Sr. No.CGHS TREATMENT PROCEDURE/INVESTIGATION

LIST

Non NABH /Non NABL

(Jaipur)

NABH/NABL(Jaipur)

1 Consultation OPD 135 1352 Consultation- for Inpatients 270 2703 Dressings of wounds 45 584 Suturing of wounds with local anesthesia 97 1125 Aspiration Plural Effusion - Diagnostic 120 1386 Aspiration Plural Effusion - Therapeutic 174 2007 Abdominal Aspiration - Diagnostic 311 3588 Abdominal Aspiration - Therapeutic 414 4769 Pericardial Aspiration 342 393

10 Joints Aspiration 285 32811 Biopsy Skin 207 23812 Removal of Stitches 013 Venesection 112 12914 Phimosis Under LA 1180 135715 Sternal puncture 156 17916 Injection for Haemorrhoids 373 42917 Injection for Varicose Veins 315 36218 Catheterisation 75 8619 Dilatation of Urethra 450 51820 Incision & Drainage 390 44921 Intercostal Drainage 113 13022 Peritoneal Dialysis 1319 1517

TREATMENT PROCEDURE SKIN23 Excision of Moles 311 35824 Excision of Warts 279 32125 Excision of Molluscum contagiosum 117 13526 Excision of Veneral Warts 144 16627 Excision of Corns 126 14528 I/D Injection Keloid 87 10029 Chemical Cautery (s) 99 114

TREATMENT PROCEDURE OPTHALMOLOGY30 Subconjunctival/subtenon’s injections in one eyes 62 7131 Subconjunctival/subtenon’s injections in both eyes 124 14332 Pterygium Surgery 77 89

Following is new CGHS approved list of procedures/investigations and rates for CGHSJaipur Circulated under OM dated 14.11.2014 effective from 17.11.2014.

Ministry of Health & Family WelfareDirectorate General of CGHS

Additional Director, CGHS Jaipur Dated: 17.11.2014

Annexure-II

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33 Conjunctival Peritomy 52 60

34Conjunctival wound repair or exploration following blunttrauma

104 120

35 Removal of corneal foreign body 104 12036 Cauterization of ulcer/subconjunctival injection in one eye 62 7137 Cauterization of ulcer/subconjunctival injection in both eyes 124 14338 Corneal grafting—Penetrating keratoplasty 5175 595139 Corneal grafting—Lamellar keratoplasty 5000 575040 Cyanoacrylate /fibrin glue application for corneal perforation 621 71441 Bandage contact lenses for corneal perforation 414 47642 Scleral grafting or conjunctival flap for corneal perforation 2070 238143 Keratoconus correction with therapeutic contact lenses 1200 138044 UV radiation for cross-linking for keratoconus 1620 186345 EDTA for band shaped keratopathy 777 89446 Arcuate keratotomy for astigmatism 2520 289847 Re-suturing (Primary suturing) of corneal wound 1035 119048 Penetrating keratoplasty ---- with glaucoma surgery 10930 1257049 Penetrating keratoplasty --- with vitrectomy 10930 1257050 Penetrating keratoplasty ---- with IOL implantation 12290 1413451 DALK- Deep anterior lamellar keratoplasty 15525 1785452 Keratoprosthesis stage I and II 10350 11903

53DSAEK- Descemet’s stripping automated endothelialkeratoplasty

15008 17259

54 ALTK- Automated lamellar therapeutic keratoplasty 14850 1707855 Probing and Syringing of lacrimal sac- in one eye 62 7156 Probing and Syringing of lacrimal sac- in both eye 124 14357 Dacryocystorhinostomy—Plain 2588 2976

58Dacryocystorhinostomy—Plain with intubation and/or withlacrimal implants

8775 10091

59 Dacryocystorhinostomy—conjunctival with implant 8280 952260 Caliculoplasty 2070 238161 Dacryocystectomy 1725 198462 Punctal plugs for dry eyes 117 13563 Refraction 36 4164 Indirect Ophthalmoscopy 60 6965 Orthoptic check-up- with synoptophore 40 4666 Lees’ charting or Hess’ charting 90 10467 Orthoptic exercises 50 5868 Pleoptic exercises 50 5869 Perimetry/field test—Goldman 130 15070 Perimetry/field test— automated 130 15071 Fluorescein angiography for fundus or iris 828 95272 Ultrasound A- Scan 777 89473 Ultrasound B- Scan 207 23874 Fundus Photo Test 180 20775 Indocyanin green angiography 828 95276 Corneal endothelial cell count with specular microscopy 207 23877 Corneal topography 298 343

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78 Corneal pachymetry 207 23879 Auto-refraction 32 3780 Macular function tests 40 4681 Potential acuity metry 100 11582 Laser interferometry 156 17983 OCT-Optical coherence tomography 1913 220084 HRT- Heidelberg’s retinal tomogram 135 15585 GDX--- Nerve fibre layer analyzer 88 10186 UBM- Ultrasound bio microscopy 135 15587 Non Contact tonometry 45 5288 IOP measurement with schiotz 27 3189 IOP measurement with applation tonometry 45 5290 Three mirror examination for reti 52 6091 90 D lens examination 45 5292 Gonioscopy 52 6093 Chalazion incision and curettage in one eye 360 41494 Chalazion incision and curettage in both eyes 388 44695 Ptosis surgery with fasanella servat procedure 2070 238196 Ptosis surgery with LPS resection one lid 4950 569397 Ptosis surgery with Sling surgery one lid 6003 690398 Ectropion surgery- one lid 1400 161099 Ectropion surgery- both lids 2500 2875

100 Epicanthus correction 1395 1604101 Cantholysis and canthotomy 518 596102 Entropion surgery- one lid 1242 1428103 Entropion surgery- both lids 1800 2070104 Tarsorraphy 650 748105 Suturing of lid lacerations 1035 1190106 Lid retraction repair 1530 1760107 Concretions removal 104 120108 Bucket handle procedure for lid tumors 311 358109 Cheek rotation flap for lid tumors 6210 7142110 Orbitotomy 7245 8332111 Enucleation 2700 3105112 Enucleation with orbital implants and artificial prosthesis 2700 3105113 Evisceration 3105 3571114 Evisceration with orbital implants and artificial prosthesis 5124 5893115 Telecanthus correction 4658 5357116 Orbital decompression 5175 5951117 Exenteration 5175 5951118 Exenteration with skin grafting 6210 7142119 Fracture orbital repair 8280 9522120 Retinal laser procedures 1350 1553121 Retinal detachment surgery 10350 11903122 Retinal detachment surgery with scleral buckling 12420 14283123 Buckle removal 1035 1190124 Silicone oil removal 2520 2898125 Anterior retinal cryopexy 1046 1203

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126 Squint correction for one eye 4500 5175127 Squint correction for both eyes 6750 7763128 Trabeculectomy 6900 7935129 Trabeculotomy 6210 7142130 Trabeculectomy with Trabeculotomy 9315 10712131 Trephition 2070 2381132 Goniotomy 311 358133 Glaucoma surgery with Glaucoma valves 6310 7256134 Cyclocryotherapy 1035 1190135 YAG laser iridotomy 1350 1553136 YAG laser capsulotomy 984 1132137 ALT-Argon laser trabeculoplasty 1495 1719138 PDT-Photodymic therapy 3105 3571139 TTT- Transpupillary thermal therapy 3000 3450140 PTK- Phototherapeutic keratectomy 6750 7763141 Argon/diode laser for retinal detatchment 1035 1190142 Intralase application for keratoconus 5175 5951143 EOG- electro-oculogram 810 932144 ERG- Electro-retinogram 715 822145 VEP- visually evoked potential 800 920146 Vitrectomy- pars plana 10350 11903147 Intravitreal injections- of antibiotics 1035 1190148 Intravitreal injections- of lucentis excluding cost of drug 2700 3105149 X- Ray orbit 110 127150 CT-orbit and brain 165 190151 MRI- Orbit and brain 3105 3571152 Dacryocystography 318 366153 Orbital angio-graphical studies 1500 1725154 ECCE with IOL 3450 3968155 SICS with IOL 4500 5175156 Phaco with foldable IOL (silicone and acrylic)/PMMA IOL 9703 11158157 Pars plana lensectomy with/without IOL 9315 10712158 Secondary IOL implantation- AC IOL PC IOL or scleral fixated 6210 7142159 Cataract extraction with IOL with capsular tension rings 12150 13973160 Optic nerve sheathotomy 6750 7763161 Iridodialysis repair or papillary reconstruction 4500 5175162 Iris cyst removal 765 880163 Lid Abscess incision and Drainage 1530 1760164 Orbital Abscess incision and Drainage 2700 3105165 Biopsy 414 476166 Paracentesis 207 238167 Scleral graft for scleral melting or perforation 2520 2898168 Amniotic membrane grafting 1000 1150169 Cyclodiathermy 2070 2381170 Intraocular foreign body removal 168 193171 Electrolysis 207 238172 Perforating injury repair 4050 4658173 Botulinum injection for blepharospasm or squint 2250 2588

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TREATMENT PROCEDURE DENTAL PROCEDURES174 Flap Operation per quadrant 324 373175 Gingivectomy per quadrant 234 269176 Reduction & immobilization of fracture- Maxilla Under LA 810 932177 Reduction & immobilization of fracture-Mandible Under LA 3150 3623178 splints/Cirucum mandibular wiring under LA 510 587179 splints/Cirucum mandibular wiring under GA 990 1139180 Internal wire fixation/plate fixation of Maxilla under LA 3000 3450181 Internal wire fixation/plate fixation of Maxilla under GA 4000 4600182 Internal wire fixation/plate fixation of Mandible under LA 3500 4025183 Internal wire fixation/plate fixation of Mandible under GA 4000 4600184 Extraction per tooth under LA 80 92185 Complicated Ext. per Tooth under LA 100 115186 Extraction of impacted tooth under LA 160 184

187Extraction in mentally retarded/patients with systemicdiseases/patient with special needs under short term GA

845 972

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

244 281

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

406 467

190Cyst & tumour of Maxilla/mandible byenucleation/excision/marsupalisation size more than 4 cmsunder GA

1000 1150

191 TM joint ankylosis- under GA 6750 7763192 Biopsy Intraoral-Soft tissue 337 388193 Biopsy Intraoral-Bone 374 430194 Hemi-mandibulectomy with graft 18900 21735195 Hemi-mandibulectomy without graft 18900 21735196 Segmental-mandibulectomy with graft 3400 3910197 Segmental-mandibulectomy without graft 990 1139198 Maxillectomy- Total with graft 2500 2875199 Maxillectomy- Total without graft 1950 2243200 Maxillectomy- partial with graft 2700 3105201 Maxillectomy- partial without graft 2250 2588

202Release of fibrous bands & grafting -in (OSMF) treatmentunder GA

1500 1725

203 Pre-prosthetic surgery- Alveoloplasty 500 575204 Pre-prosthetic surgery - ridge augmentation 1200 1380205 Root canal Treatment(RCT) Anterior teeth(per tooth) 500 575206 Root canal Treatment(RCT) Posterior teeth (per tooth) 700 805207 Apicoectomy- Single root 500 575208 Apicoectomy-Multiple roots 650 748209 Metal Crown-per unit 500 575210 Metal Crown with Acrylic facing per unit 700 805211 Complete single denture-metal based 1350 1553212 Complete denture- acrylic based per arch 950 1093213 Removable partial denture-Metal based-upto 3 teeth 700 805214 Removable partial denture-Metal based-more than 3 teeth 810 932

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215 Removable partial denture-Acrylic based-upto 3 teeth 500 575216 Removable partial denture-Acrylic based-more than 3 teeth 264 304217 Amalgum restoration-per tooth 200 230218 Composite Restoration-per tooth-anterior tooth 250 288219 Glas Ionomer-per tooth 200 230220 Scaling & polishing 270 311221 Removable Orthodontics appliance- per Arch 700 805222 Fixed Orhtodontics-per Arch 1150 1323223 Space maintainers-Fixed 500 575224 Habit breaking appliances-removable 800 920225 Habit breaking appliances-Fixed 1500 1725226 Expansion plate 1000 1150227 Feeding appliance for cleft palate 1500 1725228 Maxillo-facial prosthesis (sal/auricular/orbital/facial lost part) 3150 3623229 Functional orthodentic appliances 3000 3450230 Obturator (Maxillo-facial) 1500 1725231 Occlusal night guard(splint) 800 920

