Cat‐ 2 ‐ Fixed Orthodontics ( Ceramic Braces ) ‐ First 11430
installment
194 DFOCERS‐2 Cat‐ 2 ‐ Fixed Orthodontics ( Ceramic Braces ) ‐ 590
107
195 DFOCER‐2 Cat‐ 2 ‐ Fixed orthodontics (ceramic braces) ‐ Full amount 35820
196 DFOSSN‐2 Cat‐ 2 ‐ Fixed orthodontics (steel braces) ‐ First installment 11430
197 DFOSS‐2 Cat‐ 2 ‐ Fixed orthodontics (steel braces) ‐ Full amount 24610
198 DFOSSS‐2 Cat‐ 2 ‐ Fixed orthodontics (steel braces) ‐ Subsequent 1660
installment
199 DFOPFM‐2 Cat‐ 2 ‐ Flap operation (full mouth) 9240
200 DFOPQ‐2 Cat‐ 2 ‐ Flap operation (per quadrant) 2570
201 DFSBG‐2 Cat‐ 2 ‐ Flap surgery with bone graft (per quadrant) 4100
202 DFAPP‐2 Cat‐ 2 ‐ Fluoride application 830
203 DFRENE‐2 Cat‐ 2 ‐ Frenectomy 830
204 DGTOMY‐2 Cat‐ 2 ‐ Gingivectomy (per quadrant) 2060
205 DGPLASTY‐2 Cat‐ 2 ‐ Gingivoplasty (per quadrant) 2570
206 DIMPACT‐2 Cat‐ 2 ‐ Impaction (Bony / soft tissue) 3090
207 DIDRAIN‐2 Cat‐ 2 ‐ Incision and drainage 1650
208 DIBIOP‐2 Cat‐ 2 ‐ Incisional biopsy 830
209 DIMFA‐2 Cat‐ 2 ‐ Inter ‐ maxillary fixation with archbar 6160
210 DIWSPIL‐2 Cat‐ 2 ‐ Interdental wiring + splinting (per quadrant) 3090
211 DIAINJ‐2 Cat‐ 2 ‐ Intra articular injection 830
212 DJFCR‐2 Cat‐ 2 ‐ Jaw fracture closed reduction 7700
213 DLFREN‐2 Cat‐ 2 ‐ Lingual frenectomy 1240
214 DMFCC‐2 Cat‐ 2 ‐ Metal free ceramic crown 6160
215 DMIA‐2 Cat‐ 2 ‐ Mini ‐ implant for anchorage (per implant) 5140
216 DMFA‐2 Cat‐ 2 ‐ Myfunctional Appliance ‐ Twin Block 5450
217 DOBTU‐2 Cat‐ 2 ‐ Obturators 7700
218 DOPER‐2 Cat‐ 2 ‐ Operculectomy 1030
219 DPDAC‐2 Cat‐ 2 ‐ Partial dentures (acrylic) 1550
220 DATD‐2 Cat‐ 2 ‐ per additional tooth in denture 430
221 DPOS‐2 Cat‐ 2 ‐ Planning Orthognathic Surgery 4840
222 DPLCENE‐2 Cat‐ 2 ‐ Porcelain laminate veneers 3600
223 DPPSOCPN‐2 Cat‐ 2 ‐ Pre & post surgical orthodontics for cleft palate ‐ 10250
First installment
224 DPPSOCP‐2 Cat‐ 2 ‐ Pre & post surgical orthodontics for cleft palate ‐ 20500
Full amount
225 DPPSOCPS‐2 Cat‐ 2 ‐ Pre & post surgical orthodontics for cleft palate ‐ 2570
226 DPSOSN‐2 Cat‐ 2 ‐ Pre & post surgical orthodontics for orthognathic 15530
227 DPSOS‐2 Cat‐ 2 ‐ Pre & post surgical orthodontics for orthognathic 28710
228 DPSOSS‐2 Cat‐ 2 ‐ Pre & post surgical orthodontics for orthognathic 1660
229 DPUCAP‐2 Cat‐ 2 ‐ Pulp capping 530
230 DPULPO‐2 Cat‐ 2 ‐ Pulpotomy 1030
231 DRME‐2 Cat‐ 2 ‐ Rapid maxillary expansion ( RME ) 6680
232 DRCB‐2 Cat‐ 2 ‐ Recementation of crown / bridge 430
233 DRAT‐2 Cat‐ 2 ‐ Reimplantation of avulsed tooth 2060
234 DREDENT‐2 Cat‐ 2 ‐ Relining of denture 630
235 DRORTHON‐2 Cat‐ 2 ‐ Removable orthodontics ‐ First installment 9820
236 DRORTHO‐2 Cat‐ 2 ‐ Removable orthodontics ‐ Full amount 16410
237 DRORTHOS‐2 Cat‐ 2 ‐ Removable orthodontics ‐ Subsequent installment 1110
238 DRDENT‐2 Cat‐ 2 ‐ Repair of dentures 360
239 DRRBA‐2 Cat‐ 2 ‐ Retainers replacement (both arches) 1550
240 DRRPA‐2 Cat‐ 2 ‐ Retainers replacement (per arch) 780
241 DRCTANT‐2 Cat‐ 2 ‐ Root canal treatment ( RCT ) ‐ anterior 1860
242 DRCTPOS‐2 Cat‐ 2 ‐ Root canal treatment ( RCT ) ‐ posterior 2570
108
243 DRCAPIC‐2 Cat‐ 2 ‐ Root canal with Apicectomy 4100
244 DSFMOU‐2 Cat‐ 2 ‐ Scaling full mouth 530
246 DSMAINT‐2 Cat‐ 2 ‐ Space maintainers 2570
247 DSPREMO2 Cat‐ 2 ‐ Splint Removal 1030
248 DSMODEL‐2 Cat‐ 2 ‐ Study model 280
249 DSSCFM‐2 Cat‐ 2 ‐ Subgingival scaling & curretage full mouth 2570
250 DSETO‐2 Cat‐ 2 ‐ Surgical extraction of tooth 2060
251 DSREMO‐2 Cat‐ 2 ‐ Suture removal 750
252 DTINLY‐2 Cat‐ 2 ‐ Tooth inlay 1550
253 DTEXCI‐2 Cat‐ 2 ‐ Tumour excision 6160
254 DVOSPL‐2 Cat‐ 2 ‐ Vacuum formed occlusal splint 2570
255 FPD6‐2 Cat‐ 2 ‐ Velaplast (Flexible Partial Dentures) ‐ Upto 6 8400
256 FPD9‐2 Cat‐ 2 ‐ Velaplast (Flexible Partial Dentures) ‐ Upto or 10500
257 FPD3‐2 Cat‐ 2 ‐ Velaplast (Flexible Partial Dentures)‐ Upto 3 4900
258 DALVPLS2 Cat‐ 2‐ Alveoloplasty 1030
259 LADC2 Local Anaesthesia Category 2 ‐ Dental 100
260 DBP‐3 Cat‐ 3 ‐ Bite plate 890
261 DBT‐3 Cat‐ 3 ‐ Bleaching of teeth 2210
262 DCPD‐3 Cat‐ 3 ‐ Cast partial dentures (metal casting) 1990
263 DCERLAM3 Cat‐ 3 ‐ Ceramic laminate 1550
264 DCULAR‐3 Cat‐ 3 ‐ Closure of upper & lower anterior spaces + 5280
retainers
265 DENCDUL‐3 Cat‐ 3 ‐ Complete denture upper and lower (both) 3960
266 DENCDUOL‐3 Cat‐ 3 ‐ Complete denture upper or lower (either one) 2210
267 DCOMPVEN3 Cat‐ 3 ‐ Composite veneers 670
268 DCBC‐3 Cat‐ 3 ‐ Crown / Bridge per unit (ceramic) 1550
269 DCBM‐3 Cat‐ 3 ‐ Crown / Bridge per unit (metal) 890
270 DDIFS‐3 Cat‐ 3 ‐ Dental implant (first stage) 3510
271 DDIMP4‐3 Cat‐ 3 ‐ Dental implant (second stage) 3090
272 NGA‐3 Cat‐ 3 ‐ Dental Night Guard Appliance 1110
273 DFMASK‐3 Cat‐ 3 ‐ Face mask 2860
274 DFOCERN‐3 Cat‐ 3 ‐ Fixed Orthodontics ( Ceramic Braces ) ‐ First 5860
installment
275 DFOCER‐3 Cat‐ 3 ‐ Fixed orthodontics (ceramic braces) ‐ Full amount 15370
276 DFOSSN‐3 Cat‐ 3 ‐ Fixed orthodontics (steel braces) ‐ First installment 5860
277 DFOSS‐3 Cat‐ 3 ‐ Fixed orthodontics (steel braces) ‐ Full amount 10560
278 DFOSSS‐3 Cat‐ 3 ‐ Fixed orthodontics (steel braces) ‐ Subsequent 590
installment
279 DMFCC‐3 Cat‐ 3 ‐ Metal free ceramic crown 2640
280 DMIA‐3 Cat‐ 3 ‐ Mini ‐ implant for anchorage (per implant) 2210
281 DMFA‐3 Cat‐ 3 ‐ Myfunctional Appliance ‐ Twin Block 3030
282 DOBTU‐3 Cat‐ 3 ‐ Obturators 3310
283 DPDAC‐3 Cat‐ 3 ‐ Partial dentures (acrylic) 670
284 DATD‐3 Cat‐ 3 ‐ per additional tooth in denture 190
285 DPLCENE‐3 Cat‐ 3 ‐ Porcelain laminate veneers 1550
286 DPPSOCPN‐3 Cat‐ 3 ‐ Pre & post surgical orthodontics for cleft palate ‐ 5860
First installment
287 DPPSOCP‐3 Cat‐ 3 ‐ Pre & post surgical orthodontics for cleft palate ‐ 8790
Full amount
288 DPPSOCPS‐3 Cat‐ 3 ‐ Pre & post surgical orthodontics for cleft palate ‐ 750
109
289 DPSOSN‐3 Cat‐ 3 ‐ Pre & post surgical orthodontics for orthognathic 7620
290 DPSOS‐3 Cat‐ 3 ‐ Pre & post surgical orthodontics for orthognathic 12310
291 DPSOSS‐3 Cat‐ 3 ‐ Pre & post surgical orthodontics for orthognathic 590
292 DRME‐3 Cat‐ 3 ‐ Rapid maxillary expansion ( RME ) 2860
293 DRCB‐3 Cat‐ 3 ‐ Recementation of crown / bridge 190
294 DREDENT‐3 Cat‐ 3 ‐ Relining of denture 280
295 DRORTHON‐3 Cat‐ 3 ‐ Removable orthodontics ‐ First installment 4400
296 DRORTHO‐3 Cat‐ 3 ‐ Removable orthodontics ‐ Full amount 7040
297 DRORTHOS‐3 Cat‐ 3 ‐ Removable orthodontics ‐ Subsequent installment 450
298 DRDENT‐3 Cat‐ 3 ‐ Repair of dentures 170
299 DRRBA‐3 Cat‐ 3 ‐ Retainers replacement (both arches) 670
300 DRRPA‐3 Cat‐ 3 ‐ Retainers replacement (per arch) 340
302 DSMAINT‐3 Cat‐ 3 ‐ Space maintainers 1110
303 DSMODEL‐3 Cat‐ 3 ‐ Study model 120
304 DVOSPL‐3 Cat‐ 3 ‐ Vacuum formed occlusal splint 1110
305 FPD6‐3 Cat‐ 3 ‐ Velaplast (Flexible Partial Dentures) ‐ Upto 6 3600
306 FPD9‐3 Cat‐ 3 ‐ Velaplast (Flexible Partial Dentures) ‐ Upto or 4500
307 FPD3‐3 Cat‐ 3 ‐ Velaplast (Flexible Partial Dentures)‐ Upto 3 2100
308 LADC3 Local Anaesthesia Category 3 ‐ Dental 70
309 CERBR7000 Ceramic Braces Rs ‐ 10250 10250
310 DENLAB1000 Dental Lab Charges Rs ‐ 1330 1330 1330
316 DENLAB2000 Dental Lab Charges Velaplast Rs ‐ 2300 2300 2300
Dental Procedures All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
Code Description
BMSDHC BILIARY MICROLITH STUDY
OS (DOCTOR FEE + HOSPITAL
CHARGES)
BMSHC Biliary microlith study ‐ Additional hospital 6200 6200 3100 2490 1860
charges
BMSDF Biliary microlith study ‐ Doctor fee 17730 17730 8870 7100 5320
BMSHCPACS Biliary microlith study ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
BTDFHCO BEHAVIOUR THERAPY ( 50
S MINUTE SESSION ) (DOCTOR
FEE + HOSPITAL CHARGES)
BET Behaviour therapy ( 50 minute session ) ‐ 1610 1610 800 640 480 800 410
Doctor Fee
BETPSC Behaviour therapy ( 50 minute session ) ‐ 420 420 210 170 130 210 110
hospital charges
CSPTOS Dental ‐ Cavity sealant (per
tooth)‐ INPATIENT Doctor &
Hospital charges
110
CSPTHC Dental ‐ Cavity sealant (per tooth) ‐ Hospital 180 180 90 70 50
Charges
CSPT‐1 Dental Category 1 ‐ Cavity sealant (per 940 940
tooth)
DABJOS Dental ‐ Alveolectomy (both
jaws)‐ INPATIENT Doctor &
Hospital charges
DABJHC Dental ‐ Alveolectomy (both jaws) ‐ Hospital 1470 1470 740 590 440
Charges
DABJAW‐1 Dental Category 1 ‐ Alveolectomy (both 7330 5850
jaws)
DAFDOS Dental ‐ Archbar fixation
dentoalveolar fracture
segment‐ INPATIENT Doctor &
Hospital charges
DAFDHC Dental ‐ Archbar fixation dentoalveolar 900 900 450 360 270
fracture segment ‐ Hospital Charges
DAFDDS‐1 Dental Category 1 ‐ Archbar fixation 4390 2930
dentoalveolar fracture segment
DALVOS Dental ‐ Alveoloplasty‐
INPATIENT Doctor & Hospital
charges
DALVHC Dental ‐ Alveoloplasty ‐ Hospital Charges 460 460 230 190 140
DALVPLS1 Dental Category 1 ‐ Alveoloplasty 2200 1460
DAOJOS Dental ‐ Alveolectomy (one
jaws)‐ INPATIENT Doctor &
Hospital charges
DAOJHC Dental ‐ Alveolectomy (one jaws) ‐ Hospital 750 750 370 300 220
Charges
DAOJAW‐1 Dental Category 1 ‐ Alveolectomy (one jaws) 3660 2930
DAPAOS Dental ‐ Apicectomy per
additional tooth‐ INPATIENT
Doctor & Hospital charges
DAPAHC Dental ‐ Apicectomy per additional tooth ‐ 460 460 230 190 140
Hospital Charges
DAPAT‐1 Dental Category 1 ‐ Apicectomy per 2200
additional tooth
DAPIOS Dental ‐ Apicectomy
(Endodontics)‐ INPATIENT
DAPIHC Dental ‐ Apicectomy (Endodontics) ‐ Hospital 1190 1190 590 470 350
Charges
DAPICE‐1 Dental Category 1 ‐ Apicectomy 5850 3990
(Endodontics)
DARCOS Dental ‐ Apexification + Root
canal treatment ( RCT )‐
charges
DARCHC Dental ‐ Apexification + Root canal 750 750 370 300 220
treatment ( RCT ) ‐ Hospital Charges
DARCT‐1 Dental Category 1 ‐ Apexification + Root 3660 3330
canal treatment ( RCT )
DARTOS Dental ‐ Arthocentesis of TMJ‐
charges
DARTHC Dental ‐ Arthocentesis of TMJ ‐ Hospital 1470 1470 740 590 440
Charges
DARTMJ‐1 Dental Category 1 ‐ Arthocentesis of TMJ 7330 5450
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)
111
DAULOS Dental ‐ Apicectomy ( Under LA
)‐ INPATIENT Doctor & Hospital
charges
DAULHC Dental ‐ Apicectomy ( Under LA ) ‐ Hospital 1190 1190 590 470 350
Charges
DAULA‐1 Dental Category 1 ‐ Apicectomy ( Under LA ) 5850 4390
DCFIOS Dental ‐ Composite filling‐
charges
DCFIHC Dental ‐ Composite filling ‐ Hospital Charges 460 460 230 190 140
DCFILL‐1 Dental Category 1 ‐ Composite filling 2200 2000
DCUROS Dental ‐ Curettage (per
quadrant)‐ INPATIENT Doctor
& Hospital charges
DCURHC Dental ‐ Curettage (per quadrant) ‐ Hospital 750 750 370 300 220
Charges
DCURRE‐1 Dental Category 1 ‐ Curettage (per 3660 1330
quadrant)
DCYSOS Dental ‐ Cyst Enucleation /
Marsupialisation‐ INPATIENT
DCYSTMAR‐1 Dental OPD Category 1 ‐ Cyst Enucleation / 11720 5850
Marsupialisation
DDIFCOS Dental ‐ Dental implant (
complete )‐ INPATIENT Doctor
& Hospital charges
DDIFCHC Dental ‐ Dental implant ( complete ) ‐ 8780 8780 4390 3510 2630
Hospital Charges
DDIFS‐1‐C Dental OPD Category 1 ‐ Dental implant ( 66550 48400
complete )
DDIFOS Dental ‐ Dental implant (first
stage)‐ INPATIENT Doctor &
Hospital charges
DDIFHC Dental ‐ Dental implant (first stage) ‐ 5850 5850 2930 2340 1760
Hospital Charges
DDIFS‐1 Dental OPD Category 1 ‐ Dental implant 29280 11720
(first stage)
DDIMOS Dental ‐ Dental implant
(second stage)‐ INPATIENT
DDIMHC Dental ‐ Dental implant (second stage) ‐ 2930 2930 1460 1170 880
Hospital Charges
DDIMP2‐1 Dental OPD Category 1 ‐ Dental implant 14640 10250
(second stage)
DDTMOS Dental ‐ Dislocation of TMJ‐
charges
DDTMHC Dental ‐ Dislocation of TMJ ‐ Hospital 750 750 370 300 220
Charges
DDTMJ‐1 Dental Category 1 ‐ Dislocation of TMJ 3660 3030
DEB‐OS Dental ‐ Excisional biopsy‐
charges
DEB‐HC Dental ‐ Excisional biopsy ‐ Hospital Charges 900 900 450 360 270
DEB‐1 Dental OPD Category 1 ‐ Excisional biopsy 4390 2340
DEFDOS Dental ‐ Extraction of fractured
/ decayed tooth‐ INPATIENT
DEFDHC Dental ‐ Extraction of fractured / decayed 310 310 150 120 90
tooth ‐ Hospital Charges
DEFDTO‐1 Dental OPD Category 1 ‐ Extraction of 1460 880
fractured / decayed tooth
112
DEIPDHC DENTAL EXTRACTION (
OS INPATIENT ) (DOCTOR FEE +
HOSPITAL CHARGES)
DEAHC Dental extraction ( inpatient ) ‐ Additional 130 130 70 60 40
hospital charges
DEDF Dental extraction ( inpatient ) ‐ Doctor fee 1190 1190 590 470 350
DEPFOS Dental ‐ Excision of pericoronal
flap‐ INPATIENT Doctor &
Hospital charges
DEPFHC Dental ‐ Excision of pericoronal flap ‐ 310 310 150 120 90
Hospital Charges
DEPF‐1 Dental OPD Category 1 ‐ Excision of 1460 1460
pericoronal flap
DFAGOS Dental ‐ Filling amalgam /
Glass ionomer‐ INPATIENT
DFAGHC Dental ‐ Filling amalgam / Glass ionomer ‐ 220 220 110 90 70
Hospital Charges
DFAGI‐1 Dental Category 1 ‐ Filling amalgam / Glass 2240 1600
ionomer
DFAPOS Dental ‐ Fluoride application‐
charges
DFAPHC Dental ‐ Fluoride application ‐ Hospital 240 240 120 100 70
Charges
DFAPP‐1 Dental Category 1 ‐ Fluoride application 1180 1180
DFMOOS Dental ‐ Fracture mandible
open reduction under LA‐
charges
DFMOHC Dental ‐ Fracture mandible open reduction 4400 4400 2200 1760 1320
under LA ‐ Hospital Charges
DFMORLA‐1 Dental Category 1 ‐ Fracture mandible open 21970 18150
reduction under LA ( Cost of Plates & screws
etc. )
DFOPFOS Dental ‐ Flap operation (full
mouth)‐ INPATIENT Doctor &
Hospital charges
DFOPFHC Dental ‐ Flap operation (full mouth) ‐ 2930 2930 1460 1170 880
Hospital Charges
DFOPFM‐1 Dental OPD Category 1 ‐ Flap operation (full 14640 13180
mouth)
DFOPOS Dental ‐ Flap operation (per
& Hospital charges
DFOPHC Dental ‐ Flap operation (per quadrant) ‐ 900 900 450 360 270
Hospital Charges
DFOPQ‐1 Dental OPD Category 1 ‐ Flap operation (per 4390 3660
quadrant)
DFREOS Dental ‐ Frenectomy‐
charges
DFREHC Dental ‐ Frenectomy ‐ Hospital Charges 460 460 230 190 140
DFRENE‐1 Dental OPD Category 1 ‐ Frenectomy 2200 1180
DFSBOS Dental ‐ Flap surgery with bone
graft (per quadrant)‐
charges
DFSBHC Dental ‐ Flap surgery with bone graft (per 1190 1190 590 470 350
quadrant) ‐ Hospital Charges
DFSBG‐1 Dental OPD Category 1 ‐ Flap surgery with 5850 5850
bone graft (per quadrant)
DGPLOS Dental ‐ Gingivoplasty (per
& Hospital charges
113
DGPLHC Dental ‐ Gingivoplasty (per quadrant) ‐ 900 900 450 360 270
Hospital Charges
DGPLASTY‐1 Dental OPD Category 1 ‐ Gingivoplasty (per 4390 3660
quadrant)
DGTOOS Dental ‐ Gingivectomy (per
& Hospital charges
DGTOHC Dental ‐ Gingivectomy (per quadrant) ‐ 750 750 370 300 220
Hospital Charges
DGTOMY‐1 Dental OPD Category 1 ‐ Gingivectomy (per 3660 2930
quadrant)
DIAIOS Dental ‐ Intra articular
injection‐ INPATIENT Doctor &
Hospital charges
DIAIHC Dental ‐ Intra articular injection ‐ Hospital 240 240 120 100 70
Charges
DIAINJ‐1 Dental OPD Category 1 ‐ Intra articular 1180 1180
injection
DIBIOS Dental ‐ Incisional biopsy‐
charges
DIBIHC Dental ‐ Incisional biopsy ‐ Hospital Charges 460 460 230 190 140
DIBIOP‐1 Dental OPD Category 1 ‐ Incisional biopsy 2200 1180
DIDROS Dental ‐ Incision and drainage‐
charges
DIDRHC Dental ‐ Incision and drainage ‐ Hospital 620 620 310 240 190
Charges
DIDRAIN‐1 Dental OPD Category 1 ‐ Incision and 2930 2340
drainage
DIFFOS Dental ‐ Iodoform Dressing for
CYST‐ INPATIENT Doctor &
Hospital charges
DIFFHC Dental ‐ Iodoform Dressing for CYST ‐ 130 130 70 60 40
Hospital Charges
DIFF‐1 Dental Category 1 ‐ Iodoform Dressing for 590 530
CYST
DIMFOS Dental ‐ Inter ‐ maxillary
fixation with archbar‐
charges
DIMFHC Dental ‐ Inter ‐ maxillary fixation with 2070 2070 1030 830 620
archbar ‐ Hospital Charges
DIMFA‐1 Dental Category 1 ‐ Inter ‐ maxillary fixation 10250 8790
with archbar
DIMPOS Dental ‐ Impaction (Bony / soft
tissue)‐ INPATIENT Doctor &
Hospital charges
DIMPHC Dental ‐ Impaction (Bony / soft tissue) ‐ 1470 1470 740 590 440
Hospital Charges
DIMPACT‐1 Dental OPD Category 1 ‐ Impaction (Bony / 7330 6660
soft tissue)
DIWSOS Dental ‐ Interdental wiring +
splinting (per quadrant)‐
charges
DIWSHC Dental ‐ Interdental wiring + splinting (per 900 900 450 360 270
quadrant) ‐ Hospital Charges
DIWSPIL‐1 Dental OPD Category 1 ‐ Interdental wiring 4390 4390
+ splinting (per quadrant)
DJFCOS Dental ‐ Jaw fracture closed
reduction‐ INPATIENT Doctor &
Hospital charges
DJFCHC Dental ‐ Jaw fracture closed reduction ‐ 2350 2350 1180 950 710
Hospital Charges
DJFCR‐1 Dental OPD Category 1 ‐ Jaw fracture closed 11720 10990
reduction
114
DLFROS Dental ‐ Lingual frenectomy‐
charges
DLFRHC Dental ‐ Lingual frenectomy ‐ Hospital 460 460 230 190 140
Charges
DLFREN‐1 Dental OPD Category 1 ‐ Lingual frenectomy 2200 1770
DMIAOS Dental ‐ Mini ‐ implant for
anchorage (per implant)‐
charges
DMIAHC Dental ‐ Mini ‐ implant for anchorage (per 1760 1760 880 700 530
implant) ‐ Hospital Charges
DMIA‐1 Dental OPD Category 1 ‐ Mini ‐ implant for 8790 7330
anchorage (per implant)
DNBNOS Dental ‐ Nerve block in
Neuralgias‐ INPATIENT Doctor
& Hospital charges
DNBNHC Dental ‐ Nerve block in Neuralgias ‐ Hospital 900 900 450 360 270
Charges
DNBN‐1 Dental Category 1 ‐ Nerve block in 4390 3630
Neuralgias
DOACOS Dental ‐ Oro antral
communication closure ‐
charges
DOACHC Dental ‐ Oro antral communication closure ‐ 4110 4110 2060 1650 1240
Hospital Charges
DOACC‐1 Dental Category 1 ‐ Oro antral 20490
communication closure
DOBTOS Dental ‐ Obturators‐
charges
DOBTHC Dental ‐ Obturators ‐ Hospital Charges 2350 2350 1180 950 710
DOBTU‐1 Dental Category 1 ‐ Obturators 11720 10990
DOPEOS Dental ‐ Operculectomy‐
charges
DOPEHC Dental ‐ Operculectomy ‐ Hospital Charges 310 310 150 120 90
DOPER‐1 Dental Category 1 ‐ Operculectomy 1460 1460
DPIOOS Dental ‐ Placentrax Inj for
OSMF‐ INPATIENT Doctor &
Hospital charges
DPIOHC Dental ‐ Placentrax Inj for OSMF ‐ Hospital 240 240 120 100 70
Charges
DPIOSMF‐1 Dental Category 1 ‐ Placentrax Inj for OSMF 1180
DPUCOS Dental ‐ Pulp capping‐
charges
DPUCHC Dental ‐ Pulp capping ‐ Hospital Charges 220 220 110 90 70
DPUCAP‐1 Dental Category 1 ‐ Pulp capping 2240 1330
DPULOS Dental ‐ Pulpotomy‐
charges
DPULHC Dental ‐ Pulpotomy ‐ Hospital Charges 310 310 150 120 90
DPULPO‐1 Dental Category 1 ‐ Pulpotomy 1460 1460
DRATOS Dental ‐ Reimplantation of
avulsed tooth‐ INPATIENT
DRATHC Dental ‐ Reimplantation of avulsed tooth ‐ 620 620 310 240 190
Hospital Charges
DRAT‐1 Dental OPD Category 1 ‐ Reimplantation of 2930 2930
avulsed tooth
115
DRCAOS Dental ‐ Root canal with
Apicectomy‐ INPATIENT Doctor
& Hospital charges
DRCAHC Dental ‐ Root canal with Apicectomy ‐ 1470 1470 740 590 440
Hospital Charges
DRCAPIC‐1 Dental Category 1 ‐ Root canal with 7330 5850
Apicectomy
DRCTFOS Dental ‐ Root canal treatment (
RCT ) ‐ anterior‐ INPATIENT
DRCTFHC Dental ‐ Root canal treatment ( RCT ) ‐ 750 750 370 300 220
anterior ‐ Hospital Charges
DRCTANT‐1 Dental Category 1 ‐ Root canal treatment ( 3660 2930
RCT ) ‐ anterior
DRCTOS Dental ‐ Root canal treatment (
RCT ) ‐ posterior‐ INPATIENT
DRCTHC Dental ‐ Root canal treatment ( RCT ) ‐ 1190 1190 590 470 350
posterior ‐ Hospital Charges
DRCTPOS‐1 Dental Category 1 ‐ Root canal treatment ( 5850 3990
RCT ) ‐ posterior
DRFWOS Dental ‐ Removal of
Frontosuspension wiring‐
charges
DRFWHC Dental ‐ Removal of Frontosuspension 1190 1190 590 470 350
wiring ‐ Hospital Charges
DRFW‐1 Dental Category 1 ‐ Removal of 5850
Frontosuspension wiring
DROCOS Dental ‐ Removal of old
crown/bridge/unit‐ INPATIENT
DROCHC Dental ‐ Removal of old crown/bridge/unit ‐ 180 180 90 70 50
Hospital Charges
DROCBU‐1 Dental Category 1 ‐ Removal of old 740
crown/bridge/unit
DRPMOS Dental ‐ Removal of plates of
mandible and maxilla ( Under
LA )‐ INPATIENT Doctor &
Hospital charges
DRPMHC Dental ‐ Removal of plates of mandible and 2350 2350 1180 950 590
maxilla ( Under LA ) ‐ Hospital Charges
DRPMMLA‐1 Dental Category 1 ‐ Removal of plates of 11720
mandible and maxilla ( Under LA )
DRPTOS Dental ‐ Extraction (per tooth)‐
charges
DRPTHC Dental ‐ Extraction (per tooth) ‐ Hospital 180 180 90 70 50
Charges
DRPTO‐1 Dental OPD Category 1 ‐ Extraction (per 740 590
tooth)
DSETOS Dental ‐ Surgical extraction of
tooth‐ INPATIENT Doctor &
Hospital charges
DSETHC Dental ‐ Surgical extraction of tooth ‐ 620 620 310 240 190
Hospital Charges
DSETO‐1 Dental OPD Category 1 ‐ Surgical extraction 2930 2930
of tooth
DSFMOS Dental ‐ Scaling full mouth‐
charges
DSFMHC Dental ‐ Scaling full mouth ‐ Hospital 460 460 230 190 140
Charges
DSFMOU‐1 Dental Category 1 ‐ Scaling full mouth 2200 2000
116
DSPROS Dental ‐ Splint Removal‐
charges
DSPRHC Dental ‐ Splint Removal ‐ Hospital Charges 310 310 150 120 90
DSPREMO1 Dental Category 1 ‐ Splint Removal 1460 1460
DSREOS Dental ‐ Suture removal‐
charges
DSREHC Dental ‐ Suture removal ‐ Hospital Charges 180 180 90 70 50
DSREMO‐1 Dental OPD Category 1 ‐ Suture removal 1460 1030
DSSCOS Dental ‐ Subgingival scaling &
curretage full mouth‐
charges
DSSCHC Dental ‐ Subgingival scaling & curretage full 900 900 450 360 270
mouth ‐ Hospital Charges
DSSCFM‐1 Dental Category 1 ‐ Subgingival scaling & 4390 3660
curretage full mouth
DTEXOS Dental ‐ Tumour excision‐
charges
DTEXHC Dental ‐ Tumour excision ‐ Hospital Charges 2930 2930 1460 1170 880
DTEXCI‐1 Dental OPD Category 1 ‐ Tumour excision 14640 8790
DZCFOS Dental ‐ Zygonatic Complex
Fracture under LA‐ INPATIENT
DZCFHC Dental ‐ Zygonatic Complex Fracture under 2930 2930 1460 1170 880
LA ‐ Hospital Charges
DZCFULA‐1 Dental Category 1 ‐ Zygonatic Complex 14640
Fracture under LA

Dermatology Procedure Charges

1 SKINCP Skin ‐ Corn paring 670 400
2 SKINCML Skin Cauterisation ‐ Multiple lesions 2270 1370
3 SKINCSL Skin Cauterisation ‐ Single lesion 810 480
4 SKINCTL Skin Cauterisation ‐ Two lesions 1330 800
5 SKINCRML Skin Cryosurgery ‐ Multiple Lesions 3480 2090
6 SKINCRSL Skin Cryosurgery ‐ Single Lesion 1600 960
7 SKINCRTL Skin Cryosurgery ‐ Two Lesions 2400 1440
8 SKINGSP Skin OPD ‐ Gram Stain procedure 480 290
9 SKINIIP Skin OPD ‐ Intralesional injection procedure 670 400
10 SKINKPP Skin OPD ‐ KOH preparation procedure 480 290
11 SKINPUVA Skin OPD ‐ PUVA Therapy 400 240
12 SKINBP Skin OPD ‐ Skin biopsy procedure 2440 1460
13 SKINSPTP Skin OPD ‐ Skin patch testing procedure 1730 1040
14 SKINSPTPAC Skin OPD ‐ Skin patch testing procedure ‐ charges for 80 50
additional antigen
15 SKINSMAFB Skin OPD ‐ Slit smear for AFB procedure 480 290
16 SKINTACML Skin OPD ‐ Trichloacetia acid cauterisation ‐ Multiple 1330 800
lesions
17 SKINTACSL Skin OPD ‐ Trichloacetia acid cauterisation ‐ Single lesion 400 240
18 SKINTACTL Skin OPD ‐ Trichloacetia acid cauterisation ‐ Two lesions 810 480
19 SKINSFP Skin OPD scraping for fungus procedure 260 160
117
ENT Procedure Charges

20 IMPED Impedance Audiometry 620 370
21 NASENDO Nasal Endoscopy 1860 1110
22 PTDHS Position Testing ( Dix ‐ Hallpike / Head ‐ Shaking ) GOPD 350
23 AUDIOM Pure tone audiometry ( PTA ) 550 330
24 RPEM Re‐Position ( Epley's ) Manouvere GOPD 580
ENT Therapy Charges
Cat‐1D Single/
Cat‐2 Beded
Premium/
4 Bedded
GOPD
POPD
Cat‐3
Suite
1 STHER Speech Therapy (per sitting) 550 530 320 530 320

2 SPEECHC Speech Therapy per 10 Session ‐ Hospital 4730 2840 4730 2840
Charges
3 SPSINHC Speech Therapy specialised for singers ‐ 1580 950 1580 950
Hospital Charges
4 ENTINHC Tinnitus retraining therapy ‐ Hospital Charges 530 320 530 320
ENT charges
SNo Code Description POPD GOPD ALL CAT

1 DCHFENT Dressing charges for ENT 260
2 EUMCH Examination under microscope charges 280
3 TTCCH Tracheostomy tube change charges 680
4 ENGHC Videonystagmography (VNG)(Hospital Fee) 3150 3150
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 3150
Laryngology & Stroboscopy ) ‐ Doctor fee
ASEHC Speech Assessment ( Endoscopic 2100 2630
Laryngology & Stroboscopy ) ‐ Hospital
Share
2 ASSRDH Auditory Steady State
Response( ASSR )(DOCTOR FEE
+ HOSPITAL CHARGES)
ASSR Auditory Steady State Response ( ASSR ) ‐ 4120 2050
Doctor fee
ASSRHA Auditory Steady State Response ( ASSR ) ‐ 830 410
hospital amount
3 DBHLDH Detailed BERA for hearing
loss(DOCTOR FEE + HOSPITAL
CHARGES)
DBHL Detailed BERA for hearing loss ‐ Doctor fee 2650 1590
DBHLHA Detailed BERA for hearing loss‐ hospital 530 320
amount
118
4 DPOAEDH Distortion Product Otoacoustic
Emisssion( DPOAE )(DOCTOR
DPOAE Distortion Product Otoacoustic Emisssion ( 1180 590
DPOAE ) ‐ Doctor fee
DPOAEHA Distortion Product Otoacoustic Emisssion ( 240 130
DPOAE ) ‐ hospital amount
5 ELDHOS Endoscopic Laryngology
(Doctor fee + Hospital Share)
ELDF Endoscopic Laryngology ‐ Doctor fee 2100
SAELSH Endoscopic Laryngology ‐ Hospital Share 1050 1580
6 ENGOS Videonystagmography (VNG)
(Doctor fee + Hospital fee)
ENGDF Videonystagmography (VNG) (Doctor Fee) 4730 4730 3940 3150 2360 3150
ENGHC Videonystagmography (VNG)(Hospital Fee) 4730 4730 3940 3150 2360 3150 3150
7 OTOESDH OTO‐ACOUSTIC EMISSION TEST
CHOS FOR NEWBORN BABIES
CHARGES)
OETNBDF OTO‐acoustic emission test for newborn 900 900 450 360 270
babies ‐ Doctor fee
OETNBHC OTO‐acoustic emission test for newborn 480 480 240 190 140
babies ‐ Hospital charges
8 VAOS VOICE ANALYSIS
VACDC Voice analysis ‐ Clinical doctor charges 2760 1370
VAHC Voice analysis ‐ Hospital Charges 5500 2760
VASPC Voice analysis ‐ Speech pathologists charges 2760 1370
Hospital Charges
Bedside procedure charges
All Category
Cat 1B Suite
Cat 1A‐Pre/
Single Bed
2 Bedded
Casualty
Cat‐1D
4 Bed
Cat‐2
Cat‐3
Code Description
ALTEST Allergy testing in casualty / Prick testing for ant 90 80
ANINFCH Antibiotic infusion charges 320 260
BCCHC Baby care charges ( while baby is with mother i 970 970 720 480
DRESSCAS Dressing in casualty 230 210
HIDORFEOS HIGH DOSE CHEMOTHERAPY AND RESCUE ‐ Ho 21300 10660 8530 6390
ICPHC ICP Monitoring Charges (Hospital charges) 1790 1190 880 600
INJADMCH Injection administration charges 110 110
RYLETI Ryle's tube insertion in casualty 240 210
STSUTREM Stitch / Suture removal 240 210
STREMDRESS Suture removal / Dressings / Stent removal in D 170
TRACH Tracheostomy tube changing charges in casual 320 260
URCATH Urinary Foley's catheterisation in casualty 260
KTP Charges
KTPCHA KTP Service Charges 10680 5340 4010 2680 4850
Resuscitation charges
NEWBRNRESCES Resuscitation charges of newborn baby following caeserian 5070 2540 1910 1280
section
NEWBRNRESCH Resuscitation charges of newborn baby following normal 4010 2020 1520 1010

delivery
119
Bedside procedure charges (Glucometry)
Code Description POPD GOPD ALL CAT

GLUCH Glucometry test charges ( Also order stock item with this ) 80 40
Dressing set charges

ASPSER Aspiration set usage charges 360
BGAMJEER Big Gamjee Roll 110
BMSET Bone marrow set usage charges 380
DRESSET Dressing set usage charges 190
EYESET Eye set usage charges 400
GAMJEEP Gamjee Pad 20
GAMJEER Gamjee Roll 80
GAUZEP Gauze Pack ( packet of 5) 30
ICDBOTTLE Intercostal chest tube ( ICD ) bottle charges 380
KBSET Kidney biopsy set usage charges 390
LBSET Liver biopsy set usage charges 380
LPSET Lumbar puncture set usage charges 380
MAJDSET Major dressing set usage charges 280
MYELOSET Myelogram set usage charges 380
PEXTRSET Paediatric exchange transfusion set usage charges 380
PDSET Peritoneal dialysis ( PD ) set usage charges 380
TROCSET Trocar and cannula set usage charges 1790
CATHSET Urinary catheteristion set 380
Dressing set charges (CVP line)
COSET Cut open ( venesection ) / suturing set usage charges 380
Dressing set charges (in package)

ANGIOSET Angiogram set usage charges 360
Dressing set charges (Tracheostomy)

TRACSET Tracheostomy set usage charges 380
Hospital charges
ALPTRA ALPHA TRACELL CHARGES 240
ALPTRDL ALPHA TRACELL DELUX CHARGES 430
ALPXC ALPHA XCELL CHARGES 430
APAC Angiography Pool Account 2000
ACAC Angioplasty combo a/c 3000
AULG AUTOLOGIC CHARGES 490
ECMOHC ECMO ‐ Maintenance Charges Per Day (Cardiac surgery) 11030
INTERCH Interpreter charges 1320
KTPSH KTP Surcharge ‐ Hospital charges 5290
LCLL Laser Charges for Lesion ( Large ) 4850
LCLS Laser Charges for Lesion ( Small Size ) 2430
LCLM Laser Charges for Lesions ( Midium Size ) 3640
NIM NIMBUS CHARGES 610
SECARHC Screening Echo Cardiology ‐ Hospital Charges 1020
SUPAR SUPAR TEST CHARGES 610
120
LAVDMC Temporary LVAD ‐ Maintenance Charges Per Day 11030
USAVFHS Ultrasound guided venous mapping for I/J catheter insertion 600
and A.V Fistula creation ‐ Machine Charges
Hospital Charges CIC

HCCIC Home Collection Sample Charges 110
Hospital charges for Diabetic Foot Clinic
BIOTHES Biothesiometery 240 240 240
DIFOMIPOP Diabetic foot ‐ minor outpatient procedure (hospital charges) 1240 1240 1240
RHC
TOEBRAIND Toe Brachial Index 240 240
Hospital charges for haemodialysis

HDFHC Online Hemodiafiltration (HDF) (5008S) ‐ Hospital Charges 3680 3680
Hospital service charges for thalassemia patient

IPRTH Hospital service charges for thalassemia patients 700
MRD Charges
MRDCHG MRD Charges 500 (IP)/
200 (Day care)
Stoma care charges

STOMCARE Stoma care charge 210
CHRG
STOMAC3 Stoma care charges ( Complex ) 390
STOMAC1 Stoma care charges ( Easy ) 170
STOMAC4 Stoma care charges ( Extra Complex ) 560
STOMAC2 Stoma care charges ( Normal ) 320

121
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 ) 20330 10160 8140 6100
2 AVFISSF AV Fistula ‐ Surgen Fee
3 OP3397 Basilic vein transposition in OT 60980 30490 24400 18290
4 OP0240 Brachio ‐ basilic loop AV graft for haemodialysis 40610 20310 16250 12180
5 OP0242 Brachio ‐ basilic straight ( above elbow ) AV graft for 40610 20310 16250 12180
haemodialysis
6 OP0239 Brachio ‐ cephalic loop AV graft for haemodialysis 40610 20310 16250 12180
7 OP0241 Brachio ‐ cephalic straight ( above elbow ) AV graft for 40610 20310 16250 12180
haemodialysis
8 OP0245 Brachio AV fistula at elbow for haemodialysis 29230 14620 11700 8770
9 OP0443 CAPD placement ( laparosopic ) 24650 12330 9870 7390
10 OP1080 CAPD placement ( open ) 24650 12330 9400 7390
11 OP0448 CAPD removal & placement ( laparosopic ) 32340 16170 12320 9700
12 OP0445 CAPD removal & placement ( open ) 32340 16170 12940 9700
13 OP0447 CAPD removal ( laparosopic ) 15460 7730 6180 4640
14 OP0444 CAPD removal ( open ) 15460 7730 6180 4640
15 OP0446 CAPD revision ( laparosopic ) 12350 6170 4950 3710
16 OP0449 CAPD revision ( open ) 12350 6170 4710 3710
17 OP0437 Conversion of arteriovenous ( AV ) shunt to 29230 14620 11700 8770
arteriovenous ( AV ) fistula
18 OP0440 Creation of arteriovenous ( AV ) fistula at axillary 36960 18480 14780 11090
artery
19 OP0433 Creation of arteriovenous ( AV ) fistula at elbow ( 35200 18480 14780 11090
brachial artery )
20 OP1077 Creation of arteriovenous ( AV ) fistula at wrist ( radial 36960 18480 14780 11090
artery )
21 OP4205 GSV translocation for AV access 60980 30490 24400 18290
22 OP0320 Ligation of ruptured AV fistula 15460 7730 6180 4640
23 OP0319 Ligation of ruptured AV graft 20330 10160 8140 6100
24 OP0436 Placement of arteriovenous ( AV ) shunt at ankle ( 20330 10160 8140 6100
25 OP1078 Placement of arteriovenous ( AV ) shunt at wrist ( 20330 10160 8140 6100
radial artery )
26 OP0243 Radio ‐ basilic straight ( below elbow ) AV graft for 40610 20310 16250 12180
haemodialysis
27 OP0244 Radio ‐ cephalic straight ( below elbow ) AV graft for 40610 20310 16250 12180
haemodialysis
28 OP4204 Repair of A.V.Fistula aneurysm 41580 20790 16630 12470
29 OP0441 Revision of arteriovenous ( AV ) fistula at axillary 15460 7730 6180 4640
artery
30 OP0435 Revision of arteriovenous ( AV ) fistula at elbow ( 15460 7730 6180 4640
brachial artery )
31 OP0434 Revision of arteriovenous ( AV ) fistula at wrist ( radial 15490 7730 6180 4640
artery )
32 OP0439 Revision of arteriovenous ( AV ) shunt at ankle ( 10160 5080 4070 3050
33 OP0438 Revision of arteriovenous ( AV ) shunt at wrist ( radial 10160 5080 3880 3050
artery )
34 OP1083 Vascular prosthetic graft in forearm 46200 23100 18480 13860
35 OP0526 Vascular prosthetic graft in thigh 46200 23100 18480 13860
36 OP0525 Vascular prosthetic graft in upper arm 46200 23100 18480 13860

122
Aesthetic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
37 OP1305 Abdominoplasty 115500 57750 46200 34650
38 OP1303 Abdominoplasty with limited incision 92400 46200 36960 27720
39 OP1304 Abdominoplasty with liposuction 138600 69300 55440 41580
40 OP2996 Belt Lipectomy 175140 87570 70060 52540
41 OP3082 Bilateral face dimple construction ( dimploplasty ) 80850 40430 32340 24260
42 OP3007 Botox / Fillers 32150 16080 12870 9650
43 OP1803 Brachioplasty / arm lift 107120 53560 42860 32130
44 OP0842 Brow / forehead lift 141310 70650 56530 42390
45 OP1804 Buttock implant 111340 55670 44540 33410
46 OP4383 Buttock Lift 127050 63530 50820 38120
47 OP1802 Calf implant 102750 51370 41100 30820
48 OP0840 Centralisation of chin 94180 47090 37680 28250
49 OP0083 Chemical peel of face 80370 40180 32140 24100
50 OP0060 Chin augmentation ‐ multiple sliding osteotomies ( 80850 40430 32340 24260
Genioplasty )
51 OP0061 Chin augmentation ‐ osteotomy with bone graft ( 111340 55670 44540 33410
Genioplasty )
52 OP1320 Chin augmentation ‐ prosthetic / allograft ( 94180 47090 37680 28250
Genioplasty )
53 OP0059 Chin augmentation ‐ single sliding osteotomy ( 102750 51370 41100 30820
Genioplasty )
54 OP0826 Chin reduction 107120 53560 42860 32130
55 OP4382 Circumferential Body Lift 190580 95290 76230 57180
56 OP3423 Contouring of bones of the face ‐ multiple Bones 92400 46200 36960 27720
57 OP3422 Contouring of bones of the face ‐ single Bone 57750 28880 23100 17330
58 OP1365 Correction / revision of face scars ‐ multiple 59970 29990 23990 18000
59 OP1364 Correction / revision of face scars ‐ single 46270 23130 18500 13880
60 OP3060 Correction / revision of two face scars 62330 31160 24930 18700
61 OP3431 Correction of complex scar ‐ large 96450 48220 38580 28930
62 OP3430 Correction of complex scar ‐ medium 64280 32140 25710 19290
63 OP3429 Correction of complex scar ‐ small 48240 24110 19290 14480
64 OP1798 Correction of congenital ear lobule deformity 64280 32140 25710 19290
65 OP4368 Correction of Contour Deformity Face (Fat, Implant, 60980 30490 24400 18290
Flap) ‐ Minor
66 OP4369 Correction of Contour Deformity Face (Fat, Implant, 101640 50820 40660 30490
Flap)‐Majorlip
67 OP3005 Correction of multiple facial scars 77910 38960 31160 23380
68 OP1588 Corrective rhinoplasty ‐ augmentation with bone graft 96450 48220 38580 28930
69 OP1587 Corrective rhinoplasty ‐ augmentation with cartilage 96450 48220 38580 28930
70 OP1586 Corrective rhinoplasty ‐ augmentation with implant 73940 36970 29580 22190
71 OP1589 Corrective rhinoplasty ‐ augmentation with other 100630 50310 40250 30200
material
72 OP3310 Corrective rhinoplasty ‐ complete 151580 75790 60640 45470
73 OP1584 Corrective rhinoplasty ‐ nasal tip 64280 32140 25710 19290
74 OP1593 Corrective rhinoplasty ‐ reduction 100630 50310 40250 30200
75 OP1580 Corrective rhinoplasty ‐ with septoplasty 112520 56270 45010 33760
76 OP1594 Corrective rhinoplasty for crooked / deviated nose 128580 64280 51440 38580
77 OP1315 Cosmetic blepharoplasty ( four lids ) 96450 48220 38580 28930
78 OP0135 Cosmetic blepharoplasty ( one lid ) 42920 21460 17160 12880
79 OP0136 Cosmetic blepharoplasty ( three lids ) 62330 31160 24930 18700
80 OP0058 Cosmetic blepharoplasty ( two lids ) 64280 32140 25710 19290
81 OP1095 Dermabrasion 85680 42830 34270 25700
82 OP1336 Dermabrasion full face 85680 42830 34270 25700
123
83 OP1337 Dermabrasion partial face 59970 29990 23990 18000
84 OP1345 Ear lobule repair ‐ bilateral 17330 8670 6930 5200
85 OP1344 Ear lobule repair ‐ unilateral 11550 5780 4620 3470
86 OP3077 Ear lobule repair with cartilage graft 70140 35070 28050 21040
87 OP1350 Endoscopic brow / forehead lift 141310 70650 56530 42390
88 OP1349 Endoscopic face lift 192650 96330 77070 57790
89 OP1363 Eyebrow graft 70710 35350 28280 21220
90 OP0138 Eyelash graft 70710 35350 28280 21220
91 OP0841 Face lift ‐ classic operations 128580 64280 51440 38580
92 OP1767 Face lift ‐ facial suspension 85680 42830 34270 25700
93 OP1789 Face lift ‐ mid face 96450 48220 38580 28930
94 OP1766 Face lift ‐ minimum scar 112520 56270 45010 33760
95 OP1790 Face lift ‐ with SMAS 144650 72330 57870 43400
96 OP4459 Fat grafting ( Non cosmetic ) 57750 28880 23100 17330
97 OP3326 Genital labioplasty 75890 37940 30350 22770
98 OP4226 Hair transplant other then scalp (Large) 167710 83850 67080 50310
99 OP4227 Hair transplant other then scalp (Medium) 125790 62890 50310 37730
100 OP4228 Hair transplant other then scalp (Small) 55900 27950 22360 16780
101 OP0814 Hair transplantation ‐ major 282870 141430 113150 84850
102 OP0813 Hair transplantation ‐ medium 212150 106070 84850 63650
103 OP0812 Hair transplantation ‐ minor 141440 70720 56570 42440
104 OP3329 Hymenoplasty 75890 37940 30350 22770
105 OP1769 Intralesional injection (in OT) 11440 5720 4580 3430
106 OP4495 Laser Resurfacing ‐ Large 46200 36960 27720
107 OP4496 Laser Resurfacing ‐ Medium 34650 27720 20790
108 OP4497 Laser Resurfacing ‐ Small 23100 18480 13860
109 OP2969 Lateral canthoplasty 32150 16080 12870 9650
110 OP3078 Lip reconstruction with multiple flaps 116800 58400 46720 35050
111 OP3079 Lip reconstruction with single flap 109010 54510 43600 32700
112 OP1770 Lip reduction 47150 23570 18870 14150
113 OP1768 Lipo‐injection ‐ major 96450 48220 38580 28930
114 OP3081 Lipoinjection ‐ medium 80370 40180 32140 24100
115 OP1771 Lipo‐injection ‐ minor 64280 32140 25710 19290
116 OP1774 Liposuction ‐ large 94180 47090 37680 28250
117 OP3080 Liposuction ‐ medium 66230 33110 26500 19870
118 OP1776 Liposuction ‐ small 47150 23570 18870 14150
119 OP4491 Liposuction (Multiple Areas) 138600 69300 55440 41580
120 OP1805 Malar / cheek implant 94180 47090 37680 28250
121 OP3084 Malar reduction 101270 50630 40500 30380
122 OP4215 Medial Canthoplasty 55900 27950 22360 16780
123 OP3062 Midline etching 57870 28930 23140 17360
124 OP3037 Neo ‐ umbiloplasty 85680 42830 34270 25700
125 OP0084 Otoplasty for bat ears ( bilateral ) 96450 48220 38580 28930
126 OP1343 Otoplasty for bat ears ( unilateral ) 64280 32140 25710 19290
127 OP3341 Penile augumentation 126270 63130 50510 37880
128 OP3000 Penile lengthening procedure 116800 58400 46720 35050
129 OP4454 PRP injection Full face 23100 11550 9240 6930
130 OP4457 PRP injection hair or scar removal 11550 5780 4620 3470
131 OP4455 PRP Medium 11550 5780 4620 3470
132 OP4456 PRP Small 6930 3470 2770 2080
133 OP3036 Radiofrequency excision of moles ‐ multiple 57870 28930 23140 17360
134 OP3038 Radiofrequency excision of moles ‐ single 39020 19500 15610 11700
135 OP1801 Reverse abdominoplasty / torsoplasty 128480 64240 51400 38540
136 OP1800 Reverse thigh lift 128480 64240 51400 38540
137 OP3350 Scar revision of trunk of extremity ( large ) 69300 34650 27720 20790
138 OP3351 Scar revision of trunk of extremity ( medium ) 57750 28880 23100 17330
139 OP3352 Scar revision of trunk of extremity ( small ) 46200 23100 18480 13860
124
140 OP3075 Thighplasty 124580 62290 49830 37380
141 OP1797 Thread lift 94180 47090 37680 28250
142 OP3063 Transverse etching ( abdominal ) 77910 38960 31160 23380
143 OP3353 Umbilical reconstruction 75890 37940 30350 22770
144 OP1796 Umblicoplasty 64280 32140 25710 19290
145 OP3083 Unilateral face dimple construction ( dimploplasty ) 48240 24110 19290 14480
146 OP3066 Upper body lift 155690 77850 62280 46710
147 OP4472 Vaginal Rejuvenation (Laser) 46200 23100 18480 13860
148 OP4473 Vaginal Rejuvenation (Surgical) 69300 34650 27720 20790
149 OP4465 Xanthelasma Bilateral / Both Eyelid 69300 34650 27720 20790
150 OP4464 Xanthelasma Single 46200 23100 18480 13860
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) 27020 13500 10800 8110
152 OP0250 Amputation / disarticulation of toe(s) 27020 13500 10800 8110
153 OP0467 Amputation of hand ( carpal level ) 58520 29260 23400 17560
154 OP0256 Amputation of hand ( metacarpal level ) 58520 29260 23400 17560
155 OP0253 Amputation of lower limb ‐ above knee 81010 40510 32400 24300
156 OP0252 Amputation of lower limb ‐ below knee 81010 40510 32400 24300
157 OP0258 Amputation of upper limb ( above elbow ) 81010 40510 32400 24300
158 OP0257 Amputation of upper limb ( below elbow ) 81010 40510 32400 24300
159 OP1808 Chopart's amputation ( mid ‐ tarsal ) 49040 24520 19610 14710
160 OP1811 Disarticulation at the level of ankle 57950 28970 23170 17390
161 OP1810 Disarticulation at the level of knee 57950 28970 23170 17390
162 OP1817 Disarticulation of elbow joint 57950 28970 23170 17390
163 OP1812 Disarticulation of hip joint 94530 47260 37820 28360
164 OP1818 Disarticulation of shoulder joint 94530 47260 37820 28360
165 OP1815 Disarticulation of wrist joint 53140 26580 21250 15940
166 OP4154 Forefoot excisional arthroplasty (Multiple) 91990 46000 36800 27590
167 OP4153 Forefoot excisional arthroplasty (Single) 61340 30670 24540 18400
168 OP2994 Forequarter amputation 108000 54000 43200 32400
169 OP1813 Hind Quarter disarticulation 108000 54000 43200 32400
170 OP1809 Lisfranc ampuation ( tarso ‐ metatarsal ) 66150 33080 26460 19850
171 OP3033 Ray excision of digit 44100 22050 17640 13230
172 OP0254 Revision of amputation stump 60770 30390 24310 18240
173 OP0469 Syme's amputation 57950 28970 23170 17390
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 86080 43040 34430 25820
175 OP1242 Anal transposition 64540 32270 25820 19360
176 OP1243 Anoplasty 56750 28380 22700 17020
177 OP1033 Anoplasty for imperforate anus with low opening 56750 28380 22700 17020
178 OP3360 Band ligation of haemorrhoids ( in OT ) 14550 7280 5820 4370
179 OP1029 Excision / laying open of fistula in ano ( high level ) 64540 32270 25820 19360
with or without seton
180 OP1030 Excision / laying open of fistula in ano ( low level ) 51620 25810 20650 15490
181 OP1031 Haemorrhoidectomy 51620 25810 20650 15490
125
182 OP3359 Injection sclerotherapy of haemorrhoids / piles ( in OT 14550 7280 5820 4370
)
183 OP1037 Lateral sphincterotomy or fissurectomy 47370 23680 18940 14210
184 OP1276 PSARP ‐ complete 88660 44330 35470 26610
185 OP1277 PSARP ‐ limited 63080 31540 25230 18930
186 OP1281 Rectal myomectomy 34480 17240 13800 10340
187 OP1282 Rectal polyp excision 15740 7880 6300 4710
188 OP0029 Rectal prolapse repair ‐ Delormes rectopexy 98960 49480 39590 29690
189 OP0030 Rectal prolapse repair abdominal ( open technique ) 98960 49480 39590 29690
190 OP1076 Seton removal / laying open of residual fistula‐in‐ano 30120 15060 12050 9040
191 OP0689 Stapled haemorrhoidectomy 51620 25810 20650 15490
192 OP1038 Thiersch?s wiring 30120 15060 12050 9040
193 OP1280 Trans‐anal rectal biopsy 21590 10790 8630 6470
Aortic Aneurysm Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
194 OP4209 Aortic Aneurysm fenestrated stent grafting 747050 373530 298820 224110
195 OP3367 Chest wall repair in OT 176100 88040 70430 52840
196 OP4208 Complex endovascular repair of aortic aneurysm 533610 266810 213440 160080
197 OP0091 Elective infra renal abdominal aortic aneurysm repair ‐ 218780 109390 87520 65640
aorto bifemoral bypass graft
aorto bi‐iliac bypass graft
aorto uni‐iliac uni‐femoral bypass graft
tube graft
201 OP0088 Elective supra renal abdominal aortic aneurysm repair 218780 109390 87520 65640
‐ aorto bifemoral bypass graft
‐ aorto bi‐iliac bypass graft
‐ tube graft
204 OP0315 Elective thoracic aortic aneurysm repair 218780 109390 87520 65640
205 OP4207 Endovascular repair of aortic aneurysm 373530 186760 149420 112060
206 OP0086 Ruptured infra renal abdominal aortic aneurysm 266810 133400 106720 80040
repair ‐ aorto bifemoral bypass graft
repair ‐ aorto bi‐iliac bypass graft
repair ‐ aorto uni‐iliac uni‐femoral bypass graft
repair ‐ tube graft
210 OP0105 Ruptured supra renal abdominal aortic aneurysm 266810 133400 106720 80040
repair ‐ aorto bi‐iliac bypass graft
repair ‐ aorto‐bifemoral bypass graft
repair ‐ tube graft
Appendicular Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
126
213 OP1013 Appendicectomy 56750 28380 22700 17020
214 OP1014 Appendicular abscess drainage 64540 32270 25820 19360
215 OP1268 Laparoscopic appendicectomy 56750 28380 22700 17020
Arthrodesis
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
216 OP3253 Arthrodesis ( hip ) 74170 37090 29670 22250
217 OP3254 Arthrodesis ( SI Joints ) 74170 37090 29670 22250
218 OP1980 Arthrodesis ankle 74170 37090 29670 22250
219 OP1981 Arthrodesis foot ‐ Bachelor's / Green Grice 56290 28150 22510 16890
220 OP1983 Arthrodesis knee joint 74170 37090 29670 22250
221 OP1984 Arthrodesis of elbow joint 74170 37090 29670 22250
222 OP1989 Arthrodesis of hand & foot bone(s) 60240 30120 24100 18070
223 OP1982 Arthrodesis of shoulder joint 74170 37090 29670 22250
224 OP1985 Arthrodesis of wrist joint 74170 37090 29670 22250
225 OP4142 Calcaneo‐cuboid arthrodesis 77860 38930 31140 23360
226 OP4338 Joint Arthrogram 48510 24260 19400 14550
227 OP4339 Joint Arthrotomy with debridement 97020 48510 38810 29110
228 OP1979 Lambrinudi / Triple Arthrodesis of ankle 74170 37090 29670 22250
229 OP4349 Large Joint Arthrodesis 101870 50940 40750 30570
230 OP4144 MTP Joint fusion 54770 27380 21900 16430
231 OP4140 Subtalar fusion / arthrodesis 67430 33720 26960 20230
232 OP4141 Talonavicular arthrodesis 77860 38930 31140 23360
233 OP4337 Triple Arthrodesis (Adult) 101870 50940 40750 30570
Arthroscopic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

234 OP4247 Arthoroscopic biceps tenodesis 64170 32090 25660 19250
235 OP4243 Arthoroscopic PASTA repair 63000 31500 25200 18900
236 OP4244 Arthoroscopic subscapularis repair 55790 27900 22310 16740
237 OP2150 Arthroscopic ACL and PCL reconstruction of knee 141100 70550 56440 42330
238 OP4578 Arthroscopic ACL and PCL Reconstruction single stage 193200 96600 77280 57960
( Two site graft )
239 OP4253 Arthroscopic ACL avulsion fracture fixation 94840 47420 37940 28460
240 OP4576 Arthroscopic ACL Ganglion cyst Decompression 84000 42000 33600 25200
241 OP2151 Arthroscopic ACL reconstruction of knee ( arthroscopy 105200 52610 42080 31560
with single site tendon graft )
242 OP2152 Arthroscopic arthrodesis of ankle 74170 37090 29670 22250
243 OP2153 Arthroscopic arthrofibrolysis of elbow 74170 37090 29670 22250
244 OP2154 Arthroscopic arthrofibrolysis of hip 74170 37090 29670 22250
245 OP2155 Arthroscopic arthrofibrolysis of knee 74170 37090 29670 22250
246 OP2156 Arthroscopic arthrofibrolysis of shoulder 74170 37090 29670 22250
247 OP2157 Arthroscopic arthrofibrolysis of wrist 74170 37090 29670 22250
248 OP4254 Arthroscopic Bankart's Repair (Soft Tissue) 98430 49210 39380 29530
249 OP4560 Arthroscopic Biceps Tenodesis 126000 63000 50400 37800
250 OP4258 Arthroscopic Bony Bankart's Repair 103220 51610 41290 30960
251 OP4246 Arthroscopic capsulorrhaphy 64170 32090 25660 19250
252 OP2158 Arthroscopic carpal repair of wrist 69300 34650 27720 20790
253 OP2159 Arthroscopic debridement of ankle 69300 34650 27720 20790
127
254 OP2160 Arthroscopic debridement of elbow 69300 34650 27720 20790
255 OP2161 Arthroscopic debridement of hip 69300 34650 27720 20790
256 OP2162 Arthroscopic debridement of knee 69300 34650 27720 20790
257 OP2163 Arthroscopic debridement of shoulder 69300 34650 27720 20790
258 OP2164 Arthroscopic debridement of wrist 69300 34650 27720 20790
259 OP2165 Arthroscopic diagnostic arthroscopy of ankle 32430 16220 12980 9730
260 OP4245 Arthroscopic global labrum repair (A‐P) ‐ Anterior ‐ 92060 46030 36820 27620
Posterior
261 OP2166 Arthroscopic impingement release of ankle 69300 34650 27720 20790
262 OP4572 Arthroscopic labral cyst decompression 94500 47250 37800 28350
263 OP2167 Arthroscopic lateral collateral ligament reconstruction 69300 34650 27720 20790
of knee
264 OP2168 Arthroscopic lateral release of knee 69300 34650 27720 20790
265 OP2169 Arthroscopic lavage of ankle 32430 16220 12980 9730
266 OP2170 Arthroscopic lavage of knee 32430 16220 12980 9730
267 OP2171 Arthroscopic loose body removal from ankle 69300 34650 27720 20790
268 OP2172 Arthroscopic loose body removal from elbow 69300 34650 27720 20790
269 OP2173 Arthroscopic loose body removal from hip 69300 34650 27720 20790
270 OP2174 Arthroscopic loose body removal from knee 69300 34650 27720 20790
271 OP2175 Arthroscopic loose body removal from shoulder 69300 34650 27720 20790
272 OP2176 Arthroscopic loose body removal from wrist 69300 34650 27720 20790
273 OP2177 Arthroscopic medial collateral ligament reconstruction 69300 34650 27720 20790
of knee
274 OP2179 Arthroscopic meniscal repair of knee 69300 34650 27720 20790
275 OP4575 Arthroscopic Meniscus repair with implant 94500 47250 37800 28350
276 OP4251 Arthroscopic microfracture of OCD 63000 31500 25200 18900
277 OP2180 Arthroscopic osteoarticular transport / mosaic plasty 69300 34650 27720 20790
of knee
278 OP4571 Arthroscopic Partial Meniscectomy ‐ Discoid Meniscus 115500 57750 46200 34650
279 OP2181 Arthroscopic partial meniscectomy of knee 69300 34650 27720 20790
280 OP2182 Arthroscopic patellar stabilisation 69300 34650 27720 20790
281 OP2183 Arthroscopic PCL avulsion fixation of knee 76410 38200 30570 22920
282 OP2184 Arthroscopic PCL reconstruction of knee ( arthroscopy 141100 70550 56440 42330
with two site tendon graft )
283 OP4577 Arthroscopic PCL Reconstruction with implants 141750 70880 56700 42530
284 OP2185 Arthroscopic posterolateral corner repair of knee 69300 34650 27720 20790
285 OP2186 Arthroscopic release of frozen shoulder 69300 34650 27720 20790
286 OP4570 Arthroscopic release of impingment of ankle 115500 57750 46200 34650
287 OP4569 Arthroscopic release of tennis elbow 105000 52500 42000 31500
288 OP4579 Arthroscopic Remplissage Shoulder 94500 47250 37800 28350
289 OP4563 Arthroscopic repair of posterior labrum 115500 57750 46200 34650
290 OP4574 Arthroscopic Revision ‐ ACL Reconstruction 136500 68250 54600 40950
291 OP2187 Arthroscopic rotator cuff repair of shoulder 69300 34650 27720 20790
292 OP4256 Arthroscopic Rotator Cuff Repair with Anchors 103220 51610 41290 30960
(Double Row)
293 OP4255 Arthroscopic Rotator Cuff Repair with Anchors (Single 98430 49210 39380 29530
Row)
294 OP4257 Arthroscopic Rotator Cuff Repair with Biceps 103220 51610 41290 30960
Tenotomy
295 OP2188 Arthroscopic SLAP lesion repair of shoulder 69300 34650 27720 20790
296 OP2189 Arthroscopic stabilisation of shoulder for Recurrent 89990 44990 35990 27000
dislocation
297 OP2190 Arthroscopic subacromial decompression / 69300 34650 27720 20790
acromioplasty of shoulder
298 OP4259 Arthroscopic Superior Labrum Repair 98430 49210 39380 29530
299 OP2191 Arthroscopic synovectomy of ankle 69300 34650 27720 20790
300 OP2192 Arthroscopic synovectomy of elbow 69300 34650 27720 20790
301 OP2193 Arthroscopic synovectomy of hip 69300 34650 27720 20790
302 OP2194 Arthroscopic synovectomy of knee 69300 34650 27720 20790
128
303 OP2195 Arthroscopic synovectomy of shoulder 69300 34650 27720 20790
304 OP2196 Arthroscopic synovectomy of wrist 69300 34650 27720 20790
305 OP2198 Arthroscopic tibial plateau reconstruction of knee 69300 34650 27720 20790
306 OP2199 Arthroscopic tibial spine fixation of knee 69300 34650 27720 20790
307 OP2197 Arthroscopic triangular fibro‐cartilage ( TFC ) repair of 69300 34650 27720 20790
wrist
308 OP4573 Arthroscpic Para Meniscal Cyst Decompression 115500 57750 46200 34650
309 OP4557 Arthrscopic both Meniscus Partial Meniscectomy 115500 57750 46200 34650
310 OP4567 Comlex Ligament Reconstruction ‐ Single 136500 68250 54600 40950
311 OP4568 Complex Ligamant Reconstrcuction ‐ Multiple 178500 89250 71400 53550
312 OP2200 Diagnostic arthroscopy of elbow 32430 16220 12980 9730
313 OP2201 Diagnostic arthroscopy of hip 32430 16220 12980 9730
314 OP2202 Diagnostic arthroscopy of knee 32430 16220 12980 9730
315 OP2203 Diagnostic arthroscopy of shoulder 32430 16220 12980 9730
316 OP2204 Diagnostic arthroscopy of wrist 32430 16220 12980 9730
317 OP4301 MPFL Reconstruction for Recurrent Dislocation Patella 98430 49210 39380 29530
318 OP4562 Open Biceps Tenodesis 105000 52500 42000 31500
319 OP4302 Open Fixation of Intra ‐ Articular Osteochondral 98430 49210 39380 29530
Fragment
320 OP4565 Open LCL Reconstruction 136500 68250 54600 40950
321 OP4561 Open LCL Repair 115500 57750 46200 34650
322 OP4559 Open MCL Reconstrction 115500 57750 46200 34650
323 OP4558 Open MCL repair 94500 47250 37800 28350
324 OP4300 Open PCL Avulsion + Fixation 104300 52150 41720 31290
325 OP4564 Open release of tennis elbow 105000 5250 42000 31500
326 OP4566 Open release of tennis elbow with fixation 136500 68250 54600 40950
Bedsore Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

327 OP0042 Coccygeal bedsore excision with flap closure 106280 53140 42510 31890
328 OP1310 Coccygeal bedsore excision with primary closure 89900 44950 35960 26960
329 OP3424 Debridement of bedsore 33080 16540 13230 9920
330 OP0053 Ischial bedsore excision with myocutaneous / muscle 122640 61320 49070 36790
flap closure ( bilateral )
331 OP0049 Ischial bedsore excision with myocutaneous / muscle 89900 44950 35960 26960
flap closure ( unilateral )
332 OP0051 Ischial bedsore excision with primary closure ( 122640 61320 49070 36790
bilateral )
333 OP0047 Ischial bedsore excision with primary closure ( 89900 44950 35960 26960
unilateral )
334 OP0052 Ischial bedsore excision with skin grafting ( bilateral ) 122640 61320 49070 36790
335 OP0048 Ischial bedsore excision with skin grafting ( unilateral ) 106280 53140 42510 31890
336 OP0037 Other bedsore excision with myocutaneous flap 122640 61320 49070 36790
closure
337 OP0033 Other bedsore excision with primary closure 81780 40890 32710 24530
338 OP0036 Other bedsore excision with skin flap closure 106280 53140 42510 31890
339 OP0034 Other bedsore excision with skin grafting 106280 53140 42510 31890
340 OP0045 Sacral bedsore excision with myocutaneous flap 122640 61320 49070 36790
closure
341 OP0043 Sacral bedsore excision with primary closure 89900 44950 35960 26960
342 OP0044 Sacral bedsore excision with skin flap closure 106280 53140 42510 31890
343 OP0046 Sacral bedsore excision with skin grafting 106280 53140 42510 31890
344 OP0057 Trochanteric bedsore excision with myocutaneous flap 134880 67440 53960 40470
closure ( bilateral )
129
345 OP0035 Trochanteric bedsore excision with myocutaneous flap 106280 53140 42510 31890
closure ( unilateral )
346 OP0054 Trochanteric bedsore excision with primary closure ( 106280 53140 42510 31890
bilateral )
347 OP0050 Trochanteric bedsore excision with primary closure ( 89900 44950 35960 26960
unilateral )
348 OP0055 Trochanteric bedsore excision with skin flap closure ( 122640 61320 49070 36790
bilateral )
349 OP0020 Trochanteric bedsore excision with skin flap closure ( 106280 53140 42510 31890
unilateral )
350 OP0056 Trochanteric bedsore excision with skin grafting ( 134880 67440 53960 40470
bilateral )
351 OP0032 Trochanteric bedsore excision with skin grafting ( 106280 53140 42510 31890
unilateral )
Bone Tumour Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
352 OP2007 Curettage and bone grafting ‐ long bones 70960 35480 28380 21290
353 OP2006 Curettage and bone grafting ‐ small bones 47030 23520 18810 14110
354 OP2001 Excision of large exostosis 47030 23520 18810 14110
355 OP2003 Excision of large tumours ( without bone grafting ) ‐ 70960 35480 28380 21290
long bones
356 OP2005 Excision of large tumours + reconstruction with 165510 82750 66200 49650
custom prosthesis
357 OP2002 Excision of large tumours with bone grafting ‐ long 77420 38710 30960 23230
bones
358 OP2004 Excision of large tumours with bone grafting with 92230 46120 36890 27680
fixation for long bones
359 OP2000 Excision of small exostosis 23710 11850 9480 7110
Breast Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

360 OP3308 Augmentation mammoplasty by fat grafting 161430 80710 64580 48440
361 OP1772 Augmentation mammoplasty by implant 103220 51610 41290 30960
362 OP4476 Bilateral Mastectomy with free nipple graft 110250 55130 44100 33080
363 OP2821 Breast abscess drainage 19380 9690 7750 5810
364 OP4718 Breast Conservation Surgery with SLNB 86667 43334 34667 26000
365 OP4719 Breast Conservation Surgery with SLNB with axillary 93334 46667 37334 28000
clearance
366 OP1777 Breast lift / mastopexy 111790 55900 44720 33540
367 OP2873 Breast lumpectomy ‐ large 40910 20450 16360 12270
368 OP1023 Breast lumpectomy ‐ small 30120 15060 12050 9040
369 OP0602 Breast lumpectomy with axillary clearance ( BCS ) 86080 43040 34430 25820
370 OP2868 Breast lumpectomy with axillary sampling 64540 32270 25820 19360
371 OP2869 Breast lumpectomy with sentinal lymph node biopsy 64540 32270 25820 19360
372 OP2833 Breast reconstruction using free flap 214970 107480 85980 64480
373 OP2832 Breast reconstruction using implant 129030 64520 51620 38710
374 OP2829 Breast reconstruction using latisimus dorsi muscle 154790 77400 61920 46440
375 OP2830 Breast reconstruction using rectus abdominis muscle 171990 86000 68800 51600
376 OP3085 Breast reconstruction with DIEP flap 195450 97720 78180 58630
377 OP1806 Correction of inverted nipple ‐ unilateral 103220 51610 41290 30960
378 OP1807 Correction of inverted nipples ‐ bilateral 129030 64520 51620 38710
130
379 OP2971 Endoscopic breast lump excision 35320 17660 14130 10590
380 OP1781 Endoscopic gynaecomastia excision ‐ bilateral 103220 51610 41290 30960
381 OP1788 Endoscopic gynaecomastia excision ‐ unilateral 68840 34420 27540 20650
382 OP1018 Excision of breast lump under ultrasound guidance 40910 20450 16360 12270
383 OP1787 Excision of supernumerary / accessory breast ‐ 103220 51610 41290 30960
bilateral
384 OP1775 Excision of supernumerary / accessory breast ‐ 68840 34420 27540 20650
unilateral
385 OP1019 Gynaecomastia excision ‐ bilateral 103220 51610 41290 30960
386 OP0599 Gynaecomastia excision ‐ unilateral 68840 34420 27540 20650
387 OP4715 Gynecomastia ‐ Large 100000 50000 40000 30000
388 OP4714 Gynecomastia ‐ Medium 80000 40000 32000 24000
389 OP4713 Gynecomastia ‐ Small 60000 30000 24000 18000
390 OP1783 Liposuction and excision of gynaecomastia ‐ bilateral 129030 64520 51620 38710
391 OP1782 Liposuction and excision of gynaecomastia ‐ unilateral 86080 43040 34430 25820
392 OP4381 Mastectomy For Gender Identify Disorder 84890 42450 33960 25470
393 OP1024 Micodochotomy & removal of papilloma in breast 43110 21560 17240 12940
duct
394 OP0603 Needle localisation biopsy of breast mass / lump 51620 25810 20650 15490
395 OP1792 Nipple reconstruction ‐ bilateral 95480 47740 38190 28640
396 OP1791 Nipple reconstruction ‐ unilateral 63700 31850 25480 19110
397 OP1778 Peri‐areolar breast lift / mastopexy 94590 47300 37840 28380
398 OP1022 Radical / modified radical mastectomy 86080 43040 34430 25820
399 OP4720 Radical / Modified Radical Mastectomy with SLNB 86667 43334 34667 26000
400 OP4721 Radical / Modified Radical Mastectomy with SLNB 93334 46667 37334 28000
with axillary clearance
401 OP2828 Radical / modified radical mastectomy with 86080 43040 34430 25820
supraclavicular lymph node clearance
402 OP1773 Reduction mammoplasty ‐ bilateral 141920 70960 56760 42580
403 OP1786 Reduction mammoplasty ‐ unilateral 94590 47300 37840 28380
404 OP2831 Removal of breast implant 86080 43040 34430 25820
405 OP1021 Simple mastectomy 53840 26920 21550 16150
406 OP2871 Simple mastectomy with axillary sampling 64540 32270 25820 19360
407 OP2870 Simple mastectomy with sentinal lymph node biopsy 64540 32270 25820 19360
Cardiac Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