TREATMENT PROCEDURE ENT232 Pure Tone Audiogram 155 178233 Impedence with stepedeal reflex 207 238234 SISI Tone Decay 119 137235 Multiple hearing assessment test to Adults 104 120236 Speech Discrimination Score 81 93237 Speech Assessment 108 124238 Speech therapy per session of 30-40 minutes 118 136239 Cold Calorie Test for Vestibular function 155 178240 Removal of foreign body From Nose 311 358241 Removal of foreign body From Ear 207 238242 Syringing (Ear) 149 171243 Polyp removal under LA 518 596244 Polyp removal under GA 765 880245 Peritonsillar abscess Drainage under LA 1304 1500246 Myringoplasty 6210 7142247 Staepedectomy 8280 9522248 Myringotomy with Grommet insertion 4140 4761249 Tympanotomy 7763 8927250 Tympanoplasty 12420 14283251 Mastoidectomy 13455 15473252 Otoplasty 14490 16664253 Labyrinthectomy 12420 14283254 Skull Base surgery 22500 25875255 Facial Nerve Decompression 15525 17854256 Septoplasty 5175 5951257 Submucous Resection 6583 7570258 Septo-rhinoplasty 14490 16664259 Rhinoplasty- Non-cosmetic 10350 11903260 Fracture Reduction 4000 4600261 Intra nasal Diathermy 1035 1190

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262 Turbinectomy 5175 5951263 Endoscopic DCR 11700 13455264 Endoscopic Surgery 12420 14283265 Septal Perforation Repair 12420 14283266 Antrum Puncture 855 983267 Lateral Rhinotomy 900 1035268 Cranio-facial resection 22950 26393269 Caldwell Luc Surgery 9563 10997270 Angiofibroma Excision 15300 17595271 Endoscopic Hypophysectomy 19350 22253272 Endoscopic Optic Nerve Decompression 29498 33923273 Decompression of Orbit 22950 26393274 Punch/Wedge biopsy 674 775275 Tonsillectomy 5000 5750276 Uvulo-palatoplasty 15000 17250277 FESS for antrochoal polyp 5750 6613278 FESS for ethmoidal polyp 5750 6613279 Polyp removal ear 748 860280 Polyp removal Nose(Septal polyp) 748 860

281Mastoidectomy plus Ossciculoplasty including TORP or PORP 2415 2777

282 Endolymphatic sac decompression 2875 3306283 Diagnostic endoscopy under GA 2300 2645284 Yonges operation for Atrophic rhinitis 6210 7142285 Vidian neurectomy for vasomotor Rhinitis 9315 10712286 Nasal Packing-anterior 345 397287 Nasal Packing-posterior 805 926288 Ranula Excision 6159 7083289 Tongue Tie excision 1440 1656290 Sub Mandibular Duct Lithotomy 269 309291 Adenoidectomy 5076 5837292 Palatopharyngoplasty 8165 9390293 Pharyngoplasty 15474 17795294 Styloidectomy 8800 10120295 Direct laryngoscopy including Biopsy under GA 4500 5175296 Oesophagoscopy/foreign body removal from 1800 2070297 Bronchoscopy with F.B.removal 2438 2804298 Other Major Surgery 15000 17250299 Other Minor Surgery 8500 9775

TREATMENT PROCEDURE FOR HEAD AND NECK300 Ear Lobe Repair one side 450 518

301Excision of Pinna for Growth (Squamous/Basal/ Injuries) SkinOnly

3600 4140

302Excision of Pinna for Growth (Squamous/Basal/ Injuries) Skinand Cartilage

3420 3933

303 Partial Amputation of Pinna 4050 4658304 Total Amputation of Pinna 5580 6417305 Total Amputation & Excision of External Auditory Meatus 1500 1725

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306 Excision of Cystic Hygroma 4658 5357307 Excision of Cystic Hygroma Extensive 6707 7713308 Excision of Branchial Cyst 9315 10712309 Excision of Branchial Sinus 9315 10712310 Excision of Pharyngeal Diverticulum 10580 12167311 Excision of Carotid Body-Tumours 11615 13357312 Operation for Cervical Rib 12500 14375313 Block Dissection of Cervical Lymph Nodes 13500 15525314 Pharyngectomy & Reconstruction 14500 16675315 Operation for Carcinoma Lip - Wedge-Excision 7245 8332316 Operation for Carcinoma Lip - Vermilionectomy 5182 5959

317Operation for Carcinoma Lip - Wedge Excision andVermilonectomy

8363 9617

318 Estlander Operation 6728 7737319 Abbe Operation 8820 10143320 Cheek Advancement 8798 10118321 Excision of the Maxilla 17388 19996322 Excision of mandible-segmental 13973 16069323 Mandibulectomy 18900 21735324 Partial Glossectomy 4968 5713325 Hemiglossectomy 7000 8050326 Total Glossectomy 20597 23687327 Commondo Operation 19800 22770328 Parotidectomy - Superficial 10868 12498329 Parotidectomy - Total 13500 15525330 Parotidectomy - Radical 17595 20234331 Repair of Parotid Duct 10350 11903332 Removal of Submandibular Salivary gland 7763 8927333 Hemithyroidectomy 9350 10753334 Partial Thyroidectomy (lobectomy) 10350 11903335 Subtotal Thyroidectomy 11748 13510336 Total Thyroidectomy 17100 19665337 Resection Enucleation of thyroid Adenoma 9522 10950338 Total Thyroidectomy and Block Dissection 23805 27376339 Excision of Lingual Thyroid 15194 17473340 Excision of Thyroglossal Cyst/Fistula 11903 13688341 Excision of Parathyroid Adenoma/Carcinoma 19148 22020342 Laryngectomy 17100 19665343 Laryngo Pharyngectomy 27000 31050344 Hyoid Suspension 9315 10712345 Genioplasty 10800 12420346 Direct Laryngoscopy including biopsy under GA 4658 5357347 Phonosurgery 12420 14283348 Fibroptic examition of Larynx under LA 1553 1786349 Microlaryngeal Surgery 9315 10712350 Laryngofissure 15525 17854351 Tracheal Stenosis Excision 17802 20472

Head and neck cancer

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352 Excisional Biopsies 5175 5951353 Benign Tumour Excisions 8550 9833354 Temporal Bone subtotal resection 18630 21425355 Modified Radical Neck Dissection 22770 26186356 Carotid Body Excision 23400 26910357 Total Laryngectomy 35273 40564358 Flap Reconstructive Surgery 37260 42849359 Parapharyngeal Tumour Excision 35397 40707360 Other Major Surgery 21250 24438361 Other Minor Surgery 5000 5750

TREATMENT PROCEDURE BREAST362 Drainage of abscess 5400 6210363 Excision of lumps 6272 7213364 Local mastectomy-simple 11385 13093365 Radical mastectomy-formal or modified. 25875 29756366 Excision of mammary fistula 13973 16069367 Segmental resection of breast 14490 16664368 Other Major Surgery 23000 26450369 Other Minor Surgery 5000 5750

TREATMENT PROCEDURE GENERAL SURGERY370 Injury Of Superficial Soft Tissues 425 489371 Suturing of small wounds 242 278372 Secondary suture of wounds 290 334373 Debridement of wounds 450 518374 Removal Of Foreign Bodies 275 316

Biopsies375 Excision of Cervical Lymph Node 1553 1786376 Excision of Axillary Lymph Node 2049 2356377 Excision of Inguinal Lymph Node 2049 2356378 Excision Biopsy of Ulcers 1400 1610379 Excision Biopsy of Superficial Lumps 2898 3333380 Incision Biopsy of Growths/Ulcers 1323 1521381 Trucut Needle Biopsy 1395 1604382 Percutaneous Kidney Biopsy 1323 1521383 Marrow Biopsy (Open) 1060 1219384 Muscle Biopsy 1323 1521385 Scalene Node Biopsy 1215 1397386 Excision of Sebaceous Cysts 1118 1286387 Excision of Superficial Lipoma 1739 2000388 Excision of Superficial Neurofibroma 2250 2588389 Excision of Dermoid Cysts 2049 2356390 Haemorrhoidectomy 18648 21445391 Stappler haemorrhoidectomy 34200 39330392 keloid excision 1100 1265

393Vericose vein surgery;Tendelenburg operation with suturing orligation.

7763 8927

TREATMENT PROCEDURE OESOPHAGUS394 Atresia of Oesophagus and Tracheo Oesophageal Fistula 25875 29756

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395 Operations for Replacement of Oesophagus by Colon 22500 25875396 Oesophagectomy for Carcinoma Easophagus 22500 25875397 Oesophageal Intubation (Mausseau Barbin Tube) 10350 11903398 Achalasia Cardia Transthoracic 13455 15473399 Achalasia Cardia Abdominal 11385 13093400 Oesophago Gastrectomy for mid 1/3 lesion 22046 25353401 Heller’s Operation 17775 20441402 Colon-Inter position or Replacement of Oesophagus 20286 23329403 Oesophago Gastrectomy – Lower Corringers procedure 19251 22139404 Other Major Surgery 24863 28592405 Other Minor Surgery 5000 5750

TREATMENT PROCEDURE ABDOMEN / GI SURGERY

406 Gastroscopy 1553 1786407 Gastric & Duodenal Biopsy (Endoscopic) 1950 2243408 Pyloromyotomy 2670 3071409 Gastrostomy 7763 8927410 Simple Closure of Perforated peptic Ulcer 8800 10120411 Vagotomy Pyleroplasty / Gastro Jejunostomy 12420 14283412 Duodenojejunostomy 17055 19613413 Partial/Subtotal Gastrectomy for Carcinoma 20700 23805414 Partial/Subtotal Gastrectomy for Ulcer 20183 23210415 Operation for Bleeding Peptic Ulcer 18878 21710416 Operation for Gastrojejunal Ulcer 17802 20472417 Total Gastrectomy for Cancer 21400 24610418 Highly Selective Vagotomy 16767 19282419 Selective Vagotomy & Drainage 16767 19282420 Congenital Diaphragmatic Hernia 17078 19640421 Hiatus Hernia Repair- Abdominal 13860 15939422 Hiatus Hernia Repair- Transthoracic 14490 16664423 Exploratory Laparotomy 11385 13093424 Epigastric Hernia Repair 10247 11784425 Umbilical Hernia Repair 10247 11784426 Ventral /incisional Hernia Repair 9850 11328427 Inguinal Hernia Herniorraphy 13352 15355428 Inguinal Hernia - Hernioplasty 14850 17078429 Femoral Hernia Repair 16457 18926430 Rare Hernias Repair (Spigalion, Obturator, Lumbar, Sciatic) 17078 19640431 Splenectomy - For Trauma 17078 19640432 Splenectomy - For Hypersplenism 13860 15939433 Splenorenal Anastomosis 20900 24035434 Portocaval Anastomosis 26400 30360435 Direct Operation on Oesophagus for Portal Hypertension 20597 23687436 Mesentericocaval Anastomosis 24750 28463437 Warren Shunt 25875 29756438 Pancerato Duodenectomy 20790 23909439 By Pass Procedure for Inoperable Carcinoma of Pancreas 20700 23805440 Cystojejunostomy or Cystogastrostomy 13860 15939

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441 Cholecystectomy 9850 11328442 Cholecystectomy & Exploration of CBD 13200 15180443 Repair of CBD 13600 15640444 Operation for Hydatid Cyst of Liver 11385 13093445 Cholecystostomy 9850 11328446 Hepatic Resections (Lobectomy /Hepatectomy) 13750 15813447 Operation on Adrenal Glands - Bilateral 23495 27019448 Operation on Adrenal Glands - Unilateral 13200 15180449 Appendicectomy 7755 8918450 Appendicular Abscess – Drainage 8798 10118451 Mesenteric Cyst- Excision 9936 11426452 Peritonioscopy/Laparoscopy 4140 4761453 Jejunostomy 5500 6325454 Ileostomy 14300 16445455 Resection & Anastomosis of Small Intestine 18630 21425456 Duodenal Diverticulum 16560 19044457 Operation for Intestinal Obstruction 9900 11385458 Operation for Intestinal perforation 34200 39330459 Benign Tumours of Small Intestine 17595 20234460 Excision of Small Intestine Fistula 17595 20234461 Operations for GI Bleed 16000 18400462 Operations for Haemorrhage of Small Intestines 17595 20234463 Operations of the Duplication of the Intestines 16500 18975

464Operations for Recurrent Intestinal Obstruction (NoblePlication & Other Operations for Adhesions)

20700 23805

465 Ilieosigmoidostomy and related resection 15111 17378466 Ilieotransverse Colostomy and related resection 15111 17378467 Caecostomy 3513 4040468 Loop Colostomy Transverse Sigmoid 11799 13569469 Terminal Colostomy 15525 17854470 Closure of Colostomy 15732 18092471 Right Hemi-Colectomy 13200 15180472 Left Hemi-Colectomy 13200 15180473 Total Colectomy 15525 17854474 Operations for Volvulus of Large Bowel 22428 25792475 Operations for Sigmoid Diverticulitis 16767 19282

476Fissure in Ano with Internal sphinctrectomy with fissurectomy. 12420 14283

477 Fissure in Ano - Fissurectomy 5750 6613478 Rectal Polyp-Excision 5092 5856479 Fistula in Ano - High Fistulectomy 15102 17352480 Fistula in Ano - Low Fistulectomy 8800 10120481 Prolapse Rectum - Theirch Wiring 9315 10712482 Prolapse Rectum - Rectopexy 5500 6325483 Prolapse Rectum - Grahams Operation 16560 19044484 Operations for Hirschsprungs Disease 12834 14759485 Excision of Pilonidal Sinus (open) 10350 11903486 Excision of Pilonidal Sinus with closure 11500 13225

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487 Abdomino-Perineal Excision of Rectum 16500 18975488 Anterior Resection of rectum 19665 22615489 Pull Through Abdominal Resection 15453 17771490 Retro Peritoneal Tumor Removal 18000 20700491 Radio ablation of varicose veins 1800 2070492 Laser ablation of varicose veins 17250 19838493 Laproscopic Fundoplication 19300 22195494 Laproscopic Spleenectomy 25000 28750495 Laproscopic Removal of hydatid cyst 18000 20700496 Laproscopic treatment of Pseudo Pancreatic cyst 18000 20700497 Laproscopic whipples operation 18000 20700498 Laproscopic GI bypass operation 22000 25300499 Laproscopic Total Colectomy 25000 28750500 Laproscopic Hemi Colectomy 23000 26450501 Laproscopic Anterior Resection 23000 26450502 Laproscopic Cholecystetomy 18975 21821503 Laproscopic Appedicectomy 18000 20700504 Laproscopic Hernia inguinal repair 18000 20700505 Laproscopic ventral Hernia Repair 17500 20125506 Laproscopic Paraumblical Hernia Repair 12580 14467507 Laproscopic Adrenelectomy 12000 13800508 Laproscopic Nephrectomy 19800 22770509 Other Major Surgery 38000 43700510 Other Minor Surgery 6000 6900

TREATMENT PROCEDURE ICU/CCU PROCEDURES(SPECIAL CARE CASES)

511 Coronary Care with Cardiac Monitoring (Room Rent extra) 750 863512 Compressed air / piped oxygen /per hour 50 58513 Ventilator charges (Per day) 525 604514 Paediatric care for New born (Per day) 167 192515 Incubator charges (Per day) 330 380516 Neonatal ICU charges (Per day) 352 405517 Resuscitation 180 207518 Exchange Transfusion 260 299519 Pneupack ventilator in Nursery (Per day) 518 596

TREATMENT PROCEDURE CARDIOVASCULAR ANDCARDIAC SURGERY & INVESTIGATIONS

520 ASD Closure 51808 59579521 VSD with graft 51808 59579522 TOF/TAPVC/TCPC/REV/RSOV repair 114368 131523523 B.D.Glenn/Left atrium myxoma 80750 92863524 Senning/ASO with graft 122188 140516525 DSO 103615 119157526 AV Canal repair 150000 172500527 Fonten 152100 174915528 Conduit repair 152100 174915529 CABG 114368 131523530 CABG + IABP 152100 174915

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531 CABG + Valve. 163000 187450532 CABG without bypass. 135000 155250533 Ascending aorta replacement 130000 149500534 DVR 47700 54855535 MVR/AVR 93254 107242536 MV repair + AV repair 103615 119157537 Aorta femoral bypass 46800 53820538 B.T Shunt/Coaractation 51980 59777539 P.A.Banding septostomy 51980 59777540 Pericardectomy 38088 43801541 CMV/PDA 46782 53799542 Gunshot injury 46782 53799543 Heart transplant 248400 285660544 Balloon coronary angioplasty/PTCA with VCD 74000 85100545 Balloon coronary angioplasty/PTCA without VCD 73000 83950546 Rotablation 48875 56206547 balloon valvotomy/PTMC 10264 11804548 CATH 9000 10350549 Arch Replacement 10350 11903550 Aortic Dissection 12650 14548551 Thoraco Abdominal Aneurism Repair 15000 17250552 Embolectomy 21000 24150553 Vascular Repair 35000 40250554 Bentall Repair with Prosthetic Valve 30000 34500555 Bentall Repair with Biologic Valve 127500 146625556 Coaractation dilatation 14500 16675557 Coaractation dilatation with Stenting 18500 21275558 TPI Single Chamber 6750 7763559 TPI Dual Chamber 7344 8446560 Permanent pacemaker implantation- Single Chamber 13200 15180561 Permanent pacemaker implantation- Dual Chamber 17388 19996562 Permanent pacemaker implantation Biventricular 34500 39675563 AICD implantation Single Chamber 28750 33063564 AICD implantation Dual Chamber 40000 46000565 Combo device implantation 40000 46000566 Diagnostic Electrophysiological studies conventional 4095 4709567 Ambulatory BP monitoring 587 675568 External Loop/event recording 2563 2947569 RF Ablation conventional 31500 36225570 RF Ablation Atrial Tachycardia/Carto 45000 51750571 Endomyocardial biopsy 10000 11500572 IABP 7820 8993573 Intra vascular coils 41400 47610574 Septostomy- Balloon 16150 18573575 Septostomy- Blade 19550 22483576 AVBD/PVBD 43470 49991577 Digital subtraction angiography-Peripheral artery 10350 11903578 Digital subtraction angiography- venogram 10350 11903

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579 C.T Guided biopsy 1139 1310580 Sinogram 777 894581 Peripheral Angioplasty with VCD 11500 13225582 Peripheral Angioplasty without VCD 11500 13225583 Renal Angioplasty 54315 62462584 IVUS 22500 25875585 FFR 11475 13196586 Holter analysis 850 978587 Aortic stent grafting for aortic aneurysm 70650 81248588 IVC Filter implantation 14516 16693589 ASD/VSD/PDA device closure 32603 37493590 ECG 50 58591 HUTT 1980 2277592 2 D echocardiography 1080 1242593 3 D echocardiography 1403 1613594 Fetal Echo 1260 1449595 2 D TEE 1263 1452596 3 D TEE(Transoesophageal echo ) 1403 1613597 Stress Echo- exercise 1500 1725598 Stress Echo- pharmacological 2500 2875599 Stress MPI- exercise 1760 2024600 Stress MPI - pharmacological 2475 2846601 Coronary angiography 11000 12650602 CT coronary angiography 6030 6935603 Cardiac CT scan 2150 2473604 Cardiac MRI 2380 2737605 Stress Cardiac MRI 2700 3105606 MR angiography. 5390 6199607 Cardiac PET 1350 1553608 Pericardiocentesis 3150 3623609 Other Major Surgery 18000 20700610 Other Minor Surgery 3825 4399

TREATMENT PROCEDURE OBSTETRICS ANDGYNAECOLOGY

611 Normal delivery with or without Episiotomy & P. repair 7200 8280612 vacuum delivery 7763 8927613 Forceps Delivery 8280 9522614 Cesarean Section 13200 15180615 Cesarean Hysterectomy 17078 19640616 Rupture Uterus closure & repair with Tubal Ligation 15525 17854617 Perforation of Uterus after D/E Laparotomy & Closure 12420 14283618 Laparotomy for Ectopic pregnancy 12420 14283619 Laparotomy-peritonitis Lavage and Drainage 10350 11903620 Salphingo-Oophorectomy/ Oophorectomy Laproscopic 9000 10350621 Ovarian Cystectomy-laparoscopic. 10350 11903622 Ovarian Cystectomy -laparotomy. 12420 14283623 Salpingo-Oophorectomy-laparotomy 11520 13248

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624Laproscopic Broad Ligament Hematoma Drainage with repair 6210 7142

625 Exploration of perineal Haematoma & Repair 7200 8280

626Exploration of abdominal Haematoma (after laparotomy +LSCS)

7700 8855

627 Manual Removal of Placenta 3105 3571628 Examination under anesthesia (EUA) 1000 1150629 Burst-abdomen Repair 9000 10350630 Gaping Perineal Wound Secondary Suturing 1490 1714631 Gaping abdominal wound Secondary Suturing 3105 3571632 Complete perineal tear-repair 1915 2202633 Exploration of PPH-tear repair 3150 3623634 Suction evacuation vesicular mole 4500 5175635 Suction evacuation Missed abortion/ incomplete abortion 4658 5357636 Colpotomy 3105 3571637 Repair of post-coital tear/ perineal injury 3157 3631638 Excision of urethral caruncle 3105 3571639 Shirodhkar/ Mc. Donald’s stitch 2898 3333

640Abdominal Hysterectomy with or without salpingo-oophorectomy

15525 17854

641 Vaginal Hysterectomy (NDVH) 15525 17854642 Vaginal Hysterectomy with repairs (UV Prolapse) 15525 17854643 Myomectomy -laparotomy 14000 16100644 Myomectomy -laparoscopic 6325 7274645 Vaginoplasty 13455 15473646 Vulvectomy -Simple 8800 10120647 Vulvectomy-Radical 8800 10120648 RVF Repair 14000 16100649 Manchester Operation 13500 15525

650Shirodkar’s sling Operation or other sling operations forprolapse uterus

3300 3795

651 Laparoscopic sling operations for prolapse uterus 25200 28980652 Diagnostic Curettage 2236 2571653 Cervical Biopsy 1620 1863654 Polypectomy 1366 1571655 Other-Minor Operation Endometrial 2200 2530656 Excision Vaginal Cyst/Bartholin Cyst 3105 3571657 Excision Vaginal Septum 4140 4761

658Laparoscopy -Diagnostic with chromopertubation and oradhesiolysis and drilling

3850 4428

659 Laparoscopy Sterilization 3300 3795660 LAVH 22719 26127661 Balloon Temponade for PPH 2800 3220662 Total laparoscopic hysterectomy 23100 26565

663Laparoscopic treatment of Ectopic pregnancy-salpingectomy/salpinostomy conservative

8798 10118

664 Conisation of cervix 4025 4629665 Trachhelectomy of cervix for early CA cervix 5500 6325

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666 Hysteroscopic cannulation 2875 3306667 Laparotomy recannalization of Fallopian tubes-(Tubuloplasty) 22425 25789

668Laparoscopic recannalization of Fallopian tubes-(Tubuloplasty) 19500 22425

669 Colposcopy 900 1035670 Inversion of Uterus – Vaginal Reposition 2500 2875671 Inversion of Uterus – Abdominal Reposition 2500 2875672 Laparoscopic VVF Repair 28000 32200673 Abdominal VVF Repair 28000 32200674 Vaginal VVF Repair 28000 32200675 Interventional Ultrasonography (CVS) 880 1012676 Amniocentesis 880 1012677 Karyotyping 800 920678 Thermal balloon ablation. 10350 11903679 Ultrasonographic myolysis 9264 10654680 Vaginal Myomectomy 10000 11500681 Intra Uterine Inseminition 920 1058682 ICSI 11500 13225683 Laparotomy abdominal sacro-colpopexy 15000 17250684 Vaginal Colpopexy 19800 22770685 Laparoscopic abdominal sacro-colpopexy 18000 20700686 Laparotomy pelvic Lymphadenectomy 1200 1380687 Laparoscopic pelvic Lymphadenectomy 3500 4025688 Endometrial aspiration cytology/biopsy 513 590

689Transvaginal sonography (TVS for Follicular monitioring/aspiration)