408 OP0410 Aortic arch replacement
409 OP0366 Aortic valve repair
410 OP0365 Aortic valve replacement
411 OP0367 Aortic valve replacement + Tricuspid valve repair
412 OP0407 Ascending aorta replacement
413 OP0371 Atrial septal defect ( ASD ) closure
414 OP0383 Atrio‐ventricular canal defect repair
415 OP0406 Bentall's Procedure ( aortic root replacement )
Within Package
416 OP3236 Bidirectional glen shunt
417 CABGDO CABG (off pump) ‐ amount given to surgeon from
within package
418 OP3232 Cardiac clot excision
419 OP0411 Cardiac myxoma excision
420 OP3231 Cardiac tumor excision
421 OP3235 Central shunt ( aorto pulmonary shunt )
422 CHSDOC Closed heart surgery ‐ amount given to cardiac
surgeon from within the package
131
423 OP0387 Closed mitral valvotomy Within Package
424 OP4581 Complex CABG
425 OP0384 Congenital aneurysm of the sinus of Valsalva repair
426 OP0385 Congenital aortic stenosis repair
427 OP0386 Congenital mitral valve repair
Within Package
428 OP0382 Cor Triatriatum repair
429 OP0392 Coronary artery bypass surgery OFF pump
430 OP0391 Coronary artery bypass surgery ON pump
431 OP3239 DOR procedure
432 OP4505 ECMO Initiation Charges ‐ Cardiac Surgery 185220 92610 73870 55130
433 OP3365 Epicardial pacemaker Explantation in OT 80040 40030 32010 24010
434 OP3364 Epicardial pacemaker Implantation in OT 76230 38120 30490 22870
435 OP3233 Fontan's procedure
436 HRPDC High risk ADD ON for cardiac surgery ‐ amount given
to surgeon from within the package
437 HPSF Hybrid procedure ‐ amount given to surgeon within
package
438 IABPDPC IABP ‐ ADD ON for cardiac surgery ‐ Doctor operation
charges
439 OP0378 Intracardiac repair of aorto‐pulmonary window
440 OP0376 Intracardiac repair of Ebstein's malformation
441 OP0373 Intracardiac repair of tetrology of Fallots
442 OP0380 Intracardiac repair of total anomalous pulmonary
venous connection
443 OP0377 Intracardiac repair of truncus arteriosus
444 OP0374 Intracardiac repair of ventricular septal defect ( VSD )
+ pulmonary stenosis ( PS )
445 OP0408 Left ventricular (cardiac) aneurysm repair
446 OP0413 Maze procedure for atrial fibrillation
447 OP0368 Mitral valve repair
448 OP0393 Mitral valve replacement
449 OP3242 Omentoplasty for sternal closure
450 OHDOC Open Heart Surgery/CABG (On Pump) ‐ amount given
to cardiac surgeon from within the package
451 PCHSL1 Paediatric Closed Heart Surgery Level One ‐ Paeds
Card Sciences charges Within Package
452 PCHSL1E Paediatric Closed Heart Surgery Level One ‐ Prof. fee (
In case of Emergency Surgery )
453 PCHSL3 Paediatric Closed Heart Surgery Level Three ‐ Paeds
Card Sciences charges
454 PCHSL3E Paediatric Closed Heart Surgery Level Three ‐ Prof. fee
( In case of Emergency Surgery )
455 PCHSL2 Paediatric Closed Heart Surgery Level Two ‐ Paeds
456 PCHSL2E Paediatric Closed Heart Surgery Level Two ‐ Prof. fee (
457 POHSL1 Paediatric Open Heart Surgery Level One ‐ Paeds Card
Sciences charges
458 POHSL1 Paediatric Open Heart Surgery Level One ‐ Prof. fee (
459 POHSL3 Paediatric Open Heart Surgery Level Three ‐ Paeds
460 POHSL3 Paediatric Open Heart Surgery Level Three ‐ Prof. fee (
461 POHSL2 Paediatric Open Heart Surgery Level Two ‐ Paeds Card
Sciences charges
462 POHSL2 Paediatric Open Heart Surgery Level Two ‐ Prof. fee (
463 OP0388 Patent ductus arteriosus (PDA) closure
464 OP0389 Pericardiectomy
465 OP3244 Pericardiostomy
132
466 OP4504 Permanent LVAD ‐ Cardiac Surgery 1323000 661500 529200 396900
467 OP0409 Post infarction venticular septal defect repair Within Package
468 OP3366 Premie PDA clipping in OT 160080 80040 64030 48030
469 OP3237 Pulmonary artery banding
470 OP3238 Pulmonary valvotomy
471 OP3230 Redo aortic valve replacement
472 OP3240 Redo coronary artery bypass surgery OFF pump
473 OP3241 Redo coronary artery bypass surgery ON pump
Within Package
474 OP3229 Redo mitral valve replacement
475 OP0412 Repair of cardiac injury
476 OP0390 Repair of coarctation of the aorta
477 OP3243 Sternectomy
478 OP3234 Systemic pulmonary shunt ( BT shunt )
479 OP4503 Temporary LVAD Initiation Charge ‐ Cardiac Surgery 441000 220500 176400 132300
480 OP0369 Tricuspid valve repair
481 OP0370 Tricuspid valve replacement Within Package
482 OP0372 Ventricular septal defect ( VSD ) closure
Cardiology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
483 OP0680 Aortic aneurysm stent grafting
484 OP1301 ASD device closure
485 OP0642 Bi‐ventricular pacing ( Heart failure device )
486 OP0659 Check coronary angiography ( CAG ) ‐ femoral route
487 OP0660 Check coronary angiography ( CAG ) ‐ radial route
488 OP0650 Coronary angiography ( CAG ) ‐ femoral route
489 OP0651 Coronary angiography ( CAG ) ‐ radial route
490 OP0652 Coronary angioplasty via femoral route ‐ elective
491 OP0662 Coronary angioplasty via femoral route ‐ primary, for
cardiogenic shock
492 OP0653 Coronary angioplasty via femoral route ‐ primary,
routine
493 OP0654 Coronary angioplasty via femoral route ‐ rescue
494 OP0655 Coronary angioplasty via femoral route for re‐stenosis
495 OP0656 Coronary angioplasty via radial route ‐ elective
496 OP0661 Coronary angioplasty via radial route ‐ primary, for
cardiogenic shock
Within Package
497 OP0663 Coronary angioplasty via radial route ‐ primary,
routine
498 OP0657 Coronary angioplasty via radial route ‐ rescue
499 OP0658 Coronary angioplasty via radial route for re‐stenosis
500 OP0667 Coronary angioplasty with directional atherectomy
501 OP0666 Coronary angioplasty with rotablation ( rotational
atherectomy )
502 OP0647 Electrophysiology study ‐ major ( EP )
503 OP0648 Electrophysiology study ‐ minor ( EP )
504 OP0665 Implantable cardioverter defibrilator ( ICD )
implantation ‐ combo device
implantation ‐ dual chamber device
implantation ‐ single chamber device
507 OP0649 Intra aortic balloon pump insertion ( IABP )
508 ASDPCS Paediatric ASD Device ‐ Paeds Card Sciences charges
133
509 PASDEM Paediatric ASD Device ‐ Prof. Fee ( In case of
Emergency )
510 PBSEPPC Paediatric Balloon Septostomy ‐ Paeds Card Sciences
charges
511 PBSEMC Paediatric Balloon Septostomy ‐ Prof. Fee ( In case of
Emergency )
512 CAPC Paediatric Cardiac angiography ‐ Paeds Card Sciences
charges
513 PCAEMC Paediatric Cardiac angiography ‐ Prof. Fee ( In case of
Emergency )
514 CCEPC Paediatric Cardiac coil Embolisation ‐ Paeds Card
Sciences charges
515 PCCEMC Paediatric Cardiac coil Embolisation ‐ Prof. Fee ( In
case of Emergency )
516 PDAPF Paediatric PDA Device ‐ Paeds Card Sciences charges
517 PPDAEM Paediatric PDA Device ‐ Prof. Fee ( In case of
Emergency )
518 PVALPC Paediatric Valvuloplasty ‐ Paeds Card Sciences charges Within Package
519 PVEMCH Paediatric Valvuloplasty ‐ Prof. Fee ( In case of
Emergency )
520 OP1300 PDA device closure
521 OP0639 Pericardiocentesis
522 OP0676 Peripheral embolisation
523 OP0643 Permanent pacemaker insertion ‐ dual chamber ( PPI )
524 OP0644 Permanent pacemaker insertion ‐ single chamber ( PPI
)
525 OP0646 Radio‐frequency ablation ( RFA )
526 OP0645 Sinus node recovery time analysis ( SNRT )
527 OP0640 Temporary pacemaker insertion
528 OP0677 Valvuloplasty ‐ aortic
529 OP1302 Valvuloplasty ‐ mitral
530 OP0679 Valvuloplasty ‐ pulmonary
531 OP0678 Valvuloplasty ‐ tricuspid
Cleft Lip And Palate Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

532 OP1322 Cleft lip and anterior palate repair ‐ any one of two 98080 49040 39230 29420
stages ( bilateral )
533 OP1321 Cleft lip and anterior palate repair ‐ single stage ( 110250 55130 44100 33080
bilateral )
534 OP1575 Cleft lip and anterior palate repair ‐ single stage ( 88200 44100 35280 26460
unilateral )
535 OP1585 Cleft lip nose rhinoplasty ‐ complete 92060 46030 36820 27620
536 OP1583 Cleft lip nose rhinoplasty ‐ nasal tip 76710 38360 30680 23010
537 OP1323 Cleft lip repair ‐ bilateral complete 88200 44100 35280 26460
538 OP1576 Cleft lip repair ‐ bilateral incomplete 98080 49040 39230 29420
539 OP0062 Cleft lip repair ‐ unilateral complete 89900 44950 35960 26960
540 OP1577 Cleft lip repair ‐ unilateral incomplete 73580 36790 29440 22070
541 OP1247 Cleft palate repair ‐ complete 110250 55130 44100 33080
542 OP1248 Cleft palate repair ‐ posterior 88200 44100 35280 26460
543 OP4305 PALATAL IMPLANT (SET OF 3) 40030 20010 16010 12000
544 OP4306 PALATAL IMPLANT (SET OF 5) 53360 26680 21350 16010
545 OP0041 Palatal re‐repair / lengthening 88200 44100 35280 26460
546 OP1307 Repair of palatal fistula with alveolar bone grafting 130710 65350 52280 39220
547 OP0038 Repair of palatal fistula with buccal flap 106280 53140 42510 31890
548 OP1578 Repair of palatal fistula with free flap 187950 93980 75180 56390
134
549 OP0040 Repair of palatal fistula with local flap 122640 61320 49070 36790
550 OP0039 Repair of palatal fistula with tongue flap ‐ first stage 98080 49040 39230 29420
551 OP1579 Repair of palatal fistula with tongue flap ‐ second 73580 36790 29440 22070
stage
552 OP1581 Revision of lip repair 89900 44950 35960 26960
553 OP1582 Revision of lip repair and Alveolar bone grafting 122640 61320 49070 36790
Closed Reduction And Internal Fixation
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
554 OP1890 Closed Ender's nailing for fracture shaft femur 93630 46810 37450 28090
555 OP1888 Closed Ender's nailing for fracture tibia 93630 46810 37450 28090
556 OP1887 Closed interlock nailing for fracture tibia 93630 46810 37450 28090
557 OP1889 Closed interlocking nailing for fracture shaft femur 93630 46810 37450 28090
558 OP3260 Closed nailing humerus 84150 42070 33660 25250
559 OP2993 Closed percutaneous screw fixation for neck of 54820 27410 21920 16450
humerus
560 OP1886 Closed percutaneous screw fixation for tibial plateau 49750 24870 19900 14930
fracture
561 OP1893 Closed reduction fracture distal radius with K‐wire 26940 13470 10780 8090
fixation
562 OP1896 Closed reduction fracture neck humerus with K‐wire 52920 26460 21170 15880
fixation
563 OP1895 Closed reduction fracture supracondylar humerus 52920 26460 21170 15880
with K‐wire fixation
564 OP3065 Closed reduction of ankle 20930 10460 8370 6270
565 OP3045 Closed reduction of elbow 20930 10460 8370 6270
566 OP4131 Closed reduction of femur 19010 9500 7610 5700
567 OP4128 Closed reduction of forearm bones 19010 9500 7610 5700
568 OP3447 Closed reduction of fracture of metacarpal / phalynx 29350 14680 11740 8810
569 OP3057 Closed reduction of hip 20930 10460 8370 6270
570 OP4130 Closed reduction of humerus 19010 9500 7610 5700
571 OP4133 Closed reduction of IP / MP Joints 19010 9500 7610 5700
572 OP4129 Closed reduction of leg bones 19010 9500 7610 5700
573 OP3058 Closed reduction of shoulder 20930 10460 8370 6270
574 OP3055 Closed reduction of wrist 20930 10460 8370 6270
575 OP1894 K‐wire fixation for fracture radial styloid 26940 13470 10780 8090
576 OP3263 Nailing of radius and ulna 84150 42070 33660 25250
Dental
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

577 OP3094 Alveolectomy ( both jaws ) in OT 15390 7700 6150 4620 7700
578 OP3095 Alveolectomy ( one jaws ) in OT 7710 3850 3090 2310 3850
579 OP3096 Alveoloplasty in OT 4640 2320 1860 1400 2320
580 OP3099 Apicectomy ( per tooth ) in OT 12310 6150 4920 3700 6150
581 OP4086 Archbar fixation dentoalveolar fracture per segement 9240 4620 3700 2770 4620
‐ Dental
582 OP3102 Arthocentesis of TMJ in OT 15390 7700 6150 4620 7700
583 OP3103 Cavity sealant ( per tooth ) in OT 1970 990 790 590 990
584 OP4114 Ceramic laminate ‐ Dental 12310 6150 4920 3700 6150
585 OP3105 Chemical cauterisation in OT 1580 790 630 470 790
135
586 OP3130 Circum‐mandibular splint removal in OT 3090 1540 1240 920 1540
587 OP3104 Composite filling in OT 4640 2320 1860 1400 2320
588 OP4110 Composite veneers ‐ Dental 4640 2320 1860 1400 2320
589 OP4109 Core build up (prefab) ‐ Dental 3090 1540 1240 920 1540
590 OP4108 Core buildup (casting) ‐ Dental 4640 2320 1860 1400 2320
591 OP4117 Crown / Bridge per unit (procera) ‐ Dental 41940 20970 16780 12580 20970
592 OP4116 Crown/Bridge per unit (metal) ‐ Dental 9240 4620 3700 2770 4620
593 OP4115 Crown/Bridge per unit (PFM) ‐ Dental 13860 6930 5540 4160 6930
594 OP4124 Curettage (Per quadrant) ‐ Dental 7710 3850 3090 2310 3850
595 OP3136 Dental Implant in OT 139760 69880 55900 41930 69880
596 OP4087 Dislocation of TMJ ‐ Dental 7710 3850 3090 2310 3850
597 OP3132 Elevation of zygomatic complex fracture in OT 30740 15370 12300 9220 15370
598 OP4098 Excisional biopsy ‐ Dental 9240 4620 3700 2770 4620
599 OP4097 Extraction‐ All Teeth‐ Both Jaws ‐ Dental 24610 12310 9850 7380 12310
600 OP4099 Extraction of fractured/decayed tooth ‐ Dental 3090 1540 1240 920 1540
601 OP3147 Extraction of impacted tooth in OT 15390 7700 6150 4620 7700
602 OP4088 Fabrication of Circummandibular splint ‐ Dental 12310 6150 4920 3700 6150
603 OP3110 Filling amalgam / Glass ionomer in OT 4700 2350 1880 1410 2350
604 OP3142 Flap operation ( per quadrant ) in OT 9240 4620 3700 2770 4620
605 OP4125 Flap operation (full arch) ‐ Dental 30740 15370 12300 9220 15370
606 OP3143 Flap surgery with bone graft ( per quadrant ) in OT 12310 6150 4920 3700 6150
607 OP4112 Fluoride application per arch ‐ Dental 2480 1240 990 750 1240
608 OP4089 Fracture mandible open reduction (cost of plates & 46140 23070 18460 13840 23070
screws extra ) ‐ Dental
609 OP4100 Frenectomy ‐ Dental 4640 2320 1860 1400 2320
610 OP3145 Gingivectomy ( per quadrant ) in OT 7710 3850 3090 2310 3850
611 OP3146 Gingivoplasty ( per quadrant ) in OT 9240 4620 3700 2770 4620
612 OP4126 Implant Surgery First Stage) ‐ Dental 61490 30740 24590 18450 30740
613 OP4127 Implant Surgery Second Stage ‐ Dental 30740 15370 12300 9220 15370
614 OP4102 Incision & drainage ‐ Dental 6170 3090 2470 1850 3090
615 OP4101 Incisional biopsy ‐ Dental 4640 2320 1860 1400 2320
616 OP4103 Inta articular injection ‐ Dental 2480 1240 990 750 1240
617 OP3150 Interdental wiring + splinting ( per quadrant ) in OT 9240 4620 3700 2770 4620
618 OP4090 Inter‐maxillary fixation with archbar ‐ Dental 21530 10760 8610 6460 10760
619 OP4091 Iodoform Dressing ‐ Dental 1240 620 490 370 620
620 OP4104 Jaw fracture closed reduction ‐ Dental 24610 12310 9850 7380 12310
621 OP4118 Metal Free ceramic crown ‐ Dental 21530 10760 8610 6460 10760
622 OP3154 Mini implant for anchorage ( per implant ) in OT 18460 9230 7380 5530 9230
623 OP4092 Nerve block in Neuralgias ‐ Dental 9240 4620 3700 2770 4620
624 OP3116 Obturator for cleft palate in OT 24610 12310 9850 7380 12310
625 OP4093 Operculectomy ‐ Dental 3090 1540 1240 920 1540
626 OP4094 Oro antral communication closure ‐ Dental 43050 21530 17220 12920 21530
627 OP3119 Placentrax injection for OSMF in OT 2480 1240 990 750 1240
628 OP3121 Pulp capping in OT 4700 2350 1880 1410 2350
629 OP3122 Pulpotomy in OT 3090 1540 1240 920 1540
630 OP4122 Rapid maxillary expansion (RME) ‐ Dental 21530 10760 8610 6460 10760
631 OP4119 Recementation of crown /bridge per unit ‐ Dental 1870 930 750 560 930
632 OP3155 Reimplantation of avulsed tooth in OT 6170 3090 2470 1850 3090
633 OP4120 Relining of Denture ‐ Dental 1870 930 750 560 930
634 OP3123 Removal of Fronto‐suspension wiring in OT 12310 6150 4920 3700 6150
635 OP4121 Removal of old crown/ bridge per unit ‐ Dental 1580 790 630 470 790
636 OP4095 Removal of plates of mandible and maxilla ‐ Dental 24610 12310 9850 7380 12310
637 OP3125 Removal of plates of mandible and maxilla in OT 24610 12310 9850 7380 12310
638 OP3126 Root canal treatment ( RCT ) ‐ anterior in OT 7710 3850 3090 2310 3850
639 OP3127 Root canal treatment ( RCT ) ‐ posterior in OT 12310 6150 4920 3700 6150
640 OP3129 Scaling full mouth in OT 4640 2320 1860 1400 2320
641 OP3140 Simple extraction of tooth in OT 1580 790 630 470 790
136
642 OP4123 Space maintainers ‐ Dental 7710 3850 3090 2310 3850
643 OP4107 Splint removal ‐ Dental 3090 1540 1240 920 1540
644 OP3131 Subgingival scaling & curretage full mouth in OT 9240 4620 3700 2770 4620
645 OP3156 Surgical extraction of tooth in OT 6170 3090 2470 1850 3090
646 OP4105 Suture removal ‐ Dental 3090 1540 1240 920 1540
647 OP4096 TMJ Physiotherapy ‐ Dental 1580 790 630 470 790
648 OP4111 Tooth inlay ‐ Dental 4640 2320 1860 1400 2320
649 OP4106 Tumour excision ‐ Dental 30740 15370 12300 9220 15370
Endocrine Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
650 OP0540 Endoscopic hemi‐thyroidectomy / lobectomy 58700 29350 23490 17610
651 OP0542 Endoscopic parathyroidectomy 94590 47300 37840 28380
652 OP0541 Endoscopic subtotal thyroidectomy 94590 47300 37840 28380
653 OP1043 Excision of lingual thyroid 43110 21560 17240 12940
654 OP1044 Excision of thyroglossal cyst 43110 21560 17240 12940
655 OP1272 Excision of thyroglossal fistula / sinus 43110 21560 17240 12940
656 OP4722 Hemithyroidectomy (size <5 cms) 61467 30734 24587 18440
657 OP4724 Hemithyroidectomy (size >10 cms) 80000 40000 32000 24000
658 OP4723 Hemithyroidectomy (size 5 ‐ 10 cms) 70000 35000 28000 21000
659 OP1051 Hemi‐thyroidectomy / lobectomy 64540 32270 25820 19360
660 OP4388 Laparoscopic Adrenalectomy 133400 66710 53360 40030
661 OP0567 Laparoscopic adrenalectomy ( transabdominal ) 103220 51610 41290 30960
662 OP4389 Open Adrenalectomy 121280 60640 48510 36380
663 OP0627 Parathyroidectomy ‐ multiple glands 86080 43040 34430 25820
664 OP0626 Parathyroidectomy ‐ multiple glands & reimplantation 86080 43040 34430 25820
in muscle
665 OP1045 Parathyroidectomy ‐ single gland 86080 43040 34430 25820
666 OP0568 Retroperitoneoscopic adrenalectomy 94590 47300 37840 28380
667 OP4537 Robotic Adrenalectomy 158810 79410 63530 47650
668 OP1011 Subtotal adrenalectomy 113940 56960 45580 34180
669 OP0806 Subtotal thyroidectomy 64540 32270 25820 19360
670 OP0628 Thyroid isthmectomy 64540 32270 25820 19360
671 OP1012 Total adrenalectomy 129030 64520 51620 38710
672 OP1050 Total thyroidectomy 86080 43040 34430 25820
673 OP4727 Total Thyroidectomy ‐ Large (>10 cms) 106667 53334 42667 32000
674 OP4726 Total Thyroidectomy ‐ Medium (5‐10 cms) 93334 46667 37334 28000
675 OP4725 Total Thyroidectomy ‐ Small (<5 cms) 81967 40984 32787 24590
676 OP2874 Total thyroidectomy with sternotomy for retrosternal 129030 64520 51620 38710
goiter
Ent
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

677 OP0988 Adenoidectomy 21720 10860 8680 6520
678 OP0960 Adeno‐tonsillectomy 41430 20720 16570 12420
679 OP4588 Advanced Schwannomas and Hemangiomas of the 150000 75000 60000 45000
Facial Nerve
680 OP0996 Antral puncture & wash ‐ bilateral 15700 7850 6290 4700
681 OP0405 Antral puncture & wash ‐ unilateral 9480 4750 3790 2850
682 OP4585 Arytenoidectomy 55000 27500 22000 16500
137
683 OP3470 Augmentation laryngeal surgery 50870 25430 20350 15260
684 OP4587 Aural Atresia Recanalization 82500 41250 33000 24750
685 OP3466 Aural Meatoplasty 34510 17250 13810 10350
686 OP4580 BAHA 75000 37500 30000 22500
687 OP4596 Bleeding Polypus Septum Removal 17500 8750 7000 5250
688 OP0962 Caldwel Luc's operation ‐ bilateral 37990 18990 15190 11400
689 OP0978 Caldwel Luc's operation ‐ unilateral 25050 12530 10020 7520
690 OP0922 Choanal atresia repair 107520 53760 43010 32260
691 OP3496 Coblation / radiofrequency channeling anterior and 34510 17250 13810 10350
posterior tonsillar pillar
692 OP3497 Coblation / radiofrequency channeling base of tongue 34510 17250 13810 10350
693 OP3495 Coblation / radiofrequency channeling of soft palate 34510 17250 13810 10350
694 OP4603 Coblation Assisted Inferior Turbinate Reduction 25000 12500 10000 7500
695 OP4325 COBLATION ENDOSCOPIC ADENOIDECTOMY 48510 24260 19400 14550
696 OP4703 Coblation Lingual Tonsillectomy 37500 18750 15000 11250
697 OP3492 Coblation tonsillectomy 37910 18950 15160 11370
698 OP4706 Collaural Fistula 50000 25000 20000 15000
699 OP0938 Cortical mastoidectomy 58500 29250 23390 17560
700 OP4607 Crico Thyroid Approximation 37500 18750 15000 11250
701 OP4589 Debridement for Malignant Otitis Externa 80000 40000 32000 24000
702 OP0914 Decompression of endolymphatic sac 97740 48880 39090 29330
703 OP0999 Diagnostic nasal endoscopy 7040 3520 2810 2110
704 OP0756 Dilatation of hypopharynx 21720 10860 8680 6520
705 OP0990 Direct laryngoscopy 21720 10860 8680 6520
706 OP3472 DRAF I ‐ bilateral 50610 25310 20240 15180
707 OP3471 DRAF I ‐ unilateral 34510 17250 13810 10350
708 OP3474 DRAF II ‐ bilateral 68250 34130 27300 20480
709 OP3473 DRAF II ‐ unilateral 50610 25310 20240 15180
710 OP3475 DRAF III 97740 48880 39090 29330
711 OP4085 Emergency foreign body removal by rigid 76310 38160 30520 22900
bronchoscope with optical forceps
712 OP0975 Endoscopic adenoidectomy 31510 15750 12600 9450
713 OP0966 Endoscopic antrostomy ‐ bilateral 23550 11770 9420 7070
714 OP0402 Endoscopic antrostomy ‐ unilateral 15700 7850 6290 4700
715 OP3476 Endoscopic clivus resection of lesion / approach 102180 51090 40870 30650
716 OP0959 Endoscopic DCR 39710 19860 15890 11920
717 OP0972 Endoscopic frontal recess clearance of disease ‐ 30120 15060 12050 9040
bilateral
718 OP0982 Endoscopic frontal recess clearance of disease ‐ 25050 12530 10020 7520
unilateral
719 OP0971 Endoscopic maxillary clearance of disease ‐ bilateral 30120 15060 12050 9040
720 OP0981 Endoscopic maxillary clearance of disease ‐ unilateral 25050 12530 10020 7520
721 OP0989 Endoscopic maxillary clearance of disease ( canine 30120 15060 12050 9040
fossa approach ) ‐ bilateral
722 OP0404 Endoscopic maxillary clearance of disease ( canine 19960 9980 7980 5990
fossa approach ) ‐ unilateral
723 OP3485 Endoscopic nasal + sinus Debridment for invasive 73380 36690 29350 22020
fungal sinusitis ‐ bilateral
724 OP3484 Endoscopic nasal + sinus Debridment for invasive 58700 29350 23490 17610
fungal sinusitis ‐ unilateral
725 OP0994 Endoscopic nasal biopsy 16430 8210 6570 4920
726 OP0920 Endoscopic orbital decompression 107520 53760 43010 32260
727 OP0919 Endoscopic pan sinus surgery ‐ bilateral 107520 53760 43010 32260
728 OP0398 Endoscopic pan sinus surgery ‐ unilateral 75110 37550 30040 22530
729 OP3488 Endoscopic Septoplasty 36080 18040 14430 10830
730 OP3398 Endoscopic transnasal medial maxillectomy 179730 89870 71890 53930
731 OP0954 Endoscopy and surgical decannulation of 21720 10860 8680 6520
tracheostomy
138
732 OP0985 Endoscopy, decannulation & strapping of 21720 10860 8680 6520
tracheostomy
733 OP0998 Examination under microscopy (ENT) 7040 3520 2810 2110
734 OP0908 Excision of acoustic neuroma ‐ translabrynthine 140720 70360 56290 42210
approach
735 OP0909 Excision of glomus jugulare tumour 140720 70360 56290 42210
736 OP0947 Excision of laryngeal papilloma 55970 27980 22390 16790
737 OP0951 Excision of palatal mass 55970 27980 22390 16790
738 OP1401 Excision of pharyngeal diverticulum 75110 37550 30040 22530
739 OP1358 Excision of pharyngeal pouch and cricopharyngeal 75110 37550 30040 22530
myotomy
740 OP0965 Excision of tumour of external auditory canal 31510 15750 12600 9450
741 OP4420 Exploratory Tympanotomy 30690 15350 12290 9210
742 OP0934 External ethmoidectomy ‐ bilateral 75110 37550 30040 22530
743 OP0943 External ethmoidectomy ‐ unilateral 55970 27980 22390 16790
744 OP0918 External osteoplastic frontal sinus surgery 107520 53760 43010 32260
745 OP4701 Feminizing Thyroplasty 87500 43750 35000 26250
746 OP0941 FESS ‐ bilateral 58500 29250 23390 17560
747 OP0955 FESS ‐ unilateral 39710 19860 15890 11920
748 OP0928 FESS ( extended ) ‐ bilateral 78520 39260 31410 23560
749 OP0940 FESS ( extended ) ‐ unilateral 58500 29250 23390 17560
750 OP0969 FESS ( minimal ) ‐ bilateral 39710 19860 15890 11920
751 OP0957 FESS ( minimal ) ‐ unilateral 31510 15750 12600 9450
752 OP2958 FESS revision surgery ‐ bilateral 43330 21660 17340 13000
753 OP2960 FESS revision surgery ‐ unilateral 34380 17190 13740 10310
754 OP1000 Fibreoptic laryngoscopy 7380 3690 2950 2210
755 OP0898 Foreign body ear removal 9920 4970 3970 2980
756 OP0899 Foreign body nose removal 9920 4970 3970 2980
757 OP3478 Frontal ostium balloon sinuplasty‐bilateral 50610 25310 20240 15180
758 OP3477 Frontal ostium bBalloon sinuplasty‐unilateral 34510 17250 13810 10350
759 OP3498 Hyoid bone suspension 68250 34130 27300 20480
760 OP0991 Hypopharyngoscopy 21720 10860 8680 6520
761 OP0902 Incision and drainage of Ludwigs angina 49040 24520 19610 14710
762 OP4605 Injection Laryngoplasty ‐ Fat 30000 15000 12000 9000
763 OP4705 Intratympanic Injection 10000 5000 4000 3000
764 OP4608 Laryngeal Drop 25000 12500 10000 7500
765 OP4702 Laryngeal T‐tube Placement 50000 25000 20000 15000
766 OP0948 Laryngeal web excision 50870 25430 20350 15260
767 OP0945 Laryngofissure & repair 58500 29250 23390 17560
768 OP3494 Laser / coblation / radiofrequency assisted 68250 34130 27300 20480
uvulopalatoplasty
769 OP3468 Laser / coblation excision of laryngeal papilloma 68250 34130 27300 20480
770 OP3469 Laser / coblation MLS decortication 68250 34130 27300 20480
771 OP3493 Laser / coblation resection of midline base of tongue 46040 23020 18420 13820
772 OP4591 Laser Assisted Resurfacing of Buccal Mucosa 25000 12500 10000 7500
773 OP3467 Laser MLS 50870 25430 20350 15260
774 OP4609 Laser Stapedotomy 75000 37500 30000 22500
775 OP3183 Laser Tonsillectomy 48450 24220 19380 14530
776 OP0897 Major vessel ligation for epistaxis 58700 29350 23490 17610
777 OP0927 Mastoidectomy with cavity obliteration 75110 37550 30040 22530
778 OP3480 Maxillary ostium balloon sinuplasty‐bilateral 50610 25310 20240 15180
779 OP3479 Maxillary ostium balloon sinuplasty‐unilateral 34510 17250 13810 10350
780 OP0949 Microlaryngoscopic ( MLS ) decortication 55970 27980 22390 16790
781 OP0968 Microlaryngoscopic ( MLS ) excision of nodule / polyp 31510 15750 12600 9450
782 OP0980 Microlaryngoscopy ( MLS ) & biopsy 26200 13090 10480 7860
783 OP0964 MLS radiofrequency biopsy of mass (ENT) 31510 15750 12600 9450
784 OP0953 MLS radiofrequency excision of mass / nodule / polyp 39710 19860 15890 11920
(ENT)
139
785 OP0925 Modified radical mastoidectomy 78520 39260 31410 23560
786 OP0937 Myringoplasty 55970 27980 22390 16790
787 OP3462 Myringotomy ‐ bilateral 19740 9870 7900 5920
788 OP3463 Myringotomy ‐ unilateral 14930 7470 5970 4470
789 OP0986 Myringotomy with grommet ‐ bilateral 30690 15350 12290 9210
790 OP0997 Myringotomy with grommet ‐ unilateral 15350 7680 6140 4610
791 OP3465 Myringotomy with T‐Tube insertion ‐ unilateral 36080 18040 14430 10830
792 OP3464 Myringotomy with T‐Tube insertion‐ bilateral 37840 18920 15140 11360
793 OP0894 Nasal anterior & posterior (both) packing 19870 9930 7950 5960
794 OP0896 Nasal anterior packing 8220 4120 3290 2470
795 OP0893 Nasal endoscopic cautery 24760 12380 9900 7430
796 OP0895 Nasal posterior packing 14970 7490 5990 4480
797 OP0903 Nasal septal abscess drainage 9920 4970 3970 2980
798 OP0976 Nasal septoplasty 26200 13090 10480 7860
799 OP0958 Nasal septoplasty + submucosal diathermy 39710 19860 15890 11920
800 OP3487 Nasal septoplasty‐Complex 36080 18040 14430 10830
801 OP4599 Nasal Septum Perforation Closure (Local Flap) 37500 18750 15000 11250
802 OP3483 Nasal spacer plate placement 19180 9600 7680 5750
803 OP3491 Nasal valve correction ‐ bilateral 34510 17250 13810 10350
804 OP3490 Nasal valve correction ‐ unilateral 22770 11390 9100 6840
805 OP4700 Nasolabilal Cyst Excision 45000 22500 18000 13500
806 OP0702 Oral excisional biopsy 18860 9430 7540 5660
807 OP1001 Oral incisional biopsy 9520 4760 3810 2860
808 OP0932 Ossiculoplasty 75110 37550 30040 22530
809 OP0973 Pan‐endoscopy (ENT) 31510 15750 12600 9450
810 OP0900 Parapharyngeal abscess drainage 26200 13090 10480 7860
811 OP4582 Parapharyngeal Tumour Excision 62500 31250 25000 18750
812 OP3486 Partial septectomy 34510 17250 13810 10350
813 OP4084 Pediatric Tracheotomy with superior tracheal flap 58700 29350 23490 17610
814 OP0935 Pharyngeal diverticulum excision 75110 37550 30040 22530
815 OP4704 Pinna Seroma Drainage 25000 12500 10000 7500
816 OP4594 Plunging Ranula Excision 45000 22500 18000 13500
817 OP4592 Posterior Cordectomy and Arytenoidectomy 62500 31250 25000 18750
818 OP0961 Pre‐auricular sinus excision ‐ bilateral 39710 19860 15890 11920
819 OP0979 Pre‐auricular sinus excision ‐ unilateral 26200 13090 10480 7860
820 OP4583 Quincy Incision and Drainage 20000 10000 8000 6000
821 OP0926 Radical mastoidectomy 78520 39260 31410 23560
822 OP0963 Radiofrequency excision of mass in nose 37990 18990 15190 11400
823 OP0974 Radiofrequency nose submucosal diathermy 30120 15060 12050 9040
824 OP0984 Radiofrequency turbinate reduction 25050 12530 10020 7520
825 OP4584 Ranula Marsupialisation 30000 15000 12000 9000
826 OP1285 Release of tongue tie / frenuloplasty 13130 6560 5250 3940
827 OP2962 Repair of CSF otorrhea 97800 48900 39110 29340
828 OP0950 Repair of oro‐antral fistula with flap 55970 27980 22390 16790
829 OP0983 Retropharyngeal abscess drainage 26200 13090 10480 7860
830 OP2968 Revision mastoidectomy 81780 40890 32710 24530
831 OP2961 Revision tympanoplasty 78260 39120 31300 23470
832 OP4597 Rhinolith Removal 12500 6250 5000 3750
833 OP4598 Rhinosporidiosis Excision 62500 31250 25000 18750
834 OP4000 SEPTAL FRAMEWORK SURGERY 88040 44030 35220 26420
835 OP3482 Sphenoid ostium balloon sinuplasty‐bilateral 50610 25310 20240 15180
836 OP3481 Sphenoid ostium balloon sinuplasty‐unilateral 34510 17250 13810 10350
837 OP0942 Sphenoidotomy ‐ bilateral 55970 27980 22390 16790
838 OP0956 Sphenoidotomy ‐ unilateral 37990 18990 15190 11400
839 OP3489 Spurectomy 22770 11390 9100 6840
840 OP0931 Stapedectomy 78520 39260 31410 23560
841 OP0802 Stomaplasty ( tracheal ) 23550 11770 9420 7070
140
842 OP0944 Styloidectomy ‐ bilateral 55970 27980 22390 16790
843 OP0967 Styloidectomy ‐ unilateral 30120 15060 12050 9040
844 OP0952 Submucosal uvulo‐palato‐pharyngo‐plasty by 37990 18990 15190 11400
radiofrequency ( UPPP )
845 OP0987 Surgical turbinate reduction ‐ bilateral 20770 10380 8320 6230
846 OP0403 Surgical turbinate reduction ‐ unilateral 15700 7850 6290 4700
847 OP0946 Thyroplasty ‐ type 1 55970 27980 22390 16790
851 OP0977 Tonsillectomy 30690 15350 12290 9210
852 OP4604 Tonsillotomy 25000 12500 10000 7500
853 OP0917 Tracheal reconstruction 107520 53760 43010 32260
854 OP4593 Tracheal Stoma Closure (Tracheo cutaneous fistula 30000 15000 12000 9000
closure)
855 OP0799 Tracheo‐oesophageal puncture 16430 8210 6570 4920
856 OP0798 Tracheo‐oesophageal valve insertion 20550 10280 8220 6160
857 OP0889 Tracheostomy ( open ) ‐ elective 29900 14950 11960 8980
858 OP0890 Tracheostomy ( open ) ‐ emergency 34820 17410 13920 10440
859 OP0394 Tracheostomy ( percutaneous ) ‐ elective 28620 14310 11450 8590
860 OP0395 Tracheostomy ( percutaneous ) ‐ emergency 33270 16630 13300 9980
861 OP4707 Tracheostomy Site Bleeding re‐exploration 37500 18750 15000 11250
862 OP4601 Trans Tymapanic BERA ‐ Bilateral 22500 11250 9000 6750
863 OP4600 Trans Tymapanic BERA ‐ Unilateral 12500 6250 5000 3750
864 OP0929 Trans‐nasal vidian neurectomy ‐ bilateral 84050 42030 33630 25210
865 OP0939 Trans‐nasal vidian neurectomy ‐ unilateral 55970 27980 22390 16790
866 OP0734 Triple endoscopy ( laryngoscopy, tracheoscopy & 39190 19590 15680 11750
oesophagoscopy )
867 OP0933 Tympanoplasty 75110 37550 30040 22530
868 OP0936 Uvulo‐palato‐pharyngo‐plasty ( UPPP ) 31510 15750 12600 9450
869 OP4595 Vallecular Cyst Excision 37500 18750 15000 11250
870 OP4606 Vocal Fold Injection ‐ Fillers/Steroid 20000 10000 8000 6000
871 OP4326 Z‐PLATAPLASTY 77620 38810 31050 23290
OP4762 Submandibular gland combined approach 50000 25000 20000 15000
OP4763 Parotid gland combined approach 62500 31250 25000 18750
External Fixators
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

872 OP1957 Ankle / foot deformity correction using JESS fixator 134900 67450 53960 40480
873 OP1909 Ankle arthrodesis using Ilizarov fixator 77550 38780 31030 23270
874 OP3456 Application of Ilizarov & Hexapod/Ortho‐SUV frame 122730 61360 49100 36820
875 OP4448 ATFL/CFL ankle reconstruction 105840 52920 42340 31750
876 OP1917 Bone transport femur using Ilizarov fixator 77550 38780 31030 23270
877 OP1933 Bone transport femur using Orthofix fixator 77550 38780 31030 23270
878 OP1918 Bone transport tibia using Ilizarov fixator 77550 38780 31030 23270
879 OP1938 Bone transport tibia using Orthofix fixator 77550 38780 31030 23270
880 OP4451 Capitullum or coronoid fracture fixation / excision 52920 26460 21170 15880
881 OP4444 Change of wires / screws 18520 9260 7410 5550
882 OP2845 Closed ankle / foot fracture fixation using JESS fixator 77550 38780 31030 23270
883 OP1921 Closed elbow fracture fixation using Ilizarov fixator 77550 38780 31030 23270
884 OP1902 Closed femoral condyle fracture using Ilizarov fixator 77550 38780 31030 23270
885 OP2837 Closed femoral shaft fracture fixation using Ilizarov 77550 38780 31030 23270
fixator
141
886 OP1922 Closed forearm fracture fixation using Ilizarov fixator 77550 38780 31030 23270
887 OP2847 Closed forearm fracture fixation using JESS fixator 77550 38780 31030 23270
888 OP1919 Closed fracture dislocation shoulder fixation using 77550 38780 31030 23270
Ilizarov fixator
889 OP1930 Closed fracture femur fixation using Orthofix fixator 77550 38780 31030 23270
890 OP1944 Closed fracture forearm fixation using Orthofix fixator 77550 38780 31030 23270
891 OP2851 Closed fracture humerus fixation using Orthofix fixator 77550 38780 31030 23270
892 OP2848 Closed fracture metacarpal and phalanges fixation 85420 42710 34170 25620
using JESS fixator
893 OP1934 Closed fracture tibia fixation using Orthofix fixator 77550 38780 31030 23270
894 OP1950 Closed fracture wrist joint fixation using Orthofix 77550 38780 31030 23270
fixator
895 OP1920 Closed humerus fracture fixation using Ilizarov fixator 77550 38780 31030 23270
896 OP4450 Closed reduction of fractur with percutaneous fixation 52920 26460 21170 15880
with screw / wire
897 OP1905 Closed tibial plafond and ankle fracture fixation using 77550 38780 31030 23270
Ilizarov fixator
898 OP1903 Closed tibial plateau fracture fixation using Ilizarov 77550 38780 31030 23270
fixator
899 OP1904 Closed tibial shaft fracture fixation using Ilizarov 77550 38780 31030 23270
fixator
900 OP1923 Closed wrist fracture fixation using Ilizarov fixator 77550 38780 31030 23270
901 OP2849 Closed wrist fracture fixation using JESS fixator 32430 16220 12980 9730
902 OP4453 Complex joint reconstruction using external fixator 114660 57330 45860 34400
903 OP4443 Complex trauma fixation using external fixator / 77180 38590 30870 23150
K‐wire
904 OP1955 Contractures fingers release using JESS fixator 148380 74180 59350 44510
905 OP3262 Corticotomy ‐ long bones 74170 37090 29670 22250
906 OP1899 Cross leg fixaton in flap surgery using Universal 71970 35980 28790 21590
External Fixator
907 OP1910 Deformity correction femur using Ilizarov fixator 77550 38780 31030 23270
908 OP1932 Deformity correction femur using Orthofix fixator 77550 38780 31030 23270
909 OP1912 Deformity correction foot and ankle using Ilizarov 77550 38780 31030 23270
fixator
910 OP1942 Deformity correction foot using Orthofix fixator 77550 38780 31030 23270
911 OP1949 Deformity correction forearm bones using Orthofix 77550 38780 31030 23270
fixator
912 OP1925 Deformity correction forearm using Ilizarov fixator 77550 38780 31030 23270
913 OP1924 Deformity correction humerus using Ilizarov fixator 77550 38780 31030 23270
914 OP1948 Deformity correction humerus using Orthofix fixator 77550 38780 31030 23270
915 OP1954 Deformity correction of wrist using JESS fixator 85420 42710 34170 25620
916 OP1911 Deformity correction tibia using Ilizarov fixator 77550 38780 31030 23270
917 OP1937 Deformity correction tibia using Orthofix fixator 77550 38780 31030 23270
918 OP1926 Deformity correction wrist using Ilizarov fixator 77550 38780 31030 23270
919 OP2865 External fixation for closed fracture femur using 54020 27020 21610 16210
Universal External Fixator
920 OP2867 External fixation for closed fracture forearm using 54020 27020 21610 16210
921 OP2866 External fixation for closed fracture humerus using 54020 27020 21610 16210
922 OP2864 External fixation for closed fracture tibia using 54020 27020 21610 16210
923 OP1897 External fixation for open fracture femur using 54020 27020 21610 16210
924 OP2859 External fixation for open fracture forearm using 54020 27020 21610 16210
925 OP2860 External fixation for open fracture humerus using 54020 27020 21610 16210
926 OP2861 External fixation for open fracture tibia using 54020 27020 21610 16210
142
927 OP1900 External fixator application for fracture pelvis using 54020 27020 21610 16210
928 OP1913 Femoral lengthening using Ilizarov fixator 77550 38780 31030 23270
929 OP1940 High tibial osteotomy ( HTO ) of tibia with Orthofix 77550 38780 31030 23270
930 OP1931 Infected non‐union femur fixation using Orthofix 77550 38780 31030 23270
fixator
931 OP2855 Infected non‐union tibia fixation using Orthofix fixator 77550 38780 31030 23270
932 OP1908 Knee arthrodesis using Ilizarov fixator 77550 38780 31030 23270
933 OP1915 Knee contracture release using Ilizarov fixator 77550 38780 31030 23270
934 OP1935 Lenghtening femur using Orthofix fixator 77550 38780 31030 23270
935 OP1939 Lenghtening tibia using Orthofix fixator 77550 38780 31030 23270
936 OP1945 Lengthening humerus using Orthofix fixator 77550 38780 31030 23270
937 OP1947 Lengthening metacarpals / phalanges hand using 77550 38780 31030 23270
Orthofix fixator
938 OP1941 Lengthening metatarsals and foot bones using 77550 38780 31030 23270
Orthofix fixator
939 OP1956 Lengthening of metacarpals & phalanges using JESS 85420 42710 34170 25620
fixator
940 OP1958 Lengthening of metatarsal using JESS fixator 35400 17690 14150 10620
941 OP1946 Lenthening forearm ( radius or ulna ) using Orthofix 77550 38780 31030 23270
fixator
942 OP4446 Lower limb tendon tenodesis 105840 52920 42340 31750
943 OP2854 Non‐infected non‐union femur fixation using Orthofix 77550 38780 31030 23270
fixator
944 OP1936 Non‐infected non‐union tibia fixation using Orthofix 77550 38780 31030 23270
fixator
945 OP2834 Non‐union femur fixation using Ilizarov fixator ( 77550 38780 31030 23270
Infected )
946 OP1927 Non‐union femur fixation using Ilizarov fixator ( 77550 38780 31030 23270
Non‐infected )
947 OP3457 Only application of Hexapod/Ortho‐SUV frame on 33760 16880 13500 10130
already applied Ilizarov fixator
948 OP2846 Open ankle / foot fracture fixation using JESS fixator 77550 38780 31030 23270
949 OP2835 Open elbow fracture fixation using Ilizarov fixator 77550 38780 31030 23270
950 OP2836 Open femoral condyle fracture using Ilizarov fixator 77550 38780 31030 23270
951 OP1901 Open femoral shaft fracture fixation using Ilizarov 77550 38780 31030 23270
fixator
952 OP2838 Open forearm fracture fixation using Ilizarov fixator 77550 38780 31030 23270
953 OP1951 Open forearm fracture fixation using JESS fixator 77550 38780 31030 23270
954 OP2839 Open fracture dislocation shoulder fixation using 77550 38780 31030 23270
Ilizarov fixator
955 OP2850 Open fracture femur fixation using Orthofix fixator 77550 38780 31030 23270
956 OP2856 Open fracture forearm fixation using Orthofix fixator 77550 38780 31030 23270
957 OP1943 Open fracture humerus fixation using Orthofix fixator 77550 38780 31030 23270
958 OP1953 Open fracture metacarpal and phalanges fixation 32430 16220 12980 9730
using JESS fixator
959 OP2852 Open fracture tibia fixation using Orthofix fixator 77550 38780 31030 23270
960 OP2853 Open fracture wrist joint fixation using Orthofix fixator 77550 38780 31030 23270
961 OP2840 Open humerus fracture fixation using Ilizarov fixator 77550 38780 31030 23270
962 OP4449 Open reduction of fracture with screw / K‐wire 66150 33080 26460 19850
fixation
963 OP2841 Open tibial plafond and ankle fracture fixation using 77550 38780 31030 23270
Ilizarov fixator
964 OP2842 Open tibial plateau fracture fixation using Ilizarov 88200 44100 35280 26460
fixator
965 OP2843 Open tibial shaft fracture fixation using Ilizarov fixator 77550 38780 31030 23270
966 OP2844 Open wrist fracture fixation using Ilizarov fixator 77550 38780 31030 23270
967 OP1952 Open wrist fracture fixation using JESS fixator 36820 18420 14730 11050
968 OP1929 Osteotomy hip using Orthofix fixator 77550 38780 31030 23270
969 OP4447 Patellar tendon reconstruction/repair 105840 52920 42340 31750
970 OP4452 Pelvic repositioning osteotomy 114660 57330 45860 34400
143
971 OP1914 Tibial lengthening using Ilizarov fixator 77550 38780 31030 23270
972 OP1898 Transarticular external fixation of ankle using 54020 27020 21610 16210
973 OP2863 Transarticular external fixation of knee using Universal 54020 27020 21610 16210
External Fixator
974 OP2862 Transarticular external fixation of wrist using Universal 54020 27020 21610 16210
External Fixator
975 OP4445 Upper limb tendon tenodesis 105840 52920 42340 31750
Eye And Eyelid Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
976 OP4498 AC Formation 4340 2170 1740 1300
977 OP0414 Aminotic membrane transplant of cornea 59420 29710 23770 17820
978 OP1235 Antenor chamber paracentesis 3320 1660 1330 990
979 OP2327 Anti VEGF injection (per eye) ‐ Surgeon fee
980 OP4500 Biopsy ( Conjunctival / Eyelid / Ocular Surface ) 14440 7220 5780 4280
981 OP2898 Blepharoplasty lower lid for ectropion ( both eyes ) 65580 32790 26240 19670
982 OP2897 Blepharoplasty lower lid for ectropion ( single eye ) 41060 20530 16420 12310
983 OP0134 Blepharoplasty lower lid for entropion ( both eyes ) 65580 32790 26240 19670
984 OP0133 Blepharoplasty lower lid for entropion ( single eye ) 41060 20530 16420 12310
985 OP2896 Blepharoplasty upper lid for ectropion ( both eyes ) 65580 32790 26240 19670
986 OP2895 Blepharoplasty upper lid for ectropion ( single eye ) 41060 20530 16420 12310
987 OP0132 Blepharoplasty upper lid for entropion ( both eyes ) 65580 32790 26240 19670
988 OP0131 Blepharoplasty upper lid for entropion ( single eye ) 41060 20530 16420 12310
989 OP0130 Blepharoplasty, with grafting, lower lid for ectropion ( 81980 40990 32790 24590
both eyes )
990 OP0129 Blepharoplasty, with grafting, lower lid for ectropion ( 55340 27670 22130 16600
single eye )
991 OP0128 Blepharoplasty, with grafting, upper lid for ectropion ( 81980 40990 32790 24590
both eyes )
992 OP0127 Blepharoplasty, with grafting, upper lid for ectropion ( 55340 27670 22130 16600
single eye )
993 OP1238 Buckle removal 5670 2840 2270 1700
994 OP1189 Conjunctival flap creation 15440 7720 6180 4630
995 OP0904 Corneal foreign body removal ‐ deep 20600 10300 8240 6180
996 OP1190 Corneal foreign body removal ‐ superficial 7460 3730 2980 2240
997 OP1191 Corneal grafting 76680 38340 30670 23000
998 OP1192 Cyclocryopexy 9410 4700 3760 2820
999 OP1193 Dacryocystorhinostomy / cystectomy 43840 21920 17530 13160
1000 OP1200 Enucleation of eye ( with implant) 49120 24560 19660 14740
1001 OP1199 Enucleation of eye ( without implant ) 26680 13340 10670 8010
1002 OP0430 Epicanthus & telecanthus correction 69660 34830 27860 20890
1003 OP1201 Epicanthus correction 34840 17420 13940 10450
1004 OP0021 Evisceration of eye ( with implant ) 49120 24560 19660 14740
1005 OP1202 Evisceration of eye ( without implant ) 26680 13340 10670 8010
1006 OP1204 Exenteration of orbit 69660 34830 27860 20890
1007 OP1203 Eye examination under GA 4600 2300 1840 1380
1008 OP0137 Eye lid reconstruction ( multiple lids ) 88060 44030 35230 26410
1009 OP1362 Eye lid reconstruction ( one lid ) 38200 19100 15270 11460
1010 OP0416 Fascia lata sling surgery (Eye) 77800 38900 31120 23340
1011 OP1188 Incision and drainage of chalazion 4600 2300 1840 1380
1012 OP1205 Intraocular foreign body removal 63940 31970 25580 19180
1013 OP1206 Intraocular lens implant (THIS IS NOT A CATARACT 57380 28690 22950 17220
OPERATION)
1014 OP1207 Intraocular surgery of anterior segment for glaucoma 51280 25640 20520 15390
144
1015 OP0022 Intraocular surgery of anterior segment for secondary 51280 25640 20520 15390
IOL
1016 OP1234 Intravitreal injection 4580 2290 1830 1380
1017 OP1194 Lacrimal abscess drainage 6800 3400 2720 2040
1018 OP1208 Lensectomy 63940 31970 25580 19180
1019 OP1195 Lid abscess drainage 6800 3400 2720 2040
1020 OP4499 Lid Cyst / Benign Mass Excision 17340 8670 6930 5200
1021 OP1197 Lid entropion correction ‐ both eyes 47360 23680 18940 14210
1022 OP2899 Lid entropion correction ‐ single eye 31540 15770 12630 9470
1023 OP1209 Lid tumour excision & repair ( WITHOUT grafting or 38200 19100 15270 11460
flaps )
1024 OP1210 Lid tumour excision & repair with skin / mucosal 59420 29710 23770 17820
grafting or flap construction
1025 OP0415 Limbal stem cell transplant (eye) 59420 29710 23770 17820
1026 MICSSF Micro Incision Cataract Surgery ( including high 15400
viscosity visco elastic ) ‐ Surgeon's fees
1027 OP1223 Orbital abscess drainage 24660 12330 9870 7400
1028 OP1211 Orbitotomy 76680 38340 30670 23000
1029 OP3023 Phaco‐emulsification cataract operation (without IOL) 52160 26080 20860 15650
‐ NOT FOR DAYCARE
1030 OP1233 Pneumatic retinopexy 29840 14920 11940 8960
1031 OP1213 Probing and syringing of naso‐lacrimal duct 7460 3730 2980 2240
1032 OP1214 Probing and syringing of naso‐lacrimal duct with 24660 12330 9870 7400
inferior turbinate infracture
1033 OP1232 Prophylactic retinal detachment surgery ( buckling 22430 11210 8970 6730
procedure )
1034 OP1216 Pterygium surgery ( with grafting ) 32420 16210 12970 9720
1035 OP1215 Pterygium surgery ( without grafting ) 11680 5840 4680 3510
1036 OP1217 Ptosis surgery 47140 23570 18870 14150
1037 OP1237 Reinjection of silicone oil 18710 9360 7490 5620
1038 OP1218 Repair of lacrimal canaliculi 51280 25640 20520 15390
1039 OP1220 Repair of lid coloboma 38200 19100 15270 11460
1040 OP1219 Repair of lid coloboma with skin / mucosal grafting or 59420 29710 23770 17820
flap construction
1041 OP1221 Repair of lid injuries 39800 19900 15920 11950
1042 OP1222 Repair of lid injuries with flaps or grafts 59420 29710 23770 17820
1043 OP1212 Repair of perforating injury of eyeball 51280 25640 20520 15390
1044 OP1224 Retinal detachment surgery 58130 29060 23250 17440
1045 OP1225 Retinocryopexy 22430 11210 8970 6730
1046 OP1236 Silicone oil removal 14950 7480 5990 4480
1047 OP1226 Squint horizontal muscle surgery 49120 24560 19660 14740
1048 OP1227 Squint vertical muscle surgery 63940 31970 25580 19180
1049 OP1228 Symblephron release ( WITHOUT grafting ) 24660 12330 9870 7400
1050 OP1229 Symblephron release with grafting 47980 23990 19200 14390
1051 OP1230 Tarsorrhaphy 13140 6570 5260 3940
1052 OP1799 Tarsorrhaphy release 4600 2300 1840 1380
1053 OP1231 Vitrectomy 58130 29060 23250 17440
Foot Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1054 OP4151 Ankle ligament reconstruction 95630 47820 38260 28690
1055 OP4150 Ankle ligament repair 63000 31500 25200 18900
1056 OP4331 Extensive CTEV Release 92170 46080 36870 27650
1057 OP4332 Medial CTEV Release 65490 32750 26200 19650
1058 OP4333 Posterior CTEV Release 65490 32750 26200 19650
145
1059 OP4149 Tarsal tunnel release 49040 24520 19610 14710
1060 OP4148 Tibialis post tendon release 49040 24520 19610 14710
Gastro‐duodenal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
1061 OP4540 Bariatric Surgery Super Obese ( BMI > 50 ) 211520 105760 84600 63450
1062 OP1009 Closure of perforated duodenal ulcer 85420 42710 34170 25620
1063 OP0027 Closure of perforated gastric ulcer 85420 42710 34170 25620
1064 OP3392 Delayed gastric pull‐up 129130 64560 51650 38750
1065 OP1003 Gastro‐jejunostomy (without vagotomy) 94590 47300 37840 28380
1066 OP1004 Gastrostomy 60240 30120 24100 18070
1067 OP1005 Highly selective vagotomy 67470 33740 26990 20240
1068 OP3391 Laparoscopic distal gastrectomy with Bilroth 1 225990 112990 90390 67790
reconstruction
1069 OP3368 Laparoscopic distal gastrectomy with Roux‐en‐Y 180790 90390 72310 54230
gastrojejunostomy
1070 OP0564 Laparoscopic duodenal perforation closure 94590 47300 37840 28380
1071 OP3027 Laparoscopic gastrectomy 102380 51190 40950 30710
1072 OP0688 Laparoscopic gastric perforation closure 94590 47300 37840 28380
1073 OP0560 Laparoscopic gastro ‐ jejunostomy ( GJ ) 98870 49430 39540 29660
1074 OP0634 Laparoscopic gastrostomy 60240 30120 24100 18070
1075 OP3369 Laparoscopic pyloromyotomy 77510 38760 31010 23250
1076 OP3370 Laparoscopic pyloroplasty 77510 38760 31010 23250
1077 OP3375 Laparoscopic total gastrectomy with with roux‐en‐Y 258270 129140 103310 77480
oesophagojejunostomy
1078 OP0636 Laparoscopic truncal vagotomy & gastro ‐ jejunostomy 112430 56220 44970 33730
1079 OP3377 Laparoscopic truncal vagotomy and pyloroplasty 129130 64560 51650 38750
1080 OP1402 Partial / subtotal gastrectomy 84470 42240 33790 25350
1081 OP1279 Pyloromotomy for pyloric stenosis 57090 28540 22840 17130
1082 OP1404 Radical gastrectomy 106680 53340 42670 32000
1083 OP4538 Revisional Bariatric Surgery 211520 105760 84600 63450
1084 OP4534 Robotic Sleeve Gastrectomy 211520 105760 84600 63450
1085 OP4529 Single Incision Sleeve Gastrectomy 211520 105760 84600 63450
1086 OP1403 Total gastrectomy 132080 66050 52840 39630
1087 OP1010 Truncal vagotomy & gastro ‐ jejunostomy 98870 49430 39540 29660
1088 OP0635 Truncal vagotomy & pyloroplasty 107520 53760 43010 32260
General Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1089 OP2016 Aspiration of ganglion with local / steroid injection 5910 2960 2370 1770
1090 OP2317 Aspiration of hematoma 5910 2960 2370 1770
1091 OP1299 Central venous access in neonate 30010 15000 12000 9000
1092 OP3024 Central venous line insertion in OT 9430 4710 3770 2840
1093 OP1328 Debridement ( large ) in OT 27720 13860 11090 8320
1094 OP1329 Debridement ( medium ) in OT 18480 9240 7390 5540
1095 OP1330 Debridement ( small ) in OT 13860 6930 5540 4160
1096 OP3311 Debridement of crush avulsion injury of extremity 58020 29010 23220 17410
1097 OP0318 Debridement of foot ‐ forefoot / heel 48240 24120 19290 14470
1098 OP0317 Debridement of foot ‐ toes 27070 13530 10840 8120
1099 OP0544 Diagnostic laparoscopy ( with or without biopsy ) 32880 16430 13150 9860
146
1100 OP3164 Drainage of abdominal wall haematoma 40610 20310 16240 12190
1101 OP2046 Drainage of paravertebral abscess 32500 16250 13010 9740
1102 OP2047 Drainage of psoas abscess 32500 16250 13010 9740
1103 OP0140 Excision of Bartholin's cyst 22620 11310 9040 6780
1104 OP4327 Excision of Bony Tumour with Reconstruction & 157540 78770 63020 47260
Fixation
1105 OP1072 Excision of carbuncle 67610 33810 27050 20290
1106 OP2020 Excision of ganglion 34650 17330 13860 10400
1107 OP0248 Excision of haemangioma ‐ extremities / trunk (5 ‐ 10 69300 34650 27720 20790
cm)
1108 OP0355 Excision of haemangioma ‐ extremities / trunk (less 60870 30440 24350 18260
than 5 cm)
1109 OP0249 Excision of haemangioma ‐ extremities / trunk (more 99100 49550 39640 29730
than 10 cm)
1110 OP0354 Excision of haemangioma ‐ face (less than 2 cm) 60870 30440 24350 18260
1111 OP0247 Excision of haemangioma ‐ face (more than 2 cm) 99100 49550 39640 29730
1112 OP1073 Excision of large superficial soft tissue mass / tumour ‐ 57750 28880 23100 17330
Excluding neuroma or ganglion
1113 OP2318 Excision of medium size superficial soft tissue mass / 46200 23100 18480 13860
tumour ‐ Excluding neuroma or ganglion
1114 OP2970 Excision of multiple cysts 46200 23100 18480 13860
1115 OP3073 Excision of pilonidal sinus with flap cover 102450 51230 40980 30730
1116 OP1027 Excision of pilonidal sinus with primary closure 57750 28880 23100 17330
1117 OP1028 Excision of pilonidal sinus without primary closure 46200 23100 18480 13860
1118 OP1275 Excision of preauricular tags 23100 11550 9240 6930
1119 OP3035 Excision of sinus ( soft tissue ) 24700 12350 9880 7400
1120 OP1075 Excision of small superficial soft tissue mass / tumour ‐ 34650 17330 13860 10400
Excluding neuroma or ganglion
1121 OP1256 Exomphalos ( omphalocele ) repair 114480 57250 45800 34350
1122 OP1002 Exploratory laparotomy ( including small biopsy ) 47200 23590 18870 14160
1123 OP0111 Gastroschisis repair 114480 57250 45800 34350
1124 OP1736 Glomus tumour excision 41930 20970 16770 12580
1125 OP3361 Incision & drainage of MULTIPLE deep abscesses 33820 16910 13520 10140
1126 OP0601 Incision and drainage of large / deep abscess 20310 10150 8120 6090
1127 OP0901 Incision and drainage of small / superficial abscess 9980 4990 4000 2990
1128 OP1034 Ischorectal abscess drainage 56410 28200 22560 16930
1129 OP1267 Laparoscopic division of intra‐abdominal adhesions / 74340 37170 29730 22300
bands ( adhesiolysis )
1130 OP0546 Laparoscopic drainage of intra‐abdominal collection 74340 37170 29730 22300
1131 OP3054 Laparoscopic removal of infected mesh (following 73780 36890 29520 22130
hernia repair)
1132 OP0562 Laparoscopic splenectomy 103580 51790 41430 31070
1133 OP2901 Laparotomy and division of intra‐abdominal adhesions 76560 38270 30620 22960
/ bands
1134 OP1139 Marsupialization of Bartholin's cyst 16500 8240 6590 4950
1135 OP1006 Mesenteric cyst excision 67610 33810 27050 20290
1136 OP4143 MTP Joint debridement 49130 24570 19660 14740
1137 OP0518 Muscle biopsy 16290 8150 6510 4880
1138 OP0117 Neuroblastoma excision 115570 57780 46220 34670
1139 OP1007 Omentectomy 67610 33810 27050 20290
1140 OP3363 Paediatric vascular cut down ( venesection ) in OT 33820 16910 13520 10140
1141 OP1035 Perianal abscess drainage 45160 22590 18060 13550
1142 OP3450 Preauricular tag excision ‐ complex 46130 23070 18460 13840
1143 OP3449 Preauricular tag excision ‐ simple 30740 15370 12310 9230
1144 OP3348 Repair of complex lacerated wound 46200 23100 18480 13860
1145 OP1144 Resuturing of abdomen 66740 33370 26690 20010
1146 OP1394 Retroperitoneal drainage of abscess 65120 32560 26050 19530
1147 OP1008 Retroperitoneal tumour excision 98910 49460 39570 29670
1148 OP2010 Secondary wound closure ( suturing ) 66740 33370 26690 20010
147
1149 OP0593 Splenectomy ( open ) 108380 54190 43350 32520
1150 OP0905 Suturing of large lacerated wound 34650 17330 13860 10400
1151 OP0906 Suturing of small lacerated wound 23100 11550 9240 6930
1152 OP4146 Tendoachilles debridement 77080 38550 30840 23120
1153 OP4145 Tendoachilles decompression 51380 25680 20550 15400
1154 OP4312 Umbilectomy with/ without entering peritoneal cavity 68610 34300 27450 20580
(umbilical exploration / PVID)
1155 OP1298 Venesection 24140 12080 9660 7250
1156 OP2319 Wide excision of superficial tumour ( trunk / limbs ) 67610 33810 27050 20290
1157 OP1294 Wilms? tumour excision 115570 57780 46220 34670
Hand Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
1158 OP4385 Anastomosis by Vein Graft in Reimplantation ( 121280 60640 48510 36380
Multiple )
1159 OP4384 Anastomosis by Vein Graft in Reimplantation ( Single ) 72770 36380 29110 21830
1160 OP1612 AO plating for fracture distal phalynx 65450 32720 26180 19640
1161 OP1613 AO plating for fracture middle phalynx 65450 32720 26180 19640
1162 OP1614 AO plating for fracture proximal phalynx 65450 32720 26180 19640
1163 OP1615 AO plating for metacarpal fracture 65450 32720 26180 19640
1164 OP1325 Burns contracture release ‐ multiple fingers / 122640 61320 49070 36790
extensive
1165 OP1326 Burns contracture release ‐ one finger / toe / minor 81780 40890 32710 24530
1166 OP2304 Burns contracture release ‐ two fingers / toes / 98080 49040 39230 29420
medium
1167 OP1763 Button hole deformity correction ‐ multiple fingers 122640 61320 49070 36790
1168 OP1764 Button hole deformity correction ‐ single finger 81780 40890 32710 24530
1169 OP1765 Button hole deformity correction ‐ two fingers 102250 51120 40910 30670
1170 OP1663 Closed reduction of fracture scaphoid 57250 28620 22900 17180
1171 OP4336 Complex Foot Reconstruction / Hand 109150 54580 43660 32750
1172 OP1605 Composite grafting for finger tip injuries 61360 30680 24540 18420
1173 OP4467 Contracture Hand ‐ Moderate 88200 44100 35280 26460
1174 OP4468 Contracture Hand ‐ Severe 121280 60640 48510 36380
1175 OP4466 Contracture Hand ‐ Simple 551250 27560 22050 16540
1176 OP2307 Contracture release for camptodactyly ‐ multiple 94050 47020 37620 28210
fingers
1177 OP2305 Contracture release for camptodactyly ‐ single finger 40970 20490 16380 12300
1178 OP2306 Contracture release for camptodactyly ‐ two fingers 61360 30680 24540 18420
1179 OP2310 Contracture release with tendon transfer for 130710 65350 52280 39220
camptodactyly ‐ multiple fingers
camptodactyly ‐ single finger
camptodactyly ‐ two fingers
1182 OP0420 Correction of complex bifid thumb ( Wassal type 1 ) 61360 30680 24540 18420
1188 OP1654 Correction of Mallet finger 57250 28620 22900 17180
1189 OP1655 Correction of Mallet finger ‐ extensor tendon repair 98080 49040 39230 29420
1190 OP1656 Correction of Mallet finger ‐ tendon repair with 102250 51120 40910 30670
K‐wiring
1191 OP0844 Correction of simple bifid thumb / finger 45000 22500 18010 13500
148
1192 OP1311 Correction of simple bifid toe 45000 22500 18010 13500
1193 OP1600 Cross finger flap for finger tip injuries 81780 40890 32710 24530
1194 OP1670 Debridement for hand injuries 40970 20490 16380 12300
1195 OP1702 Debulking for macrodactyly 106280 53140 42510 31890
1196 OP1616 Distractor / JESS application for fracture distal phalynx 65450 32720 26180 19640
1197 OP1617 Distractor / JESS application for fracture middle 65450 32720 26180 19640
phalynx
1198 OP1618 Distractor / JESS application for fracture proximal 65450 32720 26180 19640
phalynx
1199 OP1619 Distractor / JESS application for metacarpal fracture 65450 32720 26180 19640
1200 OP1602 Dorsal dermodesis for nail bed injuries 65450 32720 26180 19640
1201 OP1596 Drainage of subungual haematoma 24630 12320 9860 7390
1202 OP4469 Dupuytren's Contracture ‐ Mild 44100 22050 17640 13230
1203 OP4470 Dupuytren's Contracture ‐ Moderate 66150 33080 26460 19850
1204 OP4471 Dupuytren's Contracture ‐ Severe 88200 44100 35280 26460
1205 OP1683 Excision of extra digit (excluding thumb) 61360 30680 24540 18420
1206 OP0419 Excision of extra digit with ligament reconstruction 81780 40890 32710 24530
(excluding thumb)
1207 OP4372 Excision of glomus tumor finger 72770 36380 29110 21830
1208 OP1635 Extensor tendon repair ( Zone 1) 65450 32720 26180 19640
1209 OP1636 Extensor tendon repair ( Zone 2) ‐ single tendon 65450 32720 26180 19640
1210 OP1640 Extensor tendon repair ( Zone 2) ‐ two tendons 81780 40890 32710 24530
1211 OP1639 Extensor tendon repair ( Zone 3) ‐ multiple tendons 102250 51120 40910 30670
1223 OP1699 First web release for cleft hand 81780 40890 32710 24530
1224 OP1620 Flexor tendon repair ( Zone 1) 65450 32720 26180 19640
1225 OP1621 Flexor tendon repair ( Zone 2) ‐ single tendon 73580 36790 29440 22070
1226 OP1625 Flexor tendon repair ( Zone 2) ‐ two tendons 89900 44950 35960 26960
1227 OP1624 Flexor tendon repair ( Zone 3) ‐ multiple tendons 102250 51120 40910 30670
1239 OP1734 Free microvascular joint transfer 179750 89880 71900 53930
1240 OP1706 Free phalangeal / bone transfer for brachydactyly 81780 40890 32710 24530
1241 OP1604 Full thickness skin grafting for finger tip injuries 98080 49040 39230 29420
1242 OP1679 Groin / abdominal flap cover for hand injuries ‐ large ( 98080 49040 39230 29420
multiple flaps )
single flap )
149
two flaps )
1245 OP1678 Groin / abdominal flap cover for hand injuries ‐ 81780 40890 32710 24530
medium ( multiple flaps )
medium ( single flap )
medium ( two flaps )
1248 OP1677 Groin / abdominal flap cover for hand injuries ‐ small ( 65450 32720 26180 19640
multiple flaps )
single flap )
two flaps )
1251 OP1760 Hand abscess drainage 40970 20490 16380 12300
1252 OP1606 Homodigital flap for finger tip injuries 81780 40890 32710 24530
1253 OP1750 Incision and drainage for flexor tenosynovitis 40970 20490 16380 12300
1254 OP1608 K ‐ wire fixation for fracture distal phalynx 49040 24520 19610 14710
1255 OP1609 K ‐ wire fixation for fracture middle phalynx 49040 24520 19610 14710
1256 OP1610 K ‐ wire fixation for fracture proximal phalynx 49040 24520 19610 14710
1257 OP1611 K ‐ wire fixation for metacarpal fracture 61360 30680 24540 18420
1258 OP0470 Krukenberg's operation 81780 40890 32710 24530
1259 OP1664 K‐wire fixation of fracture scaphoid 61360 30680 24540 18420
1260 OP1697 Ligament reconstruction for hypoplastic thumb 81780 40890 32710 24530
1261 OP4235 Mini Plate for fracture phalanx 55790 27900 22310 16740
1262 OP3071 Nail bed reconstruction ‐ multiple fingers 118910 59460 47570 35680
1263 OP3008 Nail bed reconstruction ‐ single finger 66950 33470 26780 20090
1264 OP3072 Nail bed reconstruction ‐ two fingers 92910 46460 37170 27870
1265 OP2302 Nail bed repair ‐ multiple 55130 27560 22050 16540
1266 OP1595 Nail bed repair ‐ single 33080 16540 13230 9920
1267 OP2303 Nail bed repair ‐ two nail beds 44100 22050 17640 13230
1268 OP1599 Oblique triangular flap for finger tip injuries 81780 40890 32710 24530
1269 OP1680 On‐top plasty / pollicization 130710 65350 52280 39220
1270 OP1669 Open reduction and ligament repair of wrist 81780 40890 32710 24530
1271 OP1666 ORIF and bone grafting for non‐union of scaphoid 81780 40890 32710 24530
1272 OP1667 ORIF and vascularised bone grafting for non‐union of 163450 81730 65380 49040
scaphoid
1273 OP4487 Orthoplastic Reconstruction Thumb/Finger 110250 55130 44100 33080
1274 OP1747 Osteotomy for metacarpal malunion 81780 40890 32710 24530
1275 OP1748 Osteotomy for phalangeal malunion 81780 40890 32710 24530
1276 OP1698 Pollicization for hypoplastic thumb 155250 77630 62110 46580
1277 OP3438 Primary tendon repair by tendon graft 76710 38360 30680 23010
1278 OP1668 Proximal row carpectomy 81780 40890 32710 24530
1279 OP1684 Radial club hand ‐ centralisation / radialisation 77640 38820 31060 23300
1280 OP1686 Radial club hand ‐ distractor / external fixator 57250 28620 22900 17180
application
1281 OP1685 Radial club hand ‐ free epiphysis / fibula transfer 187950 93980 75180 56390
1282 OP1682 Radial club hand ‐ osteotomy of ulna 122640 61320 49070 36790
1283 OP1742 Radial collateral ligament reconstruction of thumb 81780 40890 32710 24530
1284 OP1744 Radial collateral ligament repair of thumb 65450 32720 26180 19640
1285 OP1703 Ray resection for macrodactyly 98080 49040 39230 29420
1286 OP1759 Release of first extensor compartment 40970 20490 16380 12300
1287 OP1607 Reverse dermal cross finger flap for finger tip injuries 81780 40890 32710 24530
1288 OP1665 Screw fixation of fracture scaphoid 57250 28620 22900 17180
1289 OP1597 Shortening and closure of finger stump 49040 24520 19610 14710
1290 OP1700 Snow ‐ Littler's procedure for cleft hand 122640 61320 49070 36790
1291 OP1603 Split skin grafting for finger tip injuries 65450 32720 26180 19640
1292 OP1756 Swan neck deformity correction ‐ multiple fingers 102250 51120 40910 30670
1293 OP1754 Swan neck deformity correction ‐ single finger 81780 40890 32710 24530
150
1294 OP1755 Swan neck deformity correction ‐ two fingers 89900 44950 35960 26960
1295 OP1708 Syndactyly release ‐ complex 122640 61320 49070 36790
1296 OP1288 Syndactyly release ‐ simple 81780 40890 32710 24530
1297 OP1652 Tendon grafting ‐ stage 1 77640 38820 31060 23300
1298 OP1653 Tendon grafting ‐ stage 2 98080 49040 39230 29420
1299 OP1650 Tenolysis of flexor / extensor tendons ‐ single 49040 24520 19610 14710
1300 OP1601 Thenar flap for finger tip injuries 89900 44950 35960 26960
1301 OP1701 Toe transfer ‐ great toe 187950 93980 75180 56390
1302 OP1740 Toe transfer ‐ second toe 187950 93980 75180 56390
1303 OP1749 Trigger finger release 33080 16540 13230 9920
1304 OP1741 Ulnar collateral ligament reconstruction of thumb 81780 40890 32710 24530
1305 OP1743 Ulnar collateral ligament repair of thumb 65450 32720 26180 19640
1306 OP1598 V ‐ Y advancement flap for finger tip injuries 81780 40890 32710 24530
1307 OP1752 Wrist synovectomy 63000 31500 25200 18900
1308 OP1746 Zimmer splint application for multiple fingers 61360 30680 24540 18420
1309 OP1745 Zimmer splint application for one finger 61360 30680 24540 18420
Head And Neck Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
1310 OP0733 Buccal mucosal radical excision 62600 31300 25040 18770
1311 OP0911 Commando operation 140720 70360 56290 42210
1312 OP0736 Composite oral resection ‐ large 125040 62530 50020 37520
1313 OP0735 Composite oral resection ‐ small 93830 46910 37530 28150
1314 OP0766 Cordectomy ‐ larynx 78260 39120 31300 23470
1315 OP4313 Cystic hygroma (major) 66710 33350 26680 20010
1316 OP4314 Cystic hygroma (minor) 53360 26680 21350 16010
1317 OP2957 Endoscopic nasal mass excision 88900 44460 35560 26670
1318 OP0115 Excision of branchial cyst / fistula ( bilateral ) 58700 29350 23490 17610
1319 OP0114 Excision of branchial cyst / fistula ( unilateral ) 39190 19590 15680 11750
1320 OP1319 Excision of carcinoma cheek 98870 49430 39540 29660
1321 OP2963 Excision of nasopharyngeal angiofibroma ‐ big 124400 62200 49770 37320
1322 OP2964 Excision of nasopharyngeal angiofibroma ‐ small 88900 44460 35560 26670
1323 OP2966 Excision of nasopharyngeal angiofibroma with 159900 79960 63970 47970
intracranial extension
1324 OP4590 Excision of Sinus in neck 37500 18750 15000 11250
1325 OP0763 Extended laryngo‐pharyngectomy 156360 78180 62550 46910
1326 OP0780 Extended maxillectomy 132880 66430 53150 39870
1327 OP0785 Extended neck dissection 132880 66430 53150 39870
1328 OP0803 Extra‐cranial skull base resection 171950 85970 68780 51590
1329 OP1046 Glossectomy ‐ partial 62600 31300 25040 18770
1330 OP0737 Glossectomy ‐ subtotal 78260 39120 31300 23470
1331 OP0738 Glossectomy ‐ total 93830 46910 37530 28150
1332 OP0797 Head and neck repair ‐ complex 62600 31300 25040 18770
1333 OP0796 Head and neck repair ‐ simple 31330 15670 12540 9410
1334 OP0776 Hypopharyngeal laser resection ‐ large 86000 43000 34400 25800
1335 OP0775 Hypopharyngeal laser resection ‐ medium 62600 31300 25040 18770
1336 OP0774 Hypopharyngeal laser resection ‐ small 39190 19590 15680 11750
1337 OP0753 Infra ‐ temporal fossa resection 140720 70360 56290 42210
1338 OP4221 Inter Maxillary Fixation 26680 13350 10670 8000
1339 OP0773 Laryngeal laser resection ‐ large 78260 39120 31300 23470
1340 OP0772 Laryngeal laser resection ‐ medium 54770 27380 21900 16430
1341 OP0771 Laryngeal laser resection ‐ small 39190 19590 15680 11750
1342 OP0762 Laryngectomy with partial pharyngectomy 125040 62530 50020 37520
151
1343 OP0912 Laryngo‐pharyngectomy 140720 70360 56290 42210
1344 OP0782 Laryngoscopic excision of tumours ‐ large 62600 31300 25040 18770
1345 OP0781 Laryngoscopic excision of tumours ‐ small 31330 15670 12540 9410
1346 OP0758 Local head and neck flap ‐ large 78260 39120 31300 23470
1347 OP3070 Local head and neck flap ‐ medium 64030 32010 25610 19200
1348 OP0757 Local head and neck flap ‐ small 54770 27380 21900 16430
1349 OP4217 Mandibular Distraction Stage‐I 66710 33350 26680 20010
1350 OP4218 mandibular Distraction Stage‐II 26680 13350 10670 8000
1351 OP0777 Mandibulectomy ‐ marginal 54770 27380 21900 16430
1352 OP0778 Mandibulectomy ‐ segmental 78260 39120 31300 23470
1353 OP0779 Mandibulotomy 62600 31300 25040 18770
1354 OP4219 Maxillary Distractor Stage ‐ I 66710 33350 26680 20010
1355 OP4220 Maxillary Distractor Stage ‐ II 26680 13350 10670 8000
1356 OP0784 Modified neck dissection 117310 58650 46920 35200
1357 OP0761 Near total laryngectomy 117310 58650 46920 35200
1358 OP0787 Neck mass excision ‐ complex 46900 23450 18760 14070
1359 OP0786 Neck mass excision ‐ simple 23550 11770 9420 7070
1360 OP0755 Oral laser resection ‐ large 117310 58650 46920 35200
1361 OP0759 Oral laser resection ‐ medium 93830 46910 37530 28150
1362 OP0754 Oral laser resection ‐ small 62600 31300 25040 18770
1363 OP0789 Oral lesion excision ‐ complex 62600 31300 25040 18770
1364 OP0788 Oral lesion excision ‐ simple 31330 15670 12540 9410
1365 OP0770 Oropharyngeal laser resection ‐ large 132880 66430 53150 39870
1366 OP0769 Oropharyngeal laser resection ‐ medium 109450 54730 43790 32830
1367 OP0768 Oropharyngeal laser resection ‐ small 78260 39120 31300 23470
1368 OP0760 Other partial laryngectomy 78260 39120 31300 23470
1369 OP0795 Parapharyngeal space excision 109450 54730 43790 32830
1370 OP0910 Partial maxillectomy 78260 39120 31300 23470
1371 OP0794 Pedicled flap for head and neck ‐ major 93830 46910 37530 28150
1372 OP0764 Pedicled flap for head and neck ‐ medium 70380 35200 28160 21120
1373 OP0792 Pedicled flap for head and neck ‐ minor 46900 23450 18760 14070
1374 OP0993 Pharyngeal fistula repair ‐ simple without flap 46900 23450 18760 14070
1375 OP2959 Pharyngeal fistula repair with flap 85330 42670 34140 25600
1376 OP2967 Pharyngeal flap 85330 42670 34140 25600
1377 OP0767 Pharyngeal repair 70380 35200 28160 21120
1378 OP2965 Pharyngoplasty 85330 42670 34140 25600
1379 OP0793 Pharyngotomy 78260 39120 31300 23470
1380 OP0791 Photo‐dynamic therapy ( PDT ) for head and neck ‐ 117310 58650 46920 35200
complex
1381 OP0790 Photo‐dynamic therapy ( PDT ) for head and neck ‐ 78260 39120 31300 23470
simple
1382 OP1047 Radical neck dissection 101650 50830 40660 30490
1383 OP0783 Selective neck dissection 86000 43000 34400 25800
1384 OP0800 Skin graft for head and neck ‐ large 66490 33240 26600 19940
1385 OP0801 Skin graft for head and neck ‐ small 39190 19590 15680 11750
1386 OP0913 Supra‐cricoid partial laryngectomy 117310 58650 46920 35200
1387 OP0924 Total laryngectomy 109450 54730 43790 32830
1388 OP0923 Total maxillectomy 109450 54730 43790 32830
1389 OP0807 Trans‐cervical base of tongue resection 93830 46910 37530 28150
1390 OP0396 Vertical partial laryngectomy 93830 46910 37530 28150
1391 OP0809 Wide excision of lesion in head and neck ‐ major 101650 50830 40660 30490
1392 OP0808 Wide excision of lesion in head and neck ‐ minor 62580 31290 25030 18770
Hepato‐bilio‐pancreatic Operations
152
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
1393 OP1368 Cholecystectomy 90320 45160 36130 27100
1394 OP1015 Cholecystectomy and choledocholithotomy ( open ) 103460 51730 41390 31040
1395 OP1386 Distal pancreatectomy & pancreatico‐jejunostomy 113540 56760 45410 34050
1396 OP1371 Excision of cholangiocarcinoma 118670 59340 47470 35600
1397 OP1370 Excision of choledochal cyst and hepatico‐jejunostomy 118670 59340 47470 35600
1398 OP1389 Frey's procedure 148350 74170 59340 44510
1399 OP1016 Hepatico ‐ jejunostomy ( open ) 113740 56870 45490 34130
1400 OP1274 Hepatico porto‐enterostomy ( Kasai's operation ) 144710 72360 57890 43420
1401 OP1387 Insulinoma excision 113540 56760 45410 34050
1402 OP4413 Laparoscopic Assisted Distal pancreatectomy 264140 132070 105650 79230
1403 OP4414 Laparoscopic Assisted Hepatico Jejunostomy 234790 117390 93910 70430
1404 OP4415 Laparoscopic Assisted Lateral Pancreatico‐ 272540 136270 109010 81760
Jejunostomy
1405 OP0554 Laparoscopic cholecystectomy 94590 47300 37840 28380
1406 OP0549 Laparoscopic cholecystectomy and 108790 54400 43510 32630
choledocholithotomy ( CBD exploration )
1407 OP0555 Laparoscopic cholecystectomy with 108790 54400 43510 32630
choledochoduodenostomy
1408 OP3393 Laparoscopic cholecystectomy with intra‐operative 109790 54890 43910 32930
cholangiogram
1409 OP0565 Laparoscopic cysto ‐ gastrostomy 98870 49430 39540 29660
1410 OP0566 Laparoscopic cysto ‐ jejunostomy 98870 49430 39540 29660
1411 OP0563 Laparoscopic deroofing of non‐hydatid liver cyst 98870 49430 39540 29660
1412 OP3031 Laparoscopic distal pancreatectomy 123700 61860 49480 37110
1413 OP0588 Laparoscopic drainage of liver abscess drainage 98870 49430 39540 29660
1414 OP1391 Laparoscopic drainage of pseudopancreatic cyst 94590 47300 37840 28380
1415 OP0591 Laparoscopic excision of choledochal cyst and 123660 61820 49460 37100
hepatico‐jejunostomy
1416 OP0550 Laparoscopic hepatico ‐ jejunostomy 123660 61820 49460 37100
1417 OP3032 Laparoscopic Peustow's operation 102250 51120 40910 30670
1418 OP3371 Laparoscopic repair of CBD injury 96840 48430 38750 29050
1419 OP3030 Laparoscopic Whipple's operation 170600 85300 68250 51180
1420 OP4412 Laparoscopic Whipples procedure 293490 146750 117390 88040
1421 OP1390 Laparotomy and drainage of pseudopancreatic cyst 69460 34730 27780 20840
1422 OP1388 Lateral pancreatico‐jejunostomy 108790 54400 43510 32630
1423 OP1375 Left hepatectomy 129030 64520 51620 38710
1424 OP1067 Left liver lobectomy 139310 69660 55720 41800
1425 OP1377 Liver abscess drainage (open) 73910 36960 29570 22180
1426 OP1372 Liver resection with excision of CBD 185680 92840 74280 55710
1427 OP1393 Necrosectomy and drainage of pancreatic abscess 98870 49430 39540 29660
1428 OP0732 Open deroofing / excision of non‐hydatid liver cyst 73910 36960 29570 22180
1429 OP1376 Partial liver resection ( lateral segmentectomy ) 83510 41750 33410 25050
1430 OP1017 Primary repair of common hepatic or bile duct ( CBD ) 62980 31490 25190 18900
1431 OP4311 Pseudo pancreatic cyst ‐ cystogastrostomy 72770 36380 29110 21830
1432 OP1369 Radical cholecystectomy ( liver bed excision with bile 117310 58650 46920 35200
duct excision + lymph nodal dissection )
1433 OP0119 Radical cholecystectomy ( lymph nodal dissection + 117310 58650 46920 35200
liver bed excision WITHOUT bile duct excision )
resection of segment 4B & 5 with bile duct excision )
right tri‐segmentectomy with bile duct excision )
1436 OP4539 Revisional Cholecystectomy Surgery 112610 56310 45050 33780
1437 OP1374 Right hepatectomy 154810 77410 61930 46450
153
1438 OP1373 Right hepatic trisegmentectomy 190770 95390 76310 57240
1439 OP4417 Robotic Assisted Distal pancreatectomy 316970 158490 126790 95090
1440 OP4419 Robotic Assisted Hepatico‐Jejunostomy 246520 123260 98610 73950
1441 OP4418 Robotic Assisted Lateral Pancreatico‐ Jejunostomy 327040 163530 130820 98110
1442 OP4416 Robotic Assisted Whipples procedure 352180 176100 140880 105650
1443 OP1392 Roux‐en‐Y cystojejunostomy ( open ) 97100 48550 38840 29130
1444 OP4528 Single Incision Laparoscopic Cholecystectomy 112610 56310 45050 33780
1445 OP1385 Whipple's procedure 176100 88040 70430 52840
Hernia Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
1446 OP0681 Bassini repair of inguinal hernia with mesh ( bilateral ) 81720 40860 32690 24520
1447 OP0682 Bassini repair of inguinal hernia with mesh ( unilateral 73070 36540 29230 21910
)
1448 OP0600 Incisional hernia repair with abdominoplasty 140740 70370 56290 42230
1449 OP1057 Inguinal herniotomy ( bilateral ) 58110 29050 23240 17430
1450 OP1058 Inguinal herniotomy ( unilateral ) 51620 25810 20650 15490
1451 OP2941 Inguinal herniotomy in Neonates ( bilateral ) 63860 31930 25550 19160
1452 OP2940 Inguinal herniotomy in Neonates ( unilateral ) 43110 21560 17240 12940
1453 OP1097 Laparoscopic epigastric hernia repair ‐ transabdominal 68840 34420 27540 20650
intra‐peritoneal onlay mesh
1454 OP0426 Laparoscopic epigastric hernia repair ‐ transabdominal 68840 34420 27540 20650
pre‐peritoneal inlay mesh
1455 OP1101 Laparoscopic incisional hernia repair ‐ transabdominal 107940 53970 43180 32380
intraperitoneal onlay mesh
1456 OP0535 Laparoscopic inguinal herniotomy ‐ bilateral 54640 27320 21850 16390
1457 OP0534 Laparoscopic inguinal herniotomy ‐ unilateral 47370 23680 18940 14210
1458 OP0598 Laparoscopic lumbar hernia repair 98960 49480 39590 29690
1459 OP1103 Laparoscopic repair of diaphragmatic hernia 250770 125390 100310 75230
1460 OP1102 Laparoscopic spigelian hernia repair ‐ transabdominal 98960 49480 39590 29690
1461 OP0531 Laparoscopic total extra‐peritoneal mesh repair of 98960 49480 39590 29690
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
1469 OP1098 Laparoscopic umbilical hernia repair ‐ transabdominal 78280 39140 31310 23490
1470 OP0427 Laparoscopic umbilical hernia repair ‐ transabdominal 78280 39140 31310 23490
pre‐peritoneal inlay mesh
1471 OP1099 Laparoscopic ventral hernia ( others ) 85350 42680 34150 25610
1472 OP4001 Laproscopic Diaphragmatic rupture repair 250770 125390 100310 75230
1473 OP1059 Mesh repair of inguinal hernia ( bilateral ) 90320 45160 36130 27100
1474 OP1060 Mesh repair of inguinal hernia ( unilateral ) 75350 37670 30150 22610
1475 OP1283 Mesh repair of Recurrent inguinal hernia ( bilateral ) 94590 47300 37840 28380
154
1476 OP1284 Mesh repair of Recurrent inguinal hernia ( unilateral ) 81720 40860 32690 24520
1477 OP3380 Open incisional hernia repair with component 225990 112990 90390 67790
separation with flap advancement and mesh
placement
1478 OP3026 Open removal of infected mesh (following hernia 58700 29350 23490 17610
repair)
1479 OP1053 Open repair of epigastric hernia with mesh 62380 31190 24950 18710
1480 OP0684 Open repair of epigastric hernia without mesh 62380 31190 24950 18710
1481 OP1054 Open repair of femoral hernia 68840 34420 27540 20650
1482 OP1055 Open repair of incisional hernia ( first repair ) with 94420 47210 37770 28320
mesh
1483 OP1056 Open repair of incisional hernia ( first repair ) without 85420 42710 34170 25620
mesh
1484 OP0025 Open repair of lumbar hernia 98960 49480 39590 29690
1485 OP0024 Open repair of obturator hernia 98960 49480 39590 29690
1486 OP1062 Open repair of Recurrent incisional hernia with mesh 107940 53970 43180 32380
1487 OP1287 Repair of congenital diaphragmatic hernia 127630 63810 51050 38290
1488 OP2942 Repair of Recurrent inguinal hernia without mesh ( 94590 47300 37840 28380
bilateral )
1489 OP2943 Repair of Recurrent inguinal hernia without mesh ( 81720 40860 32690 24520
unilateral )
1490 OP1425 Repair of traumatic diaphragmatic hernia ( open ) 208990 104500 83590 62700
1491 OP1291 Repair of umbilical hernia with mesh ( open ) 94590 47300 37840 28380
1492 OP0683 Repair of umbilical hernia without mesh ( open ) 70960 35480 28380 21290
1493 OP1065 Repair of ventral hernia (not umbilical or epigastric) 94590 47300 37840 28380
with mesh
1494 OP1064 Repair of ventral hernia (not umbilical or epigastric) 70960 35480 28380 21290
without mesh
1495 OP4536 Robotic Hiatus Hernia Repair 112610 56310 45050 33780
1496 OP4535 Robotic RYGB 211520 105760 84600 63450
1497 OP4533 Single Incision IPOM 93190 46590 37280 27960
1498 OP4532 Single Incision TEP ( Bilateral ) 117810 58910 47120 35340
1499 OP4531 Single Incision TEP ( Unilateral ) 98860 49430 39540 29660
1500 OP1061 Spigelian hernia repair 98960 49480 39590 29690
1501 OP0431 Strangulated incisional hernia repair ( open technique 103460 51730 41390 31040
)
1502 OP1063 Strangulated non‐incisional ventral hernia repair ( 98960 49480 39590 29690
open technique)
1503 OP1306 Ventral hernia repair with abdominoplasty 129030 64520 51620 38710
Hydatid Cyst Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1504 OP1378 Excision or drainage of hydatid cyst of liver (open) 108790 54400 43510 32630
1505 OP0589 Excision or drainage of intraperitoneal hydatid cyst 108790 54400 43510 32630
1506 OP1379 Laparoscopic excision or drainage of hydatid cyst of 94590 47300 37840 28380
liver
1507 OP1066 Laparoscopic excision or drainage of intraperitoneal 94590 47300 37840 28380
hydatid cyst
Intestinal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1508 OP1406 Abdominoperineal resection ( APR ) ‐ open 117390 58700 46960 35220
155
1509 OP1026 Anterior resection of rectum ( open ) 117390 58700 46960 35220
1510 OP1405 Anterior resection with total mesorectal excision ( 106680 53340 42670 32000
TME ) ‐ open
1511 OP2947 Bishop Koop ileostomy in Neonates 68840 34420 27540 20650
1512 OP1296 Closure of colostomy 51620 25810 20650 15490
1513 OP0118 Closure of ileostomy 51620 25810 20650 15490
1514 OP1398 Colonic interposition 98870 49430 39540 29660
1515 OP1250 Colostomy and colonic biopsy 68840 34420 27540 20650
1516 OP3394 Delayed colon interpostion 161430 80710 64580 48440
1517 OP1507 Duhamel's abdomino‐perineal pull through resection 94590 47300 37840 28380
with colo‐anal anastomosis for Hirschprung's disease
1518 OP4308 Duodenal atresia/annular pancreas( 77620 38810 31050 23290
dudenodudenostomy/dudenojejunostomy)
1519 OP2950 End colostomy in Neonates 68840 34420 27540 20650
1520 OP0101 End ileostomy 53840 26920 21550 16150
1521 OP2949 End ileostomy in Neonates 68840 34420 27540 20650
1522 OP4307 Gastro‐jejunostomy and pyloroplasty 70340 35180 28140 21110
1523 OP1266 Imaging guided hydrostatic reduction of 43110 21560 17240 12940
intussusception
1524 OP0026 Jejunostomy / feeding jejunostomy 60240 30120 24100 18070
1525 OP4395 Laparoscoic Sigmoid colectomy with colo‐colic 205440 102720 82180 61640
anastmosis
1526 OP4397 Laparoscopic Abdomino‐perineal resection with 264140 132070 105650 79230
permanent Colostomy
1527 OP4396 Laparoscopic Anterior Resection with TME with 234790 117390 93910 70430
Colorectal anastmosis with/without diverting stoma
1528 OP0552 Laparoscopic anterior resection with total mesorectal 119630 59810 47850 35890
excision ( TME )
1529 OP0553 Laparoscopic assisted abdominoperineal resection ( 119630 59810 47850 35890
APR )
1530 OP0551 Laparoscopic assisted left hemicolectomy 98870 49430 39540 29660
1531 OP0592 Laparoscopic assisted right hemicolectomy 98870 49430 39540 29660
1532 OP2903 Laparoscopic closure of intestinal perforation 94590 47300 37840 28380
1533 OP4391 Laparoscopic Left hemicolectomy with Colo‐Colic 205440 102720 82180 61640
Anastmosis with/without Diverting Stoma
1534 OP3093 Laparoscopic Meckel's diverticulectomy 61410 30700 24560 18430
1535 OP3028 Laparoscopic proctocolectomy 127970 63990 51190 38390
1536 OP4393 Laparoscopic Procto‐colectomy with diverting 234790 117390 93910 70430
Ileostomy
1537 OP1505 Laparoscopic pull through for Hirschprung's disease 98960 49480 39590 29690
1538 OP0561 Laparoscopic rectopexy 113740 56870 45490 34130
1539 OP4394 Laparoscopic Restorative Procto‐colectomy with/ 293490 146750 117390 88040
without diverting Ileostomy
1540 OP4390 Laparoscopic Right hemicolectomy with 205440 102720 82180 61640
Ileo‐Transverse Anastmosis with/without Diverting
Stoma
1541 OP4399 Laparoscopic Sigmoid Colectomy with Colo‐Rectal 234790 117390 93910 70430
Anastmosis with diverting loop ileostomy
1542 OP4398 Laparoscopic Sigmoid Colectomy with Hartman's 205440 102720 82180 61640
Procedure
1543 OP0545 Laparoscopic small bowel resection 98870 49430 39540 29660
1544 OP3029 Laparoscopic total colectomy 127970 63990 51190 38390
1545 OP4400 Laparoscopic Total Colectomy For IBD/Cancer 234790 117390 93910 70430
1546 OP4392 Laparoscopic Total Colectomy with Ileo‐ Rectal 234790 117390 93910 70430
anastmosis
1547 OP1070 Laparotomy & bowel resection for intussusception 75090 37540 30030 22520
1548 OP2902 Laparotomy & closure of intestinal perforation 68840 34420 27540 20650
1549 OP1265 Laparotomy & reduction of intussusception 68840 34420 27540 20650
1550 OP1297 Laparotomy for correction of intestinal malrotation 60240 30120 24100 18070
1551 OP0432 Left hemicolectomy ( open ) 98870 49430 39540 29660
156
1552 OP2952 Loop colostomy in Neonates 68840 34420 27540 20650
1553 OP0001 Loop ileostomy 53840 26920 21550 16150
1554 OP2951 Loop ileostomy in Neonates 68840 34420 27540 20650
1555 OP4310 Meckel's diverticulum (open) 53360 26680 21350 16010
1556 OP4309 Mesentric cyst excision 50940 25470 20370 15280
1557 OP2948 Miculicz operation in Neonates 68840 34420 27540 20650
1558 OP1508 Modified Soave's abdomino‐perineal pull through 98960 49480 39590 29690
resection with colo‐anal anastomosis for total colonic
Hirschprung's disease
1559 OP1271 Multiple intestinal resection and anastomosis 112430 56220 44970 33730
1560 OP2946 Multiple intestinal resection and anastomosis in 113740 56870 45490 34130
Neonates
1561 OP1409 Proctocolectomy ( open ) 107940 53970 43180 32380
1562 OP4324 PSARP + laparotomy for anorectal malformation 97020 48510 38810 29110
1563 OP1412 Rectal prolapse repair with mesh ( laproscopic ) 96180 48090 38480 28850
1564 OP1411 Rectal prolapse repair with mesh ( open ) 63860 31930 25550 19160
1565 OP2953 Resection of band of Ladd 77840 38920 31130 23350
1566 OP1410 Restorative proctocolectomy 148350 74170 59340 44510
1567 OP1407 Right hemicolectomy ( open ) 103460 51730 41390 31040
1568 OP4408 Robotic Assisted Abdomino‐perineal resection with 316970 158490 126790 95090
permanent Colostomy
1569 OP4407 Robotic Assisted Anterior Resection with TME with 281760 140880 112700 84530
Colorectal anastmosis with/without diverting stoma
1570 OP4402 Robotic Assisted Left hemicolectomy with Colo‐colic 246520 123260 98610 73950
Anastmosis with/without Diverting Stoma
1571 OP4404 Robotic Assisted Procto‐colectomy with diverting 281760 140880 112700 84530
Ileostomy
1572 OP4405 Robotic Assisted Restorative Procto‐colectomy with/ 352180 176100 140880 105650
without diverting Ileostomy
1573 OP4401 Robotic Assisted Right hemicolectomy with 246520 123260 98610 73950
Ileo‐Transverse Anastmosis with/without Diverting
Stoma
1574 OP4406 Robotic Assisted Sigmoid colectomy with Colo‐Colic 246520 123260 98610 73950
anastmosis
1575 OP4411 Robotic Assisted Sigmoid Colectomy with Colo‐Rectal 281760 140880 112700 84530
Anastmosis with diverting loop ileostomy
1576 OP4410 Robotic Assisted Sigmoid Colectomy with Hartman's 246520 123260 98610 73950
Procedure
1577 OP4409 Robotic Assisted Total Colectomy For IBD/Cancer 281760 140880 112700 84530
1578 OP4403 Robotic Assisted Total Colectomy with Ileo‐ Rectal 281760 140880 112700 84530
anastmosis
1579 OP1036 Sigmoid / descending colectomy ( open ) 107940 53970 43180 32380
1580 OP0100 Sigmoid end colostomy 53840 26920 21550 16150
1581 OP1249 Sigmoid loop colostomy 53840 26920 21550 16150
1582 OP1041 Sigmoid resection for volvulus of colon 103460 51730 41390 31040
1583 OP1042 Simple untwisting for volvulus of colon 67470 33740 26990 20240
1584 OP1071 Single intestinal resection and anastomosis 58700 29350 23490 17610
1585 OP2945 Single intestinal resection and anastomosis in 77840 38920 31130 23350
Neonates
1586 OP3010 Small bowel transplant recipient operation(Normal / 123260 61640 49310 36980
Early)
1587 OP1278 Soave's abdomino‐perineal pull through resection 98960 49480 39590 29690
1588 OP1408 Subtotal colectomy ( open ) 107940 53970 43180 32380
1589 OP1506 Swenson's abdomino‐perineal pull through resection 98960 49480 39590 29690
1590 OP0587 Transabdominal rectopexy ( open ) 103460 51730 41390 31040
1591 OP1032 Trans‐anal pull through for Hirschprung's disease 98960 49480 39590 29690
1592 OP1039 Transverse colectomy ( open ) 103460 51730 41390 31040
1593 OP0099 Transverse colostomy 98960 49480 39590 29690
157
1594 OP1040 Tube caecostomy 43110 21560 17240 12940
Kidney Transplantation
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
1595 OP1081 Donor nephrectomy ( open ) 74640 37320 29850 22400
1596 OP0450 Laparoscopic donor nephrectomy 95940 47970 38380 28790
1597 OP0528 Laparoscopic internal drainage of post renal 53360 26680 21350 16010
transplant lymphocele
1598 OP0442 Native nephro‐ureterectomy of prospective / 88900 44460 35560 26670
operated renal transplant patient ‐ bilateral
1599 OP1079 Native nephro‐ureterectomy of prospective / 60420 30210 24170 18120
operated renal transplant patient ‐ unilateral
1600 OP0524 Nephrectomy of transplanted kidney 78140 39070 31260 23440
1601 OP1084 Post renal transplant lymphocele aspiration / drain 53360 26680 21350 16010
insertion in OT
1602 OP0527 Post renal transplant lymphocele internal drainage ( 53360 26680 21350 16010
open procedure )
1603 OP1082 Renal transplant recipient surgery 132080 66050 52840 39630
1604 OP0523 Rexploration & drainage of collection following renal 53360 26680 21350 16010
transplant recipient surgery
1605 OP0456 Rexploration following renal transplant recipient 53360 26680 21350 16010
surgery for acute graft rejection
surgery for chronic graft rejection
surgery for graft dysfunction
surgery for haemorrhage
surgery for thrombosis
surgery for urinary leaks
surgery for urinary obstruction
Liver Transplant Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1612 OP0616 Extended left lateral segment orthotopic liver
transplantation
1613 OP0610 Extended left lateral segmentectomy of liver donor
1614 OP0608 Extended right hepatectomy of liver donor
1615 OP0613 Extended right lobe orthotopic liver transplantation
1616 OP0607 Left hepatectomy of liver donor
1617 OP0606 Left hepatectomy with caudate lobe, of liver donor
Within Package
1618 OP0615 Left lateral segment orthotopic liver transplantation
1619 OP0609 Left lateral segmentectomy of liver donor
1620 OP0618 Left lobe + caudate lobe orthotopic liver
transplantation
1621 OP0614 Left lobe orthotopic liver transplantation
1622 LINHIDC Liver Transplant High Risk ‐ Doctors operation charges
1623 LIVTDOC Liver Transplant Low ‐ Doctors operation charges
158
1624 LIVNOR Liver Transplant Normal Risk ‐ Doctors operation
charges
1625 LTSDOC Liver transplant surgery ( adult ) Normal/Early ‐
recipient ‐ amount given to surgeon from within the
package
1626 LTSCDO Liver transplant surgery (child) ‐ recipient ‐ amount
given to surgeon from within the package
1627 OP0625 Monosegment orthotopic liver transplantation
1628 OP0843 Re‐exploration of liver donor
1629 OP0619 Re‐exploration of liver recipient and control of
bleeding
1630 OP0624 Re‐exploration of liver recipient and excision of
hepatic artery pseudoaneurysm Within package
1631 OP0623 Re‐exploration of liver recipient and hepatic artery
reconstruction
1632 OP0622 Re‐exploration of liver recipient and portal vein
thrombectomy
1633 OP0621 Re‐exploration of liver recipient and repair of cut
surface leak
1634 OP0620 Re‐exploration of liver recipient and revised biliary
reconstruction
1635 OP0605 Right hepatectomy of liver donor
1636 OP0612 Right lobe orthotopic liver transplantation
1637 OP0611 Whole graft orthotopic liver transplantation
LYMPHADENECTOMY
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1638 OP2822 Axillary clearance for breast carcinoma 86080 43040 34430 25820
1639 OP2823 Axillary sampling for breast disease 86080 43040 34430 25820
1640 OP2824 Axillary sentinal lymph node biopsy 34480 17240 13800 10340
1641 OP0543 Endoscopic axillary lymph node sampling 34480 17240 13800 10340
1642 OP0687 Ilio‐inguinal lymph nodal block dissection ‐ bilateral 96800 48410 38720 29040
1643 OP0686 Ilio‐inguinal lymph nodal block dissection ‐ unilateral 64540 32270 25820 19360
1644 OP4166 Ilioinguinal lymphadenectomy ( Bilateral ) 160080 80040 64030 48030
1645 OP4165 Ilioinguinal lymphadenectomy ( Unilateral ) 106720 53360 42690 32010
1646 OP2875 Inguinal lymph nodal block dissection ‐ bilateral 96800 48410 38720 29040
1647 OP2876 Inguinal lymph nodal block dissection ‐ unilateral 64540 32270 25820 19360
1648 OP3395 Laparoscopic abdominal lymphadenectomy 109790 54890 43910 32930
1649 OP1074 Lymph node biopsy 21590 10790 8630 6470
1650 OP0765 Paratracheal lymph nodal dissection 82620 41310 33050 24780
1651 OP2878 Pelvic lymph nodal block dissection 86080 43040 34430 25820
1652 OP0017 Retroperitoneal lymphadenectomy for malignancy ( 107520 53760 43010 32260
RPLND )
1653 OP4386 RPLND Bilateral 145530 72770 58210 43660
1654 OP4387 RPLND Unilateral 97020 48510 38810 29110
1655 OP4729 Superficial Inguinal Lymph Nodal Dissection ‐ Bilateral 80000 40000 32000 24000
1656 OP4728 Superficial Inguinal Lymph Nodal Dissection ‐ 50000 25000 20000 15000
Unilateral
1657 OP3383 Thoracic lymphadenectomy (open) 96840 48430 38750 29050
1658 OP3386 Thoracoscopic lymphadenectomy 96840 48430 38750 29050

159
Medicines
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
1659 OP4492 Incisional Hernia Repair with Component Separation 154350 77180 61740 46310
1660 OP4490 Release of Tongue Tie with Z plasty 44100 22050 17640 13230
1661 OP4458 Suturing of Multiple lacerated wound 55130 27560 22050 16540
Miscellaneous Orthopaedics Procedures
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
1662 OP2011 Above‐knee / Above‐elbow plaster cast application 10870 5440 4350 3270
1663 OP2982 Application of skeletal traction 10700 5340 4270 3210
1664 OP3255 Arthrotomy for septic arthritis 49170 24590 19670 14750
1665 OP2015 Aspiration of hemarthrosis 5890 2940 2360 1760
1666 OP2012 Below‐knee / Below‐elbow plaster cast application 8140 4060 3260 2440
1667 OP2991 Bone grafting / Allograft / Bone subsitute ‐ Long bone 51560 25780 20620 15470
1668 OP2992 Bone grafting / Allograft / Bone subsitute ‐ Short bone 33560 16780 13430 10070
1669 OP3061 Capsulotomy of elbow 62540 31270 25010 18760
1670 OP3053 Capsulotomy of metatarsophalyngeal ( MP ) joints 57310 28650 22920 17190
1671 OP3052 Capsulotomy of metatarsophalyngeal + 62540 31270 25010 18760
interphalyngeal ( MP & IP ) joints
1672 OP3261 Closed tendo‐achilles tenotomy 23310 11660 9320 6990
1673 OP2987 Core decompression hip 57310 28650 22920 17190
1674 OP2985 Core decompression hip + bone grafting 73650 36820 29460 22090
1675 OP1973 Curettage, drainage & debridement for osteomyelitis 34660 17340 13870 10400
1676 OP1976 DeQuervein's release 24650 12330 9860 7400
1677 OP2984 Egger's Operation 57310 28650 22920 17190
1678 OP2983 Epiphyseal Drilling 49170 24590 19670 14750
1679 OP2974 Epiphysiodesis 57310 28650 22920 17190
1680 OP4318 Examination under general anaesthesia 12130 6070 4850 3640
1681 OP2027 Fasciotomy ‐ Upper / Lower limb 39590 19790 15830 11880
1682 OP3042 Halo pelvis application 40990 20500 16390 12300
1683 OP2986 Halo vest application 24650 12330 9860 7400
1684 OP2022 Ingrowing toe nail excision 33080 16540 13230 9920
1685 OP2014 Intra‐articular injections 5890 2940 2360 1760
1686 OP4317 Large procedure (Misc) ‐ Paed 40030 20010 16010 12000
1687 OP2017 Local hydrocortisone infiltration 5890 2940 2360 1760
1688 OP2990 Manipulation of club foot 10700 5340 4270 3210
1689 OP2029 Manipulation of frozen shoulder joint under GA 18960 9480 7580 5690
1690 OP2018 Manipulation of joints with hydrocortisone infiltration 10410 5210 4170 3120
1691 OP2030 Manipulation of stiff knee under GA 18960 9480 7580 5690
1692 OP4316 Medium procedure (Misc) ‐ Paed 26680 13350 10670 8000
1693 OP2981 Needle biopsy of bone / soft tissue, in OT 20550 10280 8220 6160
1694 OP2975 Open adductor tenotomy 40990 20500 16390 12300
1695 OP2976 Open adductor tenotomy with obturator neurectomy 57310 28650 22920 17190
1696 OP2989 Open Bone Biopsy 14750 7370 5900 4420
1697 OP3265 Open synovectomy ( ankle ) 69300 34650 27720 20790
1698 OP3266 Open synovectomy ( elbow ) 69300 34650 27720 20790
1699 OP3267 Open synovectomy ( Hip ) 69300 34650 27720 20790
1700 OP3268 Open synovectomy ( knee ) 69300 34650 27720 20790
1701 OP3269 Open synovectomy ( small joints of foot ) 69300 34650 27720 20790
160
1702 OP3270 Open synovectomy ( small joints of hand ) 69300 34650 27720 20790
1703 OP3381 Partial claviculectomy 54020 27020 21610 16210
1704 OP3382 Partial manubriectomy 54020 27020 21610 16210
1705 OP1840 Partial patellectomy 56430 28210 22560 16930
1706 OP4350 Periarticular Soft Tissue Reconstruction 72770 36380 29110 21830
1707 OP1974 Posteromedial release for CTEV 58870 29440 23550 17660
1708 OP2900 Removal of deep foreign body ‐ limbs or trunk 39590 19790 15830 11880
1709 OP2025 Removal of superficial foreign body ‐ limbs or trunk 22580 11290 9030 6770
1710 OP1972 Sequestrectomy + saurcerisation (major) for 53980 26990 21590 16190
osteomyelitis
1711 OP1971 Sequestrectomy + saurcerisation (minor) for 24650 12330 9860 7400
osteomyelitis
1712 OP4315 Small procedure (Misc) ‐Paed 13350 6670 5330 4000
1713 OP1978 Souter's / Yount's contracture release for polio 49530 24760 19810 14860
1714 OP2013 Spica plaster cast application in OT 18200 9090 7280 5460
1715 OP2977 Subcutaneous Adductor Tenotomy 23310 11660 9320 6990
1716 OP2028 Synovial biopsy 14750 7370 5900 4420
1717 OP1841 Total patellectomy 56430 28210 22560 16930
1718 OP1977 Trigger thumb / finger release 33080 16540 13230 9920
Miscellaneous Vascular Operations

OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
SNo Code Description Suite
1719 OP0417 Carotid body tumour excision 111790 55900 44720 33540
1720 OP0418 Internal iliac artery ligation 34420 17210 13770 10330
1721 OP2918 Pseudoaneurysm repair 68800 34400 27520 20640
1722 OP3022 Stem cell therapy for limb ischaemia 78260 39120 31300 23470
1723 OP0316 Temporal artery biopsy 23490 11740 9400 7050
Morbid Obesity Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1724 OP0536 Laparoscopic adjustable gastric banding 107520 53760 43010 32260
1725 OP0539 Laparoscopic bilio‐pancreatic diversion 195430 97710 78170 58630
1726 OP0547 Laparoscopic gastric band removal 39190 19590 15680 11750
1727 OP0537 Laparoscopic Roux‐en‐Y gastric bypass 177680 88840 71060 53310
1728 OP0538 Laparoscopic sleeve gastrectomy 177680 88840 71060 53310
1729 OP4530 Single Incision RYGB 211520 105760 84600 63450
Nerve Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1730 OP1710 Anterior transposition of ulnar nerve 75670 37840 30270 22700
1731 OP2178 Arthroscopic median nerve decompression 51620 25810 20650 15490
1732 OP1312 Brachial plexus exploration & nerve repair 132300 66150 52920 39690
1733 OP1313 Brachial plexus exploration & nerve transfer / 154350 77180 61740 46310
neurotization
1734 OP1314 Brachial plexus exploration with nerve grafting 171990 86000 68800 51600
161
1735 OP1112 Brachial plexus repair ‐ neurolysis 132300 66150 52920 39690
1736 OP3257 Carpal tunnel release (open) with synovectomy 51620 25810 20650 15490
1737 OP1705 Carpal tunnel release operation with Guyon's canal 51620 25810 20650 15490
release
1738 OP1704 Carpal tunnel release operation with opponensplasty 129030 64520 51620 38710
1739 OP1712 Carpal tunnel release operation with synovectomy 111790 55900 44720 33540
1740 OP1707 Cubital tunnel release 51620 25810 20650 15490
1741 OP1716 Digital nerve grafting 66150 33080 26460 19850
1742 OP1713 Digital nerve repair 55130 27560 22050 16540
1743 OP0921 Endoscopic optic nerve decompression 118300 59150 47320 35490
1744 OP1722 Excision of neuroma ‐ major nerve 111790 55900 44720 33540
1745 OP1721 Excision of neuroma ‐ minor nerve 77440 38720 30990 23230
1746 OP3433 Exploration (alone) for brachial plexus injury 66150 33080 26460 19850
1747 OP0930 Facial nerve decompression ‐ vertical / tympanic 154790 77400 61920 46440
segment
1748 OP0915 Facial nerve decompression complete ( vertical + 154790 77400 61920 46440
horizontal segment )
1749 OP1176 Laparoscopic presacral neurectomy 86080 43040 34430 25820
1750 OP1720 Median nerve grafting 137550 68780 55020 41270
1751 OP1715 Median nerve repair 94590 47300 37840 28380
1752 OP1107 Micro‐surgical decompression of 5th cranial nerve ( 154790 77400 61920 46440
trigeminal )
1753 OP0479 Micro‐surgical decompression of 7th cranial nerve ( 154790 77400 61920 46440
facial )
1754 OP3335 Miscellaneous nerve grafting ( complex ) 115260 57620 46110 34580
1755 OP3336 Miscellaneous nerve grafting ( simple ) 69280 34640 27720 20780
1756 OP1123 Nerve biopsy 15570 7780 6230 4670
1757 OP2300 Nerve exploration + neurolysis for median nerve 75670 37840 30270 22700
1758 OP2301 Nerve exploration + neurolysis for radial nerve 75670 37840 30270 22700
1759 OP1968 Nerve exploration + neurolysis for ulnar nerve 75670 37840 30270 22700
1760 OP4225 Neurolysis for major nerve 80040 40030 32010 24010
1761 OP1966 Neurolysis of lateral popliteal nerve 120440 60220 48180 36130
1762 OP1969 Other nerve repair 86080 43040 34430 25820
1763 OP1090 Peripheral neurectomy ( maxilla / mandible ) 41790 20900 16720 12540
1764 OP4708 Peroneal Nerve Repair ( Direct ) 90000 45000 36000 27000
1765 OP4709 Peroneal Nerve Repair ( with nerve graft ) 120000 60000 48000 36000
1766 OP1719 Radial nerve grafting 129030 64520 51620 38710
1767 OP1717 Radial nerve repair 103220 51610 41290 30960
1768 OP3271 Sciatic nerve exploration 75670 37840 30270 22700
1769 OP3448 Sciatic nerve exploration and repair 106720 53360 42690 32010
1770 OP4240 Sciatic Nerve repair (with nerve graft) 133400 66710 53360 40030
1771 OP0907 Total facial nerve decompression upto geniculate 154790 77400 61920 46440
ganglion
1772 OP0397 Total facial nerve repair 154790 77400 61920 46440
1773 OP1718 Ulnar nerve grafting 129030 64520 51620 38710
1774 OP1714 Ulnar nerve repair 103220 51610 41290 30960
Neurosurgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1775 OP1124 Application of skull traction 15550 7770 6220 4660
1776 OP1126 Brain abscess tapping 98960 49480 39590 29690
1777 OP1120 Chronic subdural haematoma tapping 137550 68780 55020 41270
1778 OP1122 Cisternal puncture 15130 7560 6050 4550
162
1779 OP1104 Clipping of aneurysm of anterior communicating 200770 100380 80300 60230
artery of brain
1780 OP0198 Clipping of aneurysm of anterior inferior cerebellar 200770 100380 80300 60230
artery
1781 OP0005 Clipping of aneurysm of basilar artery of brain 200770 100380 80300 60230
1782 OP0192 Clipping of aneurysm of carotid bifurcation 200770 100380 80300 60230
1783 OP0191 Clipping of aneurysm of distal anterior cerebral artery 200770 100380 80300 60230
1784 OP0195 Clipping of aneurysm of distal extracranial internal 200770 100380 80300 60230
carotid artery
1785 OP0004 Clipping of aneurysm of internal carotid artery 200770 100380 80300 60230
1786 OP0008 Clipping of aneurysm of middle cerebral artery 200770 100380 80300 60230
bifurcation
1787 OP0200 Clipping of aneurysm of middle cerebral artery cortical 200770 100380 80300 60230
branches
1788 OP0199 Clipping of aneurysm of middle cerebral artery 200770 100380 80300 60230
trifurcation
1789 OP0197 Clipping of aneurysm of posterior cerebral artery 200770 100380 80300 60230
1790 OP0003 Clipping of aneurysm of posterior communicating 200770 100380 80300 60230
artery of brain
1791 OP0196 Clipping of aneurysm of superior cerebellar artery 200770 100380 80300 60230
1792 OP0006 Clipping of aneurysm of vertebral artery 200770 100380 80300 60230
1793 OP0007 Clipping of aneurysm of vertebro basilar artery 200770 100380 80300 60230
1794 OP0193 Clipping of clinoidal / para‐clinoidal region aneurysm 200770 100380 80300 60230
1795 OP3216 Clipping of complex aneurysm of anterior 248590 124300 99440 74570
communicating artery of brain
1796 OP3213 Clipping of complex aneurysm of anterior inferior 248590 124300 99440 74570
cerebellar artery
1797 OP3204 Clipping of complex aneurysm of basilar artery of 248590 124300 99440 74570
brain
1798 OP3209 Clipping of complex aneurysm of carotid bifurcation 248590 124300 99440 74570
1799 OP3208 Clipping of complex aneurysm of distal anterior 248590 124300 99440 74570
cerebral artery
1800 OP3210 Clipping of complex aneurysm of distal extracranial 248590 124300 99440 74570
internal carotid artery
1801 OP3203 Clipping of complex aneurysm of internal carotid 248590 124300 99440 74570
artery
1802 OP3207 Clipping of complex aneurysm of middle cerebral 248590 124300 99440 74570
artery bifurcation
artery cortical branches
artery trifurcation
1805 OP3212 Clipping of complex aneurysm of posterior cerebral 248590 124300 99440 74570
artery
1806 OP3202 Clipping of complex aneurysm of posterior 248590 124300 99440 74570
communicating artery of brain
1807 OP3211 Clipping of complex aneurysm of superior cerebellar 248590 124300 99440 74570
artery
1808 OP3205 Clipping of complex aneurysm of vertebral artery 248590 124300 99440 74570
1809 OP3206 Clipping of complex aneurysm of vertebro basilar 248590 124300 99440 74570
artery
1810 OP0194 Clipping of ophthalmic artery aneurysm 200770 100380 80300 60230
1811 OP0496 Cranioplasty with artificial bone cement / prosthetic 193840 96930 77540 58160
implant
1812 OP0495 Cranioplasty with reposition of bone flap 193840 96930 77540 58160
1813 OP1105 Craniotomy for acute / subacute subdural 156010 78000 62400 46800
haematomas
1814 OP3410 Craniotomy for bleed in anterior cranial fossa ( ACF ) 248590 124300 99440 74570
1815 OP1128 Craniotomy for brain abscess excision 170230 85110 68090 51070
1816 OP0482 Craniotomy for brain stem tumours 193840 96930 77540 58160
1817 OP0483 Craniotomy for cerebellar brain tumours 193840 96930 77540 58160
1818 OP0488 Craniotomy for cerebello‐pontine angle tumours 200770 100380 80300 60230
163
1819 OP0471 Craniotomy for chronic subdural haematomas 137550 68780 55020 41270
1820 OP0484 Craniotomy for clival / petrous region tumours 200770 100380 80300 60230
1821 OP3413 Craniotomy for complex intra ventricular tumor 248590 124300 99440 74570
1822 OP3404 Craniotomy for complex Parenchyma Brain tumors 248590 124300 99440 74570
1823 OP0487 Craniotomy for convexity meningiomas of brain 170230 85110 68090 51070
1824 OP1111 Craniotomy for CSF rhinorrhoea repair 179730 89870 71890 53930
1825 OP0475 Craniotomy for decompression of malignant infarcts ( 170230 85110 68090 51070
supra‐tentorial )
1826 OP0473 Craniotomy for depressed fracture of skull 156010 78000 62400 46800
1827 OP0474 Craniotomy for extradural haematomas 156010 78000 62400 46800
1828 OP3405 Craniotomy for intra cerebral bleed 170230 85110 68090 51070
1829 OP0480 Craniotomy for intraventricular brain tumours 170230 85110 68090 51070
1830 OP3221 Craniotomy for large cerebello‐pontine angle tumours 248590 124300 99440 74570
1831 OP3218 Craniotomy for large clival / petrous region tumours 248590 124300 99440 74570
1832 OP3402 Craniotomy for large Convexity Meningioma of brain 248590 124300 99440 74570
1833 OP3406 Craniotomy for large intra cerebral bleed 248590 124300 99440 74570
1834 OP3217 Craniotomy for large pineal region tumours 248590 124300 99440 74570
1835 OP3400 Craniotomy for Large posterior fossa tumor 248590 124300 99440 74570
1836 OP3220 Craniotomy for large sellar / parasellar tumours 248590 124300 99440 74570
1837 OP3219 Craniotomy for large skull base tumours 248590 124300 99440 74570
1838 OP3403 Craniotomy for Parasaggital Meningioma of brain 248590 124300 99440 74570
1839 OP1109 Craniotomy for parenchymal brain tumours 170230 85110 68090 51070
1840 OP0472 Craniotomy for parenchymal contusions of brain 156030 78020 62410 46810
1841 OP0481 Craniotomy for pineal region tumours 200770 100380 80300 60230
1842 OP0491 Craniotomy for posterior fossa ( infra‐tentorial ) 193840 96930 77540 58160
infarcts
1843 OP0490 Craniotomy for posterior fossa haematomas 193840 96930 77540 58160
1844 OP0489 Craniotomy for posterior fossa tumours 193840 96930 77540 58160
1845 OP0486 Craniotomy for sellar / parasellar tumours 200770 100380 80300 60230
1846 OP3399 Craniotomy for Severe Brain injury 248590 124300 99440 74570
1847 OP0485 Craniotomy for skull base tumours 200770 100380 80300 60230
1848 OP0716 Craniotomy for subtemporal decompression of 170230 85110 68090 51070
infective disorders
1849 OP4501 Deep Brain Stimulation (DBS) 330750 165380 132300 99230
1850 OP0493 Endoscopic CSF rhinorrhoea repair 179730 89870 71890 53930
1851 OP3396 Endoscopic Skull Base Tumor Surgery 200770 100380 80300 60230
1852 OP1129 Endoscopic third ventriculostomy ( ETV ) 151330 75660 60530 45400
1853 OP3408 Endoscopic VP shunt 137550 68780 55020 41270
1854 OP0009 Excision of AVM of anterior mesial temporal region of 200770 100380 80300 60230
brain
1855 OP0206 Excision of AVM of basal ganglion of brain 200770 100380 80300 60230
1856 OP0203 Excision of AVM of medial frontal region of brain 200770 100380 80300 60230
1857 OP0201 Excision of AVM of medial occipital region of brain 200770 100380 80300 60230
1858 OP0202 Excision of AVM of medial parietal region of brain 200770 100380 80300 60230
1859 OP0011 Excision of AVM of medial trigonal region of brain 200770 100380 80300 60230
1860 OP0207 Excision of AVM of posterior fossa of brain ( cerebellar 200770 100380 80300 60230
)
1861 OP0211 Excision of AVM of posterior fossa of brain ( CPA ) 200770 100380 80300 60230
1862 OP0210 Excision of AVM of posterior fossa of brain ( 200770 100380 80300 60230
flocculo‐nodular )
1863 OP0209 Excision of AVM of posterior fossa of brain ( 200770 100380 80300 60230
para‐median )
1864 OP0208 Excision of AVM of posterior fossa of brain ( vermian ) 200770 100380 80300 60230
1865 OP0010 Excision of AVM of posterior mesial temporal region 200770 100380 80300 60230
of brain
1866 OP0204 Excision of AVM of thalamo‐caudate region of brain 200770 100380 80300 60230
1867 OP0205 Excision of AVM of third ventricular region of brain 200770 100380 80300 60230
1868 OP0213 Excision of brain stem AVM ( mid‐brain ) 200770 100380 80300 60230
1869 OP0212 Excision of brain stem AVM ( pontine ) 200770 100380 80300 60230
164
1870 OP3201 Excision of complex AVM of brain 248590 124300 99440 74570
1871 OP3196 External lumbar drain 42640 21330 17050 12790
1872 OP3222 External ventricular drainage 56830 28410 22730 17040
1873 OP1121 Lumbar puncture in OT 10500 5250 4200 3150
1874 OP3411 Microscopic 3rd ventriculostomy 150660 75340 60260 45200
1875 OP3401 Mini craniotomy for Subdural Hematoma 170230 85110 68090 51070
1876 OP0514 Revision of ventriculoperitoneal ( VP ) shunt 82770 41390 33110 24830
1877 OP0519 Stereotactic aspiration of intracerebral abscess 137550 68780 55020 41270
1878 OP0520 Stereotactic biopsy of brain tumours / lesions 170230 85110 68090 51070
1879 OP1127 Stereotactic evacuation of intracerebral haematoma 161270 80640 64510 48370
1880 OP0521 Stereotactic surgery for movement disorders 200770 100380 80300 60230
1881 OP1116 Syringomyelia shunt surgery 137550 68780 55020 41270
1882 OP0515 Thecoperitoneal ( TP ) shunt 82770 41390 33110 24830
1883 OP1110 Trans‐sphenoidal pituitary decompression surgery ( 187230 93620 74900 56180
endoscopic )
1884 OP0492 Trans‐sphenoidal pituitary decompression surgery ( 170230 85110 68090 51070
microscopic )
1885 OP1125 Ventricular puncture ( brain ) 18940 9470 7570 5680
1886 OP3195 Ventricular reservoir placement 56830 28410 22730 17040
1887 OP3159 Ventricular Tapping ‐ done in OT 17220 8610 6890 5170
1888 OP0516 Ventriculoatrial ( VA ) shunt 82770 41390 33110 24830
1889 OP1118 Ventriculoperitoneal ( VP ) shunt 82770 41390 33110 24830
1890 OP0513 Ventriculoperitoneal ( VP ) shunt with external 82770 41390 33110 24830
ventricular drainage
Obstetrics & Gynaecology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

1891 OP1130 Abdominal hysterectomy ( TAH ) ( level 1 ) 86700 43350 34680 26000
1892 OP0096 Abdominal hysterectomy ( TAH ) in patient with 105050 52530 42020 31520
previous pelvic surgery ( level 2 )
1893 OP0095 Abdominal hysterectomy ( TAH ) with pelvic floor 105050 52530 42020 31520
repair ( level 2 )
1894 OP1131 Abdominal sterilisation / Post partum ligation / 12450 6230 4980 3730
tubectomy
1895 OP0013 Anterior & posterior colporraphy (AP repair) 45740 22870 18290 13730
1896 OP3161 Anterior Colporraphy 37040 18520 14820 11110
1897 OP1132 Aspiration of ovarian cyst under ultrasound guidance 10370 5190 4150 3110
(in OT)
1898 OP0012 Aspiration of peritoneal collection under ultrasound 10370 5190 4150 3110
guidance
1899 OP3162 Caesarean hysterectomy 100010 50010 40000 30010
1900 OP1133 Caesarean section ( LSCS ) 54110 27060 21650 16240
1901 OP3173 Cautery of vaginal vault granuloma 3930 1960 1570 1180
1902 OP3160 Cervical encirclage 33340 16680 13330 10010
1903 OP3251 Cervical polypectomy 7010 3510 2810 2100
1904 OP3163 Cold knife cone biopsy of cervix 25940 12970 10370 7780
1905 OP1183 Colposcopy 3930 1960 1570 1180
1906 OP1185 Colposcopy with cervical biopsy ( LEEP ) & 10530 5260 4210 3170
cauterisation
1907 OP0144 Diagnostic hysteroscopy 17360 8680 6940 5210
1908 OP1167 Diagnostic laparoscopy & hysteroscopy 35050 17520 14010 10520
1909 OP3174 Dialation & curettage of uterus ( D&C ) 12450 6230 4980 3730
1910 OP1154 Drainage of vulval haematoma following delivery 37750 18880 15100 11320
1911 OP1135 End to end fallopian tubal recanalisation / 77650 38820 31050 23290
anastomosis ‐ bilateral
165
1912 OP0023 End to end fallopian tubal recanalisation / 67350 33670 26950 20210
anastomosis ‐ unilateral
1913 OP0015 Episiotomy repair ‐ secondary suturing in OT 18550 9270 7410 5570
1914 OP0014 Episiotomy repair in OT ‐ primary repair 18550 9270 7410 5570
1915 OP3168 Excision of endometrial scar 37040 18520 14820 11110
1916 OP3169 Excision of vaginal wall cyst 37040 18520 14820 11110
1917 OP3182 Fetal reduction (in OT) 10120 10120 10120 10120
1918 OP3165 Foreign body removal from vagina 22240 11120 8890 6670
1919 OP1134 Forthergill / Manchester repair of uterine prolapse 50330 25160 20130 15090
1920 OP0139 Forthergill / Manchester repair of uterine prolapse 62840 31430 25140 18850
WITH tubal ligation
1921 OP1137 Hematocolpos drainage / colpotomy 37040 18520 14820 11110
1922 OP1161 Hysteroscopic division of thick synechiae 49410 24710 19760 14830
1923 OP1157 Hysteroscopic division of thin synechiae 21640 10810 8660 6490
1924 OP1163 Hysteroscopic metroplasty 49410 24710 19760 14830
1925 OP1162 Hysteroscopic myomectomy ( less than 3 cm) 37110 18560 14850 11130
1926 OP1166 Hysteroscopic myomectomy ( more than 3 cm ) 60290 30140 24110 18100
1927 OP1158 Hysteroscopic polypectomy 22010 11010 8800 6600
1928 OP1159 Hysteroscopic removal of IUCD 21640 10810 8660 6490
1929 OP1160 Hysteroscopic removal of retained products of 36430 18220 14580 10930
conception
1930 OP1164 Hysteroscopic resection of uterine septum 49410 24710 19760 14830
1931 OP1165 Hysteroscopic trans‐cervical resection of 59220 29610 23690 17780
endometrium ( TCRE )
1932 OP1138 Hysterotomy 60670 30340 24270 18210
1933 OP1172 Laparoscopic adhesiolysis & hysteroscopy 77400 38700 30950 23210
1934 OP3166 Laparoscopic assisted vaginal hysterectomy ( LAVH ) ( 93740 46870 37500 28120
Uterus < 14 week )
1935 OP3167 Laparoscopic assisted vaginal hysterectomy (LAVH ) ( 112310 56160 44920 33680
Uterus < 14 week ) or with previous pelvic surgery
1936 OP3178 Laparoscopic colposacropexy 83010 41500 33210 24900
1937 OP3176 Laparoscopic excision of board ligament leaves 67280 33640 26910 20170
1938 OP3250 Laparoscopic excision of broad ligament leaves 74030 37020 29610 22210
1939 OP1179 Laparoscopic fallopian tubal recanalisation 86330 43160 34540 25890
1940 OP0110 Laparoscopic milking for ectopic pregnancy 74030 37020 29610 22210
1941 OP1177 Laparoscopic myomectomy ( for fibroid less than 3 cm 90240 45120 36100 27070
)
1942 OP0094 Laparoscopic myomectomy ( for fibroid more than 3 103150 51580 41260 30940
cm )
1943 OP1180 Laparoscopic neo‐vagina creation 86330 43160 34540 25890
1944 OP0108 Laparoscopic ovarian cystectomy 74030 37020 29610 22210
1945 OP2904 Laparoscopic repair of rectovaginal fistula ( RVF ) 50330 25160 20130 15090
1946 OP1143 Laparoscopic repair of Recurrent rectovaginal fistula ( 68560 34290 27420 20570
RVF )
1947 OP1175 Laparoscopic salpingectomy 75390 37700 30160 22620
1948 OP3177 Laparoscopic salpingo‐oopherectomy 67280 33640 26910 20170
1949 OP0109 Laparoscopic salpingostomy 75390 37700 30160 22620
1950 OP3175 Laparoscopic surgery for tubo ‐ ovarian torsion 67280 33640 26910 20170
1951 OP1178 Laparoscopic uterine cornual excision 86330 43160 34540 25890
1952 OP3417 Laparoscopic uterine suspension 91490 45740 36600 27460
1953 OP3179 Laparoscopic vesico‐vaginal ( VVF ) repair 86430 43210 34570 25940
1954 OP3181 Laparoscopic Wertheims ( radical ) hysterectomy 150870 75430 60350 45270
1955 OP1173 Laparoscopy & hysteroscopy with fimbrioplasty / 74030 37020 29610 22210
neosalpingostomy
1956 OP1171 Laparoscopy & hysteroscopy with LUNA 59220 29610 23690 17780
1957 OP1169 Laparoscopy & hysteroscopy with ovarian biopsy 44470 22240 17790 13340
1958 OP1168 Laparoscopy & hysteroscopy with ovarian drilling 44470 22240 17790 13340
1959 OP1170 Laparoscopy & hysteroscopy with tubal canulation 59220 29610 23690 17780
166
1960 OP0092 Laparoscopy with hysteroscopic cornual 59220 29610 23690 17780
catheterisation
1961 OP0018 Laparoscopy with ovarian biopsy 44470 22240 17790 13340
1962 OP3170 LeFort operation for uterine prolapse 44470 22240 17790 13340
1963 OP3171 Manual removal of placenta 18550 9270 7410 5570
1964 OP1140 Mid trimester abortion 35010 17510 14000 10510
1965 OP1184 MTP ‐ Medical termination of pregnancy 12450 6230 4980 3730
1966 OP1141 MTP with laparoscopic sterilisation 18470 9240 7390 5540
1967 OP1142 MTP with minilap sterilisation 18470 9240 7390 5540
1968 OP3252 Non descent vaginal hysterectomy ( NDVH ) 86700 43350 34680 26000
1969 OP3415 Non descent vaginal hysterectomy ( NDVH ) + bilateral 95630 47820 38260 28690
salphingo oopherectomy ( BSO )
1970 OP3416 Non descent vaginal hysterectomy ( NDVH ) for uterus 95630 47820 38260 28690
> 12 weeks
1971 OP1186 Normal delivery in OT 54110 27060 21650 16240
1972 OP0142 Ovarian cystectomy / oopherectomy ( open technique 49410 24710 19760 14830
)
1973 OP1136 Pelvic examination under anaesthesia and aspiration ( 12450 6230 4980 3730
EUA )
1974 OP1146 Perineal tear repair ( CPT repair ) 56570 28280 22630 16970
1975 OP3247 Perineorraphy 12710 6350 5080 3810
1976 OP1151 Radical hysterectomy for malignancy / Wertheim?s 150080 75040 60040 45020
hysterectomy
1977 OP2877 Radical hysterectomy for malignancy / Wertheim?s 150180 75090 60070 45060
hysterectomy + Cyto‐reductive surgery for ovarian
cancer
1978 OP2906 Repair of rectovaginal fistula ( RVF ) 43900 21950 17560 13170
1979 OP2905 Repair of Recurrent rectovaginal fistula ( RVF ) 54800 27400 21920 16450
1980 OP2907 Repair of Recurrent vesico‐vaginal fistula ‐ abdominal 68560 34290 27420 20570
approach
1981 OP2908 Repair of Recurrent vesico‐vaginal fistula ‐ vaginal 68560 34290 27420 20570
approach
1982 OP1482 Repair of vesico‐vaginal fistula ‐ abdominal approach 86300 43150 34520 25890
1983 OP1483 Repair of vesico‐vaginal fistula ‐ vaginal approach 86300 43150 34520 25890
1984 OP3068 Repair of vesico‐vaginal fistula ( VVF ) with flap cover 124580 62290 49830 37370
1985 OP3172 Repositioning on inverted uterus ( uterine inversion ) 18550 9270 7410 5570
1986 OP0141 Salpingectomy ( open technique ) 49410 24710 19760 14830
1987 OP1145 Salpingo‐oophrectomy ( open technique ) 49410 24710 19760 14830
1988 OP1153 Simple vulvectomy 75450 37720 30180 22630
1989 OP1155 Suturing of vaginal / vulval tears 12710 6350 5080 3810
1990 OP1147 Total ( radical ) vulvectomy with dissection of nodes 113170 56580 45270 33960
1991 OP1182 Total laparoscopic hysterectomy ( TLH ) in case of 123770 61890 49510 37130
previous pelvic surgery or intraabdominal adhesions
(excluding‐tubal‐ligation‐surgery)
1992 OP0093 Total laparoscopic hysterectomy of uterus less than 14 103150 51580 41260 30940
weeks ( TLH )
1993 OP1181 Total laparoscopic hysterectomy of uterus more than 123770 61890 49510 37130
14 weeks ( TLH )
1994 OP3249 Trachelectomy ( uterine cervix excision ) 141000 70500 56400 42310
1995 OP3248 Trachelorrhaphy ( uterine cervix repair ) 55580 27800 22240 16680
1996 OP1156 Uterine myomectomy 82930 41470 33170 24880
1997 OP0016 Vaginal hysterectomy & repair 82930 41470 33170 24880
1998 OP0143 Vaginal vault prolapse repair / vault suspension ( 81440 40720 32570 24430
abdominal approach )
1999 OP1149 Vaginal vault prolapse repair / vault suspension ( 81440 40720 32570 24430
vaginal approach )
2000 OP1292 Vaginoplasty 113010 56510 45210 33900
2001 OP1148 Vaginoplasty for vaginal agenesis 113010 56510 45210 33900
2002 OP1150 Ventrisuspension of the uterus ( open technique ) 49410 24710 19760 14830
2003 OP1152 Vulval biopsy 10680 5340 4280 3200
167
Oesophageal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2004 OP1251 Complete correction of oesophageal atresia and TEF 138430 69220 55370 41530
2005 OP0970 Dilatation of oesophageal ‐ first stage 21590 10790 8630 6470
2006 OP0992 Dilatation of oesophageal ‐ subsequent stage 15130 7560 6050 4550
2007 OP1399 Enucleation of leiomyoma of oesophagus ( 249850 124930 99940 74960
transthoracic )
2008 OP1396 Ivor Lewis oesophagectomy 146750 73370 58700 44030
2009 OP0558 Laparoscopic fundoplication ( Dor's ) & hiatus hernia 94590 47300 37840 28380
repair
2010 OP0556 Laparoscopic fundoplication ( Nissen ) & hiatus hernia 94590 47300 37840 28380
repair
2011 OP0557 Laparoscopic fundoplication ( Toupet's ) & hiatus 94590 47300 37840 28380
hernia repair
2012 OP4080 Laparoscopic fundoplication for GERD 161430 80710 64580 48440
2013 OP0630 Laparoscopic oesophageal cardiomyotomy 149900 74950 59960 44970
2014 OP0559 Laparoscopic placement of magnetic oesophageal 43110 21560 17240 12940
sphincter
2015 OP3372 Laparoscopic repair of giant paraesophageal hiatus 161430 80710 64580 48440
hernia with fundoplication
2016 OP3373 Laparoscopic repair of giant paraesophageal hiatus 129130 64560 51650 38750
hernia without fundoplication
2017 OP3374 Laparoscopic repair of recurrent hiatus hernia / redo 245370 122680 98140 73620
fundoplication
2018 OP3376 Laparoscopic transhiatal oesophagectomy with gastric 258270 129140 103310 77480
pull‐up
2019 OP1424 Ligation of oesophagus 84740 42370 33890 25420
2020 OP1397 Mc‐Keown oesophagectomy 161430 80710 64580 48440
2021 OP2944 Nissen fundoplication & hiatus hernia repair 98870 49430 39540 29660
2022 OP1400 Oesophageal cardiomyotomy 124940 62460 49980 37490
2023 OP4083 Oesophageal Perforation repair 124940 62460 49980 37490
2024 OP0028 Oesophageal stricturoplasty 84740 42370 33890 25420
2025 OP3378 Oesophagectomy with colon interpostion (abdomen 258270 129140 103310 77480
and chest incision for oesophagectomy)
2026 OP3379 Oesophagectomy with colonic interpostion (abdomen, 322830 161420 129140 96850
chest and neck oesophagectomy)
2027 OP1255 Oesophagostomy 63080 31540 25230 18930
2028 OP1413 Removal of foreign body oesophagus by flexible 31490 15740 12590 9450
oesophagoscope
2029 OP0892 Removal of foreign body oesophagus by rigid 21590 10790 8630 6470
oesophagoscope
2030 OP3384 Thoracoscopic and laparoscopic oesophagectomy with 290560 145280 116220 87160
gastric pull‐up (chest anastomosis)
2031 OP3385 Thoracoscopic and laparoscopic oesophagectomy with 322830 161420 129140 96850
gastric pull‐up (neck anastomosis)
2032 OP3387 Trans hiatal oesophagectomy with colonic 225990 112990 90390 67790
interpostion
2033 OP3388 Trans thoracic fundoplication 142070 71030 56830 42620
2034 OP3389 Trans thoracic redo fundoplicaton 225990 112990 90390 67790
2035 OP1381 Transaction of oesophagus and EEA stapling 84740 42370 33890 25420
2036 OP1395 Transhiatal oesophagectomy 102730 51370 41090 30820
2037 OP3390 VATS enuceation of oesophageal tumors 129130 64560 51650 38750
2038 OP4055 VATS Enucleation of leiomyoma of esophagus 299800 149900 119920 89940
Onco Surgery
168
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2039 OP4322 Saccrococcygel teratoma ‐ External 67910 33960 27160 20370
2040 OP4323 Saccrococcygel teratoma ‐ with intra‐ pelvic extension 84890 42450 33960 25470
Oncology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2041 OP2910 Bone marrow / stem cell transplantation (if done in 195430 97710 78170 58630
OT)
2042 OP3025 Bone marrow harvesting procedure (if done in OT) 43060 21540 17220 12930
Open Reduction And Internal Fixation
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2043 OP4334 Ankle Bimalleolar Fixation with Syndesmosis screw 116420 58210 46570 34920
2044 OP1824 Calcaneal pin insertion 11770 5890 4700 3530
2045 OP4345 Complex Fracture Fixation with Ilizarov 116420 58210 46570 34920
2046 OP4344 Complex Fracture Fixation with Nailing 116420 58210 46570 34920
2047 OP4343 Complex Fracture Fixation with Plating 116420 58210 46570 34920
2048 OP4348 Complex Joint Reconstruction with Ilizarov 126130 63060 50450 37840
2049 OP4347 Complex Joint Reconstruction with Nailing 126130 63060 50450 37840
2050 OP4346 Complex Joint Reconstruction with Plating 126130 63060 50450 37840
2051 OP1845 Condylar plate fixation for supracondylar fracture 89920 44960 35960 26970
femur
2052 OP1848 DCS fixation for subtrochanteric fracture femur 89920 44960 35960 26970
2053 OP1844 DCS fixation for supracondylar fracture femur 89920 44960 35960 26970
2054 OP1846 DHS fixation for intertrochanteric fracture femur 89920 44960 35960 26970
2055 OP4134 Fixation of radial head 70520 35260 28200 21160
2056 OP4136 Fixation of tibial tuberosity 55720 27860 22290 16720
2057 OP1860 K‐wire fixation for fracture metacarpal / phalanx 28180 14090 11270 8450
2058 OP1819 K‐wire fixation for fracture metatarsal / phalanx 25960 12980 10380 7780
2059 OP1876 Lateral condyle fixation for fracture humerus 56430 28210 22560 16930
2060 OP1875 Medial condyle fixation for fracture humerus 56430 28210 22560 16930
2061 OP4138 Mid tarsal joint plate fixation 81740 40870 32700 24520
2062 OP1859 Mini plate fixation for fracture metacarpals 39390 19690 15750 11820
2063 OP1822 Mini plate fixation for fracture metatarsals 37840 18920 15140 11360
2064 OP1861 Multiple K‐wire fixation for fracture metacarpals / 42200 21110 16880 12650
phalanges
2065 OP1820 Multiple K‐wire fixation for fracture metatarsals / 34360 17180 13730 10310
phalanges
2066 OP1847 Multiple screw fixation for fracture neck of femur 89920 44960 35960 26970
2067 OP4328 Non‐Union of Long Bones ‐ ORIF with Bone Grafting 116420 58210 46570 34920
2068 OP4250 Open ACI tansplant (Autologous Chondrocyte Implant) 95630 47820 38260 28690
2069 OP1863 Open reduction + K‐wire fixation for carpal dislocation 39390 19690 15750 11820
2070 OP1879 Open reduction fracture medial epicondyle + K‐wire 53980 26990 21590 16190
fixation / screw
2071 OP1883 Open reduction fracture neck humerus + fibular 103370 51680 41350 31020
grafting
2072 OP1882 Open reduction fracture neck humerus + plate fixation 77550 38780 31030 23270
169
2073 OP4329 Open Reduction of Dislocated Large Joint 92170 46080 36870 27650
2074 OP3264 Open Reduction of dislocated MP Joint of thumb / 74170 37090 29670 22250
finger
2075 OP1877 Open reduction supracondylar fracture humerus with 56430 28210 22560 16930
K‐wire fixation
2076 OP4341 ORIF Metacarpal / Metatarsal 101870 50940 40750 30570
2077 OP4330 Osteochondral Fracture Fixation 116420 58210 46570 34920
2078 OP1855 Osteosynthesis anterior pillar / wall of acetabulum 158660 79330 63460 47600
(Screw / Plate)
2079 OP1854 Osteosynthesis posterior pillar / wall of acetabulum 158660 79330 63460 47600
(screw / Plate)
2080 OP1849 PFN for subtrochanteric fracture femur 87960 43970 35190 26390
2081 OP1829 Plating / nail fixation for fracture lateral malleolus 61300 30650 24520 18390
2082 OP1885 Plating for fracture clavicle 56430 28210 22560 16930
2083 OP1842 Plating for fracture femur 89920 44960 35960 26970
2084 OP1851 Plating for fracture femur with bone grafting 103370 51680 41350 31020
2085 OP1835 Plating for fracture fibula 56430 28210 22560 16930
2086 OP1880 Plating for fracture humerus 89920 44960 35960 26970
2087 OP1881 Plating for fracture humerus + bone grafting 103370 51680 41350 31020
2088 OP1832 Plating for fracture lateral tibial condyle 77550 38780 31030 23270
2089 OP1830 Plating for fracture medial & lateral tibial condyles 77550 38780 31030 23270
2090 OP1831 Plating for fracture medial tibial condyle 77550 38780 31030 23270
2091 OP1836 Plating for fracture shaft of tibia 89920 44960 35960 26970
2092 OP1837 Plating for fracture shaft tibia + bone grafting 103370 51680 41350 31020
2093 OP1834 Plating for fracture tibial plafond 77550 38780 31030 23270
2094 OP1856 Plating for pubic symphysis fracture 158660 79330 63460 47600
2095 OP1867 Plating for radius & ulna fracture 77550 38780 31030 23270
2096 OP1865 Plating for radius fracture 56430 28210 22560 16930
2097 OP1858 Plating for SI joint disruption ‐ bilateral 128110 64060 51240 38430
2098 OP1857 Plating for SI joint disruption ‐ unilateral 128110 64060 51240 38430
2099 OP1866 Plating for ulna fracture 56430 28210 22560 16930
2100 OP1871 Plating of fracture radius & ulna + bone grafting 98900 49440 39550 29670
2101 OP1870 Plating of fracture radius + bone grafting 78760 39390 31510 23630
2102 OP2892 Plating of fracture ulna + bone grafting 78760 39390 31510 23630
2103 OP4137 Plating of ilium 81740 40870 32700 24520
2104 OP1823 Reconstruction plate fixation for fracture calcaneum 89920 44960 35960 26970
2105 OP3190 Sacral fracture ‐ open reduction and fixation ( ORIF ) 111370 55690 44550 33420
2106 OP3191 Sacral fracture ‐ percutaneous fixation 111370 55690 44550 33420
2107 OP1821 Screw fixation for fracture 5th metatarsal base 34660 17340 13870 10400
2108 OP1853 Screw fixation for fracture head femur 89920 44960 35960 26970
2109 OP1862 Screw fixation for fracture scaphoid 58870 29440 23550 17660
2110 OP1838 Screw fixation for fracture tibial spine 77550 38780 31030 23270
2111 OP4147 Screw fixation navicular / calcaneum 53520 26750 21410 16050
2112 OP4135 Screw fixation patella 51270 25630 20510 15380
2113 OP4252 Stem cell transplant in knee/shoulder/hip 61360 30680 24540 18420
2114 OP1850 Supracondylar nail for supracondylar fracture femur 87960 43970 35190 26390
2115 OP4340 Surgery for Recurrent Shoulder Dislocation 101870 50940 40750 30570
2116 OP1864 T‐buttress plate fixation for fracture distal radius 58870 29440 23550 17660
2117 OP1839 Tension band wiring / encirclage wiring for fracture 56430 28210 22560 16930
patella
2118 OP1828 Tension band wiring / malleolar screw for fracture 61300 30650 24520 18390
medial malleolus
medial malleolus & plating lateral malleolus
medial malleolus & plating lateral malleolus with
screw fixation distal tibia
2121 OP1843 Tension band wiring for fracture greater trochanter 56430 28210 22560 16930
2122 OP1884 Tension band wiring for fracture lateral end clavicle 56430 28210 22560 16930
170
2123 OP1872 Tension band wiring proximal ulna / screw fixation for 58870 29440 23550 17660
fracture ulna
2124 OP4335 Tillaux Fracture ORIF 101870 50940 40750 30570
2125 OP1874 Ulnar osteotomy + coronoid fixation 56430 28210 22560 16930
2126 OP1873 Ulnar osteotomy + fixation of intercondylar femur 97900 48950 39170 29370
humerus ‐ both pillars
Operations For Dislocations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2127 OP1990 Close reduction acromio‐clavicular joint with K‐wire 25600 12800 10240 7690
fixation
2128 OP1891 Closed reduction fracture or dislocation carpal / wrist 24810 12400 9920 7440
with K‐wire fixation
2129 OP3459 Dislocation Foot ‐ Closed reduction 22550 11280 9020 6770
2130 OP4248 Open latarjet with coracoid 95630 47820 38260 28690
2131 OP4249 Open latarjet with iliac crest 103220 51610 41290 30960
2132 OP1991 Open reduction acromio‐clavicular joint with tension 56430 28210 22560 16930
band wiring
2133 OP1995 Open reduction for dislocation of carpal / wrist joint 53520 26750 21410 16050
2134 OP3460 Open reduction for dislocation of tarsal bones 49040 24520 19610 14710
2135 OP1996 Open reduction for dislocation shoulder 75610 37800 30240 22680
2136 OP1994 Open reduction for elbow joint dislocation 72440 36210 28970 21740
2137 OP1992 Open reduction for hip joint dislocation 75610 37800 30240 22680
2138 OP1993 Open reduction for knee joint dislocation 75610 37800 30240 22680
2139 OP3458 Open reduction of ankle joint 81740 40870 32700 24520
2140 OP1998 Open repair for Recurrent dislocation of elbow joint 98900 49440 39550 29670
2141 OP1999 Open repair for Recurrent dislocation of patella 98900 49440 39550 29670
2142 OP1997 Open repair for Recurrent dislocation of shoulder 98900 49440 39550 29670
Operations For Portal Hypertension
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