414 476

690 laparoscopic treatment for stress incontinence 13500 15525691 Transvaginal tapes for Stress incontinence 13500 15525692 trans-obturator tapes for Stress incontinence 10800 12420693 Interventional radiographic arterial embolization 16200 18630694 Diagnostic cystoscopy 2588 2976695 Staging laparotomy surgery for CA Ovary 6050 6958696 Internal Iliac ligation 3250 3738697 stepwise devascularisation 8280 9522698 Assisted breech delivery 9833 11308699 Intra-uterine fetal blood transfusion 19148 22020700 Hysteroscopy TCRE 8500 9775701 Hysteroscopy Removal of IUCD 6750 7763702 Hysteroscopy Removal of Septum 9900 11385703 Hysteroscopy Diagnostic 7500 8625

704Radical Hysterectomy for Cancer cervix with pelviclymphadenectomy

7650 8798

705Radical Hysterectomy for Cancer endometrium extending tocervix with pelvic and para aortic lymphadenectomy

7650 8798

706 Sterilization Post partum (minilap) 3750 4313707 Sterilization interval (minilap) 3750 4313708 Ultrasonography Level II scan/Anomaly Scan 500 575709 Fetal nuchal Translucency 300 345

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710 Fetal Doppler/Umblical Doppler/Uterine Vessel Doppler 825 949711 MTP- 1st Trimester 3000 3450712 MTP - 2nd Trimester 4370 5026713 Quadruple test 2000 2300714 Biophysical score 600 690715 Other Major Surgery 25200 28980716 Other Minor Surgery 5000 5750

TREATMENT PROCEDURE NEPHROLOGY ANDUROLOGY

717 Partial Nephrectomy -open 14594 16783718 Partial Nephrectomy-laproscopic/endoscopic 13860 15939719 Nephrolithomy -open 12000 13800720 Nephrolithomy -laproscopic/endoscopic 14000 16100721 Pyelolithotomy-open 13000 14950722 Pyelolithotomy -laproscopic/endoscopic 10120 11638723 Operations for Hydronephrosis -pyeloplasty open 16560 19044724 Operations for Hydronephrosis -pyeloplasty Lap/endoscopic 19000 21850725 Operations for Hydronephrosis Endoplyelotomy antegrade 18000 20700726 Operations for Hydronephrosis Endoplyelotomy retrograde 18000 20700727 Operations for Hydronephrosis -ureterocalicostomy 17600 20240728 Operations for Hydronephrosis-Ileal ureter 18000 20700729 Open Drainage of Perinephric Abscess 7200 8280

730Percutaneous Drainage of Perinephric Abscess -Ultrasoundguided

5175 5951

731 Cavernostomy 9775 11241732 Operations for Cyst of the Kidney -open 10764 12379733 Operations for Cyst of the Kidney -Lap/endoscopic 13420 15433734 Ureterolithotomy -open 11923 13711735 Ureterolithotomy-Lap/Endoscopic 10000 11500736 Nephroureterectomy open 14490 16664737 Nephroureterectomy -Lap/Endoscopic 15400 17710738 Operations for Ureter for -Double Ureters 17100 19665739 Operations for Ureter -for Ectopia of Single Ureter 16500 18975740 Operations for Vesico- ureteric Reflux -Open 16200 18630741 Operations for Vesico- ureteric Reflux-Lap/Endoscopic 16500 18975

742Operations for Vesico- ureteric Reflux/ Urinary incontinencewith bulking agents

18700 21505

743 Ureterostomy - Cutaneous 12000 13800744 Uretero-Colic anastomosis 14400 16560745 Formation of an Ileal Conduit 15525 17854746 Ureteric Catheterisation 621 714747 Biopsy of Bladder (Cystoscopic) 2200 2530748 Cysto-Litholapaxy 9833 11308749 Operations for Injuries of the Bladder 10000 11500750 Suprapubic Drainage (Cystostomy/vesicostomy) 5400 6210751 Simple Cystectomy 15525 17854752 Diverticulectomy -open 14400 16560

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753 Diverticulectomy- Lap/Endoscopic 16560 19044754 Diverticulectomy -Endoscopic incision of neck 1650 1898755 Augmentation Cystoplasty 6380 7337756 Operations for Extrophy of the Bladder- Single stage repair 20070 23081757 Operations for Extrophy of the Bladder- Multistage repair 19910 22897

758Operations for Extrophy of the Bladder- simple cystectomywith urinary diversion

22000 25300

759 Repair of Ureterocoel -Open 12420 14283760 Repair of Ureterocoel -Lap/Endoscopic 13750 15813761 Repair of Ureterocoel -Endoscopic incision 11700 13455762 Open Suprapubic Prostatectomy 18630 21425763 Open Retropubic Prostatectomy 18113 20830764 Transurethral Resection of Prostate (TURP) 16767 19282765 Urethroscopy/ Cystopanendoscopy 4140 4761766 Internal urethrotomy -optical 5500 6325767 Internal urethrotomy -Core through urethroplasty 9936 11426768 Urethral Reconstruction -End to end ansatamosis 3300 3795

769Urethral Reconstruction - substitution urethroplasty(Transpubic urethroplasty

18700 21505

770 Abdomino Perineal urethroplasty 14000 16100771 Posterior Urethral Valve fulguration. 10143 11664772 Operations for Incontinence of Urine - Male -Open 15525 17854773 Operations for Incontinence of Urine - Male -Sling 16560 19044774 Operations for Incontinence of Urine - Male-Bulking agent 18590 21379775 Operations for Incontinence of Urine - Female -Open 15525 17854776 Operations for Incontinence of Urine - Female-Sling 16560 19044777 Operations for Incontinence of Urine - Female-Bulking agent 18590 21379778 Reduction of Paraphimosis 1650 1898779 Circumcision 2700 3105780 Meatotomy 2111 2428781 Meatoplasty 2898 3333782 Operations for Hypospadias + Chordee Correction 8280 9522783 Operations for Hypospadias - Second Stage 14960 17204784 Operations for Hypospadias - One Stage Repair 9200 10580785 Operations for Crippled Hypospadias 11000 12650786 Operations for Epispadias _primary repair 12045 13852787 Operations for Epispadias-crippled epispadias 10890 12524788 Partial Amputation of the Penis 9688 11141789 Total amputation of the Penis 10800 12420790 Orchidectomy-Simple 8798 10118791 Orchidectomy -Radical 11000 12650

792Post Radical Orchidectomy retroperitoneal lymph nodedissection.

14000 16100

793 Epididymectomy 7200 8280

794Adreneclectomy Unilateral/Bilateral for Tumour/ForCarcinoma- Open

22770 26186

795Adreneclectomy Unilateral/Bilateral for Tumour/ForCarcinoma -Lap/Endoscopic

13750 15813

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796 Operations for Hydrocele - Unilateral 5279 6071797 Operations for Hydrocele - Bilateral 7700 8855798 Operation for Torsion of Testis 10350 11903

799Micro-surgical Vasovasostomy /Vaso epidedymal ansatamosis. 10560 12144

800 Operations for Varicocele Unilateral-Microsurgical 7370 8476801 Operations for Varicocele Palomo’s Unilateral - Lap 8800 10120802 Operations for Varicocele Bilateral --Microsurgical 12100 13915803 Operations for Varicocele Bilateral – Lap/ Palomo 14300 16445

804Block Dissection of ilio-inguinal Nodes - One Side (For Ca-Penis)

6050 6958

805Block Dissection of ilio-inguinal Nodes - Both Sides (For Ca-Penis)

20700 23805

806 Excision of Filarial Scrotum 10350 11903807 Kidney Transplantation (related) 3500 4025808 Kidney Transplantation (Spousal/ unrelated) 143000 164450809 ABO incompatible Transplantation 44100 50715810 Swap Transplantation 349200 401580811 Kidney Transplant Graft Nephrectomy 53550 61583812 Donor Nephrectomy (open) 28750 33063813 Donor Nephrectomy (Laproscopic) 46000 52900814 Cadaver Transplantation 83300 95795

815Kidney Transplant with Native Kidney Nephrectomy (Related)/Unilateral

28000 32200

816Kidney Transplant with Native Kidney Nephrectomy (Related)/Bilateral

85000 97750

817Kidney Transplant with Native Kidney Nephrectomy (Spousal/Unrelated) Unilateral

85000 97750

818Kidney Transplant with Native Kidney Nephrectomy (Spousal/Unrelated) Bilateral

85000 97750

819 Post-Transplant Collection drainage for Lymphocele (open) 6800 7820

820Post-Transplant Collection drainage for Lymphocele(percutaneous)

6120 7038

821Post-Transplant Collection drainage for Lymphocele(Laproscopic)

7650 8798

822 Arteriovenous Fistula for Haemodialysis 2300 2645823 Arteriovenous Shunt for Haemodialysis 3500 4025824 Jugular Catheterization for Haemodialysis 1500 1725825 Subclavian Catheterization for Haemodialysis 2200 2530

826One sided (single Lumen) Femoral Catheterization forHaemodialysis

1000 1150

827Bilateral (single Lumen) Femoral Catheterization forHaemodialysis

1500 1725

828 Double Lumen Femoral Catheterization for Haemodialysis 1850 2128829 Permcath Insertion 2800 3220830 Arterio venous Prosthetic Graft 1850 2128831 Single lumen Jugular Catheterization 1500 1725832 Single lumen Subclavian Catheterization 1700 1955

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833 Plasma Exchange/ Plasma phresis 1600 1840834 Open method CAPD catheter insertion 3150 3623835 Schlendinger method CAPD catheter insertion 3500 4025836 Sustained low efficiency hemodialysis 1250 1438837 Continuous Veno venous/Arteriovenous Hemofilteration 2250 2588838 Hemodialysis for Sero negative cases 1260 1449839 Hemodialysis for Sero Positive cases 1500 1725840 Acute Peritoneal Dialysis 1450 1668841 Fistologram for Arteriovenous Fistula 2500 2875842 Ultrasound guided kidney Biopsy 850 978843 Fistula stenosis dilation 2700 3105844 Slow continuous Ultrafilteration 2250 2588845 PCNL - Unilateral 18000 20700846 PCNL - Bilateral 25000 28750847 Endoscopic Bulking agent Inject 4400 5060848 Testicular Biopsy 1870 2151849 Radical Nephrectomy -Open 16500 18975850 Radical Nephrectomy -Lap/Endoscopic 19800 22770851 Radical Nephrectomy plus IV thrombus 22000 25300852 Radical Nephrectomy plus IV thrombus plus cardiac bypass. 22000 25300853 Vesico Vaginal Fistula Repair (Open) 14400 16560854 Vesico Vaginal Fistula Repair (Laproscopic) 22000 25300855 Radical Cystectomy -Ileal conduit 17000 19550856 Radical Cystectomy - continent diversion. 15000 17250857 Radical Cystectomy – Neo bladder 18500 21275858 Nephrectomy Simple -Open 9640 11086859 Nephrectomy Simple-lap/Endoscopic 11334 13034860 Nephrostomy -Open 9000 10350861 Nephrostomy -Lap/Endoscopic 10704 12310

862Ureteric Re- implant for Megaureter/Vesicoureteric reflex/uterocele (open)

10100 11615

863Ureteric Re -implant for Megaureter/Vesicoureteric reflex/uterocele (Laproscopic)

9445 10862

864 Partial Cystectomy 12420 14283865 TURP & TUR Bladder Tumour 15525 17854866 TURP with Cystolithotripsy 15840 18216867 Closure of Urethral Fistula 9900 11385868 Orchidopexy - Unilateral -Open 8880 10212869 Orchidopexy - Unilateral- Lap/Endoscopic 11800 13570870 Orchidopexy - Bilateral -Open 11054 12712871 Orchidopexy - Bilateral -Lap/Endoscopic 14500 16675872 Cystolithotomy -Suprapubic 8798 10118873 Endoscopic Removal of Stone in Bladder 3300 3795

874Resection Bladder Neck Endoscopic /Bladder neckincision/transurethral incision on prostrate

9833 11308

875 Ureteroscopic Surgery 9315 10712876 Urethroplasty 1st Stage 9833 11308877 Scrotal Exploration 7700 8855

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878 Perineal Urethrostomy 4510 5187879 Dilatation of Stricture Urethra under G.A. 2000 2300880 Dilatation of Stricture Urethra under LA 1553 1786881 Laproscopic Nephrectomy 30015 34517882 Laproscopic partial Nephrectomy 10000 11500883 Laproscopic pyelolithotomy 11550 13283884 Laproscopic Pyeloplasty 9775 11241885 Laproscopic surgery for Renal cyst 9350 10753886 Laproscopic ureterolithotomy 11000 12650887 Laproscopic Nephro ureterotectomy 12650 14548888 Lithotripsy Extra corporeal shock wave. 19000 21850889 Uroflow Study (Uroflometry) 450 518890 Urodynamic Study (Cystometry) 440 506891 Cystoscopy with Retrograde Catheter -Unilateral /RGP 2680 3082892 Cystoscopy with Retrograde Catheter - Bilateral /RGP 4208 4839893 Cystoscopy with Bladder Biopsy (Cold Cup Biopsy) 3043 3499