2143 OP1384 Distal splenorenal shunt ( Warren shunt ) 94050 47020 37620 28210
2144 OP1382 Interposition mesocaval shunt ‐ synthetic graft 163450 81730 65380 49040
2145 OP0828 Interposition mesocaval shunt ‐ vein graft 163450 81730 65380 49040
2146 OP0827 Portacaval shunt 94050 47020 37620 28210
2147 OP1383 Proximal lienorenal shunt 94050 47020 37620 28210
2148 OP1380 Sub‐cardiac porta‐azygos disconnection & 88900 44460 35560 26670
devascularization
171
Orthognathic Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2149 OP0019 Alveolar bone grafting 81780 40890 32710 24530
2150 OP0171 Alveolar fracture ‐ closed reduction 32770 16380 13100 9840
2151 OP0172 Alveolar fracture ‐ open reduction 49040 24520 19610 14710
2152 OP1309 Arch bar application 40970 20490 16380 12300
2153 OP1308 Arch bar removal 16540 8270 6620 4970
2154 OP0706 Bilateral sagittal split osteotomy ‐ advancement 163450 81730 65380 49040
2155 OP0705 Bilateral sagittal split osteotomy ‐ setback 163450 81730 65380 49040
2156 OP4321 Clitorovaginoplasty for CAH 92170 46080 36870 27650
2157 OP1096 Dental Category 1 ‐ All teeth extraction (single jaw) in 15210 7610 6090 4570
OT
2158 OP0709 Dental OPD category 2 ‐ All teeth extraction (single 10670 5330 4260 3200
jaw)
2159 OP0152 Frontal sinus fracture ( complicated ) ‐ open reduction 81780 40890 32710 24530
( ORIF )
2160 OP0151 Frontal sinus fracture ( simple ) ‐ open reduction 69460 34730 27780 20840
2161 OP0829 Full mouth periodontal flap surgery 36800 18400 14720 11040
2162 OP0080 Jaw cyst excision ‐ simple / unilocular 32770 16380 13100 9840
2163 OP0081 Jaw cyst or tumour ‐ radical resection 65450 32720 26180 19640
2164 OP1335 Jaw cyst or tumour excision and bone grafting 81780 40890 32710 24530
2165 OP0082 Jaw cyst or tumour resection and reconstruction of 179750 89880 71900 53930
jaw with free fibula flap
2166 OP0707 LeFort I osteotomy with advancement 163450 81730 65380 49040
2167 OP0079 LeFort I osteotomy with application of distractor 163450 81730 65380 49040
2168 OP1093 LeFort I osteotomy with impaction / intrusion 163450 81730 65380 49040
2169 OP0069 LeFort III ( extracranial ) advancement 204300 102140 81720 61290
2170 OP0070 LeFort III ( intracranial ) advancement ‐ monobloc 204300 102140 81720 61290
2171 OP0169 LeFort III complicated fracture ‐ open reduction ( ORIF 130710 65350 52280 39220
)
2172 OP0168 LeFort III fracture ‐ open reduction ( ORIF ) 112430 56220 44970 33730
2173 OP0170 LeFort III fracture ( complicated ) ‐ open reduction + 147140 73570 58850 44140
bone graft ( ORIF )
2174 OP0078 LeFort III osteotomy with application of distractor 204300 102140 81720 61290
2175 OP0071 LeFort III with Lefort I advancement 245150 122580 98060 73550
2176 OP4380 Malar palate removal Multiple 97020 48510 38810 29110
2177 OP4379 Malar palate removal Single 72770 36380 29110 21830
2178 OP0177 Mandible condylar fracture ‐ open reduction 81780 40890 32710 24530
2179 OP4374 Mandible Distraction 121280 60640 48510 36380
2180 OP0173 Mandible fracture ‐ closed reduction 44160 22080 17660 13250
2181 OP0175 Mandible fracture ‐ open reduction ( ORIF ) 69500 34760 27800 20850
2182 OP0174 Mandible fracture ‐ percutaneous reduction / external 69500 34760 27800 20850
fixation
2183 OP0176 Mandible fracture ( complicated ) ‐ open reduction ( 81780 40890 32710 24530
ORIF )
2184 OP4376 Mandible palate removal Multiple 97020 48510 38810 29110
2185 OP4375 Mandible palate removal Single 72770 36380 29110 21830
2186 OP0187 Mandible reconstruction with bone graft 69500 34760 27800 20850
2187 OP0185 Mandible reconstruction with bone plate 69500 34760 27800 20850
2188 OP0188 Mandible reconstruction with free fibular flap 179750 89880 71900 53930
2189 OP0186 Mandible reconstruction with implant 81780 40890 32710 24530
172
2190 OP3332 Manual reduction of temporomandibular ( TM ) joint 28910 14460 11560 8670
dislocation under GA
2191 OP0164 Maxillary LeFort I fracture ‐ closed reduction 44160 22080 17660 13250
2192 OP0165 Maxillary LeFort I fracture ‐ open reduction ( ORIF ) 69460 34730 27780 20840
2193 OP0166 Maxillary LeFort I fracture ( complicated ) ‐ open 81780 40890 32710 24530
reduction ( ORIF )
2194 OP0167 Maxillary LeFort I fracture ( complicated ) ‐ open 98080 49040 39230 29420
reduction + bone graft ( ORIF )
2195 OP4378 Maxillary palate removal Multiple 97020 48510 38810 29110
2196 OP4377 Maxillary palate removal Single 72770 36380 29110 21830
2197 OP0190 Maxillary reconstruction ( complicated ) with bone 81780 40890 32710 24530
graft
2198 OP0189 Maxillary reconstruction without bone graft 65450 32720 26180 19640
2199 OP1085 Maxillo ‐ mandibular cyst enucleation / 57250 28620 22900 17180
marsupialisation
2200 OP0146 Nasal bone fracture ‐ closed reduction with 46040 23020 18420 13820
manipulation / stabilisation
2201 OP0145 Nasal bone fracture ‐ closed reduction without 42960 21470 17180 12880
manipulation
2202 OP0147 Nasal bone fracture ( complicated ) ‐ open reduction ( 81780 40890 32710 24530
ORIF )
2203 OP0148 Nasal bone fracture ( simple ) ‐ open reduction 69500 34760 27800 20850
2204 OP0150 Naso‐ethmoid fracture ‐ open reduction with fixation ( 81780 40890 32710 24530
ORIF )
2205 OP0149 Naso‐ethmoid fracture ‐ open reduction without 69500 34760 27800 20850
fixation
2206 OP0155 Naso‐maxillary complicated fracture ( LeFort II ) ‐ open 130710 65350 52280 39220
reduction ( ORIF )
2207 OP0156 Naso‐maxillary complicated fracture ( LeFort II ) ‐ open 147140 73570 58850 44140
reduction ( ORIF ) + bone graft
2208 OP0153 Naso‐maxillary fracture ( LeFort II ) ‐ closed reduction 49040 24520 19610 14710
2209 OP0154 Naso‐maxillary fracture ( LeFort II ) ‐ open reduction ( 112430 56220 44970 33730
ORIF )
2210 OP0159 Open reduction and internal fixation ( ORIF ) of malar 69500 34760 27800 20850
fracture
2211 OP3338 Open reduction and internal fixation of tripod fracture 96420 48220 38570 28930
of zygoma
2212 OP1094 Oral submucous cyst excision 32770 16380 13100 9840
2213 OP0708 Oral submucous cyst marsupialisation 28670 14330 11470 8600
2214 OP0160 Orbital blow out fracture ‐ open reduction + alloplastic 69500 34760 27800 20850
implant
2215 OP0161 Orbital blow out fracture ‐ open reduction + bone 81780 40890 32710 24530
graft
2216 OP0163 Orbital complicated fracture ‐ open reduction 81780 40890 32710 24530
2217 OP0162 Orbital simple fracture ‐ open reduction 69500 34760 27800 20850
2218 OP0157 Percutaneous reduction of malar fracture 49040 24520 19610 14710
2219 OP1091 Repair of oro‐antral fistula 71580 35780 28630 21470
2220 OP0548 Root canal filling + apicoectomy 16430 8210 6570 4920
2221 OP1089 Segmental mandibular osteotomy ( multiple ) 122640 61320 49070 36790
2222 OP2909 Segmental mandibular osteotomy ( single ) 98080 49040 39230 29420
2223 OP1092 Segmental maxillary osteotomy ( multiple ) 122640 61320 49070 36790
2224 OP0704 Segmental maxillary osteotomy ( single ) 98080 49040 39230 29420
2225 OP1087 Surgical disimpaction for impacted canine / 34820 17410 13920 10440
supernumerary tooth
2226 OP0703 Surgical disimpaction of all four impacted molars 57250 28620 22900 17180
2227 OP1088 Surgical disimpaction of two impacted molars 28670 14330 11470 8600
2228 OP0178 TM joint dislocation ‐ closed reduction 42960 21470 17180 12880
2229 OP0180 TM joint dislocation ‐ open reduction 69500 34760 27800 20850
173
2230 OP0179 TM joint dislocation ( complicated ) ‐ closed reduction 81780 40890 32710 24530
/ IMF ( arch bars )
2231 OP0158 Zygomatic arch fracture ‐ open reduction 69500 34760 27800 20850
Orthopaedic Implant Removal
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2232 OP3256 Broken nail removal from long bones 49040 24520 19610 14710
2233 OP3258 Cemented implant removal ( hip ) 49040 24520 19610 14710
2234 OP3259 Cemented implant removal ( knee ) 49040 24520 19610 14710
2235 OP2040 External fixator removal from long bones 16670 8340 6670 5010
2236 OP2038 Implant removal from ankle 33870 16940 13550 10160
2237 OP2979 Implant removal from large joint ( Hip, Knee, Shoudler 38850 19430 15550 11660
)
2238 OP3040 Implant removal from spine 35640 17820 14260 10700
2239 OP2034 Multiple K‐wire removal 19620 9820 7850 5890
2240 OP2031 Nail removal from long bones 22290 11150 8910 6690
2241 OP2037 Plate removal both bones forearm ‐ radius and ulna 33870 16940 13550 10160
2242 OP2036 Plate removal forearm bones ‐ Radius / Ulna 31130 15570 12460 9330
2243 OP2035 Plate removal from long bones 35340 17670 14130 10610
2244 OP2042 Removal of cross leg external fixator 16670 8340 6670 5010
2245 OP2043 Removal of pelvis external fixator 16670 8340 6670 5010
2246 OP2032 Screw removal for dynamisation 20530 10270 8210 6160
2247 OP2033 Single K‐wire removal 8270 4140 3310 2480
2248 OP3274 Tension band wire removal from medial / lateral 16670 8340 6670 5010
malleolus
2249 OP2039 Tension band wiring removal from patella / olecranon 16670 8340 6670 5010
2250 OP2041 Transarticular external fixator removal 20530 10270 8210 6160
Osteotomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

2251 OP2883 Abduction ( valgus ) osteotomy of hip 94590 47300 37840 28380
2252 OP2081 Cervical substraction osteotomy 122980 61490 49190 36890
2253 OP2082 Cervical substraction osteotomy + anterior procedure 122980 61490 49190 36890
2254 OP2881 Chiari osteotomy of hip 94590 47300 37840 28380
2255 OP1724 Derotation osteotomy for humerus 74170 37090 29670 22250
2256 OP2887 Distal radial osteotomy for malunited Colles' fracture 64500 32250 25800 19350
2257 OP2083 Dorsal substraction osteotomy 122980 61490 49190 36890
2258 OP2084 Dorsal substraction osteotomy + anterior procedure 122980 61490 49190 36890
2259 OP2889 Drawyer's calcaneal osteotomy 56290 28150 22510 16890
2260 OP2879 Emslie Trillat advancement of patellar tendon 70960 35480 28380 21290
2261 OP1868 Excision of head of radius 53980 26990 21590 16190
2262 OP2888 Excision of lower end of ulna ( Darrach's procedure ) 51620 25810 20650 15490
2263 OP4152 Hallux valgus correction / osteotomy 54770 27380 21900 16430
2264 OP1987 High tibial osteotomy ( HTO ) of tibia ‐ Coventry 74170 37090 29670 22250
2265 OP1986 Innominate osteotomy of hip 94590 47300 37840 28380
2266 OP2890 Keller's procedure for hallux valgus 36180 18090 14480 10860
174
2267 OP2884 Lateral closed wedge osteotomy for cubitus varus of 62980 31490 25190 18900
elbow
2268 OP2886 Lateral closed wedge osteotomy for genu valgum 74170 37090 29670 22250
2269 OP2085 Lumbar substraction osteotomy 122980 61490 49190 36890
2270 OP2086 Lumbar substraction osteotomy + anterior procedure 122980 61490 49190 36890
2271 OP1711 Medial epicondylectomy 60240 30120 24100 18070
2272 OP2885 Medial open wedge osteotomy for genu valgum 74170 37090 29670 22250
2273 OP1988 Osteotomy of hand / foot + K‐wire fixation 36180 18090 14480 10860
2274 OP4342 Osteotomy of Long Bone with Fixation 126130 63060 50450 37840
2275 OP2880 Salter innominate osteotomy 114660 57330 45860 34400
2276 OP2891 Supramalleolar osteotomy of lower end of tibia / 74170 37090 29670 22250
fibula
2277 OP2882 Varus derotation osteotomy of hip 94590 47300 37840 28380
Packages
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2278 CSCLSF Cataract Surgery Crysta lens ‐ Surgeon's fees
2279 CSMLSF Cataract Surgery MULTI FOCAL LENS ( Restor &
Technis Multifocal ) ‐ Surgeon's fees
2280 CSTLSFS Cataract Surgery MULTIFOCAL TORIC LENS ‐ Surgeon's
fees
2281 CSPCHSF Cataract Surgery Package ‐ GOPD ‐card holders ( with
Indian foldable lens) ‐ Surgeon's fees
2282 CSPSF Cataract Surgery Package with foldable IOL ‐ Surgeon's
fees
2283 CSPNSF Cataract Surgery Package with non ‐ foldable IOL ‐
Surgeon's fees
2284 CSPWSF Cataract Surgery Package without IOL ‐ Surgeon's fees
2285 CSTLSFS Cataract Surgery SYMFONY LENS ‐ Surgeon's fees
2286 CSTLSFS Cataract Surgery SYMFONY TORIC LENS ‐ Surgeon's
fees
2287 CSTLSF Cataract Surgery TORIC LENS ‐ Surgeon's fees
2288 CIPBWR Cochlear implantation Bilateral (with audiology) ‐
Surgeon Fee Within Package
2289 CIPBWO Cochlear Implantation Bilateral (Without Audiology) ‐
Surgeon Fee
2290 CIWPLSF Cochlear Implantation with Audiology Post Lingual
Deaf Child/Adult ‐ Surgeon Fees
2291 CIPWOS Cochlear Implantation With Audiology Pre Lingual
Deaf Child ‐ Surgeon Fees
2292 CIPWSF Cochlear Implantation Without Audiology ‐ Surgeon
Fees
2293 COCSF Colposcopy & Cautery (Surgeon Fees For Day Care)
2294 COLEEPS Colposcopy & LEEP (Surgeon Fees for Day Care)
2295 CHDCSF Colposcopy Hysteroscopy and D & C (Surgeon fees for
Day care)
2296 CHLEEPS Colposcopy Hysteroscopy and LEEP (Surgeon fees for
Day care)
2297 DHDCSF Diagnostic Hysteroscopy with D&C (Surgeon Fees for
Day Care )
2298 MTPSF MTP (Surgeon fees for Day care)
2299 OP4423 Position Testing ( Dix ‐ Hallpike / Head ‐ Shaking ) 4620 2310 1850 1390
2300 OP4424 Re‐Position ( Epley's ) Manouvere 9240 4620 3700 2770
175
Pain Control Procedures
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2302 OP2935 Celiac plexus local anaesthetic block 15000 7500 6000 4500
2303 OP0845 Celiac plexus neurolytic block 18750 9375 7500 5625
2304 OP0850 Cervical Epidural 12500 6250 5000 3750
2305 OP0888 Combined spinal and epidural block 10740 5370 4310 3220
2306 OP0846 Continuous plexus block 11250 5625 4500 3375
2307 OP2925 Continuous stellate ganglion local anaesthetic block 12500 6250 5000 3750
2308 OP4759 Disc fix 50000 25000 20000 15000
2309 OP0847 Electronic PCA pump installation in OT 9500 4750 3800 2850
2310 OP4554 Endoscopy Dissectomy 25200 12600 10080 7560
2311 OP2937 Epidural adhesioniolysis 15000 7500 6000 4500
2312 OP0849 Epidural block 10000 5000 4000 3000
2313 OP0848 Epidural block ( Lumbar ) 7120 3560 2850 2140
2314 OP0851 Epidural block ( Thoracic ) 8640 4320 3460 2590
2315 OP2938 Epidurography 1850 920 740 560
2316 OP2939 Epiduroscopy ( with epidurography ) 17860 8940 7140 5360
2317 OP2063 Facet joint block 10000 5000 4000 3000
2318 OP4735 Facet joint block ‐ Bilateral 12500 6250 5000 3750
2319 OP0852 Facet joint block by radiofrequency ablation 11250 5625 4500 3375
2320 OP4736 Facet joint block by RFA ‐ Bilateral 12500 6250 5000 3750
2321 OP2926 Ganglion impar local anaesthetic block 15000 7500 6000 4500
2322 OP0853 Ganglion impar neurolytic block 18750 9375 7500 5625
2323 OP0854 Gasserian gangalion neurolytic block 10740 5370 4310 3220
2324 OP0855 Gasserian ganglion local anaesthetic infiltration block 7120 3560 2850 2140
2325 OP0856 Gasserian ganglion radiofrequency ablation 18750 9375 7500 5625
2326 OP4552 Genicular Nerve R.F. 16250 8125 6500 4875
2327 OP4748 Genicular Nerve R.F. ‐ B/L 18750 9375 7500 5625
2328 OP0857 Glossopharyngeal nerve local anaesthetic infiltration 15000 7500 6000 4500
block
2329 OP2929 Glossopharyngeal nerve neurolytic block 8980 4480 3590 2690
2330 OP2930 Glossopharyngeal nerve radio‐frequency block 17500 8750 7000 5250
2331 OP2936 Hypogastric plexus local anaesthetic block 15000 7500 6000 4500
2332 OP0858 Hypogastric plexus neurolytic block 18750 9375 7500 5625
2333 OP0859 Infra‐orbital nerve local anaesthetic infiltration block 10000 5000 4000 4000
2334 OP0860 Infra‐orbital nerve neurolytic block 7120 3560 2850 2140
2335 OP2934 Infra‐orbital nerve radio‐frequency block 12500 6250 5000 3750
2336 OP0861 Intercostal nerve local anaesthetic block 15000 7500 6000 4500
2337 OP2927 Intercostal nerve neurolytic block 7120 3560 2850 2140
2338 OP2928 Intercostal nerve radio‐frequency block 18750 9375 7500 5625
2339 OP0862 Intrathecal / epidural neurolysis 10740 5370 4310 3220
2340 OP4747 Knee injection ‐ B/L 13750 6875 5500 4125
2341 OP4746 Knee injection ‐ U/L 12500 6250 5000 3750
2342 OP0863 Local anaesthetic infiltration into scar / trigger point 10000 5000 4000 3000
for pain relief
2343 OP4761 Lumbar Drain placement in OT 8750 4375 3500 2625
2344 OP0864 Lumbar sympathetic block ‐ Doctor fee 15000 7500 6000 4500
2345 OP0865 Lumbar sympathetic radiofrequency ablation 18750 9375 7500 5625
2346 OP0867 Mandibular nerve neurolytic block 7120 3560 2850 2140
2347 OP2931 Mandibular nerve radio‐frequency block 12500 6250 5000 3750
176
2348 OP0866 Maxillary / Mandibular 10000 5000 4000 3000
2349 OP0868 Maxillary nerve local anaesthetic infiltration block 7120 3560 2850 2140
2350 OP0869 Maxillary nerve neurolytic block 7120 3560 2850 2140
2351 OP2932 Maxillary nerve radio‐frequency block 10740 5370 4310 3220
2352 OP0870 Mechanical infusor ( Baxter ) pump installation in OT 5870 2930 2350 1760
2353 OP0871 Mechanical intrathecal pump installation in OT 17860 8940 7140 5360
2354 OP0872 Mental nerve local anaesthetic infiltration block 10000 5000 4000 3000
2355 OP0873 Mental nerve neurolytic block 7120 3560 2850 2140
2356 OP2064 Nerve block 7120 3560 2850 2140
2357 OP2065 Nerve root block 8980 4480 3590 2690
2358 OP4749 Occipital Nerve ‐ Local Infiltration 10000 5000 4000 3000
2359 OP4750 Occipital Nerve ‐ Radiofrequency Ablation 12500 6250 5000 3750
2360 OP4556 Ozone Dissectomy 8550 4270 3420 2560
2361 OP4758 Paravertebral ‐ Bilateral 17500 8750 7000 5250
2362 OP0875 Para‐vertebral local anaesthetic infiltration block 15000 7500 6000 4500
2363 OP4751 Penile Nerve ‐ Local Infiltration 10000 5000 4000 3000
2364 OP4752 Penile Nerve ‐ Radiofrequency Ablation 12500 6250 5000 3750
2365 OP4502 Percutaneous Discectomy 75000 37500 30000 22500
2366 OP0876 Programmable intrathecal pump installation in OT 25000 12500 10000 7500
2367 OP4760 Programmable intrathecal pump installation in OT ‐ 50000 25000 20000 15000
Permanent
2368 OP4553 PRP Therapy 18750 9375 7500 5625
2369 OP0877 Psoas compartment local anaesthetic infiltration block 5380 2690 2150 1610
2370 OP4555 Rami Communicans Radiofrequency 12500 6250 5000 3750
2371 OP4743 Rami Communicans Radiofrequency ‐ Bilateral 15000 7500 6000 4500
2372 OP4742 Ramus Communicans local infiltration ‐ B/L 11250 5625 4500 3375
2373 OP4741 Ramus Communicans local infiltration ‐ U/L 10000 5000 4000 3000
2374 OP4740 S. I. Joint R. F. ‐ B/L 15000 7500 6000 4500
2375 OP4739 S. I. Joint R. F. ‐ U/L 12500 6250 5000 3750
2376 OP0878 Sacroiliac joint injection block 10000 5000 4000 3000
2377 OP4738 Sacroiliac joint injection block ‐ Bilateral 11250 5625 4500 3375
2378 OP4745 Shoulder injection ‐ B/L 11250 5625 4500 3375
2379 OP4744 Shoulder injection ‐ U/L 10000 5000 4000 3000
2380 OP2922 Spheno‐palatine ganglion local anaesthetic block 12500 6250 5000 3750
2381 OP2923 Spheno‐palatine ganglion radiofrequency block 15000 7500 6000 4500
2382 OP0887 Spinal block 7120 3560 2850 2140
2383 OP0880 Spinal cord stimulation implant ( permanent ) 50000 25000 20000 15000
2384 OP0881 Spinal cord stimulation implant ( temporary ) 25000 12500 10000 7500
2385 OP2924 Stellate ganglion local anaesthetic block 15000 7500 6000 4500
2386 OP0882 Stellate ganglion neurolytic block 10740 5370 4310 3220
2387 OP0883 Stellate ganglion radiofrequency ablation 18750 7500 7500 5625
2388 OP0884 Supra‐orbital nerve local anaesthetic infiltration block 10000 5000 4000 3000
2389 OP0885 Supra‐orbital nerve neurolytic block 12500 6250 5000 3750
2390 OP2933 Supra‐orbital nerve radio‐frequency block 12500 6250 5000 3750
2391 OP4756 Supra‐scapular ‐ Local Infiltration 10000 5000 4000 3000
2392 OP4757 Supra‐scapular ‐ Radiofrequency Ablation 12500 6250 5000 3750
2393 OP0886 Trans‐foraminal block 10000 5000 4000 3000
2394 OP4737 Trans‐foraminal block ‐ Bilateral 12500 6250 5000 3750
2395 OP4755 Trigger point ‐ Radiofrequency Ablation 12500 6250 5000 3750
2396 OP4754 Trochlear Nerve ‐ Local Infiltration 10000 5000 4000 3000
2397 OP4753 Trochlear Nerve ‐ Radiofrequency Ablation 12500 6250 5000 3750
2398 OP4549 Ultrasound Guided Block For Postop Pain Relief 5250 2630 2100 1580
Brachial Plexus
Intracostal & Paravertebral
177
Sciatico Femoral
2401 OP4548 Ultrasound Guided Block For Postop Pain Relief TAP 6250 3125 2500 1875
Block
Peripheral Aneurysm Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2402 OP0303 Brachial aneurysm repair using reversed vein graft 165420 82710 66170 49620
2403 OP0302 Brachial aneurysm repair using synthetic graft 165420 82710 66170 49620
2404 OP0304 Brachial pseudo ‐ aneurysm repair using reversed vein 165420 82710 66170 49620
graft
2405 OP4206 Complex peripheral aneurysm repair 218780 109390 87520 65640
2406 OP0294 Femoral aneurysm repair using reversed vein graft 165420 82710 66170 49620
2407 OP0293 Femoral aneurysm repair using synthetic graft 165420 82710 66170 49620
2408 OP0295 Femoral pseudo ‐ aneurysm repair using reversed vein 165420 82710 66170 49620
graft
2409 OP0300 Iliac aneurysm repair using reversed vein graft 165420 82710 66170 49620
2410 OP0299 Iliac aneurysm repair using synthetic graft 165420 82710 66170 49620
2411 OP0301 Iliac pseudo ‐ aneurysm repair using reversed vein 165420 82710 66170 49620
graft
2412 OP0297 Popliteal aneurysm repair using reversed vein graft 165420 82710 66170 49620
2413 OP0296 Popliteal aneurysm repair using synthetic graft 165420 82710 66170 49620
2414 OP0298 Popliteal pseudo ‐ aneurysm repair using reversed 165420 82710 66170 49620
vein graft
2415 OP0306 Subclavian aneurysm repair using reversed vein graft 165420 82710 66170 49620
2416 OP0305 Subclavian aneurysm repair using synthetic graft 165420 82710 66170 49620
2417 OP0307 Subclavian pseudo ‐ aneurysm repair using reversed 137550 68780 55020 41270
vein graft
2418 OP3020 Ultrasound guided thrombin injection for aneurysm 165420 82710 66170 49620
repair
Peripheral Angioplasty
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

2419 OP0720 Femoral angioplasty in OT ‐ brachial route 19620 9820 7850 5890
2420 OP0696 Femoral angioplasty in OT ‐ femoral route 19620 9820 7850 5890
2421 OP0731 Femoral subintimal angioplasty in OT ( antegrade ) ‐ 19620 9820 7850 5890
femoral route
2422 OP0726 Femoral subintimal angioplasty in OT ( retrograde ) ‐ 19620 9820 7850 5890
femoral route
2423 OP0701 Iliac angioplasty in OT ‐ brachial route 19620 9820 7850 5890
2424 OP0695 Iliac angioplasty in OT ‐ femoral route 19620 9820 7850 5890
Plastic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
178
2425 OP4545 Abdomen Wall Reconstruction 96250 48130 38500 28880
2426 OP3087 ALT perforator free flap 194590 97300 77840 58380
2427 OP4524 Apronectomy 137500 68750 55000 41250
2428 OP4239 Bi‐paddle PMC 111800 55900 44730 33540
2429 OP4214 Bi‐Pedicle flap 41930 20970 16780 12570
2430 OP4362 Botox Injection in Brachial Plexus 38120 19060 15250 11440
2431 OP4359 Burn Contracture Release of Axilla 101640 50820 40660 30490
2432 OP4358 Burn Contracture Release of Elbow 101640 50820 40660 30490
2433 OP4361 Burn Contracture Release of Groin 101640 50820 40660 30490
2434 OP4360 Burn Contracture Release of Knee 101640 50820 40660 30490
2435 OP1318 Burn wound dressing ( large ) 42920 21460 17160 12880
2436 OP1317 Burn wound dressing ( medium ) 25770 12880 10310 7720
2437 OP1316 Burn wound dressing ( minor ) 17190 8600 6890 5160
2438 OP3357 Collagen dressing in OT ( large ) 50570 25280 20230 15170
2439 OP3356 Collagen dressing in OT ( medium ) 37860 18930 15150 11350
2440 OP3309 Collagen dressing in OT ( small ) 25340 12670 10140 7600
2441 OP0065 Composite graft ( large ) ‐ plastic surgery 80370 40180 32140 24100
2442 OP0064 Composite graft ( medium ) ‐ plastic surgery 64280 32140 25710 19290
2443 OP1324 Composite graft ( small ) ‐ plastic surgery 48240 24110 19290 14480
2444 OP4521 Contouring of Mandible Angle 96250 48130 38500 28880
2445 OP1795 Contracture release of lips 85680 42830 34270 25700
2446 OP1794 Contracture release of neck 119890 59950 47960 35970
2447 OP3425 Correction of Binder's Syndrome 96450 48220 38580 28930
2448 OP0810 Correction of macrostomia 38560 19270 15420 11560
2449 OP0811 Correction of microstomia 68560 34280 27420 20570
2450 OP0072 Cranioplasty with bone graft 128480 64240 51400 38540
2451 OP0066 Craniostenosis ( multiple cranial sutures ) ‐ 239690 119850 95880 71910
reconstruction of cranial vault
2452 OP0067 Craniostenosis ( multiple cranial sutures ) ‐ 188310 94160 75330 56500
reconstruction of cranial vault & bone grafting
2453 OP1327 Craniostenosis ( single cranial suture ) ‐ reconstruction 154140 77080 61660 46240
of cranial vault
2454 OP0068 Craniostenosis ( single cranial suture ) ‐ reconstruction 171260 85640 68510 51370
of cranial vault & bone grafting
2455 OP3437 Cross leg flap 80370 40180 32140 24100
2456 OP0063 Cross lip pedicle flap ( Abbe Estlander ) 85680 42830 34270 25700
2457 OP4460 Cysts removal 34650 17330 13860 10400
2458 OP3312 Debulking of large flap 40490 20250 16190 12160
2459 OP3313 Debulking of small flap 25340 12670 10140 7600
2460 OP4353 Deep ? (Biopsy) 50820 25410 20330 15250
2461 OP1331 Delay of flap 23650 11830 9460 7100
2462 OP3314 Deltopectoral flap 101010 50510 40400 30310
2463 OP1338 Dermofat graft ? large 57840 28920 23130 17350
2464 OP1339 Dermofat graft ? small 34330 17160 13730 10310
2465 OP4482 Digital Vessel Repair 69300 34650 27720 20790
2466 OP3315 Distally based fasciocutaneous flap 80850 40430 32340 24260
2467 OP3316 Division and insetting of flap ‐ single stage ( large ) 60710 30350 24280 18220
2468 OP3317 Division and insetting of flap ‐ single stage ( medium ) 50570 25280 20230 15170
2469 OP3318 Division and insetting of flap ‐ single stage ( small ) 40490 20250 16190 12160
2470 OP3432 Division of flap 24150 12070 9660 7240
2471 OP4489 Dressing (Extra Large) 23100 11550 9240 6930
2472 OP1340 Dressing in OT major 17330 8670 6930 5200
2473 OP1341 Dressing in OT medium 13860 6930 5540 4160
2474 OP1342 Dressing in OT minor / suture removal 9240 4620 3700 2770
2475 OP0823 Ear lobule reconstruction ‐ bilateral 16150 8070 6460 4840
179
2476 OP0824 Ear lobule reconstruction ‐ unilateral 10840 5410 4330 3250
2477 OP4494 Ear Lobule Repair with Contilage Graft 34650 17330 13860 10400
2478 OP1346 Ear reconstruction 1st stage ? cartilage implantation 128480 64240 51400 38540
2479 OP1347 Ear reconstruction 2nd stage ? release and graft 70660 35330 28260 21200
2480 OP1348 Ear reconstruction 3rd stage / touching and revisions 57840 28920 23130 17350
2481 OP0822 Ear reconstruction using tissue expander ( bilateral ) 192650 96330 77070 57790
2482 OP0821 Ear reconstruction using tissue expander ( unilateral ) 128480 64240 51400 38540
2483 OP3319 Excision and repair of hidradenitus suppurativa 75890 37940 30350 22770
2484 OP3320 Excision and skin grafting of hidradenitus suppurativa 126270 63130 50510 37880
2485 OP0123 Excision of extremity lesion with Z‐plasty or other 57840 28920 23130 17350
adjacent tissue transfer
2486 OP0125 Excision of hand or foot lesion with Z‐plasty or other 57840 28920 23130 17350
2487 OP1357 Excision of head and neck lesion with Z‐plasty or other 57840 28920 23130 17350
2488 OP0825 Excision of keloid ear lobule 68560 34280 27420 20570
2489 OP4732 Excision of Large Size Pelvic Soft Tissue Tumor (>10 93334 46667 37334 28000
cms)
2490 OP4731 Excision of Medium Size Pelvic Soft Tissue Tumor (5 ‐ 73334 36667 29334 22000
10 cms)
2491 OP0124 Excision of scalp lesion with Z‐plasty or other adjacent 57840 28920 23130 17350
tissue transfer
2492 OP1351 Excision of scar / lesion / wound and skin grafting ‐ 107120 53560 42860 32130
major
medium
minor
2495 OP1785 Excision of skin lesion ‐ extremities / trunk (5 ‐ 10 cm) 85680 42830 34270 25700
2496 OP1784 Excision of skin lesion ‐ extremities / trunk (less than 5 64280 32140 25710 19290
cm)
2497 OP1779 Excision of skin lesion ‐ extremities / trunk (more than 107120 53560 42860 32130
10 cm)
2498 OP1780 Excision of skin lesion ‐ face (less than 2 cm) 51370 25690 20550 15410
2499 OP1793 Excision of skin lesion ‐ face (more than 2 cm) 77090 38540 30840 23120
2500 OP4730 Excision of Small Size Pelvic Soft Tissue Tumor (<5 53334 26667 21334 16000
cms)
2501 OP4356 Excision of soft tissue swelling face & neck >2cm 60980 30490 24400 18290
2502 OP4357 Excision of soft tissue swelling face & neck less than 40660 20330 16260 12200
2cm
2503 OP0122 Excision of trunk lesion with Z‐plasty or other adjacent 57840 28920 23130 17350
tissue transfer
2504 OP0126 Expander insertion ‐ multiple 92400 46200 36960 27720
2505 OP1359 Expander insertion ‐ single 57750 28880 23100 17330
2506 OP3006 Expander insertion ( more than 2 ) 128580 64280 51440 38580
2507 OP1360 Expander removal & contouring ‐ multiple 144650 72330 57870 43400
2508 OP1361 Expander removal & contouring ‐ single 112520 56270 45010 33760
2509 OP3321 Eyebrow reconstruction with flap 75890 37940 30350 22770
2510 OP4484 Face Reanimation FFMT 173250 86630 69300 51980
2511 OP4485 Face Reanimation Muscle Flap 115500 57750 46200 34650
2512 OP4222 Face Swelling (Large) 69880 34940 27950 20970
2513 OP4223 Face Swelling (Medium) 55900 27950 22360 16780
2514 OP4224 Face Swelling (Small) 41930 20970 16780 12570
2515 OP0077 Facial bi‐partition for hyperteleorism 256830 128410 102730 77060
2516 OP4483 Facial Nerve Cross Nerve Graft 115500 57750 46200 34650
2517 OP4367 Facial Reanimation (Baby Sitting Procedure) 127050 63530 50820 38120
2518 OP4366 Facial Reanimation by cross face nerve graft 127050 63530 50820 38120
2519 OP4365 Facial Reanimation by FFMT 152460 76230 60980 45740
180
2520 OP4363 Facial Reanimation by local muscle transfer ? 1 Muscle 76230 38120 30490 22870
2521 OP4364 Facial Reanimation by local muscle transfer ? 2 Muscle 101640 50820 40660 30490
2522 OP3067 Fibular osteocutaneous free flap for long bones 194590 97300 77840 58380
2523 OP1332 Flap insetting ( large ) 51370 25690 20550 15410
2524 OP1333 Flap insetting ( small ) 34330 17160 13730 10310
2525 OP3322 Foucher flap 90930 45460 36370 27280
2526 OP4486 Free Functional Muscle Transfer 161700 80850 64680 48510
2527 OP3003 Free Perforator flap transfer 194590 97300 77840 58380
2528 OP3323 Full thickness skin graft ( large ) 101010 50510 40400 30310
2529 OP3324 Full thickness skin graft ( medium ) 75890 37940 30350 22770
2530 OP3325 Full thickness skin graft ( small ) 50570 25280 20230 15170
2531 OP3436 Gastrocnemius / Soleus muscle flap 80370 40180 32140 24100
2532 OP4474 Gender Reassignment Surgery Female to Male 161700 80850 64680 48510
2533 OP4475 Gender Reassignment Surgery Male to Female 138600 69300 55440 41580
2534 OP3327 Gracilis flap ( free ) 202150 101080 80860 60650
2535 OP3328 Gracilis flap ( pedicled ) 101010 50510 40400 30310
2536 OP3076 Groin perforator free flap 194590 97300 77840 58380
2537 OP4238 Head & neck reconstruction (Complex) 97830 48920 39130 29350
2538 OP4237 Head & neck reconstruction (Simple) 55900 27950 22360 16780
2539 OP4236 Hepatic artery anastomosis 69300 34650 27720 20790
2540 OP4544 Hernia Repair with Abdominal Wall Reconstruction 165000 82500 66000 49500
2541 OP3074 Iliac crest osteocutaneous free flap 194590 97300 77840 58380
2542 OP3330 Latissimus dorsi ( LD ) free flap 202150 101080 80860 60650
2543 OP4370 LD Pedicle Flap 101640 50820 40660 30490
2544 OP4371 LD Pedicle flap with implant for breast reconsrtruction 127050 63530 50820 38120
2545 OP3331 Littler flap 126270 63130 50510 37880
2546 OP3428 Local Advancement flap ‐ large 96450 48220 38580 28930
2547 OP3427 Local Advancement flap ‐ medium 64280 32140 25710 19290
2548 OP3426 Local Advancement flap ‐ small 48240 24110 19290 14480
2549 OP1737 Local transposition flap ‐ large 74990 37490 30000 22500
2550 OP1739 Local transposition flap ‐ medium 70660 35330 28260 21200
2551 OP1709 Local transposition flap ‐ small 51370 25690 20550 15410
2552 OP3009 Lymphaticovenous shunt 116800 58400 46720 35050
2553 OP3333 Medial plantar artery flap ( neurovascular free flap ) 252650 126320 101070 75790
2554 OP3334 Medial plantar artery flap ( pedicled ) 101010 50510 40400 30310
2555 OP0820 Medpore ear reconstruction ( bilateral ) 256830 128410 102730 77060
2556 OP0815 Medpore ear reconstruction ( unilateral ) 171260 85640 68510 51370
2557 OP4546 Nasal Framework Correction 96250 48130 38500 28880
2558 OP3337 Nasolabial flap 60710 30350 24280 18220
2559 OP3001 Neurovascular island Flap ‐ Free 194590 97300 77840 58380
2560 OP3002 Neurovascular island Flap ‐ Pedicle 116800 58400 46720 35050
2561 OP4354 Oberlin Nerve Transfer 127050 63530 50820 38120
2562 OP0074 Orbital repositioning for hyperteleorism ‐ extracranial 256830 128410 102730 77060
& intracranial approach
& intracranial approach with bone graft
approach
approach with bone graft
2566 OP0819 Otoplasty for acquired ear deformity ( bilateral ) 69300 34650 27720 20790
2567 OP0818 Otoplasty for acquired ear deformity ( unilateral ) 46200 23100 18480 13860
2568 OP0817 Otoplasty for lop ears ( bilateral ) 80850 40430 32340 24260
2569 OP0816 Otoplasty for lop ears ( unilateral ) 69300 34650 27720 20790
2570 OP4541 Panniculectomy 55000 27500 22000 16500
181
2571 OP4231 Partial Ear Reconstruction 69880 34940 27950 20970
2572 OP3339 Pectoralis major myocutaneous flap 101010 50510 40400 30310
2573 OP4373 Pedicle ALT flap 127050 63530 50820 38120
2574 OP0466 Pedicle flap cover of amputation stump 85680 42830 34270 25700
2575 OP4216 Pedicle LD for breast 83850 41930 33540 25160
2576 OP4213 Pedicled Gastronimius Flap 69880 34940 27950 20970
2577 OP3358 Pedicled perforator flap ( large ) 90930 45460 36370 27280
2578 OP3340 Pedicled perforator flap ( small ) 60710 30350 24280 18220
2579 OP4230 Penile reconstruction (Free flap) 195660 97830 78270 58700
2580 OP4229 Penile reconstruction (Pedicle flap) 139760 69880 55900 41930
2581 OP4523 Post Traumatic Ear Reconstruction Complex 110000 55000 44000 33000
2582 OP4522 Post Traumatic Ear Reconstruction Simple 55000 27500 22000 16500
2583 OP3342 Posterior interosseus artery flap 80850 40430 32340 24260
2584 OP1735 Radial artery forearm free flap 124170 62080 49670 37250
2585 OP3343 Radial artery forearm pedicled flap 90930 45460 36370 27280
2586 OP4478 Radial/Ulnar Artery Repair 69300 34650 27720 20790
2587 OP3344 Reconstruction by Limberg flap ( large ) 75890 37940 30350 22770
2588 OP3345 Reconstruction by Limberg flap ( small ) 50570 25280 20230 15170
2589 OP1592 Reconstructive rhinoplasty ‐ forehead flap ( single 96450 48220 38580 28930
stage )
2590 OP1590 Reconstructive rhinoplasty ‐ forehead flap ( stage One 80370 40180 32140 24100
of two stages )
2591 OP1591 Reconstructive rhinoplasty ‐ forehead flap ( stage Two 48240 24110 19290 14480
of two stages )
2592 OP3346 Rectus abdominis flap ( free ) 202150 101080 80860 60650
2593 OP3347 Rectus abdominis flap ( pedicled ) 101010 50510 40400 30310
2594 OP3349 Reverse sural artery flap 90930 45460 36370 27280
2595 OP4547 Skin biopsy 13750 6880 5500 4130
2596 OP0465 Skin graft of amputation stump 85680 42830 34270 25700
2597 OP2009 Skin grafting ‐ major 72810 36410 29130 21850
2598 OP2008 Skin grafting ‐ minor 38560 19270 15420 11560
2599 OP4355 Somsak Nerve Transfer 127050 63530 50820 38120
2600 OP2999 Split skin grafting ‐ medium 58470 29240 23390 17550
2601 OP1964 Sternomastoid release ‐ unipolar 37680 18840 15070 11310
2602 OP3014 Sternomastoid release Bipolar 77910 38960 31160 23380
2603 OP4352 Superficial ? (Biopsy) 30490 15250 12200 9150
2604 OP4477 Sural Nerve graft 57750 28880 23100 17330
2605 OP4351 Sural Nerve Graft Harvest 76230 38120 30490 22870
2606 OP4543 Surgical Wound Closure ‐ Complex ( By Plastic Surgery 110000 55000 44000 33000
Technique)
2607 OP4542 Surgical Wound Closure ‐ Simple ( By Plastic Surgery 55000 27500 22000 16500
Technique)
2608 OP4488 Suture Removal In Day Care 1740
2609 OP3420 Tangential excision of burn wound ‐ large 80370 40180 32140 24100
2610 OP3419 Tangential excision of burn wound ‐ medium 64280 32140 25710 19290
2611 OP3418 Tangential excision of burn wound ‐ small 48240 24110 19290 14480
2612 OP1738 Thoracic pedicle flap 85680 42830 34270 25700
2613 OP4463 Tissue expander placement ( more than 3 ) 127050 63530 50820 38120
2614 OP4461 Tissue expander placement single 69300 34650 27720 20790
2615 OP4462 Tissue expander placement two 92400 46200 36960 27720
2616 OP4232 Tube Flap Reconstruction (Large) 69880 34940 27950 20970
2617 OP4233 Tube Flap Reconstruction (Medium) 55900 27950 22360 16780
2618 OP4234 Tube Flap Reconstruction (Small) 41930 20970 16780 12570
2619 OP1733 Ulnar artery forearm free flap 124170 62080 49670 37250
2620 OP3421 Vaccum assisted wound closure ( VAC ) application 25710 12860 10300 7710
2621 OP4481 Vascular Malformation Excision ‐ Large 115500 57750 46200 34650
182
2622 OP4480 Vascular Malformation Excision ‐ Medium 80850 40430 32340 24260
2623 OP4479 Vascular Malformation Excision ‐ Small 57750 28880 23100 17330
2624 OP0464 V‐Y flap cover of amputation stump 64280 32140 25710 19290
2625 OP4711 Webspace Contrature Release + local flap 64000 32000 25600 19200
2626 OP4710 Webspace Contrature Release + Z Plasty 52000 26000 20800 15600
2627 OP4712 Webspace Contrature Release with distal flap 84000 42000 33600 25200
2628 OP3354 Z‐plasty repair of scar ( multiple ) 75890 37940 30350 22770
2629 OP3355 Z‐plasty repair of scar ( single ) 34650 17330 13860 10400
Primary Arthroplasty
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2630 OP4139 Ankle joint replacement 123150 61570 49260 36950
2631 OP1540 Bipolar hip hemiarthroplasty ‐ cemented 89520 44760 35810 26860
2632 OP1541 Bipolar hip hemiarthroplasty ‐ non cemented 89520 44760 35810 26860
2633 OP1542 Bipolar shoulder hemiarthroplasty ‐ cemented 89520 44760 35810 26860
2634 OP1543 Bipolar shoulder hemiarthroplasty ‐ non cemented 89520 44760 35810 26860
2635 OP4132 Closed reduction of Bipolar / THR 18140 9070 7260 5450
2636 OP1526 Computer assisted total knee replacement ‐ cemented 135470 67740 54190 40640
2637 OP1527 Computer assisted total knee replacement ‐ hybrid 135470 67740 54190 40640
2638 OP1528 Computer assisted total knee replacement ‐ non 135470 67740 54190 40640
cemented
2639 OP3051 Excision arthroplasty of elbow 52320 26170 20930 15700
2640 OP1510 Finger joint replacement ‐ per joint 61600 30810 24640 18480
2641 OP1572 Finger joint replacement ‐ three joints or more 92410 46210 36970 27730
2642 OP1509 Finger joint replacement ‐ two joints 92410 46210 36970 27730
2643 OP2997 Gap / implant arthroplasty 89590 44790 35840 26880
2644 OP2980 Girdle Stone Arthroplasty 44900 22450 17960 13470
2645 OP1523 Minimally invasive total hip replacement ‐ cemented 135470 67740 54190 40640
2646 OP1524 Minimally invasive total hip replacement ‐ hybrid 135470 67740 54190 40640
2647 OP1525 Minimally invasive total hip replacement ‐ non 135470 67740 54190 40640
cemented
2648 OP1529 Minimally invasive total knee replacement ‐ cemented 135470 67740 54190 40640
2649 OP1530 Minimally invasive total knee replacement ‐ hybrid 135470 67740 54190 40640
2650 OP1531 Minimally invasive total knee replacement ‐ non 135470 67740 54190 40640
cemented
2651 OP1511 Patellofemoral arthroplasty ‐ cemented 61600 30810 24640 18480
2652 OP1512 Patellofemoral arthroplasty ‐ non cemented 61600 30810 24640 18480
2653 OP3092 Patelloplasty with patellar surface replacement 93360 46680 37340 28000
2654 OP2988 THR with acetabuloplasty 143680 71840 57480 43110
2655 OP0183 TM joint ankylosis ‐ arthroplasty + allograft 98520 49260 39410 29560
2656 OP0184 TM joint ankylosis ‐ arthroplasty + prosthetic joint 98520 49260 39410 29560
replacement
2657 OP0181 TM joint ankylosis ‐ condylectomy / interposition gap 98520 49260 39410 29560
arthroplasty
2658 OP0182 TM joint ankylosis ‐ gap arthroplasty 98520 49260 39410 29560
2659 OP1514 Toe Joint Replacement ‐ single joint 61600 30810 24640 18480
2660 OP1513 Toe Joint Replacement ‐ three or more joints 92410 46210 36970 27730
2661 OP2820 Toe Joint Replacement ‐ two joints 92410 46210 36970 27730
2662 OP1515 Total elbow replacement ‐ cemented 135470 67740 54190 40640
2663 OP1516 Total elbow replacement ‐ hybrid 135470 67740 54190 40640
2664 OP1517 Total elbow replacement ‐ non cemented 135470 67740 54190 40640
2665 OP1518 Total hip replacement ‐ cemented 135470 67740 54190 40640
183
2666 OP1519 Total hip replacement ‐ hybrid 135470 67740 54190 40640
2667 OP1520 Total hip replacement ‐ non cemented 135470 67740 54190 40640
2668 OP1521 Total hip replacement ‐ non cemented stem ‐ metal on 135470 67740 54190 40640
metal
2669 OP1522 Total hip replacement ‐ resurfacing ‐ metal on metal 135470 67740 54190 40640
2670 OP3050 Total Hip Replacement with acetabular reconstruction 143680 71840 57480 43110
‐ cemented ( Primary )
‐ uncemented ( Primary )
2672 OP1532 Total knee replacement ‐ cemented 135470 67740 54190 40640
2673 OP1533 Total knee replacement ‐ hybrid 135470 67740 54190 40640
2674 OP1534 Total knee replacement ‐ non cemented 135470 67740 54190 40640
2675 OP3046 Total Knee Replacement with tibial condyle 143680 71840 57480 43110
reconstruction ( Primary )
2676 OP1535 Total shoulder replacement ‐ cemented 135470 67740 54190 40640
2677 OP1536 Total shoulder replacement ‐ hybrid 135470 67740 54190 40640
2678 OP1537 Total shoulder replacement ‐ non cemented 135470 67740 54190 40640
2679 OP1538 Unicondylar knee replacement ‐ cemented 135470 67740 54190 40640
2680 OP1539 Unicondylar knee replacement ‐ non cemented 135470 67740 54190 40640
2681 OP1544 Unipolar hip hemiarthroplasty ‐ cemented 89520 44760 35810 26860
2682 OP1545 Unipolar hip hemiarthroplasty ‐ non cemented 89520 44760 35810 26860
2683 OP1546 Unipolar shoulder hemiarthroplasty ‐ cemented 89520 44760 35810 26860
2684 OP1574 Vascularised Joint Replacement ‐ multiple joints 123180 61580 49270 36960
2685 OP1573 Vascularised Joint Replacement ‐ single joint 102650 51320 41060 30800
Procedures
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

2686 OP4421 Beside Decannulation of Tracheostomy 14550 7280 5820 4370
2687 OP4422 Endo ‐ Laryngoscopy ( Bedside ) 7280 3640 2910 2180
2688 OP4303 Tonsillar Fossa Hemostasis 14550 7280 5820 4370
Professional Charges
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

2689 ULBRSC Breast core biopsy under Ultrasound guidance ‐
Ultrasonologist fee
2690 ENDOSF Endomyocardial Package ‐ Surgoen Fee
2691 HTSPOP Heart Transplant Package ‐ Surgeon (Post op care)
2692 HTSF Heart Transplant Package ‐ Surgeon Fee
2693 HM2SF Heartmate 2 ‐ Surgoen Fee Within Package
2694 IABPDF IABP INSERTION ‐DOCOTR FEE
2695 IVUSDF IVUS ‐ Doctor Fee
2696 LTPPSF Liver Transplant Package (Paediatrics‐ Recepient) ‐
Surgeon Fee
184
Psychiatry
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2697 OP1366 Modified ECT (electro convulsive therapy) 8880 4440 3550 2670
2698 OP1367 Narco analysis 9860 4920 3950 2950
Reimplantation Revascularisation Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2699 OP3435 Exploration for reimplantation ‐ arm / forearm 58700 29350 23490 17610
2700 OP3434 Exploration for reimplantation ‐ single digit 44040 22020 17620 13210
2701 OP0741 Reimplantation of ear 195430 97710 78170 58630
2702 OP0830 Reimplantation of finger ‐ single 132300 66150 52920 39690
2703 OP1694 Reimplantation of fingers ‐ four or more fingers 198450 99230 79380 59540
2704 OP1693 Reimplantation of fingers ‐ three fingers 176100 88040 70430 52840
2705 OP0831 Reimplantation of fingers ‐ two fingers 121280 60640 48510 36380
2706 OP0748 Reimplantation of lip 195430 97710 78170 58630
2707 OP0832 Reimplantation of lower limb at ankle level 195430 97710 78170 58630
2708 OP0833 Reimplantation of lower limb at lower leg level 195430 97710 78170 58630
2709 OP0747 Reimplantation of nose 195430 97710 78170 58630
2710 OP3012 Reimplantation of one finger /Toe 106660 53330 42670 31990
2711 OP0742 Reimplantation of penis 195430 97710 78170 58630
2712 OP0749 Reimplantation of scalp 195430 97710 78170 58630
2713 OP0743 Reimplantation of testis 195430 97710 78170 58630
2714 OP0834 Reimplantation of toe ‐ single 64520 32260 25810 19360
2715 OP0835 Reimplantation of toes ‐ multiple 140720 70360 56290 42210
2716 OP3088 Reimplantation of toes ‐ three toes 177680 88840 71060 53310
2717 OP3086 Reimplantation of toes ‐ two toes 142160 71070 56870 42640
2718 OP0836 Reimplantation of upper limb at forearm level 195430 97710 78170 58630
2719 OP0837 Reimplantation of upper limb at palm level 195430 97710 78170 58630
2720 OP0838 Reimplantation of upper limb at upper arm level 195430 97710 78170 58630
2721 OP0839 Reimplantation of upper limb at wrist level 195430 97710 78170 58630
2722 OP4716 Reimplantation Single Finger (Clean Cut) 140000 70000 56000 42000
2723 OP4717 Reimplantation Single Finger (Crush avulsed with vein 160000 80000 64000 48000
graft)
2724 OP0718 Revascularisation of finger ‐ single 66150 33080 26460 19850
2725 OP0739 Revascularisation of fingers ‐ four or more fingers 132300 66150 52920 39690
2726 OP1696 Revascularisation of fingers ‐ three fingers 110250 55130 44100 33080
2727 OP1695 Revascularisation of fingers ‐ two fingers 88200 44100 35280 26460
2728 OP0750 Revascularisation of lower limb at ankle level 117310 58650 46920 35200
2729 OP0751 Revascularisation of lower limb at lower leg level 117310 58650 46920 35200
2730 OP0752 Revascularisation of lower limb at thigh level 117310 58650 46920 35200
2731 OP0717 Revascularisation of toe ‐ single 58700 29350 23490 17610
2732 OP0719 Revascularisation of toes ‐ multiple 117310 58650 46920 35200
2733 OP0745 Revascularisation of upper limb at forearm level 117310 58650 46920 35200
2734 OP0746 Revascularisation of upper limb at palm level 117310 58650 46920 35200
2735 OP0744 Revascularisation of upper limb at upper arm level 117310 58650 46920 35200
2736 OP0740 Revascularisation of upper limb at wrist level 117310 58650 46920 35200
185
Revision Arthroplasty
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2737 OP1562 Computer assisted total knee Replacement ‐ 157990 78990 63200 47400
Cemented ( Revision arthroplasty )
2738 OP1563 Computer assisted Total Knee Replacement ‐ Hybrid ( 157990 78990 63200 47400
Revision arthroplasty )
2739 OP1564 Computer assisted Total Knee Replacement ‐ non 157990 78990 63200 47400
cemented ( Revision arthroplasty )
2740 OP1549 Patellofemoral Arthroplasty ‐ Cemented ( Revision 61600 30810 24640 18480
arthroplasty )
2741 OP1550 Patellofemoral Arthroplasty ‐ non cemented ( Revision 61600 30810 24640 18480
arthroplasty )
2742 OP1551 Total Elbow Replacement ‐ Cemented ( Revision 157990 78990 63200 47400
arthroplasty )
2743 OP1552 Total Elbow Replacement ‐ Hybrid ( Revision 157990 78990 63200 47400
arthroplasty )
2744 OP1553 Total Elbow Replacement ‐ non cemented ( Revision 157990 78990 63200 47400
arthroplasty )
2745 OP1554 Total Hip Replacement ‐ Cemented ( Revision 157990 78990 63200 47400
arthroplasty )
2746 OP1555 Total Hip Replacement ‐ Hybrid ( Revision arthroplasty 157990 78990 63200 47400
)
2747 OP1556 Total Hip Replacement ‐ non cemented ( Revision 157990 78990 63200 47400
arthroplasty )
2748 OP1557 Total Hip Replacement ‐ non cemented stem ‐ Metal 157990 78990 63200 47400
on metal ( Revision arthroplasty )
2749 OP1558 Total Hip Replacement ‐ Resurfacing ‐ Metal on metal 157990 78990 63200 47400
( Revision arthroplasty )
‐ cemented ( Revision )
‐ uncemented ( Revision )
2752 OP1559 Total Hip Replacement with acetabuloplasty / Femoral 157990 78990 63200 47400
reconstruction ‐ Cemented ( Revision arthroplasty )
reconstruction ‐ Hybrid ( Revision arthroplasty )
reconstruction ‐ non cemented ( Revision arthroplasty
)
2755 OP1565 Total Knee Replacement ‐ Cemented ( Revision 157990 78990 63200 47400
arthroplasty )
2756 OP1566 Total Knee Replacement ‐ Hybrid ( Revision 157990 78990 63200 47400
arthroplasty )
2757 OP1567 Total Knee Replacement ‐ non cemented ( Revision 157990 78990 63200 47400
arthroplasty )
2758 OP3043 Total Knee Replacement with tibial condyle 143680 71840 57480 43110
reconstruction ( Revision )
2759 OP1568 Total Shoulder Replacement ‐ Cemented ( Revision 157990 78990 63200 47400
arthroplasty )
2760 OP1569 Total Shoulder Replacement ‐ Hybrid ( Revision 157990 78990 63200 47400
arthroplasty )
2761 OP1570 Total Shoulder Replacement ‐ non cemented ( 157990 78990 63200 47400
2762 OP1547 Unicondylar Knee Replacement ‐ Cemented ( Revision 157990 78990 63200 47400
arthroplasty )
186
2763 OP1548 Unicondylar Knee Replacement ‐ non cemented ( 157990 78990 63200 47400
Salivary Gland Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2764 OP0629 Excision of sublingual gland tumour 43110 21560 17240 12940
2765 OP1048 Excision of submandidular gland / tumour 43110 21560 17240 12940
2766 OP0805 Extended parotidectomy 116070 58030 46430 34820
2767 OP3506 Sialoendoscopy: Parotid duct diagnostic ‐ bilateral 27380 13690 10960 8210
2768 OP3505 Sialoendoscopy: Parotid duct diagnostic ‐ unilateral 19180 9600 7680 5750
2769 OP3508 Sialoendoscopy: Parotid duct dillatation ‐ bilateral 27380 13690 10960 8210
2770 OP3507 Sialoendoscopy: Parotid duct dillatation ‐ unilateral 19180 9600 7680 5750
2771 OP3511 Sialoendoscopy: Parotid duct multiple calculi removal 34510 17250 13810 10350
simple
2772 OP3510 Sialoendoscopy: Parotid duct single calculi removal 27380 13690 10960 8210
simple
2773 OP3509 Sialoendoscopy: Parotid duct stenting 18660 9320 7470 5600
2774 OP3500 Sialoendoscopy: Submandibular duct diagnostic ‐ 27380 13690 10960 8210
bilateral
2775 OP3499 Sialoendoscopy: Submandibular duct diagnostic ‐ 19180 9600 7680 5750
unilateral
2776 OP3502 Sialoendoscopy: Submandibular duct dialatation ‐ 27380 13690 10960 8210
bilateral
2777 OP3501 Sialoendoscopy: Submandibular duct dialatation ‐ 19180 9600 7680 5750
unilateral
2778 OP3504 Sialoendoscopy: Submandibular duct multiple calculi 34510 17250 13810 10350
removal simple
2779 OP3503 Sialoendoscopy: Submandibular duct single calculi 27380 13690 10960 8210
removal simple
2780 OP0995 Submandibular duct calculus removal 43110 21560 17240 12940
2781 OP1049 Superficial parotidectomy 86080 43040 34430 25820
2782 OP0631 Superficial parotidectomy for Recurrent tumour 86080 43040 34430 25820
2783 OP0804 Total parotidectomy 116070 58030 46430 34820
2784 OP1052 Total parotidectomy ( nerve preserving ) 116070 58030 46430 34820
2785 OP0031 Total parotidectomy ( with nerve grafting ) 154790 77400 61920 46440
2786 OP0632 Total parotidectomy for Recurrent tumour ( nerve 116070 58030 46430 34820
preserving )
2787 OP0633 Total parotidectomy for Recurrent tumour ( with 154790 77400 61920 46440
nerve grafting )
Small Bowel Transplant Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

2788 OP3362 Small bowel transplant donor operation Within Package
187
Spinal Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2789 OP2055 Anterior and posterior fusion for vertebral deformity 193520 96760 77410 58050
correction
2790 OP2056 Anterior and posterior fusion with instrumentation for 202280 101150 80910 60680
vertebral deformity correction
2791 OP3414 Anterior cervical corpectomy for DPLL 200770 100380 80300 60230
2792 OP3412 Anterior cervical corpectomy with stabilization and 200770 100380 80300 60230
instrumentation
2793 OP2087 Anterior cervical discectomy ‐ Multiple Level 163390 81700 65350 49010
2794 OP2088 Anterior cervical discectomy ‐ Single Level 154790 77400 61920 46440
2795 OP0501 Anterior cervical discectomy with instrumentation / 171990 86000 68800 51600
bone grafting
2796 OP2129 Anterior decompression + anterior interbody fusion of 171990 86000 68800 51600
lumbar spine
2797 OP2138 Anterior decompression + Fusion + Anterior 171990 86000 68800 51600
instrumentation of lumbar spine
2798 OP2137 Anterior decompression + posterior decompression + 193520 96760 77410 58050
fusion + instrumentation of lumbar spine
2799 OP2057 Anterior fusion for vertebral deformity correction 163390 81700 65350 49010
2800 OP2058 Anterior fusion with instrumentation for vertebral 163390 81700 65350 49010
deformity correction
2801 OP2134 Anterolateral decompression + Fusion + anterior 171990 86000 68800 51600
instrumentation of dorsal / thoracic spine
2802 OP2139 Anterolateral decompression + Fusion + anterior 171990 86000 68800 51600
2803 OP2135 Anterolateral decompression + Fusion + Posterior 193520 96760 77410 58050
instrumentation of dorsal / thoracic spine
2804 OP2140 Anterolateral decompression + Fusion + Posterior 193520 96760 77410 58050
2805 OP2094 Anterolateral decompression of Dorsal spine 163390 81700 65350 49010
2806 OP2107 Anterolateral decompression of Lumbar Spine 124700 62350 49880 37410
2807 OP2045 Aspiration of spinal abscess 7120 3560 2850 2140
2808 OP2079 Bone grafting for spinal dysraphism 82770 41390 33110 24830
2809 OP2089 Cervical decompression laminectomy ‐ multiple levels 154790 77400 61920 46440
2810 OP2090 Cervical decompression laminectomy ‐ single level 154790 77400 61920 46440
2811 OP0500 Cervical laminoplasty with instrumentation / bone 163390 81700 65350 49010
graft
2812 OP2048 Cervical vertebral corpectomy 163390 81700 65350 49010
2813 OP4525 COCCYX Manipulation Under GA 31500 15750 12600 9450
2814 OP3192 Coccyxdectomy 106540 53280 42620 31960
2815 OP2059 Convex epiphysiodesis of the curve for vertebral 163390 81700 65350 49010
2816 OP2060 Costoplasty of rib hump for vertebral deformity 103220 51610 41290 30960
correction
2817 OP3451 Debridement spine 28180 14090 11270 8450
2818 OP2066 Discogram 17260 8630 6900 5190
2819 OP2095 Dorsal / thoracic discectomy ‐ Microscopic ( 1 level ) 137550 68780 55020 41270
2820 OP2096 Dorsal / thoracic discectomy ‐ Microscopic ( 2 levels ) 154790 77400 61920 46440
2821 OP2097 Dorsal / thoracic discectomy ‐ Microscopic ( More 154790 77400 61920 46440
than 2 levels )
2822 OP2103 Dorsal / thoracic laminoplasty with instrumentation 163390 81700 65350 49010
2823 OP2098 Dorsal / thoracic lamintectomy and discectomy ‐ Open 154790 77400 61920 46440
( 1 level )
188
( 2 levels )
( More than 2 levels )
2826 OP2049 Dorsal / thoracic vertebral corpectomy 163390 81700 65350 49010
2827 OP0507 Endoscopic laminectomy + discectomy for lumbar disc 137130 68570 54850 41140
prolapse
2828 OP3223 Endoscopic lumbar laminotomy ‐ Multiple Levels 170230 85110 68090 51070
2829 OP3197 Endoscopic Lumbar laminotomy + Fenestration + 170230 85110 68090 51070
facetectomy ‐ Multiple Levels
2830 OP3198 Endoscopic Lumbar laminotomy + Fenestration + 151330 75660 60530 45400
facetectomy ‐ Single Level
2831 OP3199 Endoscopic Lumbar laminotomy and Fenestration ‐ 170230 85110 68090 51070
Multiple levels
2832 OP3200 Endoscopic Lumbar laminotomy and Fenestration ‐ 151330 75660 60530 45400
Single Level
2833 OP3305 Endoscopic spinal decompression 230860 115440 92350 69260
2834 OP3302 Endoscopic spinal fenestration with bilateral 177960 88990 71190 53390
foraminotomy
2835 OP3304 Endoscopic spinal fenestration with discectomy & 205970 102980 82390 61790
bilateral foraminotomy
2836 OP3303 Endoscopic spinal fenestration with discectomy & 195340 97670 78130 58600
foraminotomy
2837 OP3301 Endoscopic spinal fenestration with foraminotomy 158300 79150 63320 47480
2838 OP2143 Excision of extradural spinal cord tumour 163390 81700 65350 49010
2839 OP2144 Excision of intradural spinal cord tumour 163390 81700 65350 49010
2840 OP2145 Excision of intramedullary spinal cord tumour 171990 86000 68800 51600
2841 OP3407 Excision of large spinal tumor with duraplasty 248590 124300 99440 74570
2842 OP2973 Excision of spinal AVM 182470 91230 72990 54740
2843 OP3409 Foramen magnum decompression and duraplasty 193840 96930 77540 58160
2844 OP3452 Growing rods 148510 74260 59400 44550
2845 OP3453 Growing rods distraction 35640 17820 14260 10700
2846 OP2051 Kyphoplasty of the kyphotic vertebra 53820 26910 21540 16150
2847 OP0477 Laminectomy & decompression for extradural bony 163390 81700 65350 49010
spinal tumours
2848 OP0478 Laminectomy & decompression for extradural soft 163390 81700 65350 49010
tissue spinal tumours
2849 OP1106 Laminectomy & decompression for intradural, 163390 81700 65350 49010
extramedullary spinal tumours
2850 OP0476 Laminectomy & decompression for intradural, 171990 86000 68800 51600
intramedullary spinal tumours
2851 OP0506 Laminectomy / discectomy for lumbar disc prolapse ( 124700 62350 49880 37410
microscopic )
2852 OP1115 Laminectomy / discectomy for lumbar disc prolapse ( 124700 62350 49880 37410
open )
2853 OP2108 Lumbar discectomy ‐ Endoscopic ( 1 level ) 137130 68570 54850 41140
2854 OP2109 Lumbar discectomy ‐ Endoscopic ( 2 levels ) 137130 68570 54850 41140
2855 OP2110 Lumbar discectomy ‐ Endoscopic ( More than 2 levels ) 137130 68570 54850 41140
2856 OP2111 Lumbar discectomy ‐ Microscopic ( 1 level ) 124700 62350 49880 37410
2857 OP2112 Lumbar discectomy ‐ Microscopic ( 2 levels ) 124700 62350 49880 37410
2858 OP2113 Lumbar discectomy ‐ Microscopic ( More than 2 levels 124700 62350 49880 37410
)
2859 OP2116 Lumbar interspinous fenestration ‐ Multiple Levels 154790 77400 61920 46440
2860 OP2117 Lumbar interspinous fenestration ‐ Single Level 124700 62350 49880 37410
2861 OP2106 Lumbar laminectomy ‐ Multiple Levels 154790 77400 61920 46440
2862 OP2118 Lumbar laminectomy ‐ Single Level 124700 62350 49880 37410
2863 OP2126 Lumbar laminectomy and discectomy ‐ Open ( 1 level ) 124700 62350 49880 37410
189
2864 OP2114 Lumbar laminectomy and discectomy ‐ Open ( 2 levels 124700 62350 49880 37410
)
2865 OP2115 Lumbar laminectomy and discectomy ‐ Open ( More 163390 81700 65350 49010
than 2 levels )
2866 OP2119 Lumbar laminoplasty 124700 62350 49880 37410
2867 OP2120 Lumbar laminotomy ‐ Multiple Levels 154790 77400 61920 46440
2868 OP2122 Lumbar laminotomy + Fenestration + facetectomy ‐ 154790 77400 61920 46440
Multiple Levels
2869 OP2123 Lumbar laminotomy + Fenestration + facetectomy ‐ 137550 68780 55020 41270
Single Level
2870 OP2124 Lumbar laminotomy and Fenestration ‐ Multiple levels 154790 77400 61920 46440
2871 OP2125 Lumbar laminotomy and Fenestration ‐ Single Level 137550 68780 55020 41270
2872 OP2050 Lumbar vertebral corpectomy 171990 86000 68800 51600
2873 OP2955 Non fusion surgery of lumbar spine ( Diam spacer 124700 62350 49880 37410
insertion )
2874 OP3056 Occipito‐cervical fusion ( posterior only ) 148600 74300 59440 44570
2875 OP3091 Open biopsy of spine 23570 11780 9430 7070
2876 OP3193 Percutaneous fixation of dorsal spine 163390 81700 65350 49010
2877 OP3194 Percutaneous fixation of lumbar spine 163390 81700 65350 49010
2878 OP2091 Posterior cervical foraminotomy ‐ Multiple Levels 163390 81700 65350 49010
2879 OP2092 Posterior cervical foraminotomy ‐ Single Level 154790 77400 61920 46440
2880 OP2093 Posterior cervical laminoplasty 163390 81700 65350 49010
2881 OP2131 Posterior decompression + anterior interbody fusion 171990 86000 68800 51600
of lumbar spine
2882 OP2136 Posterior decompression + fusion + instrumentation of 171990 86000 68800 51600
dorsal / thoracic spine
2883 OP2142 Posterior decompression and posterolateral fusion + 171990 86000 68800 51600
2884 OP2133 Posterior decompression and posterolateral fusion of 171990 86000 68800 51600
lumbar Spine
2885 OP2141 Posterior decompression and transforaminal 171990 86000 68800 51600
interbody fusion + instrumentation of lumbar spine
2886 OP2132 Posterior decompression and transforaminal 171990 86000 68800 51600
Interbody fusion of Lumbar Spine
2887 OP2104 Posterior decompression of dorsal Spine ‐ Multiple 163390 81700 65350 49010
levels
2888 OP2105 Posterior decompression of dorsal Spine ‐ Single level 154790 77400 61920 46440
2889 OP2128 Posterior decompression of dorsal Spine and fusion 163390 81700 65350 49010
2890 OP2061 Posterior fusion for vertebral deformity correction 163390 81700 65350 49010
2891 OP2062 Posterior fusion with instrumentation for vertebral 187670 93840 75060 56300
2892 OP0714 Repair of diastometomyelia ( spinal dysraphism ) 82770 41390 33110 24830
2893 OP0712 Repair of lipo ‐ meningomyelocele ( spinal dysraphism 82770 41390 33110 24830
)
2894 OP0711 Repair of lipo ‐ meningomyelocele with untethering of 125140 62570 50050 37540
cord ( spinal dysraphism )
2895 OP0713 Repair of meningocele ( spinal dysraphism ) 82750 41380 33100 24830
2896 OP1117 Repair of meningomyelocele ( spinal dysraphism ) 83210 41610 33290 24960
2897 OP0512 Repair of meningomyelocele with untethering of cord 156030 78020 62410 46810
& excision of intradural lipoma ( spinal dysraphism )
2898 OP0511 Repair of meningomyelocele with untethering of cord 125140 62570 50050 37540
( spinal dysraphism )
2899 OP2972 Repair of spinal arteriovenous fistula 182470 91230 72990 54740
2900 OP0715 Repair of sub‐occipital meningomyelocele ( spinal 82770 41390 33110 24830
dysraphism )
2901 OP2074 Revision spine surgery ‐ Instrumentated 180550 90270 72220 54170
2902 OP2075 Revision spine surgery ‐ non‐instrumentated 171990 86000 68800 51600
2903 OP3306 Revision surgery for cervical disc 161430 80710 64580 48440
190
2904 OP3307 Revision surgery for lumbar disc 161430 80710 64580 48440
2905 OP0497 Spinal decompression with pedicle screw fixation ( 171990 86000 68800 51600
instrumentation )
2906 OP1113 Spinal decompression with sublaminar wiring ( 171990 86000 68800 51600
instrumentation )
2907 OP2067 Total cervical disc replacement 171990 86000 68800 51600
2908 OP2146 Total cervical spondylectomy 193520 96760 77410 58050
2909 OP2147 Total dorsal spondylectomy 193520 96760 77410 58050
2910 OP2068 Total lumbar disc replacement 193520 96760 77410 58050
2911 OP2148 Total lumbar spondylectomy 193520 96760 77410 58050
2912 OP0505 Transabdominal anterolateral spinal decompression 171990 86000 68800 51600
with instrumentation / bone grafting
2913 OP3228 Transoral decompression and posterior fusion of 248590 124300 99440 74570
cranio‐vertebral junction
2914 OP1108 Trans‐oral odontoid removal 163390 81700 65350 49010
2915 OP2956 Trans‐oral odontoid removal with posterior 193520 96760 77410 58050
instrumentation
2916 OP3041 Transpedicular biopsy of spine 23570 11780 9430 7070
2917 OP0504 Transthoracic anterolateral spinal decompression with 171990 86000 68800 51600
instrumentation / bone grafting
2918 OP0710 Untethering of cord ( spinal dysraphism ) 125140 62570 50050 37540
2919 OP3187 Vertebral corporectomy and fusion for OPLL 213090 106540 85240 63920
2920 OP3188 Vertebral Nucleoplasty ( cervical ) 71040 35520 28420 21320
2921 OP3189 Vertebral Nucleoplasty ( lumbar ) 71040 35520 28420 21320
2922 OP3454 Vertebral Transforaminal endoscopy 154750 77370 61900 46430
2923 OP3455 Vertebral Transforaminal foraminoplasty 154750 77370 61900 46430
2924 OP2052 Vertebroplasty of kyphotic vertebra 53820 26910 21540 16150
Sympathectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

2925 OP0259 Cervical sympathectomy ‐ open 69500 34760 27800 20850
2926 OP0260 Cervical sympathectomy ‐ thoracoscopic 196160 98080 78470 58850
2927 OP3044 Dorsal sympathectomy ‐ open 63220 31610 25290 18960
2928 OP0292 Laparoscopic lumbar sympathectomy 65450 32720 26180 19640
2929 OP0291 Lumbar sympathectomy ‐ open 49040 24520 19610 14710
2930 OP0583 Thoracoscopic dorsal sympathectomy 65450 32720 26180 19640
Tendon / Muscle Transfers
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

2931 OP1725 David Chuangs muscle transfer procedure 179790 89900 71910 53940
2932 OP1731 Functioning free muscle transfer ‐ Gracilis muscle 269670 134840 107870 80900
2933 OP1732 Functioning free muscle transfer ‐ Latisimus dorsi 269670 134840 107870 80900
muscle
2934 OP1730 Pedicle latisimus dorsi transfer 134900 67450 53960 40480
2935 OP1660 Tendon transfer for median nerve injuries ‐ multiple 88200 44100 35280 26460
2936 OP1659 Tendon transfer for median nerve injuries ‐ single ( 66150 33080 26460 19850
opponensplasty )
2937 OP3059 Tendon transfer for polio 57310 28650 22920 17190
191
2938 OP1658 Tendon transfer for radial nerve injuries ‐ multiple 88200 44100 35280 26460
2939 OP1657 Tendon transfer for radial nerve injuries ‐ single 66150 33080 26460 19850
2940 OP1662 Tendon transfer for ulnar nerve injuries ‐ multiple 88200 44100 35280 26460
2941 OP1661 Tendon transfer for ulnar nerve injuries ‐ single 66150 33080 26460 19850
2942 OP1962 Tendon transfer of tibialis posterior to dorsum of foot 53980 26990 21590 16190
2943 OP1727 Trapezius muscle transfer 134900 67450 53960 40480
2944 OP3069 Trapezius transfer 130820 65420 52320 39250
2945 OP1726 Triceps to biceps muscle transfer 134900 67450 53960 40480
Tendon Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
2946 OP1965 Quadriceplasty 76890 38440 30770 23070
2947 OP1286 Release of torticollis ( sterno‐mastoid tenotomy ) 55130 27560 22050 16540
2948 OP3272 Tendo‐achilles reconstruction 84650 42330 33860 25390
2949 OP3273 Tendo‐achilles repair 74170 37090 29670 22250
2950 OP1963 Tendo‐Achillles ( TA ) lengthening 43200 21600 17270 12960
2951 OP1651 Tenolysis of flexor / extensor tendons ‐ multiple 107910 53960 43170 32370
Thoracic Surgery
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