894Voiding-cysto-urethrogram and retrograde urethrogram(Nephrostogram)

400 460

895 Radical prostatectomy-Open 16043 18449896 Radical prostatectomy-Laproscopic 20125 23144

897Radical prostatectomy- Robotic (Robotic Partial Nephrectomy) 19250 22138

898 Hollmium YAG Prostate Surgery 15000 17250899 Hollmium YAG OIU 4600 5290900 Hollmium YAG Core Through 17250 19838901 Hollmium YAG Stone Lithotripsy 10200 11730902 Green Light laser for prostate 17250 19838903 RIRS/ Flexible Ureteroscopy 6800 7820904 Microscopic VEA/ Vaso-Vasostomy (for Infertility) 13500 15525

905Cystoscopic Botulinum Toxin Injection ( Over active bladder/Neurogenic bladder)

6800 7820

906 Peyronie’s disease – Plaque excision with grafting 3400 3910

907High Intensity Focus Ultrasound (HIFU) (Robotic) forCarcinoma prostrate and renal cell carcinoma

4600 5290

908 Prosthetic surgery for urinary incontinence 2300 2645909 TRUS guided prostate biopsy 575 661910 Ultra sound guided PCN 720 828911 Other Major Surgery 15000 17250912 Other Minor Surgery 6800 7820

TREATMENT PROCEDURE NEURO-SURGERY913 Craniotomy and Evacuation of Haematoma -Subdural 45644 52491914 Craniotomy and Evacuation of Haematoma -Extradural 45000 51750915 Evacuation /Excision of Brain Abscess by craniotomy 36000 41400916 Excision of Lobe (Frontal Temporal Cerebellum etc.) 36900 42435917 Excision of Brain Tumours -Supratentorial 35211 40493918 Excision of Brain Tumours -Infratentorial 40500 46575919 Surgery of spinal Cord Tumours 40500 46575920 Ventriculoatrial /Ventriculoperitoneal Shunt 22500 25875

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921 Twist Drill Craniostomy 4250 4888922 Subdural Tapping 2210 2542923 Ventricular Tapping 2670 3071924 Abscess Tapping 2588 2976925 Placement of ICP Monitor - 2588 2976926 Skull Traction Application 2300 2645927 Lumber Pressure Monitoring 3825 4399928 Vascular Malformations 19800 22770929 Meningo Encephalocoele excision and repair 15000 17250930 Meningomyelocoel Repair 24200 27830931 C.S.F. Rhinorrhaea Repair 25875 29756932 Cranioplasty 21735 24995933 Anterior Cervical Dissectomy 14940 17181934 Brachial Plexus Exploration and neurotization 13973 16069935 Median Nerve Decompression 12600 14490936 Peripheral Nerve Surgery – Major 15525 17854937 Peripheral Nerve Surgery Minor 7452 8570938 Ventriculo-Atrial Shunt 10454 12022939 Nerve Biopsy 6210 7142940 Brain Biopsy 5808 6679941 Anterior Cervical Spine Surgery with fusion 28980 33327942 Anterio Lateral Decompression of spine 25875 29756943 Brain Mapping 837 963944 Cervical or Dorsal or Lumbar Laminectomy 20700 23805945 Combined Trans-oral Surgery & CV Junction Fusion 31050 35708946 C.V. Junction Fusion procedures 27000 31050947 Depressed Fracture Elevation 22500 25875948 Lumbar Discectomy 24840 28566949 Endarterectomy (Carotid) 18000 20700950 R.F. Lesion for Trigeminal Neuralgia 10350 11903951 Spasticity Surgery - 35708 41064952 Spinal Fusion Procedure 27000 31050953 Spinal Intra Medullary Tumours 31050 35708954 Spinal Bifida Surgery Major 17078 19640955 Spinal Bifida Surgery Minor 15000 17250956 Stereotaxic Procedures- biopsy/aspiration of cyst 20700 23805957 Trans Sphenoidal Surgery 30000 34500958 Trans Oral Surgery 30000 34500959 Implantation of DBS -One electrode 31050 35708960 Implantation of DBS -two electrodes 36225 41659961 Endoscopic aqueductoplasty 14000 16100962 Facial nerve reconstruction 27000 31050963 Carotid stenting 42263 48602964 Cervical disc arthroplasty 24840 28566965 Lumbar disc arthroplasty 12420 14283966 Corpus callostomy for Epilepsy 35000 40250967 Hemishpherotomy for Epilepsy 32200 37030968 Endoscopic CSF rhinorrhea repair 27000 31050

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969 Burr hole evacuation of chronic subdural haematoma 21735 24995970 Epilepsy surgery 32603 37493971 RF lesion for facet joint pain syndrome 15525 17854972 Cervical laminoplasty 28800 33120973 Lateral mass C1-C2 screw fixation 23000 26450974 Microsurgical decompression for Trigeminal nerve 34200 39330975 Microsurgical decompression for hemifacial spasm 4646 5343976 IC EC bypass procedures 28800 33120977 Image guided craniotomy 28980 33327978 Baclofen pump implantation 35100 40365979 Programmable VP shunt 22500 25875980 Endoscopic sympathectomy 15396 17705981 Lumber puncture 207 238982 External ventricular drainage (EVD) 4140 4761983 Endoscopic 3rd ventriculostomy 36000 41400984 Endoscopic cranial surgery/Biopsy/aspiration 28382 32639985 Endoscopic discectomy (Lumbar, Cervical) 32059 36868986 Aneurysm coiling (Endovascular) 34400 39560987 Surgery for skull fractures 39900 45885988 Carpel Tunnel decompression 13500 15525989 Clipping of intracranial aneurysm 24150 27773990 Surgery for intracranial Arteriovenous malformarions(AVM) 38250 43988991 Foramen magnum decompression for Chari Malformation 1100 1265

992Dorsal column stimulation for backache in failed backsyndrome

25875 29756

993 Surgery for recurrent disc prolapse/epidural fibrosis 28980 33327994 Surgery for brain stem tumours 39589 45527

995Decompressive craniotomy for hemishpherical acute subduralhaematoma/brain swelling/large infarct

36000 41400

996 Intra-arterial thrombolysis with TPA (for ischemic stroke ) 4140 4761997 Steriotactic aspiration of intracerebral haematoma 30000 34500998 Endoscopic aspiration of intracerebellar haematoma 36000 41400

999Steriotactic Radiosurgery for brain pathology(X knife/Gamma )- ONE session

27560 31694

1000Steriotactic Radiosurgery for brain pathology(X knife / Gammaknife -Two or more sessions

51750 59513

1001 Chemotheraphy wafers for malignant brain tumors 14450 166181002 Battery Placement for DBS 19800 227701003 Baclofen pump implantation for spasticity 15597 179371004 Peripheral Nerve tumor surgery 21600 248401005 Surgery Intra Cranial Meningioma 20000 230001006 Surgery for Intracranial Schwannoma 35000 402501007 Surgery for Gliomas 45000 517501008 Surgery for Orbital tumors 40000 460001009 Surgery for Cranial (Skull) tumors 38500 442751010 Surgery for Scalp AVM’s 22500 258751011 Kyphoplasty 40000 460001012 Balloon Kyphoplasty 36000 41400

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1013 Lesioning procedures for Parkinson’s disease, Dystonia etc. 31500 362251014 Other Major Surgery 38250 439881015 Other Minor Surgery 15300 17595

TREATMENT PROCEDURE PAEDIATRIC SURGERY1016 Excision of thyroglossal Duct/Cyst 14400 16560

1017Diaphragmatic Hernia Repair (Thoracic or AbdominalApproach)

15525 17854

1018 Tracheo Oesophageal Fistula (Correction Surgery) 20700 238051019 Colon Replacement of Oesophagus 20700 238051020 Omphalo Mesenteric Cyst Excision 15525 178541021 Omphalo Mesenteric Duct- Excision 13973 160691022 Meckels Diverticulectomy 3012 34641023 Omphalocele 1st Stage (Hernia Repair) 13973 160691024 Omphalocele 2nd Stge (Hernia Repair) 15525 178541025 Gastrochisis Repair 14490 166641026 Inguinal Herniotomy 11302 129971027 Congenital Hydrocele 10800 124201028 Hydrocele of Cord 10800 124201029 Torsion Testis Operation 13500 155251030 Congenital Pyloric Stenosis- operation 12544 144261031 Duodenal- Atresia Operation 12600 144901032 Pancreatic Ring Operation 20183 232101033 Meconium Ileus Operation 13050 150081034 Malrotation of Intestines Operation 12750 146631035 Rectal Biopsy (Megacolon) 8762 100761036 Colostomy Transverse 13500 155251037 Colostomy Left Iliac 13500 155251038 Abdominal Perineal Pull Through (Hirschaprugis Disease) 17100 196651039 Imperforate Anus Low Anomaly -Cut Back Operation 9212 105941040 Imperforate Anus Low Anomaly - Perineal Anoplasty 10800 12420

1041Imperforate Anus High Anomaly -Sacroabdomino Perineal PullThrough

12500 14375

1042 Imperforate Anus High Anomaly - Closure of Colostomy 7763 89271043 Intususception Operation 18630 21425

1044Choledochoduodenostomy for Atresia of Extra Hepatic BilliaryDuct

14250 16388

1045 Operation of Choledochal Cyst 14400 165601046 Nephrectomy for -Pyonephrosis 15300 175951047 Nephrectomy for - Hydronephrosis 13500 155251048 Nephrectomy for -Wilms Tumour 13500 15525

1049Paraortic Lymphadenoctomy with Nephrectomy for WilmsTumour

18000 20700

1050 Sacro-Coccygeal Teratoma Excision 12600 144901051 Neuroblastoma Debulking 14400 165601052 Neuroblastoma Total Excision 18630 214251053 Rhabdomyosarcoma wide Excision 15000 172501054 Congenital Atresia & Stenosis of Small Intestine 17100 196651055 Muconium ileus 14400 16560

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1056 Mal-rotation & Volvulus of the Midgut 13500 155251057 Excision of Meckle’s Deverticulum 12000 138001058 Other Major Surgery 27000 310501059 Other Minor Surgery 10000 11500

TREATMENT PROCEDURE BURNS AND PLASTICSURGERY

1060 Primary Suturing of Wound 270 3111061 Injection of Keloids - Ganglion 989 11371062 Injection of Keloids - Haemangioma 1035 11901063 Free Grafts - Wolfe Grafts 1725 19841064 Free Grafts - Theirech- Small Area 5% 6728 77371065 Free Grafts - Large Area 10% 7200 82801066 Free Grafts - Very Large Area 20% and above. 9315 107121067 Skin Flaps - Rotation Flaps 8073 92841068 Skin Flaps - Advancement Flaps 11250 129381069 Skin Flaps - Direct- cross Leg Flaps- Cross Arm Flap 11250 129381070 Skin Flaps - Cross Finger 11250 129381071 Skin Flaps - Abdominal 8415 96771072 Skin Flaps - Thoracic 8415 96771073 Skin Flaps - Arm Etc. 9900 113851074 Subcutaneous Pedicle Flaps Raising 6210 71421075 Subcutaneous Pedicle Flaps Delay 5355 61581076 Subcutaneous Pedicle Flaps Transfer 5355 61581077 Cartilage Grafting 7763 89271078 Reduction of Facial Fractures of Nose 1242 14281079 Reduction of Facial Fractures of Maxilla 8000 9200

1080Reduction of Fractures of Mandible & Maxilla - Eye LetSplinting

6728 7737

1081Reduction of Fractures of Mandible & Maxilla - Cast NetalSplints

6210 7142

1082Reduction of Fractures of Mandible & Maxilla - GummingSplints

6750 7763

1083 Internal Wire Fixation of Mandible & Maxilla 10350 119031084 Cleft Lip - repair. 10350 119031085 Cleft Palate Repair 11385 130931086 Primary Bone Grafting for alveolar cleft in Cleft Lip 10350 119031087 Secondary Surgery for Cleft Lip Deformity 9000 103501088 Secondary Surgery for Cleft Palate 11385 130931089 Reconstruction of Eyelid Defects - Minor 5693 65471090 Reconstruction of Eyelid Defects - Major 8100 93151091 Plastic Surgery of Different Regions of the Ear - Minor 7245 83321092 Plastic Surgery of Different Regions of the Ear - Major 9315 107121093 Plastic Surgery of the Nose - Minor 7245 83321094 Plastic Surgery of the Nose - Major 8550 9833

1095Plastic Surgery for Facial Paralysis (Support with Reanimation) 14490 16664

1096 Pendulous Breast - Mammoplasty 13000 149501097 Underdeveloped Breast Mammoplasty 12000 13800

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1098 After Mastectomy (Reconstruction)Mammoplasty 12000 138001099 Syndactyly Repair 12750 146631100 Dermabrasion Face 11903 136881101 upto 30% Burns 1st Dressing 137 1581102 upto 30% Burns Subsequent Dressing 112 1291103 30% to 50% Burns 1st Dressing 174 2001104 30% to 50% Burns Subsequent Dressing 137 1581105 Extensive Burn -above 50% Frist Dressing 248 2851106 Extensive Burn -above 50% Subsequent dressing 174 200

TREATMENT PROCEDURE ORTHOPEDICS1107 Plaster Work 255 2931108 Fingers (post slab) 233 2681109 Fingers full plaster 259 2981110 Colles Fracture - Below elbow 880 10121111 Colles Fracture - Full plaster 895 10291112 Colles fracture Ant. Or post. slab 400 4601113 Above elbow full plaster 156 1791114 Above Knee post-slab 530 6101115 Below Knee full plaster 165 1901116 Below Knee post-slab 646 7431117 Tube Plaster (or plaster cylinder) 750 8631118 Above knee full plaster 1139 13101119 Above knee full slab 1042 11981120 Minerva Jacket 2174 25001121 Plaster Jacket 1967 22621122 Shoulder spica 1760 20241123 Single Hip spica 2019 23221124 Double Hip spica 2484 28571125 Strapping of Finger 161 1851126 Strapping of Toes 162 1861127 Strapping of Wrist 207 2381128 Strapping of Elbow 236 2711129 Strapping of Knee 311 3581130 Strapping of Ankle 311 3581131 Strapping of Chest 414 4761132 Strapping of Shoulder 466 5361133 Figure of 8 bandage 466 5361134 Collar and cuff sling 230 2651135 Ball bandage 360 4141136 Application of P.O.P Casts for Upper & Lower Limbs 633 7281137 Application of Functiol Cast Brace 1215 13971138 Application of Skin Traction 621 7141139 Application of Skeletal Tractions 854 9821140 Bandage & Strappings for Fractures 497 5721141 Aspiration & Intra Articular Injections 518 5961142 Application of P.O.P Spices & Jackets 2226 25601143 Close Reduction of Fractures of Limb & P.O.P 2340 26911144 Reduction of Compound Fractures 2484 2857

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1145 Open Reduction & Internal Fixation of Fingurs & Toes 4658 5357

1146Open Reduction offracture of Long Bones of Upper / LowerLimb -iling & Exterl Fixation

7245 8332

1147Open Reduction of fracture of Long Bones of Upper / LowerLimb -AO Procedures

8694 9998

1148 Tension Band Wirings 5092 58561149 Bone Grafting 6500 74751150 Excision of Bone Tumours 6210 71421151 Excision or other Operations for Scaphoid Fractures 6469 74391152 Sequestrectomy & Saucerisation 6210 71421153 Sequestrectomy & Saucerizations -Arthrotomy 8974 103201154 Multiple Pinning Fracture Neck Femur 10350 119031155 Plate Fixations for Fracture Neck Femur 13200 151801156 A.O.Compression Procedures for Fracture Neck Femur 14904 17140

1157Open Reduction of Fracture Neck Femur Muscle Pedicle Graftand Internal Fixations

17550 20183

1158 Close Reduction of Dislocations 2857 32861159 Open Reduction of Dislocations 3095 35591160 Open Reduction of Fracture Dislocation & Internal Fixation 12150 139731161 Neurolysis/Nerve repair 12420 142831162 Nerve Repair with Grafting 15008 172591163 Tendon with Transplant or Graft 9315 107121164 Tendon Lengthening/Tendon repair 7245 83321165 Tendon Transfer 2795 32141166 Laminectomy Excision Disc and Tumours 4347 49991167 Spil Ostectomy and Internal Fixations 21735 24995

1168Anterolateral decompression for tuberculosis/ Costo-Transversectomy

3105 3571

1169 Antereolateral Decompression and Spil Fusion 19350 222531170 Corrective Ostectomy & Internal Fixation - short bones 12420 142831171 Corrective Ostectomy & Internal Fixation - long bones 9936 114261172 Arthrodesis of - Minor Joints 9315 107121173 Arthrodesis of - Major Joints 9000 103501174 Soft Tissue Operations for C.T.E.V. 7245 83321175 Soft Tissue Operations for Polio 6210 71421176 Hemiarthroplasty- Hip 19250 221381177 Hemiarthroplasty- Shoulder 19250 221381178 Operations for Brachial Plexus & Cervical Rib 21735 249951179 Amputations - Below Knee 6600 75901180 Amputations - Below Elbow 6159 70831181 Amputations - Above Knee 8050 92581182 Amputations - Above Elbow 6159 70831183 Amputations - Forequarter 12000 138001184 Amputations -Hind Quarter and Hemipelvectomy 16560 190441185 Disarticulations - Major joint 18630 214251186 Disarticulations - Minor joint 11385 130931187 Arthrography 8280 95221188 Arthroscopy - Diagnostic 7711 8868

Page 27

1189 Arthroscopy-therapeutic: without implant 10000 115001190 Arthroscopy-therapeutic: with implant 15525 178541191 Soft Tissue Operation on JOINTS -SMALL 6210 71421192 Soft Tissue Operation on JOINTS -LARGE 13500 15525

1193Myocutaneous and Fasciocutaneous Flap Procedures for Limbs 16767 19282

1194 Removal of Wires & Screw 1584 18221195 Removal of Plates 3726 42851196 Total Hip Replacement 71000 816501197 Total Ankle Joint Replacement 95400 1097101198 Total Knee Joint Replacement 99000 1138501199 Total Shoulder Joint Replacement 71100 817651200 Total Elbow Joint Replacement 71100 817651201 Total Wrist Joint Replacement 100000 1150001202 Total finger joint replacement 18000 207001203 Tubular external fixator 4140 47611204 Ilizarov's external fixator 6987 80351205 Pelvi-acetebular fracture -Internal fixation 7763 89271206 Meniscectomy 10800 124201207 Meniscus Repair 10000 115001208 ACL Reconstruction 8500 97751209 PCL Reconstruction 13500 155251210 Knee Collateral Ligament Reconstruction 12500 143751211 Bencarf Repair Shoulder 13200 151801212 RC Repair 1500 17251213 Biceps tenodesis 14000 161001214 Distal biceps tendon repair 10380 119371215 Arthrolysis of knee 12500 143751216 Capsulotomy of Shoulder 15000 172501217 Conservative Pop 1080 12421218 Application for CTEV per sitting 1080 12421219 Total Hip Replacement Revision Stage-I 153000 1759501220 Total Hip Replacement Revision Stage-II 45000 517501221 Total Knee Replacement Revision Stage-I 31500 362251222 Total Knee Replacement Revision Stage-II 31500 36225

1223Illizarov/ external fixation for limb lengthening/ deformitycorrection

12500 14375

1224 Discectomy/ Micro Discectomy 12500 143751225 Laminectomy 4646 53431226 Spinal Fixation Cervical/dorsolumbar/ lumbosacral 16000 184001227 Fusion Surgery Cervical/ Lumbar Spine upto 2 Level 22000 253001228 More than 2 Level 12000 138001229 Scoliosis Surgery/ Deformity Correction of Spine 25000 287501230 Vertebroplasty 12000 138001231 Spinal Injections 405 4661232 DHS for Fracture Neck Femur 15000 172501233 Proximal Femoral Nail (PFN for IT Fracture) 14000 161001234 Spinal Osteotomy 1434 1649

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1235 Illizarov’s / External Fixation for Trauma 11700 134551236 Soft Tissue Operations for Polio/ Cerebral Palsy 9501 109261237 Mini Fixator for Hand/Foot 9000 103501238 Other Major Surgery 34425 395891239 Other Minor Surgery 11883 13665

TREATMENT PROCEDURE PHYSIOTHERAPY1240 Ultrasonic therapy 70 811241 S.W. Diathermy 70 811242 Electrical stimulation (therapeutic) 70 811243 Muscle testing and diagnostic 71 821244 Infra red 75 861245 U.V. Therapeutic dose 52 601246 Intermittent Lumbar Traction 70 811247 Intermittent Cervical traction 75 861248 Wax bath 70 811249 Hot pack 78 901250 Breathing Exercises & Postural Drainage 45 521251 Cerebral Palsy – exercise 50 581252 Post – polio exercise 50 58

NUCLEAR MEDICINE / RADIOTHERAPY ANDCHEMOTHERAPY

1253 Cobalt 60 therapy 57375 659811254 Radical therapy 68425 786891255 Palliative therapy 21994 252931256 Linear accelerator 26775 307911257 Radical therapy 58650 674481258    Palliative therapy 30792 354111259   3 D Planning 4888 56211260   2 D Planing 4399 50591261 IMRT(Intensity Modulated radiotherapy) 90790 1044091262 SRT (Stereotactic radiotherapy) 54896 631301263 SRS(Stereotactic radio surgery) 72491 833651264 IGRT(Image guided radiotherapy) 132314 1521611265 Respiratory Gating-alongwith Linear accelerator planning 99000 1138501266 Electron beam with Linear accelerator 60726 698351267 Tomotherapy 71460 82179

NUCLEAR MEDICINE / BRACHYTHERAPY- HIGH DOSERADIATION

1268 Intracavitory 11730 134901269 Interstitial 52785 607031270 Intraluminal 8798 101181271 Surface mould 4180 48071272 GLIADAL WAFER 84510 97187

NUCLEAR MEDICINE / CHEMOTHARAPY1273 Neoadjuvant 825 9491274 Adjuvant 825 9491275 Concurrent-chemoadiation 880 10121276 Single drug 497 572

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1277 Multiple drugs 807 9281278 Targeted therapy 880 10121279 Chemoport facility 880 10121280 PICC line (peripherally inserted Central canulisation) 880 1012

LIST OF PROCEDURES/ TESTS IN

GASTROENTEROLOGY / ENDOSCOPIC PROCEDURES1281 Upper G.I. Endoscopy + Lower G.I. Endoscopy 1553 17861282 Diagnostic endoscopy 250 2881283 Endoscopic biopsy 330 3801284 Endoscopic mucosal resection 1389 15971285 Oesophageal stricture dilatation 1650 18981286 Balloon dilatation of achalasia cardia 2588 29761287 Foreign body removal 1650 18981288 Oesophageal stenting 3000 34501289 Band ligation of oesophageal varices 2250 25881290 Sclerotherapy of oesophageal varices 2250 25881291 Glue injection of varices 2500 28751292 Argon plasma coagulation 3623 41661293 Pyloric balloon dilatation 2310 26571294 Enteranal stenting 3520 40481295 Duodenal stricture dilation 990 11391296 Single balloon enterocopy 3600 41401297 Double balloon enteroscopy 3500 40251298 Capsule endoscopy 4950 56931299 Piles banding 1066 12261300 Colonic stricture dilatation 2620 30131301 Hot biopsy forceps procedures 3000 34501302 Colonic stenting 2620 30131303 Junction biopsy 2000 23001304 Conjugal microscopy 4000 46001305 Endoscopic sphincterotomy 2310 26571306 CBD stone extraction 2310 26571307 CBD stricture dilatation 6500 74751308 Biliary stenting (plastic and metallic) 4620 53131309 Mechanical lithotripsy of CBD stones 7700 88551310 Pancreatic sphincterotomy 5775 66411311 Pancreatic stricture dilatation 5500 63251312 Pancreatic stone extraction 9088 104511313 Mechanical lithotripsy of pancreatic stones 10247 117841314 Endoscopic cysto gastrostomy 7700 88551315 Balloon dilatation of papilla 6210 71421316 Ultrasound guided FNAC 550 6331317 Ultrasound guided abscess Drainage 648 7451318 PTBD 1150 13231319 Diagnostic angiography 1800 20701320 Vascular embolization 15100 173651321 TIPS 4860 5589

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1322 IVC graphy + hepatic veinography 30791 354101323 Muscular stenting 87975 1011711324 BRTO 51750 595131325 Portal haemodymic studies 1722 19801326 Manometry and PH metry 1612 18541327 Oesophageal PH metry 5000 57501328 Oesophageal manometry 5000 57501329 Small bowel manometry 6120 70381330 Anorectal manometry 6120 70381331 Colonic manometry 6885 79181332 Biliary manometry 7650 87981333 Sengstaken blackenesse tube tempode 2588 29761334 Lintas machles tube tempode 2750 31631335 Fecal fat test/ fecal chymotrypsin/ fecal elastase 315 3621336 Breath tests 300 3451337 Extra corporeal shortwave lithotripsy 37260 428491338 Liver biopsy 1242 1428

NAME OF INVESTIGATION / DENTAL1339 Dental IOPA X-ray 50 581340 Occlusal X-ray 78 901341 OPG X-ray 196 225

NAME OF INVESTIGATION / PULMONARY1342 Lung Ventilation & Perfusion Scan (V/Q Scan) 3240 37261343 Lung Perfusion Scan 2000 2300

NAME OF INVESTIGATION / OSTEOLOGY1344 Whole Body Bone Scan with SPECT. 3079 35411345 Three phase whole body Bone Scan 3100 3565

NAME OF INVESTIGATION / NEUROSCIENCES

1346Brain Perfusion SPECT Scan with Technetium 99mradiopharmaceuticals.