2952 OP4527 Allied Assistance ‐ Major 105000 52500 42000 31500
2953 OP4526 Allied Assistance ‐ Minor 52500 26250 21000 15750
2954 OP4515 Bronchial Sleeve Resection & Repair 215430 107720 86300 64890
2955 OP4022 Bronchoplasty fistula closure 227120 113560 90850 68130
2956 OP4304 Bullet injury ‐ retrival of bullet and reconstruction face 284820 142410 113940 85450
/ head and neck
2957 OP4044 Cervical Mediastinoscopy 75590 37790 30230 22680
2958 OP0261 Cervical rib excision 170560 85280 68220 51170
2959 OP1414 Chest ( pleural ) aspiration in OT 11000 5500 4400 3300
2960 OP4076 Chest tube insertion & Pleurodesis 37350 18680 14940 11200
2961 OP4010 Chest wall tumour resection (with rib resection) and 145570 72790 58230 43670
chest wall reconstruction (Methyl methacrylate plate)
chest wall reconstruction (Prolene mesh + Large
Muscle flap
chest wall reconstruction (Prolene mesh + Medium
Muscle flap
chest wall reconstruction (Prolene mesh + Small
Muscle flap
chest wall reconstruction (Prolene mesh)
2966 OP4008 Chest wall window for empyema thoracis 170560 85280 68220 51170
2967 OP4025 Clamshell Thoracotomy 95210 47610 38080 28570
2968 OP1254 Decortication for empyema thoracis 86000 43000 34400 25800
2969 OP1245 Diagnostic bronchoscopy ( with or without biopsy ) 21350 10670 8540 6410
2970 OP0576 Diagnostic thoracoscopy and drainage 31330 15670 12540 9410
192
2971 OP0575 Diagnostic thoracoscopy with biopsy 39190 19590 15680 11750
2972 OP4026 Emergency Thoracotomy for Chest Trauma 119970 59990 48000 35990
2973 OP4030 Esophageal Exclusion in Chest Trauma 132340 66170 52940 39700
2974 OP1417 Excision of cervical rib / scalenotomy 58670 29340 23470 17610
2975 OP2825 Excision of chest wall tumour (excluding ribs) 119110 59560 47650 35730
2976 OP2826 Excision of chest wall tumour (including ribs) 86000 43000 34400 25800
2977 OP0594 Excision of mediastinal tumour ( open ) 109450 54730 43790 32830
2978 OP4081 Flexible fiber optic bronchoscopy (with or without 16010 8000 6410 4810
biopsy)
2979 OP1246 Foreign body removal by flexible bronchoscope 27380 13690 10960 8210
2980 OP0891 Foreign body removal by rigid bronchoscope 42690 21350 17070 12810
2981 OP4019 Harvesting of muscle pedicled graft & reinforcement 170560 85280 68220 51170
of Bronchial stump
2982 OP4027 Intercostal Block 19010 9500 7610 5700
2983 OP1415 Intercostal chest tube insertion ( ICD ) in OT 38410 19200 15370 11520
2984 OP4028 IVC Tumour Resection 227120 113560 90850 68130
2985 OP4042 Lung volume reduction surgery 208770 104380 83510 62630
2986 OP4029 Median Sternotomy 189970 94980 75990 56980
2987 OP4035 Open carinal pneumonectomy 293490 146750 117390 88040
2988 OP4002 Open Diaphragmatic eventration/hernia repair 189970 94980 75990 56980
2989 OP4519 Open Diaphragmatic Plication 139440 69720 55860 42000
2990 OP4051 Open excision of invasive Anterior Mediastinal mass 299800 149900 119920 89940
(including Thymoma) with lung resection and vascular
repair.
(including Thymoma) with lung resection.
(including Thymoma) with pericardiectomy
(including Thymoma) with vascular repair.
2994 OP4516 Open Excision of Large Hemithorax Mass 244020 122010 97760 73500
2995 OP4047 Open excision of non‐invasive Anterior Mediastinal 227120 113560 90850 68130
mass (including Thymoma)
2996 OP4036 Open Extrapleural Pneumonectomy in Mesothelioma 227120 113560 90850 68130
2997 OP4039 Open Lobectomy + Mediastinal LN dissection 265570 132780 106230 79660
2998 OP4079 Open Lobectomy in life threatening hemoptysis 255720 127860 102290 76710
2999 OP1419 Open lung biopsy 95210 47610 38080 28570
3000 OP4034 Open lung cyst surgery 237370 118680 94950 71210
3001 OP4053 Open PMT excision with rib resection 249830 124920 99930 74950
3002 OP4052 Open PMT excision without rib resection 227120 113560 90850 68130
3003 OP4037 Open Pneumonectomy + Mediastinal LN dissection 284090 142040 113630 85230
3004 OP4041 Open segmental resection of bronchial tumour 227120 113560 90850 68130
3005 OP4038 Open Sleeve lobectomy 265570 132780 106230 79660
3006 OP4056 Open Tracheo‐esophageal fistula repair 189970 94980 75990 56980
3007 OP4031 Pleroperitoneal Shunt 113560 56780 45420 34070
3008 OP1426 Pleural biopsy 40710 20350 16290 12210
3009 OP4517 Pleurocutaneous Window 80180 40090 32120 24150
3010 OP1430 Pleurodesis 8660 4340 3470 2600
3011 OP4032 Posterolateral Thoracotomy 95210 47610 38080 28570
3012 OP4043 Pulmonary AVM 239060 119530 95630 71720
3013 OP1421 Rib resection & drainage of collection 58670 29340 23470 17610
3014 OP4074 Rigid bronchoscopy + Bronchial stenosis dilation 42690 21350 17070 12810
3015 OP4075 Rigid bronchoscopy + Debulking of tracheo‐bronchial 53360 26680 21350 16010
tumor
3016 OP4073 Rigid bronchoscopy + tracheal stenosis dilation 42690 21350 17070 12810
3017 OP4069 Robotic Cardiomyotomy for Achalasia Cardia 147650 73830 59060 44300
193
3018 OP4060 Robotic Diaphragmatic eventration/hernia repair 246960 123480 98780 74090
3019 OP4068 Robotic Enucleation of leiomyoma of esophagus 295250 147630 118100 88580
3020 OP4067 Robotic esophagectomy + Gastric pull‐up with neck 322830 161420 129140 96850
anastomosis
3021 OP4065 Robotic excision of Anterior mediastinal tumour 295250 147630 118100 88580
3022 OP4510 Robotic Excision of Invasive Anterior Mediastinal Mass 296310 148160 118700 89250
or Thymoma
or Thymoma with Lung & Pericardial Resection
or Thymoma with Lung Resection
or Thymoma with Pericardial & Lung Resection +
Vascular Repair
or Thymoma with Pericardial Resection
3027 OP4062 Robotic lobectomy 313830 156920 125530 94150
3028 OP4063 Robotic mediastinal LN sampling 123740 61880 49510 37120
3029 OP4066 Robotic PMT excision 295250 147630 118100 88580
3030 OP4061 Robotic pneumonectomy 313830 156920 125530 94150
3031 OP4064 Robotic Radical thymectomy for MG or 295250 147630 118100 88580
small/non‐invasive Thymoma
3032 OP4023 Sinus Excision Chest 75590 37790 30230 22680
3033 OP4016 Sternal Resection Partial with (reconstruction Prolene 272100 136050 108840 81630
Mesh &/or Methyl Methacrylate plate) with Muscle
flap
3034 OP4015 Sternal Resection Partial with Methyl methacrylate 205440 102720 82180 61640
plate reconstruction
3035 OP4014 Sternal Resection Partial with Prolene mesh 186760 93390 74710 56030
reconstruction
3036 OP4082 Sternal Resection Total with Methyl methacrylate 264140 132070 105650 79230
plate reconstruction
3037 OP4017 Sternal Resection Total with Prolene Mesh 240120 120070 96050 72040
reconstruction
3038 OP4018 Sternal Resection Total with reconstruction (Prolene 325460 162730 130180 97640
Mesh &/or Methyl methacrylate plate) with Muscle
flap reconstruction
3039 OP1289 Thoracic pneumonectomy 104780 52400 41920 31440
3040 OP4020 Thoracoplasty 132340 66170 52940 39700
3041 OP4506 Thoracoscopic Blebectomy 87150 43580 34910 26250
3042 OP0577 Thoracoscopic decortication 289430 144710 115770 86840
3043 OP0596 Thoracoscopic excision of bronchogenic cyst of lung 284820 142410 113940 85450
3044 OP0581 Thoracoscopic fenestration of pericardium for 66710 33350 26680 20010
pericardial effusion
3045 OP0578 Thoracoscopic lobectomy 289700 144850 115880 86910
3046 OP0579 Thoracoscopic lung nodule excision 86000 43000 34400 25800
3047 OP0580 Thoracoscopic mediastinal lymph node biopsy 95210 47610 38080 28570
3048 OP1429 Thoracoscopic mediastinal tumour excision 272540 136270 109010 81760
3049 OP0582 Thoracoscopic pneumonectomy 289700 144850 115880 86910
3050 OP0590 Thoracoscopic removal of hydatid cyst of lung 284820 142410 113940 85450
3051 OP0595 Thoracoscopic segmental resection of lung 139310 69660 55720 41800
3052 OP4509 Thoracoscopic Segmentectomy 226590 113300 90770 68250
3053 OP0584 Thoracoscopic thymectomy 111000 55500 44390 33300
3054 OP4507 Thoracoscopic Wedge Resection 52290 26150 20950 15750
3055 OP1416 Thoracotomy & decortication of lung 241190 120590 96470 72360
3056 OP1427 Thoracotomy & evacuation of hematoma 62580 31290 25030 18770
3057 OP1428 Thoracotomy & lobectomy 241410 120700 96560 72420
3058 OP1418 Thoracotomy & mediastinal lymph node biopsy 39190 19590 15680 11750
194
3059 OP4021 Thoracotomy & Pericardial window construction 142160 71070 56870 42640
3060 OP1420 Thoracotomy & pneumonectomy 241410 120700 96560 72420
3061 OP0458 Thoracotomy & segmental resection of lung 116120 58050 46450 34840
3062 OP0463 Thoracotomy and excision of bronchogenic cyst of 237370 118680 94950 71210
lung
3063 OP0462 Thoracotomy and excision of dermoid cyst of lung 93830 46910 37530 28150
3064 OP0461 Thoracotomy and excision of hydatid cyst of lung 237370 118680 94950 71210
3065 OP0459 Thoracotomy and re‐exploration for bleeding 86000 43000 34400 25800
3066 OP1422 Thoracotomy for anterolateral decompression 93830 46910 37530 28150
3067 OP0460 Thoracotomy for penetrating injury chest 113560 56780 45420 34070
3068 OP0457 Thoracotomy, pleurectomy & excision of 170560 85280 68220 51170
emphysematous bullae
3069 OP3034 Thoroscopic lung bullectomy 204650 102320 81860 61390
3070 OP1423 Thymectomy ( open ) 227120 113560 90850 68130
3071 OP4071 Tracheal stenosis ‐ resection + EEA 213440 106720 85380 64030
3072 OP4072 Tracheal tumour ‐ resection + EEA 234790 117390 93910 70430
3073 OP4070 Tracheotomy and Foreign body removal 39310 19660 15720 11800
3074 OP4058 Transaxillary First Rib Resection in Thoracic Outlet 170560 85280 68220 51170
Syndrome
3075 OP4045 VATS biopsy of mediastinal mass 95210 47610 38080 28570
3076 OP4508 VATS Debridement of Empyema Thoracic 104580 52290 41900 31500
3077 OP4518 VATS Diaphragmatic Plication 198700 99350 79600 59850
3078 OP4003 VATS Diaphragmatic rupture repair 227980 113990 91190 68390
3079 OP4024 VATS ligation of Thoracic duct for Chylothorax 237370 118680 94950 71210
3080 OP4040 VATS Lobectomy + Mediastinal LN dissection 318660 159340 127470 95600
3081 OP4033 VATS lung biopsy 95210 47610 38080 28570
3082 OP4004 VATS Pleural Biopsy (under GA) 53360 26680 21350 16010
3083 OP4077 VATS Pleural Biopsy (under LA) 48030 24010 19200 14410
3084 OP4007 VATS Pleurodesis (Mechanical/Talc) 58700 29350 23490 17610
3085 OP4005 VATS pleurodesis (under GA) 58700 29350 23490 17610
3086 OP4078 VATS pleurodesis (under LA) 53360 26680 21350 16010
3087 OP4054 VATS PMT excision 272540 136270 109010 81760
3088 OP4046 VATS Radical thymectomy for MG or 272540 136270 109010 81760
small/non‐invasive Thymoma
3089 OP4006 VATS removal of foreign body chest 284820 142410 113940 85450
3090 OP4059 VATS resection of Cervical rib for Thoracic outlet 204650 102320 81860 61390
syndrome
3091 OP4057 VATS Tracheo‐esophageal fistula repair 227980 113990 91190 68390
3092 OP4319 VATS/ thoracoscopic drainage of empyema ‐ Paed 87320 43660 34920 26200
3093 OP4520 Video Assisted Mediastinoscopic Lymphadenectomy 209160 104580 83790 63000
Urology
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

3094 OP1489 Augmentation cystoplasty 124700 62350 49880 37410
3095 OP2316 Auto‐augmentation cystoplasty 114300 57150 45720 34290
3096 OP1431 Balloon dialation of ureter 32280 16140 12920 9680
3097 OP4429 Balloon Dilatation of PUJ 39690 19850 15880 11910
3098 OP0097 Bladder diverticulectomy ( bilateral ) 105540 52760 42210 31670
3099 OP1244 Bladder diverticulectomy ( unilateral ) 70380 35200 28160 21120
3100 OP4182 Bladder Injury repair 37350 18680 14940 11200
3101 OP1432 Bladder neck incision ( BNI ) 48950 24480 19580 14690
3102 OP4427 Bladder Rupture Repair Major 35280 17640 14110 10580
195
3103 OP4428 Bladder Rupture Repair Minor 19030 9510 7610 5710
3104 OP4173 Boari Flap Repair 120070 60030 48030 36020
3105 OP4441 Botulinum Toxin Injection Bladder 45800 22900 18320 13730
3106 OP3019 Change of PCN tube 17860 8940 7140 5360
3107 OP1262 Chordee correction 55130 27560 22050 16540
3108 OP1434 Circumcision 22510 11260 9010 6760
3109 OP3018 Closure of ureterostomy 17860 8940 7140 5360
3110 OP1435 Closure of urethral fistula 48030 24010 19200 14410
3111 OP0359 Corporo‐cavernosal penile shunt 26000 13000 10400 7790
3112 OP1438 Cystocopy with retrograde catheterisation ‐ bilateral 25050 12530 10020 7520
3113 OP1437 Cystocopy with retrograde ureteric catheterisation ‐ 20370 10190 8150 6110
unilateral
3114 OP1440 Cystoscopic stent removal 13760 6880 5500 4130
3115 OP1253 Cystoscopy 14200 7100 5680 4250
3116 OP1252 Cystoscopy and fulguration of posterior uretheral 57330 28670 22930 17200
valves
3117 OP1436 Cystoscopy with bladder biopsy 20370 10190 8150 6110
3118 OP4183 Cystoscopy with Clot Evacuation 21350 10670 8540 6410
3119 OP4178 Cystoscopy with Retrograde pyelography ‐ RGP ( 42690 21350 17070 12810
Bilateral )
3120 OP4177 Cystoscopy with Retrograde pyelography ‐ RGP ( 21350 10670 8540 6410
Unilateral )
3121 OP1290 De‐torsion and fixation of involved testis 43060 21540 17220 12930
3122 OP4179 Diagnostic Ureteroscopy 32010 16010 12810 9610
3123 OP1441 Dilatation of stricture urethra 14550 7280 5820 4370
3124 OP1485 Dismembered pyeloplasty ( Anderson Hynes ) 117150 58580 46860 35140
3125 OP3017 Dorsal slit of prepuce 17860 8940 7140 5360
3126 OP1443 Double J stent placement in ureter ‐ bilateral 45400 22700 18150 13620
3127 OP1442 Double J stent placement in ureter ‐ unilateral 28470 14240 11390 8550
3128 OP1257 Ectopic vesicae ‐ bladder turn in 91150 45580 36460 27340
3129 OP2314 Endoincision of ureteric stricture 48950 24480 19580 14690
3130 OP2315 Endopyelotomy 60220 30110 24090 18070
3131 OP1444 Endoscopic removal of stone in bladder ‐ 48510 24260 19400 14550
Cystolitholapaxy
3132 OP1446 Endoscopic teflon injection ‐ bilateral 48950 24480 19580 14690
3133 OP1445 Endoscopic teflon injection ‐ unilateral 31210 15600 12480 9360
3134 OP4167 Epididymectomy 38040 19020 15210 11410
3135 OP1487 Epispadias reconstruction / repair 80040 40030 32010 24010
3136 OP0263 Epispadias with ectopic vesicae ‐ complete repair 133400 66710 53360 40030
3137 OP1488 Extended pyelolithotomy ( Gil Vernet ) 114300 57150 45720 34290
3138 OP4168 Fournier's Gangrene 53360 26680 21350 16010
3139 OP4160 Fracture Penis repair 106720 53360 42690 32010
3140 OP4162 Graft repair of Peyronies Disease 100410 50210 40160 30120
3141 OP1258 Hemi‐nephroureterectomy ( open ) 108640 54320 43460 32590
3142 OP4170 High Orchidectomy 53360 26680 21350 16010
3143 OP4425 Hormonal Therapy injection for Cancer Prostate 6620 3310 2650 1980
3144 OP1496 Hydrocele sac eversion / excision ‐ bilateral 45200 22610 18080 13570
3145 OP1497 Hydrocele sac eversion / excision ‐ unilateral 32090 16040 12830 9630
3146 OP1263 Hypospadias MAGPI 44100 22050 17640 13230
3147 OP1261 Hypospadias second stage correction 77440 38720 30990 23230
3148 OP4426 Impacted Foley's Removal 8820 4410 3530 2650
3149 OP0358 Laparoscopic excision of bladder diverticulum 62600 31300 25040 18770
3150 OP0268 Laparoscopic lymphatic disconnection for chyluria 83690 41840 33470 25110
3151 OP0362 Laparoscopic partial cystectomy 80040 40030 32010 24010
3152 OP0266 Laparoscopic pyeloplasty 117150 58580 46860 35140
3153 OP0361 Laparoscopic radical cystectomy 146750 73370 58700 44030
196
3154 OP0270 Laparoscopic radical prostatectomy 153430 76710 61360 46030
3155 OP0357 Laparoscopic renal cyst de‐roofing 78260 39120 31300 23470
3156 OP0570 Laparoscopic transperitoneal simple nephrectomy 97640 48810 39050 29300
3157 OP0267 Laparoscopic ureteric re‐implantation 97640 48810 39050 29300
3158 OP0573 Laparoscopic varicocelectomy ‐ bilateral 51620 25810 20650 15490
3159 OP0574 Laparoscopic varicocelectomy ‐ unilateral 37550 18770 15020 11270
3160 OP1174 Laparoscopic ventri‐suspension ( Burch's 80040 40030 32010 24010
colposuspension )
3161 OP0356 Laparoscopic, transperitoneal partial nephrectomy 125530 62770 50210 37660
3162 OP0269 Laparoscopic, transperitoneal radical nephrectomy 106720 53360 42690 32010
3163 OP4433 Lumber Sinus Excision 105840 52920 42340 31750
3164 OP3180 Marshalls Marchetti Kantz ( MMK ) Open 58700 29350 23490 17610
colposuspension
3165 OP4586 Mitomycin C intilation 4840 2420 1936 1452
3166 OP4320 Mitrofanoff's (appendicovesicostomy) 82470 41230 32990 24740
3167 OP1462 Nephrectomy ( open ) 80550 40280 32210 24170
3168 OP0264 Nephrolithotomy 70980 35490 28390 21290
3169 OP0116 Nephro‐pyelolithotomy 70980 35490 28390 21290
3170 OP4155 Nephroureterectomy 125530 62770 50210 37660
3171 OP4430 Nesbit Procedure greater than 2cm 30870 15440 12350 9260
3172 OP1461 Open pyelolithotomy 70380 35200 28160 21120
3173 OP1273 Optical internal uretherotomy ( OIU ) 48950 24480 19580 14690
3174 OP1451 Orchidectomy ‐ bilateral 48950 24480 19580 14690
3175 OP1452 Orchidectomy ‐ unilateral 41850 20930 16740 12560
3176 OP1453 Orchidopexy for undescended testis ‐ bilateral 62600 31300 25040 18770
3177 OP1454 Orchidopexy for undescended testis ‐ unilateral 48950 24480 19580 14690
3178 OP1456 Palomo?s operation for varicocele ‐ unilateral 29900 14950 11960 8980
3179 OP1455 Palomos operation for varicocele ‐ bilateral 41850 20930 16740 12560
3180 OP4442 Para Phimosis Reduction 8820 4410 3530 2650
3181 OP0363 Partial amputation of penis 44680 22330 17870 13410
3182 OP1491 Partial nephrectomy ( open ) 119510 59760 47810 35860
3183 OP1486 PCNL 95940 47970 38380 28790
3184 OP1460 PCNL ( second stage ) 48010 24000 19200 14400
3185 OP2313 Penile frenuloplasty 11140 5570 4450 3340
3186 OP4159 Penile Implant 133400 66710 53360 40030
3187 OP1498 Penile venous ligation 51900 25960 20760 15570
3188 OP1458 Percutaneous nephrostomy ( PCN ) 34420 17210 13770 10330
3189 OP4431 Peri Nephric Abscess Drainage Open 88200 44100 35280 26460
3190 OP4432 Peri Nephric Abscess Drainage Pigtail like PCN 31290 15650 12520 9390
3191 OP1459 Perineal urethrostomy 32010 16010 12810 9610
3192 OP0262 Photo vaporisation of prostate ( Laser prostatectomy ) 80040 40030 32010 24010
3193 OP4161 Plication for Peyronies Disease 69370 34680 27750 20810
3194 OP1295 Prepucioplasty 22510 11260 9010 6760
3195 OP4164 Priapism ( Major ) 80040 40030 32010 24010
3196 OP4163 Priapism ( Minor ) 64030 32010 25610 19200
3197 OP0265 Prophylactic orchidopexy for prevention of torsion 37550 18770 15020 11270
3198 OP4184 Radical Cystectomy with Neobladder 181310 90660 72520 54400
3199 OP1495 Radical cystectomy with urinary diversion 153430 76710 61360 46030
3200 OP1490 Radical nephrectomy ( open ) 111570 55790 44630 33470
3201 OP1472 Reimplantation of ureter ( ureteroneocystostomy ) ‐ 93390 46690 37350 28010
unilateral
3202 OP0098 Reimplantation of ureter ( ureteroneocystostomy ) 106720 53360 42690 32010
with bladder diverticulectomy ‐ unilateral
3203 OP1492 Reimplantation of ureters ( ureteroneocystostomy ) ‐ 133400 66710 53360 40030
bilateral
197
3204 OP0002 Reimplantation of ureters ( ureteroneocystostomy ) 146750 73370 58700 44030
with bladder diverticulectomy ‐ bilateral
3205 OP0113 Repair of distal hypospadias ‐ single stage correction 88200 44100 35280 26460
3206 OP1259 Repair of hypospadias with large fistula 55130 27560 22050 16540
3207 OP0112 Repair of hypospadias with multiple fistulae 66150 33080 26460 19850
3208 OP1260 Repair of hypospadias with small fistula 44100 22050 17640 13230
3209 OP1264 Repair of proximal hypospadias ‐ single stage 125860 62930 50340 37760
correction
3210 OP4175 Retrograde intrarenal surgery ( RIRS ) for Kidney 97020 48510 38810 29110
3211 OP4174 Retrograde intrarenal surgery ( RIRS ) for ureter 72770 36380 29110 21830
3212 OP0572 Retroperitoneoscopic ureterolithotomy 74270 37130 29700 22280
3213 OP1447 Scrotal exploration 34420 17210 13770 10330
3214 OP4172 Scrotal Sebaceous Cysts 42690 21350 17070 12810
3215 OP4169 Scrotoplasty 53360 26680 21350 16010
3216 OP1463 Seminal vasiculogram ( SVG ) 21590 10790 8630 6470
3217 OP1464 Seminal vasiculogram ( SVG ) + Vasoepididymal 70380 35200 28160 21120
anastomosis ( VEA ) ‐ bilateral
3218 OP1465 Seminal vasiculogram ( SVG ) + Vasoepididymal 48950 24480 19580 14690
anastomosis ( VEA ) ‐ unilateral
3219 OP4176 Stage II Ureterenoscopy ( URS ) 32010 16010 12810 9610
3220 OP3090 Subinguinal varicocelectomy ‐ bilateral 51180 25590 20480 15360
3221 OP3089 Subinguinal varicocelectomy ‐ unilateral 37290 18650 14920 11190
3222 OP1439 Suprapubic cystolithotomy 37550 18770 15020 11270
3223 OP1468 Suprapubic trocar cystostomy ( SPC ) 28620 14310 11450 8590
3224 OP1187 Tension free vaginal tape insertion ( TVT ) for urinary 40970 20490 16380 12300
incontinence
3225 OP1466 Testicular biopsy 14550 7280 5820 4370
3226 OP4171 Testicular Implant 53360 26680 21350 16010
3227 OP0364 Total amputation of penis 94050 47020 37620 28210
3228 OP1069 Total amputation of penis with block dissection ? 156360 78180 62550 46910
bilateral
3229 OP1068 Total amputation of penis with block dissection ? 105540 52760 42210 31670
unilateral
3230 OP1467 Transurethral resection of bladder tumour ( TURBT ) 80040 40030 32010 24010
3231 OP0360 Trucut prostatic biopsy in OT 9060 4540 3620 2720
3232 OP1469 TURP 80040 40030 32010 24010
3233 OP1470 TURP & TUR(BT) 106720 53360 42690 32010
3234 OP1471 TURP + cystolithotripsy ( CLT ) 106720 53360 42690 32010
3235 OP4156 Ureterocalicostomy 120070 60030 48030 36020
3236 OP4434 Ureterocoele Incision U/L 44100 22050 17640 13230
3237 OP1478 Ureterolithotomy 62600 31300 25040 18770
3238 OP1493 Ureterolysis for retroperitoneal fibrosis ( IRPF ) ‐ 114300 57150 45720 34290
bilateral
3239 OP1474 Ureterolysis for retroperitoneal fibrosis ( IRPF ) ‐ 86000 43000 34400 25800
unilateral
3240 OP1475 Ureteroscopic removal of stone ( URS ) 67910 33960 27160 20370
3241 OP4435 Ureteroscopy Biopsy 43090 21550 17240 12930
3242 OP1269 Uretheral meatal dilatation 7850 3930 3140 2360
3243 OP1448 Uretheral meatoplasty 14860 7430 5940 4450
3244 OP1270 Uretheral meatotomy 9880 4940 3950 2960
3245 OP1476 Uretheroplasty ‐ first stage 48030 24010 19200 14410
3246 OP1477 Uretheroplasty ‐ second stage 53360 26680 21350 16010
3247 OP4438 Urethral Caruncle 22050 11030 8820 6620
3248 OP4439 Urethral Diverticulum 22050 11030 8820 6620
3249 OP4440 Urethrectomy 22050 11030 8820 6620
3250 OP1494 Urethroplasty ‐ single stage procedure 103900 51950 41570 31160
3251 OP4158 Urethroplasty for PIDD 133400 66710 53360 40030
198
3252 OP4436 Urethroplasty I Stage 20280 10140 8120 6090
3253 OP4437 Urethroplasty II Stage 21550 10770 8620 6470
3254 OP4157 Urethroplasty with Buccal Mucosa 133400 66710 53360 40030
3255 OP1433 Urinary catheterisation 8680 4350 3480 2600
3256 OP1479 Vasectomy 9260 4630 3710 2780
3257 OP1480 Vasectomy reversal ‐ bilateral 88200 44100 35280 26460
3258 OP1481 Vasectomy reversal ‐ unilateral 66150 33080 26460 19850
3259 OP1293 Vesicostomy 28640 14320 11460 8590
3260 OP4180 Vesicovaginal Repair ( Abdominal approach ) 106720 53360 42690 32010
3261 OP4181 Vesicovaginal Repair ( Vaginal approach ) 106720 53360 42690 32010
Varicose Vein Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
3262 OP4211 Endovenous ablation of varicose veins ‐ Bilateral 170750 85380 68300 51220
3263 OP4210 Endovenous ablation of varicose veins ‐ Unilateral 149420 74710 59770 44820
3264 OP3461 Foam sclerotherapy for varicose veins 53360 26680 21350 16010
3265 OP2912 High ligation, stripping & multiple avulsions for LSV 73190 36590 29270 21960
varicose veins ‐ bilateral
3266 OP0286 High ligation, stripping & multiple avulsions for LSV 64500 32250 25800 19350
varicose veins ‐ unilateral
3267 OP2913 High ligation, stripping & multiple avulsions for 73190 36590 29270 21960
Recurrent LSV varicose veins ‐ bilateral
3268 OP0289 High ligation, stripping & multiple avulsions for 64500 32250 25800 19350
Recurrent LSV varicose veins ‐ unilateral
3269 OP3246 Laser ablation of varicose veins in OT (Bilateral) 170750 85380 68300 51220
3270 OP3245 Laser ablation of varicose veins in OT (Unilateral) 149420 74710 59770 44820
3271 OP2916 Multiple avulsions for varicose veins ‐ bilateral 73190 36590 29270 21960
3272 OP0288 Multiple avulsions for varicose veins ‐ unilateral 64500 32250 25800 19350
3273 OP2914 Sapheno ‐ popliteal junction ligation for Recurrent SSV 73190 36590 29270 21960
varicose veins ‐ bilateral
3274 OP0290 Sapheno ‐ popliteal junction ligation for Recurrent SSV 64500 32250 25800 19350
varicose veins ‐ unilateral
3275 OP2915 Sapheno ‐ popliteal junction ligation for SSV varicose 73190 36590 29270 21960
veins ‐ bilateral
3276 OP0287 Sapheno ‐ popliteal junction ligation for SSV varicose 64500 32250 25800 19350
veins ‐ unilateral
Vascular Access Operations
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

3277 OP0308 Chemoport insertion 40030 20010 16010 12000
3278 OP0309 Chemoport removal 26680 13350 10670 8000
3279 OP4203 Duplex guided central venous line insertion 18680 9330 7480 5600
3280 OP0310 Hickman line insertion 40030 20010 16010 12000
3281 OP0311 Permacath placement / insertion 40030 20010 16010 12000
199
Vascular Bypass Grafting
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
3282 OP0218 Aorto ‐ Bifemoral bypass using synthetic graft 165420 82710 66170 49620
3283 OP2917 Aorto ‐ femoral bypass using synthetic graft 165420 82710 66170 49620
3284 OP0231 Axillary ‐ brachial bypass using synthetic graft 129010 64510 51610 38710
3285 OP0232 Carotid ‐ axillary bypass using synthetic graft 137550 68780 55020 41270
3286 OP4189 Carotid carotid bypass using synthetic graft 165420 82710 66170 49620
3287 OP4188 Carotid subclavian bypass using synthetic graft 165420 82710 66170 49620
3288 OP0220 Common iliac ‐ bifemoral bypass graft 129010 64510 51610 38710
3289 OP0219 Common iliac ‐ bilateral external iliac bypass graft 129010 64510 51610 38710
3290 OP4186 Complex aorto bifemoral bypass 218780 109390 87520 65640
3291 OP4185 Complex aorto femoral bypass 218780 109390 87520 65640
3292 OP4190 Complex axillo distal bypass 218780 109390 87520 65640
3293 OP4191 Complex Femoro ‐ popliteal ( above knee ) bypass 218780 109390 87520 65640
using reversed LSV
3294 OP4192 Complex Femoro ‐ popliteal ( below knee ) bypass 218780 109390 87520 65640
using reversed LSV
3295 OP4193 Complex Femoro ‐ popliteal above knee bypass using 218780 109390 87520 65640
synthetic graft
3296 OP4194 Complex Femoro ‐ popliteal above knee bypass using 218780 109390 87520 65640
synthetic graft intervening vein collar
3297 OP4196 Complex iliodistal bypass 218780 109390 87520 65640
3298 OP0223 External iliac ‐ common femoral bypass graft 137550 68780 55020 41270
3299 OP0224 Extra ‐ anatomical (extra‐peritoneal) femoro ‐ femoral 165420 82710 66170 49620
bypass graft
3300 OP0237 Extra ‐ anatomical axillo ‐ bifemoral bypass using 129010 64510 51610 38710
synthetic graft
3301 OP0238 Extra ‐ anatomical axillo ‐ femoral bypass using 129010 64510 51610 38710
synthetic graft
3302 OP0236 Extra ‐ anatomical bilateral axillo ‐ femoral bypass 129010 64510 51610 38710
using synthetic graft
3303 OP0235 Extra ‐ anatomical bilateral subclavian ‐ femoral 129010 64510 51610 38710
bypass using synthetic graft
3304 OP0233 Extra ‐ anatomical subclavian ‐ bifemoral bypass using 129010 64510 51610 38710
synthetic graft
3305 OP0234 Extra ‐ anatomical subclavian ‐ femoral bypass using 129010 64510 51610 38710
synthetic graft
3306 OP1504 Femoro ‐ popliteal ( above knee ) bypass using 165420 82710 66170 49620
reversed LSV
3307 OP0214 Femoro ‐ popliteal ( below knee ) bypass using 165420 82710 66170 49620
reversed LSV
3308 OP0225 Femoro ‐ popliteal above knee bypass using synthetic 165420 82710 66170 49620
graft
3309 OP0226 Femoro ‐ popliteal above knee bypass using synthetic 165420 82710 66170 49620
graft intervening vein collar
3310 OP0227 Femoro ‐ popliteal below knee bypass using synthetic 165420 82710 66170 49620
graft
3311 OP0228 Femoro ‐ popliteal below knee bypass using synthetic 165420 82710 66170 49620
graft intervening vein collar
3312 OP4195 Femoro distal bypass 218780 109390 87520 65640
3313 OP3021 Graft thrombectomy 111590 55800 44640 33480
3314 OP0585 Laparoscopic assisted aorto‐distal vascular 86000 43000 34400 25800
anastomosis
3315 OP0586 Laparoscopic assisted ilio‐distal vascular anastomosis 86000 43000 34400 25800
200
3316 OP0217 Popliteal ‐ anterior tibial bypass using reversed LSV 137550 68780 55020 41270
3317 OP0216 Popliteal ‐ posterior tibial bypass using reversed LSV 137550 68780 55020 41270
3318 OP0313 Re‐exploration for bleeding at vascular anastomotic 34420 17210 13770 10330
site
3319 OP0312 Removal of infected graft 41080 20540 16430 12330
3320 OP0222 Retroperitoneal, common iliac to common femoral 129010 64510 51610 38710
bypass graft
3321 OP0221 Retroperitoneal, common iliac to external iliac bypass 129010 64510 51610 38710
graft
3322 OP4187 Robotic aortic bypass 344180 172080 137670 103250
3323 OP0215 SFA ‐ popliteal bypass using reversed LSV 137550 68780 55020 41270
3324 OP0230 Subclavian ‐ brachial bypass using synthetic graft 129010 64510 51610 38710
3325 OP0229 Subclavian ‐ subclavian cross neck bypass using 165420 82710 66170 49620
synthetic graft
Vascular Embolectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
3326 OP0351 Brachial embolectomy ‐ primary closure 165420 82710 66170 49620
3327 OP0352 Brachial embolectomy ‐ PTFE patch closure 165420 82710 66170 49620
3328 OP0353 Brachial embolectomy ‐ vein patch closure 165420 82710 66170 49620
3329 OP4199 Brachial embolectomy with endarterectomy 218780 109390 87520 65640
3330 OP2920 Femoral embolectomy ‐ primary closure ( bilateral ) 224110 112060 89650 67230
3331 OP0345 Femoral embolectomy ‐ primary closure ( unilateral ) 165420 82710 66170 49620
3332 OP2919 Femoral embolectomy ‐ PTFE patch closure ( bilateral ) 224110 112060 89650 67230
3333 OP0346 Femoral embolectomy ‐ PTFE patch closure ( unilateral 165420 82710 66170 49620
)
3334 OP2921 Femoral embolectomy ‐ vein patch closure ( bilateral ) 224110 112060 89650 67230
3335 OP0347 Femoral embolectomy ‐ vein patch closure ( unilateral 165420 82710 66170 49620
)
3336 OP4200 Femoral embolectomy with endarterectomy 218780 109390 87520 65640
3337 OP4212 Fluoroscopic guided peripheral embolectomy 165420 82710 66170 49620
3338 OP4241 Fluoroscopic guided peripheral embolectomy with 218780 109390 87520 65640
endarterectomy
3339 OP0348 Popliteal embolectomy ‐ primary closure 165420 82710 66170 49620
3340 OP0349 Popliteal embolectomy ‐ PTFE patch closure 165420 82710 66170 49620
3341 OP0350 Popliteal embolectomy ‐ vein patch closure 165420 82710 66170 49620
3342 OP4201 Popliteal embolectomy with endarterectomy 218780 109390 87520 65640
Vascular Endarterectomy
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

3343 OP0282 Brachial endarterectomy with PTFE patch plasty 149420 74710 59770 44820
3344 OP0283 Brachial endarterectomy with vein patch plasty 186760 93390 74710 56030
3345 CEPDC Carotid endarterectomy ADD ON for cardiac surgery ‐ Within Package
amount given to surgeon from within the package
3346 OP0271 Carotid endarterectomy with primary closure 186760 93390 74710 56030
3347 OP0246 Carotid endarterectomy with PTFE patch plasty 186760 93390 74710 56030
3348 OP0272 Eversion carotid endarterectomy 149420 74710 59770 44820
3349 OP0276 Femoral endarterectomy with PTFE patch plasty 149420 74710 59770 44820
201
3350 OP0277 Femoral endarterectomy with vein patch plasty 149420 74710 59770 44820
3351 OP4197 Graft exploration and endarterectomy 165420 82710 66170 49620
3352 OP0275 Iliac endarterectomy with PTFE patch plasty 149420 74710 59770 44820
3353 OP0280 Popliteal endarterectomy with PTFE patch plasty 149420 74710 59770 44820
3354 OP0281 Popliteal endarterectomy with vein patch plasty 149420 74710 59770 44820
3355 OP0278 SFA endarterectomy with PTFE patch plasty 149420 74710 59770 44820
3356 OP0279 SFA endarterectomy with vein patch plasty 149420 74710 59770 44820
3357 OP0284 Subclavian endarterectomy with PTFE patch plasty 149420 74710 59770 44820
3358 OP0285 Subclavian endarterectomy with vein patch plasty 149420 74710 59770 44820
Vascular Injury Repair
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite
3359 OP3446 Anterior tibial artery / vein repair by vein graft ‐ large 80040 40030 32010 24010
defect
3360 OP3445 Anterior tibial artery / vein repair by vein graft ‐ small 53360 26680 21350 16010
defect
3361 OP0274 Carotid artery repair (post traumatic) ‐ primary 165420 82710 66170 49620
closure
3362 OP0273 Carotid artery repair (post traumatic) using PTFE patch 165420 82710 66170 49620
3363 OP4198 Explantation of infected graft with vascular repair 165420 82710 66170 49620
3364 OP0330 Exploration & repair of axillary arterial injury ‐ primary 165420 82710 66170 49620
repair
3365 OP0332 Exploration & repair of axillary arterial injury ‐ using 218780 109390 87520 65640
vein graft
3366 OP0331 Exploration & repair of axillary arterial injury ‐ using 165420 82710 66170 49620
vein patch
3367 OP0333 Exploration & repair of brachial arterial injury ‐ 165420 82710 66170 49620
primary repair
3368 OP0335 Exploration & repair of brachial arterial injury ‐ using 165420 82710 66170 49620
vein graft
3369 OP0334 Exploration & repair of brachial arterial injury ‐ using 165420 82710 66170 49620
vein patch
3370 OP0342 Exploration & repair of carotid arterial injury ‐ primary 165420 82710 66170 49620
repair
3371 OP0344 Exploration & repair of carotid arterial injury ‐ using 165420 82710 66170 49620
vein graft
3372 OP0343 Exploration & repair of carotid arterial injury ‐ using 165420 82710 66170 49620
vein patch
3373 OP0324 Exploration & repair of femoral arterial injury ‐ 165420 82710 66170 49620
primary repair
3374 OP0326 Exploration & repair of femoral arterial injury ‐ using 218780 109390 87520 65640
vein graft
3375 OP0325 Exploration & repair of femoral arterial injury ‐ using 165420 82710 66170 49620
vein patch
3376 OP0321 Exploration & repair of iliac arterial injury ‐ primary 165420 82710 66170 49620
repair
3377 OP0323 Exploration & repair of iliac arterial injury ‐ using vein 218780 109390 87520 65640
graft
3378 OP0322 Exploration & repair of iliac arterial injury ‐ using vein 165420 82710 66170 49620
patch
3379 OP0327 Exploration & repair of popliteal arterial injury ‐ 165420 82710 66170 49620
primary repair
3380 OP0329 Exploration & repair of popliteal arterial injury ‐ using 218780 109390 87520 65640
vein graft
202
3381 OP0328 Exploration & repair of popliteal arterial injury ‐ using 165420 82710 66170 49620
vein patch
3382 OP0336 Exploration & repair of radial arterial injury ‐ primary 165420 82710 66170 49620
repair
3383 OP0338 Exploration & repair of radial arterial injury ‐ using 218780 109390 87520 65640
vein graft
3384 OP0337 Exploration & repair of radial arterial injury ‐ using 165420 82710 66170 49620
vein patch
3385 OP0339 Exploration & repair of subclavian arterial injury ‐ 165420 82710 66170 49620
primary repair
using vein graft
using vein patch
3388 OP0314 Exploration and ligation for bleeding due to traumatic 40030 20010 16010 12000
(unnamed) arterial injury
3389 OP3440 Other artery / vein repair by vein graft ‐ large defect 80040 40030 32010 24010
3390 OP3439 Other artery / vein repair by vein graft ‐ small defect 53360 26680 21350 16010
3391 OP3444 Posterior tibial artery / vein repair by vein graft ‐ large 80040 40030 32010 24010
defect
3392 OP3443 Posterior tibial artery / vein repair by vein graft ‐ small 53360 26680 21350 16010
defect
3393 OP3442 Ulnar artery / vein repair by vein graft ‐ large defect 80040 40030 32010 24010
3394 OP3441 Ulnar artery / vein repair by vein graft ‐ small defect 53360 26680 21350 16010
3395 OP4202 Vascular repair for hemostasis 133400 66710 53360 40030
Vertebral Fusion
OT Day Care
Single Bed
Premium/
2 Bedded
4 Bedded
Cat‐1D
Cat‐2
Cat‐3
Suite

3396 OP2069 C1 ‐ C2 vertebral fusion 163390 81700 65350 49010
3397 OP2070 C1 ‐ C2 vertebral screw fixation 163390 81700 65350 49010
3398 OP2071 Odontoid screw fixation 163390 81700 65350 49010
3399 OP2073 Posterior cervico ‐ occipital vertebral fusion 180550 90270 72220 54170
3400 OP2072 Trans‐oral odontoid screw and posterior fixation 170230 85110 68090 51070
203
Ophthalmology Procedure Charges

1 AUTOPERID Automated Perimetery ( Double eyed patient ) 1950 1170
2 AUTOPERIO Automated Perimetery ( One eyed patient ) 980 590
3 DIARETSCR Diabetic retiniopathy screening in OPD 210 130
4 ULTRASOAB Eye Ultrasonography A & B scan 1790 1070
5 ULTRASOB Eye Ultrasonography B scan 1070 640
6 ULTRASONA Eye Ultrasonography Biometeric A scan 720 430
7 HOSSS Lee's screen charting 740 440
8 ORTHOE Orthoptic exercise 80 50
9 RORTHO Refraction and Orthoptic checkup 80 50
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 2200 2200 2200 2200 2200 2200
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 ) 880 670 440 440 520 310
3 BUSIP Biodex Unweighing System ( Inpatient 880 740 440 440
Physiotherapy )
4 EMGBIOIP EMG Biofeedback ( Inpatient Physiotherapy 880 740 440 440
)
5 GTIP Gait Trainer ( Inpatient Physiotherapy ) 880 740 440 440
6 MOTOMED Motomed 740 580 290 290 440 260
7 PYCPMEIP Physiotherapy ‐ continuous passive 810 440 370 370
mobilisation exercises ( CPM ) ‐ for
inpatients
8 PYESTIP Physiotherapy ‐ electrical stimulation 810 440 370 370
therapy ‐ for inpatients
9 PYECLTIP Physiotherapy ‐ electronic cervical / lumbar 810 440 370 370
traction ‐ for inpatients
10 PYELIP Physiotherapy ‐ exercise ( long ) ‐ for 880 580 440 440
inpatients
11 PYESIP Physiotherapy ‐ exercise ( short ) ‐ for 740 370 290 290
inpatients
12 PYITIP Physiotherapy ‐ interferential therapy ‐ for 740 440 370 370
inpatients
13 PYLTIP Physiotherapy ‐ laser therapy ‐ for 740 440 370 370
inpatients
14 PYLWDIP Physiotherapy ‐ long wave diathermy ‐ for 740 440 370 370
inpatients
15 PYMPDIP Physiotherapy ‐ microwave / pulsed 740 440 370 370
diathermy ‐ for inpatients
204
16 PYMHPCIP Physiotherapy ‐ moist hot packs / 580 290 230 230
cryotherapy ‐ for inpatients
17 PYTMIDT Physiotherapy ‐ more than 3 modalities ( 10 7030 4210
days package ) ‐ outpatients
18 PY3MIP Physiotherapy ‐ more than three modalities 1180 880 440 440
‐ for inpatients
19 PYPWBIP Physiotherapy ‐ paraffin wax bath ‐ for 580 290 230 230
inpatients
20 PYSWDIP Physiotherapy ‐ short wave diathermy ‐ for 580 290 230 230
inpatients
21 PYTTTIP Physiotherapy ‐ tilt table therapy ‐ for 670 440 370 370
inpatients
22 PYUTIP Physiotherapy ‐ ultrasonic therapy ‐ for 520 290 230 230
inpatients
23 PYPCCD Physiotherapy package charge following 2050 1320 810 810
caesarean delivery / Surgery
24 PYPCND Physiotherapy package charge following 1320 810 580 580
normal delivery
Physiotherapy Opd Tests Charges
GOPD
POPD
25 BSOP7 Balance System ( Outpatient Physiotherapy) ‐ 7 Visits 3660 2200
26 BSOP1 Balance System ( Outpatient Physiotherapy) ‐ Single Visit 580 350
27 BUSOP14 Biodex Unweighing System ( Outpatient Physiotherapy ) ‐ 14 Visits 7330 4390
30 BUSOP1 Biodex Unweighing System ( Outpatient Physiotherapy ) ‐ Single Visit 580 350
31 CMPOP30 CPM ( Outpatient ) ‐ 30 Visits 7330 4390

32 CMPOP14 CPM ( Outpatient Physiotherapy ) ‐ 14 Visits 4390 2630
33 CMPOP7 CPM ( Outpatient Physiotherapy ) ‐ 7 Visits 2200 1320
34 CMPOP1 CPM ( Outpatient Physiotherapy ) – Single Visit 370 230
35 EMGBIOOP EMG Biofeedback ( Outpatient Physiotherapy ) ‐ 14 Visits 7330 4390

14
30
7
38 EMGBIOOP EMG Biofeedback ( Outpatient Physiotherapy ) ‐ Single Visit 580 350
1
39 GTOP14 Gait Trainer ( Outpatient Physiotherapy ) ‐ 14 Visits 7330 4390
40 GTOP30 Gait Trainer ( Outpatient Physiotherapy ) ‐ 30 Visits 14640 8790
41 GTOP7 Gait Trainer ( Outpatient Physiotherapy ) – 7 Visits 3660 2200
205
42 GTOP1 Gait Trainer ( Outpatient Physiotherapy ) ‐ Single Visit 580 350
43 PHYTAPE Kineso Taping 260 150

44 CAOTH Occupational Therapy ‐ Consultation and 520 310
Asssessment
45 LEXOTHE Occupational Therapy ‐ Long Exercise 580 350
46 SEXOTHE Occupational Therapy ‐ Short Exercise 370 230
47 PHYANC4 Physiotheraphy Antenatal Classes ( 4 Visits ) 1330 1330
48 PHYANC1 Physiotheraphy Antenatal Classes ( Per Visit) 370 370
49 PYCASOP Physiotherapy ‐ consultation and assessment charges ‐ outpatients 580 350
50 PY3MOP Physiotherapy ‐ more than three modalities 810 480

‐ outpatients
51 PHYELOPD Physiotherapy exercise (long) ‐ outpatients 580 350
52 PHYESOPD Physiotherapy exercise (short) ‐ outpatients 370 230
53 PHYFSMOD Physiotherapy first & second modality ‐ outpatients 520 310
54 PHYFSMOD Physiotherapy first & second modality ( 10 day package ) ‐ outpatients 4390 2630

10
55 PHYFMOD Physiotherapy first modality ‐ outpatients 290 180
56 PHYFMOD1 Physiotherapy first modality ( 10 day package ) ‐ outpatients 2640 1580
0
57 PHYFSTMO Physiotherapy first, second & third modality 740 440
D ‐ outpatients
58 PHYFSTMO Physiotherapy first, second & third modality 5640 3390
D10 ( 10 day package ) ‐ outpatients
59 PHYCBCOS Physiotherapy charges for Care of back clinic
PHYCONCBC Physiotherapy Care of back clinic ‐ consultant charges 520
PHYCHA Physiotherapy speciality clinic ‐ department charges 520 370
60 PHYHCOS Physiotherapy charges for Hand clinic
PHYCONHC Physiotherapy Hand Clinic ‐ consultant charges 520
61 PHYSPCLCH Physiotherapy charges for Rheumatoid arthritis
clinic
PHYCON Physiotherapy ‐ Rheumatoid arthritis clinic ‐ consultant 520
charges
Physiotherapy Package
GOPD
POPD

62 PHYELOPD1 Physiotherapy exercise (long) ‐ outpatients 5420 3260
0 ‐ ( 10 day package )
63 PHYELOPD5 Physiotherapy exercise (long) ‐ outpatients 2780 1670
‐ ( 5 day package )

206
Health Check‐up Program

Comprehensive Cardiac Check‐up
SNo Code Description HCP
1 HCP‐CCC Comprehensive Cardiac Check‐up with TMT & ECHO ( Package ) 6200
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
2 ADDEHCCOMP Add on for EHC ‐ Comprehensive Breast Imaging Package ‐ Complete
EHCCOMPLETE Add on for Eexecutive Health ‐ Complete 1470
MBRANGS BRCA 1 and 2 gene analysis (BY NGS) 31500
BRULTMAM Breast Ultrasound ( Mammography )
MMCOBR2D3DMRI Comprehensive breast imaging package bilateral (2D + 3D Mammography + Breast MRI) ‐ MRI 12000
MMCOBR2D3D Comprehensive breast imaging package bilateral (2D + 3D Mammography + Breast MRI) ‐ X‐Ray 3600
3 ADDEHCTOMO Add on for EHC ‐ Tomosynthesis ( 2D + 3D Mammography ) ‐ Advanced
ADDEHC2D3DM Add on for EHC ‐ Advanced 1050
MAMMBT3D Breast Tomosynthesis (3D Mammography) 3600
4 ADDR2DMOS Add on for EHC ‐ Routine (2D Mammography) – Basic
ADDEHC Add on for EHC ‐ Basic 530
MAMMOP Mammography (bilateral) ( Xray dept charges ) 2100
5 EHCCOMPOS Add on for EHC ‐ Comprehensive Breast Imaging Package
ADDEHC2D3DM Add on for EHC – Advanced 1050
MMCOBR2D3DMRI Comprehensive breast imaging package bilateral (2D + 3D Mammography + Breast MRI) – MRI 12000
MMCOBR2D3D Comprehensive breast imaging package bilateral (2D + 3D Mammography + Breast MRI) ‐ X‐Ray 3600

6 EHCHYPEROS HYPERTENSION PROFILE ‐ EXECUTIVE HEALTH CHECKUP 6960

CBC CBC ‐ Complete blood count
EHCHP EHC ‐ Hypertension profile
ECHPATHC EHC ‐ Patient handling charges
GTT6 Glucose F + Glucose PP ( 75 g Glucose )
LIPP Lipid Profile
RENPP Renal Biochemical Profile ‐ Complete
7 EHCINFOS EHC ‐ INFECTION SCREENING 4010

207
EHCIS EHC ‐ Infection Screening
HBSAG HBsAg ( Australia antigen )
HCV Hepatitis C virus serology antibody test
HIV HIV antibody test
RCULTUREVAS Routine culture and sensitivity ( Vaginal swab )
VDRL RPR
8 EHCLUNGOS PULMONARY (CHEST) CHECK UP ‐ EXECUTIVE HEALTH CHECKUP 10490

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 )
T3T4TSH Thyroid Profile ( T3, T4, TSH )
CHOL Total Cholesterol
CHAP Xray chest AP
PNSWAT Xray paranasal sinus Waters view
9 EHCMIGROS HEADACHE/MIGRANE ‐ EXECUTIVE HEALTH CHECKUP 5740

CTHP CT head (plain)
EHCHMIG EHC ‐ Headache/Migrane
RENPI Renal Biochemical Profile ‐ Basic (BUN,Creat,Ca,PO,4,Na,K,Bicarbonate)
TSH TSH (Nuclear)
VB12 Vitamin B 12 ( B12 )
10 EHCNEUROS NEUROPATHY PROFILE‐ EXECUTIVE HEALTH CHECKUP 6770

EHCNEUP EHC ‐ Neuropathy Profile
GLYCOHA Glycosylated Haemoglobin ( HbA1c )
NCV NCV / NCS ( Nerve conduction velocity / study )
208
LIPP Lipid Profile
PROST Prostatic Specific Antigen ( PSA )
SPIROM Spirometery
WA URIA Ultrasound whole abdomen & pelvis ( Adult )
URINERE Uric Acid
CHAP Urine examination ( Routine / Microscopy )
Xray chest AP
11 EHCOBOS EHC‐ Screening for obesity 9730

PEPTIDE C ‐ Peptide Test
EHCSCOB EHC ‐ Obesity
INSULINFPP Insulin Level ( Fasting + PP )
LIPP Lipid Profile
FSH Serum FSH ( Random )
LH Serum LH ( Random )
SPROLAC Serum Prolactin
URIA Uric Acid
12 EHCOSTEOS EHC ‐ OSTEOPOROSIS PLAN 10770

25OHVIT 25‐OH VIT D Level (Nuclear RIA)
ALKP Alkaline Phosphatase ( ALP )
ANTICPP Anti CCP ( Immunoscan R A )
CALC Calcium
HS CRP ( HS ) High Sensitivity C‐Reactive Protein
BD2 DEXA Three Site bone densitometry
EHCOSP EHC ‐ Osteoporosis Plan
HMYT Homocysteine
PHOS Phosphorus
URIA Uric Acid
13 EHCPLSOS EHC ‐POLYCYSTIC OVARIAN SYNDROME/ACNE 8890

DHEAS Dehydroepiandrosterone Sulfate ( DHEA‐S )
EHCPOSA EHC ‐ Polycystic Ovarian Syndrome/Acne
LIPP Lipid Profile
TESTF Testesterone (Free)
TESTT Testesterone (Total)
209
14 EHCPREPACOB EHC ‐ PRE/PAC OBESITY SURGERY 22200

PEPTIDE C ‐ Peptide Test
CPST Coagulation profile screening (PT / APTT/ TT / CBC / PS )
EHCPREPOBSUR EHC ‐ Preop/Pac obesity surgery
FERI Ferritin
FACID Folic Acid
HBSAG HBsAg ( Australia antigen )
HCV Hepatitis C virus serology antibody test
HIV HIV antibody test
INSULINFPP Insulin Level ( Fasting + PP )
LIPP Lipid Profile
IRON Serum Iron
LH Serum LH ( Random )
SPIROM Spirometery
SECHOOS Stress Echo (Echo Deparment)
URIA Uric Acid
CHAP Xray chest AP
15 EHCVITPOS EHC ‐ VITAMIN PROFILE 4060

EHCVTP EHC ‐ Vitamin Profile
FACID Folic Acid
16 HCPBJFOS HCP ‐ BONE & JOINT CONSULTATION FEMALE 10040

HANA Anti nuclear antibodies ( ANA ) ‐ WITH Barcode
CALC Calcium
HS CRP ( HS ) High Sensitivity C‐Reactive Protein
EHCBJC EHC ‐ Bone & Joint Consultation
PHOS Phosphorus
PTH PTH Level
RF Rheumatoid factor ‐ RF ( blood )
URIA Uric Acid
210
17 HCPBJMOS HCP ‐ BONE & JOINT CONSULTATION MALE 8840
CALC Calcium
CBC HS CBC ‐ Complete blood count
EHCBJC CRP ( HS ) High Sensitivity C‐Reactive Protein
ECHPATHC EHC ‐ Bone & Joint Consultation EHC
GLYCOHA ‐ Patient handling charges
PHOS Glycosylated Haemoglobin ( HbA1c )
PTH RF Phosphorus
T3T4TSH PTH Level
URIA Rheumatoid factor ‐ RF ( blood )
Thyroid Profile ( T3, T4, TSH )
Uric Acid
18 HCP‐CC Executive Health Check‐up with TMT ( Package ) 4620

BUN BUN
HCP3 Executive Health Check‐up
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
URIA Uric Acid
19 HCPMENOPOS HCP ‐ MENOPAUSAL PLAN 19620

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
LBC Vaginal / cervical cytology by liquid base cytology ( LBC )
20 HCPMHCOS HCP ‐ MALE HEALTH CHECKUP 13670

211
BUN BUN
EHCMHC EHC ‐ Male health profile
FACID Folic Acid
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
SMAG Magnesium
SPIROM Spirometery
STOB Stool Occult blood
URIA Uric Acid
HCP1 Whole Body Check‐up
21 HCPTHYOS HCP ‐ THYROID PLAN 4950

EHCTHY EHC ‐ Thyroid Plan
T3T4 Free T3 / Free T4
TANTIBODIES Thyroid Antibodies ‐ Nuclear Medicine
TSH TSH (Nuclear)
SPT Ultrasound thyroid
22 HCPWOMENOS HCP ‐ HEALTH CHECKS FOR WOMEN 10830

CA125 CA 125
EHCHCWOM EHC ‐ Health checks for women
HPVDNAH HPV‐DNA ( High Risk ) Cervical Sample
LIPP Lipid Profile
CHAP Xray chest AP
212
23 HCP‐PRC Pre employment checkup ( Package ) 840
GLUR Glucose Random
HCP6 Pre Employment Check‐up
24 HCP‐RMC Routine Medical Check‐up ( Package ) 1580

BUN BUN
GLUF Glucose F
GLUP Glucose PP
HCP2 Routine Medical Check‐up
25 HCP‐SRC Sr. Citizen Health Check‐up ( Package for male ) 2840

BUN BUN
GLUF Glucose F
GLUP Glucose PP
HCP5 Sr. Citizen Health Check‐up
URIA Uric Acid
URINERE Urine examination ( Routine / Microscopy ) Xray chest
CHPA PA ( CXR )
213

26 HCP‐SRCF Sr. Citizen Health Check‐up ( Package for female ) 3260

BUN BUN
GLUF Glucose F
GLUP Glucose PP
HCP5 Sr. Citizen Health Check‐up
URIA Uric Acid
27 HCP‐WBCF Whole body check‐up with TMTand ECHO ( Package for female ) 8400

BUN BUN
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
SPIROM Spirometery
URIA Uric Acid
HCP1 Whole Body Check‐up
28 HCP‐WBCM Whole body check‐up with TMT and ECHO ( Package for male ) 9350

BUN BUN
GLUF Glucose F
GLUP Glucose PP
LIPP Lipid Profile
214
SPIROM Spirometery
URIA Uric Acid
CP1 Whole Body Check‐up
Miscellaneous Charges
Ambulance charges
SNo Code Description All Cat

1 CADCONCT Cardiac ambulance ‐ doctor charge (credited to hospital) 8400
‐ Outside NCT limits
2 CADCWNCT Cardiac ambulance ‐ doctor charge (credited to hospital) 1680
‐ Within NCT limits
3 NCPAONCT Neonatologist's charges for accompanying patient in 10000
ambulance ‐ outside NCT limits
4 NCPAWNCT Neonatologist's charges for accompanying patient in 6730
ambulance ‐ within NCT limits
5 PNCAPA Paediatrician / Neonatologist charges for accompanying 34950
patient in aeroplane
6 PCAPAONCT Paediatrician's charges for accompanying patient in 10000
ambulance ‐ Outside NCT limits
7 PCAPAWNCT Paediatrician's charges for accompanying patient in ambulance ‐ Within NCT 6730
limits
Diet Consultation Charges
SNo Code Description POPD GOPD IPD

8 DIET Diet Chart 320 50
9 DIETVC Dietician Visit Charges Cat 1 ‐ 210
Cat 2 ‐160
Cat 3 ‐ 110
Duplicate Bill Charges
SNo Code Description POPD GOPD All Cat

10 DUPBILL Duplicate bill charges 30 30 50
Laboratory Consultation charges
SNo Code Description POPD

11 BLCON Biochemistry consultation charges 1600
12 HLCON Haematology consultation charges 1600
13 MLCON Microbiology consultation charges 1200
NST charges
SNo Code Description All Cate

14 NSTFV NST ( first visit ) 260
15 NSTSV NST ( subsequent visit ) 210
215
OPD Card charges
SNo Code Description POPD GOPD All Cate

16 GOPDCFREE Free General OPD card 0 0
17 POPDCFREE Free Private OPD Card 0 0
18 GOPDCN General OPD registration (Rs. 100) for NEW cases 100
19 GOPDC General OPD registration (Rs.20) 20
20 GOPDSCONS General OPD Sticker alone ( NO CHARGE ) 0
21 HOMCARD Homeopathy opd registration charges (Registration 50
ONLY)
OPD Registration

22 HVCH Homeopathy Visit Charges Rs. 30 30
Other Charges

23 PARINFGUID Parent information guide NNU 120
Smart Card Registration Charges

24 SMARTREG Smart Card Registration Charges 150
25 SMARTSTICK Smart Card Sticker Only 25
ER
Telephone charges

26 TCP Telephone charges from patients 5
Dialysis machine usage charges
All Category
Cat 1B Suite
Cat 1A‐Pre/
Single Bed
2 Bedded
4 Bedded
Casualty
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
1 CRRTMPD CRRT ‐ use of machine (per day) 5780

2 SLEDDMPD SLEDD ‐ Use of machine (per day) 5780
FOB usage charges
3 AMBUVIDE AMBU Videoscope 3680
O
4 FOBUSCH Fiberoptic Bronchoscope (FOB) usage 890
charges
Image intensifier usage charges
5 INFCOTH Image intensifier fluroscopy for Ozone 740
Therapy (740 Rs)
6 IINPRP Image intensifier fluroscopy for pain 680
relief procedures in OT (680 Rs)
7 IIPROT Image intensifier fluroscopy in OT other 2100
than pain relief (2100 Rs.)
216
Infusion pump usage charges
8 EPCAPIHC Electronic PCA pump daily use ‐ Hospital 210
Charges
9 PICC Paediatric infusion pump usage charge 1270 640 450 450
Jaundice meter charges
10 JAUNMET Jaundice meter test charges 110 110
Laser machine usage charges
11 LAMCFC Endovascular Laser Ablation usage 17850 17850 17850 17850
charges (including laser fibre charges)
12 FOBCFC Fibre Optic Bronchoscopy ( FOB ) 1000
Medical monitor usage charges
13 CFM Cerebral Brain Functioning 950 740 470
14 PCRMC Paediatric cardio‐respiratory monitor 1580 790 580 420
charges
15 PPOC Paediatric pulse oximetry charges 1270 640 450 330
16 TCO2 Transcutaneous CO2 Monitor 1160 1050 950
Nebulisation charges
17 PNEBC Nebulisation charges 160 160 90 160
NIGS usage charges
18 NIGSUCH Navigation image guide system (NIGS) 3890 3890
Usage Charges
Nitric Oxide Therapy
19 NOTHCH Nitric Oxide Therapy Charges with 2630
intensive monitoring
OT machine usage charges
20 KUZA CUSA usage charges in OT 2520 2520
21 LMUC Liposuction machine usage charges 1260 1260 1260 630 1260 630
22 OTHOGC Ozone gas machine usage charges 630
23 RFEPCH Radiofrequency equipment procedures 630
charges
24 ULTCISI Ultracision Charges in OT 1260 1260
Oxygen therapy charges
25 CPAP CPAP / BiPAP usage per night 2520 1260 1260 630
26 POTCIM Paediatric oxygen therapy charges with 1220 610 430 300
intensive monitoring
Patient warmer usage charges
27 PWC Patient warmer charges 950 470 370 260
Phototherapy charges
28 PPTC Paediatric phototherapy charges 1700 850 610 430
Thromboelastography test charges
29 TEGHTC Thromboelastography ( TEG ) + 2310
Heparinase test charges
30 TEGTC Thromboelastography ( TEG ) test 1550
charges
217
Ureteroscope usage charges
31 FURESCOPE Flexible Ureteroscope usage charges 13130
Ventilator charges
32 BIPAPUCH Bipap usage charges per day ‐ Adult 2690 2690 2690 2690 2690
33 PVCICU Paediatric ventilator usage charges per 2460 2460 2460 2460
day (in PICU / NNU)
34 MICROVEN Ventilator usage charges per day ‐ Adult 2680 2680 2680 2680
TCHR
Packages
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
OS GENETIC EVALUATION
CHARGES)
AFGEDF Autopsy for foetal genetic evaluation ‐ 17760 17760 8880 7100 5330
Doctor fee
AFGEHC Autopsy for foetal genetic evaluation ‐ 1780 1780 890 710 530
hospital charges
2 AKAEPCA Above knee /above elbow
OS plaster cast application (Doctor
fee + Hospital Charges)
AKAEPCADF Above‐knee / above‐elbow plaster cast 9620 9620 4810 3850 2890 4810
application ‐ Doctor Fees
AKAEPCABSP Above‐knee / above‐elbow plaster cast 960 960 480 390 290 480
application ‐ Hospital Charges
3 BBDHCOS BEDSIDE FLEXIBLE
BRONCHOSCOPY (DOCTOR FEE
+ HOSPITAL CHARGES)
BRONHC Bedside bronchoscopy ‐ Additional hospital 1550 1550 780 620 470
charges
BRONDF Bedside bronchoscopy ‐ Doctor fees 15500 15500 7750 6200 4650
4 BEDFIOPL Bedside fibreoptic
AOS laryngoscopy (Doctor fee +
Hospital charges)
OP1000 Fibreoptic laryngoscopy 7380 7380 3690 2950 2210
FIBOPTLARHC Fibreoptic Laryngoscopy ‐ Hospital charges 740 740 370 300 220
5 BIDDHCO BEDSIDE INCISION &
S DRAINAGE (DOCTOR FEE +
HOSPITAL CHARGES)
IDHC Bedside incision & drainage ‐ Additional 1210 1210 600 480 360
hospital charges
IDDF Bedside incision & drainage ‐ Doctor fees 12060 12060 6030 4820 3620
6 BKBEPCA Below‐knee / Below‐elbow
OS plaster cast application ‐
(Doctor fee + Hospital Charges)
218
BKBEPCPDF Below‐knee / Below‐elbow plaster cast 7100 7100 3550 2840 2130
application ‐ Doctor Fees
BKBEPCPBSP Below‐knee / Below‐elbow plaster cast 710 710 360 280 210
application ‐ Hospital Charges
7 BLIGOS Band ligation of haemorrhoids
( bedside )
BLIGDC Band ligation of haemorrhoids ( bedside ) ‐ 12900 12900 6450 5160 3870
doctor charges
BLIGHC Band ligation of haemorrhoids ( bedside ) ‐ 1290 1290 650 520 390
Hospital charges
8 BMADHC BONE MARROW ASPIRATION
CHARGES)
BMAHC Bone marrow aspiration ‐ Additional 670 670 340 270 200
hospital charges
BMADF Bone marrow aspiration ‐ Doctor fees 6740 6740 3370 2700 2020
9 BMBADH BONE MARROW BIOPSY +
COS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
BMBAHC Bone marrow biopsy & aspiration ‐ 1210 1210 600 480 360
BMBADF Bone marrow biopsy & aspiration ‐ Doctor 12060 12060 6030 4820 3620
fees
10 BMBDHC BONE MARROW BIOPSY
CHARGES)
BMBHC Bone marrow biopsy ‐ Additional hospital 890 890 440 360 270
charges
BMBDF Bone marrow biopsy ‐ Doctor fees 8880 8880 4440 3550 2660
11 BOmAHA Bone marrow harvesting
ROS (Doctor fee + Hospital charges)
BOMARHARD Bone marrow harvesting ‐ doctor fee (if 46880 46880 23440 18750 14060
F done bedside)
BOMAHARHC Bone marrow harvesting ‐ hospital charges 4690 4690 2340 1880 1410
(if done bedside)
12 BOMATRB Bone Marrow Transplantation
EDOS (Doctor fee + Hospital Charges)
BOMATRBED Bone marrow transplantation procedure ‐ 213080 213080 106540 85230 63920
doctor fee (if done bedside)
BOMATRHC Bone marrow transplantation procedure ‐ 21310 21310 10650 8520 6390
hospital charges (if done bedside)
13 BSSDHCO BED SIDE SUTURING (DOCTOR
S FEE + HOSPITAL CHARGES)
BSSDF Bed side suturing ‐ Doctor fees 5860 5860 2930 2340 1760
BSSHC Bed side suturing ‐ Hospital Charges 590 590 290 230 180
14 BWDLOS Burn wound dressing LARGE ‐
Bedside Procedure
OP1318 Burn wound dressing ( large ) 42920 42920 21460 17160 12880
BWDLBSP Burn wound dressing large ‐ Bedside 4100 4100 2050 1640 1230
charges
15 BWDMIO Burn wound dressing MINOR ‐
S Bedside Procedure
OP1316 Burn wound dressing ( minor ) 17190 17190 8600 6890 5160
BWDMIBSP Burn wound dressing minor ‐ Bedside 1640 1640 820 660 490
charges
16 BWDMOS Burn wound dressing MEDIUM
‐ Bedside Procedure
OP1317 Burn wound dressing ( medium ) 25770 25770 12880 10310 7720
BWDMBSP Burn wound dressing medium ‐ Bedside 2460 2460 1230 980 740
charges
219
17 COMDHC CARDIAC OUTPUT
OS MONITORING BY THORACIC
BIO‐IMPEDANCE METHOD
CHARGES)
COMTBIDF Cardiac output monitoring by thoracic 20260 20260 10130 8100 6080
bio‐impedance method ‐ Doctor fee
COMTBIHC Cardiac output monitoring by thoracic 2030 2030 1010 810 610
bio‐impedance method ‐ hospital charges
18 CVLIDFHC CENTRAL VENOUS LINE
OS INSERTION (DOCTOR FEE +
HOSPITAL CHARGES)
CVLIHC Central venous line insertion ‐ Additional 1060 1060 530 430 320
hospital charges
CVLIDF Central venous line insertion ‐ Doctor fees 10640 10640 5320 4260 3190
USCCVLI Central Venous Line Insertion ‐ Ultrasound 210
Machine Usage Charges
19 DEBLARW Debridement ( large ) in ward
DOS (Doctor fee + Hospital charges)
DEBRIDEMEN Debridement ( large ) in ward ‐ doctor fee 25920 25920 12960 10370 7780
TL
DEBRIDEMEN Debridement ( large ) in ward ‐ hospital 2590 2590 1300 1040 780
TLH charges
20 DEBMED Debridement ( medium ) in
WDOS ward (Doctor fee + Hospital
Charges)
DEBRIDEMEN Debridement ( medium ) in ward ‐ doctor 17240 17240 8620 6900 5170
TM fee
DEBRIDEMEN Debridement ( medium ) in ward ‐ hospital 1720 1720 860 690 520
TMH charges
21 DEBSMW Debridement ( small ) in ward
D (Doctor fee + Hospital charges)
DEBRIDEMEN Debridement ( small ) in ward ‐ doctor fee 8500 8500 4250 3400 2550
T
DEBRIDEMEN Debridement ( small ) in ward ‐ hospital 850 850 430 340 260
TS charges
22 DMDFHC DRESSING IN WARD /
HOS DRESSING ROOM ( MAJOR )
CHARGES)
DWDMJAHC Dressing in ward / dressing room ( Major ) ‐ 1160 1160 580 470 350
DWDMJDF Dressing in ward / dressing room ( Major ) ‐ 11640 11640 5820 4660 3490
Doctor fee
23 DMIPDHC DRESSING IN WARD /
OS DRESSING ROOM (DOCTOR FEE
+ HOSPITAL CHARGES)
DWDMIAHC Dressing in ward / dressing room ‐ 640 640 320 260 190
DWDMIDF Dressing in ward / dressing room ‐ Doctor 6400 6400 3200 2560 1920
fee
24 DOCHERE HIGH DOSE CHEMOTHERAPY
OS AND RESCUE (Doctor fee +
Hospital Charges)
DOREDOCF HIGH DOSE CHEMOTHERAPY AND RESCUE ‐ 213080 213080 106540 85230 63920
Doctor Fee
HIDORFEOS HIGH DOSE CHEMOTHERAPY AND RESCUE ‐ 21300 21300 10660 8530 6390
Hospital Charges
25 DSSPCHD Diagnostic Sleep Studies
HCOS (Laboratory charges +
Professional charges)
DSSDF Diagnostic sleep studies ‐ Doctor fee 17760 17760 8880 7100 5330
DSSTC Diagnostic sleep studies test charges 14560 14560 7280 5820 4370
220
26 ECMODOS ECMO DIALY charges
ECMOPLSDDF ECMO DAILY charges ‐ Doctors fees 10500 8400 6300
ECMODHC ECMO DAILY charges ‐ Hospital Charges 1050 840 630
27 ECMOPLS ECMO initiation charges
OS (inlcudes PLS circuit & ECMO
cannula)
ECMOPLSDF ECMO initiation charges (includes PLS circuit 52500 42000 31500
and ECMO cannul ) ‐ Doctors fees
ECMOPLSHC ECMO initiation charges (includes PLS circuit 262500 262500 262500
and ECMO cannul ) ‐ Hospital Charges
Includes : First day Doctors fees, ECMO Planning, One PLS circuit, Placement of two central venous ultrasound guided/image internsifier guided cannulas, Setting up and priming the
circuit, Starting the ECMO, First 24 hours ECMO monitoring, If changing of ECMO circuit required, only cost of consumables will be charged extra at actual and no Doctors fees and
hospital charges will be billed, Other consumables, laboratory charges, Doctors consultation and other procedure fee will be charged extra as per prevailing schedule of charges.
28 EPANLAB Epidural analgesia for labour
OS patients
EAFLPDF Epidural analgesia for labour patient ‐ 8750 8750 4375 3500 2625
Doctor fees
EAFLPHC Epidural analgesia for labour patient ‐ 875 875 435 350 260
Hospital charges
29 EPBCORS Epidural block‐ Cervical ‐
HC (DOCTOR FEE + HOSPITAL
CHARGES)
OP0850 Cervical Epidural 12500 12500 6250 5000 3750
EPBCDHC Epidural block‐ Cervical ‐ Additional hospital 1300 1300 650 520 390
charges
30 EPBLTHOS EPIDURAL BLOCK THORACIC
DONE BEDSIDE (Doctor fee +
Hospital charges )
OP0851 Epidural block ( Thoracic ) 8640 8640 4320 3460 2590
EBTHOBC Epidural block ( Thoracic ) ‐ Hospital charges 860 860 430 350 260
31 FANCDFH Needle biopsy / FNAC (Doctor
CHOS fee + Hospital charges)
FNACHC FNAC / Needle biopsy ‐ Additional hospital 590 590 290 230 180
charges
FNACDF FNAC / Trucut needle biopsy ‐ Doctor fees 5860 5860 2930 2340 1760
32 HSSTDHC HORMONAL STIMULATION
HOS SUPPRESSION TEST (DOCTOR
HSSTHC Hormonal stimulation suppression test ‐ 590 590 290 230 180
HSSTDF Hormonal stimulation suppression test ‐ 5860 5860 2930 2340 1760
Doctor fees
33 IAIDHCHO INTRA ARTICULAR INJECTIONS
S OF STEROIDS /
HYALURONIDASE INTO SMALL
JOINT (DOCTOR FEE +
HOSPITAL CHARGES)
IAISSJHC Intra articular injections of steroids / 320 320 160 130 100
hyaluronidase into small joint ‐ Additional
hospital charges
IAISSJDF Intra articular injections of steroids / 3200 3200 1600 1280 960
hyaluronidase into small joint ‐ Doctor fees
34 IAISHDHC INTRA ARTICULAR INJECTIONS
HOS OF STEROIDS /
HYALURONIDASE INTO LARGE
JOINT (DOCTOR FEE +
HOSPITAL CHARGES)
IAISLJHC Intra articular injections of steroids / 530 530 270 210 160
hyaluronidase into large joint ‐ Additional
hospital charges
IAISLJDF Intra articular injections of steroids / 5340 5340 2670 2140 1600
hyaluronidase into large joint ‐ Doctor fees
35 ICDIDHCH INTERCOSTAL CHEST TUBE (
OS ICD ) INSERTION (DOCTOR FEE
+ HOSPITAL CHARGES)
221
ICDHC Intercostal chest tube ( ICD ) insertion ‐ 1490 1490 750 600 450
ICDDF Intercostal chest tube ( ICD ) insertion ‐ 14940 14940 7470 5980 4480
Doctor fees
36 ICDTTCOS ICD / Trachostomy tube
change IN WARD (DOCTOR FEE
+ HOSPITAL CHAGES)
ICDTCDF ICD / Trachostomy tube Change IN WARD 3900 3900 1950 1560 1170
(Doctor fees)
ICDTCHC ICD / Trachostomy tube Change IN WARD 390 390 200 160 120
(Hospital Charges)
37 INJSCLOS Injection sclerotherapy of
haemorrhoids / piles ( bedside)
INSCHDF Injection sclerotherapy of haemorrhoids / 12900 12900 6450 5160 3870
piles ( bedside) ‐ Doctor charges
INJSCLHAHC Injection sclerotherapy of haemorrhoids / 1290 1290 650 520 390
piles ( bedside) ‐ Hospital charges
38 IVPCOS IV / Peripheral cannulation IN
WARD (DOCTOR FEE +
HOSPITAL CHAGES)
IVPCDF IV / Peripheral cannulation IN WARD 3460 3460 1730 1380 1040
(Doctor fees)
IVPCHC IV / Peripheral cannulation IN WARD 350 350 170 140 100
(Hospital Charges)
39 JALDHCOS JOINT ASPIRATION ( LARGE )
CHARGES)
JALHC Joint aspiration ( large ) ‐ Additional hospital 590 590 290 230 180
charges
JALDF Joint aspiration ( large ) ‐ Doctor fees 5860 5860 2930 2340 1760
40 JASDHCH JOINT ASPIRATION ( SMALL )
CHARGES)
JASHC Joint aspiration ( small ) ‐ Additional hospital 380 380 190 150 110
charges
JASDF Joint aspiration ( small ) ‐ Doctor fees 3780 3780 1890 1510 1130
41 KBDHCHO KIDNEY BIOPSY (DOCTOR FEE +
S HOSPITAL CHARGES)
KBHC Kidney biopsy ‐ Additional hospital charges 1680 1680 840 670 500
KBDF Kidney biopsy ‐ Doctor fees 16800 16800 8400 6720 5040
42 LBDHCHO LIVER BIOPSY (DOCTOR FEE +
S HOSPITAL CHARGES)
LBHC Liver biopsy ‐ Additional hospital charges 1370 1370 680 550 410
LBDF Liver biopsy ‐ Doctor fees 14000 14000 7000 5600 4200
43 LPCSFDHC LUMBAR PUNCTURE / CSF
OS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
LPCSFDF Lumbar Puncture / CSF aspiration ‐ Doctor 8500 8500 4250 3400 2550
fees
LPCSFHC Lumbar Puncture / CSF aspiration ‐ hospital 850 850 430 340 260
charges
44 LSBOS Lumbar sympathetic block ‐
(Doctor fee + Hospital charges)
LSBBSP Lumbar sympathetic block ‐ Additional 1500 1500 750 600 450
Hospital Charges
OP0864 Lumbar sympathetic block ‐ Doctor fee 15000 15000 7500 6000 4500
45 MEFOS Manual evacuation of faeces
MEFDF Manual evacuation of faeces ‐ Doctor 11940 11940 5970 4780 3580
charges
MEOFHC Manual evacuation of faeces ‐ Hospital 1190 1190 600 480 360
charges
222
46 MNBDHC MUSCLE / NERVE BIOPSY (
HOS BEDSIDE ) (DOCTOR FEE +
HOSPITAL CHARGES)
MNBAHC Muscle / nerve biopsy ( bedside ) ‐ 1060 1060 530 430 320
MNBDF Muscle / nerve biopsy ( bedside ) ‐ Doctor 10640 10640 5320 4260 3190
fee
47 NMECHOS Neuro Monitoring Charges
NMECH Neuro Monitoring Electrode charges 16590
NMEQCH Neuro Monitoring Euipment charges 1600
48 NOSOS Nitrous Oxide Sedation
NOSCON Nitrous Oxide Sedation ‐ Consumables 1330
NOSDF Nitrous Oxide Sedation ‐ Doctor fee 7100 7100 3550 2840 2130
NOSHC Nitrous Oxide Sedation ‐ Hospital charges 710 710 360 280 210
49 NPDWDH NASAL PACKING ( DONE IN
CHOS WARD ) (DOCTOR FEE +
HOSPITAL CHARGES)
NPAHC Nasal packing ( done in ward ) ‐ Additional 1030 1030 520 410 310
hospital charges
NPDF Nasal packing ( done in ward ) ‐ Doctor fee 10320 10320 5160 4130 3100
50 OIBOS Oral Incisional biospy (bedside)
‐ Doctor fee + Hospital service
charges
OP1001 Oral incisional biopsy 9520 9520 4760 3810 2860
OIBBSP Oral incisional biopsy ‐ Hospital service 950 950 480 380 290
charges
51 OSBGSAM BLOOD GAS SAMPLING
PL (DOCTOR FEE + HOSPITAL
CHARGES)
DOCCHBGSA Charges for taking blood gas sample ‐ 5160 5160 2580 2060 1550
MP doctor charges
BSPCHBGSAM Charges for taking blood gas sample ‐ 520 520 260 210 160
P Hospital charges
52 OSVTAP Ventricular Tapping (bedside
procedure) (DOCTOR FEE +
HOSPITAL CHARGES)
HCVTAP Ventricular Tapping ( Bedside Procedure ) ‐ 1720 1720 860 690 520
Hospital charges
DOCHVTAP Ventricular Tapping ( Bedside Procedure ) 17180 17180 8590 6870 5150
Doctor charges
53 PACCLOS PULMONARY ARTERY
CATHERISATION ( SWAN GANZ
) IN CATH LAB
PACCLC Pulmonary artery catheterisation ( Swan 7950 7950 3970 3180 2380
ganz ) ‐ Cath lab charges
PACDF Pulmonary artery catheterisation ( Swan 18480 18480 9240 7390 5540
Ganz ) ‐ Doctor fee
54 PACOS PULMONARY ARTERY
CATHERISATION ( SWAN GANZ
) ‐ BEDSIDE
PACAHC Pulmonary artery catheterisation ( Swan 1850 1850 920 740 550
Ganz ) ‐ Additional hospital charges
55 PASPDHC PERICARDIAL TAPPING /
HOS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
PADF Pericardial aspiration ‐ Doctor fees 10320 10320 5160 4130 3100
PAHC Pericardial aspiration‐ hospital charges 1030 1030 520 410 310
223
56 PEPCLOS Pocket for endocardial
pacemaker under GA in Cath
lab
PEPCLAF Pocket for endocardial pacemaker under GA 16770 16770 8390 6710 5030
in Cath lab ‐ Anaesthetists charges
PEPCLCF Pocket for endocardial pacemaker under GA 22310 22310 11150 8930 6690
in Cath lab ‐ Cath Lab Charges
PEPCLSF Pocket for endocardial pacemaker under GA 55900 55900 27950 22370 16770
in Cath lab ‐ Surgeon fee
57 PERTDFHC Enzyme therapy infusion (
Doctor Fee + Hospital Charges )
PERTDF Enzyme therapy infusion ‐ Doctor fee 7820 7820 3910 3130 2350
PERTHF Enzyme therapy infusion ‐ Hospital charges 780 780 390 310 240
58 PGHDFHC Growth hormone stimulation
test ( Doctor fee + Hospital
Charges )
PGHDF Growth hormone stimulation test ‐ Doctor 7820 7820 3910 3130 2350 3910 3340
fee
PGHHC Growth hormone stimulation test ‐ Hospital 780 780 390 310 240 390
charges
59 PGSDDFH Glycogen storage disease
C stimulation test ( Doctor fee +
Hospital charges )
PGSDDF Glycogen storage disease stimulation test ( 7820 7820 3910 3130 2350 3910 3340
Doctor fee )
PGSDHC Glycogen storage disease stimulation test ( 780 780 390 310 240 390
Hospital charges )
60 PHLDHCO Phlebotomy (Doctor fee +
S Hospital charges)
PHLHC Phlebotomy ‐ Additional hospital charges 710 710 360 280 210
PHLDF Phlebotomy ‐ Doctor fees 7100 7100 3550 2840 2130
61 PIVGDFHC IVIG therapy ( Doctor fee +
Hospital Charges )
PIVGDF IVIG therapy ‐ Doctor Fee 7820 7820 3910 3130 2350 3180 3340
PIVGHC IVIG therapy ‐ Hospital charges 780 780 390 310 240 320
62 PLEDCHC PLEURODESIS ‐ BEDSIDE
HOS UNDER LA (DOCTOR FEE +
HOSPITAL CHARGES)
PLEHC Pleurodesis ‐ Additional hospital charges 590 590 290 230 180
PLEDF Pleurodesis ‐ Doctor fees 5860 5860 2930 2340 1760
63 PLGAOS Pleurodesis ‐ Bedside under GA
PLGAAF Pleurodesis ‐ Bedside under GA ‐ 1480 1480 740 590 440
Anaesthetists charges
PLGAHF Pleurodesis ‐ Bedside under GA ‐ Hospital 590 590 290 230 180
service charges
PLGASF Pleurodesis ‐ Bedside under GA ‐ Surgeon 5860 5860 2930 2340 1760
fee
64 PMINBOS Pulse monitoring infusion ‐
Non Biological ‐ (Doctor fee +
Hospital charges)
PMINBDF Pulse monitoring infusion ‐ Non Biological ‐ 5860 5860 2930 2340 1760
Doctor fee
PMINBHC Pulse monitoring infusion ‐ Non Biological ‐ 590 590 290 230 180
Hospital charges
65 PMIOS Pulse monitoring infusion ‐
Biological ‐ Doctor fee
PMIDF Pulse monitoring infusion ‐ Biological ‐ 16440 16440 8220 6580 4930
Doctor fee
PMIBHC Pulse monitoring infusion ‐ Biological ‐ 1640 1640 820 660 490
Hospital charges
224
66 PPDAOS Premie PDA clipping under GA
‐ Bedside
PPDAAF Premie PDA clipping ‐ Bedside under GA ‐ 50310 50310 25160 20120 15100
Anaesthetists charges
PPDAHF Premie PDA clipping ‐ Bedside under GA ‐ 16770 16770 8390 6710 5030
Hospital service charges
PPDASF Premie PDA clipping ‐ Bedside under GA ‐ 167710 167710 83850 67080 50320
Surgeon fee
67 PPDFHC Pamidronate infusion ( Doctor
fee + Hospital Charges )
PPDF Pamidronate infusion ‐ Doctor Fee 7820 7820 3910 3130 2350
PPHC Pamidronate infusion ‐ Hospital charges 780 780 390 310 240
68 PULPUSO Pigtail placement under usg
S guidance ‐ PULMONOLOGY
PULPUSGDF Pigtail placement under usg guidance ‐ 14700 14700 7350 5880 4410
Pulmonology Doctor Fee
PULPUSHC Pigtail placement under usg guidance ‐ 1470 1470 740 590 440
Pulmonology Hospital Charges
69 PULULTR Screening ultrasound of thorax
AOS ‐ PULMONOLOGY
PULULTRADF Screening ultrasound of thorax ‐ 2100 2100 1050 840 630
PULULTRAHC Screening ultrasound of thorax ‐ 210 210 110 80 60
70 PULUSGO Intercoastal tube drainge
S under usg guidance ‐
PULMONOLOGY
PULUSGDF Intercoastal tube drainge under usg 14700 14700 7350 5880 4410
guidance ‐ Pulmonology Doctor Fee
PULUSGHC Intercoastal tube drainge under usg 1470 1470 740 590 440
guidance ‐ Pulmonology Hospital Charges
71 SKBISHCH SKIN BIOPSY (DOCTOR FEE +
OS HOSPITAL CHARGES)
SBHC Skin biopsy ‐ Additional hospital charges 590 590 290 230 180 210
SBDF Skin biopsy ‐ Doctor fees 5860 5860 2930 2340 1760 2100 1260
72 SPCAOS Spica plaster cast application
SPCABSP Spica plaster cast application in ward ‐ 1670 1670 840 670 500
Bedside Procedure Chargers
SPCADF Spica plaster cast application in ward ‐ 16720 16720 8360 6690 5020
Doctor Fees
73 STADCHC SKULL TRACTION APPLICATION
HOS (DOCTOR FEE + HOSPITAL
CHARGES)
STAAHC Skull traction application ‐ Additional 1550 1550 770 620 460
hospital charges
STADF Skull traction application ‐ Doctor fee 15480 15480 7740 6190 4640
74 TAALVDH Ascites tapping / aspiration
COS done in WARD ( therapeutic ) ‐
large volume paracentesis
(doctor fee + hospital charges)
TAALVDF Therapeutic ascites aspiration ( large 6300 6300 3150 2520 1890
volume paracentesis ) ‐ Doctor fees
TAALVHC Therapeutic ascites aspiration ( large 630 630 320 250 190
volume paracentesis ) done in WARD ‐
75 TAASVPD Ascites tapping / aspiration ‐
HCOS small volume paracentesis
(doctor fee + hospital charges)
TAASVHC Therapeutic ascites aspiration ( small 590 590 290 230 180
volume paracentesis ) ‐ Additional hospital
charges
TAASVDF Therapeutic ascites aspiration ( small 5860 5860 2930 2340 1760
225
76 TARLOCO Target localisation in MRI / CT
S for stereotactic surgery
(Doctor fee + Hospital charges
+ Equipment charges)
STEEQUUSECH Stereotactic equipment usage charges 11320 11320 5660 4530 3400
TARLOCDF Target localisation in MRI / CT for 31980 31980 15990 12790 9590
stereotactic surgery ‐ doctor fee
TARLOCHC Target localisation in MRI / CT for 3200 3200 1600 1280 960
stereotactic surgery ‐ hospital charges
77 TBDHCHO TRACHEOSTOMY ( BEDSIDE )
S (DOCTOR FEE + HOSPITAL
CHARGES)
TRACDF Tracheostomy ( bedside ) ‐ Doctor fees 34440 34440 17220 13780 10330
TRACHC Tracheostomy ( bedside ) ‐ hospital charges 3440 3440 1720 1380 1030
78 TIVSOPOS Total Intra Venous Sedation (
TIVS ) ‐ OUTPATIENT
TIVSOP Total Intra Venous Sedation ( TIVS ) ‐ 3550 2130
OUTPATIENT
79 TIVSOS Total Intra Venous Sedation (
TIVS ) ‐ (Professional fee +
Hospital charges)
TIVSDF Total Intra Venous Sedation ( TIVS ) ‐ Doctor 7100 7100 3550 2840 2130
fee
TIVSHC Total Intra Venous Sedation ( TIVS ) ‐ 710 710 360 280 210
Hospital Charges
80 TPADCHC THERAPEUTIC PLEURAL FLUID
OS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
TPADF Therapeutic pleural aspiration ‐ Doctor fees 8200 8200 4100 3280 2460
TPFAHC Therapeutic pleural fluid aspiration ‐ 820 820 410 330 250
81 TPNSONS TPN CONSULTATION CHARGES
ULTOS (DOCTOR FEE + HOSPITAL
CHARGES)
TPNHOSCHRG TPN consultation ‐ Additional hospital 350 350 170 140 100
charges
TPNDOCFEE TPN consultation ‐ Doctor fee 3460 3460 1730 1380 1040
82 TRCRNDO Transcranial doppler (doctor
POS fee + hospital charges)
TRCRNDOPDF Transcranial doppler ‐ Doctor charges 7100 7100 3550 2840 2130 3240 1940
TRCRNDOPHC Transcranial doppler ‐ Hospital service 3540 3540 1770 1420 1060 1630 980
charges
83 UFCINOS Urinary Foleys catheterisation
IN WARD (Docter fee +
Hospital Charges)
UFCIW Urinary foley's catheterisation ‐ Hospital 950 950 480 380 290
Charges
UFCINDF Urinary Foley's catheterisation in ward ‐ 9500 9500 4750 3800 2850
Doctor Fees
84 VACBAS Vaccum assisted wound
closure ( VAC ) application
Bedside Procedure
VACBA Vaccum assisted would closure (VAC) 2450 2450 1230 980 740
application Bedside Procedure Charges
OP3421 Vaccum assisted wound closure ( VAC ) 25710 25710 12860 10300 7710
application

229
Cardiac Procedures
Cardiac rehabilitation charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
86 CARREHCH Cardiac Rehabilitation charges (Rs. 970
970)
87 CREOPPRCIP Cardiac Rehabilitation Heart 670 670 670
Failure Program for inpatients
88 CREOPPROH Cardiac Rehabilitation Heart 4000 4000
F Failure Program for outpatients
89 CREOPPRO1 Cardiac Rehabilitation outpatient 4000 4000
program ( one month )
program ( three month )
program ( two month )
92 CRPACABG Cardiac Rehabilitation Package 2670 2670 2670
after CABG
93 CRPAPTCA Cardiac Rehabilitation Package 1330 1330 1330
after PTCA
94 HYCRECH Hybrid Package rehabilitation 1050
Charge
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

95 ENDOBOS Endomyocardial Package
PostHeart Tx ‐ Package Charges
ENDOPKC Endomyocardial Package ‐ Package Charges 32000
97 HTPKOS HEART TRANSPLANT PACKAGE
HTPCH Heart Transplant Package Charges 2600000
99 IABPOS IABP INSERTION CARDIOLOGY
( Doctor fee + Hospital Charges)
IABPPC IABP INSERTION‐PACKAGE CHARGES 58000
100 IVUSOS IVUS (Doctor fee + Hospital
Charges )
IVUSPC IVUS ‐ Package Charges 34000
Heart transplant Package Includes :
 Stay up to 22 days.
 ICCU monitoring charges for 15 days
 Investigations limited to Rs. 190000/‐.
 Medicines limited to Rs. 180000/‐(including VAT)
 Consumables limited to Rs. 130000/‐(including VAT)
 Blood products limited to Rs. 80000/‐
 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).
230
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
OS CARDIAC (PACKAGE CHARGES
+ DOCTOR FEES)
HRADDCSPC High risk ADD ON for cardiac surgery 48000
package charges

All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
103 CABGOAD CABG (OFF PUMP) (PACKAGE
COS CHARGES + ALL DOCTOR FEES)
CABGOFFP CABG (off pump) package charges 421000 395000 358000 310000 240000
Package Includes :
 Stay up to 8 days including ICCU monitoring charges for 5 days
 Investigations limited to Rs. 15440/‐ in category 3 and Rs. 30870/‐ in other categories
 Blood Bank crossmatch charges.
 Cardiac Rehabilitation

Package Excludes :
 Cost of valve
 All Blood products.
 Cross references other than Cardiologist during package stay.
 Carotid Endarterectomy – Extra amount will be charged for this procedure, if required.
 Physiotherapy
 Intra‐aortic Balloon Pump (IABP) will be charged extra.
 All hospital charges for the stay beyond the package stay of 8 days.
 High Risk Surcharge will be charged extra in high risk cases.

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

105 CHSPCDC CLOSED HEART SURGERY
OS (PACKAGE CHARGES + ALL
DOCTOR FEES)
CHSPC Closed heart surgery package charges 230000 220000 190000 170000 135000
231
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

All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
107 HYBPACO HYBRID PROCEDURE PACKAGE
S (ALL CHARGES)
HYBPACHARG HYBRID PROCEDURE ‐ PACKAGE CHARGE 566000 530000 478000 422000 340000
E

Package Includes :
 In case of reexploration no separate charges for Cardiac Surgeon, Cardioligist & Anaesthetist.

Package Excludes :
 Cost of valve
 Swan Ganz Catheter, continuous cardiac output monitoring, Centrifugal pump
 Physiotherapy
 High Risk Surcharge will be charged extra iIn high risk cases.

232
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
108 OHSDHCH OPEN HEART SURGERY / CABG
OS (ON PUMP) (PACKAGE
CHARGES + ALL DOCTOR FEES)
OHSPC Open Heart Surgery/CABG (On Pump) 513000 455000 394000 354000 265000
package charges
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)

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

111 PPDHCHO PACEMAKER PROGRAMMING
S (PACKAGE CHARGES + DOCTOR
FEE)
PACEPROG Pacemaker Programming package charges 2420 2290 2160 1910 1650
112 TPPDHCH TEMPORARY PACEMAKER
OS PACKAGE CHARGES (PACKAGE
CHARGES + DOCTOR FEE)
TPPC Temporary pacemaker package charges 12200 11690 11180 9150 8390
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Day care
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

113 CARWITHI CARDIAC CATHETERISATION
NVOS WITH INVESTIGATION CATH
LAB (PACKAGE CHARGES +
DOCTOR FEE)
CARWITH CARDIAC CATHETERISATION WITH 37500 34500 27500 24500 17000 15000
INVESTIGATION PACKAGE CHARGES

233
Package includes :
 One day stay (day care stay for day care category)
 Routine Investigations
 Medicines limited to Rs. 1500/‐ (including VAT) and consumables limited to Rs. 1900/‐ (including VAT)
 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
114 PEASAOS PERICARDIAL ASPIRATION

(PACKAGE CHARGES + DOCTOR
FEE)
PRTION PERICARDIAL ASPIRATION ‐ Package 37600 37600 30000 25600 22900
charges
Includes Prof fees. and Hospital charges. All other charges towards medicines, medical consumables and investigations will be charged extra at actuals.
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
115 FFRPKCH FFR ‐ Packages charges 33000
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

117 CARCATET CARDIAC CATHETERISATION
IONOS WITHOUT INVESTIGATION
CATH LAB (PACKAGE CHARGES
+ DOCTOR FEE)
CARPACKN CARDIAC CATHETERISATION WITHOUT 32000 29900 22100 19000 14300 13000
INVESTIGATION PACKAGE CHARGES

Package includes :
 One day stay (day care stay for day care category)

Package excludes :
118 CEAONCS[ CAROTID ENDARTERECTOMY

DCOS ADD ON FOR CARDIAC
SURGERY (PACKAGE CHARGES
+ DOCTOR FEE)
CEADDCS Carotid endarterectomy ADD ON for cardiac 48300
surgery package charges
234
119 CESMAPD CARDIAC ELECTROPHYSIOLOGY
COS STUDIES (MAJOR) (PACKAGE
CESMPC Cardiac electrophysiology studies (Major) 44000 41900 39100 31200
package charges

Package includes :
 1 night stay including ICCU monitoring charges
 Medicines limited to Rs. 1000/‐.

Package excludes :
 All expenses for stay beyond the package period and not included above.
 Professional charges of other Consultants.
 Any other incidental procedures & investigations.
120 CESMIPDC CARDIAC ELECTROPHYSIOLOGY

OS STUDIES (MINOR) (PACKAGE
CELSMPC Cardiac electrophysiology studies (Minor) 26700 25700 24000 21500 20100
package charges
Package includes :
 1 night stay including ICCU monitoring charges

Package excludes :
121 CRAPDCO S CARDIAC RADIO FREQUENCY (

RF ) ABLATION (PACKAGE
CRAPC Cardiac radiofrequency ablation package 120000 110000 100000 85000 80000
charges
Package includes :
 Radio frequency ablation package includes 1 night stay including ICCU monitoring charges.
 Consumables limited to Rs. 8000/‐.

Package excludes :
 Additional medicines and consumables over and above the limit prescribed.
122 CRAPDCO COMPLEX CARDIAC RADIO

S3D FREQUENCY ( RF ) ABLATION
3D MAPPING (PACKAGE
CRAPC3D Comlex cardiac radiofrequency ablation 3D 419000 419000 364000 328000 287000
mapping package charges
Package includes :
 4 night stay including 1 day ICCU monitoring charges
 Medicines limited to Rs. 15000/‐, consumables limited to Rs. 150000/‐.
235

Package excludes :
123 IABPSPDC IABP ‐ ADD ON FOR CARDIAC

HOS SURGERY (PACKAGE CHARGES
+ DOCTOR FEE)
IABPSPC IABP ‐ ADD ON for cardiac surgery package 57750
charges

All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
125 ASDPDCO ASD / PDA / RSOU/ VSD
S CLOSURE (PACKAGE CHARGE
+ DOCTOR
ASDCPDACPC ASD closure/PDA closure with device ‐ 225000 195000 158000 132000 87000
package charges
Package Includes :
 Stay up to two days including 1 day ICCU monitoring charges
 Medicines limited to Rs. 10000/‐
 Medical consumables limited to Rs. 19000/‐

Package Excludes :
 Any additional charges other than included in the package.
 Any other incidental procedures.

Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Day care
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

126 CAPCDHC CORONARY ANGIOGRAPHY
OS WITHOUT INVESTIGATION
FEE)
CAWOPC Coronary angiography without investigation 32000 29000 21500 18500 14000 12500
package charges
127 CAWIPCH CORONARY ANGIOGRAPHY
DHCOS WITH INVESTIGATION
FEE)
CAWIPC Coronary angiography with investigation 37000 34000 27000 24000 16500 14500
package charges
236
128 CCAPPDC CHECK CORONARY
HOS ANGIOGRAM (PACKAGE
CCAPC Check coronary angiogram package charges 16940 15130 13200 12100 9680
Package includes :
 One day stay including ICCU monitoring charges.(day care stay for day care category)

Package excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
129 CAFRPDH CORONARY ANGIOPLASTY FOR
COS RESTENOSIS (PACKAGE
CAFSPC Coronary angioplasty for restenosis package 112040 103950 98180 90090 76230
charges
130 ECAWSPD ELECTIVE CORONARY
CHOS ANGIOPLASTY (PACKAGE
CHARGES + ALL DOCTOR FEE)
ECAWSPC Elective coronary angioplasty package charges 195000 180000 148000 135000 119000
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 of Rs. 5250/‐ will be charged extra.
 In complex cases, prof. fees of Rs. 10,500/‐ will be charged extra
 Additional investigations other than included in the package.
 Additional medicines and consumables over and above the limit prescribed.

237
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
133 EOTPCDC EMBOLISATION (PACKAGE
HOS CHARGES + DOCTOR FEE)
ETRHOMPC Embolisation package charges 62920 57200 51910 47190 42900
Package includes Professional fee and Cath Lab charges. Room rent and other charges will be billed at actual
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
134 EBOS ENDOMYOCARDIAL BIOPSY
FEE)
EBPC ENDOMYOCARDIAL BIOPSY PACKAGE 64000 60000 57000 52000 43000
CHARGES
Package Includes :
 Stay up to one day including ICCU monitoring charges.

Package Excludes :
 Cost of medicines and consumables
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

136 AICDIPDC AICD SINGLE CHAMBER
HOS IMPLANTATION PACKAGE (
AICDIPC AICD SINGLE CHAMBER IMPLANTATION 155000 144000 128000 115000 100000
PACKAGE ‐ Package Charges
Package Includes :
 Stay up to three days including ICCU monitoring charges for two days.
 Medicines limited to Rs. 7500/‐ (incldg VAT)

Package Excludes :
 Medicines over and above limit prescribed in package
238
137 BPIPCOS BIVENTRICULAR PACEMAKER
IMPLANTATION (PACKAGE
BPIPC BIVENTRICULAR PACEMAKER 195000 180000 155000 140000 120000
IMPLANTATION PACKAGE CHARGES
Package Includes :
 Stay up to five days including ICCU monitoring charges for three days.

Package Excludes :
138 CDAICDIPDC CRTD (PACKAGE CHARGES)

HOS
CDAICDIPC CRTD PACKAGECHARGES 216000 200000 176000 157000 135000
Package Includes :
 Stay up to five days including ICCU monitoring charges for three days.

Package Excludes :
139 DAICDIPD AICD DOUBLE CHAMBER

CHOS IMPLANTATION PACKAGE (
DAICDIPC AICD DOUBLE CHAMBER IMPLANTATION 175000 160000 145000 130000 112000
PACKAGE ‐ Package Charges
Package Includes :

Package Excludes :
239
141 LRIOS LOOP RECORDER
IMPLANTATION (PACKAGE
LRIPC LOOP RECORDER IMPLANTATION PACKAGE 64000 60000 57000 52000 43000
CHARGES

Package Includes :
 Stay for one day including ICCU monitoring charges.

Package Excludes :
 Cost of medicines and consumables
142 PDCPDHC PACEMAKER ‐ DOUBLE

HOS CHAMBER (PACKAGE CHARGES
+ DOCTOR FEE)
PDCPC Pacemaker ‐ double chamber package 125000 115000 103000 92000 80000
charges

Package Includes :

Package Excludes :
143 PSCPDHC PACEMAKER ‐ SINGLE

HOS CHAMBER (PACKAGE CHARGES
+ DOCTOR FEE)
PSCPC Pacemaker ‐ single chamber package 124000 113000 94000 83000 70000
charges

Package Includes :
 Stay up to three days including ICCU monitoring charges for one day.

Package Excludes :
240
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
145 IVCOS IVC FILTER DEVICE INSERTION
FEES)
IVCPC IVC Filter Device Insertion ‐ Package Charges 134290 134290 67150 53730 40280
Package includes Professional fee and Cath Lab charges. Room rent and other charges will be billed at actual
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
150 RAWIDHC RENAL / PERIPHERAL
HCOS ANGIOGRAPHY WITH
INVESTIGATIONS (PACKAGE
RAWIPC Renal angiography with investigations 34000 30000 23000 20000 14500
package charges

Package includes :

Package excludes :
151 RAWIODH RENAL / PERIPHERAL

CHCOS ANGIOGRAPHY WITHOUT
INVESTIGATIONS (PACKAGE
CHARGES + DOCTOR
RAWOIPC Renal angiography without investigations 30000 25000 18000 15000 12000
package charges

Package includes :

Package excludes :
241
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
152 ROTADA ROTABLATOR / DIRECTIONAL ‐
WAS ATHERCTOMY ( WITH
ANGIOLASTY & STENTING )
ROTAPKCH Rotablator / Directional atherectomy (with 236000 230000 222000 212000 191000
Angioplasty & stenting) ‐ Package charges

Package includes :
 Four days stay including ICCU monitoring charges 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
153 THTDFHC CORONARY/ PULMONARY
OS THROMBOLYTIC THERAPY
(DOCTOR FEES +
THTDF Coronary Thrombolytic Therapy ‐ Doctor
Fees 43400 43400 21700 17360 13020
THTHC CoronaryThrombolytic Therapy ‐ Hospital
charges
4340 4340 2170 1740 1300
Room rent and other charges will be billed at actual

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

154 CVPDCHO CARDIAC VALVOPLASTY (CATH
S LAB) (PACKAGE CHARGES +
DOCTOR FEE)
CVCPC Cardiac valvoplasty (Cath lab) package 108000 96000 87000 84000 70000
charges
Package includes :
 Two days stay including ICCU monitoring charges for 1 day

Package excludes :
242
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
154 PGREPOS CARDIAC PG REPLACEMENT
(CATH LAB) (PACKAGE
CHARGES +
Cardiac PG Replacement (Cath lab) 124000 113000 94000 83000 70000
package charges
Package includes :
 Three days stay including ICCU monitoring charges for 1 day
 Medicines limited to Rs. 7500/‐ (including VAT).

Package excludes :
 All Consumables

243
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
155 CSCLOS Cataract Surgery Crysta lens ‐
(PACKAGE CHARGES + ALL
DOCTOR FEES)
CATCRYSTA Cataract surgery package ‐ Crysta Lens 148000
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 VAT), consumables limited to Rs. 80000/‐(including VAT). 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.

156 CSMLAOS Cataract Surgery MULTI FOCAL
LENS ( Restor & Technis
Multifocal ) ‐ (PACKAGE
CATMFL Cataract surgery package ‐ Multi Focal Lens 76500
package charges
applicable rates.
157 CSPCHOS Cataract Surgery Package for

GOPD card holders ( with
Indian foldable lens) ‐
DOCTOR FEES)
CSPFINDIOLPC Cataract surgery package ( for GOPD 17000
patients ) ‐ with Indian foldable lense IOL
package charges
158 CSPIOLPD CATARACT SURGERY ‐ WITH
COS FOLDABLE IOL (PACKAGE
CSPNIOLPC Cataract surgery package ‐ with foldable IOL 29700
package charges
159 CSPWIOLP CATARACT SURGERY ‐
DCOS WITHOUT IOL (PACKAGE
CSPFIOLPC Cataract surgery package ‐ without IOL 25000
package charges
160 CSPWNFP CATARACT SURGERY ‐ WITH
DCOS NON‐FOLDABLE IOL (PACKAGE
CSPWNFIOLPC Cataract surgery package ‐ with 27000
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 VAT) for all packages and consumables limited to Rs. 3000/‐(including VAT) for Without IOL, Rs. 5000/‐(including
VAT) for Non Foldable IOL, Rs. 8200/‐(including VAT) for Foldable IOL and Rs. 3500/‐ (including VAT) 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.
244
161 CSTLOS Cataract Surgery TORIC LENS ‐
DOCTOR FEES)
CATTORIC Cataract surgery package ‐ Toric Lens 59000
package charges
applicable rates.
162 CSTLSYOS Cataract Surgery SYMFONY

LENS ‐ (PACKAGE CHARGES +
ALL DOCTOR FEES)
CATTORICSY Cataract surgery package ‐ Symfony Lens 88000
package charges
applicable rates.

163 CSTLSYTM Cataract Surgery MULTIFOCAL
FOS TORIC LENS ‐ (PACKAGE
CATTORICMF Cataract surgery package ‐ Multifocal Toric 97000
Lens package charges
applicable rates.
164 CSTLSYTO Cataract Surgery SYMFONY

S TORIC LENS ‐ (PACKAGE
CATTORICST Cataract surgery package ‐ Symfony Toric 111000
Lens package charges
applicable rates.
165 MICSOS Micro Incision Cataract Surgery

( including high viscosity visco
elastic ) ‐ (PACKAGE CHARGES
+ ALL DOCTOR FEES)
MICINCCATPK Micro Incision Cataract Surgery (Including 41500
high viscosity visco elastic) ‐ Package
Charges
Note: The above package includes stay in Day care room and includes Surgeon fees, Anaesthetist fees. Nursing care, diet charges, medicines
limited to Rs. 600/‐(including VAT) and consumables limited to Rs. 12000/‐(including VAT). 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.

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

167 AVEGFPC Anti VEGF injection (per eye) ‐ 18920 18920 18920 18920 18920
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

245
Cochlear Implantation Packages

All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
172 CIPBWRO COCHLEAR IMPLANTATION
S BILATERAL (WITH AUDIOLOGY‐
PACKAGE CHARGES + ALL
DOCTORS FEES
CIPCBS Cochlear implantation Bilateral (with 278000 240000 193000
audiology) ‐ Package Charges
173 CIPBWOR COCHLEAR IMPLANTATION
OS BILATERAL (WITHOUT
Audiology) ‐ PACKAGE
CHARGES + ALL DOCTORS FEES
CIPCBNS Cochlear implantation Bilateral (without 228000 186000 138000
audiology) ‐ Package Charges
Package includes:
1. 3 days stay.
2. Medicines limited to Rs. 1500/‐(including VAT).
3. Consumables limited to Rs. 6500/‐(including VAT) and one X‐ray mastoid.
4. Professional Fees of Surgeon, Speech Therapist, Anasthetist, Anasthesia and OT Charges.

Package excludes:
1. Cost of implant
2. All hospital charges for the stay beyond the package stay of 3 days
3. Additional medicines and consumables over and above prescribed limit.
4. Any investigations.
5. Professional charges of other Consultants.
Cochlear Implantation ‐ Only Surgery / Revision surgery
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

174 CIPWROS COCHLEAR IMPLANTATION
OS (WITHOUT AUDIOLOGY) (ONLY
/REVISION SURGERY) ‐
PACKAGE CHARGES + ALL
DOCTORS FEES
CIPCOS Cochlear implantation (Excluding speech 128000 102000 76500
therapy) Only / Revision Surgery ‐ Package
Charges

Package includes:
1. 3 days stay.
3. Consumables limited to Rs. 3500/‐(including VAT) and one X‐ray mastoid.
4. Professional Fees of Surgeon, Anasthetist, Anasthesia and OT Charges.

Package excludes:
1. Cost of implant

246
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
175 CIPLDDAC COCHLEAR IMPLANTATION
HCOS (WITH AUDIOLOGY)‐ POST
LINGUAL DEAF CHILD/ADULT
DOCTOR FEES)
CIPLDACPC Cochlear implantation (including speech 138000
therapy) ‐ post lingual deaf adult or child
package charges
Package includes:
1. 3 days stay.
3. Consumables (including X‐Ray Mastoids) limited to Rs. 3500/‐(including VAT).
4. Professional Fees of Surgeon, Speech therapist, Anasthetist, Anasthesia and OT Charges.

Package excludes:
1. Cost of implant
Cochlear Implantation ‐ Pre Lingual with Rehabilation
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

176 CIPLDDHC COCHLEAR IMPLANTATION
OS (WITH AUDIOLOGY)‐ PRE
LINGUAL DEAF CHILD
DOCTOR FEES)
CIPLDCPC Cochlear implantation (with audiology) ‐ pre 160000 133000 109000
lingual deaf child package charges
Package includes:
1. 3 days stay.
2. Medicines limited to Rs. 1500/‐ (including VAT).
3. Consumables limited to Rs. 3500/‐(including VAT).
4. Professional Fees of Surgeon, Speech therapist, Anasthetist, Anasthesia and OT Charges
Package excludes:
1. Cost of implant

247
Paediatric Cardiac Sciences packages
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
1017 CAPCOS Paediatric Cardiac angiography
CAPK Paediatric Cardiac angiography ‐ package 73000 64000 48000 33000 24000
charges

Package Includes :
 2 days stay.
 Investigations limited to Rs. 2370/‐ in cat 3 & Rs. 4750/‐ in other categories.
 Medicines and consumables limited to Rs. 7700/‐(including VAT))

Package Excludes :
 Blood Bank charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
1018 ASDOS Paediatric ASD Device
ASDPPC Paediatric ASD Device ‐ package charges 225000 195000 158000 132000 87000
1019 ASDPEPD ASD DEVICE CLOSURE
COS (PAEDIATRIC ONLY) (PACKAGE
CHARGE + DOCTOR FEE)
ASDCPDACPC ASD closure/PDA closure with device ‐ 97830 87660 80040 73690 69880
package charges
Package Includes :
 2 days stay including Intensive Care for 1 day
 Investigations limited to Rs. 5300/‐ in cat 3 & Rs. 10590/‐ in other catagories.
 Medicines and consumables limited to Rs. 28900/‐(including VAT)

Package Excludes :
 Blod Bank charges
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

1020 PBSEPOS Paediatric Balloon Septostomy
PBSEPC Paediatric Balloon Septostomy ‐ package 118000 103000 89000 76000 65000
charges
248

Package Includes :
 2 days stay including Intensive Care for 1 day.

Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
1021 PCHSL1OS Paediatric Closed Heart
Surgery Level One
PCHSL1P Paediatric Closed Heart Surgery Level One 218000 189000 146000 120000 87000
package charges

Package Includes :
 3 days stay including Intensive Care for 1 day.
 Medicines and consumables limited to Rs. 24000/‐(including VAT)

Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

1022 PCHSL2OS PAEDIATRIC CLOSED HEART
SURGERY LEVEL TWO ( ALL
CHARGES)
PCHSL2P Paediatric Closed Heart Surgery Level Two 315000 273000 225000 184000 129000
package charges
Package Includes :
 7 days stay including Intensive Care for 3 days

Package Excludes :
249

All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
1023 PCHSL3OS Paediatric Closed Heart
Surgery Level Three
PCHSL3P Paediatric Closed Heart Surgery Level Three 439000 383000 299000 251000 189000
package charges
Package Includes :
 9 days stay including Intensive Care for 4 days.

Package Excludes :

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

1024 CCEPCOS Paediatric Cardiac coil
Embolisation
CCEPPC Paediatric Cardiac coil Embolisation ‐ 91000 79000 71000 55000 36000
package charges
Package Includes :
 1 day stay.
 Investigations limited to Rs. 2580/‐in cat 3 & Rs. 5160/‐ in other catagories.

Package Excludes :
 All hospital charges for the stay beyond the package stay of 1 day.
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

1025 POHSL1O Paediatric Open Heart Surgery
S Level One
POHSL1P Paediatric Open Heart Surgery Level One 424000 367000 308000 251000 204000
package charges
250
Package Includes :
 Investigations limited to Rs. 13130/‐ in cat 3 Rs. 26240/‐ 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 499000 439000 366000 304000 224000
package charges
Package Includes :

Package Excludes :
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

S Level Three
POHSL3P Paediatric Open Heart Surgery Level Three 691000 612000 495000 425000 332000
package charges
Package Includes :
 10 days stay including Intensive Care for 5 days.

Package Excludes :

251
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
1028 PDAOS Paediatric PDA Device
PDAPC Paediatric PDA Device ‐ package charges 174000 152000 125000 90000 55000
Package Includes :

Package Excludes :

All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
1029 PVALOS Paediatric Valvuloplasty
PVALPPC Paediatric Valvuloplasty ‐ package charges 162000 140000 119000 98000 67000
Package Includes :
 Investigations limited to Rs. 4190/‐ in cat 3 & Rs. 8370/‐in other catagories.

Package Excludes :

252
GYNAECOLOGY PACKAGE

Day Care Package Procedures
S.No. Investigation Limit on medicines & consumables

Total Charges ((including VAT)
1. Colposcopy/Cautery 5100 100

2. Colposcopy/LEEP 8500 700
3. Diagnostic Hyster/D&C 13500 1000
4. Colpo/Hystero/D&C 15700 1000
5. Colpo/Hystero/LEEP 17200 1000
6. MTP 10500 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.

253
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
706 LIVHPAC Liver Transplant High Risk ‐ 2210000
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/‐, consumables limited to Rs. 325000/‐, 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.
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
707 LIVPACKC Liver Transplant Low Risk ‐ 1632000

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/‐, consumables limited to Rs. 220000/‐, investigations limited to Rs. 178500/‐ and Blood Bank services limited to Rs. 84000/‐.
Package Excludes
charges, etc.
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

708 LINORPC Liver Transplant Normal Risk ‐ 1920000

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/‐, consumables limited to Rs. 250000/‐, investigation limited to Rs. 189000/‐ and Blood Bank services limited to Rs.
84000/‐.
Package Excludes
charges, etc.
254
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
177 BIPAPINIT BIPAP Initiation (Doctor +
NOS Hospital Charges)
BIPAPINITNDF BIPAP Initiation ‐ Doctor Fee 3460 3460 1730 1380 1040
BIPAPINITNHC BIPAP Initiation ‐ Hospital service charges 340 340 170 140 100
178 BIPAPMO BIPAP Monitoring (Doctor +
BIPAPMONITD BIPAP Monitoring ‐ Doctor Fee 3460 3460 1730 1380 1040
F
BIPAPMONNH BIPAP Monitoring ‐ Hospital service charges 340 340 170 140 100
C
179 COMEVOS Cardiac Output Monitoring By
EV 1000 (Doctor + Hospital
Charges)
COMEV1000D Cardiac output monitoring by EV 1000 ‐ 12130
F doctor fee
COMEVBPC Cardiac output monitoring by EV1000 ‐ 1220
bedside procedure charges
COMEV1000 Cardiac output monitoring by EV1000 ‐ 1820
special equipment charges
180 CPAMOS Cardio‐Pulmonary Assessment
and Monitoring by
Ultrasound‐(Doctor
Fee+Hospital Charges)
CPAMH Cardio‐Pulmonary Assessment and 800
Monitoring by Ultrasound‐Additional
Hospital Charges
CPAMD Cardio‐Pulmonary Assessment and 16000 16000 8000 6400 4800
Monitoring by Ultrasound‐Doctor Fee
CPAMHM Cardio‐Pulmonary Assessment and 1200
Monitoring by Ultrasound‐Hospital Charges
(Machine usage)
181 NOTOS Nitric Oxide Therapy ‐ (Doctor
NOTDF Nitric Oxide Therapy ‐ Doctor Fee 12000 12000 6000 4800 3600
NOTHC Nitric Oxide Therapy ‐ Hospital Charges 3000
(Machine usage)
182 VENTINIT Ventilator Initiation (Doctor +
VENTINITNDF Ventilator Initiation ‐ Doctor Fee 3460 3460 1730 1380 1040
VENTINITNHC Ventilator Initiation ‐ Hospital service 340 340 170 140 100
charges
183 VENTMO Ventilator Monitoring (Doctor
NOS + Hospital Charges)
VENTIMONITD Ventilator Monitoring ‐ Doctor Fee 3460 3460 1730 1380 1040
F
VENTIMONNH Ventilator Monitoring ‐ Hospital service 340 340 170 140 100
C charges

255

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
249 COCADIJO Contact cast application for
DEOS diabetic joint deformity
(OUTPATIENT Doctor +
Hospital Charges )
COCADIJODED Contact cast application for diabetic joint 2210 2210
F deformity (doctor fee)
COCADIJODEH Contact cast application for diabetic joint 2030 2030
C deformity (hospital charges)
250 CONCSTO Contact cast application for
S diabetic joint deformity
(INPATIENT Doctor + Hospital
charges)
COCADIJODED Contact cast application for diabetic joint 2210 2210
F deformity (doctor fee)
COCADIJODEH Contact cast application for diabetic joint 2030 2030
C deformity (hospital charges)
251 DIFOASPR Diabetic foot assessment ‐
IPOS primary (INPATIENT Doctor +
Hospital charges)
DIFOASPRDF Diabetic foot assessment ( primary 230 230
preventive ) ‐ doctor fee
DIFOASPRHC Diabetic foot assessment (primary) ‐ 510 510
hospital charges
252 DIFOASPR Diabetic foot assessment ‐
OS primary preventive
(OUTPATIENT Doctor +
Hospital Charges)
DIFOASPRDF Diabetic foot assessment ( primary 230 230
preventive ) ‐ doctor fee
DIFOASPRHC Diabetic foot assessment (primary) ‐ 510 510
hospital charges
253 DIFOASSE Diabetic foot assessment ‐
OS secondary (OUTPATIENT
Doctor + Hospital Charges )
DIFOASSEDF Diabetic foot assessment (secondary) ‐ 440 440
doctor fee
DIFOASSEHC Diabetic foot assessment (secondary) ‐ 1040 1040
hospital charges
254 DIFODRM Diabetic foot care major
J dressing ( INPATIENT Doctor +
Hospital charges)
DFDRESSMAJ Diabetic foot clinic ( major dressing ) ‐ 810 810
doctor fee
DFCMAJHC Diabetic foot clinic ( major dressing ) ‐ 190 190 190
Hospital Charges
255 DIFOMIN Diabetic foot care minor
DROS dressing ( INPATIENT Doctor +
Hospital charges)
DIFMINHC Diabetic foot clinic ( minor dressing ) ‐ 130
bedside procedure charges
DFDRESSMIN Diabetic foot clinic ( minor dressing ) ‐ 470 470
doctor fee
256 DIFOMIP Diabetic foot ‐ minor
OPROS outpatient procedure (Doctor
Fee + Hospital Charges )
256
DIFOMIPOPRD Diabetic foot ‐ minor outpatient procedure 1040 1040
F (doctor fee)
DIFOMIPOPRH Diabetic foot ‐ minor outpatient procedure 1240 1240 1240
C (hospital charges)
257 DIFOSECO Diabetic foot assessment ‐
S secondary (INPATIENT Doctor
+ Hospital charges)
DIFOASSEDF Diabetic foot assessment (secondary) ‐ 440 440
doctor fee
DIFOASSEHC Diabetic foot assessment (secondary) ‐ 1040 1040
hospital charges
258 ETIPOS Extensor tenotomy (
INPATIENT Doctor + Hospital
charges)
OUEXTEDF Outpatient extensor tenotomy (doctor fee) 1760 1760
OUEXTEHC Outpatient extensor tenotomy (hospital 1610 1610
charges)
259 FOOPSOS FOOT PRESSURE SCAN
CHARGES)
FOOSCADF Foot scan ( foot pressure analysis ) ‐ Doctor 380 380
fee
FOOSCA Foot scan ( foot pressure analysis ) Hospital 740 740
charges
260 INSHOEPS IN ‐ SHOE PRESSURE SCAN
CHARGES)
INSHOEPCDF In‐shoe pressure scan ‐ Doctor fee 590 590
INSHOEPC In‐shoe pressure scan ‐ Hospital charges 880 880
261 LSINJOS Liquid silicone heel injection (
INPATIENT Doctor + Hospital
charges)
OULISIINJDF Outpatient liquid silicone heel injection 1760 1760
(doctor fee)
OULISIINJHC Outpatient liquid silicone heel injection 1610 1610
(hospital charges)
262 OUEXTEO Outpatient extensor tenotomy
S (Doctor Fee + Hospital
Charges)
OUEXTEDF Outpatient extensor tenotomy (doctor fee) 1760 1760
OUEXTEHC Outpatient extensor tenotomy (hospital 1610 1610
charges)
263 OULISIINJ Outpatient liquid silicone heel
OS injection (Doctor Fee +
Hospital Charges)
OULISIINJDF Outpatient liquid silicone heel injection 1760 1760
(doctor fee)
OULISIINJHC Outpatient liquid silicone heel injection 1610 1610
(hospital charges)
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

268 ABLDS Angiography of B/L Dorsolumbar 66000 66000 33000 26400 19800
Spinal Radicular Arteries ‐ Doctor
Fee
269 ACHENT AORTIC ARCHH REPLACEMENT 175000 175000 87500 70000 52500
270 ARHEVE AORTIC HEMIARCH REPLACEMENT 70000 70000 35000 28000 21000
271 ARRENT AORTIC ROOT REPLACEMENT 227500 227500 113750 91000 68250
272 ARAOHIA AORTIC ROOT, ASCENDING AORTA 367500 367500 183750 147000 110250
AND HEMIARCH REPLACEMENT
257
273 AOCLX AORTIC VALVE REPAIR COMPLEX 122500 122500 61250 49000 36750
274 AOVSI AORTIC VALVE REPAIR SIMPLE 87500 87500 43750 35000 26250
275 AVRNT AORTIC VALVES REPLACEMENT 70000 70000 35000 28000 21000
276 ASEART ASCENDING AORTAA 122500 122500 61250 49000 36750
REPLACEMENT
277 GEATSDF Ascitic Tab subsequent ‐ Doctor 5260 5260 2630 2100 1580
Fee
278 ABLR ATERIAL BYPASS 105000 105000 52500 42000 31500
LIMA‐RIMA/RADIAL
279 ATMAS ATRIAL MAZE PROCEDURE‐SINGLE 87500 87500 43750 35000 26250
280 SERER ATRIAL SEPTAL DEFECT 35000 35000 17500 14000 10500
REPAIR‐DIRECT CLOSURE
281 PREAL ATRIAL SEPTAL DEFECT 52500 52500 26250 21000 15750
REPAIR‐PERICARDIAL PATCH
282 RICEAL ATRILA MAZE 140000 140000 70000 56000 42000
PROCEDURE‐BIATRIAL
283 AUTISM AUTISM ASSESSMENT 9260 9260 4630 3700 2780
284 BASCD Balloon Angioplasty & Stenting in 198000 198000 99000 79200 59400
Cervical ICA/Vertebral ‐ Doctor Fee
285 BACEDF Balloon Assisted Coil Embolization 220000 220000 110000 88000 66000
of a Direct/Indirect Cavernous
Fistula ‐ Doctor Fee
286 BFNACRF Breast FNAC under Radiological 1580 1580 1580 1580 900 1580
guidance ‐ Radiologist fee
287 BIIR Broken Impacted Implant Removal 55100 55100 27550 22040 16530
288 DIAEXO CARDIAC TUMORR EXCISION 70000 70000 35000 28000 21000
289 CHOCED CHORDAL PROCEDURE 52500 52500 26250 21000 15750
290 CAVRCE COMPLEX AORTIC VALVE 87500 87500 43750 35000 26250
REPLACEMENT
291 CPCIDF Complex Cardiology procedure 10500
charges
292 CNDDF Conduction of normal delivery ‐ 51660 51660 25830 20660 15500
Doctor fee
293 DSC Delayed sternal closure 83340 83340 41670 33340 25000
294 DEBSIDL2 Developmental evaluation using 11020 11020 5510 4410 3310
BSID (<2 years)
295 DEBSIDG2 Developmental evaluation using 14560 14560 7280 5820 4370
BSID (greater than 2 years)
296 DFDRESSMA Diabetic foot clinic ( major dressing 810 810
J ) ‐ doctor fee
297 DFDRESSMI Diabetic foot clinic ( minor dressing 470 470
N ) ‐ doctor fee
298 EDUASS EDUCATIONAL ASSESSMENT 9260 9260 4630 3700 2780
299 ESPFD Embolization of Spinal Pial/dural 220000 220000 110000 88000 66000
Fistula ‐ Doctor Fee
306 EMPR EMERGENCY PROCEDURE 175000 175000 87500 70000 52500
307 ESO Emergency sternal opening 50820 50820 25410 20330 15250
308 EPALNT EPICARDIAL PACING WIRE 175000 175000 87500 70000 52500
IMPLANTATION
309 EPICR EPIGASTRIC HERNIA REPAIR 105000 105000 52500 42000 31500
310 ESMYO EXTENDED SEPTAL MYECTOMY 350000 350000 175000 140000 105000
FOR HOCM
311 EXSTENTCF Extra stent placement 5250
312 FDPIA Flow Divertor Placement for 264000 264000 132000 105600 79200
Intracranial Aneurysm ‐ Doctor Fee
313 FBR Foreign body retrieval 101640 101640 50820 40660 30490
314 GEPOEMDF Gastroenterology Procedures 178500 178500 89250 71400 53550
Poem ‐ Doctor Fee
315 PCD Genetic counseling & 6670
Documentation ( Samples sent
abroad )
258
316 PRC Genetics report Interpretation & 8000
counseling ( Patients / sample
coming from abroad )
317 PULGPA Guided pleural aspiration 6300 6300 3150 2520 1890
(Diagnostic) Pulmonology Doctor
Fee
318 HSC Hand sewn coil making charges 25410 25410 12710 10160 7620
319 DOREDOCF HIGH DOSE CHEMOTHERAPY AND 213080 213080 106540 85230 63920
RESCUE ‐ Doctor Fee
320 HKWLRF Hook wire localisation under 2500 2500 2500 2500 1500 2500 1500
radiological guidance ‐ Radiologist
fee
321 IAERTN IABP INSERTION 35000 35000 17500 14000 10500
322 IARVAL IABP REMOVAL 21000 21000 10500 8400 6300
323 IAVDF Intracranial Angioplasty for 132000 132000 66000 52800 39600
Vasaspasm ‐ Doctor Fee
324 IVMEC Intracranial AVM Embolization 264000 264000 132000 105600 79200
(Complex) ‐ Doctor Fee
325 IAELE Intracranial AVM Embolization 220000 220000 110000 88000 66000
using Liquid Embolic material ‐
Doctor Fee
326 ICPPF Intracranial pressure monitoring 29360 29360 14680 11740 8810
device insertion charges
(Professional fees)
327 ISRDF Intracranial Stenting in Stroke 220000 220000 110000 88000 66000
Revascularization ‐ Doctor Fee
328 IQASS IQ ASSESSMENT 14560 14560 7280 5820 4370
329 ITDF Iron therapy ‐ Doctor fee 1300
330 IMISE ISCHEMIC VENTRICULAR SEPTAL 210000 210000 105000 84000 63000
RUPTURE REPAIR
335 KTPSS KTP Surcharge ‐ Surgeon Fee 5290
336 LETURE LEAFLET PROCEDURE 52500 52500 26250 21000 15750
337 LTROC LEFT ATRIAL APPENDAGE 35000 35000 17500 14000 10500
OCCLUSION
338 LFTTRO LEFT ATRIAL TROMBUS REMOVAL 28020 28020 14010 11210 8410
339 LEVNE LEFT VENTRICULAR ANEURYSM 210000 210000 105000 84000 63000
REPAIR
340 MECS100 Melanocyte Eidermal Cell 46690
suspension (for covering at max
100 sq. cm)
341 MICS MICS 122500 122500 61250 49000 36750
342 MRAPR MITRAL LEAFLET PRESERVATION 36760 36760 18380 14700 11030
343 MVRP MITRAL VALVEE REPLACEMENT 73500 73500 36750 29400 22050
344 MTP2TRIM MTP in 2nd trimester in Labour 51760 51760 25880 20700 15530
Room ‐ Doctor fee
345 NPPNCDF Neonatologist / paediatrician 7080 7080 3540 2830 2120
post‐natal charges following
Caesarean delivery ‐ Doctor fee
346 NPPNNDF Neonatologist / paediatrician 5080 5080 2540 2030 1520
post‐natal charges following
normal delivery ‐ Doctor fee
347 NNPNRESCS Neonatologist / paediatrician 5080 5080 2540 2030 1520
DF resuscitation charges following
caesarian delivery ‐ Doctor fee
348 NNPNRESCH Neonatologist / paediatrician 4200 4200 2100 1680 1260
ADF resuscitation charges following
normal delivery ‐ Doctor fee
349 NPCRCCDF Neonatology / paediatric 12160 12160 6080 4860 3650
consultant attendance +
resuscitation charges of newborn
during Caesarean delivery ‐ Doctor
fee
259
350 NPCRNDDF Neonatology / paediatric 9340 9340 4670 3740 2800
consultant attendance +
resuscitation charges of newborn
during normal delivery ‐ Doctor fee
351 NOSOP Nitrous Oxide Sedation for 3550 2130
OUTPATIEN
352 OTRPIP Occupational therapy for 1220 1220 610 490 370
paediatric / rheumatology patients
353 OPPCSSC Off Pump PCS surgical charges 96800 96800 48400 38720 29040
354 OMLST OMENTOPLASTY 175000 175000 87500 70000 52500
355 IAMMV Open excision of invasive Anterior 273000 273000 136500 109200 81900
Mediastinal mass (including
Thymoma) Vascular repair ‐ Add
On
356 IAMML Open excision of invasive Anterior 273000 273000 136500 109200 81900
Thymoma) With lung resection ‐
Add On
357 IAMMLV Open excision of invasive Anterior 294000 294000 147000 117600 88200
Thymoma) With lung resection and
vascular repair ‐ Add On
358 IAMM Open excision of invasive Anterior 247800 247800 123900 99120 74340
Thymoma) with pericardiectomy ‐
Add On
359 NIAMM Open excision of non ‐ invasive 226800 226800 113400 90720 68040
Anterior Mediastinal mass
(including Thymoma) ‐ Add On
360 THYOAD Open Thymectomy ‐ Add on 226800 226800 113400 90720 68040
361 OAFSVLDF Outpatient Arterial flow studies in 530 530 530
vascular lab ‐ Doctor fee
362 OVFSVLDF Outpatient venous flow studies in 850
vascular lab ‐ Doctor fee
363 ONVEEG12D Overnight Video EEG for 12 hours ‐ 2200 1320
Doctor Fee
364 OTHDF Ozone Therapy (Doctor fee) 4610
365 PAWVA PACING WIRE REMOVAL 16660 16660 8330 6660 5000
366 CHW PCS Chest Wall repair 152460 152460 76230 60980 45740
367 PCSVA2 PCS Procedure Access in Neonate 100000 100000 50000 40000 30000
and Infant
368 PCSVA4 PCS Procedure Complex Surgical 300000 300000 150000 120000 90000
369 PCSVA3 PCS Procedure Pericariocentesis 66660 66660 33330 26660 20000
370 PCSVA1 PCS Procedure Vascular Access 66660 66660 33330 26660 20000
PCS Bedside Pleural Sclerosis 5000 5000 2500 2000 1500
371 GEFNADF Percutaneous USG guided FNA ‐ 6300 6300 3150 2520 1890
Doctor Fee
372 PEDFPSDF Portable Echocardiography ( 1730 1730
Paediatric Cardiac Sciences ) ‐
Doctor Fees ( If Done Outside
Working Hrs )
373 PEDF Portable echocardiography in 1730
emergency hours ‐ Doctor fees
374 PCDBG Posterior Cervical Discectomy with 163800 163800 81900 65520 49140
Instrumentation / Bone Grafting
375 NEUDBS Programming of DBS (in OT) 36840 36840 18420 14740 11050
376 NEUDBSW Programming of DBS (in Ward) 18420 18420 9210 7370 5530
377 PUMBR PULMONARY 262500 262500 131250 105000 78750
THROMBOENDARTERECTOMY
BOTH SIDE
260
378 PTHROT PULMONARY 175000 175000 87500 70000 52500
THROMBOENDARTERECTOMY ONE
SIDE
379 RASCUINTRF Radiological guidance charges for 500 500 500 500 500 500 500
Ascites / Effusion tapping /
Drainage ( interventional) ‐
Radiologist fee
380 RDFNACINTR Radiological guidance charges for 500 500 500 500 500 500
F FNAC / Biopsy ( interventional) ‐
Radiologist Fee
381 RSMS Redo sternotomy / Mini 101640 101640 50820 40660 30490
sternotomy
382 REERY REDO SURGERY 175000 175000 87500 70000 52500
383 REVITEMB Re‐Vitrification ‐ Embryologist fee 2760
384 RATYMI RING ANNULOPLASTY‐MITRAL 70000 70000 35000 28000 21000
385 SECARDF Screening Echo Cardiology ‐ Doctor 640
Fee
386 SVCAD Six Vessel Cerabral Angiogram ‐ 55000 55000 27500 22000 16500
Doctor fee
387 SACEI Stent Assisted Coil Embolization of 220000 220000 110000 88000 66000
Intracranial ICA Aneurysm ‐ Doctor
Fee
388 STEWL STERNAL WIRE REMOVAL 87500 87500 43750 35000 26250
389 SBEG Suction Blister Epidermal Grafting 33350
(for covering at max 60 sq. cm.)
390 TIVSOPD Total Intra Venous Sedation ( TIVS ) 2670 2670
‐ MRI/CT
391 TIVSOP Total Intra Venous Sedation ( TIVS ) 3550 2130
‐ OUTPATIENT
392 TRIPVRER Tricuspid Valve Repair ‐ Add on 70000 70000 35000 28000 21000
393 USEMGHRSD Ultrasound during emergency 3800 3800 1900 1520 1140 1900 1140
F hours (done in U/S room) ‐ doctor
fee
394 USAVFDF Ultrasound guided venous 600
mapping for I/J catheter insertion
and A.V Fistula creation ‐ Doctor
Fee
395 VCCC Valved Conduit Construction 76230 76230 38120 30490 22870
Charges
396 VCAU Vertebral Cement Augmentation 68400 68400 34200 27300 20510
397 OWCSTDF Wound care therapy charges FOR 610 610 610
OUTPATIENTS ( Intermittent
pneumatic limb compression ) ‐
Doctor fee
398 WRETU WOUND RESUTURE 35000 35000 17500 14000 10500
399 YSBAD Y‐Stenting in a Basilar Top 264000 264000 132000 105600 79200
Aneurysm ‐ Doctor Fee
Doctor procedure charges (bronchoscopy)
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