8798 10118

1347 Radionuclide Cisternography for CSF leak 3740 4301NAME OF INVESTIGATION / GASTRO ANDHEPATOBILIARY

1348 Gastro esophageal Reflux Study (G.E.R. Study) 1900 2185

1349Gastro intestinal Bleed (GloB.) Study with Technetium 99mlabeled RBCs.

3079 3541

1350 Hepatobiliary Scintigraphy. 2444 28111351 Meckel's Scan 1955 2248

1352Hepatosplenic scintigraphy with Technetium-99mradiopharmaceuticals

1870 2151

1353 Gastric emptying 1148 1320NAME OF INVESTIGATION / GENITOURINARY

1354 Renal Cortical Scintigraphy with Technetium 99m D.M.S.A. 3079 35411355 Dynamic Renography. 3079 35411356 Dynamic Renography with Diuretic. 3079 35411357 Dynamic Renography with Captopril 1960 22541358 Testicular Scan 1466 1686

NAME OF INVESTIGATION / ENDOCRINOLOGY

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1359 Thyroid Uptake measurements with 131-Iodine. 1500 17251360 Thyroid Scan with Technetium 99m Pertechnetate. 1466 16861361 Lodine-131 Whole Body Scan. 2933 33731362 Whole Body Scan with M.I.B.G. 15836 182111363 Parathyroid Scan 4888 5621

NAME OF INVESTIGATION / RADIO-ISOTOPE THERAPY

1364 131-lodine Therapy 1530 17601365 131-lodine Therapy <15mCi 3854 44321366 131-lodine Therapy 15-50mCi 4500 51751367 131-lodine Therapy 51-100mCi 10800 124201368 131-lodine Therapy >100mCi 15000 172501369 Phosphorus-32 therapy for metastatic bone pain palliation 4500 51751370 Samarium-153 therapy for metastatic bone pain palliation 10450 120181371 Radiosynovectomy with Yttrium 19125 21994

NAME OF INVESTIGATION / CARDIOLOGY1372 Stress thallium / Myocardial Perfusion Scintigraphy 8505 97811373 Rest thallium / Myocardial Perfusion Scintigraphy 8000 92001374 Venography 3300 37951375 TMT 489 5621376 TEE 489 5621377 Lymph angiography 1500 1725

NAME OF INVESTIGATION / TUMOUR IMAGING1378 Scintimammography. 4500 51751379 Indium lableled octeriotide Scan. 67500 77625

NAME OF INVESTIGATION / PET SCAN1380 FDG Whole body PET / CT Scan 19800 227701381 Brain I Heart FDG PET / CTScan, 13500 15525

1382Gallium-68 Peptide PET / CT imaging for NeuroendocrineTumor

15000 17250

LABORATORY MEDICINE / CLINICAL PATHOLOGY

1383Urine routine- pH, Specific gravity, sugar, protein andmicroscopy

35 40

1384 Urine-Microalbumin 63 721385 Stool routine 33 381386 Stool occult blood 22 251387 Post coital smear examination 27 311388 Semen analysis 35 40

LABORATORY MEDICINE / HAEMATOLOGY1389 Haemoglobin (Hb) 18 211390 Total Leucocytic Count (TLC) 31 361391 Differential Leucocytic Count (DLC) 31 361392 E.S.R. 25 291393 Total Red Cell count with MCV,MCH,MCHC,DRW 29 33

1394Complete Haemogram/CBC, Hb,RBC count and indices, TLC,DLC, Platelet, ESR, Peripheral smear examination

135 155

1395 Platelet count 43 491396 Reticulocyte count 48 55

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1397 Absolute Eosinophil count 43 491398 Packed Cell Volume (PCV) 13 151399 Peripheral Smear Examination 43 491400 Smear for Malaria parasite 37 431401 Bleeding Time 35 401402 Osmotic fragility Test 50 581403 Bone Marrow Smear Examination 70 811404 Bone Marrow Smear Examination with iron stain 250 2881405 Bone Marrow Smear Examination and cytochemistry 400 4601406 Activated partial ThromboplastinTime (APTT) 100 1151407 Rapid test for malaria(card test) 44 511408 WBC cytochemistry for leukemia -Complete panel 110 127

1409Bleeding Disorder panel- PT, APTT, Thrombin TimeFibrinogen, D-Dimer/ FDP

400 460

1410 Factor Assays-Factor VIII 720 8281411 Factor Assays-Factor IX 680 7821412 Platelet Function test 50 58

1413Tests for hypercoagulable states- Protein C, Protein S,Antithrombin

360 414

1414 Tests for lupus anticoagulant 150 173

1415Tests for Antiphospholipid antibody IgG, IgM ( for cardiolipinand B2 Glycoprotein 1)

450 518

1416 Thalassemia studies (Red Cell indices and Hb HPLC) 560 6441417 Tests for Sickling / Hb HPLC) 69 79

LABORATORY MEDICINE / BLOOD BANK1418 Blood Group & RH Type 30 351419 Cross match 50 581420 Coomb’s Test Direct 90 1041421 Coomb’s Test Indirect 100 1151422 3 cell panel- antibody screening for pregnant female 170 1961423 11 cells panel for antibody identification 170 1961424 HBs Ag 102 1171425 HCV 128 1471426 HIV I and II 150 1731427 VDRL 43 491428 RH Antibody titer 80 921429 Platelet Concentrate 56 641430 Random Donor Platelet(RDP) 115 1321431 Single Donor Platelet (SDP- Aphresis) 150 173

LABORATORY MEDICINE / HISTOPATHOLOGY1432 Routine-H & E 81 931433 special stain 65 751434 Immunohistochemistry(IHC) 700 8051435 Frozen section 702 8071436 Paraffin section 343 394

LABORATORY MEDICINE / CYTOLOGY1437 Pap Smear 135 1551438 Body fluid for Malignant cells 135 155

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1439 FNAC 200 230NAME OF INVESTIGATION / FLOW CYTOMETRY

1440 Leukemia panel /Lymphoma panel 1382 15891441 PNH Panel-CD55,CD59 1000 1150

LABORATORY MEDICINE / CYTOGENETIC STUDIES

1442 Karyotyping 1539 17701443 FISH 500 575

LABORATORY MEDICINE / BIO-CHEMISTRY1444 Blood Glucose Random 24 281445 24 hrs urine for Proteins,Sodium, creatinine 45 521446 Blood Urea Nitrogen 54 621447 Serum Creatinine 55 631448 Urine Bile Pigment and Salt 23 261449 Urine Urobilinogen 18 211450 Urine Ketones 27 311451 Urine Occult Blood 32 371452 Urine total proteins 16 181453 Rheumatoid Factor test 100 1151454 Bence Jones protein 42 481455 Serum Uric Acid 55 631456 Serum Bilirubin total & direct 80 921457 Serum Iron 90 1041458 C.R.P. 100 1151459 C.R.P Quantitative 160 1841460 Body fluid (CSF/Ascitic Fluid etc.)Sugar, Protein etc. 90 1041461 Albumin. 18 211462 Creatinine clearance. 80 921463 Serum Cholesterol 62 711464 Total Iron Binding Capacity 80 921465 Glucose (Fasting & PP) 47 541466 Serum Calcium –Total 60 691467 Serum Calcium –Ionic 44 511468 Serum Phosphorus 60 691469 Total Protein Alb/Glo Ratio 50 581470 IgG. 240 2761471 IgM. 240 2761472 IgA. 240 2761473 ANA. 200 2301474 Ds DNA. 350 4031475 S.G.P.T. 55 631476 S.G.O.T. 55 631477 Serum amylase 117 1351478 Serum Lipase 130 1501479 Serum Lactate 72 831480 Serum Magnesium 100 1151481 Serum Sodium 50 581482 Serum Potassium 45 52

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1483 Serum Ammonia 100 1151484 Anemia Profile 204 2351485 Serum Testosterone 135 1551486 Imprint Smear From Endoscopy 216 2481487 Triglyceride 75 861488 Glucose Tolerance Test (GTT) 90 1041489 Triple Marker. 720 8281490 C.P.K. 100 1151491 Foetal Haemoglobin (HbF) 85 981492 Prothrombin Time (P.T.) 99 1141493 L.D.H. 100 1151494 Alkaline Phosphatase 60 691495 Acid Phosphatase 70 811496 CK MB 171 1971497 CK MB Mass 140 1611498 Troponin I 100 1151499 Troponin T 550 6331500 Glucose Phosphate Dehydrogenase (G, 6PD) 100 1151501 Lithium. 130 1501502 Dilantin (phenytoin). 400 4601503 Carbamazepine. 360 4141504 Valproic acid. 300 3451505 Feritin. 250 2881506 Blood gas analysis 120 1381507 Blood gas analysis with electrolytes 414 4761508 Urine pregnancy test 65 751509 Tests for Antiphospholipid antibodies syndrome. 280 3221510 Hb A1 C 130 1501511 Hb Electrophoresis/ Hb HPLC 100 1151512 Kidney Function Test. 203 2331513 Liver Function Test. 225 2591514 Lipid Profile.( Total cholesterol,LDL,HDL,treigylcerides) 200 230

Nutritional Markers1515 Serum Iron 90 1041516 Total Iron Binding Capacity 90 1041517 Serum Ferritin 100 1151518 Vitamin B12 assay. 250 2881519 Folic Acid assay. 300 345

1520Extended Lipid Profile.( Totalcholesterol,LDL,HDL,treigylcerides,Apo A1,Apo B,Lp(a) )

536 616

1521 Apo A1. 200 2301522 Apo B. 199 2291523 Lp (a). 445 5121524 CD 3,4 and 8 counts 170 1961525 CD 3,4 and 8 percentage 170 1961526 LDL. 62 711527 Homocysteine. 400 4601528 HB Electrophoresis. 440 506

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1529 Serum Electrophoresis. 220 2531530 Fibrinogen. 149 1711531 Chloride. 54 621532 Magnesium. 150 1731533 GGTP. 90 1041534 Lipase. 239 2751535 Fructosamine. 200 2301536 β2 microglobulin 90 1041537 Catecholamines. 1050 12081538 Creatinine clearance. 108 124

NAME OF INVESTIGATION / TUMOUR MARKERS1539 PSA- Total. 312 3591540 PSA- Free. 338 3891541 AFP. 293 3371542 HCG. 260 2991543 CA. 125. 391 4501544 CA 19,9. 616 7081545 CA 15.3. 560 6441546 Vinyl Mandelic Acid 350 4031547 Calcitonin 450 5181548 Carcioembryonic antigen(CEA) 340 391

OTHERS1549 Immunofluorescence 150 1731550 Direct(Skin and kidney Disease) 383 4401551 Indirect (antids DNA Anti Smith ANCA) 425 4891552 VitD3 assay 550 633