400 UFNACDF Breasr FNAC under ultrasound 1580 950
guidance ‐ Consultant Fee
401 BRGINJDF Bronchoscopic glue injection ‐ 22860 22860 11430 9140 6860
Doctor Fee
402 BRAPCDF Bronchoscopic tumor debulking ( 31500 31500 15750 12600 9450
Cautery / APC ) ‐ Doctor Fee
Doctor procedure charges (colonoscopy)
261
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
403 IFSTKD Intrapleural Fibronolysis with STK ‐ 8260 8260 4130 3300 2480
Doctor Fee
404 MTHD Medical thoracoscopy Diagnostic ‐ 37280 37280 18640 14910 11180
Doctor Fee
405 MADHED Medical thoracoscopy with 46200 46200 23100 18480 13860
Adhesiolysis ‐Doctor Fee
406 PADIADF Pleural aspiration diagnostic ‐ 5040 5040 2520 2020 1510
Doctor Fee
Gastroenterology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
426 AMDHCO ANORECTAL OR OESOPHAGEAL
S MANOMETRY (DOCTOR FEE +
HOSPITAL CHARGES)
AMHC Anorectal manometery ‐ Additional hospital 860 860 430 340 260
charges
AMDF Anorectal manometery ‐ Doctor fees 1960 1960 980 780 590
427 ATDOS Ascitic Tap Diagnostic (Doctor
ATDHC Ascitic Tap Diagnostic ‐ Additional hospital 2000 2000 1000 800 600
charges
ATDDF Ascitic Tap Diagnostic ‐ Doctor Fee 5000 5000 2500 2000 1500
ATDPACS Ascitic Tap Diagnostic ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
428 BATOS Breath Analyser Test
BATDF Breath Analyser Test ‐ Doctor fee 12000 12000 6000 4800 3600
BATPACS Breath Analyser Test ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
BATHC Breath Analyser Test ‐ Hospital charges 4800 4800 2400 1920 1440
BATCH Breath Anlyser Test ‐ Consumable charges 2420 2420 1210 1210 1210
429 BPWLOS BALLOON PLACEMENT FOR
WEIGHT FOR WEIGHT LOSS ‐
(Doctor Fee + Hospital
Charges)
BPWLHC BALLOON PLACEMENT FOR WEIGHT FOR 8000 6400 4800
WEIGHT LOSS ‐ Additional Hospital Charges
BPWLDC BALLOON PLACEMENT FOR WEIGHT FOR 20000 16000 12000
WEIGHT LOSS ‐ Doctor Fee
430 BRAPCOS Bronchoscopic tumor
debulking ( Cautery / APC ) ‐
Charges)
BRAPCDF Bronchoscopic tumor debulking ( Cautery / 31500 31500 15750 12600 9450
APC ) ‐ Doctor Fee
BRAPCPACS Bronchoscopic tumor debulking ( Cautery /
APC ) ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
BRAPCHC Bronchoscopic tumor debulking ( Cautery / 12000 12000 6000 4800 3600
APC ) ‐ Hospital Charges
431 BRCOS BALLOON REPLACEMENT (BRT)
CHARGES ‐ (Doctor fee +
Hospital Charges)
BRCHC BALLON REPLACEMENT (BRT) CHARGES ‐ 1200 960 720
Additional Hospital Charges
262
BRCDC BALLON REPLACEMENT (BRT) CHARGES ‐ 3000 2400 1800
Doctor Fee
FLCX FLUROSCOPY CHARGES (X‐RAY) 1000 1000 1000
432 BREBUSO Bronchoscopy + EBUS ‐ (Doctor
S Fee + Hospital Charges)
BREBUSDF Bronchoscopy + EBUS ‐ Doctor Fee 27830 27830 13920 11130 8350
BREBUSPACS Bronchoscopy + EBUS ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
BREBUSHC Bronchoscopy + EBUS ‐ Hospital Charges 11130 11130 5570 4460 3340
433 BRFBROS Bronchoscopic foreign body
removal ‐ (Doctor Fee+Hospital
Charges)
BRFBRDF Bronchoscopic foreign body removal ‐ 21780 21780 10890 8710 6530
Doctor Fee
BRFBRPACS Bronchoscopic foreign body removal ‐ For
PACS ‐ NOT FOR BILLING PURPOSE
BRFBRHC Bronchoscopic foreign body removal ‐ 8710 8710 4360 3490 2620
Hospital Charges
434 BRGINJOS Bronchoscopic glue injection ‐
Charges)
BRGINJDF Bronchoscopic glue injection ‐ Doctor Fee 22860 22860 11430 9140 6860
BRGINJPACS Bronchoscopic glue injection ‐ For PACS ‐
NOT FOR BILLING PURPOSE
BRGINJHC Bronchoscopic glue injection ‐ Hospital 8710 8710 4360 3490 2620
Charges
435 BRONDHC BRONCHOSCOPY ‐ Done in
OS Endoscopy (DOCTOR FEE +
HOSPITAL CHARGES)
BRONPACS BRONCHOSCOPY ‐ Done in Endoscopy ‐ For
BRONDFN Bronchoscopy (Done in endoscopy) ‐ Doctor 14060 14060 7030 5620 4220
fees
BRONENHC Bronchoscopy (Done in endoscopy)‐ 5620 5620 2820 2240 1690
436 BRTBSDO Tracheal/Bronchial stricture
S dilation ‐ (Doctor Fee +
Hospital Charges)
BRTBSDDF Tracheal/Bronchial stricture dilation ‐ 21780 21780 10890 8710 6530
Doctor Fee
BRTBSDPACS Tracheal/Bronchial stricture dilation ‐ For
BRTBSDHC Tracheal/Bronchial stricture dilation ‐ 8710 8710 4360 3490 2620
Hospital Charges
437 BRTDSTO Bronchoscoic tumor debulking
S + stenting ‐ (Doctor Fee +
Hospital Charges)
BRTDSTDF Bronchoscoic tumor debulking + stenting ‐ 50000 50000 25000 20000 15000
Doctor Fee
BRTDSTPACS Bronchoscopic tumor debulking + stenting ‐
For PACS ‐ NOT FOR BILLING PURPOSE
BRTDSTHC Bronchoscopic tumor debulking + stenting ‐ 20000 20000 10000 8000 6000
Hospital Charges
438 BRTRSTOS Bronchoscopic
tracheal/bronchial stenting ‐
Charges)
BRTRSTDF Bronchoscopic tracheal/bronchial stenting ‐ 34760 34760 17380 13900 10430
Doctor Fee
BRTRSTPACS Bronchoscopic tracheal/bronchial stenting ‐
BRTRSTHC Bronchoscopic tracheal/bronchial stenting ‐ 13900 13900 6950 5570 4170
Hospital Charges
439 BRWLLOS Bronchoscopic whole lung
lavage ‐ (Doctor Fee + Hospital
Charges)
BRWLLDF Bronchoscopic whole lung lavage ‐ Doctor 50000 50000 25000 20000 15000
Fee
263
BRWLLPACS Bronchoscopic whole lung lavage ‐ For PACS
‐ NOT FOR BILLING PURPOSE
BRWLLHC Bronchoscopic whole lung lavage ‐ Hospital 20000 20000 10000 8000 6000
Charges
440 CEDHCOS CAPSULE ENDOSCOPY
CHARGES)
CEHC Capsule endoscopy ‐ Additional hospital 12000 12000 6000 4800 3600
charges
CEDF Capsule endoscopy ‐ Doctor fee 30000 30000 15000 12000 9000
CEPACS Capsule endoscopy ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
441 CLLSDHCO COLONOSCOPY ( LIMITED TO
S LEFT SIDE ) ‐ (DOCTOR FEE +
HOSPITAL CHARGES)
CLSHC Colonoscopy ( limited to left side ) ‐ 4000 4000 2000 1600 1200
CLSDF Colonoscopy ( limited to left side ) ‐ Doctor 10000 10000 5000 4000 3000
fee
CLSDPACS Colonoscopy ( limited to left side ) ‐ For PACS
442 COLOS Colonoscopy done outside
endoscopy suite (Doctor fee +
Hospital Charges)
COLOSHC Colonoscopy done outside endoscopy suite ‐ 6970 6970 3490 2790 2090
COLOS Colonoscopy done outside endoscopy suite ‐ 17420 17420 8710 6970 5230
doctor fee
COLOSPACS Colonoscopy done outside endoscopy suite ‐
443 CTSTOS Colonic Transit Study ‐ (Doctor
Fee + Hospital Charges)
CTSTH Colonic Transit Study ‐ Additional hospital 4000 4000 2000 1600 1200
charges
CTSTD Colonic Transit Study ‐ Doctor Fee 10000 10000 5000 4000 3000
CTSTPACS Colonic Transit Study ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
444 CWDFHC COLONOSCOPY ( WHOLE ) ‐
CHARGES)
CWHC Colonoscopy ( whole ) ‐ Additional hospital 5600 5600 2800 2240 1680
charges
CWDF Colonoscopy ( whole ) ‐ Doctor fee 14000 14000 7000 5600 4200
CWDPACS Colonoscopy ( whole ) ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
445 DBEBOS Double Balloon Enteroscopy
Both side (Doctor fee +
Hospital charges)
DBEBSHC Double Balloon Enteroscopy Both side ‐ 17600 17600 8800 7040 5280
DBEBSDF Double Balloon Enteroscopy Both side ‐ 44000 44000 22000 17600 13200
Doctor Fee
DBEBSPACS Double Balloon Enteroscopy Both side ‐ For
446 DBESSOS Double Balloon Enteroscopy
Single side (Doctor fee +
Hospital charges)
DBESSHC Double Balloon Enteroscopy Single side ‐ 14400 14400 7200 5760 4320
DBESSDF Double Balloon Enteroscopy Single side ‐ 36000 36000 18000 14400 10800
Doctor Fee
DBESSPACS Double Balloon Enteroscopy Single side ‐ For
447 DIATHOO Diagnostic Thoracoscopy with
S biopsy in Endoscopy Room ‐
DIATHOPACS Diagnostic Thoracoscopy with biopsy in
Endoscopy Room ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
264
DIATHORBIOH Diagnostic Thoracoscopy with biopsy in 14200 14200 7110 5680 4270
C Endoscopy Room ‐ Hospital Charges
DTHOR BIO Diagnostic Thoracoscopy with biopsy in 35510 35510 17750 14200 10650
Endoscopy Room Doctor fee
448 DNSEPOE Diagnostic nasal & sinus
COS endoscopy / postoperative
endoscopic cleaning (Doctor
DNSEPOECDF Diagnostic nasal & sinus endoscopy / 3810 3810 1900 1520 1140 1900 960
postoperative endoscopic cleaning ‐ Doctor
fee
DNSEPOECHC Diagnostic nasal & sinus endoscopy / 180 100
postoperative endoscopic cleaning ‐ hospital
charges
449 EBDHCHO ENDOSCOPIC BANDING ( FIRST
S SESSION ) (DOCTOR FEE +
HOSPITAL CHARGES)
EBFSHC Endoscopic banding ( first session ) ‐ 8000 8000 4000 3200 2400
EBFSDF Endoscopic banding ( first session ) ‐ Doctor 20000 20000 10000 8000 6000
fee
EBFSPACS Endoscopic banding ( first session ) ‐ For
450 EBSDCHO ENDOSCOPIC BILIARY
S STENTING (DOCTOR FEE +
HOSPITAL CHARGES)
EBSHC Endoscopic biliary stenting ‐ Additional 16000 16000 8000 6400 4800
hospital charges
EBSDF Endoscopic biliary stenting ‐ Doctor fee 40000 40000 20000 16000 12000
EBSPACS Endoscopic biliary stenting ‐ For PACS ‐ NOT
FOR BILLING PURPOSE
451 EBSDHCH ENDOSCOPIC BANDING (
OS SUBSEQUENT SESSION )
CHARGES)
EBSSHC Endoscopic banding ( subsequent session ) ‐ 5600 5600 2800 2240 1680
EBSSDF Endoscopic banding ( subsequent session ) ‐ 14000 14000 7000 5600 4200
Doctor fee
EBSSPACS Endoscopic banding ( subsequent session ) ‐
452 EBUSOS EBUS ‐ ( Doctor Fee + Hospital
Charges )
EBUSDF EBUS ‐ Doctor Fee 21080 21080 10540 8430 6320
EBUPACS EBUS ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
EBUSHC EBUS ‐ Hospital Charges 8430 8430 4210 3370 2530
453 EBUSTBN EBUS and TBNA ( For Northern
A Railway )
FNANEED $$ FNA Needle 5000
FLUOREAFBAS Direct Fluorescent staining for AFB ( 560
PN Aspirate ) Northern Railway
ENDOBROULN Endobronchial Ultrasound ( Northern 6320
DC Railway ) ‐ Doctor Fee
ENDOBROULN Endobronchial Ultrasound ( Northern 2740
HC Railway ) ‐ Hospital charges
MCEUSN FNAC for Endoscopic ultrasound specimen ( 1520
EUSFNAC ) Northern Railway ‐ Cytology
RAPIDWITHO Rapid AFB culture ( BacT/Alert 3D ) with 1410
UTSENN accuprobe identification without sensitivity
Northern Railway
454 EDNUDFH ENDOSCOPIC ULTRASOUND
CHOS (DOCTOR FEE + HOSPITAL
CHARGES)
EUHC Endoscopic ultrasound ‐ Additional hospital 4800 4800 2400 1920 1440 2400 1440
charges
EUDF Endoscopic ultrasound ‐ Doctor fee 12000 12000 6000 4800 3600 6000 3600
EUHCPACS Endoscopic ultrasound ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
265
455 EDSDSSD ENDOSCOPIC OESOPHAGEAL
HCHOS STRICTURE DILATATION (
SUBSEQUENT SESSION )
CHARGES)
EOSDSSHC Endoscopic oesophageal stricture dilatation 4800 4800 2400 1920 1440
( subsequent session ) ‐ Additional hospital
charges
EOSDSSDF Endoscopic oesophageal stricture dilatation 12000 12000 6000 4800 3600
( subsequent session ) ‐ Doctor fee
EOSDSSPACS Endoscopic oesophageal stricture dilatation
( subsequent session ) ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
456 EEPDFDC ENDOSCOPIC
HOS ENDO‐PROSTHESIS
PLACEMENT (DOCTOR FEE +
HOSPITAL CHARGES)
EEPPHC Endoscopic endo‐prosthesis placement ‐ 12000 12000 6000 4480 3600
EEPPDF Endoscopic endo‐prosthesis placement ‐ 30000 30000 15000 12000 9000
Doctor fee
EEPPACS Endoscopic endo‐prosthesis placement ‐ For
457 EFBRDHC ENDOSCOPIC FOREIGN BODY
HOS REMOVAL (DOCTOR FEE +
HOSPITAL CHARGES)
EFBRHC Endoscopic foreign body removal ‐ 9600 9600 4800 3840 2880
EFBRDF Endoscopic foreign body removal ‐ Doctor 24000 24000 12000 9600 7200
fee
EFBRPACS Endoscopic foreign body removal ‐ For PACS
458 EMLDFHC ENDOSCOPIC MECHANICAL
HOS LITHOTROPSY (DOCTOR FEE +
HOSPITAL CHARGES)
EMLHC Endoscopic mechanical lithotropsy ‐ 16000 16000 8000 6400 4800
EMLDF Endoscopic mechanical lithotropsy ‐ Doctor 40000 40000 20000 16000 12000
fee
EMLPACS Endoscopic mechanical lithotropsy ‐ For
459 EMROS Endoscopy Mucosal Resection
EMRHC Endoscopy Mucosal Resection ‐ Additional 20000 20000 10000 8000 6000
hospital charges
EMRDF Endoscopy Mucosal Resection ‐ Doctor Fee 50000 50000 25000 20000 15000
EMRHCPACS Endoscopy Mucosal Resection ‐ For PACS ‐
460 ENDOBAD Endoscopic banding done
OS outside endoscopy suite
ENDOBAN Endoscopic banding done outside endoscopy 9680 9680 4840 3870 2900
suite ‐ Additional hospital charges
ENDBAOS Endoscopic banding done outside endoscopy 24200 24200 12100 9680 7260
suite ‐ doctor fee
ENDBAPACS Endoscopic banding done outside endoscopy
suite ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
461 ENDOSCL Endoscopic sclerotherapy done
OS outside endoscopy suite
ENDSCLHC Endoscopic sclerotherapy done outside 9680 9680 4840 3870 2900
endoscopy suite ‐ Additional hospital
charges
ENDSCLOS Endoscopic sclerotherapy done outside 24200 24200 12100 9680 7260
endoscopy suite ‐ doctor fee
ENDSCLOSPAC Endoscopic sclerotherapy done outside
S endoscopy suite ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
266
462 ENTDHCH ENTEROSCOPY (DOCTOR FEE +
OS HOSPITAL CHARGES)
EHC Enteroscopy ‐ Additional hospital charges 8000 8000 4000 3200 2400
EDF Enteroscopy ‐ Doctor fee 20000 20000 10000 8000 6000
EHCPACS Enteroscopy ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
463 ENTEROS Enteroscopy done outside
Hospital Charges)
ENTEROHC Enteroscopy done outside endoscopy suite ‐ 11290 11290 5640 4510 3380
ENTEROS Enteroscopy done outside endoscopy suite ‐ 28230 28230 14110 11290 8470
doctor fee
ENTEROSPACS Enteroscopy done outside endoscopy suite ‐
464 EODADHC ENDOSCOPIC OESOPHAGEAL
HOS DILATATION FOR ACHALASIA
CHARGES)
EODAHC Endoscopic oesophageal dilatation for 9600 9600 4800 3840 2880
achalasia ‐ Additional hospital charges
EODADF Endoscopic oesophageal dilatation for 24000 24000 12000 9600 7200
achalasia ‐ Doctor fee
EODAPACS Endoscopic oesophageal dilatation for
achalasia ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
465 EOSDFSD ENDOSCOPIC OESOPHAGEAL
HCHOS STRICTURE DILATATION ( FIRST
SESSION ) (DOCTOR FEE +
HOSPITAL CHARGES)
EOSDFSHC Endoscopic oesophageal stricture dilatation 8000 8000 4000 3200 2400
( first session ) ‐ Additional hospital charges
EOSDFSDF Endoscopic oesophageal stricture dilatation 20000 20000 10000 8000 6000
( first session ) ‐ Doctor fee
EOSDFSPACS Endoscopic oesophageal stricture dilatation
( first session ) ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
466 EPDHCHO ENDOSCOPIC POLYPECTOMY
S (DOCTOR FEE + HOSPITAL
CHARGES)
EPHC Endoscopic polypectomy ‐ Additional 16000 16000 8000 6400 4800
hospital charges
EPDF Endoscopic polypectomy ‐ Doctor fee 40000 40000 20000 16000 12000
EPHCPACS Endoscopic polypectomy ‐ For PACS ‐ NOT
FOR BILLING PURPOSE
467 EPEPTDHC ENDOSCOPIC PAPILLOTOMY (
HOS EPT ) (DOCTOR FEE + HOSPITAL
CHARGES)
EPTHC Endoscopic papillotomy ( EPT ) ‐ Additional 14400 14400 7200 5760 4320
hospital charges
EPTDF Endoscopic papillotomy ( EPT ) ‐ Doctor fee 36000 36000 18000 14400 10800
EPTPACS Endoscopic papillotomy ( EPT ) ‐ For PACS ‐
468 EPRTDHC ENDOSCOPIC PLACEMENT OF
HOS RYLES TUBE (DOCTOR FEE +
HOSPITAL CHARGES)
EPRTHC Endoscopic placement of Ryles tube ‐ 4690 4690 2340 1870 1400
EPRTDF Endoscopic placement of Ryles tube ‐ Doctor 11700 11700 5850 4680 3510
fee
469 EPSDFHC ENDOSCOPIC PANCREATIC
HOS STENTING (DOCTOR FEE +
HOSPITAL CHARGES)
EPSHC Endoscopic pancreatic stenting ‐ Additional 16000 16000 8000 6400 4800
hospital charges
EPSDF Endoscopic pancreatic stenting ‐ Doctor fee 40000 40000 20000 16000 12000
267
470 ERCHDFH ERCP (DOCTOR FEE + HOSPITAL
COS CHARGES)
ERCPHC ERCP ‐ Additional hospital charges 6000 6000 3000 2400 1800
ERCPDF ERCP ‐ Doctor fee 15000 15000 7500 6000 4500
ERCPHCPACS ERCP ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
471 ERCPCOS ERCP Cystogastromy (Doctor
ERCPCHC ERCP Cystogastromy ‐ Additional hospital 18400 18400 9200 7360 5520
charges
ERCPCDF ERCP Cystogastromy ‐ Doctor Fee 46000 46000 23000 18400 13800
ERCPCHCPACS ERCP Cystogastromy ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
472 ERCPOS ERCP done outside endoscopy
suite (Doctor fee + Hospital
Charges)
ERCPOSHC ERCP done outside endoscopy suite ‐ 7740 7740 3870 3100 2320
ERCPOS ERCP done outside endoscopy suite ‐ doctor 19360 19360 9680 7740 5810
fee
ERCPOSHCPAC ERCP done outside endoscopy suite ‐ For
S PACS ‐ NOT FOR BILLING PURPOSE
473 ERMDHC OESOPHAGEAL AND RECTAL
OS MANOMETRY (DOCTOR FEE +
HOSPITAL CHARGES)
ERMHC Esophageal and Rectal manometery ‐ 5600 5600 2800 2240 1680
ERMDF Esophageal and Rectal manometery ‐ 10000 14000 7000 5600 4200
Doctor fees
ERMDPACS Esophageal and Rectal manometery ‐ For
474 ESDOS Endoscopy submucosal
dissection (Doctor fee +
Hospital charges)
CCGRAP $$ Co ‐ Grasper 2515
INJTORM $$ Injector Force Max 25G 1442
ITNAM $$ IT Nano 10791
ILYCAP $$ Olympus Cap 1173
SPRACAT $$ Spray Cathetar 1550
ESDHC Endoscopy submucosal dissection ‐ 68000 68000 34000 27200 20400
ANAANAF Endoscopy submucosal dissection ‐ 53550 53550 26780 21420 16070
Anaesthetists Fee
ENDOANAC Endoscopy submucosal dissection ‐ 24990 24990 12500 10000 7500
Anasthesia Consumable
ESDDF Endoscopy submucosal dissection ‐ Doctor 170000 170000 85000 68000 51000
Fee
ESDHCPACS Endoscopy submucosal dissection ‐ For PACS
475 ESFSDHCH ENDOSCOPIC SCLEROTHERAPY
CHARGES)
ESFSHC Endoscopic sclerotherapy ‐ Additional 7760 7760 3880 3104 2328
hospital charges
ESFSDF Endoscopic sclerotherapy ‐ Doctor fee 19400 19400 9700 7760 5820
ESFSDFPACS Endoscopic sclerotherapy ‐ For PACS ‐ NOT
FOR BILLING PURPOSE
476 EUSCOS EUS Coiling ‐ (Doctor Fee +
Hospital Charges)
EUSCH EUS Coiling ‐ Additional hospital charges 12000 12000 6000 4800 3600
EUSCD EUS Coiling ‐ Doctor fee 30000 30000 15000 12000 9000
EUSCPACS EUS Coiling ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
477 EUSGCOS Endoscopic ( EUS ) guided
cystogastromy (Doctor fee +
Hospital charges)
268
EUSGCHC Endoscopic ( EUS ) guided cystogastromy ‐ 17600 17600 8800 7040 5280
EUSGCDF Endoscopic ( EUS ) guided cystogastromy ‐ 44000 44000 22000 17600 13200
Doctor Fee
EUSGPACS Endoscopic ( EUS ) guided cystogastromy ‐
478 EUSGOS Endoscopic ultrasound ( EUS )
guided celiac block (Doctor fee
+ Hospital charges)
EUSGHC Endoscopic ultrasound ( EUS ) guided celiac 12000 12000 6000 4800 3600
block ‐ Additional hospital charges
EUSGDF Endoscopic ultrasound ( EUS ) guided celiac 30000 30000 15000 12000 9000
block ‐ Doctor Fee
EUSGHCPACS Endoscopic ultrasound ( EUS ) guided celiac
block ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
479 EUTOS Endoultrasound therapeutic
EUTHC Endoultrasound therapeutic ‐ Additional 8000 8000 4000 3200 2400
hospital charges
EUTDF Endoultrasound therapeutic ‐ Doctor Fee 20000 20000 10000 8000 6000
EUTHCPACS Endoultrasound therapeutic ‐ For PACS ‐
480 FIBSOS FIBROSCAN
FIBSHC Fibroscan ‐ Collection charges (Hospital) 2400 2400 1200 960 720 1200
FIBSDF Fibroscan ‐ Doctor fee 6000 6000 3000 2400 1800 3000
FIBPAC Fibroscan ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
481 FLXSIGOS Flexible sigmoidoscopy done
outside endoscopy suite
FLEXSIGHC Flexible sigmoidoscopy done outside 3190 3190 1600 1280 960
endoscopy suite ‐ Additional hospital
charges
FSIGOS Flexible sigmoidoscopy done outside 7990 7990 3990 3190 2390
endoscopy suite ‐ doctor fee
FLEXSIGHCPA Flexible sigmoidoscopy done outside
CS endoscopy suite ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
482 FSDFHCH FLEXIBLE SIGMOIDOSCOPY
CHARGES)
FSHC Flexible sigmoidoscopy ‐ Additional hospital 2640 2640 1320 1060 800
charges
FSDF Flexible sigmoidoscopy ‐ Doctor fee 6600 6600 3300 2640 1980
FSDFHPACS Flexible sigmoidoscopy ‐ For PACS ‐ NOT
FOR BILLING PURPOSE
483 GEATSOS Ascitic Tab subsequent
CHARGES)
GEATSHC Ascitic Tab subsequent ‐ Additional Hospital 2100 2100 1050 840 630
Charges
GEATSDF Ascitic Tab subsequent ‐ Doctor Fee 5260 5260 2630 2100 1580
484 GEFNAOS Percutaneous USG guided FNA
CHARGES)
GEFNAHC Percutaneous USG guided FNA ‐ Additional 2520 2520 1260 1010 760
Hospital Charges
GEFNADF Percutaneous USG guided FNA ‐ Doctor Fee 6300 6300 3150 2520 1890
485 GEPOEMA Gastroenterology Procedures
OS Poem (DOCTOR FEE +
HOSPITAL CHARGES)
CCGRAP $$ Co ‐ Grasper 2515
FUJICAP $$ Fujinon Cap 1167
INJTORM $$ Injector Force Max 25G 1442
LIPSCAPEM $$ Olympus Cap Poem 587
SPRACAT $$ Spray Cathetar 1550
269
KNITT $$ TT Knife J 7534
GEPOEMAHC Gastroenterology Procedures Poem ‐ 71400 71400 35700 28560 21420
PROANACHAC Gastroenterology Procedures Poem ‐ 24990 24990 12500 10000 7500
Anasthesia Consumable
GASPROPOEM Gastroenterology Procedures Poem ‐ 53550 53550 26780 21420 16070
Anasthetist Fee
GEPOEMDF Gastroenterology Procedures Poem ‐ Doctor 178500 178500 89250 71400 53550
Fee
486 GSOS GASTROGRAFFIN STUDY ‐
Charges)
GSHC GASTROGRAFFIN STUDY ‐ Additional 800 640 480
Hospital Charges
GSDC GASTROGRAFFIN STUDY ‐ Doctor Fee 2000 1600 1200
487 HVPGOS HVPG
HVPGCH HVPG ‐ Consumable charges 4250 4250 4250 4250 4250
HVPGDF HVPG ‐ Doctor Fee 14000 14000 7000 5600 4200
HVPGFC HVPG ‐ Fluroscopy charges 4660 4660 2330 1870 1400
HVPGHC HVPG ‐ Hospital charges 19600 19600 9800 2240 1680
HVPGCHPACS HVPGCH ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
488 IFSTKOS Intrapleural Fibronolysis with
STK ( Doctor fee + Additional
hospital charges )
INSTKA Intrapleural Fibronolysis with STK ‐ 3300 3300 1650 1320 990
IFSTKD Intrapleural Fibronolysis with STK ‐ Doctor 8260 8260 4130 3300 2480
Fee
489 LBHCHEO LIVER BIOPSY ‐ DONE IN
S ENDOSCOPY (DOCTOR FEE +
HOSPITAL CHARGES)
LBDF Liver biopsy ‐ Doctor fees 14000 14000 7000 5600 4200
LBDPACS Liver biopsy ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
LBEHC Liver biopsy (done in endoscopy) ‐ Additional 5600 5600 2800 2240 1680
hospital charges
490 MADHEO Medical thoracoscopy with
S Adhesiolysis ( Doctor fee +
Additional hospital charges )
MTHADI Medical thoracoscopy with Adhesiolysis ‐ 18480 18480 9240 7390 5540
MADHED Medical thoracoscopy with Adhesiolysis 46200 46200 23100 18480 13860
‐Doctor Fee
491 MAPSSOS Microlith analysis of
pre‐supplied samples (Doctor
fee + Hospital Charges)
MAPSSHC Microlith analysis of pre‐supplied samples ‐ 900 900 450 360 270
MAPSSDF Microlith analysis of pre‐supplied samples ‐ 2270 2270 1130 900 680
Doctor Fee
MAPSSHCPAC Microlith analysis of pre‐supplied samples ‐
S For PACS ‐ NOT FOR BILLING PURPOSE
492 MTHDOS Medical thoracoscopy
Diagnostic ( Doctor Fee +
Additional hospital charges )
MCTHA Medical thoracoscopy Diagnostic ‐ 14910 14910 7460 5960 4470
MTHD Medical thoracoscopy Diagnostic ‐ Doctor 37280 37280 18640 14910 11180
Fee
493 NASJEJFL NASO‐JEJUNAL TUBE
UOS INSERTION ‐ FLUROSCOPIC
CHARGES)
NASJEJTUNFLS Naso‐jejunal tube insertion ( Fluroscopic ) ‐ 12000 12000 6000 4800 3600
DOC doctor fee
270
NASJEJTUNFLS Naso‐jejunal tune insertion ( Fluroscopic) ‐ 4800 4800 2400 1920 1440
HOS Hospital service charges
494 NASJEJTU NASO‐JEJUNAL TUBE
BINSOS INSERTION (DOCTOR FEE +
HOSPITAL SERVICE CHARGES)
NASJEJTUNINS Naso‐jejunal tube insertion ( endoscopic ) ‐ 12000 12000 6000 4800 3600
DOC doctor fee
NASJEPACS Naso‐jejunal tune insertion ( endoscopic ) ‐
NASJEJTUNINS Naso‐jejunal tune insertion ( endoscopic )‐ 4800 4800 2400 1920 1440
HOS Hospital service charges
495 NBDDHCH NASO‐BILIARY DRAINANGE (
OS NBD ) (DOCTOR FEE +
HOSPITAL CHARGES)
NBDHC Naso‐biliary drainange ( NBD ) ‐ Additional 14000 14000 7000 5600 4200
hospital charges
NBDDF Naso‐biliary drainange ( NBD ) ‐ Doctor fee 35000 35000 17500 14000 10500
NBDHCPACS Naso‐biliary drainange ( NBD ) ‐ For PACS ‐
496 NFTOS NASOJEJUNAL FEEDING TUBE
REPOSITIONING CHARGES ‐
Charges)
NFTHC NASOJEJUNAL FEEDING TUBE 1200 960 720
REPOSITIONING CHARGES ‐ Additional
Hospital Charges
NFTDC NASOJEJUNAL FEEDING TUBE 3000 2400 1800
REPOSITIONING CHARGES ‐ Doctor Fee
497 OPHDHCH OESOPHAGEAL PH
OS MONITORING (DOCTOR FEE +
HOSPITAL CHARGES)
OPMHC Oesophageal pH monitoring ‐ Additional 6400 6400 3200 2560 1920
hospital charges
OPMDF Oesophageal pH monitoring ‐ Doctor fee 16000 16000 8000 6400 4800
OPMHCPACS Oesophageal pH monitoring ‐ For PACS ‐
498 PADIADO Pleural aspiration diagnostic (
S Doctor fee + Additional
hospital charges )
PADIAD Pleural aspiration diagnostic ‐ Additional 2020 2020 1010 810 600
hospital charges
PADIADF Pleural aspiration diagnostic ‐ Doctor Fee 5040 5040 2520 2020 1510
499 PBROS PEG/BRT REMOVAL CHARGES ‐
Charges)
PBRHC PEG/BRT REMOVAL CHARGES ‐ Additional 400 320 240
Hospital Charges
PBRDC PEG/BRT REMOVAL CHARGES ‐ Doctor Feee 1000 800 600
500 PEGDHCH PERCUTANEOUS ENDOSCOPIC
OS GASTROSTOMY ( PEG )
CHARGES)
PEGHC Percutaneous endoscopic gastrostomy ( PEG 11200 11200 5600 4480 3360
) ‐ Additional hospital charges
PEGDF Percutaneous endoscopic gastrostomy ( PEG 28000 28000 14000 11200 8400
) ‐ Doctor fee
PEGHCPACS Percutaneous endoscopic gastrostomy ( PEG
) ‐ For PACS ‐ NOT FOR BILLING PURPOSE
501 PNBRONO PNEUMO PROJECT
S BRONCHOSCOPY
PNBRONENPA PNEUMO PROJECT BRONCHOSCOPY ‐ For
CS PACS ‐ NOT FOR BILLING PURPOSE
PNBRONENHC PNEUMO PROJECT BRONCHOSCOPY ‐ 1280
HOSPITAL CHARGES
PNBRONDF PNEUMO PROJECT BRONCHOSCOPY 3190
‐DOCTOR PROCEDURE CHARGES
271
502 REBUSOS Radial EBUS charges ‐ (Doctor
REBUSDF Radial EBUS charges ‐ Doctor Fee 21080 21080 10540 8430 6320
REBUSHCPACS Radial EBUS charges ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
REBUSHC Radial EBUS charges ‐ Hospital Charges 8430 8430 4210 3370 2530
503 RFAOS Radio frequency ( RF ) ablation
‐ Gastroenterology (Doctor fee
+ Hospital charges)
RFAHC Radio frequency ablation ( Gastroenterology 11720 11720 5850 4690 3510
RFADF Radio frequency ablation ( Gastroenterology 29280 29280 14640 11720 8780
) ‐ Doctor Fee
RFAHCPACS Radio frequency ablation ( Gastroenterology
) ‐ For PACS ‐ NOT FOR BILLING PURPOSE
504 RGBRDOS Rigid Bronchoscopy Diagnostic
‐ (Doctor Fee + Hospital
Charges)
RGBRDDF Rigid Bronchoscopy Diagnostic ‐ Doctor Fee 21780 21780 10890 8710 5450
RGBRDHCPAC Rigid Bronchoscopy Diagnostic ‐ For PACS ‐
S NOT FOR BILLING PURPOSE
RGBRDHC Rigid Bronchoscopy Diagnostic ‐ Hospital 8710 8710 4360 3490 2620
Charges
505 RGBRFBR Rigid Bronchoscopy ‐ Foreign
OS body removal ‐ (Doctor Fee +
Hospital Charges)
RGBRFBRDF Rigid Bronchoscopy ‐ Foreign body removal ‐ 30000 30000 15000 12000 9000
Doctor Fee
RGBRFBRPACS Rigid Bronchoscopy ‐ Foreign body removal ‐
RGBRFBRHC Rigid Bronchoscopy ‐ Foreign body removal ‐ 12000 12000 6000 4800 3600
Hospital Charges
506 RGBRSTT Rigid Bronchoscopy + stenting
DBOS + tumor de‐bulking ‐ (Doctor
Fee + Doctor Fee)
RGBRSTTDBPA Rigid Bronchoscopy + stenting + tumor
CS de‐bulking ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
RGBRSTTDBHC Rigid Bronchoscopy + stenting + tumor 15000 15000 7500 6010 4500
de‐bulking ‐ Hospital Charges
272
RGBRSTTDBDF Rigid Bronchoscopy = stenting + tumor 37510 37510 18760 15000 11260
de‐bulking ‐ Doctor Fee
507 RGBRTBS Rigid Bronchoscopy +
TOS tracheal/bronchial stenting ‐
Charges)
RGBRTBSTDF Rigid Bronchoscopy + tracheal/bronchial 37510 37510 18760 15000 11260
stenting ‐ Doctor Fee
RGBRTBSTPAC Rigid Bronchoscopy + tracheal/bronchial
S stenting ‐ For PACS ‐ NOT FOR BILLING
PURPOSE
RGBRTBSTHC Rigid Bronchoscopy + tracheal/bronchial 15000 15000 7500 6010 4500
stenting ‐ Hospital Charges
508 RGBRTDB Rigid Bronchoscopy + Tumor
OS de‐bulking ‐ (Doctor Fee +
Hospital Charges)
RGBRTDBDF Rigid Bronchoscopy + Tumor de‐bulking ‐ 29040 29040 14520 11620 8710
Doctor Fee
RGBRTDBPACS Rigid Bronchoscopy + Tumor de‐bulking ‐
RGBRTDBHC Rigid Bronchoscopy + Tumor de‐bulking ‐ 11620 11620 5810 4640 3490
Hospital Charges
509 SBOWTRA Small bowel transplant
SUROS recipient operation (NORMAL
RISK) (Package charges +
Gastroenterologist fee)
SBTSAGAS Small bowel transplant surgery (Normal / 66000
Early)‐ amount given to gastroenterology
from within the package
SBTSPCN Small bowel transplant surgery (Normal)‐ 2365000
510 SBTSPCEO Small bowel transplant
S recipient operation (EARLY
DISCHARGE) (Package charges
+ Gastroenterologist fee)
SBTSPCE Small bowel transplant surgery (Early 2200000
Discharge)‐ recipient package charges
SBTSAGAS Small bowel transplant surgery (Normal / 66000
Early)‐ amount given to gastroenterology
from within the package
511 SPGCBOS Spy Glass
Cholangioscopy+Consumables
(Optical Fiber‐Spy Scope) ‐
(Doctor Fee+ Hospital Charges)
‐ Spybite Biopsy
COFSPY Consumables ( Optical fiber + Spyscope ) 18000
charges
SBBIO Spy bite biopsy charges 6000
SPGCH Spy Glass Cholangioscopy ‐ Additional 12800 12800 6400 5120 3840
hospital charges
SPGCD Spy Glass Cholangioscopy ‐ Doctor Fee 32000 32000 16000 12800 9600
SGXR X‐Ray ( Spy Glass ) 4000
512 SPGCLOS Spy Glass
Cholangioscopy+Consumables
(Optical Fiber‐Spy Scope) ‐
(Doctor Fee+Hospital Charges)
‐ Laser Lithotripsy
COFSPY Consumables ( Optical fiber + Spyscope ) 18000
charges
LASLI Laser Lithotripsy 12000
SPGCH Spy Glass Cholangioscopy ‐ Additional 12800 12800 6400 5120 3840
hospital charges
SPGCD Spy Glass Cholangioscopy ‐ Doctor Fee 32000 32000 16000 12800 9600
SGXR X‐Ray ( Spy Glass ) 4000
273
513 STPDHCH SENGSTAKEN TUBE
OS PLACEMENT (DOCTOR FEE +
HOSPITAL CHARGES)
DTPHC Sengstaken tube placement. ‐ Additional 5600 5600 2800 2240 1680
hospital charges
STPDF Sengstaken tube placement. ‐ Doctor fee 14000 14000 7000 5600 4200
514 TAALVHC Ascites tapping / aspiration
ENDOS done in ENDOSCOPY (
therapeutic ) ‐ large volume
paracentesis (doctor fee +
hospital charges)
TAALVDF Therapeutic ascites aspiration ( large 6300 6300 3150 2520 1890
TAALVHCEND Therapeutic ascites aspiration ( large 2400 2400 1200 1240
volume paracentesis ) done in ENDOSCOPY
room ‐ Additional hospital charges
515 TJLBEOS Transjuglar liver biopsy (done
in endoscopy) (Doctor fee +
Hospital Charges)
TJLBE Transjuglar liver biopsy (done in endoscopy) 8000 8000 4000 3200 2400
‐ Additional hospital charges
TJLBEDF Transjuglar liver biopsy (done in endoscopy) 20000 20000 10000 8000 6000
‐ Doctor Fee
TJLBEPACS Transjuglar liver biopsy (done in endoscopy)
‐ For PACS ‐ NOT FOR BILLING PURPOSE
516 TRANBOS Transjuglar Biopsy
TRANBCC Transjuglar Biopsy ‐ Consumable Charges 18150 18150 9080
TRANBDF Transjuglar Biopsy ‐ Doctor fee 49920 49920 24960 19970 14980
TRANBFC Transjuglar Biopsy ‐ Fluroscopy charges 17470 17470 8730 6990 5240
TRANBPACS Transjuglar Biopsy ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
TRANBHC Transjuglar Biopsy ‐ Hospital charges 19970 19970 9990 7990 5990
517 UGGGIED UPPER GASTROINTESTINAL (
CHOS UGI ) ENDOSCOPY (DOCTOR
UGIHC Upper gastrointestinal ( UGI ) endoscopy ‐ 3600 3600 1800 1440 1080
UGIDF Upper gastrointestinal ( UGI ) endoscopy ‐ 9000 9000 4500 3600 2700
Doctor fee
UGIPACS Upper gastrointestinal ( UGI ) endoscopy ‐
518 UGIOS Upper gastrointestinal (UGI )
endoscopy done outside
Hospital Charges)
UGIOSHC Upper gastrointestinal (UGI ) endoscopy 4690 4690 2340 1870 1400
done outside endoscopy suite ‐ Additional
hospital charges
UGIOS Upper gastrointestinal (UGI ) endoscopy 11700 11700 5850 4690 3510
done outside endoscopy suite ‐ doctor fee
519 ULTIOS Ultroid Injection ‐ (Doctor Fee
+ Hospital Charges)
ULTIH Ultroid Injection ‐ Additional hospital 6400 6400 3200 2560 1920
charges
ULTID Ultroid Injection ‐ Doctor Fee 16000 16000 8000 6400 4800
ULTIPACS Ultroid Injection ‐ For PACS ‐ NOT FOR
BILLING PURPOSE
520 USCOS USG FOR SIZE OF COLLECTION
/ USG FOR ASCITES ‐ (Doctor
USCHC USG FOR SIZE OF COLLECTION / USG FOR 400 320 240
ASCITES ‐ Additional Hospital Charges
USCDC USG FOR SIZE OF COLLECTION / USG FOR 1000 800 600
ASCITES ‐ Doctor Fee
274
521 USGOS USG GUIDED SINGLE TIME
ASPIRATION ‐ (Doctor Fee +
Hospital Charges)
UGSHC USG GUIDED SINGLE TIME ASPIRATION ‐ 1200 960 720
UGSDC USG GUIDED SINGLE TIME ASPIRATION ‐ 3000 2400 1800
Doctor Fee
Interventional Neurology
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
555 ABLDSOS Angiography of B/L
Dorsolumbar Spinal Radicular
Arteries
ABLDAF Angiography of B/L Dorsolumbar Spinal 13200 13200 6600 5280 3960
Radicular Arteries ‐ Anasthetist fee
ABLDS Angiography of B/L Dorsolumbar Spinal 66000 66000 33000 26400 19800
Radicular Arteries ‐ Doctor Fee
ABLDSLA Angiography of B/L Dorsolumbar Spinal 28380 28380 14190 11350 8510
Radicular Arteries ‐ Lab charges
556 ATHOS Intracranial stenting for
Atherosclerosis ‐
INTERVENTION NEUROLOGY
ATHDF Intracranial stenting for Atherosclerosis ‐ 181500 181500 90750 72600 54450
Surgeon Fee
557 AVMOS Complex AVM/AVF
Embolization via trans arterial
and transvenous route ‐
AVMLC Complex AVM/AVF Embolization via trans 78050 78050 39020 31220 23410
arterial and transvenous route ‐ Intervention
lab charges
AVMDF Complex AVM/AVF Embolization via trans 181500 181500 90750 72600 54450
arterial and transvenous route ‐ Surgeon
Fee
558 BACEDOS Balloon Assisted Coil
Embolization of a
Direct/Indirect Cavernous
Fistula
BACEDAN Balloon Assisted Coil Embolization of a 44000 44000 22000 17600 13200
Direct/Indirect Cavernous Fistula ‐
Anasthetist fee
BACEDF Balloon Assisted Coil Embolization of a 220000 220000 110000 88000 66000
Direct/Indirect Cavernous Fistula ‐ Doctor
Fee
BACEDLB Balloon Assisted Coil Embolization of a 94600 94600 47300 37840 28380
Direct/Indirect Cavernous Fistula ‐ Lab
charges
559 BASCIOS Balloon Angioplasty & Stenting
in Cervical ICA/Vertebral
BASCAN Balloon Angioplasty & Stenting in Cervical 39600 39600 19800 15840 11880
ICA/Vertebral ‐ Anasthetist Fee
BASCD Balloon Angioplasty & Stenting in Cervical 198000 198000 99000 79200 59400
ICA/Vertebral ‐ Doctor Fee
BASCLC Balloon Angioplasty & Stenting in Cervical 85140 85140 42570 34060 25540
ICA/Vertebral ‐ Lab charges
560 BTOUMO Balloon test occlusion ( Under
S2 Monitoring )
BTOANM2 Balloon test occlusion ‐ anaesthetists 16100 16100 8060 6440 4840
charges for monitoring
BTODF2 Balloon test occlusion ‐ doctor fee 80530 80530 40270 32210 24170
BTOLC2 Balloon test occlusion ‐ intervention lab 34630 34630 17320 13850 10390
charges
275
561 CASUMOS Carotid angioplasty & stenting
2 ( Under Monitoring )
CASANM2 Carotid angioplasty & stenting ‐ 25770 25770 12890 10300 7730
anaesthetists charges for monitoring
CASDF2 Carotid angioplasty & stenting ‐ doctor fee 128840 128840 64420 51540 38640
CASLC2 Carotid angioplasty & stenting ‐ intervention 55400 55400 27700 22160 16620
lab charges
562 CCDSAOS Check cerebral DSA ( Under LA
2 )
CCDSADF2 Check cerebral DSA ‐ doctor fee 29000 29000 14500 11590 8700
CCDSALC2 Check cerebral DSA ‐ intervention lab 12470 12470 6240 4980 3740
charges
563 CCDSAUG Check cerebral DSA ( Under GA
AOS2 )
CCDANGA2 Check cerebral DSA ‐ anaesthetists charges 8690 8690 4360 3480 2620
for GA
charges
564 CCDSAUM Check cerebral DSA ( Under
OS2 Monitoring )
CCDANM2 Check cerebral DSA ‐ anaesthetists charges 5810 5810 2900 2310 1740
for monitoring
charges
565 CCFEUGA CCF embolisation ( Under GA )
OS2
CCFEANGA2 CCF embolisation ‐ anaesthetists charges for 43480 43480 21750 17400 13050
GA
CCFEDF2 CCF embolisation ‐ doctor fee 144950 144950 72480 57980 43480
CCFELC2 CCF embolisation ‐ intervention lab charges 62330 62330 31170 24930 18700
566 CDSAGAO Cerebral DSA ( Under GA )
S
CDANGA2 Cerebral DSA ‐ anaesthetists charges for GA 9670 9670 4830 3860 2890
CDANM2 Cerebral DSA ‐ anaesthetists charges for 6440 6440 3220 2570 1940
monitoring
CDSADF2 Cerebral DSA ‐ doctor fee 32210 32210 16100 12890 9670
LC2 Cerebral DSA ‐ intervention lab charges 13850 13850 6920 5540 4160
567 CDSALAO Cerebral DSA ( Under LA )
S2
CDSADF2 Cerebral DSA ‐ doctor fee 32210 32210 16100 12890 9670
LC2 Cerebral DSA ‐ intervention lab charges 13850 13850 6920 5540 4160
568 CHBOS Intraarterial chemotherapy for
malignant brain tumours ‐
CHBLC Intraarterial chemotherapy for malignant 83250 83250 41620 33300 24970
brain tumours ‐ Intervention Lab charges
CHBDF Intraarterial chemotherapy for malignant 193600 193600 96800 77440 58080
brain tumours ‐ Surgeon Fee
569 CHHNOS Intra‐arterial chemotherapy of
head and neck tumours ‐
CHHNLC Intra‐arterial chemotherapy of head and 78050 78050 39020 31220 23410
neck tumours ‐ Intervention Lab charges
CHHNDF Intra‐arterial chemotherapy of head and 181500 181500 90750 72600 54450
neck tumours ‐ Surgeon Fee
570 CIATUGA Cerebral intra‐arterial
OS2 thrombolysis ( Under GA )
CIATANGA2 Cerebral intra‐arterial thrombolysis ‐ 29000 29000 14500 11590 8700
anaesthetists charges for GA
CIATDF2 Cerebral intra‐arterial thrombolysis ‐ doctor 96640 96640 48310 38640 29000
fee
CIATLC2 Cerebral intra‐arterial thrombolysis ‐ 41560 41560 20770 16620 12470
intervention lab charges
276
571 CIATUMO Cerebral intra‐arterial
S2 thrombolysis ( Under
Monitoring )
CIATANM2 Cerebral intra‐arterial thrombolysis ‐ 19330 19330 9670 7730 5800
CIATDF2 Cerebral intra‐arterial thrombolysis ‐ doctor 96640 96640 48310 38640 29000
fee
CIATLC2 Cerebral intra‐arterial thrombolysis ‐ 41560 41560 20770 16620 12470
572 CVSTUGA Cerebral venous sinus
OS2 thrombolysis ( Under GA )
CVSTANGA2 Cerebral venous sinus thrombolysis ‐ 38640 38640 19330 15470 11590
CVSTDF2 Cerebral venous sinus thrombolysis ‐ doctor 128840 128840 64420 51540 38640
fee
CVSTLC2 Cerebral venous sinus thrombolysis ‐ 55400 55400 27700 22160 16620
573 CVSTUMO Cerebral venous sinus
S2 thrombolysis ( Under
Monitoring )
CVSTANM2 Cerebral venous sinus thrombolysis ‐ 25770 25770 12890 10300 7730
CVSTDF2 Cerebral venous sinus thrombolysis ‐ doctor 128840 128840 64420 51540 38640
fee
CVSTLC2 Cerebral venous sinus thrombolysis ‐ 55400 55400 27700 22160 16620
574 ESPFDOS Embolization of Spinal
Pial/dural Fistula
ESPFDNA Embolization of Spinal Pial/dural Fistula ‐ 44000 44000 22000 17600 13200
Anasthetist fee
ESPFD Embolization of Spinal Pial/dural Fistula ‐ 220000 220000 110000 88000 66000
Doctor Fee
ESPFDLA Embolization of Spinal Pial/dural Fistula ‐ 94600 94600 47300 37840 28380
Lab charges
575 FDPIAOS Flow Divertor Placement for
Intracranial Aneurysm
FDPIANA Flow Divertor Placement for Intracranial 52800 52800 26400 21120 15840
Aneurysm ‐ Anasthetist fee
FDPIA Flow Divertor Placement for Intracranial 264000 264000 132000 105600 79200
Aneurysm ‐ Doctor Fee
FDPIALC Flow Divertor Placement for Intracranial 113520 113520 56760 45410 34060
Aneurysm ‐ Lab charges
576 IACMUGA Intracranial aneurysm coiling (
OS2 multiple / complex ) ( Under
GA )
IACMANGA2 Intracranial aneurysm coiling ( multiple / 57980 57980 29000 23190 17400
complex ) ‐ anaesthetists charges for GA
IACMDF2 Intracranial aneurysm coiling ( multiple / 193260 193260 96640 77310 57980
complex ) ‐ doctor fee
IACMLC2 Intracranial aneurysm coiling ( multiple / 83100 83100 41560 33240 24930
complex ) ‐ intervention lab charges
577 IACSUGA Intracranial aneurysm coiling
OS2 (single) ( Under GA )
IACSANGA2 Intracranial aneurysm coiling (single) ‐ 43480 43480 21750 17400 13050
IACSDF2 Intracranial aneurysm coiling (single) ‐ 144950 144950 72480 57980 43480
doctor fee
IACSLC2 Intracranial aneurysm coiling (single) ‐ 62330 62330 31170 24930 18700
578 IADUGAO Intracranial angioplasty (
S2 Under GA )
IAANGA2 Intracranial angioplasty ‐ anaesthetists 48310 48310 24170 19330 14500
charges for GA
IADF2 Intracranial angioplasty ‐ doctor fee 161050 161050 80530 64420 48310
IALC2 Intracranial angioplasty ‐ intervention lab 69250 69250 34630 27700 20770
charges
579 IAELEOS Intracranial AVM Embolization
using Liquid Embolic material
IAELNA Intracranial AVM Embolization using Liquid 44000 44000 22000 17600 13200
Embolic material ‐ Anasthetist fee
277
IAELE Intracranial AVM Embolization using Liquid 220000 220000 110000 88000 66000
Embolic material ‐ Doctor Fee
IAELLC Intracranial AVM Embolization using Liquid 94600 94600 47300 37840 28380
Embolic material ‐ Lab charges
580 IAVDOS Intracranial Angioplasty for
Vasaspasm
IAVDNA Intracranial Angioplasty for Vasaspasm ‐ 26400 26400 13200 10560 7920
Anasthetist fee
IAVDF Intracranial Angioplasty for Vasaspasm ‐ 132000 132000 66000 52800 39600
Doctor Fee
IAVDLA Intracranial Angioplasty for Vasaspasm ‐ 56760 56760 28380 22700 17030
Lab charges
581 IAVLAOS2 Intra arterial vasodialation
(interventional neurology) (
Under LA )
IAVDF2 Intra arterial vasodialation (interventional 45100 45100 22540 18040 13530
neurology) ‐ doctor fee
IAVLC2 Intra arterial vasodialation (interventional 19390 19390 9690 7760 5820
neurology) ‐ intervention lab charges
582 IAVMEUG Intracranial AVM embolisation
AOS2 ( Under GA )
IAVMEANGA2 Intracranial AVM embolisation ‐ 43480 43480 21750 17400 13050
IAVMEDF2 Intracranial AVM embolisation ‐ doctor fee 144950 144950 72480 57980 43480
IAVMELC2 Intracranial AVM embolisation ‐ 62330 62330 31170 24930 18700
583 IAVUGAO Intra arterial vasodialation
S2 (interventional neurology) (
Under GA )
IAVANGA2 Intra arterial vasodialation (interventional 13530 13530 6770 5420 4060
neurology) ‐ anaesthetists charges for GA
584 IAVUMOS Intra arterial vasodialation
2 (interventional neurology) (
Under Monitoring )
IAVANM2 Intra arterial vasodialation (interventional 9030 9030 4510 3610 2710
neurology) ‐ anaesthetists charges for
monitoring
585 ISRDOS Intracranial Stenting in Stroke
Revascularization
ISRNA Intracranial Stenting in Stroke 44000 44000 22000 17600 13200
Revascularization ‐ Anasthetist fee
ISRDF Intracranial Stenting in Stroke 220000 220000 110000 88000 66000
Revascularization ‐ Doctor Fee
ISRLC Intracranial Stenting in Stroke 94600 94600 47300 37840 28380
Revascularization ‐ Lab charges
586 ISUGAOS2 Intracranial stenting ( Under
GA )
ISANGA2 Intracranial stenting ‐ anaesthetists charges 48310 48310 24170 19330 14500
for GA
ISDF2 Intracranial stenting ‐ doctor fee 161050 161050 80530 64420 48310
ISLC2 Intracranial stenting ‐ intervention lab 69250 69250 34630 27700 20770
charges
587 ITEUGAOS Intracranial tumour
2 embolisation ( Under GA )
ITEANGA2 Intracranial tumour embolisation ‐ 24170 24170 12090 9670 7250
ITEDF22 Intracranial tumour embolisation ‐ doctor 80530 80530 40270 32210 24170
fee
ITELC2 Intracranial tumour embolisation ‐ 34630 34630 17320 13850 10390
278
588 ITEUMOS Intracranial tumour
2 embolisation ( Under
Monitoring )
ITEANM2 Intracranial tumour embolisation ‐ 16100 16100 8060 6440 4840
ITEDF22 Intracranial tumour embolisation ‐ doctor 80530 80530 40270 32210 24170
fee
ITELC2 Intracranial tumour embolisation ‐ 34630 34630 17320 13850 10390
589 IVMECOS Intracranial AVM Embolization
(Complex)
IVMECNA Intracranial AVM Embolization (Complex) ‐ 52800 52800 26400 21120 15840
Anasthetist fee
IVMEC Intracranial AVM Embolization (Complex) ‐ 264000 264000 132000 105600 79200
Doctor Fee
IVMECLC Intracranial AVM Embolization (Complex) ‐ 113520 113520 56760 45410 34060
Lab charges
590 IVSUGAO Intracranial Venous stenting (
S2 Under GA )
IVSANGA2 Intracranial Venous stenting ‐ anaesthetists 38640 38640 19330 15470 11590
charges for GA
IVSDF2 Intracranial Venous stenting ‐ doctor fee 128840 128840 64420 51540 38640
IVSLC2 Intracranial Venous stenting ‐ intervention 55400 55400 27700 22160 16620
lab charges
591 MTASROS Mechanical thrombectomy for
actue stroke using stent
retrievers ‐ INTERVENTION
NEUROLOGY
MRASRLC Mechanical thrombectomy for actue stroke 78050 78050 39020 31220 23410
using stent retrievers ‐ intervention lab
charges
MTASRDF Mechanical thrombectomy for actue stroke 181500 181500 90750 72600 54450
using stent retrievers ‐ Surgeon Fee
592 PSTEUGA Percutaneous Spinal tumour
OS2 embolisation ( Under GA )
PSTEANGA2 Percutaneous Spinal tumour embolisation ‐ 15470 15470 7730 6190 4630
PSTEDF2 Percutaneous Spinal tumour embolisation ‐ 51540 51540 25770 20610 15470
doctor fee
PSTELC2 Percutaneous Spinal tumour embolisation ‐ 22160 22160 11080 8860 6650
593 PSTEUMO Percutaneous Spinal tumour
S2 embolisation ( Under
Monitoring )
PSTEANM2 Percutaneous Spinal tumour embolisation ‐ 10300 10300 5160 4130 3100
PSTEDF2 Percutaneous Spinal tumour embolisation ‐ 51540 51540 25770 20610 15470
doctor fee
PSTELC2 Percutaneous Spinal tumour embolisation ‐ 22160 22160 11080 8860 6650
594 PSUMOS2 Percutaneous Sclerotherapy
Under Monitoring )
PSANM2 Percutaneous Sclerotherapy (interventional 9030 9030 4510 3610 2710
monitoring
PSDF2 Percutaneous Sclerotherapy (interventional 45100 45100 22540 18040 13530
PSLC2 Percutaneous Sclerotherapy (interventional 19390 19390 9690 7760 5820
595 PVUMOS2 Percutaneous Vertebroplasty
Under Monitoring )
PVANM2 Percutaneous Vertebroplasty (interventional 10300 10300 5160 4130 3100
monitoring
PVDF2 Percutaneous Vertebroplasty (interventional 51540 51540 25770 20610 15470
PVLC2 Percutaneous Vertebroplasty (interventional 22160 22160 11080 8860 6650
279
596 SACEIOS Stent Assisted Coil
Embolization of Intracranial
ICA Aneurysm
SACEAN Stent Assisted Coil Embolization of 44000 44000 22000 17600 13200
Intracranial ICA Aneurysm ‐ Anasthetist fee
SACEI Stent Assisted Coil Embolization of 220000 220000 110000 88000 66000
Intracranial ICA Aneurysm ‐ Doctor Fee
SACELC Stent Assisted Coil Embolization of 94600 94600 47300 37840 28380
Intracranial ICA Aneurysm ‐ Lab charges
597 SACEOS Stent assisted coil
embolization of intracranial
aneurysms ‐ INTERVENTION
NEUROLOGY
SADELC Stent assisted coil embolization of 83250 83250 41620 33300 24970
intracranial aneurysms ‐ intervention lab
charges
SACEDF Stent assisted coil embolization of 193600 193600 96800 77440 58080
intracranial aneurysms ‐ Surgeon Fee
598 SAVMEUG Spinal AVM embolisation (
AOS2 Under GA )
SAVMEANGA2 Spinal AVM embolisation ‐ anaesthetists 43480 43480 21750 17400 13050
charges for GA
SAVMEDF2 Spinal AVM embolisation ‐ doctor fee 144950 144950 72480 57980 43480
SAVMELC2 Spinal AVM embolisation ‐ intervention lab 62330 62330 31170 24930 18700
charges
599 SDSAUGA Spinal DSA ( Under GA )
OS2
SDSAANGA2 Spinal DSA ‐ anaesthetists charges for GA 11590 11590 5810 4640 3490
SDSADF2 Spinal DSA ‐ doctor fee 38640 38640 19330 15470 11590
SDSALC2 Spinal DSA ‐ intervention lab charges 16620 16620 8310 6650 4980
600 SVCAOS Six Vessel Cerabral Angiogram
SVCAAC Six Vessel Cerabral Angiogram ‐ Anasthetist 11000 11000 5500 4400 3300
Fee
SVCAD Six Vessel Cerabral Angiogram ‐ Doctor fee 55000 55000 27500 22000 16500
SVCALB Six Vessel Cerabral Angiogram ‐ Lab charges 23650 23650 11830 9460 7100
601 VSSLAOS2 Venous sinus sampling ( Under
LA )
VSSDF2 Venous sinus sampling ‐ doctor fee 80530 80530 40270 32210 24170
VSSLC2 Venous sinus sampling ‐ intervention lab 34630 34630 17320 13850 10390
charges
602 VSSUGAO Venous sinus sampling ( Under
S2 GA )
VSSANGA2 Venous sinus sampling ‐ anaesthetists 24170 24170 12090 9670 7250
charges for GA
charges
603 VSSUMOS Venous sinus sampling ( Under
2 Monitoring )
VSSANM2 Venous sinus sampling ‐ anaesthetists 16100 16100 8060 6440 4840
charges for monitoring
charges
604 YSBAOS Y‐Stenting in a Basilar Top
Aneurysm
YSBAN Y‐Stenting in a Basilar Top Aneurysm ‐ 52800 52800 26400 21120 15840
Anasthetist fee
YSBAD Y‐Stenting in a Basilar Top Aneurysm ‐ 264000 264000 132000 105600 79200
Doctor Fee
YSBALC Y‐Stenting in a Basilar Top Aneurysm ‐ Lab 113520 113520 56760 45410 34060
charges

280
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
606 BEMBOS Bronchial a embolization
(Intervention Radiology ) ‐
Doctor Fee + Hospital Charges
BEMBDF Bronchial a embolization (Intervention 87850 87850 43920 35130 26360
Radiology ) ‐ Doctor Fee
BEMBHC Bronchial a embolization (Intervention 37780 37780 18890 15110 11330
Radiology) ‐ Hospital Charges
607 BEXOS Biliary externalization
BEXHC Biliary externalization (Intervention 27700 27700 13850 11080 8310
BEXDF Biliary externalization Intervention 64420 64420 32210 25770 19330
608 BIXOS Biliary internalization
(Intervention Radiology) ‐
Doctor fee + Hospital Charges
BIXDF Biliary internalization (Intervention 64420 64420 32210 25770 19330
Radiology) ‐ Doctor Fee
BIXHC Biliary internalization (Intervention 27700 27700 13850 11080 8310
609 BRTOIROS Balloon occluded retrograde
transvenous obliteration of
varices (BRTO) IT (Doctor +
Hospital Charges)
BRTOIRDC Balloon occluded retrograde transvenous 196900 196900 98450 78760 59070
obliteration of varices (BRTO) IT ‐ Doctor
Charges
BRTOIRHC Balloon occluded retrograde transvenous 84670 84670 42330 33870 25400
obliteration of varices (BRTO) IT ‐ Hospital
Charges
610 CABIROS Chemical Ablation of Tumour
IR (Doctor+Hospital Charges)
CABIRDC Chemical Ablation of Tumour IR Doctor 67000 67000 33500 26800 20100 33500
Charges
CABIRHC Chemical Ablation of Tumour IR Hospital 28810 28810 14410 11520 8640 14410
Charges
611 CGRFAOS CT Guided RFA of Tumour IR
Cath Lab (Doctor + Hospital
Charges)
CGRFADC CT Guided RFA of Tumour Cath Lab IR ‐ 113600 113600 56800 45440 34080 56800
Doctor Charges
CGRFAHC CT Guided RFA of Tumour Cath Lab IR ‐ 48850 48850 24420 19540 14650 24420
Hospital Charges
612 COILEMB Coil embolization (
OLOS Interventional radiology )
(Doctor fee + Hospital service
charges)
COILEMBOLDF Coil embolization ( Interventional radiology ) 70860 70860 35430 28350 21260
‐ Doctor Fee
281
COILEMBOLHC Coil embolization ( Interventional radiology ) 30470 30470 15230 12190 9140 8870 4430
‐ Hospital charges
613 COIVESTC Coiling of vessels + TC 99
99OS infusion (Interventional
Radiology) (Doctor fee +
Hospital charges)
COIVESTC99D Coiling of vessels + TC 99 infusion ‐ 99840 99840 49920 39930 24960
F Interventional radiology (Doctor fee)
COIVESTC99H Coiling of vessels + TC 99 infusion ‐ 39930 39930 19970 15970 9990 12470 6260
C Interventional radiology (Hospital charges)
614 COMBIRO Complex Biliary Externalization
S (Two/Three System ) IR
(Doctor + Hospital Charges)
COMBIRDC Complex Biliary Externalization (Two/Three 144000 144000 72000 57600 43200
System ) IR ‐ Doctor Fee
COMBIRHC Complex Biliary Externalization (Two/Three 61920 61920 30960 24770 18580
System ) IR ‐ Hospital Charges
615 COMINTIR Complex Biliary internalization
OS (Two/Three System ) IR ‐
(Doctor + Hosptal Charges)
COMINTIRDC Complex Biliary internalization (Two/Three 168000 168000 84000 67200 50400
System ) IR ‐ Doctor Fee
COMINTIRHC Complex Biliary internalization (Two/Three 72240 72240 36120 28900 21670
System ) IR ‐ Hospital Charges
616 CONECTIR Cone Beam CT assisted TACE IR
OS ‐ (Doctor + Hospital Charges)
CONECTIRDC Cone Beam CT assisted TACE IR ‐ Doctor 192000 192000 96000 76800 57600
Charges
CONECTIRHC Cone Beam CT assisted TACE IR ‐ Hospital 82560 82560 41280 33020 24770
Charges
617 CTBIOS CT Guided Biopsy ‐ IR (
Interventional radiology )
(Doctor Fee + Hospital service
charges)
CTBIOD CT Guided Biopsy ‐ IR ( Interventional 22000 22000 11000 8800 6600 11000
radiology ) (Doctor Fees)
CTBIOHC CT Guided Biopsy ‐ IR ( Interventional 2200 2200 1100 880 660 1100
radiology ) (Hospital service charges)
618 CTBONOS CT Guided Bone Biopsy ‐ IR (
charges)
CTBODC CT Guided Bone Biopsy ‐ IR ( Interventional 25000 25000 12500 10000 7500 12500
CTGUHC CT Guided Bone Biopsy ‐ IR ( Interventional 2500 2500 1250 1000 750 1250
619 CTPMULO CT Guided PCD Multiple (
S Interventional radiology )
charges)
PCDMULD CT Guided PCD Multiple ( Interventional 35000 35000 17500 14000 10500 17500
CTPCHOS CT Guided PCD Multiple ( Interventional 3500 3500 1750 1400 1050 1750
620 DIAGPLEO USG Guided Ascitic / Pleural
S Diagnostic Tapping ‐ IR (
charges)
PLEDIAGD USG Guided Ascitic / Pleural Diagnostic 8800 8800 4400 3520 2640 4400
Tapping ‐ IR ( Interventional radiology )
(Doctor Fees)
282
GUITAPPIRH USG Guided Ascitic / Pleural Diagnostic 880 880 440 360 270 440
(Hospital service charges)
621 DOXOTAC Doxorubicin loaded bead TACE
EIROS IR (Doctor + Hospital Charges)
DOXOTACEIRD Doxorubicin loaded bead TACE IR ‐ Doctor 168000 168000 84000 67200 50400
C Charges
DOXOTACEIRH Doxorubicin loaded bead TACE IR ‐ Hospital 72240 72240 36120 28900 21670
C Charges
622 EMBABDT Embolization of abdominal
UMOS tumours (Interventional
radiology) ‐ (Doctor fee +
Hospital service charges)
EMBABDTUM Embolization of abdominal tumours 70860 70860 35430 28350 21260
DF (Interventional radiology) ‐ Doctor fee
EMBABDTUM Embolization of abdominal tumours 30470 30470 15230 12190 9140
HC (Interventional radiology) ‐ Hospital charges
624 GPCIDOS Guided PCD/ICD done in Cath
Lab IR (Doctor + Hospital
Charges)
GPCIDC Guided PCD/ICD done in Cath Lab IR Doctor 22000 22000 11000 8800 6600 11000
Fee
GPCIHC Guided PCD/ICD done in Cath Lab IR Hospial 9460 9460 4730 3780 2840 4730
Charges
625 GUIDRAN CT Guided Dranage ‐ IR (
OS Interventional radiology )
charges)
GUIDEDD CT Guided Dranage ‐ IR ( Interventional 18800 18800 9400 7520 5640 9400
CTHOSN CT Guided Dranage ‐ IR ( Interventional 1880 1880 940 760 570 940
626 GUIPLEM USG Guided Ascitic / Pleural
OBOS Diagnostic Tapping (Mob) ‐ IR (
charges)
GUIPLE USG Guided Ascitic / Pleural Diagnostic 12800 12800 6400 5120 3840
Tapping (Mob) ‐ IR ( Interventional radiology
) (Doctor Fees)
TAPPHOSIR USG Guided Ascitic / Pleural Diagnostic 1280 1280 640 520 390
) (Hospital service charges)
627 INCYTOS Intraductal Cytology/Biopsy IR
Cath Lab (Doctor + Hospital
Charges)
INCYTOB Intraductal Cytology/Biopsy IR Cath Lab ‐ 30000 30000 15000 12000 9000 15000
Doctor Fee
INCYTOBHC Intraductal Cytology/Biopsy IR Cath Lab ‐ 12900 12900 6450 5160 3870 6450
Hospital Charges
283
628 IRRDCOS Irrigation of Drain / Change of
Dressing ‐ IR ( Interventional
radiology ) (Doctor Fee +
IRR Irrigation of Drain / Change of Dressing ‐ IR ( 5000 5000 2500 2000 1500
Interventional radiology ) (Doctor Fees)
IRRDESHC Irrigation of Drain / Change of Dressing ‐ IR ( 500 500 250 200 150
Interventional radiology ) (Hospital service
charges)
629 IRRDERM Irrigation of Drain / Change of
OBOS Dressing (Mob) ‐ IR (
(Doctor Fee Hospital service
charges)
IRRCHADC Irrigation of Drain / Change of Dressing 7000 7000 3500 2800 2100
(Mob) ‐ IR ( Interventional radiology )
(Doctor Fees)
IRRCHAHC Irrigation of Drain / Change of Dressing 700 700 350 280 210
(Mob) ‐ IR ( Interventional radiology )
630 PAIROS PAIR Interventinal Radiology IR
‐ (Doctor + Hospital Charges)
PAIRDC PAIR Interventinal Radiology IR ‐ Doctor 6700 6700 33500 26800 20100
Charges
PAIRHC PAIR Interventinal Radiology IR ‐ Hospital 26800 26800 13400 10720 8040 13400
Charges
632 PBEMOS Percutaenous Biopsy with tract
embolization ath Lab IR
PBEMCF Percutaenous Biopsy with tract embolization 10750 10750 5380 4300 3230 5380
‐ Cath Lab Charges
PBEMB Percutaenous Biopsy with tract embolization 25000 25000 1250 10000 7500 12500
‐ Doctor Charges
633 PCDCHCO Percutaneous Cholecystotomy
S ‐ Doctor Fee + Hospital Charges
PCDF Percutaneous Cholecystotomy ‐ Doctor Fee 24200 24200 12100 9080 7260
PCHC Percutaneous Cholecystotomy ‐ Hospital 10410 10410 5200 3900 3120
Charges
634 PCDCTOS CT Guided PCD ‐ IR (
charges)
PCDDOCC CT Guided PCD ‐ IR ( Interventional radiology 25000 25000 12500 10000 7500
) (Doctor Fees)
PCDHOSPI CT Guided PCD ‐ IR ( Interventional radiology 2500 2500 1250 1000 750 900
635 PCDMOB USG Guided PCD (Mob) ‐ IR (
charges)
PCDDOC USG Guided PCD (Mob) ‐ IR ( Interventional 26000 26000 13000 10400 7800
284
PCSDHC USG Guided PCD (Mob) ‐ IR ( Interventional 2600 2600 1300 1040 780
636 PDEBOS Precision TACE by drug eluting
beads (Intervention Radiology
) ‐ Doctor Fee + Hospital
Charges
PDEBDF Precision TACE by drug eluting beads 105410 105410 52710 42170 31630
(Intervention Radiology ) ‐ Doctor Fee
PDEBHC Precision TACE by drug eluting beads 45330 45330 22670 18130 13600
(Intervention Radiology) ‐ Hospital Charges
637 PDSPOS Partial devascularization of
spleen ( for hypersplenism)
PDSPDF Partial devascularization of spleen ( for 87850 87850 43920 35130 26360
hypersplenism) (Intervention Radiology ) ‐
Doctor Fee
PDSPHC Partial devascularization of spleen (for 37780 37780 18890 15110 11330
hypersplenism) (Intervention Radiology) ‐
Hospital Charges
638 PEADSNE Percutaenous Esophagostomy/
WOS Gastrostomy/ Jejunostomy/
Caecostomy ‐ IR (
charges)
PEGJDOC Percutaenous Esophagostomy/ 84800 84800 42400 33920 25440
Gastrostomy/ Jejunostomy/ Caecostomy ‐ IR
( Interventional radiology ) (Doctor Fee)
IPFGPJHC Percutaenous Esophagostomy/ 36460 36460 18230 14590 10940
Gastrostomy/ Jejunostomy/ Caecostomy ‐ IR
( Interventional radiology ) (Hospital service
charges)
639 PERANGIR Percutaenous Endovascular
OS Angioplasty IR (Doctor +
Hospital Charges)
PERANGIRDC Percutaenous Endovascular Angioplasty IR ‐ 197000 19700 98500 78800 59100
Doctor Charges
PERANGIRHC Percutaenous Endovascular Angioplasty IR ‐ 84670 84670 42330 33870 25400
Hospital Charges
643 PROSIROS Prostatic Artery Embolization
IR (Doctor + Hospital Charges)
PROSIRDH Prostatic Artery Embolization IR ‐ Doctor 124000 124000 62000 49600 37200
Charges
PROSIRHC Prostatic Artery Embolization IR ‐ Hospital 53320 53320 26660 21330 16000
Charges
644 PVFDOS Portal vein flow diversion
PVFDDF Portal vein flow diversion (Intervention 105410 105410 52710 42170 31630
PVFDHC Portal vein flow diversion (Intervention 45330 45330 22670 18130 13600
645 RABTUOS Radiofrequency ablation of
Tumour Interventional
Radiology IR Cath Lab (Doctor
+ Hospital Charges)
RABTUDC Radiofrequency ablation of Tumour 113600 113600 56800 45440 34080 56800
Interventional Radiology IR Cath Lab ‐
Doctor Charges
RABTUHC Radiofrequency ablation of Tumour 48850 48850 24420 19540 14650 24420
Interventional Radiology IR Cath Lab ‐
Hospital Charges
647 RFAIROS RFA of Osteiod Osteoma IR ‐
RFAIRDC RFA of Osteiod Osteoma IR ‐ Doctor Charges 84800 84800 42400 33920 2544 42400
285
RFAIRHC RFA of Osteiod Osteoma IR ‐ Hospital 36460 36460 18230 14590 10940 18230
Charges
648 STHROIRO Selective Thrombolysis IR
S (Hospital + Doctor Charges)
STHROIRDC Selective Thrombolysis IR ‐ Doctor Charges 124000 124000 62000 49600 16000
STHROIRHC Selective Thrombolysis IR ‐ Hospital Charges 53320 53320 26660 21330 16000
649 TACEOS TACE (Trans arterial chemo
embolization) (Intervention
Radiology) ‐ Doctor Fee +
Hospital Charges
TACEDF TACE (Trans arterial chemo embolization) 87850 87850 43920 35130 26360
(Intervention Radiology ) Doctor Fee
TACEHC TACE (Trans arterial chemo embolization) 37780 37780 18890 15110 11330
(Intervention Radiology) ‐ Hospital Charges
650 TAPPASO USG Guided Ascitic / Pleural
S Therapeutic Tapping ‐ IR (
charges)
THEPLED USG Guided Ascitic / Pleural Therapeutic 11200 11200 5600 4480 3360 5600
(Doctor Fees)
THEPLERAHC USG Guided Ascitic / Pleural Therapeutic 1120 1120 560 450 340 560
651 TBIOPOS Transjugular Trucut Biopsy in
Cath Lab IR (Doctor + Hospital
Charges )
TBIOPDC Transjugular Trucut Biopsy in Cath Lab IR ‐ 42000 42000 21000 16800 12600
Doctor Charge
TBIOPHC Transjugular Trucut Biopsy in Cath Lab IR ‐ 18060 18060 9030 7220
Hospital Charge
652 TIPPSOS TIPSS (Doctor fee + Hospital
charges)
TIPSARWP TIPSS ‐ Interventional radiology ‐ amount 209360 209360 104690 83740 62810
given to doctor
TIPSPC TIPSS ‐ Interventional radiology ‐ hospital 90020 90020 45020 36010 27010
charges
653 TIPSSROS TIPSS Revision (Intervention
Radiology ) ‐ Doctor Fee +
Hospital Charges
TIPPSRDF TIPSS Revision (Intervention Radiology ) ‐ 64420 64420 32210 25770 19330
Doctor Fee
TIPPSRHC TIPSS Revision (Intervention Radiology) ‐ 27700 27700 13850 11080 8310
Hospital Charges
655 TRUSGUO TRUS Guided Prostate Biopsy ‐
S IR ( Interventional radiology )
charges)
TRUSDOC TRUS Guided Prostate Biopsy ‐ IR ( 22000 22000 11000 8800 6600 11000
TRUSNHC TRUS Guided Prostate Biopsy ‐ IR ( 2200 2200 1100 880 660 1100
charges)
656 TRUSTVS TRUS/TVS Guided Drainage ‐ IR
OS ( Interventional radiology )
charges)
TVSUSGD TRUS/TVS Guided Drainage ‐ IR ( 21600 21600 10800 8640 6480 10800
USDETVSH TRUS/TVS Guided Drainage ‐ IR ( 2160 2160 1080 870 650 1080
charges)
286
657 TUBEUPO Tube Change / Tube Upsizing /
S Tube Repositioning ‐ IR (
charges)
TUBERESD Tube Change / Tube Upsizing / Tube 12800 12800 6400 5120 3840 6400
Repositioning ‐ IR ( Interventional radiology )
(Doctor Fees)
TUPERESHC Tube Change / Tube Upsizing / Tube 1280 1280 640 520 390 640
Repositioning ‐ IR ( Interventional radiology )
658 TVSTRUS TVS or TRUS Guidedsampling ‐
OS IR ( Interventional radiology )
charges)
TVSTQSD TVS or TRUS Guidedsampling ‐ IR ( 18800 18800 9400 7520 5640 9400
TVSUSHC TVS or TRUS Guidedsampling ‐ IR ( 1880 1880 940 870 570 940
charges)
659 USGASIPL USG Guided Ascitic / Pleural
TAOS Therapeutic Tapping (Mob) ‐ IR
( Interventional radiology )
charges)
USGMOBDC USG Guided Ascitic / Pleural Therapeutic 15200 15200 7600 6080 4560
) (Doctor Fees)
USGMOBHCC USG Guided Ascitic / Pleural Therapeutic 1520 1520 760 610 460
660 USGASPRI USG Guided Aspiration /
OS Drainage ‐ IR ( Interventional
radiology ) (Doctor Fee +
USGASPID USG Guided Aspiration / Drainage ‐ IR ( 10200 10200 5100 4080 3060 5100
USGPIDRAH USG Guided Aspiration / Drainage ‐ IR ( 1020 1020 510 410 310 510
charges)
661 USGBION USG Guided Biopsy Multiple ‐
OS IR ( Interventional radiology )
charges)
USGBIOD USG Guided Biopsy Multiple ‐ IR ( 29000 29000 14500 8640 8700 14500
USGBIOHC USG Guided Biopsy Multiple ‐ IR ( 2900 2900 1450 1160 870 1450
charges)
662 USGBIOS USG Guided Biopsy ‐ IR (
charges)
USGBID USG Guided Biopsy ‐ IR ( Interventional 21600 21600 10800 8640 6480 10800
USGBHC USG Guided Biopsy ‐ IR ( Interventional 2160 2160 1080 870 650 1080
663 USGDEPO USG Making in dept ‐ (IR) (
charges)
USGDEPDOC USG Making in dept ‐ (IR) ( Interventional 7200 7200 3600 2880 2160
USGDEPHC USG Making in dept ‐ (IR) ( Interventional 720 720 360 290 220
287
664 USGFLUD USG and Fluoroscopic Guided
OOS PCD done in Cath Lab ‐ IR (
charges)
USGPCIRD USG and Fluoroscopic Guided PCD done in 32000 32000 16000 12800 9600 16000
Cath Lab ‐ IR ( Interventional radiology )
(Doctor Fees)
USGDAHC USG and Fluoroscopic Guided PCD done in 13760 13760 6880 5500 4130 6880
Cath Lab ‐ IR ( Interventional radiology )
665 USGFNA USG Guided FNAC Multiple‐ IR
MOS ( Interventional radiology )
charges)
USGFNADOC USG Guided FNAC Multiple‐ IR ( 9000 9000 4500 3600 2700 4500
USGFNAHC USG Guided FNAC Multiple‐ IR ( 900 900 450 360 270 450
charges)
666 USGGUIO USG Guided FNAC ‐ IR (
(Doctor fee + Hospital service
charges)
USGDOC USG Guided FNAC ‐ IR ( Interventional 6100 6100 3050 2440 1830 3050
radiology ) (Doctor Fee )
USGHOSPI USG Guided FNAC ‐ IR ( Interventional 610 610 310 250 190 310
radiology ) Hospital service charges)
667 USGGUM USG Guided Biopsy (Mob) ‐ IR (
(Doctor Fee Hospital service
charges)
USGMOD USG Guided Biopsy (Mob) ‐ IR ( 25600 25600 12800 10240 7680
MOBNEWHC USG Guided Biopsy (Mob) ‐ IR ( 2560 2560 1280 1030 770
charges)
668 USGICDOS USG Guided ICD ‐ IR (
charges)
USGICDD USG Guided ICD ‐ IR ( Interventional 22000 22000 11000 8800 6600 11000
USGICDHC USG Guided ICD ‐ IR ( Interventional 2200 2200 1100 880 660 1100
669 USGMOB USG Guided Aspiration /
1OS Drainage (Mob) ‐ IR (
charges)
MOBUSGIRD USG Guided Aspiration / Drainage (Mob) ‐ IR 14200 14200 7100 5680 4260
( Interventional radiology ) (Doctor Fees)
MOBDOSHC USG Guided Aspiration / Drainage (Mob) ‐ IR 1420 1420 710 570 430
( Interventional radiology ) (Hospital service
charges)
670 USGMOB USG Guided FNAC (Mob) ‐ IR (
charges)
SGGDOCC USG Guided FNAC (Mob) ‐ IR ( Interventional 10100 10100 5050 4040 3030
USGMH USG Guided FNAC (Mob) ‐ IR ( Interventional 1010 1010 510 410 310
288
671 USGMUL USG Guided PCD Multiple ‐ IR (
charges)
USGMULD USG Guided PCD Multiple ‐ IR ( 29000 29000 14500 11600 8700 14500
USGHOSM USG Guided PCD Multiple ‐ IR ( 2900 2900 1450 1160 870 1450
charges)
672 USGMULT USG Guided ICD Multiple ‐ IR (
IOS Interventional radiology )
charges)
USGMOLTID USG Guided ICD Multiple ‐ IR ( Interventional 29000 29000 14500 11600 8700 14500
USGDOCN USG Guided ICD Multiple ‐ IR ( Interventional 2900 2900 1450 1160 870 1450
673 USGOTOS USG Making in Ward / OT ‐ (IR)
( Interventional radiology )
charges)
USGOTDOC USG Making in Ward / OT ‐ (IR) ( 11200 11200 5600 4480 3360
USGOTHC USG Making in Ward / OT ‐ (IR) ( 1120 1120 560 450 340
charges)
674 USGPCDO USG Guided PCD ‐ IR (
charges)
USGPCDH USG Guided PCD ‐ IR ( Interventional 2200 2200 1100 880 660 1100
USGPCD USG Guided PCD ‐ IR( Interventional 22000 22000 11000 8800 6600 11000
675 USSGBOM USG Guided ICD (Mob) ‐ IR (
DOS Interventional radiology )
charges)
USGMOBD USG Guided ICD (Mob) ‐ IR ( Interventional 26000 26000 13000 10400 7800
USGMOBHC USG Guided ICD (Mob) ‐ IR ( Interventional 2600 2600 1300 1040 780
676 XAOBIOP Abdominal Organ Biopsy ‐
OS Interventional Radiology
Charges)
XAOBIOPDF Abdominal Organ Biopsy ‐ Interventional 13310 13310 6660 4990 3990
Radiology (Doctor Fee)
XAOBIOPHC Abdominal organ biopsy ‐ Interventional 5720 5720 2860 2150 1720
Radiology (Hospital charges)
677 XBAAOS Bronchial Artery Angiography ‐
Interventional Radiology
Charges)
XBAADF Bronchial Artery Angiography ‐ 26620 26620 13310 9990 7990
Interventional Radiology (Doctor Fee)
XBAAHC Bronchial Artery Angiography ‐ 11450 11450 5720 4300 3440
Interventional Radiology (Hospital charges)
678 XBDJSVCL Bilateral DJ Stenting (IR) in
OS Vascular Cath Lab ‐
Charges)
XBDJSVCLDF Bilateral DJ Stenting (IR) in Vascular Cath 79860 79860 39930 29950 23960
Lab ‐ Interventional Radiology (Doctor Fee)
289
XBDJSVCLHC Bilateral DJ stenting (IR) in Vascular Cath 34340 34340 17170 12880 10300
Lab ‐ Interventional Radiology (Hospital
charges)
679 XCBAEOS Complex Bronchial Artery
Embolization ‐ Interventional
Radiology (Doctor Fee +
Hospital Charges)
XCBAEDF Complex Bronchial Artery Embolization ‐ 133100 133100 66550 49920 39930
XCBAEHC Complex Bronchial Artery Embolization ‐ 57230 57230 28620 21470 17170
680 XCBEOS Complex Biliary Externalization
‐ Interventional Radiology
Charges)
XCBEDF Complex Biliary Externalization ‐ 106480 106480 53240 39930 31940
XCBEHC Complex Biliary Externalization ‐ 45790 45790 22890 17170 13730
681 XCBIOS Complex Biliary Internalization
‐ Interventional Radiology
Charges)
XCBIDF Complex Biliary Internalization ‐ 106480 106480 53240 39930 31940
XCBIHC Complex Biliary Internalization ‐ 45790 45790 22890 17170 13730
682 XEVOS Embolization for varicocele ‐
Charges)
XEVDF Embolization for Varicocele ‐ Interventional 106480 106480 53240 39930 31940
XEVHC Embolization for Varicocele ‐ Interventional 45790 45790 22890 17170 13730
684 XMACDOS Multiple Abscess / Collection
drainage ‐ Interventional
Hospital Charges)
XMACDDF Multiple Abscess / Collection Drainage ‐ 26620 26620 13310 9990 7990
XMACDHC Multiple Abscess / Collection Drainage ‐ 11450 11450 5720 4300 3440
685 XMBIOPO Miscellaneous biopsy ‐
S Interventional Radiology
Charges)
XMBIOPDF Miscellaneous Biopsy ‐ Interventional 13310 13310 6660 4990 3990
XMBIOPHC Miscellaneous Biopsy ‐ Interventional 5720 5720 2860 2150 1720
686 XMCTACE Multiple / Complex TACE ‐
Charges)
XMCTACEDF Multiple / Complex TACE ‐ Interventional 159720 159720 79860 59900 47920
XMCTACEHC Multiple / Complex TACE ‐ Interventional 68680 68680 34340 25760 20610
687 XPCNVCL PCN (IR) in Vascular Cath Lab ‐
Charges)
XPCNVCLDF PCN (IR) in Vascular Cath Lab ‐ 53240 53240 26620 19970 15970
XPCNVCLHC PCN (IR) in Vascular Cath Lab ‐ 22890 22890 11450 8590 6870
290
688 XPPVEOS Presurgical portal vein
embolization ‐ Interventional
Hospital Charges)
XPPVEDF Presurgical Portal Vein Embolization ‐ 133100 133100 66550 49920 39930
XPPVEHC Presurgical Portal Vein Embolization ‐ 57230 57230 28620 21470 17170
690 XRYANGA ANGIOPLASTY OF ABDOMINAL
BVSOS VESSELS (Doctor fee + hospital
service charges)
XRAYANGPLA Angioplasty of abdominal vessels ‐ 70860 70860 35430 28350 21260 35430 17710
BDVSL Interventional radiology (done in X‐ray dept)
‐ doctor fee
XRAYANGPLST Angioplasty of abdominal vessels ‐ 30470 30470 15230 12190 9140 15230 7620
ABVSHSP Interventional radiology (done in X‐ray dept)
‐ hospital service charges
691 XRYSELAB Selective Abdominal
DANGOS Angiography (Doctor fee +
hospital service charges)
XRYSELABDAN Selective Abdominal Angiography ‐ 20940 20940 10480 8380 6290 1060 530
GDF Interventional radiology ‐ doctor fee
XRYSELABDAN Selective Abdominal Angiography ‐ 9000 9000 4510 3600 2700 460 230
GHC Interventional radiology ‐ hospital service
charges
692 XSIRTLTII Selective Internal Radiation
OS Therapy for Liver Tumors Part
II (SIRT) ‐ Interventional
Hospital Charges)
XSIRTLTIIDF Selective Internal Radiation Therapy for 79860 79860 39930 29950 23960
Liver Tumors Part II (SIRT) ‐ Interventional
XSIRTLTIIHC Selective Internal Radiation Therapy for 34340 34340 17170 12880 10300
Liver Tumors Part II (SIRT) ‐ Interventional
693 XSIRTLTIO Selective Internal Radiation
S Therapy for Liver Tumors Part I
(SIRT) ‐ Interventional
Hospital Charges)
XSIRTLTIDF Selective Internal Radiation Therapy for 202310 202310 101160 75870 60700
Liver Tumors Part I (SIRT) ‐ Interventional
XSIRTLTIHC Selective Internal Radiation Therapy for 86990 86990 43500 32620 26100
Liver Tumors Part I (SIRT) ‐ Interventional
Radiology (Hospital Charges)
694 XUDJSVCL Unilateral DJ Stenting (IR) in
OS Vascular Cath Lab ‐
Charges)
XUDJSVCLDF Unilateral DJ Stenting (IR) in Vascular Cath 63890 63890 31940 23960 19160
Lab ‐ Interventional Radiology (Doctor Fee)
XUDJSVCLHC Unilateral DJ stenting (IR) in Vascular Cath 27470 27470 13730 10300 8240
Lab ‐ Interventional Radiology (Hospital
charges)

291

LITHOTRIPSY PACKAGE
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
700 LITHOFSPC Lithotripsy follow‐up session 0
package charges
701 LITPDHCH LITHOTRIPSY PROCEDURE
OS1 (STONE < 1 CM) (PACKAGE
LITHO1PC Lithotripsy procedure (stone < 1 cm) 26000
package charges
OS12 (STONE 1.6 ‐ 2.5 CM)
FEE)
LITHO12PC Lithotripsy procedure (stone 1.6 ‐ 2.0 cm) 40000
package charges
OS15 (STONE 1 ‐ 1.5 CM) (PACKAGE
LITHO15PC Lithotripsy procedure (stone 1 ‐ 1.5 cm) 32000
package charges
OS21 (STONE 2.1 ‐ 2.5 CM)
FEE)
package charges
OS23 (STONE 2.6 ‐ 3.0 CM)
FEE)
package charges
Minor OT Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

795 ABJMOTO Dental ‐ Alveolectomy (Both
S jaws) For Minor OT
ABJMOTAC Alveolectomy (Both jaws) For Minor OT ( 2310
ABJMOTHC Alveolectomy (Both jaws) For Minor OT ( 3850
Hospital Charges )
ABJMOTSC Alveolectomy (Both jaws) For Minor OT ( 9240
Surgeon Charges )
796 AFDFOS Dental ‐ Archbar fixation
dentoalveolar fracture
segment For Minor OT
AFDFAC Archbar fixation dentoalveolar fracture 1390
segment For Minor OT ( Anaesthetists
Charges )
AFDFHC Archbar fixation dentoalveolar fracture 2310
segment For Minor OT ( Hospital Charges )
AFDFSF Archbar fixation dentoalveolar fracture 5530
segment For Minor OT ( Surgeon Charges )
292
797 ALPMOTO Dental ‐ Alveoloplasty For
S Minor OT
ALPMOTAC Alveoloplasty For Minor OT ( Anaesthetists 690
Charges )
ALPMOTHC Alveoloplasty For Minor OT ( Hospital 1160
Charges )
ALPMOTSF Alveoloplasty For Minor OT ( Surgeon 2770
Charges )
798 ANDLOS Anal Dilatation For Minor OT
ANDLANA Anal Dilatation For Minor OT ( Anaesthetists 830
Charges )
ANDLHC Anal Dilatation For Minor OT ( Hospital 1390
Charges )
ANDL Anal Dilatation For Minor OT ( Surgeon 3310
Charges )
799 ARCTOS Dental ‐ Apexification + Root
canal treatment (RCT) For
Minor OT
ARCTAC Apexification + Root canal treatment (RCT) 1160
ARCTHC Apexification + Root canal treatment (RCT) 1920
For Minor OT ( Hospital Charges )
ARCTSC Apexification + Root canal treatment (RCT) 4610
For Minor OT ( Surgeon Charges )
800 ASJNOS Dental ‐ Alveolectomy (one
jaws) For Minor OT
ASJNMOTAC Alveolectomy (one jaws) For Minor OT ( 1160
ASJNMOTHC Alveolectomy (one jaws) For Minor OT ( 1920
Hospital Charges )
ASJNOTAC Alveolectomy (one jaws) For Minor OT ( 4610
Surgeon Charges )
801 ATEBJOS Dental ‐ All teeth extractions
(both jaws) For Minor OT
ATEBJMOTAC All teeth extractions (both jaws) For Minor 3700
ATEBJMOTHC All teeth extractions (both jaws) For Minor 6150
OT ( Hospital Charges )
ATEBJMOTDC All teeth extractions (both jaws) For Minor 14760
OT ( Surgeon Charges )
802 AULAOS Dental ‐ Apicectomy (Under
LA) For Minor OT
AULAC Apicectomy (Under LA) For Minor OT ( 1850
AULAHC Apicectomy (Under LA) For Minor OT ( 3080
Hospital Charges )
AULASC Apicectomy (Under LA) For Minor OT ( 7370
Surgeon Charges )
803 BAVOS Brachio AV fistula at elbow for
hemodialysis
BAVAC Brachio AV fistula at elbow for hemodialysis 2300
‐ Anaesthetists Charges
BAVHC Brachio AV fistula at elbow for hemodialysis 3860
‐ Hospital Charges
BAVDF Brachio AV fistula at elbow for hemodialysis 9210
‐ Surgeon Charges
804 CARAVFO Conversion of arteriovenous
S (AV) shunt to arteriovenous
(AV) fistula
CARAVFAC Conversion of arteriovenous (AV) shunt to 2300
arteriovenous (AV) fistula ‐ Anaesthetists
Charges
CARAVFHC Conversion of arteriovenous (AV) shunt to 3860
arteriovenous (AV) fistula ‐ Hospital Charges
CARAVFDC Conversion of arteriovenous (AV) shunt to 9210
arteriovenous (AV) fistula ‐ Surgeon Charges
805 CAREVFB Creation of arteriovenous (AV)
OS Fistula at elbow ( Brachial
artery )
293
CAREVFBAC Creation of arteriovenous (AV) Fistula at 2910
elbow ( Brachial artery ) ‐ Anaesthetists
Charges
CAREVFBHC Creation of arteriovenous (AV) Fistula at 4890
elbow ( Brachial artery ) ‐ Hospital Charges
CAREVFBDC Creation of arteriovenous (AV) Fistula at 11640
elbow ( Brachial artery ) ‐ Surgeon Charges
806 CAREVFB Creation of arteriovenous (AV)
WOS Fistula at wrist ( Radial Artery )
CAREVFWBAC Creation of arteriovenous (AV) Fistula at 2910
wrist ( Radial Artery ) ‐ Anaesthetists
Charges
CAREVFBWHC Creation of arteriovenous (AV) Fistula at 4890
wrist ( Radial Artery ) ‐ Hospital Charges
CAREVFBWDC Creation of arteriovenous (AV) Fistula at 11640
wrist ( Radial Artery ) ‐ Surgeon Charges
807 CAREVFO Creation of arteriovenous (AV)
S Fistula at axillary artery
CAREVFAC Creation of arteriovenous (AV) Fistula at 2910
axillary artery ‐ Anaesthetists Charges
CAREVFHC Creation of arteriovenous (AV) Fistula at 4890
axillary artery ‐ Hospital Charges
CAREVFDC Creation of arteriovenous (AV) Fistula at 11640
axillary artery ‐ Surgeon Charges
808 CCMOS Circumcision For Minor OT
CCMANA Circumcision For Minor OT ( Anaesthetists 1490
Charges )
CCMHC Circumcision For Minor OT ( Hospital 2480
Charges )
CCM Circumcision For Minor OT ( Surgeon 5950
Charges )
809 CIMCPLA CIRCUMCISION +
OS PHRENULOPLASTY ( Doctor
Charges + Hospital Charges)
CIRLASTYA Circumcision + Phrenuloplasty For Minor OT 3940
( Anaesthetists Charges )
PLALASTY Circumcision + Phrenuloplasty For Minor OT 15750
( Doctor Charges )
CIRPHEH Circumcision + Phrenuloplasty For Minor OT 6560
( Hospital Charges )
810 COEOSKG Scar Revision Complex ( Doctor
RAOS Charges + Hospital Charges )
COATKGRAA Scar Revision Complex For Minor OT ( 5510
COATKGRAD Scar Revision Complex For Minor OT ( 22050
Doctor Charges )
COATKGRAH Scar Revision Complex For Minor OT ( 9190
Hospital Charges )
811 CROSKGR Crossfinger Flap ( Doctor
AOS Charges + Hospital Charges )
CROATKGRAA Crossfinger Flap For Minor OT ( 3940
CROATKGRAD Crossfinger Flap For Minor OT ( Doctor 15750
Charges )
CROATKGRAH Crossfinger Flap For Minor OT ( Hospital 6560
Charges )
812 CTZOS Catheterization For Minor OT
CTZANA Catheterization For Minor OT ( 490
CTZHC Catheterization For Minor OT ( Hospital 830
Charges )
CTZ Catheterization For Minor OT ( Surgeon 1980
Charges )
813 DBFMOS Diagnostic Bronchoscopy For
Minor OT
DBFMNA Diagnostic Bronchoscopy For Minor OT ( 1840
DBFMHC Diagnostic Bronchoscopy For Minor OT ( 3090
Hospital Charges )
DBFM Diagnostic Bronchoscopy For Minor OT ( 7350
Surgeon Charges )
294
814 DBWBOS Diagnostic Bronchoscopy with
Biopsy For Minor OT
DBWBNA Diagnostic Bronchoscopy with Biopsy ( 2240
DBWBHC Diagnostic Bronchoscopy with Biopsy ( 3750
Hospital Charges )
DBWB Diagnostic Bronchoscopy with Biopsy ( 8930
Surgeon Charges )
815 DCDROS Dressing change/drain removal
For Minor OT
DCDRA Dressing change/drain removal For Minor 410
OT (Anaesthetists Charges)
DCDRH Dressing change/drain removal For Minor 690
OT (Hospital Charges)
DCDR Dressing change/drain removal For Minor 1660
OT (Surgeon Charges)
816 DENIMPO Dental Implant (first stage) For
S Minor OT
DENIMPAC Dental Implant (first stage) For Minor OT ( 9220
DENIMHC Dental Implant (first stage) For Minor OT ( 15370
Hospital Charges )
DENIMSC Dental Implant (first stage) For Minor OT ( 36900
Surgeon Charges )
817 DISTMJOS Dental ‐ Dislocation of TMJ For
Minor OT
DISTMJAC Dislocation of TMJ For Minor OT ( 1160
DISTMJHC Dislocation of TMJ For Minor OT ( Hospital 1920
Charges )
DISTMJSC Dislocation of TMJ For Minor OT ( Surgeon 4610
Charges )
818 DOSOS Dorsal Slit For Minor OT
DOSANA Dorsal Slit For Minor OT ( Anaesthetists 1180
Charges )
DOSHC Dorsal Slit For Minor OT ( Hospital Charges ) 1930
DOS Dorsal Slit For Minor OT ( Surgeon Charges ) 4630
819 DREMOS Dressing (minor) For Minor OT
DREMA Dressing (minor) For Minor OT ( 490
DREMH Dressing (minor) For Minor OT ( Hospital 830
Charges )
DREM Dressing (minor) For Minor OT ( Surgeon 1980
Charges )
820 ELRBOS Ear lobe repair BL For Minor
OT
ELRBA Ear lobe repair BL For Minor OT ( 1000
ELRBH Ear lobe repair BL For Minor OT ( Hospital 1740
Charges )
ELRB Ear lobe repair BL For Minor OT ( Surgeon 3970
Charges )
821 ELRUOS Ear lobe repair UL For Minor
OT
ELRUA Ear lobe repair UL For Minor OT ( 660
ELRUH Ear lobe repair UL For Minor OT ( Hospital 1170
Charges )
ELRU Ear lobe repair UL For Minor OT ( Surgeon 2650
Charges )
822 EXBIMOS Dental‐ Excisional biospy For
Minor OT
EXBIMAC Excisional biospy For Minor OT ( 1390
EXBIMHC Excisional biospy For Minor OT ( Hospital 2310
Charges )
EXBIMOT Excisional biospy For Minor OT ( Surgeon 5530
Charges )
823 EXPFOS Dental ‐ Excision of pericoronal
flap For Minor OT
295
EXPFAC Excision of pericoronal flap For Minor OT ( 460
EXPFHC Excision of pericoronal flap For Minor OT ( 770
Hospital Charges )
EXPFSC Excision of pericoronal flap For Minor OT ( 1840
Surgeon Charges )
824 FATKGRA Fat Grafting Major ( Doctor
OS Charges + Hospital Charges )
FATKGRAA Fat Grafting Major For Minor OT ( 4730
FATKGRAD Fat Grafting Major For Minor OT ( Doctor 18900
Charges )
FATKGRAH Fat Grafting Major For Minor OT ( Hospital 7880
Charges )
825 FLAMOTO Dental ‐ Fracture mandible
S open reduction under LA (Cost
of plates & screws etc.) For
Minor OT
FLAMOTAC Fracture mandible open reduction under LA 6920
(Cost of plates & screws etc.) For Minor OT (
FLAMOTHC Fracture mandible open reduction under LA 11540
Hospital Charges )
FLAMOTSC Fracture mandible open reduction under LA 27680
Surgeon Charges )
826 FLDIMTOS Flap Division and Inset For
Minot OT
FLDIMTAC Flap Division and Inset For Minor OT ( 2840
Anaesthetists Charges)
FLDIMTHC Flap Division and Inset For Minor OT ( 4730
Hospital Charges)
FLDIMTSC Flap Division and Inset For Minor OT ( 11340
Surgeon Charges)
827 FLMTOS Flap Large For Minor OT
FLMTAC Flap Large For Minor OT ( Anaesthetists 4730
Charges )
FLMTHC Flap Large For Minor OT ( Hospital Charges ) 7880
FLMTSC Flap Large For Minor OT ( Surgeon Charges ) 18900
828 FNPOS Frenuloplasty For Minor OT
FNPANA Frenuloplasty For Minor OT ( Anaesthetists 750
Charges )
FNPHC Frenuloplasty For Minor OT ( Hospital 1300
Charges )
FNP Frenuloplasty For Minor OT ( Surgeon 2980
Charges )
829 FOASOS Foam Sclerotherapy For Minor
OT
FOASA Foam Sclerotherapy For Minor OT ( 3310
FOASH Foam Sclerotherapy For Minor OT ( Hospital 5510
Charges )
FOAS Foam Sclerotherapy For Minor OT ( Surgeon 13230
Charges )
830 FRMOTOS Dental ‐ Frenectomy For Minor
OT
FRMOTAC Frenectomy For Minor OT ( Anaesthetists 690
Charges )
FRMOTHC Frenectomy For Minor OT ( Hospital Charges 1160
)
FRMOTSC Frenectomy For Minor OT ( Surgeon Charges 2770
)
831 FSBQOS Dental ‐ Flap surgery with bone
graft (per quadrant) For Minor
OT
FSBQAC Flap surgery with bone graft (per quadrant) 1850
FSBQHC Flap surgery with bone graft (per quadrant) 3080
FSBQSC Flap surgery with bone graft (per quadrant) 7370
296
832 FSMTOS Flap Small For Minor OT
FSMTAC Flap Small For Minor OT ( Anaesthetists 3940
Charge)
FSMTHC Flap Small For Minor OT ( Hospital Charges ) 6560
FSMTSC Flap Small For Minor OT ( Surgeon Charges ) 15750
833 GINPMOT Dental ‐ Gingivoplasty For
OS Minor OT
GINPMOTAC Gingivoplasty For Minor OT ( Anaesthetists 1390
Charges )
GINPMOTHC Gingivoplasty For Minor OT ( Hospital 2310
Charges )
GINPMOTSC Gingivoplasty For Minor OT ( Surgeon 5530
Charges )
834 IBSMOTO Dental ‐ Impaction (Bony/soft
S tissue) For Minor OT
IBSMOTAC Impaction (Bony/soft tissue) For Minor OT ( 2310
IBSMOTHC Impaction (Bony/soft tissue) For Minor OT ( 3850
Hospital Charges )
IBSMOTSC Impaction (Bony/soft tissue) For Minor OT ( 9240
Surgeon Charges )
835 ICCPLOS ICD insertion for complex
effusion/pneumothorax For
Minor OT
ICCPLNA ICD insertion for complex 1840
effusion/pneumothorax For Minor OT (
ICCPLHC ICD insertion for complex 3090
Hospital Charges )
ICCPL ICD insertion for complex 7350
Surgeon Charges )
836 ICDSMOS ICD insertion for simple
effusion/pneumothorax For
Minor OT
ICDSMNA ICD insertion for simple 790
ICDSMHC ICD insertion for simple 1320
Hospital Charges )
ICDSMOT ICD insertion for simple 3150
Surgeon Charges )
837 IDLAOS Incision and Drainage of
Multiple/ Large Superficial
Abscess For Minor OT
IDLANA Incision and Drainage of Multiple/ Large 1320
Superficial Abscess For Minor OT (
IDLAHC Incision and Drainage of Multiple/ Large 2210
Superficial Abscess For Minor OT ( Hospital
charges )
IDLA Incision and Drainage of Multiple/ Large 5290
Superficial Abscess For Minor OT ( Surgeon
charges )
838 IDSAOS Incision And Drainage of
Small/Superficial Abscess For
Minor OT
IDSANA Incision And Drainage of Small/Superficial 660
Abscess For Minor OT ( Anaesthetists
Charges )
IDSAHC Incision And Drainage of Small/Superficial 1100
Abscess For Minor OT ( Hospital Charges )
IDSA Incision And Drainage of Small/Superficial 2650
Abscess For Minor OT ( Surgeon Charges )
839 IMFMOTO Dental ‐ Inter ‐ Maxillary
S fixation with archbar For Minor
OT
297
IMFMOTHC Inter ‐ Maxillary fixation with archbar For 5390
Minor OT ( Hospital Charges )
IMFMOTDC Inter ‐ Maxillary fixation with archbar For 12920
Minor OT ( Surgeon Charges )
IMFMOTAC Inter ‐ Maxillary fixation with archbar For 3230
Minor OT( Anaesthetists Charges )
840 INADMOS Incision and drainage (major)
For Minor OT
INADMA Incision and drainage (major) For Minor OT ( 1320
INADMH Incision and drainage (major) For Minor OT ( 2210
Hospital Charges )
INADM Incision and drainage (major) For Minor OT ( 5290
Surgeon Charges )
841 INADOS Incision and drainage For
Minor OT
INADA Incision and drainage (Minor) For Minor OT 660
INADH Incision and drainage (Minor) For Minor OT 1100
( Hospital Charges )
INAD Incision and drainage (Minor) For Minor OT 2650
(Surgeon Charges)
842 INDMOTO Dental ‐ Incision and drainage
S For Minor OT
INDMOTHC Incision and drainage For Minor OT ( 1540
Hospital Charges )
INDMOTSC Incision and drainage For Minor OT ( 3700
Surgeon Charges )
INDMOTAC Incision and drainage For Minor OT( 920
843 IOTNOS Ingrowing toe nail For Minor
OT
IOTNANA Ingrowing toe nail For Minor OT ( 2320
IOTNHC Ingrowing toe nail For Minor OT ( Hospital 3860
Charges )
IOTN Ingrowing toe nail For Minor OT ( Surgeon 9260
Charges )
844 JFMOTOS Dental ‐ Jaw fracture closed
reduction For Minor OT
JFMOTSC Jaw fracture closed reduction For Minor OT ( 14760
Surgeon Charges )
JFMOTAC Jaw fracture closed reduction For Minor OT( 3700
JFMOTHC Jaw fracture closed reduction For Minor OT( 6150
Hospital Charges )
845 LATKGRA Skin Lesion Large ( Doctor
LATKGRAA Skin Lesion Large For Minor OT ( 5040
LATKGRAD Skin Lesion Large For Minor OT ( Doctor 20160
Charges )
LATKGRAH Skin Lesion Large For Minor OT ( Hospital 8400
Charges )
846 LNBMOS Lymph Node Biopsy For Minor
OT
LNBMN Lymph Node Biopsy For Minor OT ( 790
LNBMHC Lymph Node Biopsy For Minor OT ( Hospital 1320
Charges )
LNBM Lymph Node Biopsy For Minor OT ( Surgeon 3150
Charges )
847 MADMOS Major Debridement For Minor
OT
MADMANA Major Debridement For Minor OT ( 1660
MADMHC Major Debridement For Minor OT ( Hospital 2760
Charges )
MADM Major Debridement For Minor OT ( Surgeon 6620
Charges )
848 MATKGRA Fat Grafting Minor ( Doctor
298
MATKGRAA Fat Grafting Minor For Minor OT ( 3150
MATKGRAD Fat Grafting Minor For Minor OT ( Doctor 12600
Charges )
MATKGRAH Fat Grafting Minor For Minor OT ( Hospital 5250
Charges )
849 MINDOS Minor debridement For Minor
OT
MINDA Minor debridement For Minor OT ( 830
MINDH Minor debridement For Minor OT ( Hospital 1390
Charges )
MIND Minor debridement For Minor OT ( Surgeon 3310
Charges )
850 MINIMPO Dental ‐ Mini implant for
S anchorage (per implant) For
Minor OT
MINIMPHC Mini implant for anchorage (per implant) 4620
MINIMPAC Mini implant for anchorage (per implant) 2770
For Minor OT( Anaesthetists Charges )
MINIMPDC Mini implant for anchorage (per implant) 11080
For Minor OT( Surgeon Charges )
851 MINPOS Dental ‐ Root canal with
Apicectomy For Minor OT
MINIMPDC Mini implant for anchorage (per implant) 11080
For Minor OT( Surgeon Charges )
MINPAC Root canal with Apicectomy For Minor OT ( 2310
MINPHC Root canal with Apicectomy For Minor OT( 3850
Hospital Charges )
852 MTOS Meatotomy For Minor OT
MTANA Meatotomy For Minor OT ( Anaesthetists 690
Charges )
MTHC Meatotomy For Minor OT ( Hospital Charges 1170
)
MT Meatotomy For Minor OT ( Surgeon Charges 2780
)
853 NEDLAOS Needle aspiration For Minor
OT
NEDLAA Needle aspiration For Minor OT 410
NEDLAH Needle aspiration For Minor OT (Hospital 690
Charges )
NEDLA Needle aspiration For Minor OT (Surgeon 1660
charges)
854 NERBLOS Dental ‐ Nerve block in
Neuralgias For Minor OT
NERBLAC Nerve block in Neuralgias For Minor OT ( 1390
NERBLSC Nerve block in Neuralgias For Minor OT( 2310
Hospital Charges )
NERBLDC Nerve block in Neuralgias For Minor OT( 5530
Surgeon Charges )
855 ORANCOS Dental ‐ Oro antral
communication closure For
Minor OT
ORANCAC Oro antral communication closure For Minor 6460
ORANCDC Oro antral communication closure For Minor 25820
ORANCHC Oro antral communication closure For Minor 10760
OT (Hospital Charges )
856 PTBOS Prostatic Trucut Biopsy For
Minor OT
PTBANA Prostatic Trucut Biopsy For Minor OT ( 660
PTBHC Prostatic Trucut Biopsy For Minor OT ( 1100
Hosiptal Charges )
PTB Prostatic Trucut Biopsy For Minor OT ( 2650
Surgeon Charges )
299
857 RATMOT Dental ‐ Reimplantation of
OS avulsed tooth For Minor OT
RATMOTDC Reimplantation of avulsed tooth For Minor 3700
RATMOTAC Reimplantation of avulsed tooth For Minor 920
RATMOTHC Reimplantation of avulsed tooth For Minor 1540
OT( Hospital Charges )
858 REOSKGR Scar Revision Simple ( Doctor
REATKGRAA Scar Revision Simple For Minor OT ( 3150
REATKGRAD Scar Revision Simple For Minor OT ( Doctor 12600
Charges )
REATKGRAH Scar Revision Simple For Minor OT ( Hospital 5250
Charges )
859 RIOHOS Reduction of Irreducible
Obstructed Hernia For Minor
OT
RIOHAN Reduction of Irreducible Obstructed Hernia 4140
RIOHC Reduction of Irreducible Obstructed Hernia 6900
For Minor OT ( Hospital charges )
RIOH Reduction of Irreducible Obstructed Hernia 16540
For Minor OT ( Surgeon charges )
860 RPMLAOS Dental ‐ Removal of plates of
mandible and maxilla (Under
LA) For Minor OT
RPMLAAC Removal of plates of mandible and maxilla 3700
(Under LA) For Minor OT( Anaesthetists
Charges )
RPMLAHC Removal of plates of mandible and maxilla 1540
(Under LA) For Minor OT( Hospital Charges )
RPMLADC Removal of plates of mandible and maxilla 14760
(Under LA) For Minor OT( Surgeon Charges )
861 RSPOS Reduction of Stomal Prolapsed
For Minor OT
RSPANA Reduction of Stomal Prolapsed For Minor OT 2480
RSPHC Reduction of Stomal Prolapsed For Minor OT 4140
( Hospital charges )
RSP Reduction of Stomal Prolapsed For Minor OT 9920
( Surgeon charges )
862 SATKGRA Skin Lesion Small ( Doctor
SATKGRAA Skin Lesion Small For Minor OT ( 2840
SATKGRAD Skin Lesion Small For Minor OT ( Doctor 11340
Charges )
SATKGRAH Skin Lesion Small For Minor OT ( Hospital 4730
Charges )
863 SCMOTOS Dental ‐ Scaling full mouth For
Minor OT
SCMOTAC Scaling full mouth For Minor OT ( 690
SCMOTDC Scaling full mouth For Minor OT ( Surgeon 2770
Charges )
SCMOTHC Scaling full mouth For Minor OT( Hospital 1160
Charges )
864 SCUBCUR Dental ‐ Subgingival scaling &
OS curretage full mouth For Minor
OT
SUBCURDC Subgingival scaling & curretage full mouth 5530
SUBCURAC Subgingival scaling & curretage full mouth 1390
For Minor OT (Anaesthetists Charges)
SUBCURHC Subgingival scaling & curretage full mouth 2310
For Minor OT (Hospital Charges)
865 SKGMTOS Skin Grafting For Minor OT
SKGMTAC Skin Grafting For Minor OT ( Anaesthetists 3150
Charges )
300
SKGMTHC Skin Grafting For Minor OT ( Hospital 5250
Charges )
SKGMTSC Skin Grafting For Minor OT ( Surgeon 12600
Charges )
866 SMALLSK Small skin graft for Minot OT
OS
SMSKGRAA Small Skin Grafting For Minor OT ( 3150
SMSKGRAD Small Skin Grafting For Minor OT ( Doctor 12600
Charges )
SMSKGRAH Small Skin Grafting For Minor OT ( Hospital 5250
Charges )
867 SMLOS Suturing of Medium
Lacerations (Large) For Minor
OT
SMLANA Suturing of Medium Lacerations (Large) For 2320
SMLHC Suturing of Medium Lacerations (Large) For 3860
Minor OT ( Hospital charges )
SML Suturing of Medium Lacerations (Large) For 9260
Minor OT ( Surgeon charges )
868 SOFTSWE Soft Tissue Swelling Large (
NOS Doctor Charges + Hospital
Charges )
SOFTTSACC Soft Tissue Swelling Large For Minor OT ( 4730
SOFTTSFD Soft Tissue Swelling Large For Minor OT ( 18900
Doctor Charges )
SOFTTSHH Soft Tissue Swelling Large For Minor OT ( 7880
Hospital Charges )
869 SOFTSWE Soft Tissue Swelling Small (
OS Doctor Charges + Hospital
Charges )
SOFTTSAC Soft Tissue Swelling Small For Minor OT ( 3150
SOFTTSD Soft Tissue Swelling Small For Minor OT ( 12600
Doctor Charges )
SOFTTSH Soft Tissue Swelling Small For Minor OT ( 5250
Hospital Charges )
870 SPREMOS Dental ‐ Splint Removal For
Minor OT
SPREMOTAC Splint Removal For Minor OT ( Anaesthetists 460
Charges )
SPREMOTHC Splint Removal For Minor OT ( Hospital 770
Charges )
SPREMOTSC Splint Removal For Minor OT ( Surgeon 1840
Charges )
871 SPTCOS SPC (Suprapubic Trocar
Cystostomy) For Minor OT
SPTCANA SPC (Suprapubic Trocar Cystostomy) For 1980
SPTCHC SPC (Suprapubic Trocar Cystostomy) For 3310
SPTC SPC (Suprapubic Trocar Cystostomy) For 7940
872 SSFTOS Secondary Suturing For Minor
OT
SSFTNA Secondary Suturing For Minor OT ( 1050
SSFTHC Secondary Suturing For Minor OT ( Hospital 1760
Charges )
SSFT Secondary Suturing For Minor OT ( Surgeon 4200
Charges )
873 SSLOS Suturing of Small Lacerations
For Minor OT
SSLANA Suturing of Small Lacerations For Minor OT ( 1320
SSLHC Suturing of Small Lacerations For Minor OT ( 2210
Hospital Charges )
SSL Suturing of Small Lacerations For Minor OT ( 5290
Surgeon Charges )
301
874 STSEOS Soft tissue swelling excision
For Minor OT
STSEA Soft tissue swelling excision for Minor OT 2320
STSEH Soft tissue swelling excision for Minor OT 3860
(Hospital Charges )
STSE Soft tissue swelling excision for Minor OT 9260
(Surgeon Charges )
875 STUMINI Stump Closure Major ( Doctor
OS Charges + Hospital Charges)
STUAINAC Stump Closure Major For Minor OT ( 4730
STUMINIO Stump Closure Major For Minor OT ( Doctor 18900
Charges )
STUCLOMIN Stump Closure Major For Minor OT ( 7880
Hospital Charges )
876 STUMINO Stump Closure Minor ( Doctor
S Charges + Hospital Charges)
STUANAC Stump Closure Minor For Minor OT ( 3150
STUMINO Stump Closure Minor For Minor OT ( Doctor 12600
Charges )
STUCLMIN Stump Closure Minor For Minor OT ( 5250
Hospital Charges )
877 SUEXTOS Dental ‐ Surgical extraction of
tooth For Minor OT
SUEXTDC Surgical extraction of tooth For Minor OT ( 3700
Surgeon Charges )
SUEXTAC Surgical extraction of tooth For Minor OT 920
SUEXTHC Surgical extraction of tooth For Minor OT 1540
(Hospital Charges)
878 SUTREOS Suture removal For Minor OT
SUTREA Suture removal For Minor OT (Anaesthetists 410
Charges)
SUTREH Suture removal For Minor OT (Hospital 690
Charges)
SUTRE Suture removal For Minor OT (Surgeon 1660
Charges)
879 TCBOS Teslicular Biopsy For Minor OT
TCBANA Teslicular Biopsy For Minor OT ( 1000
TCBHC Teslicular Biopsy For Minor OT ( Hospital 1660
Charges )
TCB Teslicular Biopsy For Minor OT ( Surgeon 3970
Charges )
880 TPATKGR Finger Tip Injury ( Doctor
URLATKGRAA Finger Tip Injury For Minor OT ( 3150
URLATKGRAD Finger Tip Injury For Minor OT ( Doctor 12600
Charges )
URLATKGRAH Finger Tip Injury For Minor OT ( Hospital 5250
Charges )
881 TUEXOS Dental ‐ Tumour Excision For
Minor OT
TUEXDC Tumour excision For Minor OT ( Surgeon 18450
Charges )
TUEXAC Tumour Excision For Minor OT 4610
TUEXHC Tumour excision For Minor OT (Hospital 7690
Charges)
882 UCADOS Urethral Calibration and
Dilatation For Minor OT
UCADANA Urethral Calibration and Dilatation For 660
UCADHC Urethral Calibration and Dilatation For 1100
UCAD Urethral Calibration and Dilatation For 2650
883 URCAOS Uretheral Catheterization For
Minor OT
302
URCANA Uretheral Catheterization For Minor OT ( 490
URCAHC Uretheral Catheterization For Minor OT ( 830
Hospital charges )
URCA Uretheral Catheterization For Minor OT ( 1980
Surgeon charges )
884 URDLOS Urethral dilatation For Minor
OT
URDLA Urethral dilatation For Minor OT 830
URDLH Urethral dilatation For Minor OT (Hospital 1390
Charges)
URDL Urethral dilatation For Minor OT (Surgeon 3310
Charges)
885 VAMSOS VAC Application For Minor OT
VAMSNA VAC Application For Minor OT ( 530
VAMHC VAC Application For Minor OT ( Hospital 880
Charges )
VAMS VAC Application For Minor OT ( Surgeon 2100
Charges )
886 WDMTOS Wound Debridement For
Minor OT
WDMTN Wound Debridement For Minor OT ( 530
WDMTHC Wound Debridement For Minor OT ( 880
Hospital Charges )
WDMT Wound Debridement For Minor OT ( 2100
Surgeon Charges )
Oncology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
SNo Code Description Cat‐3

925 CPSDHCO CHEMOTHERAPY PLANNING /
S SUPERVISION (DOCTOR FEE +
HOSPITAL CHARGES)
CPSAHC Chemotherapy planning / supervision ‐ 340 340 170 140 100
CPSDF Chemotherapy planning / supervision ‐ 3320 3320 1660 1330 1000
Doctor fee
926 EDCF Early detection of cancer ( 1400
Package of women )
MAMMOP Mammography (bilateral) ( Xray dept
charges )
PAPS PAP smear / Hormonal smear / Vault smear
/ Cervical smear WITH Barcode
WA Ultrasound whole abdomen & pelvis ( Adult
)
927 EDCM Early detection of cancer ( 1400
Package of men )
WA Ultrasound whole abdomen & pelvis ( Adult
)
303
Ophthalmology Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
928 ACFOS AC Formation ‐ (Doctor
ACFAC AC Formation ‐ Anasthesia Consumables 250
ACFCO AC Formation ‐ Consumables Charges 600
ACFDF AC Formation ‐ Doctor Fee 1200
ACFTC AC Formation ‐ Theatre Charges 540
ANPACCHSY Anaesthetist PAC charges for Daycare 580
Packages (Rs. 580)
MRDCHG MRD Charges 500 500 500 500 500
929 ALPDHCO RETINAL LASER
SDM PHOTOCOAGULATION ‐ SINGLE
SITTING (DOCTOR FEE +
HOSPITAL CHARGES)
ALPDMHC Argon laser photocoagulation ( single sitting 1620 1620
) for diabetic maculopathy ‐ Additional
hospital charges
ALPDMDF Argon laser photocoagulation ( single sitting 2780 2780
) for diabetic maculopathy ‐ Doctor fees
930 BIBLBIOS Botox Injection ‐ Bilateral
BIBLBI Botox Injection Blepharospasam ‐ Bilateral 15000 15000 7500 6000 4500
BOIEBI Botox Injection Epiphora ‐ Bilateral 7500 7500 3750 3000 2250
BISTPBI Botox Injection Squint/Lid retraction/ Four 7500 7500 3750 3000 2250
inducing temporary Ptosis ‐ Bilateral
931 BIBUNIOS Botox Injection ‐ Unilateral
BIBLUNI Botox Injection Blepharospasam ‐ Unilateral 10000 10000 5000 4000 3000
BOIEUNI Botox Injection Epiphora ‐ Unilateral 5000 5000 2500 2000 1500
BISTPUNI Botox Injection Squint/Lid retraction/ Four 5000 5000 2500 2000 1500
inducing temporary Ptosis ‐ Unilateral
932 C3ROS C3R (laser room) ‐ (Doctor
Fee+Hospital Charges )
C3RHC C3R (laser room) ‐ Additional Hospital 8000
Charges
C3RCC C3R (laser room) ‐ Consumables Charges 5000
C3RDF C3R (laser room) ‐ Doctor Fee 12000
C3REC C3R (laser room) ‐ Equipment Charges 3000
933 CAGAOS Cyno Acrylate Glue Application
( Surgeon Fee + Hospital
Charges )
CAGAHC Cyno Acrylate Glue Application ( Hospital 530 320
Charges )
CAGASC Cyno Acrylate Glue Application ( Surgeon 790 480
Charges )
934 CFBOS Corneal Foreign Body Removal
( Surgeon Fee + Hospital
Charges )
CFBHC Corneal Foreign Body Removal ( Hospital 530 320
Charges )
CFBR Corneal Foreign Body Removal ( Surgen 790 480
Charges )
935 CFPSOS Colour Fundus Photography (
Surgen Fee + Hospital Charges )
CFPHC Colour Fundus Photography ( Hospital 500 300
Charges )
CFPSF Colour Fundus Photography ( Surgeon Fee ) 850 500
304
936 CLIOLOS Glued IOL ‐ (Doctor
Packages (Rs. 580)
GLIOLCA Glued IOL ‐ Anasthesia Consumables 250
GLIOLAC Glued IOL ‐ Anasthetist Charges 3240
GLIOLCO Glued IOL ‐ Consumables Charges 5000
GLIOLDF Glued IOL ‐ Doctor Fee 18000
GLIOLTC Glued IOL ‐ Theatre Charges 8100
937 CORSOS Corneal Scrapping ‐ (Doctor
CORSDF Corneal Scrapping ‐ Doctor Fee 600
CORSHC Corneal Scrapping ‐ Hospital Charges 400
938 CRDFICGP COMBINED RETINAL DIGITAL
DCOS FLUORESCEIN & INDOCYANINE
GREEN ( ICG ) IMAGING
CHARGES)
CRDFICGHC Combined retinal digital fluorescein & 5640 5640
indocyanine green ( ICG ) imaging
angiography ‐ Additional hospital charges
CRDFICGDF Combined retinal digital fluorescein & 2420 2420
indocyanine green ( ICG ) imaging
angiography ‐ Doctor fees
939 DALKOS DALK ‐ (Doctor Fee+Hospital
Charges)
Packages (Rs. 580)
DALKCA DALK ‐ Anasthesia Consumables 250
DALKAC DALK ‐ Anasthetist Charges 6840
DALKCO DALK ‐ Consumables Charges 7000
DALKDF DALK ‐ Doctor Fee 38000
DALKTC DALK ‐ Theatre Charges 17100
940 DECSDHC DIABETIC EYE CARE SERVICE
CHARGES)
DECHC Diabetic eye care service ‐ Additional 610 610
hospital charges
DECDF Diabetic eye care service ‐ Doctor fee 360 360
941 DSEKOS Descemets's stripping
Endothelial Keraoplasty ‐
Packages (Rs. 580)
DSEKCA Descemets's stripping Endothelial 250
Keraoplasty ‐ Anasthesia Consumables
DSEKAC Descemets's stripping Endothelial 6480
Keraoplasty ‐ Anasthetist charges
DSEKCO Descemets's stripping Endothelial 7000
Keraoplasty ‐ Consumables Charges
DSEKDF Descemets's stripping Endothelial 36000
Keraoplasty ‐ Doctor Fee
DSEKTC Descemets's stripping Endothelial 16200
Keraoplasty ‐ Theatre charges
942 EDBCLOS Epithelial Debridetment with
BCL ‐ (Doctor Fee+Hospital
Charges)
Packages (Rs. 580)
305
EDBCLCA Epithelial Debridetment with + BCL ‐ 250
Anasthesia Consumables
EDBCLAC Epithelial Debridetment with + BCL ‐ 1800
Anasthetist Charges
EDBCLCO Epithelial Debridetment with + BCL ‐ 7000
Consumables Charges
EDBCLDF Epithelial Debridetment with + BCL ‐ Doctor 10000
Fee
EDBCLTC Epithelial Debridetment with + BCL ‐ Theatre 4500
Charges
943 ELTLOS Electrolysis ‐ (Doctor
ELTLDF Electrolysis ‐ Doctor Fee 3000
ELTLHC Electrolysis ‐ Hospital Charges 2000
944 HALOS Chalazion ( Surgen Fee +
Hospital Charges )
CHALA Chalazion ( Surgen Charges ) 3300 1980
CHALHC Chalazion Hospital Charges 2200 1320
945 IITAOS Intravitreal Injection TA (OT) ‐
Packages (Rs. 580)
IITACO Intravitreal Injection TA (OT) ‐ Anasthesia 250
consumables
IITAAC Intravitreal Injection TA (OT) ‐ Anasthetist 720
charges
IITAOC Intravitreal Injection TA (OT) ‐ Consumable 900
charges
IITADF Intravitreal Injection TA (OT) ‐ Doctor Fee 4000
IITATC Intravitreal Injection TA (OT) ‐ Theatre 1800
usage charges
946 KRTPOS Keratoprosthesis ‐ (Doctor
Packages (Rs. 580)
KRTPCA Keratoprosthesis ‐ Anasthesia Consumables 250
KRTPAC Keratoprosthesis ‐ Anasthetist Charges 7200
KRTPCO Keratoprosthesis ‐ Consumables Charges 14000
KRTPDF Keratoprosthesis ‐ Doctor Fee 40000
KRTPTC Keratoprosthesis ‐ Theatre Charges 18000
947 LBDOS Lid Abscess Drainage ( Surgeon
LBDHC Lid Abscess Drainage ( Hospital Charges ) 2640 1590
LBDSC Lid Abscess Drainage ( Surgeon Charges ) 3960 2380
948 LBOOS Lid Biopsy (OT) ‐ (Doctor
Packages (Rs. 580)
LBOCA Lid Biopsy (OT) ‐ Anasthesia consumables 250
LBOAC Lid Biopsy (OT) ‐ Anasthetist charges 900
LBOCO Lid Biopsy (OT) ‐ Consumables Charges 4000
LBODF Lid Biopsy (OT) ‐ Doctor Fee 5000
LBOTC Lid Biopsy (OT) ‐ Theatre charges 2250
949 LMMMOS Lid Margin Mucous Membrane
Graft Fibrin Glue ‐ (Doctor
Packages (Rs. 580)
306
LMMMCA Lid Margin Mucous Membrane Graft + 250
Fibrin Glue ‐ Anasthesia Consumables
LMMMAC Lid Margin Mucous Membrane Graft + 5400
Fibrin Glue ‐ Anasthetist charges
LMMMCO Lid Margin Mucous Membrane Graft + 7000
Fibrin Glue ‐ Consumables Charges
LMMMDF Lid Margin Mucous Membrane Graft + 30000
Fibrin Glue ‐ Doctor Fee
LMMMTC Lid Margin Mucous Membrane Graft + 13500
Fibrin Glue ‐ Theatre charges
950 LPARMDD Laser photocoagulation for
FHC ARMD ‐ (Doctor fee+Hospital
Charges)
LPARMDDF Laser photocoagulation for ARMD ‐ doctor 5310 5310
fee
LPARMDHC Laser photocoagulation for ARMD ‐ hospital 3240 3240
charges
951 LPLAT2DF Laser photocoagulation for
HC LATTICE ( 2 quadrants ) ‐
LPLAT2DF Laser photocoagulation for LATTICE ( 2 2780 2780
quadrants ) ‐ doctor fee
LPLAT2HC Laser photocoagulation for LATTICE ( 2 1620 1620
quadrants ) ‐ hospital charges
952 LPLAT3DF Laser photocoagulation for
HC LATTICE ( 3 quadrants ) ‐
Charges)
LPLAT3DF Laser photocoagulation for LATTICE ( 3 5310 5310
quadrants ) ‐ doctor fee
LPLAT3HC Laser photocoagulation for LATTICE ( 3 3220 3220
quadrants ) ‐ hospital charges
953 LPLATM3 Laser photocoagulation for
DFHC LATTICE ( more than 3
quadrants ) ‐ (Doctor Fee +
Hospital Charges)
LPLATM3DF Laser photocoagulation for LATTICE ( more 8060 8060
than 3 quadrants ) ‐ doctor fee
LPLATM3HC Laser photocoagulation for LATTICE ( more 4840 4840
than 3 quadrants ) ‐ hospital charges
954 LPPRPDFH Laser photocoagulation PRP
C Package ( Doctor Fee +
Hospital Charges)
LPPRPDF Laser photocoagulation ( PRP package ) ‐ 8060 8060
doctor fee
LPPRPHC Laser photocoagulation ( PRP package ) ‐ 4840 4840
hospital charges
955 LPRBDFHC Laser photocoagulation for
retinal break ‐ (Doctor Fee +
Hospital Charges)
LPRBDF Laser photocoagulation for retinal break ‐ 5310 5310
doctor fee
LPRBHC Laser photocoagulation for retinal break ‐ 3220 3220
hospital charges
956 LPROPDF Laser photocoagulation for
HC retinopathy of prematurity (
ROP ) ‐ (Ddoctor Fee + Hospital
Charges)
LPROPDF Laser photocoagulation for retinopathy of 8060 8060
prematurity ( ROP ) ‐ doctor fee
LPROPHC Laser photocoagulation for retinopathy of 4840 4840
prematurity ( ROP ) ‐ hospital charges
307
957 LPVMQDF Laser photocoagulation for
HC vasculitis ( more than one
quadrant ) ‐ (Doctor Fee +
Hospital Charges)
LPVMQDF Laser photocoagulation for vasculitis ( more 5310 5310
than one quadrant ) ‐ doctor fee
LPVMQHC Laser photocoagulation for vasculitis ( more 3220 3220
than one quadrant ) ‐ hospital charges
958 LPVOMQ Laser photocoagulation for
DFHC vascular occlusions ( more than
one quadrant ) ‐ (Doctor Fee +
Hospital Charges)
LPVOMQDF Laser photocoagulation for vascular 5310 5310
occlusions ( more than one quadrant ) ‐
doctor fee
LPVOMQHC Laser photocoagulation for vascular 3220 3220
occlusions ( more than one quadrant ) ‐
hospital charges
959 LPVOOQD Laser photocoagulation for
FHC vascular occlusions ( one
quadrant ) ‐ (Doctor Fee +
Hospital Charges)
LPVOOQDF Laser photocoagulation for vascular 2780 2780
occlusions ( one quadrant ) ‐ doctor fee
LPVOOQHC Laser photocoagulation for vascular 1620 1620
occlusions ( one quadrant ) ‐ hospital
charges
960 LPVOQDF Laser photocoagulation for
HC vasculitis ( one quadrant ) ‐
Charges)
LPVOQDF Laser photocoagulation for vasculitis ( one 2780 2780
quadrant ) ‐ doctor fee
LPVOQHC Laser photocoagulation for vasculitis ( one 1620 1620
quadrant ) ‐ hospital charges
961 MLLOS Minor Lid Laceration ( Surgeon
MLLHC Minor Lid Laceration ( Hospital Charges ) 2640 1590
MLLSC Minor Lid Laceration ( Surgeon Charges ) 3960 2380
962 OBOS Orbital Biopsy (OT) ‐ (Doctor
Packages (Rs. 580)
OBCA Orbital Biopsy (OT) ‐ Anasthesia 250
consumables
OBAC Orbital Biopsy (OT) ‐ Anasthetist charges 1440
OBCO Orbital Biopsy (OT) ‐ Consumables Charges 900
OBDF Orbital Biopsy (OT) ‐ Doctor Fee 8000
OBTC Orbital Biopsy (OT) ‐ Theatre charges 3600
963 OPTMAC OPTICAL COHERENCE
ULADFHC TOMOGRAPHY (MACULA)
OCTMACULAD Optical coherence tomography ( OCT ) 1130 1130
OC (MACULA) ‐ doctor charges
OCTMACULAH Optical coherence tomography ( OCT ) 2420 2420
OS (MACULA) ‐ hospital service charge
964 OPTRNFL OPTICAL COHERENCE
DFHC TOMOGRAPHY (RNFL)
OCTRNFLDOC Optical coherence tomography ( OCT ) 1130 1130
(RNFL) ‐ doctor charges
OCTRNFLHOS Optical coherence tomography ( OCT ) 2420 2420
(RNFL) ‐ hospital service charge
308
965 PHOTAC Photodynamic therapy ‐ All
Charges
PHOTDC Photodynamic therapy ‐ doctor fee 16100 16100
PHOTTDYE Photodynamic therapy ‐ dye charges 70000 70000
PHOTHC Photodynamic therapy ‐ hospital charges 6440 6440
PHOTLRC Photodynamic therapy ‐ laser rental charges 16100 16100
966 PSIOOS Punctal Snip with Intubation
(OT) ‐ (Doctor Fee+Hospital
Charges)
Packages (Rs. 580)
PSICA Punctal Snip with Intubation (OT) ‐ 250
Anasthesia consumables
PSIAC Punctal Snip with Intubation (OT) ‐ 1260
Anasthetist charges
PSICO Punctal Snip with Intubation (OT) ‐ 4000
Consumables Charges
PSIDF Punctal Snip with Intubation (OT) ‐ Doctor 7000
Fee
PSITC Punctal Snip with Intubation (OT) ‐ Theatre 3150
charges
967 PSIOS Posterior Subtenon Injection (
Surgeon Fee + Hospital Charges
)
PSIHC Posterior Subtenon Injection ( Hospital 1000
Charges )
PSISC Posterior Subtenon Injection ( Surgeon 1500
Charges )
968 RDFIDCHC RETINAL DIGITAL
HOS FLURORESCEIN IMAGING
RDFIHC Retinal digital flurorescein imaging 1770 1770
angiography ‐ Additional hospital charges
RDFIDF Retinal digital flurorescein imaging 1130 1130
angiography ‐ Doctor fees
969 RDICGDH RETINAL DIGITAL
CHOS INDOCYANINE GREEN ( ICG )
IMAGING (DOCTOR FEE +
HOSPITAL CHARGES)
RDICGHC Retinal digital indocyanine green ( ICG ) 5640 5640
imaging angiography ‐ Additional hospital
charges
RDICGDF Retinal digital indocyanine green ( ICG ) 1610 1610
imaging angiography ‐ Doctor fees
970 SFIOLOS SF ‐ IOL Scleral Fixated ‐
Packages (Rs. 580)
SFIOLCA SF ‐ IOL Scleral Fixated ‐ Anasthesia 250
Consumables
SFIOLAC SF ‐ IOL Scleral Fixated ‐ Anasthetist Charges 3240
SFIOLCO SF ‐ IOL Scleral Fixated ‐ Consumables 5000
Charges
SFIOLDF SF ‐ IOL Scleral Fixated ‐ Doctor Fee 18000
SFIOLTC SF ‐ IOL Scleral Fixated ‐ Theatre Charges 8100
971 SYPOS Syringing & Probing ‐ (Doctor
SYPDF Syringing & Probing ‐ Doctor Fee 600
SYPHC Syringing & Probing ‐ Hospital Charges 400
972 TOS Trasorrhaphy ( Surgeon Fee +
Hospital Charges )
THC Trasorrhaphy ( Hospital Charges ) 2640 1590
309
TSC Trasorrhaphy ( Surgeon Charges ) 3960 2380
973 TROS Trasorrhaphy Release (
Surgeon Fee + Hospital Charges
)
TRHC Trasorrhaphy Release ( Hospital Charges ) 1320 800
TRSC Trasorrhaphy Release ( Surgeon Charges ) 1980 1200
974 TRSPOS Tarasoraphy ‐ (Doctor
TRSPDF Tarasoraphy ‐ Doctor Fee 4800
TRSPHC Tarasoraphy ‐ Hospital Charges 3200
975 VITENDOL Vitrectomy (Endolaser) ‐
AOS Doctor fee + Hospital Charges
VITENDOLA Vitrectomy (Endolaser) ‐ Doctor Fee 3330
VITENDOLAHC Vitrectomy (Endolaser) ‐ Hospital Charges 3330
976 YAGLPDH YAG LASER
CHOS PHOTOCOAGULATION
CHARGES)
YAGHC YAG laser photocoagulation ‐ Additional 1630 1630
hospital charges
YAGDF YAG laser photocoagulation ‐ Doctor fees 2570 2570
Other Procedure
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
983 AATDHCO ANTIGEN ALLERGY PRICK
S TESTING (DOCTOR FEE +
HOSPITAL CHARGES)
AATPTHC Antigen allergy testing ( prick testing ) ‐ 1720 1720 1900
AATPTDF Antigen allergy testing ( prick testing ) ‐ 3380 3380 3720
Doctor fees
984 AATDHOS ANTIGEN ALLERGY
INTRADERMAL TESTING
CHARGES)
AATITHC Antigen allergy testing ( intradermal testing 1220 1220 1340
AATITDF Antigen allergy testing ( intradermal testing 2550 2550 2800
) ‐ Doctor fees
985 CPAPDHC CPAP TITRATION
OS (LABORATORY CHARGES +
PROFESSIONAL CHARGES)
CPAPDF CPAP titration ‐ Doctor fee 11200 11200 5600 4480 3360 5600 3360
CPAPTC CPAP titration test charges 8400 8400 4200 3360 2520 4200 2520
986 ECOS ELECTIVE CARDIOVERSION
FEE)
ECPC ELECTIVE CARDIOVERSION PACKAGE 13090 12130 11640 10190 6980
CHARGES
987 EPCTOS EUPHORBIA PROSTRATA
CLINICAL TRIAL
APTT APTT ( Activated partial thromboplastin 650 400
time )
CRT Clot retraction test 300 200
CBCDLC Complete blood count ( CBC ) with 550 350
Differential leukocyte count ( DLC )
GLUR Glucose Random 120 80
310
HEPA LFT ‐ Liver Function Test ( Hepatic Profile ) 1150 690
PT Prothrombin time ( PT ) Haematology Lab 400 240
RENPI Renal Biochemical Profile ‐ Basic 1200 720
(BUN,Creat,Ca,PO,4,Na,K,Bicarbonate)
988 GRAOS Granulocyte transfusion ( GCSF
mobilized, third party) ‐Doctor
fee + Hospital vharges
GRADF Granulocyte transfusion ( GCSF mobilized, 44100 44100 22050 17640 13230
third party) ‐ Doctor fee
GRAHC Granulocyte transfusion ( GCSF mobilized, 4420 4420 2210 1770 1330
third party) ‐ Hospital Charges
989 HAPOS Haploidentical allogenic
stem/bone marrow
transplantation ‐ Doctor fee +
Hospital Charges
HAPDF Haploidentical allogenic stem/bone marrow 330760 330760 165380 132300 99230
transplantation ‐ Doctor fee
HAPHC Haploidentical allogenic stem/bone marrow 33080 33080 16540 13230 9920
transplantation ‐ Hospital Charges
990 HLITOS LIT therapy ( Doctor fee + lab
charges)
HLITDF LIT therapy ‐ Doctor fee 3510 3510 3510 3510 2760
HLIT LIT therapy ‐ Lab charges 3510 3510 3510 3510 2460
991 MLSTDHC MULTIPLE SLEEP LATENCY TEST
OS ( MLST ) PACKAGE CHARGES
Professional Charges +
HOSPITAL CHARGES)
MLSTDF Multiple sleep latency test ( MLST ) ‐ Doctor 11200 11200 5600 4480 3360
fee
MLSTTC Multiple sleep latency test ( MLST ) test 8400 8400 4200 3360 2520
charges
992 PACSGDC PULMONARY ARTERY
HCHOS CATHETERISATION (
SWAN‐GANZ ) (DOCTOR FEE +
HOSPITAL CHARGES)
PACAHC Pulmonary artery catheterisation ( Swan 1850 1850 920 740 550
Ganz ) ‐ Additional hospital charges
993 PULFNAC Guided FNAC/Needle Biopsy ‐
OS PULMONOLOGY
PULFNACDF Guided FNAC/Needle Biopsy ‐ Pulmonology 5260 5260 2630 2100 1580
Doctor Fee
PULFNACHC Guided FNAC/Needle Biopsy ‐ Pulmonology 520 520 260 210 160
Hospital Charges
994 PULGAOS Guided Abscess drainage ‐
PULMONOLOGY
PULGAHC Guided Abscess drainage ‐ Hospital Charges 630 630 320 250 190
PULGADF Guided Abscess drainage ‐ Pulmonology 6300 6300 3150 2520 1890
Doctor Fee
995 PULGPAO Guided pleural aspiration
S (Diagnostic ) ‐ PULMONOLOGY
PULGPA Guided pleural aspiration (Diagnostic) 6300 6300 3150 2520 1890
PULGPAHC Guided pleural aspiration (Diagnostic) 640 640 320 260 190
996 PULGPOS Guided pleural aspiration
(Therapeutic ) ‐
PULMONOLOGY
PULGTDF Guided pleural aspiration (Therapeutic) 9460 9460 4730 3780 2840
PULGTHC Guided pleural aspiration (Therapeutic) 940 940 470 380 280
997 PULGTBO Guided trucut biopsy (Small) ‐
S PULMONOLOGY
311
PULGTBDF Guided trucut biopsy (Small) ‐ Pulmonology 9460 9460 4730 3780 2840
Doctor Fee
PULGTBHC Guided trucut biopsy (Small) ‐ Pulmonology 940 940 470 380 280
Hospital Charges
Paediatric Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
998 ALBOS Aspiration of liver abscess ‐
(Docor Fee + Hospital Charges)
ALADF Aspiration of liver abscess ‐ Docor Fee 10180 10180 5090 4070 3050
ALAHC Aspiration of liver abscess ‐ Hospital 1540 1540 770 620 460
Charges
999 ANOS Anal dilatation ‐ (Docor Fee +
Hospital Charges)
ANDF Anal dilatation ‐ Docor Fee 16560 16560 8280 6620 4970
ANHC Anal dilatation ‐ Hospital Charges 2480 2480 1240 990 740
1000 BPVCDOS Bedside paediatric vascular cut
down under GA ( venesection )
BPVCDAF Bedside paediatric vascular cut down under 7280 7280 3640 2910 2180
GA ( venesection ) ‐ Anaesthetists charges
BPVCDHF Bedside paediatric vascular cut down under 3640 3640 1820 1460 1090
GA ( venesection ) ‐ Hospital service charges
BPVCDSF Bedside paediatric vascular cut down under 24260 24260 12130 9700 7280
GA ( venesection ) ‐ Surgeon fee
1001 ETDFHCH EXCHANGE TRANSFUSION
CHARGES)
ETHC Exchange transfusion ‐ Additional hospital 2020 2020 1010 810 610
charges
ETDF Exchange transfusion ‐ Doctor fees 13420 13420 6710 5370 4030
1002 PBMADC PAEDIATRIC BONE MARROW
HOS ASPIRATION (DOCTOR FEE +
HOSPITAL CHARGES)
PBMAAD Paediatric bone marrow aspiration ‐ Doctor 2100 2440
fee
PBMAAHC Paediatric bone marrow aspiration ‐ 370
hospital service charge
1003 PBMBAD PAEDIATRIC BONE MARROW
HCHOS BIOPSY + ASPIRATION
CHARGES)
PBMBAD Paediatric bone marrow biopsy + aspiration 4340
‐ Doctor fee
PBMBAAHC Paediatric bone marrow biopsy + aspiration 650
‐ hospital service charge
1004 PBMBDHC PAEDIATRIC BONE MARROW
HOS BIOPSY (DOCTOR FEE +
HOSPITAL CHARGES)
PBMBADP Paediatric bone marrow biopsy ‐ Doctor fee 3180
PBMBAHC Paediatric bone marrow biopsy ‐ hospital 470
service charge
1005 PBRPDHC PAEDIATRIC BRONCHOSCOPY
CHARGES)
PBADWP Paediatric bronchoscopy ‐ Doctor fee 5530
PBAHC Paediatric bronchoscopy ‐ hospital service 830
charge
1006 PKBDCHC PAEDIATRIC KIDNEY BIOPSY
CHARGES)
312
PKBADWP Paediatric kidney biopsy ‐ Doctor fee 4450
PKBAHC Paediatric kidney biopsy ‐ hospital service 640 670
charge
1007 PLBDCHC PAEDIATRIC LIVER BIOPSY
CHARGES)
PLBADWP Paediatric liver biopsy ‐ Doctor fee 4450
PLBAHC Paediatric liver biopsy ‐ hospital service 640 670
charge
1008 PLPDHCH PAEDIATRIC LUMBAR
OS PUNCTURE (DOCTOR FEE +
HOSPITAL CHARGES)
PLPADWP Paediatric lumbar puncture ‐ Doctor fee 3060
PLPAHC Paediatric lumbar puncture ‐ hospital 430 460
service charge
1009 PPTDCHC PAEDIATRIC PLEURAL TAP
CHARGES)
PPTADWP Paediatric pleural tap ‐ Doctor fee 2930
PPTAHC Paediatric pleural tap ‐ hospital service 440
charge
1010 PVCDOS Paediatric vascular cut down (
venesection ) under GA in Cath
Lab
PVCDAF Paediatric vascular cut down ( venesection ) 8670 8670 4340 3470 2600
under GA in Cath Lab ‐ Anaesthetists
charges
PVCDCF Paediatric vascular cut down ( venesection ) 12430 12430 6210 4970 3730
under GA in Cath Lab ‐ Cath lab Charges
PVCDSF Paediatric vascular cut down ( venesection ) 28900 28900 14450 11560 8670
under GA in Cath Lab ‐ Surgeon fee
1011 RPOS Reduction of paraphimosis ‐
(Docor Fee + Hospital Charges)
RPDF Reduction of paraphimosis ‐ Docor Fee 12740 12740 6370 5100 3820
RPHC Reduction of paraphimosis ‐ Hospital 1920 1920 960 770 580
Charges
1012 SDPDHCH SURFACTANT DELIVERY
COS PROCEDURE (DOCTOR FEE +
HOSPITAL CHARGES)
SDPAHC Surfactant delivery procedure ‐ Additional 1660 1660 830 660 500
hospital charges
SDPDF Surfactant delivery procedure ‐ Doctor fee 11080 11080 5540 4430 3320
1013 SPOS Separation of prepucial/ labial
adhesion ‐ (Docor Fee +
Hospital Charges)
SPLADF Separation of prepucial/ labial adhesion ‐ 12740 12740 6370 5100 3820
Docor Fee
SPLHC Separation of prepucial/ labial adhesion ‐ 1920 1920 960 770 580
Hospital Charges
1014 SWTECFO Sweat test (Doctor fee + lab
S charges)
BSWTBSP Sweat test for cystic fibrosis ‐ Additional 370 190
hospital charges
BSWTDC Sweat test fot cystic fibrosis ‐ doctor fee 2420 1940 1220 2420 1220
Pain Control Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

1015 EPCADHC ELECTRONIC PCA PUMP
HOS INSTALLATION (DOCTOR FEE +
HOSPITAL CHARGES)
313
EPCAPI Electronic PCA pump installation ‐ Doctor 10660 10660 5330 4260 3200
fees
ELPCAINSTBSP Electronic PCA pump installation ‐ hospital 1070 1070 530 430 320
service charges
1016 MIBPINSD MECHANICAL INFUSOR (
HCOS BAXTER ) PUMP INSTALLATION
CHARGES)
MIBAXPIHC Mechanical infusor ( Baxter ) pump 660 660 330 260 200
installation ‐ Additional hospital charges
MIBAXPI Mechanical infusor ( Baxter ) pump 6460 6460 3230 2580 1940
installation ‐ Doctor fees

Psychiatry Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3
1030 ARTPAOS ARTERIAL PRESSURE ANALYSIS
CHARGES)
ARTPNDF Arterial pressure analysis ‐ Doctor fee 70 70
ARTPAHC Arterial pressure analysis ‐ Hospital Charges 150 150 150 150 80 150 150
1031 ATDHCOS AVERSION THERAPY (DOCTOR
AVTDF Aversion therapy ‐ Doctor Fee 1440 1440 720 580 430 720 430
AVTPSC Aversion therapy ‐ hospital charges 300 300 150 120 90 150 90
1032 BTDHCOS BIOFEEDBACK THERAPY
CHARGES)
BIT Biofeedback therapy ‐ Doctor Fee 1440 1440 720 580 430 720 430
BITPSC Biofeedback therapy ‐ hospital charges 300 300 150 120 90 150 90
1033 GT1DHCH GROUP THERAPY ( 1 HOUR )
CHARGES)
GT Group therapy ( 1 hour ) ‐ Doctor Fee 3520 3520 1760 1410 1060 1760 1060
GTPSC Group therapy ( 1 hour ) ‐ hospital charges 720 720 360 290 220 360 220
1034 PSYDCHC PSYCHOTHERAPY ( 50 MINUTE
HOS SESSION ) (DOCTOR FEE +
HOSPITAL CHARGES)
PSHO Psychotherapy ( 50 minute session ) ‐ Doctor 1760 1760 880 700 530 880 530
Fee
PSHPSC Psychotherapy ( 50 minute session ) ‐ 360 360 180 140 110 180 110
hospital charges
1035 RTDHCHC RELAXATION THERAPY ( 30‐40
OS MINUTE SESSION ) (DOCTOR
RET Relaxation therapy ( 30‐40 minute session ) 1760 1760 880 700 530 880 530
‐ Doctor Fee
RETPSC Relaxation therapy ( 30‐40 minute session ) 360 360 180 140 110 180 110
‐ hospital charges
1036 VENRAOS VENOUS REFLUX ANALYSIS
CHARGES)
VENRADF Venous reflux analysis ‐ Doctor fee 80 80
VENRAHC Venous reflux analysis ‐ Hospital Charges 140 150 140

314
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
1038 ROBSURG Robotic Surgery
ROBBG30 $$ Bowel Grasper, 30mm Jaw 18100
ROBCF $$ Cadiere Forceps 15800
ROBCS $$ Curved Scissors (NOT hot shears) 15800
ROBDFG $$ Double Fenestrated Grasper 15800
ROBDK3 $$ Drape Kit, 3 Arm 3200
ROBDK4 $$ Drape Kit, 4 Arm 4200
ROBFBF $$ Fenestrated Bipolar Forceps 21500
ROBHACE $$ Harmonic ACE (requires Harmonic ACE 4400
Insert)
ROBHACEI $$ Harmonic ACE Insert 34100
ROBHS $$ Hot Shears (Monopolar Curved Scissors ‐ 25200
requires tip cover 400180)
ROBLCA $$ Large Clip Applier (used with Weck P/N 1100
544240)
ROBLND $$ Large Needle Driver 17300
ROBMBF $$ Maryland Bipolar Forceps 21500
ROBMD $$ Maryland Dissector 18100
ROBMND $$ Mega Needle Driver 17300
ROBND $$ Needle driver 18100
ROBPCH $$ Permanent Cautery Hook 15800
ROBPF $$ ProGrasp Forceps 17300
ROBSG $$ Small Graptor (Grasping Retractor) 18900
ROBSI $$ Suction/ Irrigator 17300
ROBTF $$ Tenaculum Forceps 17300
ROBSURCH Robot Usage ‐ Hospital charges 46000
Vascular Procedures
All Category
Cat 1B Suite
4 Beddded
Cat 1A‐Pre
Single Bed
2 Bedded
Cat‐1D
GOPD
POPD
Cat‐2
Cat‐3

1097 ABITMOS Ankle ‐ brachial index ( ABI )
tonometry
ABITM Ankle ‐ brachial index ( ABI ) tonometry 480
Doctor fee
ABITMHC Outpatient ankle ‐ brachial index ( ABI ) 480 480
tonometry ‐ Lab Charges
1098 ACSFDHC ARTERIAL LINE
OS CATHETERISATION (
SUBCLAVIAN / FEMORAL / ANY
OTHER ) (DOCTOR FEE +
HOSPITAL CHARGES)
BACHC Arterial catheterisation ( subclavian / 1070 1070 540 430 330
femoral / any other ) ‐ Additional hospital
charges
BACDF Arterial catheterisation ( subclavian / 10670 10670 5330 4260 3200
femoral / any other ) ‐ Doctor fees
1099 AVAOS AV Access in cath lab
AVCLC AV Access in cath lab ‐ Cath Lab Charges 18360 18360 9180 7340 5510
AVAC AV Access in cath lab ‐ Doctor Fee 42690 42690 21350 17070 12810
1100 BVTOS Basilic vein transposition in
Cath lab
BVTDPCL Basilic vein transposition ‐ Cath lab charges 30280 30280 15140 12110 9090
315
BVTDP Basilic Vein Transposition in Cath Lab ‐ 70430 70430 35220 28170 21130
Doctor fee
1101 CEBOS Complex endoluminal bypass
CEBCLC Complex endoluminal bypass ‐ Cath Lab 91780 91780 45890 36710 27530
Charges
CEBDF Complex endoluminal bypass ‐ Doctor Fee 213440 213440 106720 85380 64030
1102 CFANGPO Complex Fistula Angioplasty
S (Doctor fee + Cath Lab charges)
CFANGCLC Complex Fistula Angioplasty ‐ Cath Lab 30100 30100 15050 12040 9030
charges
CFANGDF Complex Fistula Angioplasty ‐ Doctor fee 69990 69990 35000 27990 21000
1103 CHRPOS Chemoport removal (Doctor
fee + Cath Lab charges)
CHRCLC Chemoport removal ‐ Cath Lab charges 11290 11290 5650 4520 3390
CHRDF Chemoport removal ‐ Doctor fee 26250 26250 13130 10500 7880
1104 CIRETOS Caval Interruption using
retrievable device (Doctor Fee
+ Hospital charges)
CIRETDF Caval Interruption using retrievable device ‐ 93910 93910 46960 37570 28170
Doctor Fee
CIRETDBSP Caval Interruption using retrievable device ‐ 40380 40380 20190 16160 12110
Hospital Charges
1105 CLIPOS Chemoport/Permacath/Centra
l Line Insertion (Doctor fee +
Cath Lab charges)
CLICLC Chemoport/Permacath/Central Line 16550 16550 8280 6620 4970
Insertion ‐ Cath Lab charges
CLIDC Chemoport/Permacath/Central Line 38490 38490 19250 15390 11550
Insertion ‐ Doctor fee
1106 CPEBOS Complex peripheral
embolisation for bleeding
CPECLC Complex peripheral embolisation for 57360 57360 28690 22940 17210
bleeding ‐ Cath Lab Charges
CPEB Complex peripheral embolisation for 133400 133400 66710 53360 40030
bleeding ‐ Doctor Fee
1107 CPTEOS Complex peripheral tumor
embolisation
CPTECLC Complex peripheral tumor embolisation ‐ 57360 57360 28690 22940 17210
Cath Lab Charges
CPTMDF Complex peripheral tumor embolisation ‐ 133400 133400 66710 53360 40030
Doctor Fee
1108 CRCOS Complex recanalisation for
chronic total vascular occlusion
CRCTVCLC Complex recanalisation for chronic total 91780 91780 45890 36710 27530
vascular occlusion ‐ Cath Lab Charges
CRCTVDF Complex recanalisation for chronic total 213440 213440 106720 85380 64030
vascular occlusion ‐ doctor fee
1109 EMMALO Embolisation of vascular
S malformation in cath lab
EVMCLC Embolisation of vascular malformation in 34420 34420 17210 13760 10320
cath lab ‐ cath lab charges
EVMCL Embolisation of vascular malformation in 80040 80040 40030 32010 24010
cath lab ‐ doctor fee
1110 ENDOBYO Endoluminal bypass (Doctor
S Fee + Hospital charges)
ENDOBYDF Endoluminal bypass ‐ Doctor Fee 93910 93910 46960 37570 28170
ENDOBYBSP Endoluminal bypass ‐ Hospital Charges 40380 40380 20190 16160 12110
1111 ENRPSEOS Endovascular Repair of
Pseudoaneurysm
ERPCLC Endovascular repair of pseudoaneurysm in 36710 36710 18360 14690 11010
ERPCL Endovascular repair of pseudoaneurysm in 85380 85380 42690 34160 25610
1112 FANGPOS Fistula Angioplasty (Doctor fee
+ Cath Lab charges)
FANGCLC Fistula Angioplasty ‐ Cath Lab charges 15050 15050 7530 6020 4520
316
FANGDF Fistula Angioplasty ‐ Doctor fee 35010 35010 17500 14010 10500
1113 FGPOS Fluoroscopic guided
percutanous tumor
embolisation
FGPCLC Fluoroscopic guided percutanous tumor 34420 34420 17210 13760 10320
embolisation ‐ Cath Lab Charges
FGPTEDF Fluoroscopic guided percutanous tumor 80040 80040 40030 32010 24010
embolisation ‐ Doctor Fee
1114 FLVSCOS Fluroscopy guided vascular
sclerotherapy in cath lab
FLVSCLC Fluroscopy guided vascular sclerotherapy in 22940 22940 11470 9180 6880
FLVSCL Fluroscopy guided vascular sclerotherapy in 53360 53360 26680 21350 16010
1115 IABIOS Inpatient Ankle brachial index (
ABI ) tonometry
IABIDF Inpatient Ankle brachial index ( ABI ) 480
tonometry ‐ Doctor fee
IABIHC Inpatient Ankle brachial index ( ABI ) 480 480
tonometry ‐ Lab Charges
1116 ICVADPOS Implantable Central Venous
Access Device Placement
Charges)
ICVADPDF Implantable Central Venous Access Device 29350 29350 14680 11740 8810
Placement ‐ Doctor Fee
ICVENADPBSP Implantable Central Venous Access Device 12620 12620 6310 5050 3790
Placement ‐ Hospital Charges
1117 ICVAOS Implantable central venous
access device removal
ICVACLC Implantable central venous access device 11470 11470 5740 4590 3440
removal ‐ Cath Lab Charges
ICVARDF Implantable central venous access device 26680 26680 13350 10670 8000
removal ‐ Doctor Fee
1118 IPASVLPD INPATIENT ARTERIAL FLOW
HCOS STUDIES IN VASCULAR LAB
CHARGES)
IAFSVLAHC Inpatient Arterial flow studies in vascular lab 480 480
IAFSVLDF Inpatient Arterial flow studies in vascular lab 480
‐ Doctor fee
1119 IVFSVLDH INPATIENT VENOUS FLOW
COS STUDIES IN VASCULAR LAB
CHARGES)
IVFSVLAHC Inpatient venous flow studies in vascular lab 480 480
IVFSVLDF Inpatient venous flow studies in vascular lab 480
‐ Doctor fee
1120 OVFSVLOS Outpatient venous flow studies
in vascular lab
OVFSVLDF Outpatient venous flow studies in vascular 850
lab ‐ Doctor fee
OVFSVLHC Outpatient venous flow studies in vascular 850 850
lab ‐ Lab Charges
1121 PCGTCOS Peripheral catheter guided
thrombolysis in cath lab
PCGTCLC Peripheral catheter guided thrombolysis in 30490 30490 15250 12200 9150
PCGTCL Peripheral catheter guided thrombolysis in 76230 76230 38120 30490 22870
1122 PEBOS Peripheral embolisation for
bleeding
317
PEBCLC Peripheral embolisation for bleeding ‐ Cath 34420 34420 17210 13760 10320
Lab Charges
PEFB Peripheral embolisation for bleeding ‐ 80040 80040 40030 32010 24010
Doctor Fee
1123 PTEOS Peripheral tumor embolisation
PTECLC Peripheral tumor embolisation ‐ Cath Lab 34420 34420 17210 13760 10320
Charges
PTEDF Peripheral tumor embolisation ‐ Doctor Fee 80040 80040 40030 32010 24010
1124 RCIDOS Removal of Caval Interruption
Device (Doctor Fee + Hospital
charges)
RCINDBSP Removal of Caval Interruption Device ‐ 13760 13760 6880 5510 4130
Bedside Procedure Charges
RCIDDF Removal of Caval Interruption Device ‐ 32010 32010 16010 12810 9610
Doctor Fee
1125 RFCHTVO Recanalization for Chronic
OS Total Vascular Occlusion
(Doctor Fee + Hospital charges)
RFCHTVODF Recanalization for Chronic Total Vascular 82180 82180 41090 32870 24650
Occlusion ‐ Doctor Fee
RCHTVOBSP Recanalization for Chronic Total Vascular 35340 35340 17670 14130 10600
Occlusion ‐ Hospital Charges
1126 SKINOXY Tissue ischaemia monitoring
CHARGES)
OTISISCMOND Tissue ischaemia monitoring ‐ Doctor fee 150 150
F
SKINOXYHC Tissue ischaemia monitoring ‐ Hospital 370 370
Charges
1127 UAECOS Uterine artery embolisation in
cath lab
UAECLC Uterine artery embolisation in cath lab ‐ 34420 34420 17210 13760 10320
cath lab charges
UAECL Uterine artery embolisation in cath lab ‐ 80040 80040 40030 32010 24010
doctor fee
1128 USGDHOS Ultrasound Guided Procedure
in Cath Lab ‐ ( Doctor Fee +
Hospital Charges )
USGD Ultrasound Guided Procedure in Cath Lab ‐ 560
Doctor Fee
USGH Ultrasound Guided Procedure in Cath Lab ‐ 560
Hospital Charges
1129 VENGSVC Venography guide laser assited
BOS saphenous vein closure (B\L)
VENGSVCBBSP Venography guided laser assisted 44170 44170 22090 17670 13250
saphenous vein closure (B/L) ‐ Hospital
Charges
VENGSVCBDF Venography guided laser assisted 102720 102720 51370 41090 30820
saphenous vein closure (bilateral)‐ Doctor
Fee
1130 VENGSVC Venography guide laser assited
OS saphenous vein closure (U\L)
VENGSVCBSP Venography guided laser assisted 35340 35340 17670 14130 10600
saphenous vein closure (U/L)‐ Hospital
Charges
VENGSVCDF Venography guided laser assisted 82180 82180 41090 32870 24650
saphenous vein closure (unilateral)‐ Doctor
Fee
318

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Ganga Ram Hospital

1 Birthing Suite (LR) 12000

Intensive care charges 4 Bedded

SNo Service Area Code

1 CCU / IMCU monitoring charges INTMONCHCCU 13300 11100 8900

2 NNU charges - level 1 1900

3 NNU charges - level 2 2900

4 NNU charges - level 3 4600 4600 4600 4400 4100

5 Observation nursery charges 720

INTENSIVE CARE AREAS

2. General Information on Procedure/ Investigation Charges

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

i) Room booking / maternity booking

ii) Advance deposit at the time of admission:

S.NO. Type of accommodation Amount

1. Categroy 1A/ 1B 100000

In surgical cases (confirmed booking)

S.NO. Department Category 1 Category 2 Category 3

1. GI Surgery 120000 100000 70000

2. General Surgery 50000 40000 30000

3. Neuro Surgery 120000 100000 70000

4. Ortho-Surgery 70000 60000 50000

5. Kidney Transplantation 750000

6. Cardiac Package 100% 100% 100%

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

Hepatitis C virus serology antibody test [HCV] 1040 620

HIV antibody test [HIV] 780 470

RPR [VDRL] 330 200

1 Additional Transfusion Charges 3100 3100 2550 1600 2350 1350 0

1 Aphaeresis Collection & Storage 71500 71500 66000 55000 38500

SNo Code Description

SNo Description Code POPD/ GOPD/

SNo Description Code POPD/ GOPD/

SNo Description Code POPD/ GOPD/

SNo Description Code POPD/ GOPD/

SNo Description Code POPD/ GOPD/

SNo Description Code POPD/ GOPD/

HLA Serological & Molecular Charges

SNo Description Code POPD/ GOPD/

Molecular Genetics Charges

SNo Description Code POPD/ GOPD/

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

SNo Description Code POPD/ GOPD/

SNo Description Code POPD/ GOPD/

2 DIAGNOSTIC SPERM EXTRACTION ( TESA / PESA ) DSEPCADCHOS

7 Intra‐cytoplasmic sperm injection ( ICSI ) ‐ (Embryologists ICSIOS

13 Oocyte Cryopreservation cycle (upto 9 oocytes) IVFOC9O

17 Renewal charges for embryo cryopreservation (for every RENCRYOOS

18 Re‐Vitrification (Embryologists fee + Hospital charges) REVITEOS

SNo Code Description

Biochemistry Laboratory Charges

S No Description Code POPD/ GOPD/

168 NGAL (Plasma) NGALP 1840 1100

248 Urine spot test for sodium & potassium URINSODPOTOS

SNo Description Code POPD/ GOPD/

SNo Description Code POPD/ GOPD/

SNo Description Code POPD/ GOPD/

Clinical Pathology Charges

SNo Description Code POPD/ GOPD/

Diabetology Laboratory Charges

SNo Description Code POPD/ GOPD/

132 Thromobophilia Panel ( Molecular + Coagulant assays ) ( THROMMH 18500 16000