1553Serum Protein electrophoresis withimmunofixationelectrophoresis (IFE)

300 345

1554 BETA-2 Microglobulin assay 100 1151555 Anti cycliocitrullinated peptide (Anti CCP) 450 5181556 Anti tissuetransglutaminase antibody 425 4891557 Serum Erythropoetin 425 4891558 ACTH 450 518

HARMONES1559 T3, T4, TSH 200 2301560 T3 64 741561 T4 64 741562 TSH 90 1041563 LH 150 1731564 FSH 150 1731565 Prolactin 150 1731566 Cortisol 250 2881567 PTH(Paratharmone) 500 5751568 C-Peptide. 330 3801569 Insulin. 150 1731570 Progesterone. 225 2591571 17-DH Progesterone. 440 5061572 DHEAS. 440 506

Page 36

1573 Androstendione. 600 6901574 Growth Hormone. 340 3911575 TPO. 300 3451576 Throglobulin. 300 3451577 Hydatic Serology. 318 3661578 Anti Sperm Antibodies. 380 4371579 Qualitative. 2000 23001580 Quantitative. 1500 17251581 Qualitative. 1691 19451582 HPV serology 218 2511583 Rota Virus serology 130 1501584 PCR for TB 900 10351585 PCR for HIV 600 6901586 Chlamydae antigen 765 8801587 chlamydae antibody 238 2741588 Brucella serology 230 2651589 Influenza A serology 943 1084

USG, X-RAY , CT, MRI, BONE DENSITOMETRY1590 USG for Obstetrics -  Anomalies scan 323 3711591 Abdomen USG 232 2671592 Pelvic USG ( prostate, gynae, infertility etc) 255 2931593 Small parts USG ( scrotum, thyroid , parathyroid etc) 349 4011594 Neonatal head (Tranfontanellar) 425 4891595 Neonatal spine 497 5721596 Contrast enhanced USG 810 9321597 USG Breast 349 4011598 USG Hystero-Salpaingography  (HSG) 255 2931599 Carotid Doppler 850 9781600 Arterial Colour Doppler 706 8121601 Venous Colour Doppler 706 8121602 Colour Doppler, renal arteries/any other organ 800 9201603 USG guided intervention- FNAC 490 5641604 USG guided intervention - biopsy 720 8281605 USG guided intervention - nephrostomy 720 828

X-Ray1606 Abdomen AP Supine or Erect (One film) 115 1321607 Abdomen Lateral view (one film) 115 1321608 Chest PA view (one film) 60 691609 Chest Lateral (one film) 60 691610 Mastoids: Towne view, oblique views (3 films) 225 2591611 Extremities, bones  & Joints AP & Lateral views (Two films) 255 2931612 Pelvis A.P  (one film) 99 1141613 T. M. Joints (one film) 99 1141614 Abdomen & Pelvis for K. U. B. 115 1321615 Skull A. P. & Lateral (2 films) 250 2881616 Spine A. P. & Lateral (2 films) 225 2591617 PNS view (1 film) 99 114

X RAY CONTRAST STUDIES

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1618 Barium Swallow 510 5871619 Barium Upper GI study 800 9201620 Barium Upper GI study (Double contrast) 935 10751621 Barium Meal follow through 935 10751622 Barium Enema (Single contrast/double contrast) 850 9781623 Small bowel  enteroclysis 1000 1150

1624ERCP (Endoscopic Retrograde Cholangio – Pancreatography) 2250 2588

1625General :Fistulography/Sinography/Sialography/Dacrocystography/ T-Tubecholangiogram/Nephrostogram

574 660

1626 Percutaneous transhepatic cholangiography (PTC) 1296 14901627 Intravenous Pyelography (IVP) 1071 12321628 Micturating  Cystourethrography (MCU) 612 7041629 Retrograde Urethrography (RGU) 612 7041630 Contrast Hystero-Salpingography (HSG) 918 10561631 X ray - Arthrography 700 8051632 Cephalography 150 1731633 Myelography 2500 28751634 Diagnostic Digital Subtraction Angiography (DSA) 1749 2011

MAMMOGRAPHY1635 X-ray Mammography 315 3621636 MRI Mammography 2550 2933

CT1637 CT Head-Without Contrast 900 10351638 CT Head- with Contrast  (+/- CT angiography) 1350 15531639 C. T. Chest  - without contrast (for lungs) 1700 19551640 C. T. Scan Lower Abdomen(incl. Pelvis) With Contrast 1700 19551641 C. T. Scan Lower Abdomen( Incl. Pelvis) Without Contrast 1500 17251642 C. T. Scan Whole Abdomen Without Contrast   2700 31051643 C. T. Scan Whole Abdomen With Contrast 4050 46581644 Triple Phase CT abdomen 4050 46581645 CT angiography abdomen/ Chest 4500 51751646 CT Enteroclysis 5500 63251647 C. T. Scan Neck – Without Contrast 1500 17251648 C. T. Scan Neck  – With Contrast 1870 21511649 C. T. Scan Orbits - Without Contrast 1190 13691650 C. T. Scan Orbits - With Contrast 1615 18571651 C. T. Scan of Para  Nasal Sinuses- Without Contrast 900 10351652 C. T. Scan of Para  Nasal Sinuses - With Contrast 1600 1840

1653C. T. Spine (Cervical, Dorsal, Lumbar, Sacral)–without contrast

1500 1725

1654 CT Temporal bone – without contrast 893 10271655 CT - Dental 1275 14661656 C. T. Scan Limbs  -Without Contrast 1700 19551657 C. T. Scan Limbs  -With Contrast including CT angiography 2253 25911658 C.T. Guided intervention –FNAC 1080 12421659 C.T. Guided Trucut Biopsy 1200 1380

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1660C. T. Guided intervention -percutaneous  catheter  drainage /tube placement

1305 1501

MRI1661 MRI Head – Without Contrast 1998 22981662 MRI Head – With Contrast 2848 32751663 MRI Orbits – Without Contrast 1445 16621664 MRI Orbits – With Contrast 2000 23001665 MRI Nasopharynx and PNS – Without Contrast 2450 28181666 MRI Nasopharynx and PNS – With Contrast 3500 40251667 MR for Salivary Glands with Sialography 2700 31051668 MRI Neck - Without Contrast 3000 34501669 MRI Neck- with contrast 5000 57501670 MRI Shoulder – Without contrast 2000 23001671 MRI Shoulder – With conntrast 2600 29901672 MRI shoulder both Joints - Without contrast 2750 31631673 MRI Shoulder both joints – With  contrast 4000 46001674 MRI Wrist Single joint - Without contrast 2125 24441675 MRI Wrist Single joint - With contrast 4000 46001676 MRI Wrist both  joints - Without contrast 2125 24441677 MRI Wrist Both joints - With contrast 5000 57501678 MRI knee Single joint - Without contrast 2125 24441679 MRI knee Single joint - With contrast 5000 57501680 MRI knee both joints - Without contrast 2125 24441681 MRI knee both  joints - With contrast 5000 57501682 MRI Ankle Single joint - Without contrast 2125 24441683 MRI Ankle single  joint - With contrast 5000 57501684 MRI Ankle both  joints - With contrast 4500 51751685 MRI Ankle both  joints - Without contrast 2500 28751686 MRI Hip - With contrast 2500 28751687 MRI Hip – without contrast 2125 24441688 MRI Pelvis – Without Contrast 2125 24441689 MRI  Pelvis – with contrast 4500 51751690 MRI Extremities - With contrast 5000 57501691 MRI Extremities - Without contrast 2125 24441692 MRI Temporomandibular – B/L  - With contrast 4000 46001693 MRI Temporomandibular – B/L  - Without contrast 2125 24441694 MR Temporal Bone/ Inner ear with contrast 4000 46001695 MR Temporal Bone/ Inner ear without contrast 2500 28751696 MRI Abdomen – Without Contrast 2125 24441697 MRI Abdomen – With Contrast 5000 57501698 MRI Breast - With Contrast 4250 48881699 MRI Breast - Without Contrast 2125 24441700 MRI Spine Screening - Without Contrast 1000 11501701 MRI Chest – Without Contrast 2125 24441702 MRI Chest – With Contrast 4000 46001703 MRI Cervical/Cervico Dorsal Spine – Without Contrast 2125 24441704 MRI Cervical/ Cervico Dorsal Spine – With Contrast 4000 46001705 MRI Dorsal/ Dorso Lumbar Spine - Without Contrast 2125 2444

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1706 MRI Dorsal/ Dorso Lumbar Spine – With Contrast 4000 46001707 MRI Lumbar/ Lumbo-Sacral Spine  – Without Contrast 2125 24441708 MRI Lumbar/ Lumbo-Sacral Spine – With Contrast 5000 57501709 Whole body MRI (For oncological workup) 5100 58651710 MRI Angiography - with contrast 5000 57501711 MR cholecysto-pancreatography. 4950 56931712 MR Enteroclysis 2125 2444

BONE DENSITOMETRY (DEXA SCAN)1713 Dexa Scan Bone Densitometry - Two sites 1350 1553

1714Dexa Scan Bone Densitometry - Three sites (Spine, Hip &extremity)

2000 2300

1715 Dexa Scan Bone Densitometry Whole body 2250 2588NEUROLOGICAL INVESTIGATIONS AND PROCEDURES

1716 EEG/Video EEG 298 3431717 EMG (Electro myography) 638 7341718 Nerve condition velocity (at least 2 limbs) 638 7341719 Decremental response (before and after neo stigmine) 595 6841720 Incremental response 595 6841721 SSEP (Somato sensory evoked potentials) 638 7341722 Poly somnography 638 7341723 Brachial plexus study 638 7341724 Muscle biopsy 383 4401725 ACHR anti body titre 1848 21251726 Anti MUSK body titre 2340 26911727 Serum COPPER 450 5181728 Serum ceruloplasmin 450 5181729 Urinary copper 450 5181730 Serum homocystine 450 5181731 Serum valproate level 315 3621732 Serum phenol barbitone level 350 4031733 Coagulation profile 498 5731734 Protein C, S anti thrombine – III 2400 27601735 Serum lactate level 450 518

CSF

1736Basic studies including cell count, protein, sugar, gram stain,India Ink preparation and smear for AFP

240 276

1737 Special studies 900 10351738 PCR for tuberculosis/ Herpes simplex 1200 13801739 Bacterial culture and sensitivity 180 2071740 Mycobacterial culture and sensitivity 180 2071741 Fungal culture 128 1471742 Malignant cells 64 741743 Anti measles antibody titre (with serum antibody titre) 801 9211744 Viral culture 255 293

1745Antibody titre (Herpes simplex, cytomegalo virus, flavivirus,zoster varicella virus)

760 874

1746 Oligoclonal band 1200 1380

Page 40

1747 Myelin Basic protein 1871 21521748 Lactate 298 3431749 Crypto coccal antigen 1024 1178

TESTS IN GASTRO-ENTEROLOGY1750 D-xylase test 765 8801751 Fecal fat test/ fecal chymotrypsin/ fecal elastase 765 8801752 Breath tests 1170 13461753 H pylori serology for ciliac disease 500 5751754 HBV genotyping 2250 25881755 HCV genotyping 4388 5046

TESTS IN ENDOCRINOLOGY ( IN ADDITION TO THOSEINCLUDED UNDER HARMONES)

1756 Urinary VMA 1500 17251757 Urinary metanephrine/Normetanephrine 1138 13091758 Urinary free catecholamine 1690 19441759 Serum catecholamine 3400 39101760 Serum aldosterone 1125 12941761 24 Hr urinary aldosterone 920 10581762 Plasma renin activity 1000 11501763 Serum aldosterone/renin ratio 1200 13801764 Osmolality urine 128 1471765 Osmolality serum 128 1471766 Urinary sodium 80 921767 Urinary Chloride 43 491768 Urinary potassium 80 921769 Urinary calcium 72 831770 Thyroid binding globulin 510 5871771 24 hr. urinary free cotisole 200 2301772 Islet cell antebody 750 8631773 GAD antibody 1330 15301774 Insulin associated antibody 449 5161775 IGF-1 1350 15531776 IGF-BP3 1650 18981777 Sex hormone binding globulin 1333 15331778 USG guided FNAC thyroid gland 387 4451779 E2 208 2391780 Thyro globulin antibody 587 675

Additional DirectorCGHS, Jaipur.

(Dr. J. K. Khatri)

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